Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival.Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results.AIM To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results.METHODS This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan,from August 2022 to February 2023.All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this study.SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility.RESULTS The mean age of all patients was 35.32±11.08 years.Among these,126(81.8%)were males and 28(18.2%)were females.The mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 m2.Kidney allograft biopsy results showed chronic changes in 55(37.66%)biopsies.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage.It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.

The long-term trend of the sea surface wind speed and the wave height (wind wave, swell, mixed wave) in global ocean during the last 44 a

Utilizing the 45 a European Centre for Medium-Range Weather Forecasts （ECMWF） reanalysis wave da- ta （ERA-40）, the long-term trend of the sea surface wind speed and （wind wave, swell, mixed wave） wave height in the global ocean at grid point 1.5°× 1.5° during the last 44 a is analyzed. It is discovered that a ma- jority of global ocean swell wave height exhibits a significant linear increasing trend （2-8 cm/decade）, the distribution of annual linear trend of the significant wave height （SWH） has good consistency with that of the swell wave height. The sea surface wind speed shows an annually linear increasing trend mainly con- centrated in the most waters of Southern Hemisphere westerlies, high latitude of the North Pacific, Indian Ocean north of 30°S, the waters near the western equatorial Pacific and low latitudes of the Atlantic waters, and the annually linear decreasing mainly in central and eastern equator of the Pacific, Juan. Fernandez Archipelago, the waters near South Georgia Island in the Atlantic waters. The linear variational distribution characteristic of the wind wave height is similar to that of the sea surface wind speed. Another find is that the swell is dominant in the mixed wave, the swell index in the central ocean is generally greater than that in the offshore, and the swell index in the eastern ocean coast is greater than that in the western ocean inshore, and in year-round hemisphere westerlies the swell index is relatively low.

Analysis of the Global Swell Distributions Using ECMWF Re-Analyses Wind Wave Data

The existence of three well-defined tongue-shaped zones of swell dominance,termed as 'swell pools',in the Pacific,the Atlantic and the Indian Oceans,was reported by Chen et al.(2002)using satellite data.In this paper,the ECMWF Re-analyses wind wave data,including wind speed,significant wave height,averaged wave period and direction,are applied to verify the existence of these swell pools.The swell indices calculated from wave height,wave age and correlation coefficient are used to identify swell events.The wave age swell index can be more appropriately related to physical processes compared to the other two swell indices.Based on the ECMWF data the swell pools in the Pacific and the Atlantic Oceans are confirmed,but the expected swell pool in the Indian Ocean is not pronounced.The seasonal variations of global and hemispherical swell indices are investigated,and the argument that swells in the pools seemed to originate mostly from the winter hemisphere is supported by the seasonal variation of the averaged wave direction.The northward bending of the swell pools in the Pacific and the Atlantic Oceans in summer is not revealed by the ECMWF data.The swell pool in the Indian Ocean and the summer northward bending of the swell pools in the Pacific and the Atlan-tic Oceans need to be further verified by other datasets.

Further analysis of scintillation index for a laser beam propagating through moderate-to-strong non-Kolmogorov turbulence based on generalized effective atmospheric spectral model

A new expression of the scintillation index （SI） for a Gaussian-beam wave propagating through moderate-to-strong non-Kolmogorov turbulence is derived, using a generalized effective atmospheric spectrum and the extended Rytov approx- imation theory. Finite inner and outer scale parameters and high wave number ＂bump＂ are considered in the spectrum with a generalized spectral power law in the range of 3-4, instead of the fixed classical Kolmogorov power law of 11/3. The obtained SI expression is then used to analyze the effects of the spectral power law and the inner scale and outer scale on SI under various non-Kolmogorov fluctuation conditions. These results will be useful in future investigations of optical wave propagation through atmospheric turbulence.

Compressive near-field millimeter wave imaging algorithm based on Gini index and total variation mixed regularization

A compressive near-field millimeter wave(MMW)imaging algorithm is proposed.From the compressed sensing(CS)theory,the compressive near-field MMW imaging process can be considered to reconstruct an image from the under-sampled sparse data.The Gini index(GI)has been founded that it is the only sparsity measure that has all sparsity attributes that are called Robin Hood,Scaling,Rising Tide,Cloning,Bill Gates,and Babies.By combining the total variation(TV)operator,the GI-TV mixed regularization introduced compressive near-field MMW imaging model is proposed.In addition,the corresponding algorithm based on a primal-dual framework is also proposed.Experimental results demonstrate that the proposed GI-TV mixed regularization algorithm has superior convergence and stability performance compared with the widely used l1-TV mixed regularization algorithm.

Web GIS-Based Temporal Analysis of Climatic Factors Impacting Heat Stroke in Karachi

This study focuses on the impact of climate change, specifically the increasing threat of heatwaves, in Pakistan, with a particular emphasis on the city of Karachi. The Pakistan Meteorological Department (PMD) analysed a century of climatic data to reveal warming trends, attributing them to human-induced factors. The vulnerability of Pakistan to climate change is highlighted, given its warm climate and location in a region where temperature increases are expected to surpass global averages. The study examines the past three decades, noting a significant rise in the frequency of hot days, especially in Karachi, where heatwaves have become more prevalent. The aims and objectives of the study involve identifying temporal changes in temperature, rainfall, humidity, and wind speed from 1984 to 2014 in Karachi. The literature review emphasizes the health implications of heatwaves, citing increased mortality during such events globally. The study incorporates a comprehensive temporal analysis, addressing gaps in previous research by considering multiple climate indicators responsible for heatwaves. The methodology involves statistical analyses, including linear regression and Pearson correlation, applied to temperature data and urbanization parameters. Results indicate an increasing trend in heat index temperature, with heatwave vulnerability peaking in the last three decades. Heat Index Temperature Anomalies show a clear surge, emphasizing the need for new indices to control critical heat stress conditions. The study concludes that tropical climate variability, particularly heat index, is linked to extreme hot days, urging measures to reduce population vulnerability. The findings underscore the importance of policy strategies, such as integrated coastal zone management, to mitigate the adverse health effects of heatwaves in Karachi’s vulnerable population.

Improvement of hepatic fibrosis after tenofovir disoproxil fumarate switching to tenofovir alafenamide for three years

BACKGROUND Both tenofovir alafenamide(TAF)and tenofovir disoproxil fumarate(TDF)are the first-line treatments for chronic hepatitis B(CHB).We have showed switching from TDF to TAF for 96 weeks resulted in further alanine aminotransferase(ALT)improvement,but data remain lacking on the long-term benefits of TDF switching to TAF on hepatic fibrosis.AIM To assess the benefits of TDF switching to TAF for 3 years on ALT,aspartate aminotransferase(AST),and hepatic fibrosis improvement in patients with CHB.METHODS A single center retrospective study on 53 patients with CHB who were initially treated with TDF,then switched to TAF to determine dynamic patterns of ALT,AST,AST to platelet ratio index(APRI),fibrosis-4(FIB-4)scores,and shear wave elastography(SWE)reading improvement at switching week 144,and the associated factors.RESULTS The mean age was 55(28-80);45.3%,males;15.1%,clinical cirrhosis;mean baseline ALT,24.8;AST,25.7 U/L;APRI,0.37;and FIB-4,1.66.After 144 weeks TDF switching to TAF,mean ALT and AST were reduced to 19.7 and 21,respectively.From baseline to switching week 144,the rates of ALT and AST<35(male)/25(female)and<30(male)/19(female)were persistently increased;hepatic fibrosis was also improved by APRI<0.5,from 79.2%to 96.2%;FIB-4<1.45,from 52.8%to 58.5%,respectively;mean APRI was reduced to 0.27;FIB-4,to 1.38;and mean SWE reading,from 7.05 to 6.30 kPa after a mean of 109 weeks switching.The renal function was stable and the frequency of patients with glomerular filtration rate>60 mL/min was increased from 86.5%at baseline to 88.2%at switching week 144.CONCLUSION Our data confirmed that switching from TDF to TAF for 3 years results in not only persistent ALT/AST improvement,but also hepatic fibrosis improvement by APRI,FIB-4 scores,as well as SWE reading,the important clinical benefits of long-term hepatitis B virus antiviral treatment with TAF.

Assessment of Arterial Stiffness Index in Hypertensive Patients in Relation to Their Treatment Status Attending a Tertiary Care Center in South India

Objectives: To assess the arterial stiffness index (ASI) and pulse wave velocity (PWV) in patients with hypertension and to compare with age matched healthy controls;to assess and compare the ASI and PWV in relation to the treatment status. Methods: The study was observational-cross sectional. Group one included chronic hypertensive patients on regular treatment for more than 2 months;group two included newly diagnosed hypertensive patients and group three had age matched healthy controls with normal blood pressure. The hypertensives subjects with other comormid conditions such as renal disease, diabetes were excluded from the study. The study was approved by the Institute Ethics Committee. The subjects were interviewed and explained the purpose of the study. All subjects gave written informed consent. The noninvasive periscope device was used to measure PWV, ASI and pulse pressure. Results: PWV, ASI and pulse pressure were statistically higher in hypertensive patients when compared to controls. Further, carotid-femoral PWV was correlated with mean arterial pressure in hypertensive subjects and was found to be statistically significant. Conclusion: PWV, ASI and pulse pressure are significantly higher in chronic and newly diagnosed non-diabetic hypertensives as compared to controls irrespective of their treatment status.

Application of rigorous coupled-wave theory on quality analysis of natural jadeite

In order to make more available methods for natural jadeite quality evaluation,this study applied rigorous coupled wave theory to calculate and simulate the reflection characteristics of various natural jadeites,and establish evaluation standard based on the relationship between refractive index and reflectivity and responses of reflection efficiency to refractive index,grating thickness and incident angles,etc.The results suggest that reflection efficiency varies significantly as a function of the natural jadeite quality,which can provide a new method to evaluate natural jadeite.

On the basis of the morphology of the T-wave alternans: A Poincare mapping method research

Presently T-wave alternans (TWA) has become a clinical index of non-invasive diagnosis for heart sudden death prediction, and detecting T-wave alternate accurately is particularly important. This paper introduces an algorithm for detecting TWA using Poincare mapping method which is a technique for nonlinear dynamic systems to display periodic behavior. Sample series of beat to beat cycles were selected to prepare Poincare mapping method. Vector Angle Index (VAI), which is the mean of the difference between θi (the angle between the line connecting the i point to the origin and the X axis) and 45 degrees was used to present the presence or absence of TWA. The value of 0.9 rad ≤ VAI ≤ 1.03 rad is accepted as a level determinative for presence of TWA. VAI via Poincare mapping method (PM) is used for correlation analysis with T-wave alternans voltage (Vtwa) by way of the spectral method (SM). The cross-correlation coefficient between Vtwa and VAI is γ = 0.8601. The algorithm can identify the absence and presence of TWA accurately and provide idea for further study of TWA-PM.

Planetary Wave Reflection and Its Impact on Tropospheric Cold Weather over Asia during January 2008

Reflection of stratospheric planetary waves and its impact on tropospheric cold weather over Asia during January 2008 were investigated by applying two dimensional Eliassen-Palm （EP） flux and three-dimensional Plumb wave activity fluxes.The planetary wave propagation can clearly be seen in the longitude-height and latitude-height sections of the Plumb wave activity flux and EP flux,respectively,when the stratospheric basic state is partially reflective.Primarily,a wave packet emanating from Baffin Island/coast of Labrador propagated eastward,equatorward and was reflected over Central Eurasia and parts of China,which in turn triggered the advection of cold wind from the northern part of the boreal forest regions and Siberia to the subtropics.The wide region of Central Eurasia and China experienced extreme cold weather during the second ten days of January 2008,whereas the extraordinary persistence of the event might have occurred due to an anomalous blocking high in the Urals-Siberia region.

Penetration characteristics of VLF wave from atmosphere into lower ionosphere

The factors affecting the reflection and transmission coefficient of the ionosphere have been analyzed.These factors include wave frequency,incident angle,geomagnetic inclination,electron density and collision frequency in the ionosphere.The ionosphere refractive index is also analyzed.The ionosphere above 70 km is considered to be homogeneous and anisotropic,and the reflection and transmission coefficient matrix is calculated using matrix method.Simultaneously the Booker quartic equation is solved to get the refractive index in the ionosphere.The results show that when the wave frequency is higher,it is easier to penetrate into the ionosphere from its bottom boundary and the propagation attenuation in the ionosphere is smaller.TE（traverse electric） wave and TM（traverse magnetic） wave can both penetrate into the ionosphere with a small incident angle,while TE wave can hardly transmit into the ionosphere when the incident angle is large.The transmission coefficient decreases as the geomagnetic inclination increases.TE and TM wave cannot penetrate into the ionosphere at magnetic equator.When the electron collision frequency is higher,it is easier for VLF wave to penetrate into the ionosphere and the attenuation of ordinary wave is weaker,which may be caused by the energy transportation between the waves and the particles.The ordinary（O） wave experiences severer attenuation than extraordinary（X） wave,and X wave is a penetration mode whereas O wave is a non-penetration mode in the ionosphere.All the results indicate that VLF wave with higher frequency is easier to penetrate into the ionosphere and to be recorded by the satellites at high latitude.It is hard for ULF and the lower frequency VLF wave to transmit into the ionosphere directly for the severe reflection and attenuation.It may transmit into the ionosphere with a small incident angle due to the nonlinear effect,for example,the interaction between the waves and the particles or cross modulation,and then propagate along the whistle duct with small attenuation.This work may be a preliminary theoretical exploration for the future calculation on the response of ground based VLF artificial transmitter in the ionosphere and further study on the seismic ionosphere coupling model.

Surface effect and non-local elasticity in wave propagation of functionally graded piezoelectric nano-rod excited to applied voltage

A non-local solution for a functionally graded piezoelectric nano-rod is pre- sented by accounting the surface effect. This solution is used to evaluate the charac- teristics of the wave propagation in the rod structure. The model is loaded under a two-dimensional （2D） electric potential and an initially applied voltage at the top of the rod. The mechanical and electrical properties are assumed to be variable along the thick- ness direction of the rod according to the power law. The Hamilton principle is used to derive the governing differential equations of the electromechanical system. The effects of some important parameters such as the applied voltage and gradation of the material properties on the wave characteristics of the rod are studied.

Effects of Wave Breaking on Freak Wave Generation in Random Wave Train

The experimental studies of the wave breaking effects on freak wave generation are presented within a finite-depth random wave train in a laboratory wave tank. The main attention is paid to the abnormal index, AI = Hmas/Hs, being used to characterize the freak waves, and the changes of the coefficient due to wave breaking. The results show that the occurrence probability of freak wave events in non-breaking waves is much larger than that in bleaking waves and such occurrence in deep water is larger than that in shallow water.

Changes in pulse pressure × heart rate, hs-CRP, and arterial stiffness progression in the Chinese general population: a cohort study involving 3978 employees of the Kailuan Company

Background Pulse wave velocity(PWV) is a marker of arterial stiffness, which represents sub-clinical atherosclerosis. Pulsatile stress and high-sensitivity C-reactive protein(hs-CRP) are associated with arteriosclerosis. However, there is no prospective data confirming whether changes in pulsatile stress and inflammatory markers affect the progression of arterial stiffness. The aim of this study was to investigate the relationships over time between the effects of changes in pulsatile stress and hs-CRP, and arterial stiffness progression during a 2-year follow-up. Methods We performed a longitudinal study involving 3978 participants. All participants underwent a physical examination in 2010–2011 and 2012–2013, during which we measured participants’ hs-CRP levels, brachial–ankle pulse wave velocity(ba PWV), and pulsatile stress. Results Baseline hs-CRP was correlated with ba PWV(r = 0.18, P = 0.000);however the correlation was weaker than that with systolic blood pressure(r = 0.65), pulsatile stress(r = 0.57), and rate-pressure product(r = 0.58). Multiple linear regression analysis demonstrated that changes in pulsatile stress, mean arterial pressure, and low-density lipoprotein-C(LDL-C) were positively correlated with changes in ba PWV, with correlation coefficients of 0.27, 0.25, and 0.07, respectively, but not with changes in hs-CRP. Moreover, each 100-a U increase in pulsatile stress, 1 mm Hg increase in mean blood pressure, and 1 mmol/L increase in LDL-C was associated with a 3 cm/s, 4.78 cm/s, and 17.37 cm/s increase in ba PWV, respectively. Conclusions Pulsatile stress increases are associated with arterial stiffness progression, but that changes in hs-CRP had no effect on arterial stiffness progression. Hs-CRP may simply be a marker of inflammation in arterial stiffness and has no association with arterial stiffness progression.

Controlling an acoustic wave with a cylindrically-symmetric gradient-index system

We present a detailed theoretical description of wave propagation in an acoustic gradient-index system with cylindrical symmetry and demonstrate its potential to numerically control acoustic waves in different ways.The trajectory of an acoustic wave within the system is derived by employing the theory of geometric acoustics,and the validity of the theoretical descriptions is verified numerically by using the finite element method simulation.The results show that by tailoring the distribution function of the refractive index,the proposed system can yield a tunable manipulation of acoustic waves,such as acoustic bending,trapping,and absorbing.

Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with type 2 diabetes

The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

How changes of groundwater level affect the desert riparian forest ecosystem in the Ejina Oasis,Northwest China

Groundwater is a key factor controlling the growth of vegetation in desert riparian systems. It is important to recognise how groundwater changes affect the riparian forest ecosystem. This information will not only help us to understand the ecological and hydrological process of the riparian forest but also provide support for ecological recovery of riparian forests and water-resources management of arid inland river basins. This study aims to estimate the suitability of the Water Vegetation Energy and Solute Modelling(WAVES) model to simulate the Ejina Desert riparian forest ecosystem changes,China, to assess effects of groundwater-depth change on the canopy leaf area index(LAI) and water budgets, and to ascertain the suitable groundwater depth for preserving the stability and structure of desert riparian forest. Results demonstrated that the WAVES model can simulate changes to ecological and hydrological processes. The annual mean water consumption of a Tamarix chinensis riparian forest was less than that of a Populus euphratica riparian forest, and the canopy LAI of the desert riparian forest should increase as groundwater depth decreases. Groundwater changes could significantly influence water budgets for T. chinensis and P. euphratica riparian forests and show the positive and negative effects on vegetation growth and water budgets of riparian forests. Maintaining the annual mean groundwater depth at around 1.7-2.7 m is critical for healthy riparian forest growth. This study highlights the importance of considering groundwater-change impacts on desert riparian vegetation and water-balance applications in ecological restoration and efficient water-resource management in the Heihe River Basin.

Experimental Study of A Pile-Restrained Floating Breakwater Constructed of Pontoon and Plates

A pile-restrained pontoon-plate floating breakwater is proposed in this paper. The laboratory physical-model tests are conducted to investigate the wave-dissipation property and heave-motion response of a model. The influence of the model＇s geometric parameters including relative pontoon width, plate width, number of plates and pontoon draft on wavedissipation performance and heave-motion response are discussed, as well as the correlation between these two factors. The result indicates that wave-dissipation performance of the proposed structure is better than the pontoon structure： its transmission coefficient and heave-motion height are reduced by 0.2 and 0.3, respectively, in comparison with those of the pile-restrained pontoon model at a relative pontoon width of 0.2.

Experimental Study of Wave Breaking on Gentle Slope

An experimental study of regular wave and irregular wave breaking is performed on a gentle slope of 1:200, In the experiment, asymmetry of wave profile is analyzed to determine its effect on wave breaker indices and to explain the difference between Goda and Nelson about the breaker indices of regular waves on very mild slopes. The study shows that the breaker index of irregular waves is under less influence of bottom slope l, relative water depth d/ L-0 and the asymmetry of wave profile than that of regular waves. The breaker index of regular waves from Goda may be used in the case of irregular waves, while the coefficient A should be 0.15. The ratio of irregular wavelength to the length calculated by linear wave theory is 0.74. Analysis is also made on the waveheight damping coefficient of regular waves after breaking and on the breaking probability of large irregular waves.