Exploring the Role of Serum Cystatin C in Early Detection of Acute Kidney Injury among On-Pump Cardiac Surgery Patients: A Single-Center Investigation in Bangladesh

Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment.

A Single Center Experience in Biological Therapy for the Treatment of Rheumatoid Arthritis in Saudi Arabia

Background: Biological therapy is indicated in the treatment of RA (Rheumatoid Arthritis) after failure of disease-modifying anti-rheumatic drugs (DMARDS) by the ACR/EULAR recommendations. The objective of the study is to describe the characteristics of Saudi patients at the initiation of biological therapy and to evaluate clinical effectiveness of this therapy measured by the disease activity score DAS 28. Methods: This was a retrospective cohort study of RA (rheumatoid arthritis) patients in King Fahad Hospital in Jeddah, Saudi Arabia from January 2005-July 2011. Data were collected from the medical records of all RA patients on biological therapy including: demographics, disease characteristics, comorbid illnesses and DAS 28 score over a period of 1 year. Results: 139 patients were studied (mean age 46 ± 13 years), of which 118 (84%) were females;mean duration of affliction with RA was 7.2 years ranging 1-45 years. Rheumatoid factor (RF) was positive in 88 patients (63.3%) and one or more comorbidities were present in 102 patients (73.3%). First choice of biological drug was ADA (Adalimumab) 44 patients (31.7%) and RTX (Rituximab) was the 2nd frequently prescribed biological drug. Mean DAS 28 activity at baseline was in ADA 41 patients (6.10 ± 1.62), ETA (Etarnercept) 29 patients (6.64 ± 1.42) and RTX 50 patients (6.7 ± 1.32). Moderate to good EULAR response was obtained in 74%, 85.7% and 53.3% at 6 months in ADA, ETA and RTX patients respectively. Moderate to good EULAR response was obtained in 61.8%, 86.6% and 72% in ADA, ETA AND RTX patients respectively at 1 year of treatment. Therapeutic effectiveness was comparable with the response rates in published observational trials. Conclusion: Our data demonstrate daily clinical practice in management of RA. The pattern of prescription is in agreement with the ACR/EULAR recommendations for initiation of biologicals in the treatment of RA.

A single center experience of combined liver and kidney transplantation

Objective To summarize the experience of treating the end stage of liver disease complicated with renal failure using combined liver - kidney transplantation. Methods The clinical data of 28 cases receiving combined liver - kidney transplantation were retrospectively ana-

Single Neuron PID Control Based on Expert Experiences for Temperature Difference Control System of a Digester

Considering the temperature difference of displacement cooking characterized by severe non-linearity, large time delay, and real-time control, a cascade PID adaptive control strategy composed of a single neuron is proposed to ensure cooking temperature uniformity. The control strategy introduces expert experiences to adjust the single neuron gain K, while a single neuron PID self-learning and adaptive ability, as well as cascade advantage can be combined to realize the real-time and fast temperature difference control. In the Simulink, the s-function of this control strategy is used to carry out a dynamic simulation experiment with temperature difference characteristics and verify the robustness and response to model mismatch. Compared to conventional temperature difference-flow PID cascade control and single neuron PID cascade control, this control strategy has better robustness and stronger adaptability. The results of real-time control on the THJSK-1 experiment platform indicate this control strategy is feasible.

Analysis on the characteristics of Yi nationality herbal single experience prescription in wuliangshan district

Yi nationality medicine is an important part of traditional Chinese medicine. It has both the connotation of traditional Chinese medicine and distinct national and medicinal characteristics. Many of the single experience prescriptions circulated among the Yi people in Wuliangshan areas originate from the classics. They attach importance to diet therapy, medication according to local sources, flexible treatment, remarkable curative effect, and unique medication bath method for women during childbirth and Han (Xian) jiao therapy in Beginning of Summer, which deserve our attention.

Recent advances in regulating the performance of acid oxygen reduction reaction on carbon-supported non-precious metal single atom catalysts

Developing high performance and low-cost catalysts for oxygen reduction reaction(ORR)in challenging acid condition is vital for proton-exchange-membrane fuel cells(PEMFCs).Carbon-supported nonprecious metal single atom catalysts(SACs)have been identified as potential catalysts in the field.Great advance has been obtained in constructing diverse active sites of SACs for improving the performance and understanding the fundamental principles of regulating acid ORR performance.However,the ORR performance of SACs is still unsatisfactory.Importantly,microenvironment adjustment of SACs offers chance to promote the performance of acid ORR.In this review,acid ORR mechanism,attenuation mechanism and performance improvement strategies of SACs are presented.The strategies for promoting ORR activity of SACs include the adjustment of center metal and its microenvironment.The relationship of ORR performance and structure is discussed with the help of advanced experimental investigations and theoretical calculations,which will offer helpful direction for designing advanced SACs for ORR.

A virtual experiment showing single particle motion on a linearly vibrating screen-deck

A virtual sieving experimental simulation system was built using physical simulation principles.The effects of vibration frequency and amplitude,the inclination angle of the screen-deck and the vibration direction angle of screen on single particle kinematics were predicted.Properties such as the average velocity and the average throw height were studied.The results show that the amplitude and the angle of vibration have a great effect on particle average velocity and average height.The vibration frequency and the screen-deck inclination angle appear to have little influence on these responses.For materials that are difficult to screen the vibration frequency and amplitude,the screen-deck inclination angle and the vibration angle should be set to 14 Hz,6.6 mm,6° and 40°,respectively,to obtain optimal particle kinematics.A screening process can be simulated reliably by means of a virtual experiment and these results provide references for both screening theory research and sieving practice.

Study on Strength and Life of Anisotropic Single Crystal Blade - Part Ⅱ: Experimental Research

The single crystal blade is one of the key technologies for improving the performance, durability and reliability of aero-engines and ground gas-turbine engines. However, the anisotropic mechanical properties of the single crystal material makes a great deal of difficulties on the development and the application of the single crystal blade, which is a challenge for the engineering application of the single crystal superalloy and the theoretic bases of the application. Some researches on the strength analysis and the life prediction of the anisotropic single crystal blade were carried out by the authors' research team. They are as follows. The crystallographic constitutive models for the plastic and the creep behaviors and the method of the rupture life prediction were established and verified. The tensile or the creep experiments for DD3 single crystal alloy with different orientations under different temperatures and different tensile rates or under different temperatures and different stress levels were carried out. The experimental data and the anisotropic properties at intermediate and high temperatures revealed by the experiments are significant for the application of the single crystal alloy. In addition, the experimental research for a kind of single crystal blade was also made. As the application of the researches the strength analysis and the life prediction were carried out for the single crystal blade of a certain aeroengine. In this part, the experimental research work is describled, and the constitutive models and applications have been described in part I.

Chemical Bonds between Charged Atoms in the Even-Odd Rule and a Limitation to Eight Covalent Bonds per Atom in Centered-Cubic and Single Face-Centered-Cubic Crystals

A crystal is a highly organized arrangement of atoms in a solid, wherein a unit cell is periodically repeated to form the crystal pattern. A unit cell is composed of atoms that are connected to some of their first neighbors by chemical bonds. A recent rule, entitled the even-odd rule, introduced a new way to calculate the number of covalent bonds around an atom. It states that around an uncharged atom, the number of bonds and the number of electrons have the same parity. In the case of a charged atom on the contrary, both numbers have different parity. The aim of the present paper is to challenge the even-odd rule on chemical bonds in well-known crystal structures. According to the rule, atoms are supposed to be bonded exclusively through single-covalent bonds. A distinctive criterion, only applicable to crystals, states that atoms cannot build more than 8 chemical bonds, as opposed to the classical model, where each atom in a crystal is connected to every first neighbor without limitation. Electrical charges can be assigned to specific atoms in order to compensate for extra or missing bonds. More specifically the article considers di-atomic body-centered-cubic, tetra-atomic and dodeca-atomic single-face-centered-cubic crystals. In body-centered crystals, atoms are interconnected by 8 covalent bonds. In face-centered crystal, the unit cell contains 4 or 12 atoms. For di-element crystals, the total number of bonds for both elements is found to be identical. The neutrality of the unit cell is obtained with an opposite charge on the nearest or second-nearest neighbor. To conclude, the even-odd rule is applicable to a wide number of compounds in known cubic structures and the number of chemical bonds per atom is not related to the valence of the elements in the periodic table.

Model experiment of rock blasting with single borehole and double free-surface

In order to improve the quality of laneways and tunnel excavation by drilling and blasting and by making effective use of explosive energy, a model experiment of rock blasting with a single borehole and a double free-surface was performed with the objective of studying the effect of parameters such as charge structure, free-surface and rock compressive strength on rock blasting.The model experiments indicate that:1) the smaller the rock compressive strength and density, the more distinctive the cavity expanding action by blasting;2) the powder factor in an air-decoupling charge structure is larger than that in a coupling charge structure, i.e., the explosive energy in an air-decoupling charge structure transferred to the rocks is less than that in a coupling charge structure;3) a free-surface improves the utilizations of explosive energy;4) an air-decoupling charge structure helps to maintain the integrity and stability of wall rock in controlled perimeter blasting, such as in roadways and tunnel excavation by drilling and blasting.

Single-event response of the SiGe HBT in TCAD simulations and laser microbeam experiment

In this paper the single-event responses of the silicon germanium heterojunction bipolar transistors(SiGe HBTs) are investigated by TCAD simulations and laser microbeam experiment. A three-dimensional(3D) simulation model is established, the single event effect(SEE) simulation is further carried out on the basis of Si Ge HBT devices, and then, together with the laser microbeam test, the charge collection behaviors are analyzed, including the single event transient(SET) induced transient terminal currents, and the sensitive area of SEE charge collection. The simulations and experimental results are discussed in detail and it is demonstrated that the nature of the current transient is controlled by the behaviors of the collector–substrate(C/S) junction and charge collection by sensitive electrodes, thereby giving out the sensitive area and electrode of SiGe HBT in SEE.

The Structure of Background-error Covariance in a Four-dimensional Variational Data Assimilation System:Single-point Experiment

A four dimensional variational data assimilation （4DVar） based on a dimension-reduced projection （DRP-4DVar） has been developed as a hybrid of the 4DVar and Ensemble Kalman filter （EnKF） concepts. Its good flow-dependent features are demonstrated in single-point experiments through comparisons with adjointbased 4DVar and three-dimensional variational data （3DVar） assimilations using the fifth-generation Pennsylvania State University-National Center for Atmospheric Research Mesoscale Model （MM5）. The results reveal that DRP-4DVar can reasonably generate a background error covariance matrix （simply B-matrix） during the assimilation window from an initial estimation using a number of initial condition dependent historical forecast samples. In contrast, flow-dependence in the B-matrix of MM5 4DVar is barely detectable. It is argued that use of diagonal estimation in the B-matrix of the MM5 4DVar method at the initial time leads to this failure. The experiments also show that the increments produced by DRP-4DVar are anisotropic and no longer symmetric with respect to observation location due to the effects of the weather trends captured in its B-matrix. This differs from the MM5 3DVar which does not consider the influence of heterogeneous forcing on the correlation structure of the B-matrix, a condition that is realistic for many situations. Thus, the MM5 3DVar assimilation could only present an isotropic and homogeneous structure in its increments.

Experimental study on heavy ion single-event effects in flash-based FPGAs

With extensive use of flash-based field-programmable gate arrays(FPGAs) in military and aerospace applications, single-event effects(SEEs) of FPGAs induced by radiations have been a major concern. In this paper, we present SEE experimental study of a flash-based FPGA from Microsemi Pro ASIC3 product family. The relation between the cross section and different linear energy transfer(LET) values for the logic tiles and embedded RAM blocks is obtained. The results show that the sequential logic cross section depends not too much on operating frequency of the device. And the relationship between 0 →1 upsets(zeros) and 1 →0 upsets(ones) is different for different kinds of D-flip-flops. The devices are not sensitive to SEL up to a LET of 99.0 Me V cm2/mg.Post-beam tests show that the programming module is damaged due to the high-LET ions.

Experimental verification of the parasitic bipolar amplification effect in PMOS single event transients

The contribution of parasitic bipolar amplification to SETs is experimentally verified using two P-hit target chains in the normal layout and in the special layout. For PMOSs in the normal layout, the single-event charge collection is composed of diffusion, drift, and the parasitic bipolar effect, while for PMOSs in the special layout, the parasitic bipolar junction transistor cannot turn on. Heavy ion experimental results show that PMOSs without parasitic bipolar amplification have a 21.4% decrease in the average SET pulse width and roughly a 40.2% reduction in the SET cross-section.

THE MOTION OF ORGANIZATION CENTER OF SCROLL WAVES IN EXCITABLE MEDIA WITH SINGLE DIFFUSION

The motion of organization center of three_dimensional untwisted scroll waves in excitable media with single diffusion is studied by singular perturbation method in this paper. The relation of curvature and the linear law are derived for untwisted organization center. These results have explicit physical meaning and are in good agreement with experiments.

Analysis on influencing factors of patients experience in community health centers of Shenzhen,China

Objective To investigate the patients experience in community health centers( CHCs) and explore its associated factors. Methods A cross-sectional study was conducted among 330 patients who visited CHCs in Shenzhen,China from January to March 2018. Dependent variable was patient experience. Key descriptive variables were age,gender,marital status,working status groups,visits frequency for the past 6 months,whether patients had signed a family doctor,whether trusted in family doctor,whether had chronic diseases. Results Questionnaires for 300 patients were assessed. In the univariate analysis,patients experience total score was significantly associated with marital status( P < 0. 1),working status groups( P < 0. 1),frequency of visit for the past 6 months( P < 0. 05),whether had signed a family doctor( P < 0. 05),whether trusted in family doctor( P < 0. 05),whether had chronic diseases( P < 0. 05). The multivariate analysis showed that unmarried patients( P = 0. 011,OR = 2. 96,95% CI: 1. 24-5. 43) and had signed a family doctor( P = 0. 023,OR = 0. 44,95% CI: 0. 22-0. 85) were more likely to get a higher score. Conclusions Findings of this study showed a medium-level score of patients experience in the community. Patients had a quite good experience and more interventions should be focused upon the influence factors to improve patients experience.

The Even-Odd and the Isoelectronicity Rules Applied to Single Covalent Bonds in Ionic, Double-Face-Centered Cubic and Diamond-Like Crystals

Although atom configuration in crystals is precisely known thanks to imaging techniques, there is no experimental way to know the exact location of bonds or charges. Many different representations have been proposed, yet no theory to unify conceptions. The present paper describes methods to derive bonds and charge location in double-face-centered cubic crystals with 4 and 6 atoms per unit cell using two novel rules introduced in earlier works: the even-odd and the isoelectronicity rules. Both of these rules were previously applied to ions, molecules and some solids, and the even-odd rule was also tested on two covalent crystal structures: centered-cubic and single-face-centered cubic crystals. In the present study, the diamond-like structure was subjected to the isoelectronicity rule in order to derive Zinc-blende structures. Rock-salt-like crystals were derived from each other using both rules. These structures represent together more than 230 different crystals. Findings for these structures are threefold: both rules describe a very sure method to obtain valid single covalent-bonded structures;single covalent structures can be used in every case instead of the classical ionic model;covalent bonds and charges positions do not have any relation with the valence number given in the periodic table.

The Effect of COVID-19 on the Cancer Patients Treated with Radiotherapy in Low Risk Area: A Single-Center Descriptive

Objective: To investigate the influence of the new coronavirus epidemic on tumor radiotherapy patients in Zigong City, and provide radiotherapy feasibility and safety in other prefecture-level or low-risk areas. Methods: Retrospective Collection of data from January 31, 2020, in our hospital, this time period is an epidemic group. The control group was data from January 31, 2019-May 31, in our hospital. Patient data includes gender, age, tumor type, hospitalization fee, average hospitalization day, radiotherapy completion, treatment destination, and other information. Results: The patients with epidemic groups and control groups were 320 and 237, respectively, and the radiotherapy patients increased by 25.9%, increasing patients mainly from other departures outside the tumor department underperformance reform intervention. The epidemic group of brain and breast tumor patients were 39 and 37, respectively, with statistical differences (P < 0.05) compared to the control group (25 and 16 respectively). The number of tumor radiotherapy patients in other parts increased, but there was no statistical difference (P > 0.05). Inpatient costs, the average hospitalization day, radiotherapy completion, the purpose of treatment, and other data epidemic groups and control groups have no statistical difference (P > 0.05). Conclusion: The number of COVID-2019 epidemic interventions has increased the number of cancer radiotherapy patients in our hospital, and the epidemic situation has no effect on hospitalization, the average hospitalization day, radiotherapy, and the like. Optimizing the process of clinical treatment, strict prevention and control measures can ensure timely and safe radiotherapy in low-risk areas.

The lived experience of a 24-hour support center for persons with psychiatric disabilities: Making me feel almost like an ordinary person

This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenological-hermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.