摘要： Introduction: C.E.R.A. reported effective correction of anaemia and was well tolerated in International studies on CKD patients not on dialysis. Objective: The study aimed to describe the management of renal anaemia in CKD patients not on dialysis with C.E.R.A. in routine clinical practice in India. Methods: This was a prospective, single-arm, open-label, multi-centre, non-interventional, Phase IV study which followed 108 CKD Stage III-IV patients, not on dialysis with Hb < 10 g/dL for correction of anaemia with C.E.R.A. Results: Of the 108 patients with Hb < 10 g/dL at baseline, 83 (90.2%) patients achieved target Hb of 10-12 g/dL and the time taken to achieve correction of anaemia was 9.6 weeks ± 6.13 weeks in the Intent-to-treat population. Haemoglobin concentration increased from 8.59 ± 0.808 g/ dL pre-therapy to 10.91 ± 0.634 g/dL post-therapy. The change in mean ± SD Hb value was 2.32 ± 0.174 g/dL. Maintenance of Hb levels within the target range of Hb 10 - 12 g/dL was observed in 78.2% of ITT and 80.8% of the PP population for mean duration of 16.69 weeks. Four patients (3.7%) experienced 5 AEs and 2 patients (1.9%) experienced 3 SAEs in the safety population. As per the treating physician none of the AEs or SAEs was considered related to study drug. There were no deaths reported. Conclusions: This study demonstrated successful correction of anaemia in Indian patients with C.E.R.A. treatment as well as maintenance of Hb levels within the target range. C.E.R.A. was well tolerated with no new safety concerns specific to the Indian population. The less frequent up to monthly dosing schedule of C.E.R.A. may offer clinicians and patients a simplified regimen of anaemia management as compared to traditional frequently administered (thrice weekly to once weekly) ESAs. © 2017, Journal of Association of Physicians of India. All rights reserved.

关键词： Lactobacillus plantarum   Undaria pinnatifida   Superoxide anion radical-scavenging   Human enterocyte-like HT-29-luc cells   IBD modelled mouse  

摘要： Most wakame Undaria pinnatifida, a brown algae, products are made from the frond portion. In this study, the polysaccharide content and antioxidant property of aqueous extract solutions (AESs) of the four parts (frond: wakame, stem of the frond: kuki-wakame, sporophyll: mekabu, and kuki-mekabu) of wakame were investigated. Polysaccharide content was high in both the wakame and mekabu. Superoxide anion (O-2(-)) radical-scavenging capacities were high in the mekabu. These AESs could be fermented by Lactobacillus plantarum Sanriku-SU7. The O-2(-) radical-scavenging activity of the kuki-wakame, mekabu, and kuki-mekabu were increased by the fermentation. Fermented mekabu clearly showed a protective effect on human enterocyte-like HT-29-luc cells and in a mouse model of dextran sodium sulphate-induced inflammatory bowel disease (IBD). These results suggest that the mekabu fermented by L. plantarum Sanriku-SU7 has anti-IBD effect related to O-2(-) radical-scavenging.

关键词： Natural disasters   Decision support systems   Economic recovery   Built environment   Disaster relief  

摘要： Natural disasters affect the built environment's infrastructure and disturb the economic sector's sustainability and welfare. This requires a disaster recovery decision support tool that capitalizes on the redevelopment opportunities to elevate societies to a more-sustainable and less-vulnerable status. As such, this paper presents an agent-based model approach that aims to meet the objectives of stakeholders while decreasing the community's economic vulnerability. Accordingly, the proposed model adopts a five-step research methodology: (1)implementing a comprehensive economic vulnerability assessment tool;(2)developing the objective functions and learning algorithms of the associated stakeholders;(3)modeling the different attributes and potential strategies of the various stakeholders;(4)creating an interdependent agent based model that simulates the aforementioned information;and (5)interpreting and analyzing the results generated from the developed model. The model is developed and tested on the post-Katrina residential housing and economic financial recovery in three Mississippi coastal counties. The model proposed an evolving optimal budget distribution that decreased the economic vulnerability and increased the residential and economic recovery. Ultimately, the holistic framework utilized in this study lays down the foundation for a new generation of interdisciplinary managerial decision-making support tools.

摘要： 23B

关键词： Geant4   image reconstruction   proton computed tomography   stopping power  

摘要： Purpose: Proton computed tomography (pCT) is a promising imaging technique to substitute or at least complement x-ray CT for more accurate proton therapy treatment planning as it allows calculating directly proton relative stopping power from proton energy loss measurements. A proton CT scanner with a silicon-based particle tracking system and a five-stage scintillating energy detector has been completed. In parallel a modular software platform was developed to characterize the performance of the proposed pCT. Method: The modular pCT software platform consists of (1) a Geant4-based simulation modeling the Loma Linda proton therapy beam line and the prototype proton CT scanner, (2) water equivalent path length (WEPL) calibration of the scintillating energy detector, and (3) image reconstruction algorithm for the reconstruction of the relative stopping power (RSP) of the scanned object. In this work, each component of the modular pCT software platform is described and validated with respect to experimental data and benchmarked against theoretical predictions. In particular, the RSP reconstruction was validated with both experimental scans, water column measurements, and theoretical calculations. Results: The results show that the pCT software platform accurately reproduces the performance of the existing prototype pCT scanner with a RSP agreement between experimental and simulated values to better than 1.5%. Conclusions: The validated platform is a versatile tool for clinical proton CT performance and application studies in a virtual setting. The platform is flexible and can be modified to simulate not yet existing versions of pCT scanners and higher proton energies than those currently clinically available. (C) 2017 American Association of Physicists in Medicine

关键词： Ship management   maintenance   planned maintenance system   AHP and SWOT analysis  

摘要： Repair and maintenance is a critical technical aspect on board ship. Poor maintenance planning may lead to serious impairment in safety, efficiency, and environmental performance since researches show that a significant breakdowns and damage to ships with maintenance system. This study investigates the potential of existing planned maintenance system (PMS), mainly adopted strategy on board ships, to point out the required improvements. The PMS is a comprehensive periodic maintenance system for equipment or machinery. It is formulated by the ship management company or ship owner associated with requirements of manufacturer and ship classification society. An A'WOT hybrid methodology is utilized to quantify the strengths, weakness, opportunities and threats of PMS. To develop an e-PMS concept, the proposed solutions are decided respectively. The e-PMS concept enables a considerable amount of contributions to ship system performance and reliability once it integrates into safety management system.

关键词： Participatory design   New technology adoption   Naval architecture  

摘要： Computer-aided solutions are essential for naval architects to manage and optimize technical complexities when developing a ship's design. Although there are an array of software solutions aimed to optimize the human element in design, practical ergonomics methodologies and technological solutions have struggled to gain widespread application in ship design processes. This paper explores how a new ergonomics technology is perceived by naval architecture students using a mixed-methods framework. Thirteen Naval Architecture and Ocean Engineering Masters students participated in the study. Overall, results found participants perceived the software and its embedded ergonomics tools to benefit their design work, increasing their empathy and ability to understand the work environment and work demands end-users face. However, participant's questioned if ergonomics could be practically and efficiently implemented under real-world project constraints. This revealed underlying social biases and a fundamental lack of understanding in engineering postgraduate students regarding applied ergonomics in naval architecture. (C) 2016 Elsevier Ltd. All rights reserved.

关键词： Tooth prognosis   CDSSs   Tooth extraction   Tooth retention   Decision-making  

摘要： Clinical decision support system for tooth retention or extraction Treatment planning with regard to retention or extraction decision-making is often challenging, especially to dental students and inexperienced dentists. Such a decision requires consideration of many factors and clinical parameters to achieve an accurate definitive plan and therefore proper dental care. Contemporary dentistry has adopted the concept of evidence-based practice guidelines. Our project has followed this concept, thus literature evidence, clinician's expertise, patient's desires and preferences were factored-in to develop a contemporary approach for determining the overall tooth prognosis accurately. Although, several studies have been published to report the affect of specific clinical parameters on individual tooth prognosis, these studies were isolated and focused on particular aspects for developing tooth prognosis scale rather than evaluation of teeth in comprehensive manner covering all factors relevant to retention or extraction decision-making. Retention of non-salvageable teeth as well as extraction of salvageable teeth can be drastically devastating to patients since they are time consuming, cost more time and money and may lead to loss of trust and confidence in care givers. Thus, a multi-factorial approach for development of accurate prognosis is required. This approach requires sound knowledge of principles that span across multiple dental specialties of restorative/prosthodontics, periodontics and endodontics. It is extremely difficult for clinicians to recall an extensive list of factors that determine the overall tooth prognosis, especially for dental students and less experienced clinicians. On the other hand, expert clinicians with their knowledge and years of experience are accustomed to critical thinking utilizing comprehensive list of factors on day-to-day clinical practice. However, experts may not always be accessible for consultation at the point of care. To fulf

摘要： Inflammatory bowel diseases (IBD) are widespread inflammatory diseases that cause debilitating health problems including cancer. In this study, we show that ZnO nanoparticle (ZnONP) treatment has markedly dose-dependent effects on the remission of dextran sulfate sodium (DSS)-induced ulcerative colitis in mice. We demonstrate the mechanism involves the antioxidant and anti-inflammatory abilities of ZnONPs to suppress ROS and malondialdehyde (MDA) production;increase GSH level;suppress proinflammatory cytokines IL-1 beta and TNF-beta and myeloperoxidase (MPO). The ZnONP treatment is able to activate the Nrf2 pathway in the cellular antioxidant defense system. The novel finding is that ZnONP combined with mesalazine (5-ASA) can enhance the therapeutic efficacy of 5-ASA in the treatment of DSS-induced colitis. Lastly, we found that ZnONP treatment can restore the changes in special colonic bacteria of DSS-mice while the drug 5-ASA cannot. These results indicate that ZnONPs can act as a medical additive for the therapy of IBD.

摘要： Lithium and quetiapine are effective treatments for bipolar disorder, but their potential neuroprotective effects in humans remain unclear. A single blinded equivalence randomized controlled maintenance trial was conducted in a prospective cohort of first-episode mania (FEM) patients (n=26) to longitudinally compare the putative protective effects of lithium and quetapine on grey and white matter volume. A healthy control sample was also collected (n=20). Using structural MRI scans, voxel-wise grey and white matter volumes at baseline and changes over time in response to treatment were investigated. Patients were assessed at three time points (baseline, 3 and 12-month follow-up), whereas healthy controls were assessed at two time points (baseline and 12-month follow-up). Patients were randomized to lithium (serum level 0.6 mmol l -1 , n=20) or quetiapine (flexibly dosed up to 800 mg per day, n=19) monotherapy. At baseline, compared with healthy control subjects, patients with FEM showed reduced grey matter in the orbitofrontal cortex, anterior cingulate, inferior frontal gyrus and cerebellum. In addition, patients had reduced internal capsule white matter volume bilaterally (t 1,66 >3.20, P<0.01). Longitudinally, there was a significant treatment × time effect only in the white matter of the left internal capsule (F2,112 =8.54, P<0.01). Post hoc testing showed that, compared with baseline, lithium was more effective than quetiapine in slowing the progression of white matter volume reduction after 12 months (t1,24 =3.76, P<0.01). Our data support the role of lithium but not quetiapine therapy in limiting white matter reduction early in the illness course after FEM.