A Composite Index of Compliance for Chronic In‐Center Hemodialysis Patients

We developed a composite compliance index as the sum of the compliance scores for interdialytic weight gain (IDWG), pre‐dialysis serum potassium and phosphorus concentrations (each scored from zero to 3, with 3 indicating the poorest compliance), and skipping hemodialysis sessions (scored from zero to 9, with 9 indicating the poorest compliance). We used this composite score to prospectively evaluate compliance in 25 prevalent hemodialysis patients over a period of 1 year. We then followed these patients for another 3.5 years. The patients studied were divided into two groups: group A (poor compliance) consisted of 9 subjects with composite score ≥ 9 (13.2 ± 3.2); group B (better compliance) consisted of 16 subjects with composite score < 9 (4.7 ± 1.8). Age, duration of hemodialysis, and frequency of diabetes mellitus did not differ between the groups. Group A contained higher fractions of subjects with history of alcoholism (66.7% vs 12.5%, p = 0.010), other substance addiction (44.4% vs 0%, p = 0.010), and severe psychosocial problems (88.9% vs 18.8%, p = 0.002). Mean survival from the beginning of observation, estimated by actuarial life‐table survival analysis, was 1.19 years in group A and 2.60 years in group B (p = 0.0265). A composite compliance index incorporating domains indicating adherence to diet, medications, and dialysis schedule identified other behavioral problems in poorly compliant patients. Hemodialysis patients characterized by this composite index as poorly compliant had shortened survival.     

Synergism of Toughening Mechanisms in Whisker-Reinforced Ceramic-Matrix Composites

The improved fracture resistance of whisker-reinforced ceramic-matrix composites involves more than one energy-absorbing mechanism. The possible mechanisms are reviewed and a micromechanical model evaluating the relative contributions to the overall toughness is presented. The mechanisms involve microcracking, load transfer, bridging, and crack deflection. The synergism of these mechanisms is examined using an energy release rate balance equation. The basic assumption of the proposed model is that the load transfer between the matrix and the whiskers is due to Coulomb friction. The model has been applied to an Al₂O₃/SiC whisker composite and shows reasonable agreement with reported experimental results. The role of the thermal residual stresses is also examined in light of the frictional load transfer assumption.     

Towards a consolidated model for a collaborative courseware authoring system

Abstract In an effort to reduce the expensive resource requirements in courseware production and to allow effective management of, and communication and collaboration between authors, a model is needed to harmonize the diverse theoretical backgrounds such a process requires. To this end we look at five abstract models which where chosen for their apparent appropriateness within the general area of collaborative authoring and reuse of multimedia courseware. These models consist of a functional model of hypertext, an infrastructure model for an open collaborative authoring system, two object-oriented communication models, and a courseware production model. We attempt a consolidation of these models and ultimately make several conclusions, which are exposed during a conceptual harmonisation. The principal conclusion is that a hypermedia logical model is not by itself adequate to support collaboration and reuse. Our modeling conclusions have driven the design of a system which will be implemented and tested.     

The Association of Human Herpesviruses with Malignant Brain Tumor Pathology and Therapy: Two Sides of a Coin

The role of certain viruses in malignant brain tumor development remains controversial. Experimental data demonstrate that human herpesviruses (HHVs), particularly cytomegalovirus (CMV), Epstein–Barr virus (EBV) and human herpes virus 6 (HHV-6), are implicated in brain tumor pathology, although their direct role has not yet been proven. CMV is present in most gliomas and medulloblastomas and is known to facilitate oncomodulation and/or immunomodulation, thus promoting cancer cell proliferation, invasion, apoptosis, angiogenesis, and immunosuppression. EBV and HHV-6 have also been detected in brain tumors and high-grade gliomas, showing high rates of expression and an inflammatory potential. On the other hand, due to the neurotropic nature of HHVs, novel studies have highlighted the engagement of such viruses in the development of new immunotherapeutic approaches in the context of oncolytic viral treatment and vaccine-based strategies against brain tumors. This review provides a comprehensive evaluation of recent scientific data concerning the emerging dual role of HHVs in malignant brain pathology, either as potential causative agents or as immunotherapeutic tools in the fight against these devastating diseases.     

MILLING PERFORMANCE OF COATED INSERTS WITH VARIABLE COATING THICKNESS ON THEIR RAKE AND FLANK

During the Physical Vapour Deposition of coatings, the orientation of cemented carbides insert surfaces to the plasma flux direction affects the occurring film thickness distribution on the rake and flank, which in turn might influence the wear propagation in cutting processes. In the present paper the cutting performance in milling of PVD coated cemented carbides inserts with variable film thickness on the rake and flank is introduced and with the aid of FEM-supported calculations explained. The investigation results revealed that a thicker film on the tool rake in comparison to the existing one on the flank and moreover a thick and uniformly deposited film in the cutting wedge region significantly enhances the cutting performance in milling.     

Thickness control in structural optimization via a level set method

In the context of structural optimization via a level-set method we propose a framework to handle geometric constraints related to a notion of local thickness. The local thickness is calculated using the signed distance function to the shape. We formulate global constraints using integral functionals and compute their shape derivatives. We discuss different strategies and possible approximations to handle the geometric constraints. We implement our approach in two and three space dimensions for a model of linearized elasticity. As can be expected, the resulting optimized shapes are strongly dependent on the initial guesses and on the specific treatment of the constraints since, in particular, some topological changes may be prevented by those constraints.     

Public-Private Partnerships in the Water Sector

Abstract

Types of partnerships between public and private companies in water and sewage services are evaluated on the basis of the economic efficiency of the scheme for each partner. Modeling of public-private partnerships involves the formulation of a contract prototype, which determines the roles, functions, and responsibilities as well as the allocation of costs and revenues for each partner. Alternative water management scenarios are used to identify the investments required for meeting the projected demand for water and sewage services. Investment and operational costs as well as revenues from water and sewage services are estimated according to the allocation defined in the contract prototype. The economic efficiency of the scheme is assessed through a cost benefit analysis for each partner. The evaluation of different water management scenarios indicates that, for the Cyclades Islands, Greece, there is a substantial water market where several forms of partnerships could be attractive for both the public and the private sectors. Such partnerships include, among others, lease purchase, temporary privatization, built operate transfer (BOT), and built own operate transfer (BOOT). These forms of public-private partnerships could also be successful in similar regions where significant improvements and expansion of the infrastructure is required while access to the required funds and expertise is restricted for small public water companies.     

A study on corrosion‐fatigue behavior of AA7075‐T651 subjected to different surface modification treatments

Two corrosive media were used (3.5 wt% NaCl aqueous solution and distilled water) to examine the corrosion‐fatigue behavior of AA 7075‐T651, subjected to various surface modifications (wire‐EDM, blasting, and anodizing). An in‐situ corrosion‐fatigue device was used to test the corrosion‐fatigue durability. The apparatus is able to generate cyclic loads within a corrosive solution. The mechanical loading is simulated with the aid of finite element method (FEM). At both corrosive environments, a prolongation of the corrosion‐fatigue life was achieved by the blasting procedure, compared with the as‐machined specimens under same conditions. Anodizing had a deleterious impact in all examined cases.