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Three-dimensional FDEM numerical simulation of failure processes observed in Opalinus Clay laboratory samples

Journal of Rock Mechanics and Geotechnical Engineering 2014年第6期6卷 591-606页

作者： Omid Mahabadi Patrick Kaifosh paul marschall Tim Vietor Geomechanica Inc. 90 Adelaide St W Suite 300 Toronto ON M5H 3V9 Canada National Cooperative for the Disposal of Radioactive Waste (NAGRA) Wettingen Switzerland

This study presents the first step of a research project that aims at using a three-dimensional （3D） hybridfinite-discrete element method （FDEM） to investigate the development of an excavation damaged zone（EDZ） around tunnels in a clay shale formation known as Opalinus Clay. The 3D FDEM was first calibratedagainst standard laboratory experiments, including Brazilian disc test and uniaxial compression test. Theeffect of increasing confining pressure on the mechanical response and fracture propagation of the rockwas quantified under triaxial compression tests. Polyaxial （or true triaxial） simulations highlighted theeffect of the intermediate principal stress （s2） on fracture directions in the model： as the intermediateprincipal stress increased, fractures tended to align in the direction parallel to the plane defined by themajor and intermediate principal stresses. The peak strength was also shown to vary with changing s2. 2014 Institute of Rock and Soil Mechanics, Chinese Academy of Sciences. Production and hosting byElsevier B.V. All rights reserved.

关键词： Three-dimensional(3D) hybrid finitediscrete element method(FDEM) Intermediate principal stress Discrete element methods True triaxial behaviour Failure envelope

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Costing of Malaria treatment in a rural district hospital

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Health 2010年第7期2卷 759-768页

作者： Insa Koné paul marschall Steffen Flessa 不详

Objective: It is the aim of this paper to estimate the provider’s cost of treating paediatric cases of Malaria in a rural African hospital. Furthermore, we intend to give some insights into the possibilities of improving the efficiency of treating children with this disease in order to support policy makers in the resource allocation process. Methods: The cost analysis was done in the district hospital of Nouna, Burkina Faso. Based on a comprehensive cost-of-illness information system, the cost of treating paediatric Malaria in the district hospital in the year 2005 were estimated using a combination of top- down and activity-based costing. It divides the entire treatment process into a set of activities along the clinical pathway and allocates monetary values for the resource consumption to each activity. Results: The average actual provider’s cost were 6.74 US$ for a paediatric outpatient with Malaria, 61.08 US$ for a paediatric Malaria inpatient with anaemia and, respectively 74.29 US$ for a case of paediatric Malaria with neurological affection. 54% of the cost was due to laboratory work. This high unit cost was mainly due to a severe underutilisation of the hospital capacity. The current cost recovery rate per case was between 18% and 43%. It would be between 32% and 73% if the occupancy increased to 80%. Conclusion: The paper demonstrates that detailed costing is possible in a district hospital in rural Africa. The unit cost seems to be extra-ordinary high and the share of laboratory cost is tremendous. However, this is mainly due to a very strong underutilisation of the existing capacities. This fact calls for intensive efforts of the management of the institution to attract more patients by improving the quality of services and in particular the satisfaction of the patients.

关键词： Burkina Faso Cost Analysis Clinical Pathway Cost Recovery Paediatric Malaria

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Analysis of ileal sodium/bile acid cotransporter and related nuclear receptor genes in a family with multiple cases of idiopathic bile acid malabsorption

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World Journal of Gastroenterology 2006年第47期12卷 7710-7714页

作者： Marco Montagnani Anna Abrahamsson Cecilia Glman Gsta Eggertsen Hanns-Ulrich marschall Elisa Ravaioli Curt Einarsson paul A Dawson Dipartimento di Medicina Interna e Gastroenterologia Università di Bologna Bologna Italy Center for Applied Biomedi-cal Research Università di Bologna Bologna Italy Center for Gastroenterology and Hepatology Karolinska University Hospital Huddinge Stockholm Sweden Center for Metabolism and Endocrinology Karolinska University Hospital Huddinge Stockholm Sweden Department of Laboratory Medicine Division of Clinical Chemistry Karolinska University Hospital Huddinge Stockholm Sweden Department of Internal Medicine Wake Forest University School of Medicine Winston-Salem NC 27157 United States

The etiology of most cases of idiopathic bile acid malabsorption （IBAH） is unknown. In this study, a Swedish family with bile acid malabsorption in three consecutive generations was screened for mutations in the ileal apical sodium-bile acid cotransporter gene （ASBT; gene symbol, SLC10A2） and in the genes for several of the nuclear receptors known to be important for ASBT expression： the farnesoid X receptor （FXR） and peroxisome proliferator activated receptor alpha （PPARα）. The patients presented with a clinical history of idiopathic chronic watery diarrhea, which was responsive to cholestyramine treatment and consistent with IBAH. Bile acid absorption was determined using ^75Se-homocholic acid taurine （SeHCAT）; bile acid synthesis was estimated by measuring the plasma levels of 7α-hydroxy-4-cholesten-3-one （C4）. The ASBT, FXR, and PPARα genes in the affected and unaffected family members were analyzed using single stranded conformation polymorphism （SSCP）, denaturing HPLC, and direct sequencing. No ASBT mutations were identified and the ASBT gene did not segregate with the bile acid malabsorption phenotype. Similarly, no mutations or polymorphisms were identified in the FXR or PPARα genes associated with the bile acid malabsorption phenotype. These studies indicate that the intestinal bile acid malabsorption in these patients cannot be attributed to defects in ASBT. In the absence of apparent ileal disease, alternative explanations such as accelerated transit through the small intestine may be responsible for the IBAM.

关键词： Bile acid malabsorption Diarrhea Genetics ^75Se-homocholic acid taurine test Nuclear receptors

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Association of mineral and bone biomarkers with adverse cardiovascular outcomes and mortality in the German Chronic Kidney Disease(GCKD)cohort

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Bone Research 2023年第4期11卷 764-771页

作者： Katharina Charlotte Reimer Jennifer Nadal Heike Meiselbach Matthias Schmid Ulla T.Schultheiss Fruzsina Kotsis Helena Stockmann Nele Friedrich Matthias Nauck Vera Krane Kai-Uwe Eckardt Markus P.Schneider Rafael Kramann Jürgen Floege Turgay Saritas Department of Nephrology Rheumatologyand Clinical ImmunologyUniversity Hospital RWTH AachenAachenGermany Institute of Experimental Medicine and Systems Biology RWTH Aachen UniversityAachenGermany Institute for Cell and Tumor Biology RWTH Aachen UniversityAachenGermany Institute of Medical Biometry Informatics and EpidemiologyUniversity Hospital of BonnBonnGermany Department of Nephrology and Hypertension University of Erlangen-NürnbergErlangenGermany Institute of Genetic Epidemiology Faculty of Medicine and Medical Center-University of FreiburgFreiburgGermany Department of Medicine IV-Nephrology and Primary Care Faculty of Medicine and Medical Center-University of FreiburgFreiburgGermany Department of Nephrology and Medical Intensive Care Charité-Universitätsmedizin BerlinBerlinGermany Department of Nephrology University Medical Center RegensburgRegensburgGermany Institute of Clinical Chemistry and Laboratory Medicine University Medicine GreifswaldGreifswaldGermany DZHK(German Centre for Cardiovascular Research) Partner Site GreifswaldUniversity MedicineGreifswaldGermany Department of Medicine I Division of NephrologyUniversity Hospital WürzburgWürzburgGermany

Mineral and bone disorder(MBD)in chronic kidney disease(CKD)is tightly linked to cardiovascular disease(CVD).In this study,we aimed to compare the prognostic value of nine MBD biomarkers to determine those associated best with adverse cardiovascular(CV)outcomes and *** 5217 participants of the German CKD(GCKD)study enrolled with an estimated glomerular filtration rate(eG FR)between 30–60 mL·min-1 per 1.73 m2 or overt proteinuria,serum osteoprotegerin(OPG),C-terminal fibroblast growth factor-23(FGF23),intact parathyroid hormone(iP TH),bone alkaline phosphatase(BAP),cross-linked C-telopeptide of type 1 collagen(CTX1),procollagen 1intact N-terminal propeptide(P1NP),phosphate,calcium,and 25-OH vitamin D were measured at *** with missing values among these parameters(n=971)were excluded,leaving a total of 4246 participants for *** a median follow-up of6.5 years,387 non-CV deaths,173 CV deaths,645 nonfatal major adverse CV events(MACEs)and 368 hospitalizations for congestive heart failure(CHF)were *** and FGF23 were associated with all outcomes,with the highest hazard ratios(HRs)for *** the final Cox regression model,adjusted for CV risk factors,including kidney function and all other investigated biomarkers,each standard deviation increase in OPG was associated with non-CV death(HR 1.76,95%CI:1.35–2.30),CV death(HR 2.18,95%CI:1.50–3.16),MACE(HR 1.38,95%CI:1.12–1.71)and hospitalization for CHF(HR 2.05,95%CI:1.56–2.69).Out of the nine biomarkers examined,stratification based on serum OPG best identified the CKD patients who were at the highest risk for any adverse CV outcome and mortality.

关键词： Kidney cardiovascular vitamin

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