Search results for: meditation on twin heart
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1424

Search results for: meditation on twin heart

944 WebAppShield: An Approach Exploiting Machine Learning to Detect SQLi Attacks in an Application Layer in Run-time

Authors: Ahmed Abdulla Ashlam, Atta Badii, Frederic Stahl

Abstract:

In recent years, SQL injection attacks have been identified as being prevalent against web applications. They affect network security and user data, which leads to a considerable loss of money and data every year. This paper presents the use of classification algorithms in machine learning using a method to classify the login data filtering inputs into "SQLi" or "Non-SQLi,” thus increasing the reliability and accuracy of results in terms of deciding whether an operation is an attack or a valid operation. A method Web-App auto-generated twin data structure replication. Shielding against SQLi attacks (WebAppShield) that verifies all users and prevents attackers (SQLi attacks) from entering and or accessing the database, which the machine learning module predicts as "Non-SQLi" has been developed. A special login form has been developed with a special instance of data validation; this verification process secures the web application from its early stages. The system has been tested and validated, up to 99% of SQLi attacks have been prevented.

Keywords: SQL injection, attacks, web application, accuracy, database

Procedia PDF Downloads 133
943 The Combined Effect of Different Levels of Fe(III) in Diet and Cr(III) Supplementation on the Ca Status in Wistar

Authors: Staniek Halina

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The inappropriate trace elements supply such as iron(III) and chromium(III) may be risk factors of many metabolic disorders (e.g., anemia, diabetes, as well cause toxic effect). However, little is known about their mutual interactions and their impact on these disturbances. The effects of Cr(III) supplementation with a deficit or excess supply of Fe(III) in vivo conditions are not known yet. The objective of the study was to investigate the combined effect of different Fe(III) levels in the diet and simultaneous Cr(III) supplementation on the Ca distribution in organs in healthy rats. The assessment was based on a two-factor (2x3) experiment carried out on 54 female Wistar rats (Rattus norvegicus). The animals were randomly divided into 9 groups and for 6 weeks, they were fed semi-purified diets AIN-93 with three different Fe(III) levels in the diet as a factor A [control (C) 45 mg/kg (100% Recommended Daily Allowance for rodents), deficient (D) 5 mg/kg (10% RDA), and oversupply (H) 180 mg/kg (400% RDA)]. The second factor (B) was the simultaneous dietary supplementation with Cr(III) at doses of 1, 50 and 500 mg/kg of the diet. Iron(III) citrate was the source of Fe(III). The complex of Cr(III) with propionic acid, also called Cr₃ or chromium(III) propionate (CrProp), was used as a source of Cr(III) in the diet. The Ca content of analysed samples (liver, kidneys, spleen, heart, and femur) was determined with the Atomic Absorption Spectrometry (AAS) method. It was found that different dietary Fe(III) supply as well as Cr(III) supplementation independently and in combination influenced Ca metabolism in healthy rats. Regardless of the supplementation of Cr(III), the oversupply of Fe(III) (180 mg/kg) decreased the Ca content in the liver and kidneys, while it increased the Ca saturation of bone tissue. High Cr(III) doses lowered the hepatic Ca content. Moreover, it tended to decrease the Ca content in the kidneys and heart, but this effect was not statistically significant. The combined effect of the experimental factors on the Ca content in the liver and the femur was observed. With the increase in the Fe(III) content in the diet, there was a decrease in the Ca level in the liver and an increase in bone saturation, and the additional Cr(III) supplementation intensified those effects. The study proved that the different Fe(III) content in the diet, independently and in combination with Cr(III) supplementation, affected the Ca distribution in organisms of healthy rats.

Keywords: calcium, chromium(III), iron(III), rats, supplementation

Procedia PDF Downloads 183
942 Congenital Heart Defect(CHD) “The Silent Crises”; The Need for New Innovative Ways to Save the Ghanaian Child - A Retrospective Study

Authors: Priscilla Akua Agyapong

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Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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941 Digital Twin Strategies and Technologies for Modern Supply Chains

Authors: Mayank Sharma, Anubhaw Kumar, Siddharth Desai, Ankit Tomar

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With the advent of cost-effective hardware and communication technologies, the scope of digitalising operations within a supply chain has tremendously increased. This has provided the opportunity to create digital twins of entire supply chains through the use of Internet-of-Things (IoT) and communication technologies. Adverse events like the COVID-19 pandemic and unpredictable geo-political situations have further warranted the importance of digitalization and remote operability of day-to-day operations at critical nodes. Globalisation, rising consumerism & e-commerce has exponentially increased the complexities of existing supply chains. We discuss here a scalable, future-ready and inclusive framework for creating digital twins developed along with the industry leaders from Cisco, Bosch, Accenture, Intel, Deloitte & IBM. We have proposed field-tested key technologies and frameworks required for creating digital twins. We also present case studies of real-life stable deployments done by us in the supply chains of a few marquee industry leaders.

Keywords: internet-of-things, digital twins, smart factory, industry 4.0, smart manufacturing

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940 Utilization of Mustard Leaves (Brassica juncea) Powder for the Development of Cereal Based Extruded Snacks

Authors: Maya S. Rathod, Bahadur Singh Hathan

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Mustard leaves are rich in folates, vitamin A, K and B-complex. Mustard greens are low in calories and fats and rich in dietary fiber. They are rich in potassium, manganese, iron, copper, calcium, magnesium and low in sodium. It is very rich in antioxidants and Phytonutrients. For the optimization of process variables (moisture content and mustard leave powder), the experiments were conducted according to central composite Face Centered Composite design of RSM. The mustard leaves powder was replaced with composite flour (a combination of rice, chickpea and corn in the ratio of 70:15:15). The extrudate was extruded in a twin screw extruder at a barrel temperature of 120°C. The independent variables were mustard leaves powder (2-10 %) and moisture content (12-20 %). Responses analyzed were bulk density, water solubility index, water absorption index, lateral expansion, hardness, antioxidant activity, total phenolic content and overall acceptability. The optimum conditions obtained were 7.19 g mustard leaves powder in 100 g premix having 16.8 % moisture content (w.b).

Keywords: extrusion, mustard leaves powder, optimization, response surface methodology

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939 Protective Effect of Bexarotene, a Selective RXRα Agonist, against Hypotension Associated with Inflammation and Tissue Injury Linked to Decreased Circulating iNOS Levels in A Rat Model of Septic Shock

Authors: Bahar Tunctan, Sefika Pinar Kucukkavruk, Meryem Temiz-Resitoglu, Demet Sinem Guden, Ayse Nihal Sari, Seyhan Sahan-Firat

Abstract:

We hypothesized that rexinoids such as bexarotene, a selective retinoid X receptor α (RXRα) agonist, may be beneficial for preventing mortality due to inflammation associated with increased expression/activity of inducible nitric oxide synthase (iNOS) induced by lipopolysaccharide (LPS). Therefore, we investigated effects of bexarotene on the changes in circulating protein levels of iNOS (an index for systemic iNOS expression), myeloperoxidase (MPO) (an index for systemic inflammation), and lactate dehydrogenase (LDH) (an index for systemic tissue injury) in LPS-induced systemic inflammation model resulting in septic shock in rats. Rats were injected with saline (4 ml/kg; i.p.), LPS (10 mg/kg; i.p.), dimethylsulphoxide (4 ml/kg, 0.1%; s.c.) at time 0. Mean arterial blood pressure and heart rate were measured using a tail-cuff device. Bexarotene (0.03, 0.1, 0.3, and 1 mg/kg; s.c.) was administered to separate groups of rats 1 h after injection of saline or LPS. The rats were sacrificed 4 h after saline or LPS injection and blood was collected for measurement of serum iNOS, MPO, and LDH protein levels. Blood pressure decreased by 31 mmHg and heart rate increased by 63 bpm in the LPS-treated rats. Bexarotene at 0.3 and 1 mg/kg doses caused 20% mortality 4 h after LPS injection. In the LPS-treated rats, serum iNOS, MPO, and LDH protein levels were increased. Bexarotene only at 0.1 mg/kg dose prevented the LPS-induced hypotension and increased in iNOS, MPO, and LDH protein levels. These data are consistent with the view that a decrease in systemic iNOS levels contributes to the beneficial effect of bexarotene to prevent the hypotension associated with inflammation and tissue injury during rat endotoxemia. [This work was financially supported by The Scientific and Technological Research Council of Turkey (SBAG-109S121)].

Keywords: bexarotene, inflammation, iNOS, lipopolisaccharide, RXRa

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938 Recurrent Torsades de Pointes Post Direct Current Cardioversion for Atrial Fibrillation with Rapid Ventricular Response

Authors: Taikchan Lildar, Ayesha Samad, Suraj Sookhu

Abstract:

Atrial fibrillation with rapid ventricular response results in the loss of atrial kick and shortened ventricular filling time, which often leads to decompensated heart failure. Pharmacologic rhythm control is the treatment of choice, and patients frequently benefit from the restoration of sinus rhythm. When pharmacologic treatment is unsuccessful or a patient declines hemodynamically, direct cardioversion is the treatment of choice. Torsades de pointes or “twisting of the points'' in French, is a rare but under-appreciated risk of cardioversion therapy and accounts for a significant number of sudden cardiac death each year. A 61-year-old female with no significant past medical history presented to the Emergency Department with worsening dyspnea. An electrocardiogram showed atrial fibrillation with rapid ventricular response, and a chest X-ray was significant for bilateral pulmonary vascular congestion. Full-dose anticoagulation and diuresis were initiated with moderate improvement in symptoms. A transthoracic echocardiogram revealed biventricular systolic dysfunction with a left ventricular ejection fraction of 30%. After consultation with an electrophysiologist, the consensus was to proceed with the restoration of sinus rhythm, which would likely improve the patient’s heart failure symptoms and possibly the ejection fraction. A transesophageal echocardiogram was negative for left atrial appendage thrombus; the patient was treated with a loading dose of amiodarone and underwent successful direct current cardioversion with 200 Joules. The patient was placed on telemetry monitoring for 24 hours and was noted to have frequent premature ventricular contractions with subsequent degeneration to torsades de pointes. The patient was found unresponsive and pulseless; cardiopulmonary resuscitation was initiated with cardioversion, and return of spontaneous circulation was achieved after four minutes to normal sinus rhythm. Post-cardiac arrest electrocardiogram showed sinus bradycardia with heart-rate corrected QT interval of 592 milliseconds. The patient continued to have frequent premature ventricular contractions and required two additional cardioversions to achieve a return of spontaneous circulation with intravenous magnesium and lidocaine. An automatic implantable cardioverter-defibrillator was subsequently implanted for secondary prevention of sudden cardiac death. The backup pacing rate of the automatic implantable cardioverter-defibrillator was set higher than usual in an attempt to prevent premature ventricular contractions-induced torsades de pointes. The patient did not have any further ventricular arrhythmias after implantation of the automatic implantable cardioverter-defibrillator. Overdrive pacing is a method utilized to treat premature ventricular contractions-induced torsades de pointes by preventing a patient’s susceptibility to R on T-wave-induced ventricular arrhythmias. Pacing at a rate of 90 beats per minute succeeded in controlling the arrhythmia without the need for traumatic cardiac defibrillation. In our patient, conversion of atrial fibrillation with rapid ventricular response to normal sinus rhythm resulted in a slower heart rate and an increased probability of premature ventricular contraction occurring on the T-wave and ensuing ventricular arrhythmia. This case highlights direct current cardioversion for atrial fibrillation with rapid ventricular response resulting in persistent ventricular arrhythmia requiring an automatic implantable cardioverter-defibrillator placement with overdrive pacing to prevent a recurrence.

Keywords: refractory atrial fibrillation, atrial fibrillation, overdrive pacing, torsades de pointes

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937 Rheological and Thermomechanical Properties of Graphene/ABS/PP Nanocomposites

Authors: Marianna I. Triantou, Konstantina I. Stathi, Petroula A. Tarantili

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In the present study, the incorporation of graphene into blends of acrylonitrile-butadiene-styrene terpolymer with polypropylene (ABS/PP) was investigated focusing on the improvement of their thermomechanical characteristics and the effect on their rheological behavior. The blends were prepared by melt mixing in a twin-screw extruder and were characterized by measuring the MFI as well as by performing DSC, TGA and mechanical tests. The addition of graphene to ABS/PP blends tends to increase their melt viscosity, due to the confinement of polymer chains motion. Also, graphene causes an increment of the crystallization temperature (Tc), especially in blends with higher PP content, because of the reduction of surface energy of PP nucleation, which is a consequence of the attachment of PP chains to the surface of graphene through the intermolecular CH-π interaction. Moreover, the above nanofiller improves the thermal stability of PP and increases the residue of thermal degradation at all the investigated compositions of blends, due to the thermal isolation effect and the mass transport barrier effect. Regarding the mechanical properties, the addition of graphene improves the elastic modulus, because of its intrinsic mechanical characteristics and its rigidity, and this effect is particularly strong in the case of pure PP.

Keywords: acrylonitrile-butadiene-styrene terpolymer, blends, graphene, polypropylene

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936 Acquisition of Anticipatory Coarticulation in Italian-Speaking Children: An Acoustic Study

Authors: Patrizia Bonaventura

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The aim of this study is to analyze the influence of prosody on the acquisition of temporal aspects of V-V anticipatory lingual coarticulation in productions by Italian-speaking children. Two twin 7-years old male children, native Italian speakers, interacted with the same adult, repeating nonsense disyllables containing VtV sequences where V1 = {i, a} and V2 = {a,e, i, o,u}, with different stress patterns (e.g. pi’ta, pi’ta). The duration of the VC F2 transitions and the CV/VC F2 transitions durations ratios in different V2 contexts and stress conditions were measured by spectrographic analysis and compared between pronunciations by each child vs. the adult to test whether the child was able to imitate the duration of the transitions as produced by the adult in different stress conditions. Consequences highlighted a significant difference in durations of VC transitions between children and adult: longer VC transitions durations, indicating a greater amount of coarticulation, were found for one child in every context, and for the other, only in stressed [it] sequences. The data support the hypothesis of the presence of different temporal patterns of anticipatory coarticulation in adults and children, and of a greater amount of coarticulation in children, with different strategies of implementation across different prosodic conditions.

Keywords: speech acquisition, coarticulation, Italian language, prosody

Procedia PDF Downloads 77
935 Concrete Mixes for Sustainability

Authors: Kristyna Hrabova, Sabina Hüblova, Tomas Vymazal

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Structural design of concrete structure has the result in qualities of structural safety and serviceability, together with durability, robustness, sustainability and resilience. A sustainable approach is at the heart of the research agenda around the world, and the Fibrillation Commission is also working on a new model code 2020. Now it is clear that the effects of mechanical, environmental load and even social coherence need to be reflected and included in the designing and evaluating structures. This study aimed to present the methodology for the sustainability assessment of various concrete mixtures.

Keywords: concrete, cement, sustainability, Model Code 2020

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934 Smart Grids in Morocco: An Outline of the Recent Development, Key Drivers and Recommendations for Future Implementation

Authors: Mohamed Laamim, Aboubakr Benazzouz, Abdelilah Rochd, Abdellatif Ghennioui, Abderrahim El Fadili

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Smart grids have recently sparked a lot of interest in the energy sector as they allow for the modernization and digitization of the existing power infrastructure. Smart grids have several advantages in terms of reducing the environmental impact of generating power from fossil fuels due to their capacity to integrate large amounts of distributed energy resources. On the other hand, smart grid technologies necessitate many field investigations and requirements. This paper focuses on the major difficulties that governments face around the world and compares them to the situation in Morocco. Also presented in this study are the current works and projects being developed to improve the penetration of smart grid technologies into the electrical system. Furthermore, the findings of this study will be useful to promote the smart grid revolution in Morocco, as well as to construct a strong foundation and develop future needs for better penetration of technologies that aid in the integration of smart grid features.

Keywords: smart grids, microgrids, virtual power plants, digital twin, distributed energy resources, vehicle-to-grid, advanced metering infrastructure

Procedia PDF Downloads 138
933 Eradication of Mental Illness through Buddhism

Authors: Deshar Bashu Dev

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In this modern age, most people in developed and developing countries are affected by mental illness. There are many mental illnesses, and their differing symptoms impact peoples’ lives in different ways. These illnesses affect the way people think and feel, as well as how they behave with others. Mental illness results from compound interactions between the mind, body, and environment. New technologies and sciences make the world a better place. These technologies are becoming smarter and are being developed every day to help make daily life easier However, people suffer from mental illness in every part of the world. The philosophy propounded by the Buddha, Buddhism, teaches that all life is connected, from the microcosm to macrocosm. In the 2,500 years that elapsed since the death of the Buddha, his disciples have spread his teachings and developed sophisticated psycho-therapeutic methodologies. We can find many examples in Buddhist texts and in the modern age where Buddhist philosophy modern science could not solve. The Noble Eightfold Path, which is one of the main philosophies of Buddhism; it eradicates hatred and ill will and cultivates good deeds, kindness, and compassion. Buddhism, as a practice of dialectic conversation and mindfulness training, is full of rich therapeutic tools that the mental health community has adopted to help people. Similarly, Buddhist meditation is very necessary; it purifies thoughts and avoids unnecessary thinking. This research aims to study different causes of mental illness; analyzes the different approaches to eradicate mental illness problems and provides conclusions and recommendations present solutions through Buddhism in this modern age.

Keywords: mental illness, Buddhism, mindfulness, Buddhist practices

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932 Metaverse in Future Personal Healthcare Industry: From Telemedicine to Telepresence

Authors: Mohammed Saeed Jawad

Abstract:

Metaverse involves the convergence of three major technologies trends of AI, VR, and AR. Together these three technologies can provide an entirely new channel for delivering healthcare with great potential to lower costs and improve patient outcomes on a larger scale. Telepresence is the technology that allows people to be together even if they are physically apart. Medical doctors can be symbolic as interactive avatars developed to have smart conversations and medical recommendations for patients at the different stages of the treatment. Medical digital assets such as Medical IoT for real-time remote healthcare monitoring as well as the symbolic doctors’ avatars as well as the hospital and clinical physical constructions and layout can be immersed in extended realities 3D metaverse environments where doctors, nurses, and patients can interact and socialized with the related digital assets that facilitate the data analytics of the sensed and collected personal medical data with visualized interaction of the digital twin of the patient’s body as well as the medical doctors' smart conversation and consultation or even in a guided remote-surgery operation.

Keywords: personal healthcare, metaverse, telemedicine, telepresence, avatar, medical consultation, remote-surgery

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931 Advanced Technologies and Algorithms for Efficient Portfolio Selection

Authors: Konstantinos Liagkouras, Konstantinos Metaxiotis

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In this paper we present a classification of the various technologies applied for the solution of the portfolio selection problem according to the discipline and the methodological framework followed. We provide a concise presentation of the emerged categories and we are trying to identify which methods considered obsolete and which lie at the heart of the debate. On top of that, we provide a comparative study of the different technologies applied for efficient portfolio construction and we suggest potential paths for future work that lie at the intersection of the presented techniques.

Keywords: portfolio selection, optimization techniques, financial models, stochastic, heuristics

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930 Wind Interference Effects on Various Plan Shape Buildings Under Wind Load

Authors: Ritu Raj, Hrishikesh Dubey

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This paper presents the results of the experimental investigations carried out on two intricate plan shaped buildings to evaluate aerodynamic performance of the building. The purpose is to study the associated environment arising due to wind forces in isolated and interference conditions on a model of scale 1:300 with a prototype having 180m height. Experimental tests were carried out at the boundary layer wind tunnel considering isolated conditions with 0° to 180° isolated wind directions and four interference conditions of twin building (separately for both the models). The research has been undertaken in Terrain Category-II, which is the most widely available terrain in India. A comparative assessment of the two models is performed out in an attempt to comprehend the various consequences of diverse conditions that may emerge in real-life situations, as well as the discrepancies amongst them. Experimental results of wind pressure coefficients of Model-1 and Model-2 shows good agreement with various wind incidence conditions with minute difference in the magnitudes of mean Cp. On the basis of wind tunnel studies, it is distinguished that the performance of Model-2 is better than Model-1in both isolated as well as interference conditions for all wind incidences and orientations respectively.

Keywords: interference factor, tall buildings, wind direction, mean pressure-coefficients

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929 Imperatives for Teacher Empowerment in Devising Extension Education as Part of the Holistic Curriculum for Hospitality and Tourism Domains: A Conceptual Study in Indian Context

Authors: Rajiv Mishra, Mantun Kumar Singh

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The role of educator or teacher in the Indian context is circumscribed by the objective of social transformation as articulated in the Indian National Movement and later enshrined in the Preamble to the Indian Constitution, in the Fundamental Rights and in the Directive Principles of State Policy. Extension, which is the additional dimension of professional practice among teachers at higher education can be used as a revolutionary tool to modify the existing slogan of ‘education for all’ to ‘education for all and for-ever’, thereby making the ‘life-long education’, a reality. This conceptual paper addresses the twin needs of preparing the students for individual growth as also to facilitate them to contribute to social development. It focuses on the inclusion of the measures required to be taken for providing social consciousness and sensitivity, as this happens to be a neglected part of the curriculum. The extra effort so needed to build community based activities presupposes the requirement for professional training to be given to the hospitality and tourism educators as a continuing education initiative.

Keywords: continuing education, extension activities, holistic curriculum, hospitality and tourism educators

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928 Evaluation of Cryoablation Procedures in Treatment of Atrial Fibrillation from 3 Years' Experiences in a Single Heart Center

Authors: J. Yan, B. Pieper, B. Bucsky, B. Nasseri, S. Klotz, H. H. Sievers, S. Mohamed

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Cryoablation is evermore applied for interventional treatment of paroxysmal (PAAF) or persistent atrial fibrillation (PEAF). In the cardiac surgery, this procedure is often combined with coronary arterial bypass graft (CABG) and valve operations. Three different methods are feasible in this sense in respect to practicing extents and mechanisms such as lone left atrial cryoablation, Cox-Maze IV and III in our heart center. 415 patients (68 ± 0.8ys, male 68.2%) with predisposed atrial fibrillation who initially required either coronary or valve operations were enrolled and divided into 3 matched groups according to deployed procedures: CryoLA-group (cryoablation of lone left atrium, n=94); Cox-Maze-IV-group (n=93) and Cox-Maze-III-group (n=8). All patients additionally received closure of the left atrial appendage (LAA) and regularly underwent three-year ambulant follow-up assessments (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation were assessed directly by means of cardiac monitor (Reveal XT, Medtronic) or of 3-day Holter electrocardiogram. Herewith, attacks frequencies of AF and their circadian patterns were systemically analyzed. Furthermore, anticoagulants and regular rate-/rhythm-controlling medications were evaluated and listed in terms of anti-rate and anti-rhythm regimens. Concerning PAAF treatment, Cox Maze IV procedure provided therapeutically acceptable effect as lone left atrium (LA) cryoablation did (5.25 ± 5.25% vs. 10.39 ± 9.96% AF-burden, p > 0.05). Interestingly, Cox Maze III method presented a better short-term effect in the PEAF therapy in comparison to lone cryoablation of LA and Cox Maze IV (0.25 ± 0.23% vs. 15.31 ± 5.99% and 9.10 ± 3.73% AF-burden within the first year, p < 0.05). But this therapeutic advantage went lost during ongoing follow-ups (26.65 ± 24.50% vs. 8.33 ± 8.06% and 15.73 ± 5.88% in 3rd follow-up year). In this way, lone LA-cryoablation established its antiarrhythmic efficacy and 69.5% patients were released from the Vit-K-antagonists, while Cox Maze IV liberated 67.2% patients from continuous anticoagulant medication. The AF-recurrences mostly performed such attacks property as less than 60min duration for all 3 procedures (p > 0.05). In the sense of the circadian distribution of the recurrence attacks, weighted by ongoing follow-ups, lone LA cryoablation achieved and stabilized the antiarrhythmic effects over time, which was especially observed in the treatment of PEAF, while Cox Maze IV and III had their antiarrhythmic effects weakened progressively. This phenomenon was likewise evaluable in the therapy of circadian rhythm of reverting AF-attacks. Furthermore, the strategy of rate control was much more often applied to support and maintain therapeutic successes obtained than the one of rhythm control. Derived from experiences in our heart center, lone LA cryoablation presented equivalent effects in the treatment of AF in comparison to Cox Maze IV and III procedures. These therapeutic successes were especially investigable in the patients suffering from persistent AF (PEAF). Additional supportive strategies such as rate control regime should be initialized and implemented to improve the therapeutic effects of the cryoablations according to appropriate criteria.

Keywords: AF-burden, atrial fibrillation, cardiac monitor, COX MAZE, cryoablation, Holter, LAA

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927 Co-Liquefaction of Cellulosic Biomass and Waste Plastics

Authors: Katsumi Hirano, Yusuke Kakuta, Koji Yoshida, Shozo Itagaki, Masahiko Kajioka, Toshihiko Okada

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A conversion technology of cellulosic biomass and waste plastics to liquid fuel at low pressure and low temperature has been investigated. This study aims at the production of the liquefied fuel (CPLF) of substituting diesel oil by mixing cellulosic biomass and waste plastics in the presence of solvent. Co-liquefaction of cellulosic biomass (Japan cedar) and polypropylene (PP) using wood tar or mineral oil as solvent at 673K with an autoclave was carried out. It was confirmed that the co-liquefaction gave CPLF in a high yield among the cases of wood or of polypropylene Which was ascribed the acceleration of decomposition of plastics by radicals derived from the decomposition of wood. The co-liquefaction was also conducted by a small twin screw extruder. It was found that CPLF was obtained in the co-liquefaction, And the acceleration of decomposition of plastics in the presence of cellulosic biomass. The engine test of CPLF showed that the engine performances, Compression ignition and combustion characteristics were almost similar to those of diesel fuel at any mixing ratio of CPLF and any load, Therefore, CPLF could be practically used as alternative fuel for diesel engines.

Keywords: Cellulosic Biomass, Co-liquefaction, Solvent, Waste Plastics

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926 Digital Mapping as a Tool for Finding Cities' DNA

Authors: Sanja Peter

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Transformation of urban environments can be compared to evolutionary processes. Systematic digital mapping of historical data can enable capturing some of these processes and their outcomes. For example, it may help reveal the structure of a city’s historical DNA. Gathering historical data for automatic processing may be giving a basis for cultural algorithms. Gothenburg City museum is trying to make city’s heritage information accessible through GIS-platforms and is now partnering with academic institutions to find appropriate methods to make accessible the knowledge on the city’s historical fabric. Hopefully, this will be carried out through a project called Digital Twin Cities. One part of this large project, concerning matters of Cultural Heritage, will be in collaboration with Chalmers University of Technology. The aim is to create a layered map showing historical developments of the city and extracting quantitative data about its built heritage, above and below the earth. It will allow interpreting the information from historic maps through, for example, names of the streets/places, geography, structural changes in urban fabric and information gathered by archaeologists’ excavations. Through the study of these geographical, historical and local metamorphoses, urban environment will reveal its metaphorical DNA or its MEM (Dawkins).

Keywords: Gothenburg, mapping, cultural heritage, city history

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925 Modified Norhaya Upper Limp Elevation Sling-Quick Approach Ensuring Timely Limb Elevation

Authors: Prem, Norhaya, Vwrene C., Mohammad Harris A., Amarjit, Fazir M.

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Upper limb surgery is a common orthopedic procedure. After surgery, it is necessary to raise the patient's arm to reduce limb swelling and promote recovery. After an injury or surgery, swelling (edema) in the limbs is common. This swelling can be painful, cause stiffness, and affect movement and ability to do daily activities. One of the easiest ways to manage swelling is to elevate the swollen limb. The goal is to elevate the swollen limb slightly above the level of the heart. This helps the extra fluid move back towards the heart for circulation to the rest of the body. Conventional arm sling or pillows are usually placed under the arm to raise it, but in this way the arm cannot be fixed well and easily slide down, without ideal raising effect. Conventional arm sling need experience to tie the sling and this delay in the application process. To reduce the waiting time and cost, modified Norhaya upper limb elevation sling was designed and made readily available. The sling is made from calico fabric, readily available in the ward. Measurements of patients’ arm lengths are obtained, and fabric sizes are cut into the average arm lengths, as well as 1 size above and below. The cut calico fabric is then sewn together with thick sewing threads. Its application is easy and junior most staff or doctor will be able to apply it on patient. The time taken to set up the sling is also reduced. Feedback gathered from ground staff regarding ease of setting up the sling was tremendous and patient also feel comfort in the modified Norhaya sling. The device can freely adjust the raising height of the affected limb and effectively fix the affected limb to reduce its swelling, thus promoting recovery. This device is worthy to be clinically popularized and applied. The Modified Norhaya upper limb elevation sling is the quickest to set up and the delay in elevating the patient’s hand is significantly reduced. Moreover, it is reproducible and there is also significant cost savings.

Keywords: elevate, effective, sling, timely

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924 Sex Differences in Age-Related AMPK-Sirt1 Axis Alteration in Human Heart

Authors: Maria Luisa Barcena De Arellano, Sofya Pozdniakova, Pavelas Karkacas, Anja Kuhl, Istvan Baczko, Yury Ladilov, Vera Regitz-Zagrosek

Abstract:

Introduction: Aging is associated with deterioration of the physiological function, leading to systemic inflammation and mitochondrial dysfunction that promote the development of cardiovascular diseases. Sex differences in aging-related cardiovascular diseases have been postulated. However, their precise mechanisms remain unclear. In the current study, we aimed to investigate the sex difference in the age-related alteration in Sirt1-AMPK signaling and its relation to the mitochondrial biogenesis and inflammation. Methods: Male and female human non-disease lateral left ventricular wall tissue (young (17–40 years; n= 7 male and 7 female) and old (50–68 years; n= 9 male and 8 female)) were used. qRT-PCR, western blot and immunohistochemistry assays were performed for expression analyses of Sirt1, AMPK, pAMPK, ac-Ku70, TFAM, PGC-1α, Sirt3, SOD2 and catalase. CD68 was used as a marker for macrophages and the ratio of IL-12:IL10 (pro-inflammatory phenotype (high IL-12/low IL-10) and anti-inflammatory phenotype (low IL-12/high IL-10) was used to examine the inflammatory stage in the heart. Results: Sirt1 expression was significantly higher in young females compared to young males, whereas in aged hearts Sirt1 expression was significantly downregulated in females, but not in males. In line with the Sirt1 downregulation in aged females, acetylation of nuclear Ku70, a direct target of Sirt1, in aged female hearts was significantly elevated. The activity of AMPK was significantly decreased in aged individuals, however no sex differences in the AMPK expression or activity were found in young or old individuals. The expression of mitochondrial proteins TOM40, SOD2 and Sirt3 was significantly higher in young females compared to young males, while in aged female hearts SOD2 and TOM40 were downregulated. In addition, the expression of catalase, a key cytosolic and mitochondrial anti-oxidative enzyme was significantly higher in young females and this female sex benefit was lost in aged hearts. In addition, the number of cardiac macrophages was significantly increased in old female, but not in male hearts. Consistently, the pro-inflammatory shift in old females was further confirmed by differences in the IL12/IL10 ratio in young female cardiac tissue in a favour of the anti-inflammatory mediator IL-10 (ratio 1:4) compared to young males (ratio 1:1). The anti-inflammatory environment in the heart was lost in aged females (ratio 1:1). Conclusion: Aging leads to the significant downregulation of Sirt1 expression and elevated acetylation of Ku70 in female, but not in male hearts. Furthermore, a beneficial upregulation of mitochondrial and anti-oxidative proteins in young females is lost with aging. Moreover, the malfunctions in the expression of Sirt1 and mitochondrial proteins in aged female hearts is accompanied by a significant pro-inflammatory shift. The study provides a molecular basis for the increased incidence of cardiovascular diseases in old women.

Keywords: inflammation, mitochondrial dysfunction, aging, Sirt1-AMPK axis

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923 Hydration Matters: Impact on 3 km Running Performance in Trained Male Athletes Under Heat Conditions

Authors: Zhaoqi He

Abstract:

Research Context: Endurance performance in hot environments is influenced by the interplay of hydration status and physiological responses. This study aims to investigate how dehydration, up to 2.11% body weight loss, affects the 3 km running performance of trained male athletes under conditions mimicking high temperatures. Methodology: In a randomized crossover design, five male athletes participated in two trials – euhydrated (EU) and dehydrated (HYPO). Both trials included a 70-minute preload run at 55-60% VO2max in 32°C and 50% humidity, followed by a 3-kilometer time trial. Fluid intake was restricted in HYPO to induce a 2.11% body weight loss. Physiological metrics, including heart rate, core temperature, and oxygen uptake, were measured, along with perceptual metrics like perceived exertion and thirst sensation. Findings: The 3-kilometer run completion times showed no significant differences between EU and HYPO trials (p=0.944). Physiological indicators, including heart rate, core temperature, and oxygen uptake, did not significantly vary (p>0.05). Thirst sensation was markedly higher in HYPO (p=0.013), confirming successful induction of dehydration. Other perceptual metrics and gastrointestinal comfort remained consistent. Conclusion: Contrary to the hypothesis, the study reveals that dehydration, inducing up to 2.11% body weight loss, does not significantly impair 3 km running performance in trained male athletes under hot conditions. Thirst sensation was notably higher in the dehydrated state, emphasizing the importance of considering perceptual factors in hydration strategies. The findings suggest that trained runners can maintain performance despite moderate dehydration, highlighting the need for nuanced hydration guidelines in hot-weather running.

Keywords: hypohydration, euhydration, hot environment, 3km running time trial, endurance performance, trained athletes, perceptual metrics, dehydration impact, physiological responses, hydration strategies

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922 Heart-Rate Variability Moderates the Relation between Life Threatening Events and Cancer-Development: Making Cancer Less “Vague”

Authors: Yori Gidron, Laura Caton, Irit Ben-Aharon

Abstract:

Background: Many patients and even certain clinicians attribute cancer development to psychosocial factors. Yet, empirical data supports more the prognostic role, rather than the etiological role, of psychosocial factors in cancer. Part of the inconsistency may result from not considering possible moderating factors in the etiological role of psychosocial factors. One important candidate moderating factor is the vagal nerve, whose activity is indexed by heart-rate variability (HRV). The vagal nerve may prevent cancer since it reduces inflammation on the one hand, and since it increases anti-tumor immunity on the other hand. This study examined the moderating role of the vagus in the relation between life threatening events (LTE) and cancer development. Method: We re-analyzed data from the Lifelines Dutch longitudinal cohort study of over 150,000 people. The present study included 82,751 adults, who initially were cancer-free. We extracted information on background factors (e.g., age, gender, fat consumption), whether they ever experienced LTE, HRV and cancer diagnosis as reported by patients in annual clinic visits. HRV was derived from brief ECGs. Results: Of the full sample, 1011 people developed cancer during a follow-up. In the full sample, LTE significantly predicted cancer development (R.R = 1.063 p < .01) and HRV significantly predicted a reduced risk of cancer development (R.R = .506 p <.001). Importantly, LTE significantly predicted cancer only when HRV was low (R.R = 1.056, 95% CI: 1.007 - 1.108, p < .05) but not when HRV was high (R.R = 1.014; 95% CI: 0.916 - 1.122, p > 0.05), independent of confounders. Conclusions: To the best of our knowledge, this is the first study showing in a large sample that LTE predict cancer development, and that this occurs only when vagal nerve activity (HRV) is relatively low. These results could result from lack of vagal modulation of inflammation and also from lack of vagal modulation of stress responses. Results are in line with the cancer-protective role of the vagus. HRV needs to be routinely monitored in the population and future intervention trials need to examine whether vagal nerve activation can prevent cancer in people with LTE and with other cancer risk factors.

Keywords: cancer development, life-events, moderation, vagal nerve

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921 Effect of Noise at Different Frequencies on Heart Rate Variability - Experimental Study Protocol

Authors: A. Bortkiewcz, A. Dudarewicz, P. Małecki, M. Kłaczyński, T. Wszołek, Małgorzata Pawlaczyk-Łuszczyńska

Abstract:

Low-frequency noise (LFN) has been recognized as a special environmental pollutant. It is usually considered a broadband noise with the dominant content of low frequencies from 10 Hz to 250 Hz. A growing body of data shows that LFN differs in nature from other environmental noises, which are at comparable levels but not dominated by low-frequency components. The primary and most frequent adverse effect of LFN exposure is annoyance. Moreover, some recent investigations showed that LFN at relatively low A-weighted sound pressure levels (40−45 dB) occurring in office-like areas could adversely affect the mental performance, especially of high-sensitive subjects. It is well documented that high-frequency noise disturbs various types of human functions; however, there is very little data on the impact of LFN on well-being and health, including the cardiovascular system. Heart rate variability (HRV) is a sensitive marker of autonomic regulation of the circulatory system. Walker and co-workers found that LFN has a significantly more negative impact on cardiovascular response than exposure to high-frequency noise and that changes in HRV parameters resulting from LFN exposure tend to persist over time. The negative reactions of the cardiovascular system in response to LFN generated by wind turbines (20-200 Hz) were confirmed by Chiu. The scientific aim of the study is to assess the relationship between the spectral-temporal characteristics of LFN and the activity of the autonomic nervous system, considering the subjective assessment of annoyance, sensitivity to this type of noise, and cognitive and general health status. The study will be conducted in 20 male students in a special, acoustically prepared, constantly supervised room. Each person will be tested 4 times (4 sessions), under conditions of non-exposure (sham) and exposure to noise of wind turbines recorded at a distance of 250 meters from the turbine with different frequencies and frequency ranges: acoustic band 20 Hz-20 kHz, infrasound band 5-20 Hz, acoustic band + infrasound band. The order of sessions of the experiment will be randomly selected. Each session will last 1 h. There will be a 2-3 days break between sessions to exclude the possibility of the earlier session influencing the results of the next one. Before the first exposure, a questionnaire will be conducted on noise sensitivity, general health status using the GHQ questionnaire, hearing organ status and sociodemographic data. Before each of the 4 exposures, subjects will complete a brief questionnaire on their mood and sleep quality the night before the test. After the test, the subjects will be asked about any discomfort and subjective symptoms during the exposure. Before the test begins, Holter ECG monitoring equipment will be installed. HRV will be analyzed from the ECG recordings, including time and frequency domain parameters. The tests will always be performed in the morning (9-12) to avoid the influence of diurnal rhythm on HRV results. Students will perform psychological tests 15 minutes before the end of the test (Vienna Test System).

Keywords: neurovegetative control, heart rate variability (HRV), cognitive processes, low frequency noise

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920 Implementation of a Multidisciplinary Weekly Safety Briefing in a Tertiary Paediatric Cardiothoracic Transplant Unit

Authors: Lauren Dhugga, Meena Parameswaran, David Blundell, Abbas Khushnood

Abstract:

Context: A multidisciplinary weekly safety briefing was implemented at the Paediatric Cardiothoracic Unit at the Freeman Hospital in Newcastle-upon-Tyne. It is a tertiary referral centre with a quarternary cardiac paediatric intensive care unit and provides complexed care including heart and lung transplants, mechanical support and advanced heart failure assessment. Aim: The aim of this briefing is to provide a structured platform of communication, in an effort to improve efficiency, safety, and patient care. Problem: The paediatric cardiothoracic unit is made up of a vast multidisciplinary team including doctors, intensivists, anaesthetists, surgeons, specialist nurses, echocardiogram technicians, physiotherapists, psychologists, dentists, and dietitians. It provides care for children with congenital and acquired cardiac disease and is one of only two units in the UK to offer paediatric heart transplant. The complexity of cases means that there can be many teams involved in providing care to each patient, and frequent movement of children between ward, high dependency, and intensive care areas. Currently, there is no structured forum for communicating important information across the department, for example, staffing shortages, prescribing errors and significant events. Strategy: An initial survey questioning the need for better communication found 90% of respondents agreed that they could think of an incident that had occurred due to ineffective communication, and 85% felt that incident could have been avoided had there been a better form of communication. Lastly, 80% of respondents felt that a weekly 60 second safety briefing would be beneficial to improve communication within our multidisciplinary team. Based on those promising results, a weekly 60 second safety briefing was implemented to be conducted on a Monday morning. The safety briefing covered four key areas (SAFE): staffing, awareness, fix and events. This was to highlight any staffing gaps, any incident reports to be learned from, any issues that required fixing and any events including teachings for the week ahead. The teams were encouraged to email suggestions or issues to be raised for the week or to approach in person with information to add. The safety briefing was implemented using change theory. Effect: The safety briefing has been trialled over 6 weeks and has received a good buy in from staff across specialties. The aim is to embed this safety briefing into a weekly meeting using the PDSA cycle. There will be a second survey in one month to assess the efficacy of the safety briefing and to continue to improve the delivery of information. The project will be presented at the next clinical governance briefing to attract wider feedback and input from across the trust. Lessons: The briefing displays promise as a tool to improve vigilance and communication in a busy multi-disciplinary unit. We have learned about how to implement quality improvement and about the culture of our hospital - how hierarchy influences change. We demonstrate how to implement change through a grassroots process, using a junior led briefing to improve the efficiency, safety, and communication in the workplace.

Keywords: briefing, communication, safety, team

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919 A Study of Indoor Radon, Thoron, Their Progeny Concentration Levels and Inhalation Dose in Dwellings of Different Districts of Punjab State, India

Authors: Komal Saini, B. K. Sahoo, B.S. Bajwa

Abstract:

In the present study, indoor radon and thoron concentrations have been estimated using newly developed twin cup based pin hole dosimeter with single entry face in some areas of Punjab state, India. The equilibrium equivalent concentration (EEC) of radon and thoron has also been estimated directly by using progeny sensors, fabricated by BARC, India. Observed radon and thoron concentrations varied from 38.7±5.79 to 98.7±13.11 Bq/m3 and 25.38±6.56 to 126.56±14.23 Bq/m3 with an average value of 61.59±8.11 & 70.89±9.52 Bq/m3 respectively. Average equilibrium equivalent concentration of radon and thoron was 27.98±4.66 & 2.24±0.61 Bq/m3. Calculated equilibrium factor for radon and thoron was 0.467 and 0.034 in the present study. Annual inhalation dose calculated from the present observed concentrations, varied from 1.80 to 3.60 mSv/year with an average value of 2.52 mSv/year, which is well within reference level. It has been observed from the present study that thoron is a significant contributor to the inhalation dose which is about 25% of the total inhalation dose.

Keywords: radon, thoron, pin hole cup dosimeter, DTPS/DRPS, annual inhalation dose

Procedia PDF Downloads 239
918 Effectiveness of Prehabilitation on Improving Emotional and Clinical Recovery of Patients Undergoing Open Heart Surgeries

Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

Abstract:

Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

Procedia PDF Downloads 193
917 Wave Interaction with Single and Twin Vertical and Sloped Porous Walls

Authors: Mohamad Alkhalidi, S. Neelamani, Noor Alanjari

Abstract:

The main purpose of harbors and marinas is to create a calm and safe docking space for marine vessels. Standard rubble mound breakwaters, although widely used, occupy port space and require large amounts of stones or rocks. Kuwait does not have good quality stone, so they are imported at a very high cost. Therefore, there is a need for a new wave energy dissipating structure where stones and rocks are scarce. While permeable slotted vertical walls have been proved to be a suitable alternative to rubble mound breakwaters, the introduction of sloped slotted walls may be more efficient in dissipating wave energy. For example, two slotted barriers with 60degree inclination may be equivalent to three vertical slotted barriers from wave energy dissipation point of view. A detailed physical model study is carried out to determine the effects of slope angle, porosity, and a number of walls on wave energy dissipation for a wide range of random and regular waves. The results of this study can be used to improve and optimize energy dissipation and reduce construction cost.

Keywords: porosity, slope, wave reflection, wave transmission

Procedia PDF Downloads 281
916 Relationship between Left Ventricle Position and Hemodynamic Parameters during Cardiopulmonary Resuscitation in a Pig Model

Authors: Hyun Chang Kim, Yong Hun Jung, Kyung Woon Jeung

Abstract:

Background: From the viewpoint of cardiac pump theory, the area of the left ventricle (LV) subjected to compression increases as the LV lies closer to the sternum, possibly resulting in higher blood flow in patients with LV closer to the sternum. However, no study has evaluated LV position during cardiac arrest or its relationship with hemodynamic parameters during cardiopulmonary resuscitation (CPR). The objectives of this study were to determine whether the position of the LV relative to the anterior-posterior axis representing the direction of chest compression shifts during cardiac arrest and to examine the relationship between LV position and hemodynamic parameters during CPR. Methods: Subcostal view echocardiograms were obtained from 15 pigs with the transducer parallel to the long axis of the sternum before inducing ventricular fibrillation (VF) and during cardiac arrest. Computed tomography was performed in three pigs to objectively observe LV position during cardiac arrest. LV position parameters including the shortest distance between the anterior-posterior axis and the mid-point of the LV chamber (DAP-MidLV), the shortest distance between the anterior-posterior axis and the LV apex (DAP-Apex), and the area fraction of the LV located on the right side of the anterior-posterior axis (LVARight/LVATotal) were measured. Results: DAP-MidLV, DAP-Apex, and LVARight/LVATotal decreased progressively during untreated VF and basic life support (BLS), and then increased during advanced cardiovascular life support (ACLS). A repeated measures analysis of variance revealed significant time effects for these parameters. During BLS, the end-tidal carbon dioxide and systolic right atrial pressure were significantly correlated with the LV position parameters. During ACLS, systolic arterial pressure and systolic right atrial pressure were significantly correlated with DAP-MidLV and DAP-Apex. Conclusions: LV position changed significantly during cardiac arrest compared to the pre-arrest baseline. LV position during CPR had significant correlations with hemodynamic parameters.

Keywords: heart arrest, cardiopulmonary resuscitation, heart ventricle, hemodynamics

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915 Blood Flow Estimator of the Left Ventricular Assist Device Based in Look-Up-Table: In vitro Tests

Authors: Tarcisio F. Leao, Bruno Utiyama, Jeison Fonseca, Eduardo Bock, Aron Andrade

Abstract:

This work presents a blood flow estimator based in Look-Up-Table (LUT) for control of Left Ventricular Assist Device (LVAD). This device has been used as bridge to transplantation or as destination therapy to treat patients with heart failure (HF). Destination Therapy application requires a high performance LVAD; thus, a stable control is important to keep adequate interaction between heart and device. LVAD control provides an adequate cardiac output while sustaining an appropriate flow and pressure blood perfusion, also described as physiologic control. Because thrombus formation and system reliability reduction, sensors are not desirable to measure these variables (flow and pressure blood). To achieve this, control systems have been researched to estimate blood flow. LVAD used in the study is composed by blood centrifugal pump, control, and power supply. This technique used pump and actuator (motor) parameters of LVAD, such as speed and electric current. Estimator relates electromechanical torque (motor or actuator) and hydraulic power (blood pump) via LUT. An in vitro Mock Loop was used to evaluate deviations between blood flow estimated and actual. A solution with glycerin (50%) and water was used to simulate the blood viscosity with hematocrit 45%. Tests were carried out with variation hematocrit: 25%, 45% and 58% of hematocrit, or 40%, 50% and 60% of glycerin in water solution, respectively. Test with bovine blood was carried out (42% hematocrit). Mock Loop is composed: reservoir, tubes, pressure and flow sensors, and fluid (or blood), beyond LVAD. Estimator based in LUT is patented, number BR1020160068363, in Brazil. Mean deviation is 0.23 ± 0.07 L/min for mean flow estimated. Larger mean deviation was 0.5 L/min considering hematocrit variation. This estimator achieved deviation adequate for physiologic control implementation. Future works will evaluate flow estimation performance in control system of LVAD.

Keywords: blood pump, flow estimator, left ventricular assist device, look-up-table

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