Search results for: hypotenuse leg difference method
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21966

Search results for: hypotenuse leg difference method

13986 A Cross-Sectional Study on the Correlation between Body Mass Index and Self-Esteem among Children Ages 9-12 Years Old in a Public Elementary School in Makati, Philippines

Authors: Jerickson Abbie Flores, Jana Fragante, Jan Paolo Dipasupil, Jan Jorge Francisco

Abstract:

Malnutrition is one of the rapidly growing health problems affecting the world at present. Children affected are not only at risk for significant health problems, but are also faced with psychological and social consequences, including low self-esteem. School-age children are specifically vulnerable to develop poor self-esteem especially when their peers find them physically unattractive. Thus, malnutrition, whether obesity or undernourishment, contributes a significant role to a developing child’s health and behavior. This research aims to determine if there is a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) and those children with desirable BMI. Using a cross-sectional study design, the correlation between body mass index (BMI) and self-esteem was observed among children ages 9-12 years old. Participants took the Hare self esteem questionnaire, which is specifically designed to measure self-esteem in school age children. The lowest possible score is 15 and the highest possible score is 45. A total of 1140 students with ages 9-12 years old from Cembo Elementary School (public school) participated in the study. Among the participants, 239 out of the 1140 have desirable body mass index, 878 are underweight, and 23 are overweight. Using the test questionnaire, the computed mean scores were 36.599, 36.045 and 36.583 for normal, underweight and overweight categories respectively. Using Pearson’s Correlation Test and Spearman’s Correlation Coefficient Test, the study showed positive correlation (p value of 0.047 and 0.004 respectively) between BMI and Self-esteem scores which indicates that the higher the BMI, the higher the self-esteem of the participants.

Keywords: body mass index, malnutrition, school-age children, self-esteem

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13985 Molecular Dynamics Simulation for Vibration Analysis at Nanocomposite Plates

Authors: Babak Safaei, A. M. Fattahi

Abstract:

Polymer/carbon nanotube nanocomposites have a wide range of promising applications Due to their enhanced properties. In this work, free vibration analysis of single-walled carbon nanotube-reinforced composite plates is conducted in which carbon nanotubes are embedded in an amorphous polyethylene. The rule of mixture based on various types of plate model namely classical plate theory (CLPT), first-order shear deformation theory (FSDT), and higher-order shear deformation theory (HSDT) was employed to obtain fundamental frequencies of the nanocomposite plates. Generalized differential quadrature (GDQ) method was used to discretize the governing differential equations along with the simply supported and clamped boundary conditions. The material properties of the nanocomposite plates were evaluated using molecular dynamic (MD) simulation corresponding to both short-(10,10) SWCNT and long-(10,10) SWCNT composites. Then the results obtained directly from MD simulations were fitted with those calculated by the rule of mixture to extract appropriate values of carbon nanotube efficiency parameters accounting for the scale-dependent material properties. The selected numerical results are presented to address the influences of nanotube volume fraction and edge supports on the value of fundamental frequency of carbon nanotube-reinforced composite plates corresponding to both long- and short-nanotube composites.

Keywords: nanocomposites, molecular dynamics simulation, free vibration, generalized, differential quadrature (GDQ) method

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13984 The Development of Space-Time and Space-Number Associations: The Role of Non-Symbolic vs. Symbolic Representations

Authors: Letizia Maria Drammis, Maria Antonella Brandimonte

Abstract:

The idea that people use space representations to think about time and number received support from several lines of research. However, how these representations develop in children and then shape space-time and space-number mappings is still a debated issue. In the present study, 40 children (20 pre-schoolers and 20 elementary-school children) performed 4 main tasks, which required the use of more concrete (non-symbolic) or more abstract (symbolic) space-time and space-number associations. In the non-symbolic conditions, children were required to order pictures of everyday-life events occurring in a specific temporal order (Temporal sequences) and of quantities varying in numerosity (Numerical sequences). In the symbolic conditions, they were asked to perform the typical time-to-position and number-to-position tasks by mapping time-related words and numbers onto lines. Results showed that children performed reliably better in the non-symbolic Time conditions than the symbolic Time conditions, independently of age, whereas only pre-schoolers performed worse in the Number-to-position task (symbolic) as compared to the Numerical sequence (non-symbolic) task. In addition, only older children mapped time-related words onto space following the typical left-right orientation, pre-schoolers’ performance being somewhat mixed. In contrast, mapping numbers onto space showed a clear left-right orientation, independently of age. Overall, these results indicate a cross-domain difference in the way younger and older children process time and number, with time-related tasks being more difficult than number-related tasks only when space-time tasks require symbolic representations.

Keywords: space-time associations, space-number associations, orientation, children

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13983 Modelling Flood Events in Botswana (Palapye) for Protecting Roads Structure against Floods

Authors: Thabo M. Bafitlhile, Adewole Oladele

Abstract:

Botswana has been affected by floods since long ago and is still experiencing this tragic event. Flooding occurs mostly in the North-West, North-East, and parts of Central district due to heavy rainfalls experienced in these areas. The torrential rains destroyed homes, roads, flooded dams, fields and destroyed livestock and livelihoods. Palapye is one area in the central district that has been experiencing floods ever since 1995 when its greatest flood on record occurred. Heavy storms result in floods and inundation; this has been exacerbated by poor and absence of drainage structures. Since floods are a part of nature, they have existed and will to continue to exist, hence more destruction. Furthermore floods and highway plays major role in erosion and destruction of roads structures. Already today, many culverts, trenches, and other drainage facilities lack the capacity to deal with current frequency for extreme flows. Future changes in the pattern of hydro climatic events will have implications for the design and maintenance costs of roads. Increase in rainfall and severe weather events can affect the demand for emergent responses. Therefore flood forecasting and warning is a prerequisite for successful mitigation of flood damage. In flood prone areas like Palapye, preventive measures should be taken to reduce possible adverse effects of floods on the environment including road structures. Therefore this paper attempts to estimate return periods associated with huge storms of different magnitude from recorded historical rainfall depth using statistical method. The method of annual maxima was used to select data sets for the rainfall analysis. In the statistical method, the Type 1 extreme value (Gumbel), Log Normal, Log Pearson 3 distributions were all applied to the annual maximum series for Palapye area to produce IDF curves. The Kolmogorov-Smirnov test and Chi Squared were used to confirm the appropriateness of fitted distributions for the location and the data do fit the distributions used to predict expected frequencies. This will be a beneficial tool for urgent flood forecasting and water resource administration as proper drainage design will be design based on the estimated flood events and will help to reclaim and protect the road structures from adverse impacts of flood.

Keywords: drainage, estimate, evaluation, floods, flood forecasting

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13982 Iterative Method for Lung Tumor Localization in 4D CT

Authors: Sarah K. Hagi, Majdi Alnowaimi

Abstract:

In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.

Keywords: automated algorithm , computed tomography, lung tumor, tumor localization

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13981 Anemia Among Pregnant Women in Kuwait: Findings from Kuwait Birth Cohort Study

Authors: Majeda Hammoud

Abstract:

Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

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13980 A Dual Spark Ignition Timing Influence for the High Power Aircraft Radial Engine Using a CFD Transient Modeling

Authors: Tytus Tulwin, Ksenia Siadkowska, Rafał Sochaczewski

Abstract:

A high power radial reciprocating engine is characterized by a large displacement volume of a combustion chamber. Choosing the right moment for ignition is important for a high performance or high reliability and ignition certainty. This work shows methods of simulating ignition process and its impact on engine parameters. For given conditions a flame speed is limited when a deflagration combustion takes place. Therefore, a larger length scale of the combustion chamber compared to a standard size automotive engine makes combustion take longer time to propagate. In order to speed up the mixture burn-up time the second spark is introduced. The transient Computational Fluid Dynamics model capable of simulating multicycle engine processes was developed. The CFD model consists of ECFM-3Z combustion and species transport models. A relative ignition timing difference for the both spark sources is constant. The temperature distribution on engine walls was calculated in the separate conjugate heat transfer simulation. The in-cylinder pressure validation was performed for take-off power flight conditions. The influence of ignition timing on parameters like in-cylinder temperature or rate of heat release was analyzed. The most advantageous spark timing for the highest power output was chosen. The conditions around the spark plug locations for the pre-ignition period were analyzed. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: CFD, combustion, ignition, simulation, timing

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13979 Cognitive Effects of Repetitive Transcranial Magnetic Stimulation in Patients with Parkinson's Disease

Authors: Ana Munguia, Gerardo Ortiz, Guadalupe Gonzalez, Fiacro Jimenez

Abstract:

Parkinson's disease (PD) is a neurodegenerative disorder that causes motor and cognitive symptoms. The first-choice treatment for these patients is pharmacological, but this generates several side effects. Because of that new treatments were introduced such as Repetitive Transcranial Magnetic Stimulation (rTMS) in order to improve the life quality of the patients. Several studies suggest significant changes in motor symptoms. However, there is a great diversity in the number of pulses, amplitude, frequency and stimulation targets, which results in inconsistent data. In addition, these studies do not have an analysis of the neuropsychological effects of the treatment. The main purpose of this study is to evaluate the impact of rTMS on the cognitive performance of 6 patients with H&Y III and IV (45-65 years, 3 men and 3 women). An initial neuropsychological and neurological evaluation was performed. Patients were randomized into two groups; in the first phase one received rTMS in the supplementary motor area, the other group in the dorsolateral prefrontal cortex contralateral to the most affected hemibody. In the second phase, each group received the stimulation in the area that he had not been stimulated previously. Reassessments were carried out at the beginning, at the end of each phase and a follow-up was carried out 6 months after the conclusion of the stimulation. In these preliminary results, it is reported that there's no statistically significant difference before and after receiving rTMS in the neuropsychological test scores of the patients, which suggests that the cognitive performance of patients is not detrimental. There are even tendencies towards an improvement in executive functioning after the treatment. What added to motor improvement, showed positive effects in the activities of the patients' daily life. In a later and more detailed analysis, will be evaluated the effects in each of the patients separately in relation to the functionality of the patients in their daily lives.

Keywords: Parkinson's disease, rTMS, cognitive, treatment

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13978 The Interaction between Blood-Brain Barrier and the Cerebral Lymphatics Proposes Therapeutic Method for Alzheimer’S Disease

Authors: M. Klimova, O. Semyachkina-Glushkovskaya, J. Kurts, E. Zinchenko, N. Navolokin, A. Shirokov, A. Dubrovsky, A. Abdurashitov, A. Terskov, A. Mamedova, I. Agranovich, T. Antonova, I. Blokhina

Abstract:

The direction for research of Alzheimer's disease is to find an effective non-invasive and non-pharmacological way of treatment. Here we tested our hypothesis that the opening of the blood-brain barrier (BBB) induces activation of lymphatic drainage and clearing functions that can be used as a method for non-invasive stimulation of clearance of beta-amyloid and therapy of Alzheimer’s disease (AD). To test our hypothesis, in this study on healthy male mice we analyzed the interaction between BBB opening by repeated loud music (100-10000 Hz, 100 dB, duration 2 h: 60 sec – sound; 60 sec - pause) and functional changes in the meningeal lymphatic vessels (MLVs). We demonstrate clearance of dextran 70 kDa (i.v. injection), fluorescent beta-amyloid (intrahippocampal injection) and gold nanorods (intracortical injection) via MLV that significantly increased after the opening of BBB. Our studies also demonstrate that the BBB opening was associated with the improvement of neurocognitive status in mice with AD. Thus, we uncover therapeutic effects of BBB opening by loud music, such as non-invasive stimulation of lymphatic clearance of beta-amyloid in mice with AD, accompanied by improvement of their neurocognitive status. Our data are consistent with other results suggesting the therapeutic effect of BBB opening by focused ultrasound without drugs for patients with AD. This research was supported by a grant from RSF 18-75-10033

Keywords: Alzheimer's disease, beta-amyloid, blood-brain barrier, meningeal lymphatic vessels, repeated loud music

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13977 Structural Health Monitoring Method Using Stresses Occurring on Bridge Bearings Under Temperature

Authors: T. Nishido, S. Fukumoto

Abstract:

The functions of movable bearings decline due to corrosion and sediments. As the result, they cannot move or rotate according to the behaviors of girders. Because of the constraints, the bending moments are generated by the horizontal reaction forces and the heights of girders. Under these conditions, the authors obtained the following results by analysis and experiment. Tensile stresses due to the moments occurred at temperature fluctuations. The large tensile stresses on concrete slabs around the bearings caused cracks. Even if concrete slabs are newly replaced, cracks will come out again with function declined bearings. The functional declines of bearings are generally found by using displacement gauges. However the method is not suitable for long-term measurements. We focused on the change in the strains at the bearings and the lower flanges near them at temperature fluctuations. It was found that their strains were particularly large when the movements of the bearings were constrained. Therefore, we developed a long-term health monitoring wireless system with FBG (Fiber Bragg Grating) sensors which were attached to bearings and lower flanges. The FBG sensors have the characteristics such as non-electrical influence, resistance to weather, and high strain sensitivity. Such characteristics are suitable for long-term measurements. The monitoring system was inexpensive because it was limited to the purpose of measuring strains and temperature. Engineers can monitor the behaviors of bearings in real time with the wireless system. If an office is away from bridge sites, the system will save traveling time and cost.

Keywords: bridge bearing, concrete slab,  FBG sensor, health monitoring

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13976 Particle Size Dependent Magnetic Properties of CuFe2O4 Spinel Ferrite Nanoparticles Synthesized by Starch-Assisted Sol-Gel Auto-Combustion Method

Authors: R. S. Yadav, J. Havlica, I. Kuřitka, Z. Kozakova, J. Masilko, L. Kalina, M. Hajdúchová, V. Enev, J. Wasserbauer

Abstract:

In this work, copper ferrite CuFe2O4 spinel ferrite nanoparticles with different particle size at different annealing temperature were synthesized using the starch-assisted sol-gel auto-combustion method. The synthesized nanoparticles were characterized by conventional powder X-ray diffraction (XRD) spectroscopy, Raman Spectroscopy, Fourier Transform Infrared Spectroscopy, Field-Emission Scanning Electron Microscopy, X-ray Photoelectron Spectroscopy, and Vibrating Sample Magnetometer. The XRD patterns confirmed the formation of CuFe2O4 spinel ferrite nanoparticles. Field-Emission Scanning Electron Microscopy revealed that particles are of spherical morphology with particle size 5-20 nm at lower annealing temperature. An infrared spectroscopy study showed the presence of two principal absorption bands in the frequency range around 530 cm-1 (ν1) and around 360 cm-1 (ν2); which indicate the presence of tetrahedral and octahedral group complexes, respectively, within the spinel ferrite nanoparticles. Raman spectroscopy study also indicated the change in octahedral and tetrahedral site related Raman modes in copper ferrite nanoparticles with change of particle size. This change in magnetic behavior with change of particle size of CuFe2O4 nanoparticles was also observed. The change in magnetic properties with change of particle size is due to cation redistribution, which was confirmed by X-Ray photoelectron study.

Keywords: copper ferrite, nanoparticles, magnetic property, CuFe2O4

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13975 Chaotic Electronic System with Lambda Diode

Authors: George Mahalu

Abstract:

The Chua diode has been configured over time in various ways, using electronic structures like as operational amplifiers (OAs) or devices with gas or semiconductors. When discussing the use of semiconductor devices, tunnel diodes (Esaki diodes) are most often considered, and more recently, transistorized configurations such as lambda diodes. The paper-work proposed here uses in the modeling a lambda diode type configuration consisting of two Junction Field Effect Transistors (JFET). The original scheme is created in the MULTISIM electronic simulation environment and is analyzed in order to identify the conditions for the appearance of evolutionary unpredictability specific to nonlinear dynamic systems with chaos-induced behavior. The chaotic deterministic oscillator is one autonomous type, a fact that places it in the class of Chua’s type oscillators, the only significant and most important difference being the presence of a nonlinear device like the one mentioned structure above. The chaotic behavior is identified both by means of strange attractor-type trajectories and visible during the simulation and by highlighting the hypersensitivity of the system to small variations of one of the input parameters. The results obtained through simulation and the conclusions drawn are useful in the further research of ways to implement such constructive electronic solutions in theoretical and practical applications related to modern small signal amplification structures, to systems for encoding and decoding messages through various modern ways of communication, as well as new structures that can be imagined both in modern neural networks and in those for the physical implementation of some requirements imposed by current research with the aim of obtaining practically usable solutions in quantum computing and quantum computers.

Keywords: chaos, lambda diode, strange attractor, nonlinear system

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13974 Theoretical Modal Analysis of Freely and Simply Supported RC Slabs

Authors: M. S. Ahmed, F. A. Mohammad

Abstract:

This paper focuses on the dynamic behavior of reinforced concrete (RC) slabs. Therefore, the theoretical modal analysis was performed using two different types of boundary conditions. Modal analysis method is the most important dynamic analyses. The analysis would be modal case when there is no external force on the structure. By using this method in this paper, the effects of freely and simply supported boundary conditions on the frequencies and mode shapes of RC square slabs are studied. ANSYS software was employed to derive the finite element model to determine the natural frequencies and mode shapes of the slabs. Then, the obtained results through numerical analysis (finite element analysis) would be compared with an exact solution. The main goal of the research study is to predict how the boundary conditions change the behavior of the slab structures prior to performing experimental modal analysis. Based on the results, it is concluded that simply support boundary condition has obvious influence to increase the natural frequencies and change the shape of mode when it is compared with freely supported boundary condition of slabs. This means that such support conditions have direct influence on the dynamic behavior of the slabs. Thus, it is suggested to use free-free boundary condition in experimental modal analysis to precisely reflect the properties of the structure. By using free-free boundary conditions, the influence of poorly defined supports is interrupted.

Keywords: natural frequencies, mode shapes, modal analysis, ANSYS software, RC slabs

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13973 Study on Temperature Distribution throughout the Continuous Casting Process of Copper Magnesium Alloys

Authors: Paweł Strzępek, Małgorzata Zasadzińska, Szymon Kordaszewski, Wojciech Ściężor

Abstract:

The constant tendency toward the materials properties improvement nowadays creates opportunities for the scientists, and furthermore the manufacturers all over the world to design, form and produce new alloys almost every day. Considering the fact that companies all over the world look for alloys with the highest values of mechanical properties coexisting with a reasonable electrical conductivity made it necessary to develop new materials based on copper, such as copper magnesium alloys with over 2 wt. % of Mg. Though, before such new material may be mass produced it must undergo a series of tests in order to determine the production technology and its parameters. The presented study is based on the numerical simulations calculated with the use of finite element method analysis, where the geometry of the cooling system, the material used to produce the cooling system and the surface quality of the graphite crystallizer at the place of contact with the cooling system and its influence on the temperatures throughout the continuous casting process is being investigated. The calculated simulations made it possible to propose the optimal set of equipment necessary for the continuous casting process to be carried out in laboratory conditions with various casting parameters and to determine basic materials properties of the obtained alloys such as hardness, electrical conductivity and homogeneity of the chemical composition. The authors are grateful for the financial support provided by The National Centre for Research and Development – Research Project No. LIDER/33/0121/L-11/19/NCBR/2020.

Keywords: CuMg alloys, continuous casting, temperature analysis, finite element method

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13972 Fluoranthene Removal in Wastewater Using Biological and Physico-Chemical Methods

Authors: Angelica Salmeron Alcocer, Deifilia Ahuatzi Chacon, Felipe Rodriguez Casasola

Abstract:

Polycyclic aromatic hydrocarbons (PAHs) are produced naturally (forest fires, volcanic eruptions) and human activity (burning fossil fuels). Concern for PAHs is due to their toxic, mutagenic and carcinogenic effects and so pose a potential risk to human health and ecology. Therefore these are considered the most toxic components of oil, they are highly hydrophobic, making them easily depositable on the floor, air and water. One method of removing PAHs of contaminated soil used surfactants such as Tween 80, which it has been reported as less toxic and also increases the solubility of the PAH compared to other surfactants, fluoranthene is a PAH with molecular formula C16H10, its name derives from the fluorescence which presents to UV light. In this paper, a study of the fluoranthene removal solubilized with Tween 80 in synthetic wastewater using a microbial community (isolated from soil of coffee plantations in the state of Veracruz, Mexico) and Fenton oxidation method was performed. The microbial community was able to use both tween 80 and fluoranthene as carbon sources for growth, when the biological treatment in batch culture was applied, 100% of fluoranthene was mineralized, this only occurred at an initial concentration of 100 ppm, but by increasing the initial concentration of fluoranthene the removal efficiencies decay and degradation time increases due to the accumulation of byproducts more toxic or less biodegradable, however when the Fenton oxidation was previously applied to the biological treatment, it was observed that removal of fluoranthene improved because it is consumed approximately 2.4 times faster.

Keywords: fluoranthene, polycyclic aromatic hydrocarbons, biological treatment, fenton oxidation

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13971 Efficacy of Combined CHAp and Lanthanum Carbonate in Therapy for Hyperphosphatemia

Authors: Andreea Cârâc, Elena Morosan, Ana Corina Ionita, Rica Bosencu, Geta Carac

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Lanthanum carbonate exhibits a considerable ability to bind phosphate and the substitution of Ca2+ ions by divalent or trivalent lanthanide metal ions attracted attention during the past few years. Although Lanthanum carbonate has not been approved by the FDA for treatment of hyperphosphatemia, we prospectively evaluated the efficacy of the combination of Calcium hydroxyapatite and Lanthanum carbonate for the treatment of hyperphosphatemia on mice. Calcium hydroxyapatite commonly referred as CHAp is a bioceramic material and is one of the most important implantable materials due to its biocompatibility and osteoconductivity. We prepared calcium hydroxyapatite and lanthanum carbonate. CHAp was prepared by co-precipitation method using Ca(OH)2, H3PO4, NH4OH with calcination at 1200ºC. Lanthanum carbonate was prepared by chemical method using NaHCO3 and LaCl3 at low pH environment , ph below 4.0 The confirmation of both substances structures was made using XRD characterization, FTIR spectra and SEM /EDX analysis. The study group included 20 subjects-mice divided into four groups according to the administered substance: lanthanum carbonate (group A), lanthanum carbonate + CHAp (group B), CHAp (group C) and salt water (group D). The results indicate a phosphate decrease when subjects (mice) were treated with CHAp and lanthanum carbonate (0.5 % CMC), in a single dose of 1500 mg/kg. Serum phosphate concentration decreased [from 4.5 ± 0.8 mg/dL) to 4.05 ± 0.2 mg/dL), P < 0.01] in group A and to 3.6 ± 0.2 mg/dL] only after the 24 hours of combination therapy. The combination of CHAp and lanthanum carbonate is a suitable regimen for hyperphosphatemia treatment subjects because it avoids both the hypercalcemia of CaCO3 and the adverse effects of CHAp. The ability of CHAp to decrease the serum phosphate concentration is 1/3 that of lanthanum carbonate.

Keywords: calcium hydroxyapatite, hyperphosphatemia, lanthanum carbonate, phosphate, structures

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13970 Comparative Sustainability Assessment as a Gauge of Sustainable Community Development in South Africa

Authors: B. B. van Schalkwyk, C. B. Schoeman, E. J. Cilliers

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High levels of urbanisation and the lingering effects of Apartheid have caused South African municipalities to experience difficulties in planning for sustainability and, more specifically, sustainable community development. Sustainable community development is needed in order to achieve more integrated and sustainable towns and cities with an improved living environment and a higher quality of life. Due to this, sustainable community development is of particular relevance to South Africa. Although policies and legislation exist at international, national and local level, there is a lack of suitable planning instruments to guide sustainable community development. Tlokwe Local Municipality is researched in this paper as study area to test and develop planning instruments for sustainable community development. A comparative assessment matrix of sustainability indicators is linked to Multi-Criteria Analysis (MCA) and applied to identify the themes and sub-themes applicable to sustainability in which intervention is required to improve the sustainability rating of the municipality. The result of the comparative sustainability assessment is that the Tlokwe Local Municipality is considered to be relatively sustainable, performing overall better than the three spheres of government against which it was measured. It is recommended that municipalities use the comparative assessment matrix method to determine its level of sustainability when developing respective sectorial plans (SDFs, ITPs, EMFs and IDPs). Areas in which there is a lack of sustainability are highlighted and can consequently be addressed through intervention strategies. The comparative assessment matrix method is a valuable planning instrument with which to achieve sustainable community development.

Keywords: sustainable community development, sustainability indicators, comparative sustainability, urbanisation, development planning, urban management

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13969 Monitoring Vaginal Electrical Resistance, Follicular Wave and Hormonal Profile during Estrus Cycle in Indigenous Sheep

Authors: T. A. Rosy, M. R. I. Talukdar, N. S. Juyena, F. Y. Bari, M. N. Islam

Abstract:

The ovarian follicular dynamics, vaginal electrical resistance (VER) and progesterone (P4) and estrogen (E2) profiles were investigated during estrus cycle in four indigenous ewes. Daily VER values were recorded with heat detector. The follicles were observed and measured by trans-rectal ultrasonography. Blood was collected daily for hormonal profiles. Results showed a significant variation in VER values (P<0.05) at estrus in regards to ewes and cycles. The day difference between two successive lower values in VER waves ranged from 13-17 days which might indicate the estrus cycle in indigenous ewes. Trans-rectal ultrasonography of ovaries revealed the presence of two to four waves of follicular growth during the study period. Results also showed that follicular diameter was negatively correlated with VER values. Study of hormonal profiles by ELISA revealed a positive correlation between E2 concentration and development of follicle and negative correlation between P4 concentration and development of follicle. The concentrations of estradiol increased at the time of estrus and then fall down in a basal level. Development of follicular size was accompanied by an increase in the concentration of serum estradiol. Inversely, when follicles heed to ovulation concentration of progesterone starts to fall down and after ovulation it turns its way to the zenith and remains at this state until next ovulatory follicle comes to its maximum diameter. This study could help scientists to set up a manipulative reproductive technique for improving genetic values of sheep in Bangladesh.

Keywords: ovarian follicle, hormonal profile, sheep, ultrasonography, vaginal electrical resistance

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13968 Index t-SNE: Tracking Dynamics of High-Dimensional Datasets with Coherent Embeddings

Authors: Gaelle Candel, David Naccache

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t-SNE is an embedding method that the data science community has widely used. It helps two main tasks: to display results by coloring items according to the item class or feature value; and for forensic, giving a first overview of the dataset distribution. Two interesting characteristics of t-SNE are the structure preservation property and the answer to the crowding problem, where all neighbors in high dimensional space cannot be represented correctly in low dimensional space. t-SNE preserves the local neighborhood, and similar items are nicely spaced by adjusting to the local density. These two characteristics produce a meaningful representation, where the cluster area is proportional to its size in number, and relationships between clusters are materialized by closeness on the embedding. This algorithm is non-parametric. The transformation from a high to low dimensional space is described but not learned. Two initializations of the algorithm would lead to two different embeddings. In a forensic approach, analysts would like to compare two or more datasets using their embedding. A naive approach would be to embed all datasets together. However, this process is costly as the complexity of t-SNE is quadratic and would be infeasible for too many datasets. Another approach would be to learn a parametric model over an embedding built with a subset of data. While this approach is highly scalable, points could be mapped at the same exact position, making them indistinguishable. This type of model would be unable to adapt to new outliers nor concept drift. This paper presents a methodology to reuse an embedding to create a new one, where cluster positions are preserved. The optimization process minimizes two costs, one relative to the embedding shape and the second relative to the support embedding’ match. The embedding with the support process can be repeated more than once, with the newly obtained embedding. The successive embedding can be used to study the impact of one variable over the dataset distribution or monitor changes over time. This method has the same complexity as t-SNE per embedding, and memory requirements are only doubled. For a dataset of n elements sorted and split into k subsets, the total embedding complexity would be reduced from O(n²) to O(n²=k), and the memory requirement from n² to 2(n=k)², which enables computation on recent laptops. The method showed promising results on a real-world dataset, allowing to observe the birth, evolution, and death of clusters. The proposed approach facilitates identifying significant trends and changes, which empowers the monitoring high dimensional datasets’ dynamics.

Keywords: concept drift, data visualization, dimension reduction, embedding, monitoring, reusability, t-SNE, unsupervised learning

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13967 Study of Knowledge, Attitudes and Practices of Menstrual Hygiene of Adolescent Girls Aged 12 to 19 Years Old in Secondary School

Authors: Jean Marie Vianney Ininahazwe, Patrick Bitangumutwenzi

Abstract:

Context: The issue of menstrual hygiene is an entry point for demonstrating the gender-specific nature of the needs of women and adolescent girls. Women and girls around the world face many challenges in managing their periods. They may be deprived of certain basic human rights, including those relating to education, work and health. This work describes the Knowledge, Attitudes and Practices of menstrual hygiene among adolescent girls from 12 to 19 years at Lake Tanganyika Secondary School. Method: This is a descriptive cross-sectional study among 384 adolescent girls from Lake Tanganyika secondary school over a period of 2 weeks from September 13 to September 27 and with a purely general objective of describing the Knowledge, Attitudes and Practices of menstrual hygiene in secondary schools. The study was conducted using a non-probability method and the sampling technique was for convenience. The data collection technique used was the survey by questionnaire and the exploitation of the documentary. The data collection tool used was the questionnaire. Microsoft Word 2013, Microsoft Excel 2.13 and EPI INFO7 software were used for this purpose. Results: We noticed that 55.47% of the participants knew that menstruation is a physiological process; 57.55% of the teenage girls surveyed get their information about menstrual hygiene from their mothers; 75.72% use sanitary napkins and 24.02% use fabrics as protective material; 35.16% of respondents have already lacked sanitary napkins since their menarche; 37.29% are absent from classes due to lack of sanitary napkins; 23.82% use soap and other products to wash.

Keywords: knowledge, attitudes, practices, menstrual hygiene

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13966 The Impact of the Training Program Provided by the Saudi Archery Federation on the Electromyography of the Bow Arm Muscles

Authors: Hana Aljumayi, Mohammed Issa

Abstract:

The aim of this study was to investigate the effect of the training program for professional athletes at the Saudi Archery Federation on the electrical activity of the muscles involved in pulling the bowstring, maximum muscle strength (MVC) and to identify the relationship between the electrical activity of these muscles and accuracy in shooting among female archers. The researcher used a descriptive approach that was suitable for the nature of the study, and a sample of nine female archers was selected using purposive sampling. An EMG device was used to measure signal amplitude, signal frequency, spectral energy signal, and MVC. The results showed statistically significant differences in signal amplitude among muscles, with F(8,1)=5.91 and a significance level of 0.02. There were also statistically significant differences between muscles in terms of signal frequency, with F(8,1)=8.23 and a significance level of 0.02. Bonferroni test results indicated statistically significant differences between measurements at a significance level of 0.05, with anterior measurements showing an average difference of 16.4 compared to other measurements. Furthermore, there was a significant negative correlation between signal amplitude in the calf muscle and accuracy in shooting (r=-0.78) at a significance level of 0.02. There was also a significant positive correlation between signal frequency in the calf muscle and accuracy in shooting (r=0.72) at a significance level of 0.04. In conclusion, it appears that the training program for archery athletes focused more on skill development than physical aspects such as muscle activity and strength development. However, it did have a statistically significant effect on signal amplitude but not on signal frequency or MVC development in muscles involved in pulling the bowstring.

Keywords: electrical activity of muscles, archery sport, shooting accuracy, muscles

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13965 Structure of Consciousness According to Deep Systemic Constellations

Authors: Dmitry Ustinov, Olga Lobareva

Abstract:

The method of Deep Systemic Constellations is based on a phenomenological approach. Using the phenomenon of substitutive perception it was established that the human consciousness has a hierarchical structure, where deeper levels govern more superficial ones (reactive level, energy or ancestral level, spiritual level, magical level, and deeper levels of consciousness). Every human possesses a depth of consciousness to the spiritual level, however deeper levels of consciousness are not found for every person. It was found that the spiritual level of consciousness is not homogeneous and has its own internal hierarchy of sublevels (the level of formation of spiritual values, the level of the 'inner observer', the level of the 'path', the level of 'God', etc.). The depth of the spiritual level of a person defines the paradigm of all his internal processes and the main motives of the movement through life. At any level of consciousness disturbances can occur. Disturbances at a deeper level cause disturbances at more superficial levels and are manifested in the daily life of a person in feelings, behavioral patterns, psychosomatics, etc. Without removing the deepest source of a disturbance it is impossible to completely correct its manifestation in the actual moment. Thus a destructive pattern of feeling and behavior in the actual moment can exist because of a disturbance, for example, at the spiritual level of a person (although in most cases the source is at the energy level). Psychological work with superficial levels without removing a source of disturbance cannot fully solve the problem. The method of Deep Systemic Constellations allows one to work effectively with the source of the problem located at any depth. The methodology has confirmed its effectiveness in working with more than a thousand people.

Keywords: constellations, spiritual psychology, structure of consciousness, transpersonal psychology

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13964 Modeling Core Flooding Experiments for Co₂ Geological Storage Applications

Authors: Avinoam Rabinovich

Abstract:

CO₂ geological storage is a proven technology for reducing anthropogenic carbon emissions, which is paramount for achieving the ambitious net zero emissions goal. Core flooding experiments are an important step in any CO₂ storage project, allowing us to gain information on the flow of CO₂ and brine in the porous rock extracted from the reservoir. This information is important for understanding basic mechanisms related to CO₂ geological storage as well as for reservoir modeling, which is an integral part of a field project. In this work, a different method for constructing accurate models of CO₂-brine core flooding will be presented. Results for synthetic cases and real experiments will be shown and compared with numerical models to exhibit their predictive capabilities. Furthermore, the various mechanisms which impact the CO₂ distribution and trapping in the rock samples will be discussed, and examples from models and experiments will be provided. The new method entails solving an inverse problem to obtain a three-dimensional permeability distribution which, along with the relative permeability and capillary pressure functions, constitutes a model of the flow experiments. The model is more accurate when data from a number of experiments are combined to solve the inverse problem. This model can then be used to test various other injection flow rates and fluid fractions which have not been tested in experiments. The models can also be used to bridge the gap between small-scale capillary heterogeneity effects (sub-core and core scale) and large-scale (reservoir scale) effects, known as the upscaling problem.

Keywords: CO₂ geological storage, residual trapping, capillary heterogeneity, core flooding, CO₂-brine flow

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13963 Gas Phase Extraction: An Environmentally Sustainable and Effective Method for The Extraction and Recovery of Metal from Ores

Authors: Kolela J Nyembwe, Darlington C. Ashiegbu, Herman J. Potgieter

Abstract:

Over the past few decades, the demand for metals has increased significantly. This has led to a decrease and decline of high-grade ore over time and an increase in mineral complexity and matrix heterogeneity. In addition to that, there are rising concerns about greener processes and a sustainable environment. Due to these challenges, the mining and metal industry has been forced to develop new technologies that are able to economically process and recover metallic values from low-grade ores, materials having a metal content locked up in industrially processed residues (tailings and slag), and complex matrix mineral deposits. Several methods to address these issues have been developed, among which are ionic liquids (IL), heap leaching, and bioleaching. Recently, the gas phase extraction technique has been gaining interest because it eliminates many of the problems encountered in conventional mineral processing methods. The technique relies on the formation of volatile metal complexes, which can be removed from the residual solids by a carrier gas. The complexes can then be reduced using the appropriate method to obtain the metal and regenerate-recover the organic extractant. Laboratory work on the gas phase have been conducted for the extraction and recovery of aluminium (Al), iron (Fe), copper (Cu), chrome (Cr), nickel (Ni), lead (Pb), and vanadium V. In all cases the extraction revealed to depend of temperature and mineral surface area. The process technology appears very promising, offers the feasibility of recirculation, organic reagent regeneration, and has the potential to deliver on all promises of a “greener” process.

Keywords: gas-phase extraction, hydrometallurgy, low-grade ore, sustainable environment

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13962 Comparative Policy Analysis on Agropolitan Territorial Development in Rural Area: A Study Case in Bojonegoro Regency, Indonesia

Authors: Fatihin Khoirul, Muhammad Muqorrobin Ist

Abstract:

Bojonegoro Regency is one of the districts that use the concept Agropolitan as the Territorial Development Policy. Three sub-district designated as Area Development District of Agropolitan are Kapas, Dander, and Kalitidu or commonly called KADEKA. Current policy has been shown results, but there was an inequality of results in some areas. One of them occurred in the Ngringinrejo village with the main commodities is Starfruit and Wedi village with the main commodities is Salak fruit. Therefore, a comparative study is used to search for causal factors of inequality result of the policy by using the 5 aspects compared, namely: (1) Management Development Agropolitan; (2) Physical Condition agropolitan Region; (3) Implementing Agency at the Village Level; (4) Village Government Support; and (5) Community support. Based on the discussion of qualitative analysis, it was found that five aspects have their respective roles in creating inequality of outcomes that occur in both villages. But beyond that, there are conditions where the two villages experienced the same condition that is when the initial implementation of the policy. The condition is referred to as 'the phenomenon of price trap.' The condition is caused by lower commodity prices, causing the village government's commitment in implementing policies too low, followed by public awareness in support of the policy is also low, so care for commodities is also low, and the quality is too low lead and eventually back causing low price. However, the difference is that the village Ngringinrejo able to get out of this condition with 'the new culture of administration' at the end of 2013. While the conditions in the village of Wedi compounded by not respected request assistance by the irrigation district.

Keywords: comparative policy analysis, qualitative comparative, inequallity, price trap, new culture of administration

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13961 Biosynthesis of Silver Nanoparticles Using Zataria multiflora Extract, and Study of Antibacterial Effects on UTI Bacteria (MDR)

Authors: Mohammad Hossein Pazandeh, Monir Doudi, Sona Rostampour Yasouri

Abstract:

Irregular consumption of current antibiotic makes increases of antibiotic resistance between urin pathogens on all worlds. This study selected based on this great community problem. The aim of this study was the biosynthesis of silver nanoparticles from Zataria multiflora extract and then to investigate its antibacterial effect on gram-negative bacilli common in Urinary Tract Infections (UTI) and MDR. The plant used in the present research was Zataria multiflora whose extract was prepared through Soxhlet extraction method. Green synthesis condition of silver nanoparticles was investigated in terms of three parameters including the extract amount, concentration of silver nitrate salt, and temperature. The seizes of nanoparticles were determined by Zetasizer. In order to identify synthesized silver nanoparticles Transmission Electron Microscopy (TEM) and X-ray Diffraction (XRD) methods were used. For evaluating the antibacterial effects of nanoparticles synthesized through biological method different concentrations of silver nanoparticles were studied on 140 cases of Muliple Drug Resistance (MDR) bacteria strains Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Proteus vulgaris,Citrobacter freundii, Acinetobacter bumanii and Pseudomonas aeruginosa, (each genus of bacteria, 20 samples), which all were MDR and cause urinary tract infections , for identification of bacteria were used of Polymerase Chain Reaction (PCR) test and laboratory methods (Agar well diffusion and Microdilution methods) to assess their sensitivity to Nanoparticles. The data were analyzed using SPSS software by nonparametric Kruskal-Wallis and Mann-Whitney tests. Significant results were found about the effects of silver nitrate concentration, different amounts of Zataria multiflora extract, and temperature on nanoparticles; that is, by increasing the concentration of silver nitrate, extract amount, and temperature, the sizes of synthesized nanoparticles declined. However, the effect of above mentioned factors on particles diffusion index was not significant. Based on the TEM results, particles were mainly spherical shape with a diameter range of 25 to 50 nm. The results of XRD Analysis indicated the formation of Nanostructures and Nanocrystals of silver.. The obtained results of antibacterial effects of different concentrations of silver nanoparticles on according to agar well diffusion and microdilution method, biologically synthesized nanoparticles showed 1000 mg /ml highest and lowest mean inhibition zone diameter in E.coli , Acinetobacter bumanii 23 and 15mm, respectively. MIC was observed for all of bacteria 125mg/ml and for Acinetobacter bumanii 250mg/ml.Comparing the growth inhibitory effect of chemically synthesized Nanoparticles and biologically synthesized Nanoparticles showed that in the chemical method the highest growth inhibition belonged to the concentration of 62.5 mg /ml. The inhibitory effect on the growth all of bacteria causes of urine infection and MDR was observed and by increasing silver ion concentration in Nanoparticles, antibacterial activity increased. Generally, the biological synthesis can be considered an efficient way not only in making Nanoparticles but also for having anti-bacterial properties. It is more biocompatible and may be possess less toxicity than the Nanoparticles synthesized chemically.

Keywords: biosynthesis, MDR bacteria, silver nanoparticles, UTI

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13960 Analysis of Adipose Tissue-Derived Mesenchymal Stem Cells under Atherosclerosis Microenvironment

Authors: Do Khanh Vy, Vuong Cat Khanh, Osamu Ohneda

Abstract:

During atherosclerosis (AS) progression, perivascular adipose tissue-derived mesenchymal stem cells (PVAT-MSCs) are exposed to the hypoxic environment due to the oxygenic deprivation which might influence the adipose tissue-derived mesenchymal stem cells (AT-MSCs) function. Additionally, it has been reported that the angiogenic ability of subcutaneous AT-MSCs (SAT-MSCs) was impaired in the AS patients. However, up to now, the effects of AS on the characteristics and function of PVAT-MSCs have not been clarified yet. In the present study, we analyzed the AS microenvironment effects on the characteristics and function of AT-MSCs. We found that there was no significant difference in cellular morphology and differentiation ability between SAT-MSCs and PVAT-MSCs in AS patients. However, the proliferation of AS-derived PVAT-MSCs was less than those of AS-derived SAT-MSCs. Importantly, the migration of AS-derived PVAT-MSCs was faster than AS-derived SAT-MSCs. Of note, AS-derived PVAT-MSCs showed the upregulation of SDF1, which is related to the homing, and VEGF, which is related to the angiogenesis compared to those of AS-derived SAT-MSCs. Consistent with these results, AS-derived PVAT-MSCs showed the higher ability to recruit EPCs and ECs than AS-derived SAT-MSCs. In addition, EPCs and ECs which cultured in the presence of AS-derived PVAT-MSC conditioned medium showed the higher angiogenic function of the tube formation compared to those cultured in AS-derived SAT-MSC conditioned medium. This result suggests that the higher paracrine effects of AS-derived PVAT-MSCs support the angiogenic function of the target cells. Our data showed the different characteristics and functions of AT-MSCs derived from different sources of tissues. Under the AS microenvironment, it seems that the characteristics and functions of PVAT-MSCs might reflect the progression of AS. Further study will be necessary to clarify the mechanism in the future.

Keywords: atherosclerosis, mesenchymal stem cells, perivascular adipose tissue, subcutaneous adipose tissue

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13959 A 3D Bioprinting System for Engineering Cell-Embedded Hydrogels by Digital Light Processing

Authors: Jimmy Jiun-Ming Su, Yuan-Min Lin

Abstract:

Bioprinting has been applied to produce 3D cellular constructs for tissue engineering. Microextrusion printing is the most common used method. However, printing low viscosity bioink is a challenge for this method. Herein, we developed a new 3D printing system to fabricate cell-laden hydrogels via a DLP-based projector. The bioprinter is assembled from affordable equipment including a stepper motor, screw, LED-based DLP projector, open source computer hardware and software. The system can use low viscosity and photo-polymerized bioink to fabricate 3D tissue mimics in a layer-by-layer manner. In this study, we used gelatin methylacrylate (GelMA) as bioink for stem cell encapsulation. In order to reinforce the printed construct, surface modified hydroxyapatite has been added in the bioink. We demonstrated the silanization of hydroxyapatite could improve the crosslinking between the interface of hydroxyapatite and GelMA. The results showed that the incorporation of silanized hydroxyapatite into the bioink had an enhancing effect on the mechanical properties of printed hydrogel, in addition, the hydrogel had low cytotoxicity and promoted the differentiation of embedded human bone marrow stem cells (hBMSCs) and retinal pigment epithelium (RPE) cells. Moreover, this bioprinting system has the ability to generate microchannels inside the engineered tissues to facilitate diffusion of nutrients. We believe this 3D bioprinting system has potential to fabricate various tissues for clinical applications and regenerative medicine in the future.

Keywords: bioprinting, cell encapsulation, digital light processing, GelMA hydrogel

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13958 Developing Stability Monitoring Parameters for NIPRIMAL®: A Monoherbal Formulation for the Treatment of Uncomplicated Malaria

Authors: Ekere E. Kokonne, Isimi C. Yetunde, Okoh E. Judith, Okafor E. Ijeoma, Ajeh J. Isaac, Olobayo O. Kunle, Emeje O. Martins

Abstract:

NIPRIMAL® is a mono herbal formulation of Nauclea latifolia used in the treatment of malaria. The stability of extracts made from plant material is essential to ensure the quality, safety and efficacy of the finished product. This study assessed the stability of the formulation under three different storage conditions; normal room temperature, infrared and under refrigeration. Differential Scanning Calorimetry (DSC) and Thin Layer Chromatography (TLC) were used to monitor the formulations. The DSC analysis was done from 0oC to 350oC under the three storage conditions. Results obtained indicate that NIPRIMAL® was stable at all the storage conditions investigated. Thin layer chromatography (TLC) after 6 months showed there was no significant difference between retention factor (RF) values for the various storage conditions. The reference sample had four spots with RF values of 0.47, 0.68, 0.76, 0.82 respectively and these spots were retained in the test formulations with corresponding RF values were after 6 months at room temperature and refrigerated temperature been 0.56, 0.73, 0.80, 0.92 and 0.47, 0.68, 0.76, 0.82 respectively. On the other hand, the RF values (0.55, 0.74, 0.77, 0.93) obtained under infrared after 1 month varied slightly from the reference. The sample exposed to infrared had a lower heat capacity compared to that stored under room temperature or refrigeration. A combination of TLC and DSC measurements has been applied for assessing the stability of NIPRIMAL®. Both methods were found to be rapid, sensitive and reliable in determining its stability. It is concluded that NIPRIMAL® can be stored under any of the tested conditions without degradation. This study is a major contribution towards developing appropriate stability monitoring parameters for herbal products.

Keywords: differential scanning calorimetry, formulation, NIPRIMAL®, stability, thin layer hromatography

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13957 Prediction of Super-Response to Cardiac Resynchronisation Therapy

Authors: Vadim A. Kuznetsov, Anna M. Soldatova, Tatyana N. Enina, Elena A. Gorbatenko, Dmitrii V. Krinochkin

Abstract:

The aim of the study was to evaluate potential parameters related with super-response to CRT. Methods: 60 CRT patients (mean age 54.3 ± 9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class, left ventricular ejection fraction < 35% were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7 ± 15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥ 30%) and non-SR (n=32; reduction in LVESV < 30%). Results: At baseline groups differed in age (58.1 ± 5.8 years in SR vs 50.8 ± 11.4 years in non-SR; p=0.003), gender (female gender 32.1% vs 9.4% respectively; p=0.028), width of QRS complex (157.6 ± 40.6 ms in SR vs 137.6 ± 33.9 ms in non-SR; p=0.044). Percentage of LBBB was equal between groups (75% in SR vs 59.4% in non-SR; p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only difference in left ventricular pre-ejection period (LVPEP) was statistically significant (153.0 ± 35.9 ms vs. 129.3 ± 28.7 ms p=0.032). NT-proBNP level was lower in SR (1581 ± 1369 pg/ml vs 3024 ± 2431 pg/ml; p=0.006). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002). Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P = 0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI 1.009-1.168; P=0.30) were independent predictors for CRT super-response. ROC curve analysis demonstrated sensitivity 71.9% and specificity 82.1% (AUC=0.827; p < 0.001) of this model in prediction of super-response to CRT. Conclusion: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level, and age at baseline can be used as independent predictors of CRT super-response.

Keywords: cardiac resynchronisation therapy, superresponse, congestive heart failure, left bundle branch block

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