Search results for: idiopathic intracranial hypertension physics of CSF

Authors: Mennatallah M. Hussein, Olivier de Weck

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The advancement of space exploration demands a robust space launch services program capable of reliably propelling payloads into orbit. Despite rigorous testing and quality assurance, launch failures still occur, leading to significant financial losses and jeopardizing mission objectives. Traditional failure prediction methods often lack the sophistication to account for multi-mode failure scenarios, as well as the predictive capability in complex dynamic systems. Traditional approaches also rely on expert judgment, leading to variability in risk prioritization and mitigation strategies. Hence, there is a pressing need for robust approaches that enhance launch vehicle reliability from lift-off until it reaches its parking orbit through comprehensive simulation techniques. In this study, the developed model proposes a multi-mode launch vehicle simulation framework for predicting failure scenarios when incorporating new technologies, such as new propulsion systems or advanced staging separation mechanisms in the launch system. To this end, the model combined a 6-DOF system dynamics with comprehensive data analysis to simulate multiple failure modes impacting launch performance. The simulator utilizes high-fidelity physics-based simulations to capture the complex interactions between different subsystems and environmental conditions.

Keywords: launch vehicle, failure prediction, propulsion anomalies, rocket launch simulation, rocket dynamics

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Authors: S. Srednyak

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We study a class of functional partial differential equations(FPDEs). This class is suggested by Quantum Field Theory. We derive general properties of solutions to such equations. In particular, we demonstrate that they lead to systems of coupled integral equations with singular kernels. We show that solutions to such hierarchies can be sought among functions with regular singularities at a countable set of subvarieties of the physical space. We also develop a formal analogy of basic constructions of differential geometry on functional manifolds, as this is necessary for in depth study of FPDEs. We also consider the case of linear overdetermined systems of functional differential equations and show that it can be completely solved in terms of formal solutions of a functional equation that is a functional analogy of a system of determined algebraic equations. This development leads us to formally define the functional analogy of algebraic geometry, which we call functional algebraic geometry. We study basic properties of functional algebraic varieties. In particular, we investigate the case of a formally discrete set of solutions. We also define and study functional analogy of discriminants. In the case of fully determined systems such that the defining functionals have regular singularities, we demonstrate that formal solutions can be sought in the class of functions with regular singularities. This case provides a practical way to apply our results to physics problems.

Keywords: functional equations, quantum field theory, holomorphic functions, Yang Mills mass gap problem, quantum chaos

Procedia PDF Downloads 70

Authors: Yongrong Liu, Xin Tang

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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.

Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study

Procedia PDF Downloads 74

Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

Procedia PDF Downloads 325

Authors: Ali Saeed Alghamdi, Basel Mazen Alsolami, Basel Saeed Alghamdi, Muhanad Saleh Alzahrani Alamri, Salman Anwar Thabet, Abdulhalim J. Kinsara

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Objectives: This study measures the knowledge of the cardiovascular disease among the general population in western regions of Saudi Arabia, and it aimed to increase the level of awareness about cardiovascular diseases among the general population by providing an awareness lecture that included information about the risk factors, major symptoms, and prevention of cardiovascular diseases. The lecture has been attached at the end of the questionnaire. Setting: This study was conducted through an online questionnaire that included our aim and main objectives that targeted the general population in the Western regions of Saudi Arabia (Makkah and Madinah regions). Participants: This study participants were 460 collected through an online questionnaire. Methods: All Saudi citizens and residents who live in the western region of Saudi Arabia aged 18 years and above will be invited to participate voluntarily. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart diseases, with cardiac symptoms and risk factors sections. Results: The majority of respondents were females (74.8%) and Saudis. The knowledge about cardiovascular disease risk factors was weak. Only (18.5%) scores an excellent response regarding risk factors awareness. Lack of exercise, stress, and obesity were the most known risk factors. Regarding cardiovascular disease symptoms, chest pain scores the highest symptom (87.6%) among other symptoms like dyspnea, syncope, and excessive sweating. Participants revealed a poor awareness regarding cardiovascular disease symptoms also (0.9%). However, preventable factors for cardiovascular diseases were more knowledgeable than others categories in this study (60% fall into excellent knowledge). Smoking cessation, normal cholesterol level, and normal blood pressure score the highest preventable methods (92.2%), (88.6%), and (78.7%) respectively. 83.7% of the participant have attended the awareness lecture, and 99 of the attendees reported that the lecture increased their knowledge about cardiovascular disease. Conclusion: This study discussed the level of community awareness of cardiovascular disease in terms of symptoms, risk factors, and protective factors. We found a huge lack of the participant's level of knowledge about the disease and how to prevent it. Moreover, we measure the prevalence of the comorbidities among our participants (diabetes, hypertension, hypercholesterolemia/ hypertriglyceridemia) and their extent of adherence to their medication. In conclusion, this study not only demonstrates awareness of cardiovascular disease risk factors, symptoms, management, and the association between each domain but also provides educational material. Further educational material and campaigns are required to increase awareness and knowledge about cardiovascular diseases.

Keywords: awareness, cardiovascular diseases, education, prevention, risk factors

Procedia PDF Downloads 131

Authors: Karim Kheloufi, El Hachemi Amara

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In the present study, a three-dimensional transient numerical model was developed to study the temperature field and cutting kerf shape during laser fusion cutting. The finite volume model has been constructed, based on the Navier–Stokes equations and energy conservation equation for the description of momentum and heat transport phenomena, and the Volume of Fluid (VOF) method for free surface tracking. The Fresnel absorption model is used to handle the absorption of the incident wave by the surface of the liquid metal and the enthalpy-porosity technique is employed to account for the latent heat during melting and solidification of the material. To model the physical phenomena occurring at the liquid film/gas interface, including momentum/heat transfer, a new approach is proposed which consists of treating friction force, pressure force applied by the gas jet and the heat absorbed by the cutting front surface as source terms incorporated into the governing equations. All these physics are coupled and solved simultaneously in Fluent CFD®. The main objective of using a transient phase change model in the current case is to simulate the dynamics and geometry of a growing laser-cutting generated kerf until it becomes fully developed. The model is used to investigate the effect of some process parameters on temperature fields and the formed kerf geometry.

Keywords: laser cutting, numerical simulation, heat transfer, fluid flow

Procedia PDF Downloads 339

Authors: Betim Bahtiri, B. Arash, R. Rolfes

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Epoxy-based materials are frequently exposed to high-humidity environments in many engineering applications. As a result, their material properties would be degraded by water absorption. A full characterization of the material properties under hygrothermal conditions requires time- and cost-consuming experimental tests. To gain insights into the physics of diffusion mechanisms, atomistic simulations have been shown to be effective tools. Concerning the diffusion of water in polymers, spatial trajectories of water molecules are obtained from molecular dynamics (MD) simulations allowing the interpretation of diffusion pathways at the nanoscale in a polymer network. Conventional MD simulations of water diffusion in amorphous polymers lead to discrepancies at low temperatures due to the short timescales of the simulations. In the proposed model, this issue is solved by using a combined scheme of autonomous basin climbing (ABC) with kinetic Monte Carlo and reactive MD simulations to investigate the diffusivity of water molecules in epoxy resins across a wide range of temperatures. It is shown that the proposed simulation framework estimates kinetic properties of water diffusion in epoxy resins that are consistent with experimental observations and provide a predictive tool for investigating the diffusion of small molecules in other amorphous polymers.

Keywords: epoxy resins, water diffusion, autonomous basin climbing, kinetic Monte Carlo, reactive molecular dynamics

Procedia PDF Downloads 67

Authors: Santanu Pakhira, Chandan Mazumdar, R. Ranganathan, Maxim Avdeev

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Magnetically frustrated systems are of great interest and one of the most adorable topics for the researcher of condensed matter physics, due to their various interesting properties, viz. ground state degeneracy, finite entropy at zero temperature, lowering of ordering temperature, etc. Ternary intermetallics with the composition RE₂TX₃ (RE = rare-earth element, T= d electron transition metal and X= p electron element) crystallize in hexagonal AlB₂ type crystal structure (space group P6/mmm). In a hexagonal crystal structure with the antiferromagnetic interaction between the moments, the center moment is geometrically frustrated. Magnetic frustration along with disorder arrangements of non-magnetic ions are the building blocks for metastable spin-glass ground state formation for most of the compounds of this stoichiometry. The newly synthesized compound Er₂NiSi₃ compound forms in single phase in AlB₂ type structure with space group P6/mmm. The compound orders antiferromagnetically below 5.4 K and spin freezing of the frustrated magnetic moments occurs below 3 K for the compound. The compound shows magnetic relaxation behavior and magnetic memory effect below its freezing temperature. Neutron diffraction patterns for temperatures below the spin freezing temperature have been analyzed using FULLPROF software package. Diffuse magnetic scattering at low temperatures yields spin glass state formation for the compound.

Keywords: antiferromagnetism, magnetic frustration, spin-glass, neutron diffraction

Procedia PDF Downloads 263

Authors: Tawfiq Chekifi, Brahim Dennai, Rachid Khelfaoui

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Over the last few decades, modeling immiscible fluids such as oil and water have been a classical research topic. Droplet-based microfluidics presents a unique platform for mixing, reaction, separation, dispersion of drops and numerous other functions. for this purpose Several devices were studied, as well as microfluidic oscillator. The latter was obtained from wall attachment microfluidic amplifiers using a feedback loop from the outputs to the control inputs, nevertheless this device haven’t well used for microdrops applications. In this paper, we suggest a numerical CFD study of a microfluidic oscillator with two different lengths of feedback loop. In order to produce simultaneous microdrops of gasoil on water, a typical geometry that includes double T-junction is connected to the fluidic oscillator, The generation of microdrops is computed by volume-of-fluid method (VOF). Flow oscillations of microdrops were triggered by the Coanda effect of jet flow. The aim of work is to obtain a high oscillation frequency in output of this passive device, the influence of hydrodynamics and physics parameters on the microdrops frequency in the output of our microsystem is also analyzed, The computational results show that, the length of feedback loop, applied pressure on T-junction and interfacial tension have a significant effect on the dispersion of microdrops and its oscillation frequency. Across the range of low Reynold number, the microdrops generation and its dynamics have been accurately controlled by adjusting applying pressure ratio of two phases.

Keywords: fluidic oscillator, microdrops manipulation, volume of fluid method, microfluidic oscillator

Procedia PDF Downloads 489

Authors: Castells Pau, Poetsch Christophe

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The effect of gust and turbulence encounters on aircraft is a wide field of study which allows different approaches, from high-fidelity multidisciplinary simulations to more simplified models adapted to industrial applications. The typical main goal is to predict the gust loads on the aircraft in order to ensure a safe design and achieve certification. Another topic widely studied is the gust loads reduction through an active control law. The impact of gusts on aircraft handling qualities is of interest as well in the analysis of in-service events so as to evaluate the aircraft response and the performance of the flight control laws. Traditionally, gust loads and handling qualities are addressed separately with different models adapted to the specific needs of each discipline. In this paper, an assessment of the differences between both models is presented and a strategy to better account for the physics of gust encounters in a typical flight dynamics model is proposed based on the model used for gust loads analysis. The applied corrections aim to capture the gust unsteady aerodynamics and propagation as well as the effect of dynamic flexibility at low frequencies. Results from the gust loads model at different flight conditions and measures from real events are used for validation. An assessment of a possible extension of steady aerodynamic nonlinearities to low frequency range is also addressed. The proposed corrections provide meaningful means to evaluate the performance and possible adjustments of the flight control laws.

Keywords: flight dynamics, gust loads, handling qualities, unsteady aerodynamics

Procedia PDF Downloads 147

Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

Procedia PDF Downloads 144

Authors: Claudia Vergara, Oscar Valdes, Jaime Tapia, Leonardo Santos

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The poly(amidoamine) dendrimers (PAMAM) are a class of material introduced by D. Tomalia. Modifications of the PAMAM dendrimer with several functional groups have attracted the attention for new interesting properties and new applications in many fields such as chemistry, physics, biology, and medicine. However, in the last few years, the use of dendrimers in environmental applications has increased due to pollution concerns. In this contribution, we report the synthesis of three new PAMAM derivates modified with asparagine aminoacid supported in cellulose: PG0-Asn (PAMAM-asparagine), PG0-Asn-Trt (with trityl group) and PG0-Asn-Boc-Trt (with tert-butyl oxycarbonyl group). The functionalization of generation 0 PAMAM dendrimer was carried out by amidation reaction by using an EDC/HOBt protocol. In a second step, functionalized dendrimer was covalently supported to the cellulose surface and used to study the capture of uranyl ions from aqueous solution by fluorescence spectroscopy. The structure and purity of the desired products were confirmed by conventional techniques such as FT-IR, MALDI, elemental analysis, and ESI-MS. Batch experiments were carried out to determine the affinity of uranyl ions with the dendrimer in aqueous solution. Firstly, the optimal conditions for uranyl capture were obtained, where the optimum pH for the removal was 6, the contact time was 4 hours, the initial concentration of uranyl was 100 ppm, and the amount of the adsorbent to be used was 2.5 mg. PAMAM significantly increased the capture of uranyl ions with respect to cellulose as the starting substrate, reaching 94.8% of capture (PG0), followed by 91.2% corresponding to PG0-Asn-Trt, then 70.3% PG0-Asn and 24.2% PG0-Asn-Boc-Trt. These results show that the PAMAM dendrimer is a good option to remove uranyl ions from aqueous solutions.

Keywords: asparagine, cellulose, PAMAM dendrimer, uranyl ions

Procedia PDF Downloads 139

Authors: Magdalena B. Kaziuk, Waldemar Kosiba, Marek J. Kuzniewski

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Introduction: Adipose tissue is a typical place for storage water-insoluble toxins in the body. It's connective tissue, where the intercellular substance consist of fat, which level in people with low physical activity should be 18-25% for women and 13-18% for men. Due to the fat distribution in the body we distinquish two types of obesity: android (visceral, abdominal) and gynoidal (gluteal-femoral, peripheral). Abdominal obesity increases the risk of complications of the cardiovascular system diseases, and impaired renal and liver function. Through the influence on disorders of metabolism, lipid metabolism, diabetes and hypertension, leading to emergence of the metabolic syndrome. So thus, obesity will especially overload kidney function in patients after transplantation. Aim: An attempt was made to estimate the impact of amount fat tissue on transplanted kidney function and excretory function of the liver in patients after Ktx. Material and Methods: The study included 108 patients (50 females, 58 male, age 46.5 +/- 12.9 years) with active kidney transplant after more than 3 months from the transplantation. An analysis of body composition was done by using electrical bioimpedance (BIA) and anthropometric measurements. Estimated basal metabolic rate (BMR), muscle mass, total body water content and the amount of body fat. Information about physical activity were obtained during clinical examination. Nutritional status, and type of obesity were determined by using indicators: Waist to Height Ratio (WHR) and Waist to Hip Ratio (WHR). Excretory functions of the transplanted kidney was rated by calculating the estimated renal glomerular filtration rate (eGFR) using the MDRD formula. Liver function was rated by total bilirubin and alanine aminotransferase levels ALT concentration in serum. In our patients haemolitic uremic syndrome (HUS) was excluded. Results: In 19.44% of patients had underweight, 22.37% of the respondents were with normal weight, 11.11% had overweight, and the rest were with obese (49.08%). People with android stature have a lower eGFR compared with those with the gynoidal stature (p = 0.004). All patients with obesity had higher amount of body fat from a few to several percent. The higher amount of body fat percentage, the lower eGFR had patients (p <0.001). Elevated ALT levels significantly correlated with a high fat content (p <0.02). Conclusion: Increased amount of body fat, particularly in the case of android obesity can be a predictor of kidney and liver damage. Due to that obese patients should have more frequent control of diagnostic functions of these organs and the intensive dietary proceedings, pharmacological and regular physical activity adapted to the current physical condition of patients after transplantation.

Keywords: obesity, body fat, kidney transplantation, glomerular filtration rate, liver function

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Authors: Aishvarya Gupta, Keerthana Anand, Sasirekha Rengaraj, Latha Chathurvedula

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Introduction: Advances in assisted reproductive technology and increase in the proportion of infertile couples have both contributed to the steep increase in the incidence of twin pregnancies in past decades. Maternal and perinatal complications are higher in twins than in singleton pregnancies. Studies comparing the maternal and perinatal outcomes of ART twin pregnancies versus spontaneously conceived twin pregnancies report heterogeneous results making it unclear whether the complications are due to twin gestation per se or because of assisted reproductive techniques. The present study aims to compare both maternal and perinatal outcomes in twin pregnancies which are spontaneously conceived and after assisted conception methods, so that targeted steps can be undertaken in order to improve maternal and perinatal outcome of twins. Objectives: To study perinatal and maternal outcome in twin pregnancies conceived spontaneously as well as with assisted methods and compare the outcomes between the two groups. Setting: Women delivering at JIPMER (tertiary care institute), Pondicherry. Population: 380 women with twin pregnancies who delivered in JIPMER between June 2015 and March 2017 were included in the study. Methods: The study population was divided into two cohorts – one conceived by spontaneous conception and other by assisted reproductive methods. Association of various maternal and perinatal outcomes with the method of conception was assessed using chi square test or Student's t test as appropriate. Multiple logistic regression analysis was done to assess the independent association of assisted conception with maternal outcomes after adjusting for age, parity and BMI. Multiple logistic regression analysis was done to assess the independent association of assisted conception with perinatal outcomes after adjusting for age, parity, BMI, chorionicity, gestational age at delivery and presence of hypertension or gestational diabetes in the mother. A p value of < 0.05 was considered as significant. Result: There was increased proportion of women with GDM (21% v/s 4.29%) and premature rupture of membranes (35% v/s 22.85%) in the assisted conception group and more anemic women in the spontaneous group (71.27% v/s 55.1%). However assisted conception per se increased the incidence of GDM among twin gestations (OR 3.39, 95% CI 1.34 – 8.61) and did not influence any of the other maternal outcomes. Among the perinatal outcomes, assisted conception per se increased the risk of having very preterm (<32 weeks) neonates (OR 3.013, 95% CI 1.432 – 6.337). The mean birth weight did not significantly differ between the two groups (p = 0.429). Though there were higher proportion of babies admitted to NICU in the assisted conception group (48.48% v/s 36.43%), assisted conception per se did not increase the risk of admission to NICU (OR 1.23, 95% CI 0.76 – 1.98). There was no significant difference in perinatal mortality rates between the two groups (p = 0.829). Conclusion: Assisted conception per se increases the risk of developing GDM in women with twin gestation and increases the risk of delivering very preterm babies. Hence measures should be taken to ensure appropriate screening methods for GDM and suitable neonatal care in such pregnancies.

Keywords: assisted conception, maternal outcomes, perinatal outcomes, twin gestation

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Authors: Arshad Alfoqaha, Seth Bard, Dustin Demetriou

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A new multi-physics acoustic modeling approach using ANSYS Mechanical FEA and FLUENT CFD methods is developed for modeling servers mounted to racks, such as IBM Z and IBM Power Systems, in data centers. This new approach allows users to determine the thermal and acoustic conditions that people are exposed to within the data center. The sound pressure level (SPL) exposure for a human working inside a hot aisle containment system inside the data center is studied. The SPL is analyzed at the noise source, at the human body, on the rack walls, on the containment walls, and on the ceiling and flooring plenum walls. In the acoustic CFD simulation, it is assumed that a four-inch diameter sphere with monopole acoustic radiation, placed in the middle of each rack, provides a single-source representation of all noise sources within the rack. Ffowcs Williams & Hawkings (FWH) acoustic model is employed. The target frequency is 1000 Hz, and the total simulation time for the transient analysis is 1.4 seconds, with a very small time step of 3e-5 seconds and 10 iterations to ensure convergence and accuracy. A User Defined Function (UDF) is developed to accurately simulate the acoustic noise source, and a Dynamic Mesh is applied to ensure acoustic wave propagation. Initial validation of the acoustic CFD simulation using a closed-form solution for the spherical propagation of an acoustic point source is performed.

Keywords: data centers, FLUENT, acoustics, sound pressure level, SPL, hot aisle containment, IBM

Procedia PDF Downloads 176

Authors: J. C. Cabanillas-Noris, M. I. Martínez-Hernández, I. León-Monzón

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The selection of diffractive events in the ALICE experiment during the first data taking period (RUN-I) of the Large Hadron Collider (LHC) was limited by the range over which rapidity gaps occur. It would be possible to achieve better measurements by expanding the range in which the production of particles can be detected. For this purpose, the ALICE Diffractive (AD0) detector has been installed and commissioned for the second phase (RUN-II). Any new detector should be able to take the data synchronously with all other detectors and be operated through the ALICE central systems. One of the key elements that must be developed for the AD0 detector is the Detector Control System (DCS). The DCS must be designed to operate safely and correctly this detector. Furthermore, the DCS must also provide optimum operating conditions for the acquisition and storage of physics data and ensure these are of the highest quality. The operation of AD0 implies the configuration of about 200 parameters, from electronics settings and power supply levels to the archiving of operating conditions data and the generation of safety alerts. It also includes the automation of procedures to get the AD0 detector ready for taking data in the appropriate conditions for the different run types in ALICE. The performance of AD0 detector depends on a certain number of parameters such as the nominal voltages for each photomultiplier tube (PMT), their threshold levels to accept or reject the incoming pulses, the definition of triggers, etc. All these parameters define the efficiency of AD0 and they have to be monitored and controlled through AD0 DCS. Finally, AD0 DCS provides the operator with multiple interfaces to execute these tasks. They are realized as operating panels and scripts running in the background. These features are implemented on a SCADA software platform as a distributed control system which integrates to the global control system of the ALICE experiment.

Keywords: AD0, ALICE, DCS, LHC

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Authors: G. R. Khan, Sadia Mahjabin, A. S. Mollah, M. R. Mawla

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Atmospheric dispersion modeling is significant for any nuclear facilities in the country to predict the impact of radiological doses on environment as well as human health. That is why to ensure safety of workers and population at plant site; Atmospheric dispersion modeling and radiation dose calculations were carried out for a hypothetical accidental release of airborne radionuclide from the 3 MW TRIGA research reactor of Savar, Bangladesh. It is designed with reactor core which consists of 100 fuel elements(1.82245 cm in diameter and 38.1 cm in length), arranged in an annular corefor steady-state and square wave power level of 3 MW (thermal) and for pulsing with maximum power level of 860MWth.The fuel is in the form of a uniform mixture of 20% uranium and 80% zirconium hydride. Total effective doses (TEDs) to the public at various downwind distances were evaluated with a health physics computer code “HotSpot” developed by Lawrence Livermore National Laboratory, USA. The doses were estimated at different Pasquill stability classes (categories A-F) with site-specific averaged meteorological conditions. The meteorological data, such as, average wind speed, frequency distribution of wind direction, etc. have also been analyzed based on the data collected near the reactor site. The results of effective doses obtained remain within the recommended maximum effective dose.

Keywords: accidental release, dispersion modeling, total effective dose, TRIGA

Procedia PDF Downloads 136

Authors: Guillaume Linassier, Morgan Balland, Hugo Pervier, Marie Pervier, David Hammond

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Atmospheric icing for turbojet is caused by ingestion of super-cooled water droplets. To prevent operability risks, manufacturer can implement ice protection systems. Thermal systems are commonly used for this purpose, but their activation can cause the formation of a water liquid film, that can freeze downstream the heated surface or even on other components. In the framework of STORM, a European project dedicated to icing physics in turbojet engines, a cascade rig representative of engine inlet blades was built and tested in an icing wind tunnel. This mock-up integrates two rows of blades, the upstream one being anti-iced using an electro-thermal device the downstream one being unheated. Under icing conditions, the anti-icing system is activated and set at power level to observe a liquid film on the surface and droplet re-emission at the trailing edge. These re-emitted droplets will impinge on the downstream row and contribute to ice accretion. A complete experimental database was generated, including the characterization of ice accretion shapes, and the characterization of electro-thermal anti-icing system (power limit for apparition of the runback water or ice accretion). These data will be used for validation of numerical tools for modeling thermal anti-icing systems in the scope of engine application, as well as validation of re-emission droplets model for stator parts.

Keywords: turbomachine, anti-icing, cascade rig, runback water

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Authors: Maria Amodeo, Pasquale Arpaia, Marco Buzio, Vincenzo Di Capua, Francesco Donnarumma

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Different deep neural network architectures have been compared and tested to predict magnetic hysteresis in the context of pulsed electromagnets for experimental physics applications. Modelling quasi-static or dynamic major and especially minor hysteresis loops is one of the most challenging topics for computational magnetism. Recent attempts at mathematical prediction in this context using Preisach models could not attain better than percent-level accuracy. Hence, this work explores neural network approaches and shows that the architecture that best fits the measured magnetic field behaviour, including the effects of hysteresis and eddy currents, is the nonlinear autoregressive exogenous neural network (NARX) model. This architecture aims to achieve a relative RMSE of the order of a few 100 ppm for complex magnetic field cycling, including arbitrary sequences of pseudo-random high field and low field cycles. The NARX-based architecture is compared with the state-of-the-art, showing better performance than the classical operator-based and differential models, and is tested on a reference quadrupole magnetic lens used for CERN particle beams, chosen as a case study. The training and test datasets are a representative example of real-world magnet operation; this makes the good result obtained very promising for future applications in this context.

Keywords: deep neural network, magnetic modelling, measurement and empirical software engineering, NARX

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Authors: Carolina N. França, Jônatas B. do Amaral, Maria C.O. Izar, Ighor L. Teixeira, Francisco A. Fonseca

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Introduction: Atherosclerosis is a progressive disease, characterized by lipid and fibrotic element deposition in large-caliber arteries. Conditions related to the development of atherosclerosis, as dyslipidemia, hypertension, diabetes, and smoking are associated with endothelial dysfunction. There is a frequent recurrence of cardiovascular outcomes after acute myocardial infarction and, at this sense, cycles of mobilization of monocyte subtypes (classical, intermediate and nonclassical) secondary to myocardial infarction may determine the colonization of atherosclerotic plaques in different stages of the development, contributing to early recurrence of ischemic events. The recruitment of different monocyte subsets during inflammatory process requires the expression of chemokine receptors CCR2, CCR5, and CX3CR1, to promote the migration of monocytes to the inflammatory site. The aim of this study was to evaluate the effect of lipid-lowering treatment by six months in the monocyte phenotype and chemokine receptor levels of patients after Acute Myocardial Infarction (AMI). Methods: This is a PROBE (prospective, randomized, open-label trial with blinded endpoints) study (ClinicalTrials.gov Identifier: NCT02428374). Adult patients (n=147) of both genders, ageing 18-75 years, were randomized in a 2x2 factorial design for treatment with rosuvastatin 20 mg/day or simvastatin 40 mg/day plus ezetimibe 10 mg/day as well as ticagrelor 90 mg 2x/day and clopidogrel 75 mg, in addition to conventional AMI therapy. Blood samples were collected at baseline, after one month and six months of treatment. Monocyte subtypes (classical - inflammatory, intermediate - phagocytic and nonclassical – anti-inflammatory) were identified, quantified and characterized by flow cytometry, as well as the expressions of the chemokine receptors (CCR2, CCR5 and CX3CR1) were also evaluated in the mononuclear cells. Results: After six months of treatment, there was an increase in the percentage of classical monocytes and reduction in the nonclassical monocytes (p=0.038 and p < 0.0001 Friedman Test), without differences for intermediate monocytes. Besides, classical monocytes had higher expressions of CCR5 and CX3CR1 after treatment, without differences related to CCR2 (p < 0.0001 for CCR5 and CX3CR1; p=0.175 for CCR2). Intermediate monocytes had higher expressions of CCR5 and CX3CR1 and lower expression of CCR2 (p = 0.003; p < 0.0001 and p = 0.011, respectively). Nonclassical monocytes had lower expressions of CCR2 and CCR5, without differences for CX3CR1 (p < 0.0001; p = 0.009 and p = 0.138, respectively). There were no differences after the comparison between the four treatment arms. Conclusion: The data suggest a time-dependent modulation of classical and nonclassical monocytes and chemokine receptor levels. The higher percentage of classical monocytes (inflammatory cells) suggest a residual inflammatory risk, even under preconized treatments to AMI. Indeed, these changes do not seem to be affected by choice of the lipid-lowering strategy.

Keywords: acute myocardial infarction, chemokine receptors, lipid-lowering treatment, monocyte subtypes

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Authors: Tien S. H. Pham, Peter J. Mahon, Aimin Yu

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The detection of drug molecules by voltammetry has attracted great interest over the past years. However, many drug molecules exhibit poor electrochemical signals at common electrodes which result in low sensitivity in detection. An efficient way to overcome this problem is to modify electrodes with functional materials. Since discovered in 2004, graphene (or reduced graphene oxide) has emerged as one of the most studied two-dimensional carbon materials in condensed matter physics, electrochemistry, and so on due to its exceptional physicochemical properties. Additionally, the continuous development of technology has opened the new window for the successful fabrications of many novel graphene-based nanomaterials to serve in electrochemical analysis. This research aims to synthesize and characterize gold nanoparticle coated beta-cyclodextrin functionalized reduced graphene oxide (Au NP–β-CD–RGO) nanocomposites with highly conductive and strongly electro-catalytic properties as well as excellent supramolecular recognition abilities for the modification of electrodes. The electrochemical responses of ciprofloxacin at the as-prepared nanocomposite modified electrode was effectively amplified was much higher in comparison with that at the bare electrode. The linear concentration range was from 0.01 to 120 µM, with a detection limit of 2.7 nM using differential pulse voltammetry. Thus, Au NP–β-CD–RGO nanocomposite has great potential as an ideal material to construct sensitive sensors for the electrochemical determination of ciprofloxacin or similar antibacterial drugs in the future based on its excellent stability, selectivity, and reproducibility.

Keywords: Au nanoparticles, β-CD, ciprofloxacin, electrochemical determination, graphene based nanomaterials

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Authors: Apurva Singh, S. P. Jaiswar, Apala Priyadarshini, Akancha Pandey

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Objective: The aim of this study is to find the association of PON1 gene polymorphism with pesticides In RPL subjects. Background: Recurrent pregnancy loss (RPL) is defined as three or more sequential abortions before the 20th week of gestation. Pesticides and its derivatives (organochlorine and organophosphate) are proposed to accommodate a ruler chemical for RPL in the sub-humid region of India. The paraoxonase-1 enzyme (PON1) plays an important role in the toxicity of some organophosphate pesticides, with low PON1 activity being associated with higher pesticide sensitivity Methodology: This is a case-control study done in Department of Obstetrics & Gynaecology & Department of Biochemistry, K.G.M.U, Lucknow, India. The subjects were enrolled after fulfilling the inclusion & exclusion criteria. Inclusion criteria: Cases- Subject having two or more spontaneous abortions & Control- Healthy female having one or more alive child was selected. Exclusion criteria: Cases & Control- Subject having the following disease will be excluded from the study Diabetes mellitus, Hypertension, Tuberculosis, Immunocompromised patients, any endocrine disorder and genital, colon or breast cancer any other malignancies. Blood samples were collected in EDTA tubes from cases & healthy control women & genomic DNA was extracted by phenol-chloroform method. The estimation of pesticides residue from blood was done by HPLC. Biochemical estimation was also performed. Genotyping of PON1 gene polymorphism was performed by RFLP. Statistical analysis of the data was performed using the SPSS16.3 software. Results: A sum of total 14 pesticides (12 organochlorine and 2 organophosphate) selected on the basis of their persistent nature and consumption rate. The significant level of pesticide (ppb) estimated by the Mann whiney test and it was found to be significant at higher level of β-HCH (p:0.04), γ-HCH (p:0.001), δ-HCH (p: 0.002), chloropyrifos (p:0.001), pp-DDD (p:0.001) and fenvalrate (p: 0.001) in case group compare to its control. The level of antioxidant enzymes were found to be significantly decreased among the cases. Wild homozygous TT was more frequent and prevalent among control groups. However, heterozygous group (Tt) was more in cases than control groups (CI-0.3-1.3) (p=0.06). Conclusion: Higher levels of pesticides with endocrine disrupting potential in cases indicate the possible role of these compounds as one of the causes of recurrent pregnancy loss. Possibly, increased pesticide level appears to indicate increased levels of oxidative damage that has been associated with the possible cause of Recurrent Miscarriage, it may reflect indirect evidence of toxicity rather than the direct cause. Since both factors are reported to increase risk, individuals with higher levels of these 'Toxic compounds' especially in 'high-risk genotypes' might be more susceptible to recurrent pregnancy loss.

Keywords: paraoxonase, pesticides, PON1, RPL

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

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Authors: Y. Bai, M. Bodlak, V. Frolov, S. Huber, V. Jary, I. Konorov, D. Levit, J. Novy, D. Steffen, O. Subrt, M. Virius

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In general, state-of-the-art Data Acquisition Systems (DAQ) in high energy physics experiments must satisfy high requirements in terms of reliability, efficiency and data rate capability. This paper presents the development and deployment of a debugging tool named DAQ Debugger for the intelligent, FPGA-based Data Acquisition System (iFDAQ) of the COMPASS experiment at CERN. Utilizing a hardware event builder, the iFDAQ is designed to be able to readout data at the average maximum rate of 1.5 GB/s of the experiment. In complex softwares, such as the iFDAQ, having thousands of lines of code, the debugging process is absolutely essential to reveal all software issues. Unfortunately, conventional debugging of the iFDAQ is not possible during the real data taking. The DAQ Debugger is a tool for identifying a problem, isolating the source of the problem, and then either correcting the problem or determining a way to work around it. It provides the layer for an easy integration to any process and has no impact on the process performance. Based on handling of system signals, the DAQ Debugger represents an alternative to conventional debuggers provided by most integrated development environments. Whenever problem occurs, it generates reports containing all necessary information important for a deeper investigation and analysis. The DAQ Debugger was fully incorporated to all processes in the iFDAQ during the run 2016. It helped to reveal remaining software issues and improved significantly the stability of the system in comparison with the previous run. In the paper, we present the DAQ Debugger from several insights and discuss it in a detailed way.

Keywords: DAQ Debugger, data acquisition system, FPGA, system signals, Qt framework

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Authors: Muhammad Umair, Yuri Nikolaev, Denis Artemov, Ighor Uzhinsky

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A flexible manufacturing system is an integral part of a smart factory of industry 4.0 in which every machine is interconnected and works autonomously. Robots are in the process of replacing humans in every industrial sector. As the cyber-physical-system (CPS) and artificial intelligence (AI) are advancing, the manufacturing industry is getting more dependent on computers than human brains. This modernization has boosted the production with high quality and accuracy and shifted from classic production to smart manufacturing systems. However, material handling for such automated productions is a challenge and needs to be addressed with the best possible solution. Conventional clamping systems are designed for manual work and not suitable for highly automated production systems. Researchers and engineers are trying to find the most economical solution for loading/unloading and transportation workpieces from a warehouse to a machine shop for machining operations and back to the warehouse without human involvement. This work aims to propose an advanced multi-shape tooling solution for highly automated manufacturing systems. The currently obtained result shows that it could function well with automated guided vehicles (AGVs) and modern conveyor belts. The proposed solution is following requirements to be automation-friendly, universal for different part geometry and production operations. We used a bottom-up approach in this work, starting with studying different case scenarios and their limitations and finishing with the general solution.

Keywords: artificial intelligence, cyber physics system, Industry 4.0, material handling, smart factory, flexible manufacturing system

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Authors: Shabnam Naderi

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Traditional understandings of ethics considered translators, translations, technologies and other agents as separate and prioritized human agents. In fact, ethics was equated with morality. This disengaged understanding of ethics is superseded by an ethics of relation/entanglement in the posthuman philosophy. According to this ethics of entanglement, human and nonhuman agents are in constant ‘intra-action’. The human is not separate from nature, from technology and from other nonhuman entities, and an ethics of translation in this regard cannot be separated from technology and ecology and get defined merely within the realm of human-human encounter. As such, a posthuman ethics offers opportunities for change and responds to the changing nature of reality, it is negotiable and reveals itself as a moment-by-moment practice (i.e. as temporally emergent and beyond determinacy and permanence). Far from the linguistic or cultural, or individual concerns, posthuman translational ethics discusses how the former rigid norms and laws are challenged in a process ontology which puts emphasis on activity and activation and considers ethics as surfacing in activity, not as a predefined set of rules and values. In this sense, traditional ethical principles like faithfulness, accuracy and representation are superseded by principles of privacy, sustainability, multiplicity and decentralization. The present conceptual study, drawing on Ferrando’s philosophical posthumanism (as a post-humanism, as a post-dualism and as a post-anthropocentrism), Deleuze-Guattarian philosophy of immanence and Barad’s physics-philosophy strives to destabilize traditional understandings of translation ethics and bring an ethics that has loose ends and revolves around multiplicity and decentralization into the picture.

Keywords: ethics of entanglement, post-anthropocentrism, post-dualism, post-humanism, translation

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Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

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Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

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Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

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Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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Authors: Hong Yu, Ion Matei

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Carbon fiber reinforced composites (CFRP) used as aircraft structure are subject to lightning strike, putting structural integrity under risk. Indirect damage may occur after a lightning strike where the internal structure can be damaged due to excessive heat induced by lightning current, while the surface of the structures remains intact. Three damage modes may be observed after a lightning strike: fiber breakage, inter-ply delamination and intra-ply cracks. The assessment of internal damage states in composite is challenging due to complicated microstructure, inherent uncertainties, and existence of multiple damage modes. In this work, a model based approach is adopted to diagnose faults in carbon composites after lighting strikes. A resistor network model is implemented to relate the overall electrical and thermal conduction behavior under simulated lightning current waveform to the intrinsic temperature dependent material properties, microstructure and degradation of materials. A fault detection and identification (FDI) module utilizes the physics based model and a particle filtering algorithm to identify damage mode as well as calculate the probability of structural failure. Extensive simulation results are provided to substantiate the proposed fault diagnosis methodology with both single fault and multiple faults cases. The approach is also demonstrated on transient resistance data collected from a IM7/Epoxy laminate under simulated lightning strike.

Keywords: carbon composite, fault detection, fault identification, particle filter

Procedia PDF Downloads 195