Search results for: like function

Authors: Magdi. M. Nabi, Ding-Li Yu

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Control of a semi-batch polymerization reactor using an adaptive radial basis function (RBF) neural network method is investigated in this paper. A neural network inverse model is used to estimate the valve position of the reactor; this method can identify the controlled system with the RBF neural network identifier. The weights of the adaptive PID controller are timely adjusted based on the identification of the plant and self-learning capability of RBFNN. A PID controller is used in the feedback control to regulate the actual temperature by compensating the neural network inverse model output. Simulation results show that the proposed control has strong adaptability, robustness and satisfactory control performance and the nonlinear system is achieved.

Keywords: Chylla-Haase polymerization reactor, RBF neural networks, feed-forward, feedback control

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Authors: Zhang Zijian

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Nowadays, spherical robots have played an important role in many fields, but the insufficient ability of obstacle surmounting limits their wider application fields. To solve this problem, a jumping system of a spherical robot is designed based on Archimedes helix. The jumping system of the robot utilizes the characteristics of Archimedes helix and isovelocity helix to achieve constant speed and stable contraction, which ensures the stability of the system. Also, the jumping action of the robot is realized by instantaneous release of elastic potential energy. In order to verify the effectiveness of the jumping system, we designed a spherical robot and its jumping system. The experimental results show that the jumping system has the advantages of light weight, small size, high energy conversion efficiency, and can realize the spherical jumping function.

Keywords: hopping mechanism, Archimedes' Helix, hopping robot, spherical robot

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Authors: Salma Aboussalam, Karima Khalil, Khalid Elkalay

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The Ecopath model was utilized to evaluate the trophic structure, function, and current status of the Moroccan Mediterranean Sea ecosystem. The model incorporated 31 functional groups, including fish species, invertebrates, primary producers, and detritus. Through the analysis of trophic interactions among these groups, an average trophic transfer efficiency of 23% was found. The findings revealed that the ecosystem produced more energy than it consumed, with high respiration and consumption rates. Indicators of stability and development were low, indicating that the ecosystem is disturbed by a linear trophic structure. Additionally, keystone species were identified through the use of the keystone index and mixed trophic impact analysis, with demersal invertebrates, zooplankton, and cephalopods found to have a significant impact on other groups.

Keywords: ecopath, food web, trophic flux, Moroccan Mediterranean Sea

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Authors: Jong Woo Kim, Go Bong Choi, Sang Hwan Son, Dae Shik Kim, Jung Chul Suh, Jong Min Lee

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The Markov Decision Process (MDP) based methodology is implemented in order to establish the optimal schedule which minimizes the cost. Formulation of MDP problem is presented using the information about the current state of pipe, improvement cost, failure cost and pipe deterioration model. The objective function and detailed algorithm of dynamic programming (DP) are modified due to the difficulty of implementing the conventional DP approaches. The optimal schedule derived from suggested model is compared to several policies via Monte Carlo simulation. Validity of the solution and improvement in computational time are proved.

Keywords: Markov decision processes, dynamic programming, Monte Carlo simulation, periodic replacement, Weibull distribution

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Authors: Muhammad A. Khan, Waseem Shahzad

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Analysis of protein sequences is carried out for the purpose to discover their structural and ancestry relationship. Sequence similarity determines similar protein structures, similar function, and homology detection. Biological sequences composed of amino acid residues or nucleotides provide significant information through sequence alignment. In this paper, we present a new similarity/dissimilarity measure to sequence alignment based on the primary structure of a protein. The approach finds the distance between the two given sequences using the novel sequence alignment algorithm and a mathematical model. The algorithm runs at a time complexity of O(n²). A distance matrix is generated to construct a phylogenetic tree of different species. The new similarity/dissimilarity measure outperforms other existing methods.

Keywords: alignment, distance, homology, mathematical model, phylogenetic tree

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Authors: Ezzat Mohamed El-Amin

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Mapping the earthquake-size distribution in various tectonic regimes on a local to regional scale reveals statistically significant variations in the range of at least 0.4 to 2.0 for the b-value in the frequency-magnitude distribution. We map the earthquake frequency–magnitude distribution (b value) as a function of depth in the Reservoir Triggered Seismicity (RTS) region in Kalabsha region, in south Egypt. About 1680 well-located events recorded during 1981–2014 in the Kalabsha region are selected for the analysis. The earthquake data sets are separated in 5 km zones from 0 to 25 km depth. The result shows a systematic decrease in b value up to 12 km followed by an increase. The increase in b value is interpreted to be caused by the presence of fluids. We also investigate the spatial distribution of b value with depth. Significant variations in the b value are detected, with b ranging from b 0.7 to 1.19. Low b value areas at 5 km depth indicate localized high stresses which are favorable for future rupture.

Keywords: seismicity, frequency-magnitude, b-value, earthquake

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Authors: Sergey Svita, Valeriy Astapenko

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The study is devoted to theoretical analysis of ultrashort electromagnetic pulses (USP) absorption on gold nanospheres. Dependencies of USP energy absorption on nanospheres placed in various matrix are compared. The results of calculation of absorbed energy on gold nanospheres as a function of ultrashort electromagnetic pulse carrier frequency and number of pulse cycles of carrier frequency show strong non-linear dependence of absorbed energy on number of cycles of carrier frequency, but for relatively large number of cycles on USP carrier frequency it goes to linear dependence.

Keywords: ultrashort electromagnetic pulses, absorption, nanospheres, theoretical research

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Authors: B. Selma, S. Chouraqui

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The pancreas is an elongated organ that extends across the abdomen, below the stomach. In addition, it secretes certain enzymes that aid in food digestion. The pancreas also manufactures hormones responsible for regulating blood glucose levels. In the present paper, we propose a mathematical model to study the homeostasis of glucose and insulin in healthy human, and a simulation of this model, which depicts the physiological events after a meal, will be represented in ordinary humans. The aim of this paper is to design an algorithm which regulates the level of glucose in the blood. The algorithm applied the concept of expert system for performing an algorithm control in the form of an "active" used to prescribe the rate of insulin infusion. By decomposing the system into subsystems, we have developed parametric models of each subsystem by using a forcing function strategy. The results showed a performance of the control system.

Keywords: modeling, algorithm, regulation, glucose-insulin, blood, control system

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Authors: Mohaddeseh Ahmadnezhad, Shahrbano Oryan, Mahmoud Bahmani, Mohammadd Sayad Bourani

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Changes in abundance and size of skin ionocytes were investigated in two larval stage of Caspian sea zander, Sander lucioperca, before and after yolk sac absorption, at 96h after transfer from fresh water (FW; <0.5‰) to 7‰ (estuary) and 12‰ (Caspian sea water=CW) salinity. Survival rate in the stage of after yolk sac absorption were more than larval pre-absorbed yolk sac in condition of salinity (p<0.05). Ionocyte abundance increased significantly in 7 and 12‰ salinity (p<0.05), but not about ionocyte size. The results of this study suggest that development of skin Ionocyte osmoregulatory function and osmoregulation capability of Caspian Sea zander larvae increased with growth of the larvae.

Keywords: Caspian Sea, larvae, Sander lucioperca, salinity, skin ionocyte

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Authors: Guillermo Manuel Flores Figueroa, Juan Alejandro Vazquez Feijoo, Jose Navarro Antonio

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A continuous nonlinear system response may be obtained by an infinite sum of the so-called Volterra operators. Each operator is obtained from multidimensional convolution of nth-order between the nth-order Volterra kernel and the system input. These operators can also be obtained from the Associated Linear Equations (ALEs) that are linear models of subsystems which inputs and outputs are of the same nth-order. Each ALEs produces a particular nth-Volterra operator. As linear models a unitary impulse response can be obtained from them. This work shows the relationship between this unitary impulse responses and the corresponding order Volterra kernel.

Keywords: Volterra series, frequency response functions FRF, associated linear equations ALEs, unitary response function, Voterra kernel

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Authors: G. Rosaz, V. Semblanet, S. Calatroni, A. Sublet, M. Taborelli

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We report in this paper the design and qualification of a cylindrical unbalanced magnetron source. The dedicated magnetic assemblies were simulated using a finite element model. A hall-effect magnetic probe was then used to characterize those assemblies and compared to the theoretical magnetic profiles. These show a good agreement between the expected and actual values. The qualification of the different magnetic assemblies was then performed by measuring the ion flux density reaching the surface of the sample to be coated using a commercial retarding field energy analyzer. The strongest unbalanced configuration shows an increase from 0.016 A.cm^-2 to 0.074 A.cm^-2 of the ion flux density reaching the sample surface compared to the standard balanced configuration for a pressure 5.10^-3 mbar and a plasma source power of 300 W.

Keywords: ion energy distribution function, magnetron sputtering, niobium, unbalanced, SRF cavities, thin film

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Authors: André Jesus, Yanjie Zhu, Irwanda Laory

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Structural health monitoring is one of the most promising technologies concerning aversion of structural risk and economic savings. Analysts often have to deal with a considerable variety of uncertainties that arise during a monitoring process. Namely the widespread application of numerical models (model-based) is accompanied by a widespread concern about quantifying the uncertainties prevailing in their use. Some of these uncertainties are related with the deterministic nature of the model (code uncertainty) others with the variability of its inputs (parameter uncertainty) and the discrepancy between a model/experiment (systematic uncertainty). The actual process always exhibits a random behaviour (observation error) even when conditions are set identically (residual variation). Bayesian inference assumes that parameters of a model are random variables with an associated PDF, which can be inferred from experimental data. However in many Bayesian methods the determination of systematic uncertainty can be problematic. In this work systematic uncertainty is associated with a discrepancy function. The numerical model and discrepancy function are approximated by Gaussian processes (surrogate model). Finally, to avoid the computational burden of a fully Bayesian approach the parameters that characterise the Gaussian processes were estimated in a four stage process (modular Bayesian approach). The proposed methodology has been successfully applied on fields such as geoscience, biomedics, particle physics but never on the SHM context. This approach considerably reduces the computational burden; although the extent of the considered uncertainties is lower (second order effects are neglected). To successfully identify the considered uncertainties this formulation was extended to consider multiple responses. The efficiency of the algorithm has been tested on a small scale aluminium bridge structure, subjected to a thermal expansion due to infrared heaters. Comparison of its performance with responses measured at different points of the structure and associated degrees of identifiability is also carried out. A numerical FEM model of the structure was developed and the stiffness from its supports is considered as a parameter to calibrate. Results show that the modular Bayesian approach performed best when responses of the same type had the lowest spatial correlation. Based on previous literature, using different types of responses (strain, acceleration, and displacement) should also improve the identifiability problem. Uncertainties due to parametric variability, observation error, residual variability, code variability and systematic uncertainty were all recovered. For this example the algorithm performance was stable and considerably quicker than Bayesian methods that account for the full extent of uncertainties. Future research with real-life examples is required to fully access the advantages and limitations of the proposed methodology.

Keywords: bayesian, calibration, numerical model, system identification, systematic uncertainty, Gaussian process

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Authors: Duhania O. Mahara, Santi W. Purnami, Aulia N. Fitria, Merissa N. Z. Wirontono, Revina Musfiroh, Shofi Andari, Sagiran Sagiran, Estiana Khoirunnisa, Wahyudi Widada

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For assessing interventions in numerous disease areas, the use of multiple time-to-event outcomes is common. An individual might experience two different events called bivariate time-to-event data, the events may be correlated because it come from the same subject and also influenced by individual characteristics. The bivariate time-to-event case can be applied by copula-based bivariate Cox survival model, using the Clayton and Frank copulas to analyze the dependence structure of each event and also the covariates effect. By applying this method to modeling the recurrent event infection of hemodialysis insertion on chronic kidney disease (CKD) patients, from the AIC and BIC values we find that the Clayton copula model was the best model with Kendall’s Tau is (τ=0,02).

Keywords: bivariate cox, bivariate event, copula function, survival copula

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Authors: Tunjo Perič, Marin Fatović

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In this paper a new methodology for vendor selection and supply quotas determination (VSSQD) is proposed. The problem of VSSQD is solved by the model that combines revised weighting method for determining the objective function coefficients, and a multiple objective linear programming (MOLP) method based on the cooperative game theory for VSSQD. The criteria used for VSSQD are: (1) purchase costs and (2) product quality supplied by individual vendors. The proposed methodology is tested on the example of flour purchase for a bakery with two decision makers.

Keywords: cooperative game theory, multiple objective linear programming, revised weighting method, vendor selection

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Authors: Talha A. Taj, Talha A. Khan, M. Imran Khalid

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Optimization techniques attract researchers to formulate a problem and determine its optimum solution. This paper presents an Enhanced Harmony Search (ENHS) algorithm for solving optimization problems. The proposed algorithm increases the convergence and is more efficient than the standard Harmony Search (HS) algorithm. The paper discusses the novel techniques in detail and also provides the strategy for tuning the decisive parameters that affects the efficiency of the ENHS algorithm. The algorithm is tested on various benchmark functions, a real world optimization problem and a constrained objective function. Also, the results of ENHS are compared to standard HS, and various other optimization algorithms. The ENHS algorithms prove to be significantly better and more efficient than other algorithms. The simulation and testing of the algorithms is performed in MATLAB.

Keywords: optimization, harmony search algorithm, MATLAB, electronic

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Authors: Y. Lasbet, A. L. Boukhalkhal, K. Loubar

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The study of mixed convection is, usually, focused on the straight channels in which the onset of the mixed convection is well defined as function of the ratio between Grashof number and Reynolds number, Gr/Re. This is not the case for a complex channel wherein the mixed convection is not sufficiently examined in the literature. Our paper focuses on the study of the mixed convection in a complex geometry in which our main contribution reveals that the critical value of the ratio Gr/Re for the onset of the mixed convection increases highly in the type of geometry contrary to the straight channel. Furthermore, the accentuated secondary flow in this geometry prevents the thermal stratification in the flow and consequently the buoyancy driven becomes negligible. To perform these objectives, a numerical study in complex geometry for several values of the ratio Gr/Re with prescribed wall heat flux (H2), was realized by using the CFD code.

Keywords: complex geometry, heat transfer, laminar flow, mixed convection, Nusselt number

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Authors: Indra Gonzalez Ojeda, Tatiana Quinones, Manuel Rosario, Igor Lednev, Juan Lopez Garriga

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Amyloid fibrils are stable aggregates of misfolded protein associated with many neurodegenerative disorders. It has been shown that hydrogen sulfide (H2S), inhibits the fibrillation of lysozyme through the formation of trisulfide (S-S-S) bonds. However, the overall mechanism remains elusive. Here, the concentration dependence of H2S effect was investigated using Atomic force microscopy (AFM), non-resonance Raman spectroscopy, Deep-UV Raman spectroscopy and circular dichroism (CD). It was found that small spherical aggregates with trisulfide bonds and a unique secondary structure were formed instead of amyloid fibrils when adding concentrations of 25 mM and 50 mM of H2S. This could indicate that H2S might serve as a protecting agent for the protein. However, further characterization of these aggregates and their trisulfide bonds is needed to fully unravel the function H2S has on protein fibrillation.

Keywords: amyloid fibrils, hydrogen sulfide, protein folding, raman spectroscopy

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Authors: Michael Zaidman, Naum Simanovsky

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The most of brachial birth palsies are transient. Children with incomplete recovery almost always develop an internal rotation and adduction contracture. The muscle imbalance around the shoulder results in glenohumeral joint deformity and functional limitations. Natural history of glenohumeral deformity is it’s progression with worsening of function. Anteversion glenoid osteotomy with latissimus dorsi and teres major tendon transfers could be an alternative procedure of proximal humeral external rotation osteotomy for patients with severe glenohumeral dysplasia secondary to brachial plexus birth palsy. We will discuss pre-operative planning and stepped operative technique of the procedure on clinical example.

Keywords: obstetric brachial plexus palsy, glenoid anteversion osteotomy, tendon transfer, operative technique

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Authors: Parminder Kaur Heer, Alexei Lapkin

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Due to global challenges of increased competition and demand for more sustainable products/processes, there is a rising pressure on the industry to develop innovative processes. Through Process Intensification (PI) the existing and new processes may be able to attain higher efficiency. However, very few PI options are generally considered. This is because processes are typically analysed at a unit operation level, thus limiting the search space for potential process options. PI performed at more detailed levels of a process can increase the size of the search space. The different levels at which PI can be achieved is unit operations, functional and phenomena level. Physical/chemical phenomena form the lowest level of aggregation and thus, are expected to give the highest impact because all the intensification options can be described by their enhancement. The objective of the current work is thus, generation of numerous process alternatives based on phenomena, and development of their corresponding computer aided models. The methodology comprises: a) automated generation of process options, and b) automated generation of process models. The process under investigation is disintegrated into functions viz. reaction, separation etc., and these functions are further broken down into the phenomena required to perform them. E.g., separation may be performed via vapour-liquid or liquid-liquid equilibrium. A list of phenomena for the process is formed and new phenomena, which can overcome the difficulties/drawbacks of the current process or can enhance the effectiveness of the process, are added to the list. For instance, catalyst separation issue can be handled by using solid catalysts; the corresponding phenomena are identified and added. The phenomena are then combined to generate all possible combinations. However, not all combinations make sense and, hence, screening is carried out to discard the combinations that are meaningless. For example, phase change phenomena need the co-presence of the energy transfer phenomena. Feasible combinations of phenomena are then assigned to the functions they execute. A combination may accomplish a single or multiple functions, i.e. it might perform reaction or reaction with separation. The combinations are then allotted to the functions needed for the process. This creates a series of options for carrying out each function. Combination of these options for different functions in the process leads to the generation of superstructure of process options. These process options, which are formed by a list of phenomena for each function, are passed to the model generation algorithm in the form of binaries (1, 0). The algorithm gathers the active phenomena and couples them to generate the model. A series of models is generated for the functions, which are combined to get the process model. The most promising process options are then chosen subjected to a performance criterion, for example purity of product, or via a multi-objective Pareto optimisation. The methodology was applied to a two-step process and the best route was determined based on the higher product yield. The current methodology can identify, produce and evaluate process intensification options from which the optimal process can be determined. It can be applied to any chemical/biochemical process because of its generic nature.

Keywords: Phenomena, Process intensification, Process models , Process options

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Authors: Munir Tasdemir

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Polymer/clay composites have received great attention in the past three decades owing to their light weight coupled with significantly better mechanical and barrier properties than the corresponding neat polymer resins. An investigation was carried out on the effects of red mud powder size and ratio on the mechanical and thermal properties of polypropylene /red mud polymer composites. Red mud, in four different concentrations (0, 10, 20 and 30 wt %) and three different powder size (180, 63 and 38 micron) were added to PP to produce composites. The mechanical properties, including the elasticity modulus, tensile & yield strength, % elongation, hardness, Izod impact strength and the thermal properties including the melt flow index, heat deflection temperature and vicat softening point of the composites were investigated. The structures of the composites were investigated by scanning electron microscopy and compared to mechanical and thermal properties as a function of red mud powder content and size.

Keywords: polypropylene, powder, red mud, mechanical properties

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Authors: Changyin Zhou

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Ba constructions are a special type of constructions in Chinese. Their syntactic behaviors are closely related to their event structural properties. The existing study which treats the semantic function of Ba as causative meets difficulty in treating the discrepancy between Ba constructions and their corresponding constructions without Ba in expressing causativity. This paper holds that Ba in Ba constructions is a functional category expressing affectedness. The affectedness expressed by Ba can be positive or negative. The functional category Ba expressing negative affectedness has the semantic property of being 'expected'. The precondition of Ba construction is the boundedness of the event concerned. This paper, holding the parallelism between motion events and change-of-state events, proposes a syntactic model based on the notions of boundedness and affectedness, discusses the transformations between Ba constructions and the related resultative constructions, and derivates the various Ba constructions concerned.

Keywords: affectedness, Ba constructions, boundedness, event structure, resultative constructions

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Authors: Yuanqing Li, Changyi Lei, Zhaopeng Xue, Zhuo Zheng, Yanbo Long

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In agricultural production and breeding, implementing automatic picking robot in orchard farming to reduce human labour and error is challenging. The core function of it is automatic identification based on machine vision. This paper focuses on apple detection and counting in orchards and implements several deep learning methods. Extensive datasets are used and a semi-automatic annotation method is proposed. The proposed deep learning models are in state-of-the-art YOLO family. In view of the essence of the models with various backbones, a multi-dimensional comparison in details is made in terms of counting accuracy, mAP and model memory, laying the foundation for realising automatic precision agriculture.

Keywords: agricultural object detection, deep learning, machine vision, YOLO family

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Authors: Natalia Kajka, Agnieszka Kulik

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The aim of the study is to present the results regarding differences in perception of cognitive progress of children with Attention Deficit Hyperactivity Disorder (ADHD) by adults and children themselves. The experiment was attended by 45 children with ADHD, their parents and teachers. The children attended the 3-month metacognitive training. Both children and adults were examined before and after joining this project. In order to show significant differences between the first and second measurement of the test, non-parametric Wilcoxon tests were performed. The analysis showed statistically significant differences in the change of cognitive functioning in children with ADHD participating in metacognitive training, this was also confirmed by the results of the parents' research. There were no significant differences in the teachers' assessment of these children.

Keywords: ADHD, executive function, Golem effect metacognitive training

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Authors: Naushad Mamode Khan

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The Com-Poisson (CMP) model is one of the most popular discrete generalized linear models (GLMS) that handles both equi-, over- and under-dispersed data. In longitudinal context, an integer-valued autoregressive (INAR(1)) process that incorporates covariate specification has been developed to model longitudinal CMP counts. However, the joint likelihood CMP function is difficult to specify and thus restricts the likelihood based estimating methodology. The joint generalized quasilikelihood approach (GQL-I) was instead considered but is rather computationally intensive and may not even estimate the regression effects due to a complex and frequently ill conditioned covariance structure. This paper proposes a new GQL approach for estimating the regression parameters (GQLIII) that are based on a single score vector representation. The performance of GQL-III is compared with GQL-I and separate marginal GQLs (GQL-II) through some simulation experiments and is proved to yield equally efficient estimates as GQL-I and is far more computationally stable.

Keywords: longitudinal, com-Poisson, ill-conditioned, INAR(1), GLMS, GQL

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Authors: Jing Zhang, Jie Chen

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In this paper, we deal with the optimal I/O point location in an automated parking system. In this system, the S/R machine (storage and retrieve machine) travels independently in vertical and horizontal directions. Based on the characteristics of the parking system and the basic principle of AS/RS system (Automated Storage and Retrieval System), we obtain the continuous model in units of time. For the single command cycle using the randomized storage policy, we calculate the probability density function for the system travel time and thus we develop the travel time model. And we confirm that the travel time model shows a good performance by comparing with discrete case. Finally in this part, we establish the optimal model by minimizing the expected travel time model and it is shown that the optimal location of the I/O point is located at the middle of the left-hand above corner.

Keywords: parking system, optimal location, response time, S/R machine

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Authors: Pim Terachinda, Witaya Wannasuphoprasit, Wasuwat Kitisomprayoonkul, Anan Srikiatkhachorn

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Restoration of hand function and dexterity remain challenges in rehabilitation after stroke. We have developed soft exoskeleton hand robot in which using tendon-driven mechanism. Finger flexion and extension can be triggered by a foot switch and force can be adjusted manually depending on patient’s grip strength. The objective of this study is to investigate feasibility and safety of this device. The study was done in 2 stroke patients with the strength of the finger flexors/extensors grade 1/0 and 3/1 on Medical Research Council scale, respectively. Grasp and release training was performed for 30 minutes. No complication was observed. Results demonstrated that the device is safe, and therapy can be tailored to individual patient’s need. However, further study is required to determine recovery and rehabilitation outcomes after training in patients after nervous system injury.

Keywords: hand, rehabilitation, robot, stroke

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Authors: Yu Qin

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In order to tackle the ever-growing problem of the lack of parking space, this paper presents the design and implementation of a smart unmanned parking system that is based on RFID (radio frequency identification) technology and Wireless communication technology. This system uses RFID technology to achieve the identification function (transmitted by 2.4 G wireless module) and is equipped with an STM32L053 micro controller as the main control chip of the smart vehicle. This chip can accomplish automatic parking (in/out), charging and other functions. On this basis, it can also help users easily query the information that is stored in the database through the Internet. Experimental tests have shown that the system has the features of low power consumption and stable operation, among others. It can effectively improve the level of automation control of the parking lot management system and has enormous application prospects.

Keywords: RFID, embedded system, unmanned, parking management

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Authors: Christine P. Gibson, Ramona Alex, Michael Farney, Johana Vallejo-Elias, Mitra Esfandiarei

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Aortic aneurysm is the leading cause of death in Marfan syndrome (MFS), a connective tissue disorder caused by mutations in fibrillin-1 gene (FBN1). MFS aneurysm is characterized by weakening of the aortic wall due to elastin fibers fragmentation and disorganization. The above-average height and distinct physical features make young adults with MFS desirable candidates for competitive sports; but little is known about the exercise limit at which they will be at risk for aortic rupture. On the other hand, aerobic cardiovascular exercise has been shown to have protective effects on the heart and aorta. We have previously reported that mild aerobic exercise can delay the formation of aortic aneurysm in a mouse model of MFS. In this study, we aimed to investigate the effects of various levels of exercise intensity on the progression of aortic aneurysm in the mouse model. Starting at 4 weeks of age, we subjected control and MFS mice to different levels of exercise intensity (8m/min, 10m/min, 15m/min, and 20m/min, corresponding to 55%, 65%, 75%, and 85% of VO2 max, respectively) on a treadmill for 30 minutes per day, five days a week for the duration of the study. At 24 weeks of age, aortic tissue were isolated and subjected to structural and functional studies using histology and wire myography in order to evaluate the effects of different exercise routines on elastin fragmentation and organization and aortic wall elasticity/stiffness. Our data shows that exercise training at the intensity levels between 55%-75% significantly reduces elastin fragmentation and disorganization, with less recovery observed in 85% MFS group. The reversibility of elasticity was also significantly restored in MFS mice subjected to 55%-75% intensity; however, the recovery was less pronounced in MFS mice subjected to 85% intensity. Furthermore, our data shows that smooth muscle cells (SMCs) contractilion in response to vasoconstrictor agent phenylephrine (100nM) is significantly reduced in MFS aorta (54.84 ± 1.63 mN/mm2) as compared to control (95.85 ± 3.04 mN/mm2). At 55% of intensity, exercise did not rescue SMCs contraction (63.45 ± 1.70 mN/mm2), while at higher intensity levels, SMCs contraction in response to phenylephrine was restored to levels similar to control aorta [65% (81.88 ± 4.57 mN/mm2), 75% (86.22 ± 3.84 mN/mm2), and 85% (83.91 ± 5.42 mN/mm2)]. This study provides the first time evidence that high intensity exercise (e.g. 85%) may not provide the most beneficial effects on aortic function (vasoconstriction) and structure (elastin fragmentation, aortic wall elasticity) during the progression of aortic aneurysm in MFS mice. On the other hand, based on our observations, medium intensity exercise (e.g. 65%) seems to provide the utmost protective effects on aortic structure and function in MFS mice. These findings provide new insights into the potential capacity, in which MFS patients could participate in various aerobic exercise routines, especially in young adults affected by cardiovascular complications particularly aortic aneurysm. This work was funded by Midwestern University Research Fund.

Keywords: aerobic exercise, aortic aneurysm, aortic wall elasticity, elastin fragmentation, Marfan syndrome

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Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan

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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.

Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes

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Authors: Wu Liching

Abstract:

Aim This case aims to discuss the pathogenesis, clinical manifestations and medical treatment of strokes caused by mitochondrial gene mutations. Methods Diagnosis of ischemic stroke caused by mitochondrial gene defect by means of "next-generation sequencing mitochondrial DNA gene variation detection", imaging examination, neurological examination, and medical history; this study took samples from the neurology ward of a medical center in northern Taiwan cases diagnosed with acute cerebral infarction as the research objects. Result This case is a 49-year-old married woman with a rare disease, mitochondrial gene mutation inducing ischemic stroke. She has severe hearing impairment and needs to use hearing aids, and has a history of diabetes. During the patient’s hospitalization, the blood test showed that serum Lactate: 7.72 mmol/L, Lactate (CSF) 5.9 mmol/L. Through the collection of relevant medical history, neurological evaluation showed changes in consciousness and cognition, slow response in language expression, and brain magnetic resonance imaging examination showed subacute bilateral temporal lobe infarction, which was an atypical type of stroke. The lineage DNA gene has m.3243A>G known pathogenic mutation point, and its heteroplasmic level is 24.6%. This pathogenic point is located in MITOMAP and recorded as Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) , Leigh Syndrome and other disease-related pathogenic loci, this mutation is located in ClinVar and recorded as Pathogenic (dbSNP: rs199474657), so it is diagnosed as a case of stroke caused by a rare disease mitochondrial gene mutation. After medical treatment, there was no more seizure during hospitalization. After interventional rehabilitation, the patient's limb weakness, poor language function, and cognitive impairment have all improved significantly. Conclusion Mitochondrial disorders can also be associated with abnormalities in psychological, neurological, cerebral cortical function, and autonomic functions, as well as problems with internal medical diseases. Therefore, the differential diagnoses cover a wide range and are not easy to be diagnosed. After neurological evaluation, medical history collection, imaging and rare disease serological examination, atypical ischemic stroke caused by rare mitochondrial gene mutation was diagnosed. We hope that through this case, the diagnosis of rare disease mitochondrial gene variation leading to cerebral infarction will be more familiar to clinical medical staff, and this case report may help to improve the clinical diagnosis and treatment for patients with similar clinical symptoms in the future.

Keywords: acute stroke, MELAS, lactic acidosis, mitochondrial disorders

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