Search results for: slip rate

Authors: Maryam I. Abdullahi, Suleiman Aliyu, Armaya'u Hamisu Bichi

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The study was conducted at the University Fish Farm, Federal University Dutsinma. The aim of the study was to determine the effects of dietary supplementation of Allium sativum and Zingiber officinale mixture on growth performance, feed utilization and survival of C. gariepinus fingerling reared in tank system. The experimental setup comprised of four treatment (4) groups labeled as T1, T2, T3 and T4, each treatment replicated 3 times with ten (10) fingerlings in each replicate respectively. Treatment 1 contained 0.5% of Zingiber officinale and 0.5% of Allium sativum (ZO-AS: 1.0%), Treatment 2 contained 0.75% Zingiber officinale, and 0.75% garlic (ZO-AS: 1.5%) while T3 contained 1% ginger and 1% Allium sativum (ZO-AS: 2.0%) respectively. The experiment lasted for twelve (12) weeks (84 days). The survival rate ranges from 90% - 100%. With a higher Final Mean Weight (893.10) and Percentage Mean Weight (942.65) as compared to the control group and others. There was no significant difference (p > 0.05) in the FMW (893.10) of the fish fed 1.5g/kg of Garlic and Ginger diets than the control (687.00). The SGR (1.20) of fish-fed Zingiber officinale and Allium sativum fortified diets shows that there is no significant difference between treatments fed 1.5g/kg Zingiber officinale and Allium sativum and the control group. Generally, there was an increased survival rate in the experimental fish-fed Zingiber officinale and Allium sativum-supplemented diets as compared to the control.

Keywords: clarias gariepinus, zingiber officinale, allium sativum, fingerlings

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Authors: Mohammad Karimi Moridani, Mohammad Abdi Zadeh, Zahra Shahiazar Mazraeh

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In recent years, the use of intelligent systems in biomedical engineering has increased dramatically, especially in the diagnosis of various diseases. Also, due to the relatively simple recording of the electrocardiogram signal (ECG), this signal is a good tool to show the function of the heart and diseases associated with it. The aim of this paper is to design an intelligent system for automatically detecting a normal electrocardiogram signal from abnormal one. Using this diagnostic system, it is possible to identify a person's heart condition in a very short time and with high accuracy. The data used in this article are from the Physionet database, available in 2016 for use by researchers to provide the best method for detecting normal signals from abnormalities. Data is of both genders and the data recording time varies between several seconds to several minutes. All data is also labeled normal or abnormal. Due to the low positional accuracy and ECG signal time limit and the similarity of the signal in some diseases with the normal signal, the heart rate variability (HRV) signal was used. Measuring and analyzing the heart rate variability with time to evaluate the activity of the heart and differentiating different types of heart failure from one another is of interest to the experts. In the preprocessing stage, after noise cancelation by the adaptive Kalman filter and extracting the R wave by the Pan and Tampkinz algorithm, R-R intervals were extracted and the HRV signal was generated. In the process of processing this paper, a new idea was presented that, in addition to using the statistical characteristics of the signal to create a return map and extraction of nonlinear characteristics of the HRV signal due to the nonlinear nature of the signal. Finally, the artificial neural networks widely used in the field of ECG signal processing as well as distinctive features were used to classify the normal signals from abnormal ones. To evaluate the efficiency of proposed classifiers in this paper, the area under curve ROC was used. The results of the simulation in the MATLAB environment showed that the AUC of the MLP and SVM neural network was 0.893 and 0.947, respectively. As well as, the results of the proposed algorithm in this paper indicated that the more use of nonlinear characteristics in normal signal classification of the patient showed better performance. Today, research is aimed at quantitatively analyzing the linear and non-linear or descriptive and random nature of the heart rate variability signal, because it has been shown that the amount of these properties can be used to indicate the health status of the individual's heart. The study of nonlinear behavior and dynamics of the heart's neural control system in the short and long-term provides new information on how the cardiovascular system functions, and has led to the development of research in this field. Given that the ECG signal contains important information and is one of the common tools used by physicians to diagnose heart disease, but due to the limited accuracy of time and the fact that some information about this signal is hidden from the viewpoint of physicians, the design of the intelligent system proposed in this paper can help physicians with greater speed and accuracy in the diagnosis of normal and patient individuals and can be used as a complementary system in the treatment centers.

Keywords: neart rate variability, signal processing, linear and non-linear features, classification methods, ROC Curve

Procedia PDF Downloads 262

Authors: Jaturong Matidtor, Krisna R. Torrissen, Saengtong Pongjareankit, Sudaporn Tongsiri, Jiraporn Rojtinnakorn

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Low survival rate has being particular problem in nursery of marble goby juvenile. The aim of this study was to investigate effect of garlic extract on protein digestive pancreatic enzymes, trypsin (T) and chymotrypsin (C). The marble goby were reared with commercial feed mixed garlic extract at concentration of 0 (control), 0.3, 0.5, 1.0, 3.0 and 5.0% (w/w) for 6 weeks. Analysis of the digestive enzymes at 2 and 6 weeks was performed. Growth parameters; weight gain (WG), specific growth rate (SGR) and feed efficiency (FE), were identified. For T, C and T/C at 2 weeks, values of T and T/C ratio of 0.3% (w/w) group showed significant difference (p < 0.05) with the highest values of 17685.64± 11981.77 U/mg protein and of 51.64 ± 27.46 U/mg protein, respectively. For C at 2 weeks, 0% (w/w) group showed the highest values of 16191.76± 2225.56 U/mg protein. Whereas value of T, C and T/C ratio at 6 weeks, there was no significant difference (p > 0.05). For growth performance, it significantly increased in all garlic extract fed groups (0.3-5.0%, w/w), both at 2 and 6 weeks. At 2 weeks, values of WG and SGR of 0.5% (w/w) group showed the highest values of 71.51 ± 1.60%, and 3.85 ± 0.07%, respectively. For FE, 0.3% (w/w) group showed the highest value of 60.21 ± 6.51%. At 6 weeks, it illustrated that all growth parameters of 5.0% (w/w) group were the highest values; WG = 35.06 ± 5.66%, SGR = 2.14 ± 0.30%, and FE = 5.86 ± 0.68%. We suggested that garlic extract could be available for protein digestive enzyme and growth enhancement in marble goby nursery with artificial feed. This result will be high benefit for commercial aquaculture of marble goby.

Keywords: marble goby, nursery, garlic extract, digestive enzyme, growth

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Authors: Hameed Rukayat Opeyemi, Pericles Pilidis, Pagone Emanuele

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An infinitesimal increase in performance can have immense reduction in operating and capital expenses in a power generation system. Therefore, constant studies are being carried out to improve both conventional and novel power cycles. Globally, power producers are constantly researching on ways to minimize emission and to collectively downsize the total cost rate of power plants. A substantial spurt of developmental technologies of low carbon cycles have been suggested and studied, however they all have their limitations and financial implication. In the area of carbon abatement in power plants, three major objectives conflict: The cost rate of the plant, Power output and Environmental impact. Since, an increase in one of this parameter directly affects the other. This poses a multi-objective problem. It is paramount to be able to discern the point where improving one objective affects the other. Hence, the need for a Pareto-based optimization algorithm. Pareto-based optimization algorithm helps to find those points where improving one objective influences another objective negatively and stops there. The application of Pareto-based optimization algorithm helps the user/operator/designer make an informed decision. This paper sheds more light on areas that multi-objective optimization has been applied in carbon abatement technologies in the last five years, developments and prospects.

Keywords: gas turbine, low carbon technology, pareto optimal, multi-objective optimization

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Authors: Shaira L. Kee, Michael Aaron G. Sy, Myles Joshua T. Tan, Hezerul Abdul Karim, Nouar AlDahoul

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Skin diseases are considered the fourth most common disease, with melanoma and non-melanoma skin cancer as the most common type of cancer in Caucasians. The alarming increase in Skin Cancer cases shows an urgent need for further research to improve diagnostic methods, as early diagnosis can significantly improve the 5-year survival rate. Machine Learning algorithms for image pattern analysis in diagnosing skin lesions can dramatically increase the accuracy rate of detection and decrease possible human errors. Several studies have shown the diagnostic performance of computer algorithms outperformed dermatologists. However, existing methods still need improvements to reduce diagnostic errors and generate efficient and accurate results. Our paper proposes an ensemble method to classify dermoscopic images into benign and malignant skin lesions. The experiments were conducted using the International Skin Imaging Collaboration (ISIC) image samples. The dataset contains 3,297 dermoscopic images with benign and malignant categories. The results show improvement in performance with an accuracy of 88% and an F1 score of 87%, outperforming other existing models such as support vector machine (SVM), Residual network (ResNet50), EfficientNetB0, EfficientNetB4, and VGG16.

Keywords: deep learning - VGG16 - efficientNet - CNN – ensemble – dermoscopic images - melanoma

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Orphaned is a risk factor for mortality in newborns since it is a condition with total or partial absence of maternal care that is essential for neonatal survival, including nursing (nutrition, the transference of passive immunity and hydration), warmth, urination, and defecation stimuli, and protection. The most common causes of mortality in orphans are related to lack of assistance, handling mistakes and infections. This study aims to describe the orphans rates in neonatal puppies, the main causes, and the mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. The orphans rate was 43.4% (319/735) of all neonates included, and the main causes for orphaned were related to maternal agalactia/hypogalactia (23.5%, 75/319); numerous litter (15.7%, 50/319), toxic milk syndrome due to maternal mastitis (14.4%, 46/319), absence of suction/weak neonate (12.2%, 39/319), maternal disease (9.4%, 30/319), cleft palate/lip (6.3%, 20/319), maternal death (5.9%, 19/319), prematurity (5.3%, 17/319), rejection/failure in maternal instinct (3.8%, 12/319) and abandonment by the owner/separation of mother and neonate (3.5%, 11/319). The main consequences of orphaned observed in the admitted neonates were hypoglycemia, hypothermia, dehydration, aspiration pneumonia, wasting syndrome, failure in the transference of passive immunity, infections and sepsis, which happened due to failure of identifying the problem early, lack of adequate assistance, negligence and handling mistakes by the owner. The total neonatal mortality rate was 8% (59/735) and the neonatal mortality rate among orphans was 18.5% (59/319). The orphaned and mortality rates were considered high, but even higher rates may be observed in locations without adequate neonatal assistance and owner orientation. The survival of these patients is related to constant monitoring of the litter, early diagnosis and assistance, and the implementation of effective handling for orphans. Understanding the correct handling for neonates and instructing the owners regarding proper handling are essential to minimize the consequences of orphaned and the mortality rates.

Keywords: orphans, neonatal care, puppies, newborn dogs

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Authors: Al Asyary, Meita Veruswati, Dian Ayyubi

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Sukabumi municipal has highest rank for maternal mortality in Indonesia with 102 by 100,000 live birth with almost 80% of birth were not attended by skilled birth attendant (SBA). Although universal health coverage has been implemented, availability and sufficiency of SBA, such as midwife in this developing country, are problematic agenda for the quality of public healthcare as well as decreasing maternal mortality rate. This study aims to describe the equal distribution of midwives in Sukabumi municipal as support of government’s program named Millennium Development Goals (MDGs) that suppressed maternal mortality rate in Indonesia. We conducted an observational study with Workload Indicator of Staffing Need (WISN) analysis to present the dispersion of midwives by their activities and workloads in 37 Puskesmas. We also generated in-depth interview with several executive chief of health sections, including chief of health offices in Sukabumi municipal. It resulted inferentially that several activities in midwives’ program were differed at once of existing than needed condition ideally (ρ value = 0.002 < 0.05). Meanwhile, decision for midwives’ procurement and placement were held by un-systematically procedure such as based on where the midwife was staying, and it also progressed by neighborhood issue priorities. The absence of formal regulation in local government is a serious problem that indicated poor political commitment, while access to SBA shall be focused carefully.

Keywords: developing country, health professional resources, health policy, need assessment

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Authors: Linyu Wang, Jiahui Ma, Jianhong Xiang, Hanyu Jiang

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For the pilot design of the sparse channel estimation model in Multiple Input Multiple Output Orthogonal Frequency Division Multiplexing (MIMO-OFDM) systems, the observation matrix constructed according to the matrix cross-correlation criterion, total correlation criterion and other optimization criteria are not optimal, resulting in inaccurate channel estimation and high bit error rate at the receiver. This paper proposes a pilot design method combining high-power sum and high-power variance criteria, which can more accurately estimate the channel. First, the pilot insertion position is designed according to the high-power variance criterion under the condition of equal power. Then, according to the high power sum criterion, the pilot power allocation is converted into a cone programming problem, and the power allocation is carried out. Finally, the optimal pilot is determined by calculating the weighted sum of the high power sum and the high power variance. Compared with the traditional pilot frequency, under the same conditions, the constructed MIMO-OFDM system uses the optimal pilot frequency for channel estimation, and the communication bit error rate performance obtains a gain of 6~7dB.

Keywords: MIMO-OFDM, pilot optimization, compressed sensing, channel estimation

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Authors: Raouf Hassan

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Biogas energy production from sewage sludge is an economically feasible and eco-friendly in nature. Sewage sludge is considered nutrient-rich substrates, but had lower values of carbone which consider an energy source for anaerobic bacteria. The lack or lower values of carbone-to-nitrogen ratio (C/N) reduced biogas yield and fermentation rate. Anaerobic co-digestion of sewage sludge offers several benefits over mono-digestion such as optimize nutrient balance, increased cost-efficiency and increased degradation rate. The high produced amounts of animal manures, which reach up to 90% of the total collected organic wastes, are recommended for the co-digestion with sewage sludge, especially with the limitations of industrial substrates. Moreover, cattle manures had high methane production potential (500 m3/t vsadded). When mixed with sewage sludge the potential methane production increased with increasing cattle manure content. In this paper, the effect of cattle manure (CM) addition as co-substrates on the sewage sludge (SS) anaerobic digestion performance was investigated under mesophilic conditions (35°C) using anaerobic batch reactors. The batch reactors were operated with a working volume 0.8 liter, and a hydraulic retention time of 30 days. The research work focus on studying two main parameters; the biogas yield (expressed as VSS) and pH values inside the reactors.

Keywords: anaerobic digestion, sewage sludge, cattle manure, mesophilic, biogas yield, pH

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Authors: Arinze Ezieke, Antonio Serrano, William Clarke, Denys Villa-Gomez

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Berry cultivation results in discharge of high organic strength putrescible solid waste which potentially contributes to environmental degradation, making it imperative to assess options for its complete management. Anaerobic digestion (AD) could be an ideal option when the target is energy generation; however, due to berry fruit characteristics high carbohydrate composition, the technology could be limited by its high alkalinity requirement which suggests dosing of additives such as buffers and trace elements supplement. Overcoming this limitation in an economically viable way could entail replacement of synthetic additives with recycled by-product waste. Consequently, ash from co-smouldering of high COD characteristic AD digestate and coco-coir could be a promising material to be used to enhance the AD of berry fruit waste, given its characteristic high pH, alkalinity and metal concentrations which is typical of synthetic additives. Therefore, the aim of the research was to evaluate the stability and process performance from the AD of BFW when ash from co-smoldered digestate and coir are supplemented as alkalinity and trace elements (TEs) source. Series of batch experiments were performed to ascertain the necessity for alkalinity addition and to see whether the alkalinity and metals in the co-smouldered digestate ash can provide the necessary buffer and TEs for AD of berry fruit waste. Triplicate assays were performed in batch systems following I/S of 2 (in VS), using serum bottles (160 mL) sealed and placed in a heated room (35±0.5 °C), after creating anaerobic conditions. Control experiment contained inoculum and substrates only, and inoculum, substrate and NaHCO3 for optimal total alkalinity concentration and TEs assays, respectively. Total alkalinity concentration refers to alkalinity of inoculum and the additives. The alkalinity and TE potential of the ash were evaluated by supplementing ash (22.574 g/kg) of equivalent total alkalinity concentration to that of the pre-determined optimal from NaHCO3, and by dosing ash (0.012 – 7.574 g/kg) of varying concentrations of specific essential TEs (Co, Fe, Ni, Se), respectively. The result showed a stable process at all examined conditions. Supplementation of 745 mg/L CaCO3 NaHCO3 resulted to an optimum TAC of 2000 mg/L CaCO3. Equivalent ash supplementation of 22.574 g/kg allowed the achievement of this pre-determined optimum total alkalinity concentration, resulting to a stable process with a 92% increase in the methane production rate (323 versus 168 mL CH4/ (gVS.d)), but a 36% reduction in the cumulative methane production (103 versus 161 mL CH4/gVS). Addition of ashes at incremental dosage as TEs source resulted to a reduction in the Cumulative methane production, with the highest dosage of 7.574 g/kg having the highest effect of -23.5%; however, the seemingly immediate bioavailability of TE at this high dosage allowed for a +15% increase in the methane production rate. With an increased methane production rate, the results demonstrated that the ash at high dosages could be an effective supplementary material for either a buffered or none buffered berry fruit waste AD system.

Keywords: anaerobic digestion, alkalinity, co-smoldered digestate ash, trace elements

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Authors: Pouya Khaleghi

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Dental implants are a successful treatment modality for restoring both function and aesthetics. Dental implant treatment has predictive results in the replacement of the lost teeth and has a high success rate even in the long term. The most important factor which is responsible for the positive course of implant treatment is the process of osseointegration between the implant structure and the host’s bone tissue. During recent years, many studies have focused on surgical and prosthetic factors, as well as the implant-related factors. However, implant failure still occurs despite the improvements that have led to the increased survival rate of dental implants, which suggests the possible role of some host-related risk factors. Vitamin D is a fat-soluble vitamin regulating calcium and phosphorus metabolism in tissues. The role of vitamin D in bone healing has been under investigation for several years. Vitamin D deficiency has also been associated with impaired and delayed callus formation and fractures healing; however, the role of vitamin D has not been clarified. Therefore, it is extremely important to study the phenomenon of a connection formed between bone tissue and the surface of a titanium implant and find correlations between the 25- hydroxycholecalciferol concentration in blood serum and the course of osseointegration. Because the processes of bone remodeling are very dynamic in the period of actual osseointegration, it is necessary to obtain the correct concentration of vitamin D3 metabolites in blood serum. In conclusion, the correct level of 25-hydroxycholecalciferol on the day of surgery and vitamin D deficiency treatment have a significant influence on the increase in the bone level at the implant site during the process of osseointegration assessed radiologically.

Keywords: implant, osseointegration, vitamin d, dental

Procedia PDF Downloads 174

Authors: Mariam Azam, Sajjad Ur Rahman, Mukarram Bashir, Muhammad Tahir, Seemal Javaid, Jawad, Aoun Muhammad, Muhammad Zohaib, Hannan Khan

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Products of microbial origin are of great importance as they have proved their value in healthcare and nutrition, use of these microbial metabolites acquired from partially fermented soya hulls and wheat bran along with Saccharomyces cerevisiae (DL-22 S/N) substantiates to be a great source for an increase in the total milk production and quality yield.1×109 CFU/ml cells of Saccharomyces cerevisiae (DL-22 S/N) were further grown under in-vivo conditions for the assessment of quality milk production. Two groups with twelve cows, each having the same physical characteristics (Group A and Group B), were under study, Group A was daily fed with 12gm of biological metabolites and 22% protein-pelleted feed. On the other hand, the animals of Group B were provided with no metabolites in their feed. In thirty days of trial, improvement in the overall health, body score, milk protein, milk fat, yield, incidence rate of mastitis, ash, and solid not fat (SNF) was observed. The collected data showed that the average quality milk production was elevated up to 0.45 liter/h/d. However, a reduction in the milk fats up to 0.45% and uplift in the SNF value up to 0.53% of cow milk was also observed. At the same time, the incidence rate of mastitis recorded for the animals under trial was reduced to half, and improved non specific immunity was reported.

Keywords: microbial metabolites, post-biotics, animal supplements, animal nutrition, proteins, animal production, fermentation

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Authors: L. Al Ahmad, C. Latrille, D. Hainos, D. Blanc, M. Clausse

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A two-dimensional finite volume axisymmetric model is developed to predict the simultaneous heat and mass transfers during the drying of industrial sludge. The simulations were run using COMSOL-Multiphysics 3.5a. The input parameters of the numerical model were acquired from a preliminary experimental work. Results permit to establish correlations describing the evolution of the various parameters as a function of the drying temperature and the sludge water content. The selection and coupling of the equation are validated based on the drying kinetics acquired experimentally at a temperature range of 45-65 °C and absolute pressure range of 200-1000 mbar. The model, incorporating the heat and mass transfer mechanisms at different operating conditions, shows simulated values of temperature and water content. Simulated results are found concordant with the experimental values, only at the first and last drying stages where sludge shrinkage is insignificant. Simulated and experimental results show that sludge drying is favored at high temperatures and low pressure. As experimentally observed, the drying time is reduced by 68% for drying at 65 °C compared to 45 °C under 1 atm. At 65 °C, a 200-mbar absolute pressure vacuum leads to an additional reduction in drying time estimated by 61%. However, the drying rate is underestimated in the intermediate stage. This rate underestimation could be improved in the model by considering the shrinkage phenomena that occurs during sludge drying.

Keywords: industrial sludge drying, heat transfer, mass transfer, mathematical modelling

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Authors: Y. Sakai, C. Wang

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The decrease in agricultural production due to soil deterioration has been an urgent task. Soil acidification is a potentially serious land degradation issue and it will have a major impact on agricultural productivity and sustainable farming systems. In China, acid soil is mainly distributed in the southern part, the decrease in agricultural production and heavy metal contamination are serious problems. In addition, not only environmental and health problems due to the exhaust gas such as mainly sulfur dioxide (SO₂) but also the generation of a huge amount of construction and demolition wastes with the accelerating urbanization has emerged as a social problem in China. Therefore, the need for the recycling and reuse of both desulfurization waste and waste concrete is very urgent and necessary. So we have investigated the effectiveness as acid soil amendments of both coal bio-briquette ash and waste concrete. In this paper, acid soil (AS1) in Nanjing (pH=6.0, EC=1.6dSm-1) and acid soil (AS2) in Guangzhou (pH=4.1, EC=0.2dSm-1) were investigated in soil amelioration test. Soil amendments were three coal bio-briquette ashes (BBA1, BBA2 and BBA3), the waste cement fine powders (CFP) ( < 200µm (particle diameter)), waste concrete particles (WCP) ( < 4.75mm ( < 0.6mm, 0.6-1.0mm, 1.0-2.0mm, 2.0-4.75mm)), and six mixtures with two coal bio-briquette ashes (BBA2 and BBA3), CFP, WCP( < 0.6mm) and WCP(2.0-4.75mm). In acid soil amelioration test, the three BBAs, CFP and various WCPs based on exchangeable calcium concentration were added to two acid soils. The application rates were from 0 wt% to 3.5 wt% in AS1 test and from 0 wt% to 6.0 wt% in AS2 test, respectively. Soil chemical properties (pH, EC, exchangeable and soluble ions (Na, Ca, Mg, K)) before and after mixing with soil amendments were measured. In addition, Al toxicity and the balance of salts (CaO, K₂O, MgO) in soil after amelioration was evaluated. The order of pH and exchangeable Ca concentration that is effective for acid soil amelioration was WCP(0.6mm) > CFP > WCP(2.0-4.25mm) > BB1 > BB2 > BB3. In all AS 1 and AS 2 amelioration tests using three BBAs, the pH and EC increased slightly with the increase of application rate and reached to the appropriate value range of both pH and EC in BBA1 only. Because BBA1 was higher value in pH and exchangeable Ca. After that, soil pH and EC with the increase in the application rate of BBA2, BBA3 and by using CFP, WC( < 0.6mm), WC(2.0-4.75mm) as soil amendment reached to each appropriate value range, respectively. In addition, the mixture amendments with BBA2, BBA3 CFP, WC( < 0.6mm), and WC(2.0-4.75mm) could ameliorate at a smaller amount of application rate in case of BBA only. And the exchangeable Al concentration decreased drastically with the increase in pH due to soil amelioration and was under the standard value. Lastly, the heavy metal (Cd, As, Se, Ni, Cr, Pb, Mo, B, Cu, Zn) contents in new soil amendments were under control standard values for agricultural use in China. Thus we could propose a new acid soil amelioration method using coal bio-briquette ash and waste concrete in China.

Keywords: acid soil, coal bio-briquette ash, soil amelioration, waste concrete

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Authors: Rajesh Kumar Meena, Suman Jhajharia, Goutam Chakraborty

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Plasmonic silver nanoparticles (Ag NPs) was synthesized by chemical reduction method using Trachyspermum Ammi (TA, Ajwain) seeds extract in aqueous medium and AgNO3 solution at different time interval. Reaction time, and concentration of AgNO3 and TA could accelerate the reduction rate of Ag+ and affect AgNPs size and concentration of NPs. Surface plasmon resonance band centered at 420-430 nm (88.78nm) was recognised as first exitonic peak of UV-Vis absorption spectra of AgNPs that used to calculate the particle size (10-30 nm). FTIR results TA supported AgNPs showed decrease in intensity of peaks at 3394, 1716 and 1618 cm-1 with respect to the plain TA indicating the involvement of O-H, carbonyl group and C=C stretching in formation of TA-AgNPs aggregates. The C-O-C and C-N stretching suggested the presence of many phytochemicals on the surface of the NPs. Impedance study reveals that at low concentration of TA the rate of charge transfer is in TA-AgNPs aggregates, found higher than the higher TA concentration condition that confirms the stability of AgNPs in water. Extract reduce silver ions into silver nanoparticles (NPs) of size 6-50nm. Pronounce effect of the time on Ag NPs concentration and particle size, was exhibited by the system These biogenic Ag NPs are characterized using UV- Vis spectrophotometry (UV-Visible), Fourier transformation infrared (FTIR) and XRD. These studies give us inside view of the most probable mechanism of biosynthesis and optoelectronic properties of the as synthesised Ag NPs.

Keywords: antimicrobial activity, bioreduction, capping agent, silver nanoparticles

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Authors: Sadeg M. Ghnia, Mahmud Alghattawi

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The NC-210 study area is located in Atshan Saddle between both Ghadamis and Murzuq basins, west Libya. The preserved Palaeozoic successions are predominantly clastics reaching thickness of more than 20,000 ft in northern Ghadamis Basin depocenter. The Carboniferous series consist of interbedded sandstone, siltstone, shale, claystone and minor limestone deposited in a fluctuating shallow marine to brackish lacustrine/fluviatile environment which attain maximum thickness of over 5,000ft in the area of Atshan Saddle and recorded 3,500 ft. in outcrops of Murzuq Basin flanks. The Carboniferous strata was uplifted and eroded during Late Paleozoic and early Mesozoic time in northern Ghadamis Basin and Atshan Saddle. The M'rar Formation age is Tournaisian to Late Serpukhovian based on palynological markers and contains about 12 cycles of sandstone and shale deposited in shallow to outer neritic deltaic settings. The hydrocarbons in the M'rar reservoirs possibly sourced from the Lower Silurian and possibly Frasinian radioactive hot shales. The M'rar Formation lateral, vertical and thickness distribution is possibly influenced by the reactivation of Tumarline Strik-Slip fault and its conjugate faults. A pronounced structural paleohighs and paleolows, trending SE & NW through the Gargaf Saddle, is possibly indicative of the present of two sub-basins in the area of Atshan Saddle. A number of identified seismic reflectors from existing 2D seismic covering Atshan Saddle reflect M’rar deltaic 12 sandstone cycles. M’rar7, M’rar9, M’rar10 and M’rar12 are characterized by high amplitude reflectors, while M’rar2 and M’rar6 are characterized by medium amplitude reflectors. These horizons are productive reservoirs in the study area. Available seismic data in the study area contributed significantly to the identification of M’rar potential traps, which are prominently 3- way dip closure against fault zone. Also seismic data indicates the presence of a significant strikeslip component with the development of flower-structure. The M'rar Formation hydrocarbon discoveries are concentrated mainly in the Atshan Saddle located in southern Ghadamis Basin, Libya and Illizi Basin in southeast of Algeria. Significant additional hydrocarbons may be present in areas adjacent to the Gargaf Uplift, along structural highs and fringing the Hoggar Uplift, providing suitable migration pathways.

Keywords: hydrocarbon potential, stratigraphy, Ghadamis basin, seismic, well data integration

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Authors: Lina Yang, Mao Wen, Jianhong Chen, Kan Zhang

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Molybdenum disulfide (MoS₂) represents a highly sought lubricant for reducing friction based on intrinsic layered structure, but for this reason, practical applications have been greatly restricted due to the fact that its low hardness would cause severe wear. Here, a novel TiMoN/MoSₓ composite coatings with TiMoN solid solution grains embedded into MoSₓ-based amorphous matrix has been successfully designed and synthesized, through magnetron co-sputtering technology. Desirably, in virtue of such special microstructure, superhardness and excellent toughness can be well achieved, along with an ultra-low wear rate at ~2×10⁻¹¹ mm³/Nm in the air environment, simultaneously, low friction at ~0.1 is maintained. It should be noted that this wear level is almost two orders of magnitude lower than that of pure TiN coating, and is, as we know, the lowest wear rate in dry sliding. Investigations of tribofilm reveal that it is amorphous MoS₂ in nature, and its formation arises directly from the MoSₓ amorphous matrix. Which contributes to effective lubrication behavior, coupled with excellent mechanical performances of such composite coating, exceptionally low wear can be guaranteed. The findings in this work suggest that the special composite structure makes it possible for the synthesis of super-hard and super-durable lubricative coating, offering guidance to synthesize ultrahigh performance protective coating for industrial application.

Keywords: hardness, MoS₂-containing composite coatings, toughness, tribological properties

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Authors: Mehrshad Khosraviani, Faramarz Abbaspour Leyl Abadi

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The fundamental component of the computer network of modern information society will be considered. These networks are connected to the network of the internet generally. Due to the fact that the primary purpose of the Internet is not designed for, in recent decades, none of these networks in many of the attacks has been very important. Today, for the provision of security, different security tools and systems, including intrusion detection systems are used in the network. A common diagnosis system based on artificial immunity, the designer, the Adhasaz Foundation has been evaluated. The idea of using artificial safety methods in the diagnosis of abnormalities in computer networks it has been stimulated in the direction of their specificity, there are safety systems are similar to the common needs of m, that is non-diagnostic. For example, such methods can be used to detect any abnormalities, a variety of attacks, being memory, learning ability, and Khodtnzimi method of artificial immune algorithm pointed out. Diagnosis of the common system of education offered in this paper using only the normal samples is required for network and any additional data about the type of attacks is not. In the proposed system of positive selection and negative selection processes, selection of samples to create a distinction between the colony of normal attack is used. Copa real data collection on the evaluation of ij indicates the proposed system in the false alarm rate is often low compared to other ir methods and the detection rate is in the variations.

Keywords: artificial immune system, abnormality detection, intrusion detection, computer networks

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Authors: S. A. H. Feghhi, Z. Gholamzadeh, Z. Alipoor, C. Tenreiro

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Currently, thorium fuel has been especially noticed because of its proliferation resistance than long half-life alpha emitter minor actinides, breeding capability in fast and thermal neutron flux and mono-isotopic naturally abundant. In recent years, efficiency of minor actinide burning up in PWRs has been investigated. Hence, a minor actinide-contained thorium based fuel matrix can confront both proliferation resistance and nuclear waste depletion aims. In the present work, minor actinide depletion rate in a CANDU-type nuclear core modeled using MCNP code has been investigated. The obtained effects of minor actinide load as mixture of thorium fuel matrix on the core neutronics has been studiedwith comparingpresence and non-presence of minor actinide component in the fuel matrix.Depletion rate of minor actinides in the MA-contained fuel has been calculated using different power loads.According to the obtained computational data, minor actinide loading in the modeled core results in more negative reactivity coefficients. The MA-contained fuel achieves less radial peaking factor in the modeled core. The obtained computational results showed 140 kg of 464 kg initial load of minor actinide has been depleted in during a 6-year burn up in 10 MW power.

Keywords: minor actinide burning, CANDU-type reactor, MCNPX code, neutronic parameters

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Authors: Samuele Abagnato, Lucia Rigamonti

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Life-Cycle-Assessment (LCA) is an effective tool to quantify the environmental impacts of reuse models and recycling technologies for textiles. In this work, publications in the last ten years about LCA on textile waste are classified according to location, goal and scope, functional unit, waste composition, impact assessment method, impact categories, and sensitivity analysis. Twenty papers have been selected: 50% are focused only on recycling, 30% only on reuse, the 15% on both, while only one paper considers only the final disposal of the waste. It is found that reuse is generally the best way to decrease the environmental impacts of textiles waste management because of the avoided impacts of manufacturing a new item. In the comparison between a product made with recycled yarns and a product from virgin materials, in general, the first option is less impact, especially for the categories of climate change, water depletion, and land occupation, while for other categories, such as eutrophication or ecotoxicity, under certain conditions the impacts of the recycled fibres can be higher. Cultivation seems to have quite high impacts when natural fibres are involved, especially in the land use and water depletion categories, while manufacturing requires a remarkable amount of electricity, with its associated impact on climate change. In the analysis of the reuse processes, relevant importance is covered by the laundry phase, with water consumption and impacts related to the use of detergents. About the sensitivity analysis, it can be stated that one of the main variables that influence the LCA results and that needs to be further investigated in the modeling of the LCA system about this topic is the substitution rate between recycled and virgin fibres, that is the amount of recycled material that can be used in place of virgin one. Related to this, also the yield of the recycling processes has a strong influence on the results of the impact. The substitution rate is also important in the modeling of the reuse processes because it represents the number of avoided new items bought in place of the reused ones. Another aspect that appears to have a large influence on the impacts is consumer behaviour during the use phase (for example, the number of uses between two laundry cycles). In conclusion, to have a deeper knowledge of the impacts of a life-cycle approach of textile waste, further data and research are needed in the modeling of the substitution rate and of the use phase habits of the consumers.

Keywords: environmental impacts, life-cycle-assessment, textiles recycling, textiles reuse, textiles waste management

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Authors: Seyedvahid Najafi, Viliam Makis

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In recent years, maintenance optimization has attracted special attention due to the growth of industrial systems complexity. Maintenance costs are high for many systems, and preventive maintenance is effective when it increases operations' reliability and safety at a reduced cost. The novelty of this research is to consider general repair in the modeling of multi-unit series systems and solve the maintenance problem for such systems using the semi-Markov decision process (SMDP) framework. We propose an opportunistic maintenance policy for a series system composed of two main units. Unit 1, which is more expensive than unit 2, is subjected to condition monitoring, and its deterioration is modeled using a gamma process. Unit 1 hazard rate is estimated by the proportional hazards model (PHM), and two hazard rate control limits are considered as the thresholds of maintenance interventions for unit 1. Maintenance is performed on unit 2, considering an age control limit. The objective is to find the optimal control limits and minimize the long-run expected average cost per unit time. The proposed algorithm is applied to a numerical example to compare the effectiveness of the proposed policy (policy Ⅰ) with policy Ⅱ, which is similar to policy Ⅰ, but instead of general repair, replacement is performed. Results show that policy Ⅰ leads to lower average cost compared with policy Ⅱ. 

Keywords: condition-based maintenance, proportional hazards model, semi-Markov decision process, two-unit series systems

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Authors: G. Kabir, A. M. Mohammed, M. A. Bawa

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The paper presents corrosion behaviors of Naval Brass, aluminum alloy and carbon steel in simulated seawater under stagnant conditions. The behaviors were characterized on the variation of chloride ions concentration in the range of 3.0wt% and 3.5wt% and exposure time. The weight loss coupon-method immersion technique was employed. The weight loss for the various alloys was measured. Based on the obtained results, the corrosion rate was determined. It was found that the corrosion rates of the various alloys are related to the chloride ions concentrations, exposure time and kinetics of passive film formation of the various alloys. Carbon steel, suffers corrosion many folds more than Naval Brass. This indicated that the alloy exhibited relatively strong resistance to corrosion in the exposure environment of the seawater. Whereas, the aluminum alloy exhibited an excellent and beneficial resistance to corrosion more than the Naval Brass studied. Despite the prohibitive cost, Naval Brass and aluminum alloy, indicated to have beneficial corrosion behavior that can offer wide range of application in seashore operations. The corrosion kinetics parameters indicated that the corrosion reaction is limited by diffusion mass transfer of the corrosion reaction elements and not by reaction controlled.

Keywords: alloys, chloride ions concentration, corrosion kinetics, corrosion rate, diffusion mass transfer, exposure time, seawater, weight loss

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Authors: Hakim Bachiri, Mohammed Znari, Moulay Abdeljalil Ait Baamranne

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Population characteristics of Atlas Barbary sheep (Ammotragus lervia lervia) were investigated 20 years following the 1999 introduction of 10 individuals into the fenced nature reserve of Amassine, High Atlas range, Morocco, for promoting wildlife watching and tourism. Population age-sex structure and density were determined in late winter-early spring during four consecutive years (2016-2019) by direct observation before the dispersal of the herd. In this latter case, the line transect distance sampling was successfully applied. Population size increased from 37 to 62 animals during the four-year study period; the maximal population size being 82 individuals recorded in 2006. An estimated population density ranged from 0.25 to 0.41 Barbary sheep/ha during the study period. The adult sex ratio varied from 91 to 67 per 100 females. The apparent birth rate was 14 to 73/100 females. Juveniles and subadults comprised 27-43% of the population, adult males 26-31% and adult females 29-45%. The survival rate from birth to 1 year of age approximated 35%, for adult males was estimated to average 69%/year. The obtained results would be helpful for developing sustainable population management and habitat restoration plan and assessing the feasibility of potential reintroduction/restocking in other areas of the Atlas range.

Keywords: atlas mountains, barbary sheep, demography, management

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Authors: Magdalena Blachnio, Viktor Bogatyrov, Mariia Galaburda, Anna Derylo-Marczewska

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Agricultural waste materials from traditional oil mill and after extraction of natural raw materials in supercritical conditions were used for the preparation of carbon nanomaterials (activated carbons) by two various methods. Chemical activation using acetic acid and physical activation with a gaseous agent (carbon dioxide) were chosen as mild and environmentally friendly ones. The effect of influential factors: type of raw material, temperature and activation agent on the porous structure characteristics of the materials was discussed by using N₂ adsorption/desorption isotherms at 77 K. Furthermore scanning electron microscope (SEM), transmission electron microscope (TEM), X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) were employed to examine the physicochemical properties of the obtained sorbents. Selection of a raw material and an optimization of the conditions of the synthesis process, allowed to obtain the cheap sorbents with a targeted distribution of pores enabling effective adsorption of the model organic pollutants carried out in the multicomponent systems. Adsorption behavior (capacity and rate) of the chosen activated carbons was estimated by utilizing Crystal violet (CV), 4-chlorophenoxyacetic acid (4-CPA), 2.4-dichlorophenoxyacetic acid (2.4-D) as the adsorbates. Both rate and adsorption capacity of the organics on the sorbents evidenced that the activated carbons could be effectively used in sewage treatment plants. The mechanisms of organics adsorption were studied and correlated with activated carbons properties.

Keywords: activated carbon, adsorption equilibrium, adsorption kinetics, organics adsorption

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Authors: Klazina T. Havinga, Hilde R. H. de Geus

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Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

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Authors: Pheeraphat Ussadamongkol, Suthasinee Sinawat

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Objective: The purpose of this study is to evaluate the anatomical and visual outcomes associated with the use of heavy silicone oil (HSO) during pars plana vitrectomy (PPV) in patients with rhegmatogenous retinal detachment (RRD). Materials and methods: A Total of 66 eyes of 66 patients with RRD patients who underwent PPV with HSO from 2018-2023 were included in this retrospective study. Risk factors of surgical outcomes were also investigated. Results: The mean age of the recruited patients was 55.26 ± 13.05 years. The most common diagnosis was recurrent RRD, with 43 patients (65.15%), and the majority of these patients (81.39%) had a history of multiple vitreoretinal surgeries. Inferior breaks and PVR grade ≧ C were present in 65.15% and 42.42% of cases, respectively. The mean duration of HSO tamponade was 7.77+5.19 months. The retinal attachment rate after surgery was 71.21%, with a final attachment rate of 87.88%. The mean final VA was 1.62 ± 1.11 logMAR. 54.54% of patients could achieve a final visual acuity (VA)  6/60. Multivariate analysis revealed that proliferative vitreoretinopathy (PVR) and multiple breaks were significantly associated with retinal redetachment, while initial good VA (  6/60) was associated with good visual outcome ( 6/60). The most common complications were glaucoma (30.3%) and epimacular membrane (7.58%). Conclusion: The use of heavy silicone oil in pars plana vitrectomy for rhegmatogenous retinal detachment yields favorable anatomical and visual outcomes. Factors associated with retinal redetachment are proliferative vitreoretinopathy and multiple breaks. Good initial VA can predict good visual outcomes.

Keywords: rhegmatogenous retinal detachment, heavy silicone oil, surgical outcome, visual outcome, risk factors

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Authors: Taylor Harris

Abstract:

Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

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Authors: Yogesh Rai, Saurabh Singh, Sanjay Pandey, Dhananjay K. Sah, B. G. Roy, B. S. Dwarakanath, Anant N. Bhatt

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One of the most common signatures of highly malignant gliomas is their capacity to metabolize more glucose to lactic acid than normal brain tissues, even under normoxic conditions (Warburg effect), indicating that aerobic glycolysis is constitutively upregulated through stable genetic or epigenetic changes. However, oxidative phosphorylation (OxPhos) is also required to maintain the mitochondrial membrane potential for tumor cell survival. In the process of tumorigenesis, tumor cells during fastest growth rate exhibit both high glycolytic and high OxPhos. Therefore, metabolically reprogrammed cancer cells with combination of both aerobic glycolysis and altered OxPhos develop a robust metabolic phenotype, which confers a selective growth advantage. In our study, we grew the high glycolytic BMG-1 (glioma) cells with continuous exposure of mitochondrial uncoupler 2, 4, dinitro phenol (DNP) for 10 passages to obtain a phenotype of high glycolysis with enhanced altered OxPhos. We found that OxPhos modified BMG (OPMBMG) cells has similar growth rate and cell cycle distribution but high mitochondrial mass and functional enzymatic activity than parental cells. In in-vitro studies, OPMBMG cells showed enhanced invasion, proliferation and migration properties. Moreover, it also showed enhanced angiogenesis in matrigel plug assay. Xenografted tumors from OPMBMG cells showed reduced latent period, faster growth rate and nearly five folds reduction in the tumor take in nude mice compared to BMG-1 cells, suggesting that robust metabolic phenotype facilitates tumor formation and growth. OPMBMG cells which were found radio-resistant, showed enhanced radio-sensitization by 2-DG as compared to the parental BMG-1 cells. This study suggests that metabolic reprogramming in cancer cells enhances the potential of migration, invasion and proliferation. It also strengthens the cancer cells to escape the death processes, conferring resistance to therapeutic modalities. Our data also suggest that combining metabolic inhibitors like 2-DG with conventional therapeutic modalities can sensitize such metabolically aggressive cancer cells more than the therapies alone.

Keywords: 2-DG, BMG, DNP, OPM-BMG

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Authors: Anđelka Stojanović, Ivan Mihajlović, Ivica Nikolić

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In the past years, due to the financial crisis and the tightening of conditions on the labor market, young people are facing great challenges in achieving financial independence and finding their place in society. Higher unemployment rates, poorer living conditions, separation from the labor market, and longer school-to-work transitions particularly affect rural youth and make significant differences between youth groups in rural and urban areas. Improving employability skills and development of instruments for further learning among young people “Not in Education, Employment, or Training” (NEET) should not be only the concerns of these people, already adequately be directed and supported by the institutions. According to the World Bank data, the share of youth not in education, employment or training (NEET), in the European Union in the past few years decreases but still shows a significant share in the total percentage of the youth population. In 2017 rate was 10.96% while in 2018 that value was 10.38%. When observing individual countries in Europe, especially those with lower incomes, this rate is much higher. It was concluded that this topic was not sufficiently elaborated and presented in the social and scientific environment. Therefore, the aim of this paper is to identify and systematize the problems of school-to-work transition among young NEETs living in rural areas as well as the initiatives for addressing their problems.

Keywords: NEET youth, risks and initiatives, rural youth, school-to-work transition

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Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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