Search results for: cardiac cycle
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2449

Search results for: cardiac cycle

2359 Sex Difference of the Incidence of Sudden Cardiac Arrest/Death in Athletes: A Systematic Review and Meta-analysis

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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2358 Bioelectronic System for Continuous Monitoring of Cardiac Activity of Benthic Invertebrates for the Assessment of a Surface Water Quality

Authors: Sergey Kholodkevich, Tatiana Kuznetsova

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The objective assessment of ecological state of water ecosystems is impossible without the use of biological methods of the environmental monitoring capable in the integrated look to reveal negative for biota changes of quality of water as habitats. Considerable interest for the development of such methods of environmental quality control represents biomarker approach. Measuring systems, by means of which register cardiac activity characteristics, received the name of bioelectronic. Bioelectronic systems are information and measuring systems in which animals (namely, benthic invertebrates) are directly included in structure of primary converters, being an integral part of electronic system of registration of these or those physiological or behavioural biomarkers. As physiological biomarkers various characteristics of cardiac activity of selected invertebrates have been used in bioelectronic system.lChanges in cardiac activity are considered as integrative measures of the physiological condition of organisms, which reflect the state of the environment of their dwelling. Greatest successes in the development of tools of biological methods and technologies of an assessment of surface water quality in real time. Essential advantage of bioindication of water quality by such tool is a possibility of an integrated assessment of biological effects of pollution on biota and also the expressness of such method and used approaches. In the report the practical experience of authors in biomonitoring and bioindication of an ecological condition of sea, brackish- and freshwater areas is discussed. Authors note that the method of non-invasive cardiac activity monitoring of selected invertebrates can be used not only for the advancement of biomonitoring, but also is useful in decision of general problems of comparative physiology of the invertebrates.

Keywords: benthic invertebrates, physiological state, heart rate monitoring, water quality assessment

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2357 Effect of SCN5A Gene Mutation in Endocardial Cell

Authors: Helan Satish, M. Ramasubba Reddy

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The simulation of an endocardial cell for gene mutation in the cardiac sodium ion channel NaV1.5, encoded by SCN5A gene, is discussed. The characterization of Brugada Syndrome by loss of function effect on SCN5A mutation due to L812Q mutant present in the DII-S4 transmembrane region of the NaV1.5 channel protein and its effect in an endocardial cell is studied. Ten Tusscher model of human ventricular action potential is modified to incorporate the changes contributed by L812Q mutant in the endocardial cells. Results show that BrS-associated SCN5A mutation causes reduction in the inward sodium current by modifications in the channel gating dynamics such as delayed activation, enhanced inactivation, and slowed recovery from inactivation in the endocardial cell. A decrease in the inward sodium current was also observed, which affects depolarization phase (Phase 0) that leads to reduction in the spike amplitude of the cardiac action potential.

Keywords: SCN5A gene mutation, sodium channel, Brugada syndrome, cardiac arrhythmia, action potential

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2356 Implications of Fuel Reloading in Heterogeneous Thorium-Based Fuel Designs for Improved Fuel Cycle Characteristics

Authors: Hendrik Bernard Van Der Walt, Frik Van Niekerk

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Fuel models render a reduction in BOL when thorium is added to a reactor core. Thorium emulates the role of a fertile poison, and is beneficial for reducing beginning of cycle (BOC) excess reactivity. In spite of the build-up of 233U over the duration of a fuel cycle, the effects of fuel reloading have a significant impact on fuel viability, especially in the case of heterogeneous thorium-based fuels. The most common practice of compensating for the reduction of BOC reactivity is the addition of fissile isotopes (uranium fuel with increased enrichment or plutonium). This study introduces a heterogeneous thorium-based fuel with minimal fissile isotope additions. A pseudo reloading scheme was developed for numerical simulations of an infinite reactor based on the North-Anna 1 reactor operating in Virginia, USA. Use of this reloading pattern allows new thorium-based fuel to be loaded into the reactor model as part of a phasing in strategy at the end of any conventional reactor cycle. Results demonstrate the effects of thorium-based fuel on fuel cycle characteristics such as fuel cycle length, neutron economy and material matrix. Application of the above mentioned approach delivered promising results and presents a heterogeneous thorium-based fuel which could replace conventional fuel of typical, currently operating (or future) reactors without the need for expensive reactor redesign or fuel recycling strategies.

Keywords: nuclear fuel, nuclear characteristics, nuclear fuel cycle, thorium-based fuel, heterogeneous design, fuel reloading

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2355 Relationship between Left Ventricle Position and Hemodynamic Parameters during Cardiopulmonary Resuscitation in a Pig Model

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

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

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

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2354 Stress Hyperglycemia: A Predictor of Major Adverse Cardiac Events in Non-Diabetic Patients With Acute Heart Failure

Authors: Fahad Raj Khan, Suleman Khan

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There is a lack of consensus about the predictive value of raised blood glucose levels in terms of major adverse cardiac events (MACEs) in non-diabetic patients admitted for acute decompensated heart failure. The purpose of this research was to examine the long-term prognosis of acute decompensated heart failure (ADHF) in non-diabetic persons who had increased blood glucose levels, i.e., stress hyperglycemia, at the time of their ADHF hospitalization. The research involved 650 non-diabetic patients. Based on their admission stress hyperglycemia, they were divided into two groups.ie with and without (SHGL). The two groups' one-year outcomes for major adverse cardiac events (MACEs) were compared, and key predictors of MACEs were discovered. For statistical analysis, the two-tailed Mann-Whitney U test, Fisher's exact test, and binary logistic regression analysis were utilized. SHGL was found in 353 (54.3%) individuals. It was more frequent in men than in women. About 27% of patients with SHGL had previously been admitted for ADHF. Almost 62% were hypertensive, whereas 14 % had CKD. MACEs were significantly predicted by SHGL, HTN, prior hospitalization for ADHF, CKD, and cardiogenic shock upon admission. SHGL at the time of ADHF admission, independent of DM status, may be a predictive indication of MACEs.

Keywords: stress hyperglycemia, acute heart failure, major adverse cardiac events, MACEs

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2353 The Influence of Applying Mechanical Chest Compression Systems on the Effectiveness of Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest

Authors: Slawomir Pilip, Michal Wasilewski, Daniel Celinski, Leszek Szpakowski, Grzegorz Michalak

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The aim of the study was to evaluate the effectiveness of cardiopulmonary resuscitation taken by Medical Emergency Teams (MET) at the place of an accident including the usage of mechanical chest compression systems. In the period of January-May 2017, there were 137 cases of a sudden cardiac arrest in a chosen region of Eastern Poland with 360.000 inhabitants. Medical records and questionnaires filled by METs were analysed to prove the effectiveness of cardiopulmonary resuscitations that were considered to be effective when an early indication of spontaneous circulation was provided and the patient was taken to hospital. A chest compression system used by METs was applied in 60 cases (Lucas3 - 34 patients; Auto Pulse - 24 patients). The effectiveness of cardiopulmonary resuscitation among patients who were employed a chest compression system was much higher (43,3%) than the manual cardiac massage (36,4%). Thus, the usage of Lucas3 chest compression system resulted in 47% while Auto Pulse was 33,3%. The average ambulance arrival time could have had a significant impact on the subsequent effectiveness of cardiopulmonary resuscitation in these cases. Ambulances equipped with Lucas3 reached the destination within 8 minutes, and those with Auto Pulse needed 12,1 minutes. Moreover, taking effective basic life support (BLS) by bystanders before the ambulance arrival was much more frequent for ambulances with Lucas3 than Auto Pulse. Therefore, the percentage of BLS among the group of patients who were employed Lucas3 by METs was 26,5%, and 20,8% for Auto Pulse. The total percentage of taking BLS by bystanders before the ambulance arrival resulted in 25% of patients who were later applied a chest compression system by METs. Not only was shockable cardiac rhythm obtained in 47% of these cases, but an early indication of spontaneous circulation was also provided in all these patients. Both Lucas3 and Auto Pulse were evaluated to be significantly useful in improving the effectiveness of cardiopulmonary resuscitation by 97% of Medical Emergency Teams. Therefore, implementation of chest compression systems essentially makes the cardiopulmonary resuscitation even more effective. The ambulance arrival time, taking successful BLS by bystanders before the ambulance arrival and the presence of shockable cardiac rhythm determine an early indication of spontaneous circulation among patients after a sudden cardiac arrest.

Keywords: cardiac arrest, effectiveness, mechanical chest compression systems, resuscitation

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2352 Thermodynamic Analysis of Zeotropic Mixture Used in Low Temperature Solar Rankine Cycle with Ejector for Power Generation

Authors: Basma Hamdi, Lakdar Kairouani, Ezzedine Nahdi

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The objective of this work is to present a thermodynamic analysis of low temperature solar Rankine cycle with ejector for power generation using zeotropic mixtures. Based on theoretical calculation, effects of zeotropic mixtures compositions on the performance of solar Rankine cycle with ejector are discussed and compared with corresponding pure fluids. Variations of net power output, thermal efficiency were calculating with changing evaporation temperature. The ejector coefficient had analyzed as independent variable. The result show that (R245fa/R152a) has a higher thermal efficiency than using pure fluids.

Keywords: zeotropic mixture, thermodynamic analysis, ejector, low-temperature solar rankine cycle

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2351 Fatty Acid Metabolism in Hypertension

Authors: Yin Hua Zhang

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Cardiac metabolism is essential in myocardial contraction. In addition to glucose, fatty acids (FA) are essential in producing energy in the myocardium since FA-dependent beta-oxidation accounts for > 70-90% of cellular ATP under resting conditions. However, metabolism shifts from FAs to glucose utilization during disease progression (e.g. hypertrophy and ischemic myocardium), where glucose oxidation and glycolysis become the predominant sources of cellular ATP. At advanced failing stage, both glycolysis and beta-oxidation are dysregulated, result in insufficient supply of intracellular ATP and weakened myocardial contractility. Undeniably, our understandings of myocyte function in healthy and diseased hearts are based on glucose (10 mM)-dependent metabolism because glucose is the “sole” metabolic substrate in most of the physiological experiments. In view of the importance of FAs in cardiovascular health and diseases, we aimed to elucidate the impacts of FA supplementation on myocyte contractility and evaluate cellular mechanisms those mediate the functions in normal heart and with pathological stress. In particular, we have investigated cardiac excitation-contraction (E-C) coupling in the presence and absence of FAs in normal and hypertensive rat left ventricular (LV) myocytes. Our results reveal that FAs increase mitochondrial activity, intracellular [Ca²+]i, and LV myocyte contraction in healthy LV myocytes, whereas FA-dependent cardiac inotropyis attenuated in hypertension. FA-dependent myofilament Ca²+ desensitization could be fundamental in regulating [Ca²+]i. Collectively, FAs supplementation resets cardiac E-C coupling scheme in healthy and diseased hearts.

Keywords: hypertension, fatty acid, heart, calcium

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2350 Cdk1 Gates Cell Cycle-Dependent tRNA Synthesis by Regulating RNA Polymerase III Activity

Authors: Maricarmen Herrera, Pierre Chymkowitch, Joe Robertson, Jens Eriksson, Jorrit Enserink

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tRNA genes are transcribed by RNA polymerase III. During recent years, it has become clear that tDNA transcription fluctuates during the cell cycle. However, the mechanism by which the cell cycle controls the amplitude of tDNA transcription remains unknown. We found that the cyclin Clb5 recruits the cyclin dependent kinase Cdk1 to tRNA genes to sharply increase tRNA synthesis during a brief interval in the cell cycle. We show that Cdk1 promotes the interaction of TFIIIB with TFIIIC, that it stimulates the recruitment of TFIIIC to tRNA genes, that it prevents the formation of an overly stable TFIIIB-tDNA complex and that it augments the dynamics of RNA polymerase III. Furthermore, we identify Bdp1 as a novel Cdk1 substrate, and phosphorylation of Bdp1 is required for the cell cycle-dependent increase in tDNA transcription. In addition, we show that phosphorylation of the Cdk1 substrate Nup60 mediates formation of a Nup60-Nup2 complex at tRNA genes, which is also required for cell cycle-dependent tDNA transcription. Together, our findings indicate that Cdk1 activity gates tRNA synthesis by regulating the dynamics of the TFIIIB-TFIIIC-RNAPIII complex, and that it may promote the formation of a nuclear pore microenvironment conducive to efficient tDNA transcription.

Keywords: Cdk1, cell cycle, RNAPIII machinery, tRNA

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2349 Thermodynamic Modeling of Three Pressure Level Reheat HRSG, Parametric Analysis and Optimization Using PSO

Authors: Mahmoud Nadir, Adel Ghenaiet

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The main purpose of this study is the thermodynamic modeling, the parametric analysis, and the optimization of three pressure level reheat HRSG (Heat Recovery Steam Generator) using PSO method (Particle Swarm Optimization). In this paper, a parametric analysis followed by a thermodynamic optimization is presented. The chosen objective function is the specific work of the steam cycle that may be, in the case of combined cycle (CC), a good criterion of thermodynamic performance analysis, contrary to the conventional steam turbines in which the thermal efficiency could be also an important criterion. The technologic constraints such as maximal steam cycle temperature, minimal steam fraction at steam turbine outlet, maximal steam pressure, minimal stack temperature, minimal pinch point, and maximal superheater effectiveness are also considered. The parametric analyses permitted to understand the effect of design parameters and the constraints on steam cycle specific work variation. PSO algorithm was used successfully in HRSG optimization, knowing that the achieved results are in accordance with those of the previous studies in which genetic algorithms were used. Moreover, this method is easy to implement comparing with the other methods.

Keywords: combined cycle, HRSG thermodynamic modeling, optimization, PSO, steam cycle specific work

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2348 Investigation of Heat Affected Zone of Steel P92 Using the Thermal Cycle Simulator

Authors: Petr Mohyla, Ivo Hlavatý, Jiří Hrubý, Lucie Krejčí

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This work is focused on mechanical properties and microstructure of heat affected zone (HAZ) of steel P92. The thermal cycle simulator was used for modeling a fine grained zone of HAZ. Hardness and impact toughness were measured on simulated samples. Microstructural analysis using optical microscopy was performed on selected samples. Achieved results were compared with the values of a real welded joint. The thermal cycle simulator allows transferring the properties of very small HAZ to the sufficiently large sample where the tests of the mechanical properties can be performed. A satisfactory accordance was found when comparing the microstructure and mechanical properties of real welds and simulated samples.

Keywords: heat affected zone, impact test, thermal cycle simulator, time of tempering

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2347 Variations of Total Electron Content over High Latitude Region during the 24th Solar Cycle

Authors: Arun Kumar Singh, Rupesh M. Das, Shailendra Saini

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The effect of solar cycle and seasons on the total electron content has been investigated over high latitude region during 24th solar cycle (2010-2014). The total electron content data has been observed with the help of Global Ionospheric Scintillation and TEC monitoring (GISTM) system installed at Indian permanent scientific 'Maitri station' [70˚46’00”S 11˚43’56” E]. The dependence of TEC over a solar cycle has been examined by the performing linear regression analysis between the vertical total electron content (VTEC) and daily total sunspot numbers (SSN). It has been found that the season and level of geomagnetic activity has a considerable effect on the VTEC. It is observed that the VTEC and SSN follow better agreement during summer seasons as compared to winter and equinox seasons and extraordinary agreement during minimum phase (during the year 2010) of the solar cycle. There is a significant correlation between VTEC and SSN during quiet days of the years as compared to overall days of the years (2010-2014). Further, saturation effect has been observed during maximum phase (during the year 2014) of the 24th solar cycle. It is also found that Ap index and SSN has a linear correlation (R=0.37) and the most of the geomagnetic activity occurs during the declining phase of the solar cycle.

Keywords: high latitude ionosphere, sunspot number, correlation, vertical total electron content

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2346 An Assessment of Financial Viability and Sustainability of Hydroponics Using Reclaimed Water Using LCA and LCC

Authors: Muhammad Abdullah, Muhammad Atiq Ur Rehman Tariq, Faraz Ul Haq

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In developed countries, sustainability measures are widely accepted and acknowledged as crucial for addressing environmental concerns. Hydroponics, a soilless cultivation technique, has emerged as a potentially sustainable solution as it can reduce water consumption, land use, and environmental impacts. However, hydroponics may not be economically viable, especially when using reclaimed water, which may entail additional costs and risks. This study aims to address the critical question of whether hydroponics using reclaimed water can achieve a balance between sustainability and financial viability. Life Cycle Assessment (LCA) and Life Cycle Cost (LCC) will be integrated to assess the potential of hydroponics whether it is environmentally sustainable and economically viable. Life cycle assessment, or LCA, is a methodology for assessing environmental impacts associated with all the stages of the life cycle of a commercial product, process, or service. While Life Cycle Cost (LCC) is an approach that assesses the total cost of an asset over its life cycle, including initial capital costs and maintenance costs. The expected benefits of this study include supporting evidence-based decision-making for policymakers, farmers, and stakeholders involved in agriculture. By quantifying environmental impacts and economic costs, this research will facilitate informed choices regarding the adoption of hydroponics with reclaimed water. It is believed that the outcomes of this research work will help to achieve a sustainable approach to agricultural production, aligning with sustainability goals while considering economic factors by adopting hydroponic technique.

Keywords: hydroponic, life cycle assessment, life cycle cost, sustainability

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2345 Therapeutic Potential of GSTM2-2 C-Terminal Domain and Its Mutants, F157A and Y160A on the Treatment of Cardiac Arrhythmias: Effect on Ca2+ Transients in Neonatal Ventricular Cardiomyocytes

Authors: R. P. Hewawasam, A. F. Dulhunty

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The ryanodine receptor (RyR) is an intracellular ion channel that releases Ca2+ from the sarcoplasmic reticulum and is essential for the excitation-contraction coupling and contraction in striated muscle. Human muscle specific glutathione transferase M2-2 (GSTM2-2) is a highly specific inhibitor of cardiac ryanodine receptor (RyR2) activity. Single channel-lipid bilayer studies and Ca2+ release assays performed using the C-terminal half of the GSTM2-2 and its mutants F157A and Y160A confirmed the ability of the C terminal domain of GSTM2-2 to specifically inhibit the cardiac ryanodine receptor activity. Objective of the present study is to determine the effect of C terminal domain of GSTM2-2 (GSTM2-2C) and the mutants, F157A and Y160A on the Ca2+ transients of neonatal ventricular cardiomyocytes. Primary cardiomyocytes were cultured from neonatal rats. They were treated with GSTM2-2C and the two mutants F157A and Y160A at 15µM and incubated for 2 hours. Then the cells were led with Fluo-4AM, fluorescent Ca2+ indicator, and the field stimulated (1 Hz, 3V and 2ms) cells were excited using the 488 nm argon laser. Contractility of the cells were measured and the Ca2+ transients in the stained cells were imaged using Leica SP5 confocal microscope. Peak amplitude of the Ca2+ transient, rise time and decay time from the peak were measured for each transient. In contrast to GSTM2C which significantly reduced the % shortening (42.8%) in the field stimulated cells, F157A and Y160A failed to reduce the % shortening.Analysis revealed that the average amplitude of the Ca2+ transient was significantly reduced (P<0.001) in cells treated with the wild type GSTM2-2C compared to that of untreated cells. Cells treated with the mutants F157A and Y160A didn’t change the Ca2+ transient significantly compared to the control. A significant increase in the rise time (P< 0.001) and a significant reduction in the decay time (P< 0.001) were observed in cardiomyocytes treated with GSTM2-2C compared to the control but not with F157A and Y160A. These results are consistent with the observation that GSTM2-2C reduced the Ca2+ release from the cardiac SR significantly whereas the mutants, F157A and Y160A didn’t show any effect compared to the control. GSTM2-2C has an isoform-specific effect on the cardiac ryanodine receptor activity and also it inhibits RyR2 channel activity only during diastole. Selective inhibition of RyR2 by GSTM2-2C has significant clinical potential in the treatment of cardiac arrhythmias and heart failure. Since GSTM2-2C-terminal construct has no GST enzyme activity, its introduction to the cardiomyocyte would not exert any unwanted side effects that may alter its enzymatic action. The present study further confirms that GSTM2-2C is capable of decreasing the Ca2+ release from the cardiac SR during diastole. These results raise the future possibility of using GSTM2-2C as a template for therapeutics that can depress RyR2 function when the channel is hyperactive in cardiac arrhythmias and heart failure.

Keywords: arrhythmia, cardiac muscle, cardiac ryanodine receptor, GSTM2-2

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2344 Analysis of Six Sigma in the Aerospace Industry

Authors: Masimuddin Mohd Khaled

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This paper subsidizes to the discussion of Six Sigma in the Aerospace Industry. The main aim of this report is to study the literature review of Six Sigma emphasizing on the aerospace industry. The implementation of Six Sigma stages are studied and how the improvement cycle ‘Define, Measure, Analyze, Improve, and Control cycle’ (DMAIC) and the design process is ‘Define, Measure, Analyze, Design, and Verify Cycle’ (DMADV) is used. The focus is also done by studying how the implementation of Six Sigma on an aerospace company has brought a positive effect to the company.

Keywords: six sigma, DMAIC, DMADV, aerospace

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2343 Glutharaldyde Free Processing of Patch for Cardiovascular Repair Is Associated with Improved Outcomes on Rvot Repair, Rat Model

Authors: Parnaz Boodagh, Danila Vella, Antonio Damore, Laura Modica De Mohac, Sang-Ho Ye, Garret Coyan, Gaetano Burriesci, William Wagner, Federica Cosentino

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The use of cardiac patches is among the main therapeutic solution for cardiovascular diseases, a leading mortality cause in the world with an increasing trend, responsible of 19 millions deaths in 2020. Several classes of biomaterials serve that purpose, both of synthetic origin and biological derivation, and many bioengineered treatment alternatives were proposed to satisfy two main requirements, providing structural support and promoting tissue remodeling. The objective of this paper is to compare the mechanical properties and the characterization of four cardiac patches: the Adeka, PhotoFix, CorPatch, and CardioCel patches. In vitro and in vivo tests included: biaxial, uniaxial, ball burst, suture retention for mechanical characterization; 2D surface topography, 3D volume and microstructure, and histology assessments for structure characterization; in vitro test to evaluate platelet deposition, calcium deposition, and macrophage polarization; rat right ventricular outflow tract (RVOT) models at 8- and 16-week time points to characterize the patch-host interaction. Lastly, the four patches were used to produce four stented aortic valve prosthesis, subjected to hydrodynamic assessment as well as durability testing to verify compliance with the standard ISO.

Keywords: cardiac patch, cardiovascular disease, cardiac repair, blood contact biomaterial

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2342 An Investigation of the Operation and Performance of London Cycle Hire Scheme

Authors: Amer Ali, Jessica Cecchinelli, Antonis Charalambous

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Cycling is one of the most environmentally friendly, economic and healthy modes of transport but it needs more efficient cycle infrastructure and more effective safety measures. This paper represents an investigation into the performance and operation of the London Cycle Hire Scheme which started to operate in July 2010 using 5,000 cycles and 315 docking stations and currently has more than 10,000 cycles and over 700 docking stations across London which are available 24/7, 365 days a year. The study, which was conducted during the second half of 2014, consists of two parts; namely, the longitudinal review of the hire scheme between its introduction in 2010 and November 2014, and a field survey in November 2014 in the form of face-face interviews of the users of the cycle scheme to ascertain the existing limitations and difficulties experienced by those users and how it could be improved in terms of capability and safety. The study also includes a correlation between the usage of the cycle scheme and the corresponding weather conditions. The main findings are that on average the number of users (hiring frequency) had increased from just over two millions hires in 2010 to just less than ten millions in 2014. The field survey showed that 80% of the users are satisfied with the performance of the scheme whilst 50% of the users raised concern about the safety level of using the available cycle routes and infrastructure. The study also revealed that a high percentage of the cycle trips were relatively short (less than 30 minutes). Although the weather condition had some effect on cycling, the cost of using the cycle scheme and the main events in London had more effect on the number of cycle hires. The key conclusions are that despite the safety concern and the lack of infrastructure for continuous routes there was an encouraging number of people who opted for cycling as a clean, affordable, and healthy mode of transport. There is a need to expand the scheme by providing more cycles and docking stations and to support that by more well-designed and maintained cycle routes. More details about the development of London Cycle Hire Scheme during the last five years, its performance and the key issues revealed by the surveyed users will be reported in the full version of the paper.

Keywords: cycling mode of transport, london cycle hire scheme, safety, environmental and health benefits, user satisfaction

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2341 Iron Supplementation for Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Authors: Matthew Cameron, Stephen Yang, Latifa Al Kharusi, Adam Gosselin, Anissa Chirico, Pouya Gholipour Baradari

Abstract:

Background: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for the potential to increase baseline hemoglobin and decrease the incidence of red blood cell (RBC) transfusion during cardiac surgery. This study's main objective was to evaluate the evidence for iron administration in cardiac surgery patients for its effect on the incidence of perioperative RBC transfusion. Methods: This systematic review protocol was registered with PROSPERO (CRD42020161927) on Dec. 19th, 2019, and was prepared as per the PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar were searched for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. Each abstract was independently reviewed by two reviewers using predefined eligibility criteria. The primary outcome was perioperative RBC transfusion, with secondary outcomes of the number of RBC units transfused, change in ferritin level, reticulocyte count, hemoglobin, and adverse events, after iron administration. The risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and the primary and secondary outcomes were analyzed with a random-effects model. Results: Out of 1556 citations reviewed, five studies (n = 554 patients) met the inclusion criteria. The use of iron demonstrated no difference in transfusion incidence (RR 0.86; 95% CI 0.65 to 1.13). There was a low heterogeneity between studies (I²=0%). The trial sequential analysis suggested an optimal information size of 1132 participants, which the accrued information size did not reach. Conclusion: The current literature does not support the routine use of iron supplementation before cardiac surgery; however, insufficient data is available to draw a definite conclusion. A critical knowledge gap has been identified, and more robust RCTs are required on this topic.

Keywords: cardiac surgery, iron, iron supplementation, perioperative medicine, meta-analysis, systematic review, randomized controlled trial

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2340 Integration of Multi Effect Desalination with Solid Oxide Fuel Cell/Gas Turbine Power Cycle

Authors: Mousa Meratizaman, Sina Monadizadeh, Majid Amidpour

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One of the most favorable thermal desalination methods used widely today is Multi Effect Desalination. High energy consumption in this method causes coupling it with high temperature power cycle like gas turbine. This combination leads to higher energy efficiency. One of the high temperature power systems which have cogeneration opportunities is Solid Oxide Fuel Cell / Gas Turbine. Integration of Multi Effect Desalination with Solid Oxide Fuel Cell /Gas Turbine power cycle in a range of 300-1000 kW is considered in this article. The exhausted heat of Solid Oxide Fuel Cell /Gas Turbine power cycle is used in Heat Recovery Steam Generator to produce needed motive steam for Desalination unit. Thermodynamic simulation and parametric studies of proposed system are carried out to investigate the system performance.

Keywords: solid oxide fuel cell, thermodynamic simulation, multi effect desalination, gas turbine hybrid cycle

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2339 Research on the Strategy of Whole-Life-Cycle Campus Design from the Perspective of Sustainable Concept: A Case Study on Hangzhou Senior High School in Zhejiang

Authors: Fan Yang

Abstract:

With the development of social economy and the popularization of quality education, the Chinese government invests more and more funding in education. Campus constructions are experiencing a great development phase. Under the trend of sustainable development, modern green campus design needs to meet new requirements of contemporary, informational and diversified education means and adapt to future education development. Educators, designers and other participants of campus design are facing new challenges. By studying and analyzing the universal unsatisfied current situations and sustainable development requirements of Chinese campuses, this paper summarizes the strategies and intentions of the whole-life-cycle campus design. In addition, a Chinese high school in Zhejiang province is added to illustrate the design cycle in an actual case. It is aimed to make all participants of campus design, especially the designers, to realize the importance of whole-life-cycle campus design and cooperate better. Sustainable campus design is expected to come true in deed instead of becoming a slogan in this way.

Keywords: campus design, green school, sustainable development, whole-life-cycle design

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2338 Study of Contrast Induced Nephropathy in Patients Undergoing Cardiac Catheterization: Upper Egypt Experience

Authors: Ali Kassem, Sharf Eldeen-Shazly, Alshemaa Lotfy

Abstract:

Introduction: Contrast-induced nephropathy (CIN) has been the third leading cause of hospital-acquired renal failure. Patients with cardiac diseases are particularly at risk especially with repeated injections of contrast media. CIN is generally defined as an increase in serum creatinine concentration of > 0.5 mg/dL or 25% above baseline within 48 hours after contrast administration. Aim of work: To examine the frequency of CIN for patients undergoing cardiac catheterization at Sohag University Hospital (Upper Egypt) and to identify possible risk factors for CIN in these patients. Material and methods: The study included 104 patients with mean age 56.11 ±10.03, 64(61.5%) are males while 40(38.5%) are females. 44(42.3%) patients are diabetics, 43(41%) patients are hypertensive, 6(5.7%) patients have congestive heart failure, 69(66.3%) patients on statins, 74 (71.2 %) are on ACEIs or ARBs, 19(15.4%) are on metformin, 6 (5.8%) are on NSAIDs, 30(28.8%) are on diuretics. RESULTS: Patients were classified at the end of the study into two groups: Group A: Included 91 patients who did not develop CIN. Group B: Included 13 patients who developed CIN, of which serum creatinine raised > 0.5mg/dl in 6 patients and raised > 25% from the baseline after the procedure in 13 patients. The overall incidence of CIN was 12.5%. CIN increased with older age. There was an increase in the incidence of CIN in diabetic versus non-diabetic patients (20.5% and 6.7%) respectively. (p< 0.03). There was a highly significant increase in the incidence of CIN in patients with CHF versus those without CHF (100% and 71%) respectively, (P<0001). Patients on diuretics showed a significant increase in the incidence of CIN representing 61.5% of all patients who developed CIN. Conclusion: Older patients, diabetic patients, patients with CHF and patients on diuretics have higher risk of developing CIN during coronary catheterization and should receive reno-protective measures before contrast exposure.

Keywords: cardiac diseases, contrast-induced nephropathy, coronary catheterization, CIN

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2337 Characterization of Pure Nickel Coatings Fabricated under Pulse Current Conditions

Authors: M. Sajjadnejad, H. Omidvar, M. Javanbakht, A. Mozafari

Abstract:

Pure nickel coatings have been successfully electrodeposited on copper substrates by the pulse plating technique. The influence of current density, duty cycle and pulse frequency on the surface morphology, crystal orientation, and microhardness was determined. It was found that the crystallite size of the deposit increases with increasing current density and duty cycle. The crystal orientation progressively changed from a random texture at 1 A/dm2 to (200) texture at 10 A/dm2. Increasing pulse frequency resulted in increased texture coefficient and peak intensity of (111) reflection. An increase in duty cycle resulted in considerable increase in texture coefficient and peak intensity of (311) reflection. Coatings obtained at high current densities and duty cycles present a mixed morphology of small and large grains. Maximum microhardness of 193 Hv was achieved at 4 A/dm2, 10 Hz and duty cycle of 50%. Nickel coatings with (200) texture are ductile while (111) texture improves the microhardness of the coatings.

Keywords: current density, duty cycle, microstructure, nickel, pulse frequency

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2336 Pinch Analysis of Triple Pressure Reheat Supercritical Combined Cycle Power Plant

Authors: Sui Yan Wong, Keat Ping Yeoh, Chi Wai Hui

Abstract:

In this study, supercritical steam is introduced to Combined Cycle Power Plant (CCPP) in an attempt to further optimize energy recovery. Subcritical steam is commonly used in the CCPP, operating at maximum pressures around 150-160 bar. Supercritical steam is an alternative to increase heat recovery during vaporization period of water. The idea of improvement using supercritical steam is further examined with the use of exergy, pinch analysis and Aspen Plus simulation.

Keywords: exergy, pinch, combined cycle power plant, supercritical steam

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2335 Cardiac Protective Effect of Olive Oil against Ischemia Reperfusion- Induced Cardiac Arrhythmias in Isolated Diabetic Rat Hearts

Authors: Ishfaq A. Bukhari, Bassem Yousef Sheikh, Abdulrahman Almotrefi, Osama Yousaf, Amer Mahmood

Abstract:

Olive oil is the primary source of fat in the Mediterranean diet which is associated with a low mortality for cardiovascular disease. Olive oil is rich in monounsaturated fatty acids, and has been reported for variety of beneficial cardiovascular effects including blood pressure lowering, anti-platelet, anti-diabetic and anti-inflammatory effects. Growing number evidences from preclinical and clinical studies have shown that olive oil improves insulin resistance, decrease vessels stiffness and prevent thromboembolism. We evaluated the effects of olive against streptozotocin-induced physiological disorders in the animal models of diabetes and ischemia and reperfusion (I/R)- induced cardiac arrhythmias. Diabetes was induced in male rats with a single intraperitoneal injection of streptozotocin (60 mg/kg), rats were treated for two months with olive oil (1 ml/kg p.o). Control animals received saline. Blood glucose, body weight were monitored every 14 days. At the end of the treatment rats were sacrificed hearts were isolated for mounting on langedorff’s apparatus. The blood glucose and body weight was not significantly different in the control and olive treated animals. The control diabetic animals exhibited 100% incidence of I/R –induced ventricular fibrillation which was reduced to 0% with olive oil, treatment. The duration of ventricular fibrillation reduced from 98.8± 2.3 (control) to 0 seconds in the olive oil treated group. Diltiazem, a calcium channel blocker (1 µm/L) showed similar results and protected the I/R-induced cardiac disorders. The biochemical analysis of the cardiac tissues showed that diabetes and I/R produce marked pathological changes in the cardiomyocytes including decreased glutathione (GSH) and increased oxidative stress (Malondialdehyde; MDA). Pretreatment of animals with olive oil (1 ml/kg p.o) increased GSH and MDA levels. Olive oil also improved the diabetic-induced histopathological changes in the cardiomyocytes. These finding indicates that olive possesses cardiac protective properties. Further studies are under way in our lab to explore the mechanism of the cardio-protective effect of olive oil.

Keywords: diabeties, ischemia-reperfusion, olive oil, rats heart

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2334 Ibrutinib and the Potential Risk of Cardiac Failure: A Review of Pharmacovigilance Data

Authors: Abdulaziz Alakeel, Roaa Alamri, Abdulrahman Alomair, Mohammed Fouda

Abstract:

Introduction: Ibrutinib is a selective, potent, and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue (CYS-481) at the active site of Btk, leading to inhibition of Btk enzymatic activity. The drug is indicated to treat certain type of cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia and Waldenström's macroglobulinaemia (WM). Cardiac failure is a condition referred to inability of heart muscle to pump adequate blood to human body organs. There are multiple types of cardiac failure including left and right-sided heart failure, systolic and diastolic heart failures. The aim of this review is to evaluate the risk of cardiac failure associated with the use of ibrutinib and to suggest regulatory recommendations if required. Methodology: Signal Detection team at the National Pharmacovigilance Center (NPC) of Saudi Food and Drug Authority (SFDA) performed a comprehensive signal review using its national database as well as the World Health Organization (WHO) database (VigiBase), to retrieve related information for assessing the causality between cardiac failure and ibrutinib. We used the WHO- Uppsala Monitoring Centre (UMC) criteria as standard for assessing the causality of the reported cases. Results: Case Review: The number of resulted cases for the combined drug/adverse drug reaction are 212 global ICSRs as of July 2020. The reviewers have selected and assessed the causality for the well-documented ICSRs with completeness scores of 0.9 and above (35 ICSRs); the value 1.0 presents the highest score for best-written ICSRs. Among the reviewed cases, more than half of them provides supportive association (four probable and 15 possible cases). Data Mining: The disproportionality of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by WHO-UMC to measure the reporting ratio. Positive IC reflects higher statistical association while negative values indicates less statistical association, considering the null value equal to zero. The results of (IC=1.5) revealed a positive statistical association for the drug/ADR combination, which means “Ibrutinib” with “Cardiac Failure” have been observed more than expected when compared to other medications available in WHO database. Conclusion: Health regulators and health care professionals must be aware for the potential risk of cardiac failure associated with ibrutinib and the monitoring of any signs or symptoms in treated patients is essential. The weighted cumulative evidences identified from causality assessment of the reported cases and data mining are sufficient to support a causal association between ibrutinib and cardiac failure.

Keywords: cardiac failure, drug safety, ibrutinib, pharmacovigilance, signal detection

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2333 The Fake News Impact on the Public Policy Cycle: A Systemic Analysis through Documentary Survey

Authors: Aron Miranda Burgos, Ergon Cugler de Moraes Silva

Abstract:

In the present article, it is observed that the constant advancement of issues related to misinformation impacts the guarantee of the public policy cycle. Thus, it is found that the dissemination of false information has a direct influence on each of the component stages of this cycle. Therefore, in order to maintain scientific and theoretical credibility in the qualitative analysis process, it was necessary to logically interpose the concepts of firehosing of falsehood, fake news, public policy cycle, as well as using the epistemological and pragmatic mechanism at the intersection of such academic concepts, such as the scientific method. It was found, through the analysis of official documents and public notes, how the multiple theoretical perspectives evidence the commitment of the provision and elaboration of public policies, verifying the way in which the fake news impact each part of the process in this atmosphere.

Keywords: firehosing of falsehood, governance, misinformation, post-truth

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2332 Balanced Ischemia Misleading to a False Negative Myocardial Perfusion Imaging (Stress) Test

Authors: Devam Sheth

Abstract:

Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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2331 Analysis of Heat Exchanger Area of Two Stage Cascade Refrigeration System Using Taguchi

Authors: A. D. Parekh

Abstract:

The present work describes relative contributions of operating parameters on required heat transfer area of three heat exchangers viz. evaporator, condenser and cascade condenser of two stage R404A-R508B cascade refrigeration system using Taguchi method. The operating parameters considered in present study includes (1) condensing temperature of high temperature cycle and low temperature cycle (2) evaporating temperature of low temperature cycle (3) degree of superheating in low temperature cycle (4) refrigerating effect. Heat transfer areas of three heat exchangers are studied with variation of above operating parameters and also optimum working levels of each operating parameter has been obtained for minimum heat transfer area of each heat exchanger using Taguchi method. The analysis using Taguchi method reveals that evaporating temperature of low temperature cycle and refrigerating effect contribute relatively largely on the area of evaporator. Condenser area is mainly influenced by both condensing temperature of high temperature cycle and refrigerating effect. Area of cascade condenser is mainly affected by refrigerating effect and the effects of other operating parameters are minimal.

Keywords: cascade refrigeration system, Taguchi method, heat transfer area, ANOVA, optimal solution

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2330 Analysis of Heat Exchanger Area of Two Stage Cascade Refrigeration System Using Taguchi Methodology

Authors: A. D. Parekh

Abstract:

The present work describes relative contributions of operating parameters on required heat transfer area of three heat exchangers viz. evaporator, condenser and cascade condenser of two stage R404A-R508B cascade refrigeration system using Taguchi method. The operating parameters considered in present study includes (1) condensing temperature of high temperature cycle and low temperature cycle (2) evaporating temperature of low temperature cycle (3) degree of superheating in low temperature cycle (4) refrigerating effect. Heat transfer areas of three heat exchangers are studied with variation of above operating parameters and also optimum working levels of each operating parameter has been obtained for minimum heat transfer area of each heat exchanger using Taguchi method. The analysis using Taguchi method reveals that evaporating temperature of low temperature cycle and refrigerating effect contribute relatively largely on the area of evaporator. Condenser area is mainly influenced by both condensing temperature of high temperature cycle and refrigerating effect. Area of cascade condenser is mainly affected by refrigerating effect and the effects of other operating parameters are minimal.

Keywords: cascade refrigeration system, Taguchi method, heat transfer area, ANOVA, optimal solution

Procedia PDF Downloads 355