Search results for: mitral valve disease
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3858

Search results for: mitral valve disease

3798 Improvement of Performance of Anti-Splash Device for Cargo Oil Tank Vent Pipe Using CFD Simulation

Authors: Sung-Min Kim, Joon-Hong Park, Hyuk Choi

Abstract:

This study is focused on the comparative analysis and improvement to grasp the flow characteristic of the anti-splash device located under the P/V valve and new concept design models using the CFD. The P/V valve located upper deck to solve the pressure rising and vacuum condition of inner tank of the liquid cargo ships occurred oil outflow accident by transverse and longitudinal sloshing force. Anti-splash device is fitted to improve and prevent this problem in the shipbuilding industry, but the oil outflow accidents are still reported by ship owners. Thus, 4 types of new design model are presented by this study, and then comparative analysis is conducted with new models and existing model. Mostly the key criterion of this problem is flux in the outlet of the anti-splash device. Therefore, the flow and velocity are grasped by transient analysis, and then it decided optimum model and design parameters to develop model. Later, it is needed to develop an anti-splash device by flow test to get certification and verification using experiment equipments.

Keywords: anti-splash device, P/V valve, sloshing, CFD

Procedia PDF Downloads 605
3797 Hypocalcaemia Inducing Heart Failure: A Rare Presentation

Authors: A. Kherraf, M. Bouziane, L. Azzouzi, R. Habbal

Abstract:

Introduction: Hypocalcaemia is a rare cause of heart failure. We report the clinical case of a young patient with reversible dilated cardiomyopathy secondary to hypocalcaemia in the context of hyperparathyroidism. Clinical case: We report the clinical case of a 23-year-old patient with a history of thyroidectomy for papillary thyroid carcinoma 3 years previously, who presented to the emergency room with a progressive onset dyspnea and edema of the lower limbs. Clinical examination showed hypotension at 90/70 mmHg, tachycardia at 102 bpm, and edema of the lower limbs. The ECG showed a regular sinus rhythm with a prolonged corrected QT interval to 520ms. The chest x-ray showed cardiomegaly. Echocardiography revealed dilated cardiomyopathy with biventricular dysfunction and a left ventricular ejection fraction of 45%, as well as moderate mitral insufficiency by restriction of the posterior mitral leaflet, moderate tricuspid insufficiency, and a dilated inferior vena cava with a pulmonary arterial pressure estimated at 46 mmHg. Blood tests revealed severe hypocalcemia at 38 mg / l with normal albumin and thyroxine levels, as well as hyperphosphatemia and increased TSH. The patient received calcium intake and vitamin D supplementation and was treated with beta blockers, ACE inhibitors, and diuretics with good progress and progressive normalization of cardiac function. Discussion: The cardiovascular manifestations of hypocalcaemia usually appear with deeply low serum calcium levels. This can lead to hypotension, arrhythmias, ventricular fibrillation, prolonged QT interval, or even heart failure. Heart failure is a rare and serious complication of hypocalcemia but most often characterized by complete normalization of myocardial function after treatment. The etiology of the hypocalcaemia, in this case, was probably related to accidental parathyroid removal during thyroidectomy. This is why careful monitoring of calcium levels is recommended after surgery. Conclusion: Hypocalcemic heart failure is rare but reversible heart disease. Systematic monitoring of serum calcium should be performed in all patients after thyroid surgery to avoid any complications related to hypoparathyroidism.

Keywords: hypocalcemia, heart failure, thyroid surgery, hypoparathyroidism

Procedia PDF Downloads 116
3796 Alzheimer’s Disease Measured in Work Organizations

Authors: Katherine Denise Queri

Abstract:

The effects of sick workers have an impact in administration of labor. This study aims to provide knowledge on the disease that is Alzheimer’s while presenting an answer to the research question of when and how is the disease considered as a disaster inside the workplace. The study has the following as its research objectives: 1. Define Alzheimer’s disease, 2. Evaluate the effects and consequences of an employee suffering from Alzheimer’s disease, 3. Determine the concept of organizational effectiveness in the area of Human Resources, and 4. Identify common figures associated with Alzheimer’s disease. The researcher gathered important data from books, video presentations, and interviews of workers suffering from Alzheimer’s disease and from the internet. After using all the relevant data collection instruments mentioned, the following data emerged: 1. Alzheimer’s disease has certain consequences inside the workplace, 2. The occurrence of Alzheimer’s Disease in an employee’s life greatly affects the company where the worker is employed, and 3. The concept of workplace efficiency suggests that an employer must prepare for such disasters that Alzheimer’s disease may bring to the company where one is employed. Alzheimer’s disease can present disaster in any workplace.

Keywords: administration, Alzheimer's disease, conflict, disaster, employment

Procedia PDF Downloads 411
3795 Calibrations and Effect of Different Operating Conditions on the Performance of a Fluid Power Control System with Servo Solenoid Valve

Authors: Tahany W. Sadak, Fouly, A. Anwer, M. Rizk

Abstract:

The current investigation presents a study on the hydraulic performance of an electro-hydraulic servo solenoid valve controlled linear piston used in hydraulic systems. Advanced methods have been used to measure and record laboratory experiments, to ensure accurate analysis and evaluation. Experiments have been conducted under different values of temperature (28, 40 and 50 °C), supply pressure (10, 20, 30, 40 and 50 bar), system stiffness (32 N/mm), and load (0.0 & 5560 N). It is concluded that increasing temperature of hydraulic oil increases the quantity of flow rate, so it achieves an increase of the quantity of flow by 5.75 % up to 48.8 % depending on operating conditions. The values of pressure decay at low temperature are less than the values at high temperature. The frequency increases with the increase of the temperature. When we connect the springs to the system, it decreases system frequency. These results are very useful in the process of packing and manufacturing of fluid products, where the properties are not affected by 50 °C, so energy and time are saved.

Keywords: electro-hydraulic servo valve, fluid power control system, system stiffness, static and dynamic performance

Procedia PDF Downloads 128
3794 Numerical Studies on Bypass Thrust Augmentation Using Convective Heat Transfer in Turbofan Engine

Authors: R. Adwaith, J. Gopinath, Vasantha Kohila B., R. Chandru, Arul Prakash R.

Abstract:

The turbofan engine is a type of air breathing engine that is widely used in aircraft propulsion produces thrust mainly from the mass-flow of air bypassing the engine core. The present research has developed an effective method numerically by increasing the thrust generated from the bypass air. This thrust increase is brought about by heating the walls of the bypass valve from the combustion chamber using convective heat transfer method. It is achieved computationally by the use external heat to enhance the velocity of bypass air of turbofan engines. The bypass valves are either heated externally using multicell tube resistor which convert electricity generated by dynamos into heat or heat is transferred from the combustion chamber. This increases the temperature of the flow in the valves and thereby increase the velocity of the flow that enters the nozzle of the engine. As a result, mass-flow of air passing the core engine for producing more thrust can be significantly reduced thereby saving considerable amount of Jet fuel. Numerical analysis has been carried out on a scaled down version of a typical turbofan bypass valve, where the valve wall temperature has been increased to 700 Kelvin. It is observed from the analysis that, the exit velocity contributing to thrust has significantly increased by 10 % due to the heating of by-pass valve. The degree of optimum increase in the temperature, and the corresponding effect in the increase of jet velocity is calculated to determine the operating temperature range for efficient increase in velocity. The technique used in the research increases the thrust by using heated by-pass air without extracting much work from the fuel and thus improve the efficiency of existing turbofan engines. Dimensional analysis has been carried to prove the accuracy of the results obtained numerically.

Keywords: turbofan engine, bypass valve, multi-cell tube, convective heat transfer, thrust

Procedia PDF Downloads 335
3793 An Improved Particle Swarm Optimization Technique for Combined Economic and Environmental Power Dispatch Including Valve Point Loading Effects

Authors: Badr M. Alshammari, T. Guesmi

Abstract:

In recent years, the combined economic and emission power dispatch is one of the main problems of electrical power system. It aims to schedule the power generation of generators in order to minimize cost production and emission of harmful gases caused by fossil-fueled thermal units such as CO, CO2, NOx, and SO2. To solve this complicated multi-objective problem, an improved version of the particle swarm optimization technique that includes non-dominated sorting concept has been proposed. Valve point loading effects and system losses have been considered. The three-unit and ten-unit benchmark systems have been used to show the effectiveness of the suggested optimization technique for solving this kind of nonconvex problem. The simulation results have been compared with those obtained using genetic algorithm based method. Comparison results show that the proposed approach can provide a higher quality solution with better performance.

Keywords: power dispatch, valve point loading effects, multiobjective optimization, Pareto solutions

Procedia PDF Downloads 251
3792 Design and Development of Engine Valve Train Wear Test Rig for the Assessment of Valve Train Tribochemistry

Authors: V. Manjunath, C. V. Chandrashekara

Abstract:

Ecosystem authority calls for the use of lubricants with less effect on the nature in terms of exhaust emission, while engine user demands more mileage per liter of fuel without any compromise on engine durability. From this viewpoint, engine manufacturers require the optimum combination of materials and lubricant additive package to minimize friction and wear in the engine components like piston, crankshaft and valve train etc. The demands are placed for requirements to operate at higher speeds, loads, temperature and for extended replacement intervals of engine oil. Besides, it is necessary to accurately predict the lubricant life or the replacement interval to prevent lubrication and valve-train components failure. Experimental tribology evaluation of new engine oils requires large amount of time and energy. Hence low cost bench test is necessary for industries and original equipment manufacturing companies (OEM) to study the performance of lubricants. The present work outlines the procedure for the design and development of a valve train wear rig (MCR) to simulate the ASTMD-6891 and to develop new engine test for Indian automobile sector to evaluate lubricants for Indian automobile market. In order to improve the lubrication between cam and follower of internal combustion engine, the influence of materials or oils viscosity and additives on the friction and wear characteristics are examined with test rig by increasing the contact load at two different revolution speed. From the experimentation following results are made obvious. Temperature, Torque, speed and wear plots are used to validate the data obtained from the newly developed multi-cam cam rig (MCR) with follower against a cast iron camshaft. Camshaft lobe wear is measured at seven different locations on cam profile. Tribofilm formed using 5W-30 oil is evaluated and correlated with the standard test results.

Keywords: ASTMD-6891, multi-cam rig (MCR), 5W-30, cam-profile

Procedia PDF Downloads 149
3791 Safety and Feasibility of Distal Radial Balloon Aortic Valvuloplasty - The DR-BAV Study

Authors: Alexandru Achim, Tamás Szűcsborus, Viktor Sasi, Ferenc Nagy, Zoltán Jambrik, Attila Nemes, Albert Varga, Călin Homorodean, Olivier F. Bertrand, Zoltán Ruzsa

Abstract:

Aim: Our study aimed to establish the safety and the technical success of distal radial access for balloon aortic valvuloplasty (DR-BAV). The secondary objective was to determine the effectiveness and appropriate role of DR-BAV within half year follow-up. Methods: Clinical and angiographic data from 32 consecutive patients with symptomatic aortic stenosis were evaluated in a prospective pilot single-center study. Between 2020 and 2021, the patients were treated utilizing dual distal radial access with 6-10F compatible balloons. The efficacy endpoint was divided into technical success (successful valvuloplasty balloon inflation at the aortic valve and absence of intra- or periprocedural major complications), hemodynamic success (a reduction of the mean invasive gradient >30%), and clinical success (an improvement of at least one clinical category in the NYHA classification). The safety endpoints were vascular complications (major and minor Valve Academic Research Consortium (VARC)-2 bleeding, diminished or lost arterial pulse or the presence of any pseudo-aneurysm or arteriovenous fistula during the clinical follow-up) and major adverse events, MAEs (the composite of death, stroke, myocardial infarction, and urgent major aortic valve replacement or implantation during the hospital stay and or at one-month follow-up). Results: 32 patients (40 % male, mean age 80 ± 8,5) with severe aortic valve stenosis were included in the study and 4 patients were excluded. Technical success was achieved in all patients (100%). Hemodynamic success was achieved in 30 patients (93,75%). Invasive max and mean gradients were reduced from 73±22 mm Hg and 49±22 mm Hg to 49±19 mm Hg and 20±13 mm Hg, respectively (p = <.001). Clinical success was achieved in 29 patients (90,6%). In total, no major adverse cardiac or cerebrovascular event nor vascular complications (according to VARC 2 criteria) occurred during the intervention. All-cause death at 6 months was 12%. Conclusion: According to our study, dual distal radial artery access is a safe and effective option for balloon aortic valvuloplasty in patients with severe aortic valve stenosis and can be performed in all patients with sufficient lumen diameter. Future randomized studies are warranted to investigate whether this technique is superior to other approaches.

Keywords: mean invasive gradient, distal radial access for balloon aortic valvuloplasty (DR-BAV), aortic valve stenosis, pseudo-aneurysm, arteriovenous fistula, valve academic research consortium (VARC)-2

Procedia PDF Downloads 56
3790 COVID-19: The Cause or the Confounder

Authors: Praveenkumar Natarajan

Abstract:

A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

Procedia PDF Downloads 114
3789 Development of Numerical Model to Compute Water Hammer Transients in Pipe Flow

Authors: Jae-Young Lee, Woo-Young Jung, Myeong-Jun Nam

Abstract:

Water hammer is a hydraulic transient problem which is commonly encountered in the penstocks of hydropower plants. The numerical model was developed to estimate the transient behavior of pressure waves in pipe systems. The computational algorithm was proposed to model the water hammer phenomenon in a pipe system with pump shutdown at midstream and sudden valve closure at downstream. To predict the pressure head and flow velocity as a function of time as a result of rapidly closing a valve and pump shutdown, two boundary conditions at the ends considering pump operation and valve control can be implemented as specified equations of the pressure head and flow velocity based on the characteristics method. It was shown that the effects of transient flow make it determine the needs for protection devices, such as surge tanks, surge relief valves, or air valves, at various points in the system against overpressure and low pressure. It produced reasonably good performance with the results of the proposed transient model for pipeline systems. The proposed numerical model can be used as an efficient tool for the safety assessment of hydropower plants due to water hammer.

Keywords: water hammer, hydraulic transient, pipe systems, characteristics method

Procedia PDF Downloads 106
3788 Varietal Screening of Watermelon against Powdery Mildew Disease and Its Management

Authors: Asim Abbasi, Amer Habib, Sajid Hussain, Muhammad Sufyan, Iqra, Hasnain Sajjad

Abstract:

Except for few scattered cases, powdery mildew disease was not a big problem for watermelon in the past but with the outbreaks of its pathotypes, races 1W and 2W, this disease becomes a serious issue all around the globe. The severe outbreak of this disease also increased the rate of fungicide application for its proper management. Twelve varieties of watermelon were screened in Research Area of Department of Plant pathology, University of Agriculture, Faisalabad to check the incidence of powdery mildew disease. Disease inoculum was prepared and applied with the help of foliar spray method. Fungicides and plants extracts were also applied after the disease incidence. Percentage leaf surface area diseased was assessed visually with a modified Horsfall-Barratt scale. The results of the experiment revealed that among all varieties, WT2257 and Zcugma F1 were highly resistant showing less than 5% disease incidence while Anar Kali and Sugar baby were highly susceptible with disease incidence of more than 65%. Among botanicals neem extract gave best results with disease incidence of less than 20%. Besides neem, all other botanicals also gave significant control of powdery mildew disease than the untreated check. In case of fungicides, Gemstar showed least disease incidence i.e. < 10%, however besides control maximum disease incidence was observed in Curzate (> 30%).

Keywords: botanicals, fungicides, pathotypes, powdery mildew

Procedia PDF Downloads 262
3787 A Study on Improvement of Performance of Anti-Splash Device for Cargo Oil Tank Vent Pipe Using CFD Simulation and Artificial Neural Network

Authors: Min-Woo Kim, Ok-Kyun Na, Jun-Ho Byun, Jong-Hwan Park, Seung-Hwa Yang, Joon-Hong Park, Young-Chul Park

Abstract:

This study is focused on the comparative analysis and improvement to grasp the flow characteristic of the Anti-Splash Device located under the P/V Valve and new concept design models using the CFD analysis and Artificial Neural Network. The P/V valve located upper deck to solve the pressure rising and vacuum condition of inner tank of the liquid cargo ships occurred oil outflow accident by transverse and longitudinal sloshing force. Anti-Splash Device is fitted to improve and prevent this problem in the shipbuilding industry. But the oil outflow accidents are still reported by ship owners. Thus, four types of new design model are presented by study. Then, comparative analysis is conducted with new models and existing model. Mostly the key criterion of this problem is flux in the outlet of the Anti-Splash Device. Therefore, the flow and velocity are grasped by transient analysis. And then it decided optimum model and design parameters to develop model. Later, it needs to develop an Anti-Splash Device by Flow Test to get certification and verification using experiment equipment.

Keywords: anti-splash device, P/V valve, sloshing, artificial neural network

Procedia PDF Downloads 564
3786 Correlation between Peripheral Arterial Disease and Coronary Artery Disease in Bangladeshi Population: A Five Years Retrospective Study

Authors: Syed Dawood M. Taimur

Abstract:

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

Procedia PDF Downloads 397
3785 Design and Implementation of a Fan Coil Unit Controller Based on the Duty Ratio Fuzzy Method

Authors: Liang Zhao, Jili Zhang, Kai Li

Abstract:

A microcontroller-based fan coil unit (FCU) fuzzy controller is designed and implemented in this paper. The controller employs the concept of duty ratio on the electric valve control, which could make full use of the cooling and dehumidifying capacity of the FCU when the valve is off. The traditional control method and its limitations are analyzed. The hardware and software design processes are introduced in detail. The experimental results show that the proposed method is more energy efficient compared to the traditional controlling strategy. Furthermore, a more comfortable room condition could be achieved by the proposed method. The proposed low-cost FCU fuzzy controller deserves to be widely used in engineering applications.

Keywords: fan coil unit, duty ratio, fuzzy controller, experiment

Procedia PDF Downloads 299
3784 Molecular Interaction of Acetylcholinesterase with Flavonoids Involved in Neurodegenerative Diseases

Authors: W. Soufi, F. Boukli Hacene, S. Ghalem

Abstract:

Alzheimer's disease (AD) is a neurodegenerative disease that leads to a progressive and permanent deterioration of nerve cells. This disease is progressively accompanied by an intellectual deterioration leading to psychological manifestations and behavioral disorders that lead to a loss of autonomy. It is the most frequent of degenerative dementia. Alzheimer's disease (AD), which affects a growing number of people, has become a major public health problem in a few years. In the context of the study of the mechanisms governing the evolution of AD disease, we have found that natural flavonoids are good acetylcholinesterase inhibitors that reduce the rate of ßA secretion in neurons. This work is to study the inhibition of acetylcholinesterase (AChE) which is an enzyme involved in Alzheimer's disease, by methods of molecular modeling. These results will probably help in the development of an effective therapeutic tool in the fight against the development of Alzheimer's disease. Our goal of the research is to study the inhibition of acetylcholinesterase (AChE) by molecular modeling methods.

Keywords: Alzheimer's disease, acetylcholinesterase, flavonoids, molecular modeling

Procedia PDF Downloads 75
3783 Influence of Valve Lift Timing on Producer Gas Combustion and Its Modeling Using Two-Stage Wiebe Function

Authors: M. Sreedhar Babu, Vishal Garg, S. B. Akella, Shibu Clement, N. K. S Rajan

Abstract:

Producer gas is a biomass derived gaseous fuel which is extensively used in internal combustion engines for power generation application. Unlike the conventional hydrocarbon fuels (Gasoline and Natural gas), the combustion properties of producer gas fuel are much different. Therefore, setting of optimal spark time for efficient engine operation is required. Owing to the fluctuating tendency of producer gas composition during gasification process, the heat release patterns (dictating the power output and emissions) obtained are quite different from conventional fuels. It was found that, valve lift timing is yet another factor which influences the burn rate of producer gas fuel, and thus, the heat release rate of the engine. Therefore, the present study was motivated to estimate the influence of valve lift timing analytically (Wiebe model) on the burn rate of producer gas through curve fitting against experimentally obtained mass fraction burn curves of several producer gas compositions. Furthermore, Wiebe models are widely used in zero-dimensional codes for engine parametric studies and are quite popular. This study also addresses the influence of hydrogen and methane concentration of producer gas on combustion trends, which are known to cause dynamics in engine combustion.

Keywords: combustion duration (CD), crank angle (CA), mass fraction burnt (MFB), producer sas (PG), Wiebe Combustion Model (WCM), wide open throttle (WOT)

Procedia PDF Downloads 280
3782 Numerical Analysis of Water Hammer in a Viscoelastic Pipe System Considering Fluid Structure Interaction

Authors: N. Tavakoli Shirazi

Abstract:

This study investigates the effects of pipe-wall viscoelasticity on water hammer pressures. Tests have been conducted in a reservoir-pipe-valve system configured of a main viscoelastic pipeline and two short steel pipes placed upstream and downstream of the main pipe. Rapid closure of a manually operated valve at the downstream end generates water hammer. Experimental measurements at several positions along the pipeline have been collected from the papers. Computer simulations of the experiment have been performed and the results of runs with various options affecting the water hammer are provided and discussed. It is shown that the incorporation of viscoelastic pipe wall mechanical behavior in the hydraulic transient model contributes to a favorable fitting between numerical results and observed data.

Keywords: pipe system, PVC pipe, viscoelasticity, water hammer

Procedia PDF Downloads 436
3781 Minimally Invasive versus Conventional Sternotomy for Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

Abstract:

Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

Procedia PDF Downloads 94
3780 Analysis of Possible Equipment in the Reduction Unit of a Low Tonnage Liquefied Natural Gas Production Plant

Authors: Pavel E. Mikriukov

Abstract:

The demand for natural gas (NG) is increasing every year around the world, so it is necessary to produce and transport NG in large quantities. To solve this problem, liquefied natural gas (LNG) plants are used, using different equipment and different technologies to achieve the required LNG quality. To determine the best efficiency of the LNG liquefaction plant, it is necessary to analyze the equipment used in this process and identify other technological solutions for LNG production using more productive and energy-efficient equipment. Based on this, mathematical models of the technological process of the LNG plant were created, which are based on a two-circuit system of heat exchange equipment and a nitrogen isolated cycle for NG cooling. The final liquefaction of natural gas is performed on the construction of the basic principle of the Joule-Thompson effect. The pressure and temperature drop are considered on different types of equipment such as throttle valve, which was used in the basic scheme; turbo expander and supersonic separator, which act as new equipment, to be compared with the efficiency of the basic scheme of the unit. New configurations of LNG plants are suggested, which can be used in almost all LNG facilities. As a result of the analysis, it turned out that the turbo expander and the supersonic separator have comparatively equal potential in comparison with the baseline scheme execution on the throttle valve. A more rational method of selecting the technology and the equipment used for natural gas liquefaction can improve the efficiency of low-tonnage plants and reduce the cost of gas for own needs.

Keywords: gas liquefaction, gas, Joule-Thompson effect, LNG, low-tonnage LNG, supersonic separator, Throttle valve, turbo expander

Procedia PDF Downloads 84
3779 Investigation of Clubroot Disease Occurrence under Chemical and Organic Soil Environment

Authors: Zakirul Islam, Yugo Kumokawa, Quoc Thinh Tran, Motoki Kubo

Abstract:

Clubroot is a disease of cruciferous plant caused by soil born pathogen Plasmodiophora brassicae and can significantly limit the production through rapid spreading. The present study was designed to investigate the effect of cultivation practices (chemical and organic soils) on clubroot disease development in Brassica rapa. Disease index and root bacterial composition were investigated for both chemical and organic soils. The bacterial biomass and diversity in organic soil were higher than those in chemical soil. Disease severity was distinct for two different cultivation methods. The number of endophytic bacteria decreased in the infected root for both soils. The increased number of endophytic bacterial number led to reduce the proliferation of pathogen spore inside the root and thus reduced the disease severity in organic plants.

Keywords: clubroot disease, bacterial biomass, root infection, disease index, chemical cultivation, organic cultivation

Procedia PDF Downloads 52
3778 Cardiovascular Disease Is Common among Patients with Systemic Lupus Erythematosus

Authors: Fathia Ehmouda Zaid, Reim Abudelnbi

Abstract:

Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Patients and method: Cross-section study (68) patients diagnosed as systemic lupus erythematosus (SLE), who visited the outpatient clinic of rheumatology, these patients were interviewed with a structured questionnaire about their past and current clinically for presence of Cardiovascular disease in systemic lupus and use SLEDAI, specific tests [ECG –ECHO –CXRAY] the data are analyzed statistically by Pearson's correlation coefficient was calculated and statistical significance was defined as P< 0.05,during period (2013-2014). Objective: Estimation Cardiovascular disease manifestation of systemic lupus erythematosus, correlation with disease activity, morbidity, and mortality. Result: (68) Patients diagnosed as systemic lupus erythematosus' age range from (18-48 years), M=(13±29Y), Sex were female 66/68 (97.1%), male 2/68 (2.9%),duration of disease range[1-15year], M =[7±8y], we found Cardiovascular disease manifestation of systemic lupus erythematosus 32/68 (47.1%), correlation with disease activity use SLEDAI,(r= 476** p=0.000),Morbidity,(r= .554**; p=0.000) and mortality (r=.181; p=.139), Cardiovascular disease manifestations of systemic lupus erythematosus are pericarditis 8/68 (11.8%), pericardial effusion 6/68 (8.8%), myocarditis 4/68 (5.9 %), valvular lesions (endocarditis) 1/68 (1.5%), pulmonary hypertension (PAH) 12/68 (17.6%), coronary artery disease 1/68 (1.5%), none of patients have conduction abnormalities involvement. Correlation with disease activity use SLEDAI, pericarditis (r= .210, p=.086), pericardial effusion (r= 0.079, p=.520), myocarditis (r= 272*, p=.027), valvular lesions (endocarditis) (r= .112, p= .362), pulmonary hypertension (PAH) (r= .257*, p=.035) and coronary artery disease (r=.075, p=.544) correlation between cardiovascular disease manifestations of systemic lupus erythematosus and specific organ involvement we found Mucocutaneous (r=.091 p= .459), musculoskeletal (MSK) (r=.110 p=.373), Renal disease (r=.278*, p=.022), neurologic disease (r=.085, p=.489) and Hematologic disease (r=-.264*, p=.030). Conclusion: Cardiovascular manifestation is more frequent symptoms with systemic lupus erythematosus (SLE) is 47 % correlation with disease activity and morbidity but not with mortality. Recommendations: Focus research to evaluation and an adequate assessment of cardiovascular complications on the morbidity and mortality of the patients with SLE are still required.

Keywords: cardiovascular disease, systemic lupus erythematosus, disease activity, mortality

Procedia PDF Downloads 415
3777 The Incidence of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting in Patients with Local and Diffuse Coronary Artery Disease

Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

Abstract:

De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

Procedia PDF Downloads 185
3776 Evaluation of Disease Risk Variables in the Control of Bovine Tuberculosis

Authors: Berrin Şentürk

Abstract:

In this study, due to the recurrence of bovine tuberculosis, in the same areas, the risk factors for the disease were determined and evaluated at the local level. This study was carried out in 32 farms where the disease was detected in the district and center of Samsun province in 2014. Predetermined risk factors, such as farm, environmental and economic risks, were investigated with the survey method. It was predetermined that risks in the three groups are similar to the risk variables of the disease on the global scale. These risk factors that increase the susceptibility of the infection must be understood by the herd owners. The risk-based contagious disease management system approach should be applied for bovine tuberculosis by farmers, animal health professionals and public and private sector decision makers.

Keywords: bovine tuberculosis, disease management, control, outbreak, risk analysis

Procedia PDF Downloads 370
3775 Computational Simulations and Assessment of the Application of Non-Circular TAVI Devices

Authors: Jonathon Bailey, Neil Bressloff, Nick Curzen

Abstract:

Transcatheter Aortic Valve Implantation (TAVI) devices are stent-like frames with prosthetic leaflets on the inside, which are percutaneously implanted. The device in a crimped state is fed through the arteries to the aortic root, where the device frame is opened through either self-expansion or balloon expansion, which reveals the prosthetic valve within. The frequency at which TAVI is being used to treat aortic stenosis is rapidly increasing. In time, TAVI is likely to become the favoured treatment over Surgical Valve Replacement (SVR). Mortality after TAVI has been associated with severe Paravalvular Aortic Regurgitation (PAR). PAR occurs when the frame of the TAVI device does not make an effective seal against the internal surface of the aortic root, allowing blood to flow backwards about the valve. PAR is common in patients and has been reported to some degree in as much as 76% of cases. Severe PAR (grade 3 or 4) has been reported in approximately 17% of TAVI patients resulting in post-procedural mortality increases from 6.7% to 16.5%. TAVI devices, like SVR devices, are circular in cross-section as the aortic root is often considered to be approximately circular in shape. In reality, however, the aortic root is often non-circular. The ascending aorta, aortic sino tubular junction, aortic annulus and left ventricular outflow tract have an average ellipticity ratio of 1.07, 1.09, 1.29, and 1.49 respectively. An elliptical aortic root does not severely affect SVR, as the leaflets are completely removed during the surgical procedure. However, an elliptical aortic root can inhibit the ability of the circular Balloon-Expandable (BE) TAVI devices to conform to the interior of the aortic root wall, which increases the risk of PAR. Self-Expanding (SE) TAVI devices are considered better at conforming to elliptical aortic roots, however the valve leaflets were not designed for elliptical function, furthermore the incidence of PAR is greater in SE devices than BE devices (19.8% vs. 12.2% respectively). If a patient’s aortic root is too severely elliptical, they will not be suitable for TAVI, narrowing the treatment options to SVR. It therefore follows that in order to increase the population who can undergo TAVI, and reduce the risk associated with TAVI, non-circular devices should be developed. Computational simulations were employed to further advance our understanding of non-circular TAVI devices. Radial stiffness of the TAVI devices in multiple directions, frame bending stiffness and resistance to balloon induced expansion are all computationally simulated. Finally, a simulation has been developed that demonstrates the expansion of TAVI devices into a non-circular patient specific aortic root model in order to assess the alterations in deployment dynamics, PAR and the stresses induced in the aortic root.

Keywords: tavi, tavr, fea, par, fem

Procedia PDF Downloads 419
3774 Effect of Time of Planting on Powdery Mildew Development on Cucumber

Authors: H. Parameshwar Naik, Shripad Kulkarni

Abstract:

Powdery mildew is a serious disease among the fungal in high humid areas with varied temperature conditions. In recent days disease becomes very severe due to uncertain weather conditions and unique character of the disease is, it produces white mycelia growth on upper and lower leaf surfaces and in severe conditions it leads to defoliation. Results of the experiment revealed that sowing of crop in the I fortnight (FN) of July recorded the minimum mean disease severity (7.96 %) followed by crop sown in II FN of July (13.19 %) as against the crop sown in II FN of August (41.44 %) and I FN of September (33.78 %) and the I fortnight of October (33.77 %). In the first date of sowing infection started at 45 DAS and progressed till 73 DAS and it was up to 14.66 Percent and in second date of sowing disease progressed up to 22.66 percent and in the third date of sowing, it was up to 59.35 percent. Afterward, the disease started earlier and progressed up to 66.15 percent and in sixth and seventh date of sowing disease progressed up to 43.15 percent and 59.85 percent respectively. Disease progress is very fast after 45 days after sowing and highest disease incidence was noticed at 73 DAS irrespective of dates of sowing. From the results of the present study, it is very clear that disease development will be very high if crop sown in between 1st fortnight of August and the 1st fortnight of September.

Keywords: cucumber, India, Karnataka, powdery mildew

Procedia PDF Downloads 229
3773 Level of Awareness of Genetic Counselling in Benue State Nigeria: Its Advocacy on the Inheritance of Sickle Cell Disease

Authors: Agi Sunday

Abstract:

A descriptive analysis of reported cases of sickle cell disease and the level of awareness about genetic counselling in 30 hospitals were carried out. Additionally, 150 individuals between ages 16-45 were randomly selected for evaluation of genetic counselling awareness. The main tools for this study were questionnaires which were taken to hospitals, and individuals completed the others. The numbers of reported cases of sickle cell disease recorded in private, public and teaching hospitals were 14 and 57; 143 and 89; 272 and 57 for the periods of 1995-2000 and 2001-2005, respectively. A general informal genetic counselling took place mostly in the hospitals visited. 122 (86%) individuals had the knowledge of genetic disease and only 43 (30.3%) individuals have been exposed to genetic counselling. 64% of individuals agreed that genetic counselling would help in the prevention of genetic disease.

Keywords: sickle disease, genetic counseling, genetic testing, advocacy

Procedia PDF Downloads 351
3772 Prediction and Reduction of Cracking Issue in Precision Forging of Engine Valves Using Finite Element Method

Authors: Xi Yang, Bulent Chavdar, Alan Vonseggern, Taylan Altan

Abstract:

Fracture in hot precision forging of engine valves was investigated in this paper. The entire valve forging procedure was described and the possible cause of the fracture was proposed. Finite Element simulation was conducted for the forging process, with commercial Finite Element code DEFORMTM. The effects of material properties, the effect of strain rate and temperature were considered in the FE simulation. Two fracture criteria were discussed and compared, based on the accuracy and reliability of the FE simulation results. The selected criterion predicted the fracture location and shows the trend of damage increasing with good accuracy, which matches the experimental observation. Additional modification of the punch shapes was proposed to further reduce the tendency of fracture in forging. Finite Element comparison shows a great potential of such application in the mass production.

Keywords: hotforging, engine valve, fracture, tooling

Procedia PDF Downloads 246
3771 Energy Efficiency Improvement of Excavator with Independent Metering Valve by Continuous Mode Changing Considering Engine Fuel Consumption

Authors: Sang-Wook Lee, So-Yeon Jeon, Min-Gi Cho, Dae-Young Shin, Sung-Ho Hwang

Abstract:

Hydraulic system of excavator gets working energy from hydraulic pump which is connected to output shaft of engine. Recently, main control valve (MCV) which is composed of several independent metering valve (IMV) has been introduced for better energy efficiency of the hydraulic system so that fuel efficiency of the excavator can be improved. Excavator with IMV has 5 operating modes depending on the quantity of regeneration flow. In this system, the hydraulic pump is controlled to supply demanded flow which is needed to operate each mode. Because the regenerated flow supply energy to actuators, the hydraulic pump consumes less energy to make same motion than one that does not regenerate flow. The horse power control is applied to the hydraulic pump of excavator for maintaining engine start under a heavy load and this control makes the flow of hydraulic pump reduced. When excavator is in complex operation such as loading or unloading soil, the hydraulic pump discharges small quantity of working fluid in high pressure. At this operation, the engine of excavator does not run at optimal operating line (OOL). The engine needs to be operated on OOL to improve fuel efficiency and by controlling hydraulic pump the engine can drive on OOL. By continuous mode changing of IMV, the hydraulic pump is controlled to make engine runs on OOL. The simulation result of this study shows that fuel efficiency of excavator with IMV can be improved by considering engine OOL and continuous mode changing algorithm.

Keywords: continuous mode changing, engine fuel consumption, excavator, fuel efficiency, IMV

Procedia PDF Downloads 356
3770 Role of DatScan in the Diagnosis of Parkinson's Disease

Authors: Shraddha Gopal, Jayam Lazarus

Abstract:

Aims: To study the referral practice and impact of DAT-scan in the diagnosis or exclusion of Parkinson’s disease. Settings and Designs: A retrospective study Materials and methods: A retrospective study of the results of 60 patients who were referred for a DAT scan over a period of 2 years from the Department of Neurology at Northern Lincolnshire and Goole NHS trust. The reason for DAT scan referral was noted under 5 categories against Parkinson’s disease; drug-induced Parkinson’s, essential tremors, diagnostic dilemma, not responding to Parkinson’s treatment, and others. We assessed the number of patients who were diagnosed with Parkinson’s disease against the number of patients in whom Parkinson’s disease was excluded or an alternative diagnosis was made. Statistical methods: Microsoft Excel was used for data collection and statistical analysis, Results: 30 of the 60 scans were performed to confirm the diagnosis of early Parkinson’s disease, 13 were done to differentiate essential tremors from Parkinsonism, 6 were performed to exclude drug-induced Parkinsonism, 5 were done to look for alternative diagnosis as the patients were not responding to anti-Parkinson medication and 6 indications were outside the recommended guidelines. 55% of cases were confirmed with a diagnosis of Parkinson’s disease. 43.33% had Parkinson’s disease excluded. 33 of the 60 scans showed bilateral abnormalities and confirmed the clinical diagnosis of Parkinson’s disease. Conclusion: DAT scan provides valuable information in confirming Parkinson’s disease in 55% of patients along with excluding the diagnosis in 43.33% of patients aiding an alternative diagnosis.

Keywords: DATSCAN, Parkinson's disease, diagnosis, essential tremors

Procedia PDF Downloads 198
3769 Improved Artificial Bee Colony Algorithm for Non-Convex Economic Power Dispatch Problem

Authors: Badr M. Alshammari, T. Guesmi

Abstract:

This study presents a modified version of the artificial bee colony (ABC) algorithm by including a local search technique for solving the non-convex economic power dispatch problem. The local search step is incorporated at the end of each iteration. Total system losses, valve-point loading effects and prohibited operating zones have been incorporated in the problem formulation. Thus, the problem becomes highly nonlinear and with discontinuous objective function. The proposed technique is validated using an IEEE benchmark system with ten thermal units. Simulation results demonstrate that the proposed optimization algorithm has better convergence characteristics in comparison with the original ABC algorithm.

Keywords: economic power dispatch, artificial bee colony, valve-point loading effects, prohibited operating zones

Procedia PDF Downloads 226