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Retinal endothelial function in cardiovascular risk patients: A randomized controlled exercise trial
(2020)
The aim of this study was to investigate, for the first time, the effects of high-intensity interval training (HIIT) on retinal microvascular endothelial function in cardiovascular (CV) risk patients. In the randomized controlled trial, middle-aged and previously sedentary patients with increased CV risk (aged 58 ± 6 years) with ≥ two CV risk factors were randomized into a 12-week HIIT (n = 33) or control group (CG, n = 36) with standard physical activity recommendations. A blinded examiner measured retinal endothelial function by flicker light-induced maximal arteriolar (ADmax) and venular (VDmax) dilatation as well as the area under the arteriolar (AFarea) and venular (VFarea) flicker curve using a retinal vessel analyzer. Standardized assessments of CV risk factors, cardiorespiratory fitness, and retinal endothelial function were performed before and after HIIT. HIIT reduced body mass index, fat mass, and low-density lipoprotein and increased muscle mass and peak oxygen uptake (VO2peak). Both ADmax (pre: 2.7 ± 2.1%, post: 3.0 ± 2.2%, P = .018) and AFarea (pre: 32.6 ± 28.4%*s, post: 37.7 ± 30.6%*s, P = .016) increased after HIIT compared with CG (ADmax, pre: 3.2 ± 1.8%, post: 2.9 ± 1.8%, P = .254; AFarea, pre: 41.6 ± 28.5%*s, post: 37.8 ± 27.0%*s, P = .186). Venular function remained unchanged after HIIT. There was a significant association between ∆-change VO2peak and ∆-changes ADmax and AFarea (P = .026, R² = 0.073; P = .019, R² = 0.081, respectively). 12-weeks of HIIT improved retinal endothelial function in middle-aged patients with increased CV risk independent of the reduction in classical CV risk factors. Exercise has the potential to reverse or at least postpone progression of small vessel disease in older adults with increased CV risk under standard medication. Dynamic retinal vessel analysis seems to be a sensitive tool to detect treatment effects of exercise interventions on retinal microvascular endothelial function in middle-aged individuals with increased CV risk.
Background
For supratentorial craniotomy, surgical access, and closure technique, including placement of subgaleal drains, may vary considerably. The influence of surgical nuances on postoperative complications such as cerebrospinal fluid leakage or impaired wound healing overall remains largely unclear. With this study, we are reporting our experiences and the impact of our clinical routines on outcome in a prospectively collected data set.
Method
We prospectively observed 150 consecutive patients undergoing supratentorial craniotomy and recorded technical variables (type/length of incision, size of craniotomy, technique of dural and skin closure, type of dressing, and placement of subgaleal drains). Outcome variables (subgaleal hematoma/CSF collection, periorbital edema, impairment of wound healing, infection, and need for operative revision) were recorded at time of discharge and at late follow-up.
Results
Early subgaleal fluid collection was observed in 36.7% (2.8% at the late follow-up), and impaired wound healing was recorded in 3.3% of all cases, with an overall need for operative revision of 6.7%. Neither usage of dural sealants, lack of watertight dural closure, and presence of subgaleal drains, nor type of skin closure or dressing influenced outcome. Curved incisions, larger craniotomy, and tumor size, however, were associated with an increase in early CSF or hematoma collection (p < 0.0001, p = 0.001, p < 0.01 resp.), and larger craniotomy size was associated with longer persistence of subgaleal fluid collections (p < 0.05).
Conclusions
Based on our setting, individual surgical nuances such as the type of dural closure and the use of subgaleal drains resulted in a comparable complication rate and outcome. Subgaleal fluid collections were frequently observed after supratentorial procedures, irrespective of the closing technique employed, and resolve spontaneously in the majority of cases without significant sequelae. Our results are limited due to the observational nature in our single-center study and need to be validated by supportive prospective randomized design.
Masked hypertension is known to induce microvascular complications. However, it is unclear whether early microvascular changes are already occurring in young, otherwise healthy adults. We therefore investigated whether retinal microvascular calibers and acute responses to a flicker stimulus are related to masked hypertension. We used the baseline data of 889 participants aged 20–30 years who were taking part in the African Prospective study on the Early Detection and Identification of Cardiovascular Disease and Hypertension. Clinic and 24-h ambulatory blood pressure were measured. The central retinal artery equivalent (CRAE) and central retinal vein equivalent were calculated from fundus images, and retinal vessel dilation was determined in response to flicker light-induced provocation. A smaller CRAE was observed in those with masked hypertension vs. those with normotension (157.1 vs. 161.2 measuring units, P < 0.001). In forward multivariable-adjusted regression analysis, only CRAE was negatively related to masked hypertension [adjusted R² = 0.267, β = −0.097 (95% CI = −0.165; −0.029), P = 0.005], but other retinal microvascular parameters were not associated with masked hypertension. In multivariable logistic regression analyses, masked hypertension [OR = 2.333, (95% CI = 1.316; 4.241), P = 0.004] was associated with a narrower CRAE. In young healthy adults, masked hypertension was associated with retinal arteriolar narrowing, thereby reflecting early microvascular alterations known to predict cardiovascular outcomes in later life.
Purpose
Globally, a detrimental shift in cardiovascular disease risk factors and a higher mortality level are reported in some black populations. The retinal microvasculature provides early insight into the pathogenesis of systemic vascular diseases, but it is unclear whether retinal vessel calibers and acute retinal vessel functional responses differ between young healthy black and white adults.
Methods
We included 112 black and 143 white healthy normotensive adults (20–30 years). Retinal vessel calibers (central retinal artery and vein equivalent (CRAE and CRVE)) were calculated from retinal images and vessel caliber responses to flicker light induced provocation (FLIP) were determined. Additionally, ambulatory blood pressure (BP), anthropometry and blood samples were collected.
Results
The groups displayed similar 24 h BP profiles and anthropometry (all p > .24). Black participants demonstrated a smaller CRAE (158 ± 11 vs. 164 ± 11 MU, p < .001) compared to the white group, whereas CRVE was similar (p = .57). In response to FLIP, artery maximal dilation was greater in the black vs. white group (5.6 ± 2.1 vs. 3.3 ± 1.8%; p < .001).
Conclusions
Already at a young age, healthy black adults showed narrower retinal arteries relative to the white population. Follow-up studies are underway to show if this will be related to increased risk for hypertension development. The reason for the larger vessel dilation responses to FLIP in the black population is unclear and warrants further investigation.
The recovery of waste heat requires heat exchangers to extract it from a liquid or gaseous medium into another working medium, a refrigerant. In Organic Rankine Cycles (ORC) on Combustion Engines there are two major heat sources, the exhaust gas and the water/glycol fluid from the engine’s cooling circuit. A heat exchanger design must be adapted to the different requirements and conditions resulting from the heat sources, fluids, system configurations, geometric restrictions, and etcetera. The Stacked Shell Cooler (SSC) is a new and very specific design of a plate heat exchanger, created by AKG, which allows with a maximum degree of freedom the optimization of heat exchange rate and the reduction of the related pressure drop. This optimization in heat exchanger design for ORC systems is even more important, because it reduces the energy consumption of the system and therefore maximizes the increase in overall efficiency of the engine.
Producing fresh water from saline water has become one of the most difficult challenges to overcome especially with the high demand and shortage of fresh water. In this context, as part of a collaboration with Germany, the authors propose a design and implementation of a pilot multi-stage solar desalination system (MSD), remotely controlled, at Douar Al Hamri in the rural town of Boughriba in the province of Berkane, Morocco. More specifically, they present their contribution on the remote control and supervision system, which makes the functioning of the MSD system reliable and guarantees the production of drinking water for the population of Douar. The results obtained show that the electronic cards and computer communication software implemented allow the acquisition of all electrical (currents, voltages, powers, yields), thermal (temperatures of each stage), and meteorological (irradiance and ambient temperature), remote control and maintenance (switching on, off, data transfer). By comparing with the literature carried out in the field of solar energy, the authors conclude that the MSD and electronic desalination systems realized during this work represent a contribution in terms of the reliability and durability of providing drinking water in rural and urban areas.
The paper presents an aerodynamic investigation of 70 different streamlined bodies with fineness ratios ranging from 2 to 10. The bodies are chosen to idealize both unmanned and small manned aircraft fuselages and feature cross-sectional shapes that vary from circular to quadratic. The study focuses on friction and pressure drag in dependency of the individual body’s fineness ratio and cross section. The drag forces are normalized with the respective body’s wetted area to comply with an empirical drag estimation procedure. Although the friction drag coefficient then stays rather constant for all bodies, their pressure drag coefficients decrease with an increase in fineness ratio. Referring the pressure drag coefficient to the bodies’ cross-sectional areas shows a distinct pressure drag minimum at a fineness ratio of about three. The pressure drag of bodies with a quadratic cross section is generally higher than for bodies of revolution. The results are used to derive an improved form factor that can be employed in a classic empirical drag estimation method. The improved formulation takes both the fineness ratio and cross-sectional shape into account. It shows superior accuracy in estimating streamlined body drag when compared with experimental data and other form factor formulations of the literature.
Thermal Characterization of additive manufactured Integral Structures for Phase Change Applications
(2020)
“Infused Thermal Solutions” (ITS) introduces a method for passive thermal control to stabilize structural components thermally without active heating and cooling systems, by using phase change material (PCM) in combination with lattice – both embedded into an additive manufactured integral structure. The technology is currently under development. This paper presents the results of the thermal property measurements performed on additive manufactured ITS breadboards. Within the breadboard campaigns key characteristics of the additive manufactured specimens were derived: Mechanical parameters: specimen impermeability, minimum wall thickness, lattice structure, subsequent heat treatment. Thermal properties: thermo-optical surface properties of the additive manufactured raw material, thermal conductivity and specific heat capacity measurements. As a conclusion the paper introduces an overview of potential ITS hardware applications, expected to increase the thermal performance.
Mechano-pharmacological testing of L-Type Ca²⁺ channel modulators via human vascular celldrum model
(2020)
Background/Aims: This study aimed to establish a precise and well-defined working model, assessing pharmaceutical effects on vascular smooth muscle cell monolayer in-vitro. It describes various analysis techniques to determine the most suitable to measure the biomechanical impact of vasoactive agents by using CellDrum technology. Methods: The so-called CellDrum technology was applied to analyse the biomechanical properties of confluent human aorta muscle cells (haSMC) in monolayer. The cell generated tensions deviations in the range of a few N/m² are evaluated by the CellDrum technology. This study focuses on the dilative and contractive effects of L-type Ca²⁺ channel agonists and antagonists, respectively. We analyzed the effects of Bay K8644, nifedipine and verapamil. Three different measurement modes were developed and applied to determine the most appropriate analysis technique for the study purpose. These three operation modes are called, particular time mode" (PTM), "long term mode" (LTM) and "real-time mode" (RTM). Results: It was possible to quantify the biomechanical response of haSMCs to the addition of vasoactive agents using CellDrum technology. Due to the supplementation of 100nM Bay K8644, the tension increased approximately 10.6% from initial tension maximum, whereas, the treatment with nifedipine and verapamil caused a significant decrease in cellular tension: 10nM nifedipine decreased the biomechanical stress around 6,5% and 50nM verapamil by 2,8%, compared to the initial tension maximum. Additionally, all tested measurement modes provide similar results while focusing on different analysis parameters. Conclusion: The CellDrum technology allows highly sensitive biomechanical stress measurements of cultured haSMC monolayers. The mechanical stress responses evoked by the application of vasoactive calcium channel modulators were quantified functionally (N/m²). All tested operation modes resulted in equal findings, whereas each mode features operation-related data analysis.
With the variety of toothbrushes on the market, the question arises, which toothbrush is best suited to maintain oral health? This thematic review focuses first on plaque formation mechanisms and then on the plaque removal effectiveness of ultrasonic toothbrushes and their potential in preventing oral diseases like periodontitis, gingivitis, and caries. We overviewed the physical effects that occurred during brushing and tried to address the question of whether ultrasonic toothbrushes effectively reduced the microbial burden by increasing the hydrodynamic forces. The results of published studies show that electric toothbrushes, which combine ultrasonic and sonic (or acoustic and mechanic) actions, may have the most promising effect on good oral health. Existing ultrasonic/sonic toothbrush models do not significantly differ regarding the removal of dental biofilm and the reduction of gingival inflammation compared with other electrically powered toothbrushes, whereas the manual toothbrushes show a lower effectiveness.
The treatment of septic wounds with curative dressings based on biocomposites containing sage and marigold phytoextracts was effective in in vitro and in vivo experiments. These dressings caused the purification of the wound surface from purulent-necrotic masses three days earlier than in the other experimental groups. The consequence of an increase in incidents of severe course of the wound and the observed tendency to increase the number of adverse effects is the development of long-term recurrent wound processes. To treat purulent wounds, the following tactics were used: The purulent wounds of animals were covered with the examined wound dressing, and then the next day samples were taken, the procedure was performed once in 2 days. To obtain the active nanostructured sorbents such as carbonized rice husks, they are functionalized with biologically active components possessing antimicrobial, anti-inflammatory, antitoxic, immunomodulating, antiallergic and other types of properties.
Activated carbons are known as excellent adsorbents. Their applications include the adsorptive removal of color, odor, taste, undesirable organic and inorganic pollutants from drinking and waste water; air purification in inhabited spaces; purification of many chemicals, pharmaceutical products and many others. This chapter elucidates the role of normal microflora in the maintenance of human health and presents materials on possible clinical displays of microecological infringements and ways of their correction. It presents new developments concerning new probiotics with immobilized Lactobacillus and Bacillus. The chapter considers the mechanisms of the intestine disbacteriosis correction by sorbed probiotics. It demonstrates the advantages and creation prospects of immobilized probiotics developed on the basis of carbonized rice husk. There are great prospects for the development of medical biotechnology due to use of carbon sorbents with a nanostructured surface. Microbial communities form a biocenosis of the biotope and together with the host organism create permanent or temporary ecosystems.
This chapter shows that nanomaterials obtained by high-temperature carbonization of inexpensive plant raw material such as rice husk, grape seeds, and walnut shells can serve as a basis for the production of highly efficient microbial drugs, biodestructors, biosorbents, and biocatalysts, which are promising for the remediation of the ecosystem contaminated with heavy and radioactive metals, oil and oil products. A strong interest in engineering zymology is dictated by the necessity to address the issues of monitoring enzymatic processes, treatment, and diagnosis of a number of common human diseases, environmental pollution, quality control of pharmaceuticals and food. Nanomaterials obtained by high-temperature carbonization of cheap plant raw material such as-rice husks, grape seeds and walnut shells, can serve as a basis for creating of highly effective microbial preparations-biodestructors, biosorbents and biocatalysts, which are promising for the use of contaminated ecosystems, and for restoration of human intestine microecology.
Integrated voice assistants (IVA) receive more and more attention and are widespread for entertainment use cases, such as radio hearing or web searches. At the same time, the health care segment suffers in process inefficiency and missing staff, whereas the usage of IVA has the potential to improve caring processes and patient satisfaction. By applying a design science approach and based on a qualitative study, we identify IVA requirements, barriers and design guidelines for the health care sector. The results reveal three important IVA functions: the ability to set appointments with care service staff, the documentation of health history and the communication with service staff. Integration, system stability and volume control are the most important nonfunctional requirements. Based on the interview results and project experiences, six design and implementation guidelines are derived.
This paper analyzes the drag characteristics of several landing gear and turret configurations that are representative of unmanned aircraft tricycle landing gears and sensor turrets. A variety of these components were constructed via 3D-printing and analyzed in a wind-tunnel measurement campaign. Both turrets and landing gears were attached to a modular fuselage that supported both isolated components and multiple components at a time. Selected cases were numerically investigated with a Reynolds-averaged Navier-Stokes approach that showed good accuracy when compared to wind-tunnel data. The drag of main gear struts could be significantly reduced via streamlining their cross-sectional shape and keeping load carrying capabilities similar. The attachment of wheels introduced interference effects that increased strut drag moderately but significantly increased wheel drag compared to isolated cases. Very similar behavior was identified for front landing gears. The drag of an electro-optical and infrared sensor turret was found to be much higher than compared to available data of a clean hemisphere-cylinder combination. This turret drag was merely influenced by geometrical features like sensor surfaces and the rotational mechanism. The new data of this study is used to develop simple drag estimation recommendations for main and front landing gear struts and wheels as well as sensor turrets. These recommendations take geometrical considerations and interference effects into account.
Reinforced concrete (RC) structures with masonry infills are widely used for several types of buildings all over the world. However, it is well known that traditional masonry infills constructed with rigid contact to the surrounding RC frame performed rather poor in past earthquakes. Masonry infills showed severe in-plane damages and failed in many cases under out-of-plane seismic loading. As the undesired interactions between frames and infills changes the load transfer on building level, complete collapses of buildings were observed. A possible solution is uncoupling of masonry infills to the frame to reduce the infill contribution activated by the frame deformation under horizontal loading. The paper presents numerical simulations on RC frames equipped with the innovative decoupling system INODIS. The system was developed within the European project INSYSME and allows an effective uncoupling of frame and infill. The simulations are carried out with a micro-modelling approach, which is able to predict the complex nonlinear behaviour resulting from the different materials and their interaction. Each brick is modelled individually and connected taking into account nonlinearity of a brick mortar interface. The calibration of the model is based on small specimen tests and experimental results for one bay one storey frame are used for the validation. The validated model is further used for parametric studies on two storey and two bay infilled frames. The response and change of the structural stiffness are analysed and compared to the traditionally infilled frame. The results confirm the effectiveness of the INODIS system with less damage and relatively low contribution of the infill at high drift levels. In contrast to the uncoupled system configurations, traditionally infilled frames experienced brittle failure at rather low drift levels.
A further development of the Added-Mass-Method allows the combined representation of the effects of both soil-structure-interaction and fluid-structure interaction on a liquid-filled-tank in one model. This results in a practical method for describing the dynamic fluid pressure on the tank shell during joint movement. The fluid pressure is calculated on the basis of the tank's eigenform and the earthquake acceleration and represented by additional masses on the shell. The bearing on compliant ground is represented by replacement springs, which are calculated dependent on the local soil composition. The influence of the shear modulus of the compliant soil is clearly visible in the pressure curves and the stress distribution in the shell. The acceleration spectra are also dependent on soil stiffness. According to Eurocode-8 the acceleration spectra are determined for fixed soil-classes, instead of calculating the accelerations for each site in direct dependence on the soil composition. This leads to unrealistic sudden changes in the system's response. Therefore, earthquake spectra are calculated for different soil models in direct dependence of the shear modulus. Thus, both the acceleration spectra and the replacement springs match the soil composition. This enables a reasonable and consistent calculation of the system response for the actual conditions at each site.