Down the Hole (DTH) Hammer drilling has high rock breaking efficiency and strong advantage in hard rock drilling, which can reduce the cost of geothermal drilling. However, when the drill bit rotation speed and the DTH percussion frequency do not match properly, specially when the drill bit diameter is large and the ball tooth diameter is small, while drilling high strength formation, the edge teeth of the drill bit are prone to fracture and break, leading to the failure of the drill bit and a significant reduction in its lifespan.This paper investigates the failure modes firstly, then analyzes the failure mechanism of large diameter DTH bit, and proposes a novel method of cluster edge teeth of DTH hammer drill bit in large diameter geothermal well with high strength rock. The drill bits of this innovative design have been mass-produced. Widespread field applications have shown significant improvements in drill bit life and drilling efficiency, obtaining the reduction of drilling costs.

Background. Transcatheter edge-to-edge repair (TEER) is a safe and effective treatment in symptomatic patients with mitral regurgitation (MR). We aimed to investigate the short-term impact of mitral TEER on left ventricular (LV) performance and identify echocardiographic prognostic indicators. Methods. Seventy-eight patients with severe MR (organic and functional etiologies) were included retrospectively. All patients had a baseline and short-term echocardi-ography after TEER and were followed up for the primary composite endpoint (heart failure hos-pitalization and cardiovascular death) over a median period of 13 months. Results. A significant decrease in left ventricular ejection fraction (LVEF), all myocardial work indices (except global wasted work), and left atrial reservoir were observed after TEER. Additionally, there was an im-provement in the pulmonary artery systolic pressure and tricuspid annular plane systolic excur-sion/pulmonary artery systolic pressure (TAPSE/PASP) ratio. 34% of all patients presented the primary composite endpoint. A TAPSE/PASP ratio post-TEER < 0.47 (HR: 4.76, p-value = 0.039), and left atrial reservoir post-TEER < 9.0% (HR: 2.77, p-value = 0.047) were independently associ-ated with the primary endpoint. Conclusions. Echocardiography post-TEER reflects impairment in ventricular performance due to preload reduction and right ventricular to pulmonary artery coupling improvement. Short-term echocardiography after TEER identifies high-risk patients who could benefit from a close clinical follow-up.

Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling, or performing another treatment, such as a root canal, or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached using randomized clinical trials, regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material. To determine which material is superior, we performed a retrospective cohort study using a large database where members of the 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014 - 2021, 260,905 patients were treated. 19,692 out of 113,281 first amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury containing amalgam.

Heart failure is a prevalent cardiovascular condition with significant health implications, necessitating effective diagnostic strategies for timely intervention. This study explores the potential of continuous monitoring of non-invasive signals, specifically integrating Photoplethysmogram (PPG) and Electrocardiogram (ECG), for enhancing early detection and diagnosis of heart failure. Leveraging a dataset from the MIMIC-III database, encompassing 682 heart failure patients and 954 controls. Feature selection techniques were used to systematically select key features which were identified for their clinical relevance and significance in capturing cardiovascular dynamics and to reduce computational complexity and to decrease the chance of overfitting the ML algorithms. These features are then utilized to train and evaluate machine learning algorithms, resulting in a model with an impressive accuracy of 98%, sensitivity of 97.60%, specificity of 96.90%, and precision of 97.20%. The integrated approach outperforms single-signal strategies, showcas-ng its potential for early, precise, and non-invasive heart failure diagnosis. Furthermore, the study underscores the significance of continuous monitoring through wearables, emphasizing the benefits of integrating multiple signals for a comprehensive evaluation of cardiovascular health. The proposed approach holds promise for implementation in hardware systems to enable continuous monitoring, aiding in early detection and prevention of critical health conditions.

Although heart failure with preserved ejection fraction (HFpEF) has become the predominant heart failure subtype, it remains clinically under-recognized. This, has been attributed to the complex pathophysiological mechanisms that accompany individuals with several co-morbidities and symptoms and signs of HFpEF. Natriuretic peptides have been recognized to have important role in the diagnosis and monitoring of patients with heart failure with reduced ejection fraction (HFrEF), but their role in HFpEF remains controversial. Its seems that the role of NtproBNP in the diagnosis of HFpEF, is mainly driven by the pathophysiological characteristics of the patients.

This review explores the crucial role of glycosphingolipids (GSLs) in the context of cardiovascular diseases (CVD), focusing on their biosynthesis, metabolic pathways, and implications for clinical outcomes. GSLs are pivotal in regulating a myriad of cellular functions that are essential for heart health and disease progression. Highlighting findings from both human cohorts and animal models, this review emphasizes the potential of GSLs as biomarkers and therapeutic targets. We advocate for more detailed mechanistic studies to deepen our understanding of GSL functions in cardiovascular health, which could lead to innovative strategies for diagnosis, treatment, and personalized medicine in cardiovascular care.

Myocardial cells and extracellular matrix fulfil their goal thanks to the energetic availability. Indeed, mechanical and electrical properties of the heart are strongly depended on the energetic production-consumption equilibrium. The produced energy is used under several forms including kinetic, dynamic, thermal energy etc. Notably, as the time goes by; aging as well as in case of heart failure, although total energy remains almost constant the contribution of each energetic form is altered. Thermal energy is increased, whereas the dynamic and kinetic energy are decreased and hence unable to satisfy adequately the cardiac work. Consequently, toxic products, unfolded /misfolded proteins, free radicals etc. are accumulated within the myocardium. Myocardial cell contraction – relaxation coupling, ion exchange, cell growth etc. function is failed, control of cell apoptosis and necrosis is lacking and cardiac micro and macro-architecture change is the final result. Energy production and consumption depends on cardiac metabolic resources and on the functional status of the cardiac silhouette including cardiomyocytes and non-cardiomyocytes cells and their metabolic - energetic behavior. Mitochondria, are intra-cellular organelles producing more than 95% of ATP and fulfill all the above prerequisites being thus very important and as such we have to better understand their anatomy, function and homeostatic properties.

Background: The clinical impact of withdrawal of sodium-glucose cotransporter 2 inhibitor (SGLT2i) on the all-cause readmission in patients with heart failure remains unknown. Methods: Consecutive 212 patients who were hospitalized for heart failure and received SGLT2i during the index hospitalization between February 2016 and July 2022 were evaluated. Of these, 51 patients terminated SGLT2i during or after their index hospitalization. The primary outcome was defined as an all-cause readmission rates/times. Results: Over a median of 23.2 months, an all-cause readmission occurred in 38 of 51 patients (74.5%) withdrawn from SGLT2i and 93 of 161 patients (57.8%) with continuation of SGLT2i (p = 0.099). The total number of all-cause readmissions per year was 0.97 [0-1.50] in patients withdrawn from SGLT2i and 0.50 [0-1.03] in patients with continuation of SGLT2i (p = 0.030). There was no significant difference in total medical cost (62,906 [502-187,246] versus 29,236 [7,920-180,305] JPY per month, p = 0.866) between both patient groups. Conclusions: Termination of SGLT2i may be associated with incremental all-cause readmission and no benefit in reducing total medical costs.

Background: Tachycardia-induced cardiomyopathy (TIC) is caused by prolonged tachycardia leading to left ventricular dilatation and systolic dysfunction with heart failure. Although TIC is more common in adult, it is rare in early infant. Methods: Clinical testing was performed as part of medical evaluation and management. Next gene se-quencing (NGS) was performed for a patient with TIC. Literature review about TIC was con-ducted. Results: The case was a 5-month-old infant referred the hospital due to symptoms with heart failure at least lasting two months. Heart rate was 200 beats per minute, left ventricular ejection fraction fell below 14%, and electrocardiograms showed atrial flutter, suggesting TIC. After cardiover-sion, there was no recurrence of atrial flutter, and cardiac function was improved at 98 days after tachycardia arrest. There were no pathogenic variants identified according to NGS. Literature review identified 8 early infantile cases with TIC reported. However, there were no previous re-ports such as our case with longer duration of TIC. Conclusions: Improvement of cardiac function depends on the duration of TIC. TIC should be considered in all patients with a dilated cardiomyopathy of uncertain origin and who have tachycardias such as atrial flutter.

Despite a large amount of research on synchronous and mutually induced kidney and heart damage, the basis of the disease is still not fully clarified. Healthy mitochondria are essential for normal kidney and heart function. Mitochondrial dysfunction occurs when the clearance or process of generation and fragmentation of mitochondria is disturbed. The kidney is the second organ after the heart in the number of mitochondria. Kidney tubules are rich in mitochondria due to the high energy requirements for absorption processes of large amounts of ultrafiltrate and dissolved substances. The place of action of oxidative stress is the influence on the balance in the production and breakdown of mitochondrial reactive oxygen species . A more precise determination of the place and role of key factors that play a role in the onset of the disease is necessary for understanding the nature of the onset of the disease and the creation of therapy in the future. The narrative review integrates results found in previously performed studies which have evaluated oxidative stress participation in renocardial syndrome type 3.

With the global warming and the frequent occurrences of harsh environments, mooring line failures are frequent. Response analysis of the platform structure and its residual mooring system under multiple mooring line failures is needed. Therefore, it is necessary to investigate the change law of platform motion response after mooring line failure to find out the reasons for the change. Studies for different failure combinations of mooring lines show that the variation of the steady-state equilibrium position of the platform is closely related to the stiffness, with a clear functional. The duration and amplitude of the transient response are mainly influenced by the Morison drag force. And it was found that the suspended mooring line reduced the motion responses. It is also found that the mooring line failure increased the effective tension and suspension length of the riser. Based on the improved Dezert-Smarandache theory (DSmT), it is calculated that mooring line failure has little effect on the failure probability in different zones of the riser.

Patients with heart failure (HF) with improved LVEF (HFimpEF) demonstrate better clinical outcomes when compared with individuals without restoration of cardiac function. Identification of predictors for HFimpEF may play a crucial role in individual management of HF with reduced EF (HFrEF). Cell-free nuclear (cf-nDNA) DNA are released from damaged cells and contribute to adverse cardiac remodeling, cardiac dysfunction and inflammation. The purpose of the study was to elucidate whether cf-nDNAs are associated with HFimpEF. It has been prescreened 1416 patients with HF using local database. Between October 2021 and August 2022 we included 452 patients chronic HFrEF after prescription of optimal guideline-based therapy and identified HFimpEF in 177 individuals from them according to the criteria of European Society of Cardiology. Measurements of circulating biomarkers were performed at baseline and in 6 months. Detection of cf-nDNA was executed with real time quantitative PCR (qPCR) using NADH dehydrogenase, ND2 and beta-2-microglobulin. We found that HFimpEF was associated with a significant decrease in the levels of cf-nDNA when compared with the patients from persistent HFrEF cohort. Presence of ischemia-induced cardiomyopathy (odds ration [OR] = 0.75; confidence interval [CI] = 0.62 – 0.88; p = 0.044), type 2 diabetes mellitus (OR = 0.77; CI = 0.71 – 0.82; p = 0.042) and digoxin administration (OR = 0.85; CI = 0.72-0.97; p = 0.042) were negative factors for HFimpEF, whereas NT-proBNP ≤1940 pmol/mL (OR = 1.42; 95% CI = 1.19-1.98, p = 0.001), relative decrease in NT-proBNP levels (&gt;35% vs. ≤35%) from baseline (OR = 1.52; 95% CI = 1.38-0.69, p = 0.001) and cf-nDNA ≤7.5 μmol/L (OR = 1.56; 95% CI = 1.07-2.94, p = 0.001) were positive predictors for HFimpEF. Multivariate logistic regression adjusted to ischemia-induced cardiomyopathy, IV HF NYHA class, and digoxin use yielded that NT-proBNP ≤1940 pmol/mL (OR = 1.43; 95% CI = 1.21-1.88, p = 0.001) and cf-nDNA ≤7.5 μmol/L (OR = 1.64; 95% CI = 1.19-2.15, p = 0.001) independently predicted HFimpEF. In conclusions: we established that the levels of cf-nDNA≤7.5 μmol/L independently predicted HFimpEF and improved discriminative ability of as single measured NT-proBNP as well as relative decrease in NT-proBNP levels ≤35% from baseline.

(1) Background: LUS has emerged as a simple, rapid and non-invasive method for the dynamic assessment of pulmonary congestion, a major prognostic factor and a therapeutic target in AHF. (2) Methods: In the single-center prospective observational study, 42 patients hospitalized for AHF in the post-emergency polyvalent medicine department of CHU Grenoble were successively included between May 2021 and July 2022. Clinical examination, LUS and electrolyte panel results were collected daily. Vital status was assessed 30 days after the last LUS. The primary endpoint was the evolution of the number of B-lines according to the dose of diuretic administered ; (3) Results: We performed 188 LUS. Our patients were elderly (85.8 [SD 8.1]) and comorbid. The median number of B-lines decreased from 17 at admission to 7 in the middle of the hospital stay, then stagnated until discharge. Simultaneously, the median dose of diuretics, initially stable at a maximum of 40 mg/d IV, decreased to 20mg/d IV by the end of hospital stay. Patients with CKD had a higher mean number of B-lines at entry (24.2 [SD 11.6]) compared to those without CKD (8.2 [SD 8.8]). However, the evolution of B-lines number was independent of creatinine levels. 30-day all-causes mortality was significantly related to the number of B-lines at discharge (15.2 [SD 10.1] in deceased patients versus 3.9 [SD 5.4] in living patients, p

At present, failure definition and damage characteristic curve (DCC) analysis included in the framework to assess bitumen fatigue cracking performance have an inconsistency in ranking bitumen fatigue behaviour. This study utilized two types of self-healing polymers (STP and IPA1w) to modify the neat asphalt (NA), and research four different types of bitumens: NA, STP-modified bitumen, IPA1w-modified bitumen, and styrene-butadiene-styrene modified bitumen (SBSB), to evaluate the above-mentioned framework. All bitumens were subjected to short-term and long-term aging and tested utilizing the Linear amplitude sweep (LAS) test and simplified viscoelastic-continuum-damage (S-VECD) model. The results showed that the SBSB exhibited the highest numbers of loading cycles (in long-term aging analysis) to reach failure points at 25°C, 28°C, and 31°C which were 2290, 2340, and 2510, respectively. However, this bitumen failed to exhibit the best performance in terms of DCC assessment under the same conditions, confirming the above-mentioned inconsistency. Besides, the current failure criterion could not accurately predict bitumen fatigue behaviour under certain test conditions because two R2 values were below 0.1. As a result, this study proposed a new failure definition and failure criterion to overcome these issues. The proposed failure definition agreed with the DCC analysis to rank bitumen fatigue performance, and the proposed failure criterion showed R2 values higher than 0.9. The new framework presented the modified bitumen containing 0.5% of STP as the asphalt binder with the best fatigue cracking performance, according to the selected test conditions.

Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostication, prognostication and therapeutical guidance of patients hospitalized for acute heart failure. There is data to sustain the role of CA 125, a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than NTpro BNP ( a classical and more utilised marker of heart failure) in several scenarios of acute heart failure.

This paper presents a review on numerical and experimental methods to predict fracture of ad-vanced high strength steels (AHSS). AHSS are widely processed through sheet metal forming processes. Although being an excellent choice when lightweight, high strength and ductility are critical factors, their multi-phase microstructure accentuates forming challenges. To accurately model forming behavior, necking based failure criteria as well as direct fracture models require improvements. As a necking based failure model, the conventional forming limit diagram/curve (FLD/FLC) presents limitations such as in estimating direct fracture (surface cracks, edge cracks, shear cracks), as well as deformation histories under nonlinear strain paths. Thus, significant re-search efforts are being made towards the needs of advanced fracture constitutive models capa-ble of predicting fracture scenarios without necking, more frequently observed in the realm of AHSS. Scientific community research is divided into several directions aiming at improving the forming and fracture behavior accuracy of parts subjected to sheet metal forming operations. In this review paper, a comprehensive overview on ductile fracture modeling is presented. Firstly, the FLD/FLC limitations modeling fracture behavior in sheet metal forming operations are stud-ied. Followed by the recent trends in constitutive material modeling. Afterwards, material char-acterization methods advancements to cover a broad range of stress states are comprised. Final-ly, damage and fracture models predicting failure in AHSS are investigated. This review paper supplies relevant information on the current issues the sheet metal forming community is chal-lenged with due to the trend towards AHSS employment in the automotive industry.

Considering the worldwide impact of heart failure, it is crucial to develop approaches that can help us comprehend its root cause and make accurate predictions about its outcome. This is essential for lowering the suffering and death rates connected with this widespread illness. Cardiomyopathies frequently result from genetic factors, and the study of heart failure genetics is advancing quickly. Dilated cardiomyopathy (DCM) is the most prevalent kind of cardiomyopathy, encompassing both hereditary and nongenetic abnormalities. It is distinguished by the enlargement of the left ventricle or both ventricles, accompanied by reduced contractility. The discovery of the molecular origins and subsequent awareness of the molecular mechanism is broadening our knowledge of DCM development. Additionally, it emphasizes the complicated nature of DCM and the necessity to formulate several different strategies to address the diverse underlying factors contributing to this disease. Genetic variations that can be transmitted from one generation to another can be a significant contributor to causing family or isolated DCM. Genetic variation also plays a significant role in determining susceptibility for acquired triggers for DCM. The genetic causes of DCM can have a diverse range of phenotypic expressions. It is crucial to select the most probable patients to have advantages from genetic testing. The purpose of this research is to emphasize the significance of identifying genetic DCM, the crucial relationships between genotype and phenotype, and the usefulness of genetic testing in the therapeutic care of both those affected and their relatives. This approach is expected to gain importance once treatment is guided by genotype-specific advice and disease-modifying medications.

Background: The adoption of self-care behaviors among patients with congestive heart failure (CHF) is essential for the management of their health condition. However, there is a lack of tools for estimating self-care in CHF patients. We aim to develop and validate the Hippocratic heart failure self-care scale (HHFSCS). Methods: the scale includes 22 items which are reviewed by a committee of experts. Individuals indicate the frequency at which they follow each self-behavior on a five-point Likert scale. Adult patients with CHF (n=250) from a General Hospital, in Athens, were participated in the study from June 2020 to March 2021. Reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and the Principal Components Method were used to assess the psychometric measurements. Results: The Cronbach’s alpha coefficient of the HHFSCS was 0.807. The exploratory factor analysis identified two domains that accounted for 88.44% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test-retest showed a significant strong correlation (r=0.973, p&lt;0.001). Conclusions: The HHFSCS is a reliable and valid tool for assessing self-behaviors in CHF patients. Health professionals can use it in their clinical practice to improve the management of patient’s health conditions.

Wind energy is one of the main drivers of the renewable energy market. The wind turbine gearbox, used as a multiplier - is one of the main components directly related to wind turbine efficiency and lifespan. Therefore, the strict control of the gearbox project and its manufacturing processes or even minor improvements in this component heavily and positively impact energy production/generation over time. This work diagnoses a 1.6 MW gearbox fracture mechanics to identify its main reason and how the chain of events took place, leading to the catastrophic failure. The diagnoses underwent numerical simulation (Finite Element Analysis - FEA) and further analysis of the lubrication system, bearings, planetary stage gears, helical stage gears, and high-speed shaft. In conclusion, although the numerical simulation showed high contact stresses between the teeth, the region with the crack nucleated was the top land (tip of the tooth). The most likely factors that led to the premature failure were the missed lubrication for the planetary bearings, lack of gear raw material cleanliness, and excessive case depth at the tip of the sun shaft gear teeth. With the sun gear, planet bearings, and planet gears broken in pieces, those small and large pieces dropped into the oil, between the gears, and into the tooth ring, ending up as a premature gearbox failure.

In this paper, single and repetitive frequency UIS characteristics of 1200 V asymmetric (AT)and double trench silicon carbide (DT-SiC) metal–oxide-semiconductor field-effect transistors (MOSFETs) under different working conditions are investigated by experiment and simulation. For asymmetric trench SiC MOSFETs, the failure mode is all thermal runaway under working conditions. However, the failure mode of double trench SiC MOSFETs mostly is gate oxide rupture, which indicates an instable avalanche robustness under UIS stress. The variations of measured parameters are recorded to evaluate typical electrical features of device failure. Furthermore, TCAD simulation is used to reveal the electro-thermal stress inside the device during avalanche. Additionally, failed devices are decapsulated to verify the location of failure point from the perspective of the semiconductor die. Finally, a new type of stepped-oxide vertical power DT MOSFET with P-type shielding and current spread layers is proposed for improvement of gate dielectric reliability.

The behavior of concrete beams reinforced with steel and Glass Fiber Reinforced Polymer (GFRP) rebars, without shear reinforcement is investigated in the current study. This study includes testing experimentally of twenty-four steel and GFRP Reinforced Concrete (RC) beams cast with different percentage of fibers. The beams were split into two types, steel and GFRP RC beams. Beams of different fiber ratios (0, 0.5, 1.5 and 2.5%) were developed and tested, in two groups, each consists of twelve specimens, steel and GFRP reinforced RC beams. Both steel and GFRP RC beams were cast as singly reinforced with 10 mm diameter longitudinal bars at the bottom. In order to ensure that the beam to fail under shear, the top reinforcement and stirrups are removed. The concrete cover was kept as 30 mm. Three concrete grades (M30, M60 and M80) were examined for different dosage of fibers for both steel and GFRP RC beams. The size of the beam samples was kept as 150 ×200×1500 mm. The key parameters were the form of reinforcement material (steel and GFRP), compressive strength of concrete and fiber percentage. Failure mode, ultimate load carrying capacity, mid-span deflection, strain in concrete and reinforcement (steel and GFRP) of the beams have been reported. It is found that the effect of using fibers and higher grade of concrete is more pronounced in improving stiffness of GFRP RC beams compared to steel RC beams. Hence it can be concluded that GFRP rebars can be used as an efficient type of reinforcement in RC beams.

Background/Objectives: Body surface area is one of the most important anthropometric parameters in medicine. The study's primary objective is to compare the consistency of the BSA estimation results through applying available formulas. Other objectives include determining the ability of these formulas to discriminate between the deaths and living patients, comparing the formulas’ diagnostic features as well as investigating whether the risk associated with a low BSA is independent of BMI. Methods: The study included 1029 patients (median age: 54 years, female: 13.7%, NYHA I/II/III/IV: 6.3% / 36.5% / 47.7% / 9.5%) diagnosed with heart failure. For each patient, BSA was calculated using the 25 formulas. Over the 3-year observation period, 31.2% of the patients died. Results: The average BSA value of the optimal discrimination thresholds was 1.79 m2 ± 0.084 m2 and the BSA difference between the estimators with the lowest (BSAMeeh1879) and the highest (BSANwoye1989) optimal discrimination thresholds was 0.42 m2. The lowest mortality rate was 35.2% and occurred in the subgroup of individuals with BSA values below the optimal discrimination threshold using the BSASchlich2010 estimator. The highest mortality was observed when estimators BSAMeeh1879 or BSALivingston&Lee2001 were used. Conclusions: Our study has shown a relatively good concordance of 25 BSA estimators in BSA assessment in patients, without extremes of weight or height known to disrupt it. All BSA estimators presented a significant, although weak, ability to discriminate death from alive in 3-year follow-up. The higher risk of death in smaller patients as shown by BSA was independent of BMI in all but 2 BSA estimators.

Background: beta blockers of three generations are first-line drugs in the treatment of chronic heart failure (CHF). However, to date there is no clear understanding of the effect of beta blockers on myocardial energy metabolism disorders in CHF. The aim of the study: to conduct a study of beta-blockers of different generations on myocardial energy metabolism in the experimental CHF. Methods: CHF was modeled in white outbred rats by administering doxorubicin. The study drugs were administered intragastrically – new drug Hypertril (1-(β-phenylethyl)-4-amino-1,2,4-triazolium bromide)-3.5 mg/kg, metoprolol - 15 mg/kg, Nebivolol -10 mg/kg, Carvedilol 50 mg/kg, Bisoprolol, 10 mg/kg. In the myocardium, the main indices of energy metabolism were determined - ATP, ADP, AMP, malate, lactate, pyruvate, succinate dehydrogenase (SDH) activity, NAD-dependent malate dehydrogenase (NAD-MDH) activity. Results: traditional second-generation beta-blockers (Metoprolol and Bisoprolol) did not affect the studied indices of energy metabolism, and third-generation beta-blockers with additional properties - Carvedilol and, especially, Nebivalol and Hypertril improved myocardial energy metabolism. Conclusions: obtained results will help to expand our understanding of the effect of beta-blockers of various generations used to treat cardiovascular diseases on energy metabolism, and are also an experimental justification for the practical choice of these drugs in the complex therapy of CHF.

Diastolic dysfunction, a prevalent condition characterized by impaired relaxation and filling of the left ventricle, significantly contributes to heart failure with preserved ejection fraction (HFpEF). Galectin-3, a β-galactoside-binding lectin, has garnered attention as a potential biomarker and mediator of fibrosis and inflammation in cardiovascular diseases. This comprehensive review investigates the impact of galectin-3 on diastolic dysfunction. We explore its molecular mechanisms, including its involvement in cellular signaling pathways and interaction with components of the extracellular matrix. Evidence from both animal models and clinical studies elucidates galectin-3's role in cardiac remodeling, inflammation, and fibrosis, shedding light on the underlying pathophysiology of diastolic dysfunction. Additionally, we examine the diagnostic and therapeutic implications of galectin-3 in diastolic dysfunction, emphasizing its potential as both a biomarker and a therapeutic target. This review underscores the significance of comprehending galectin-3's role in diastolic dysfunction and its promise in enhancing diagnosis and treatment approaches for HFpEF patients.

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is an extremely rare type of vasculitis characterized by inflammation within small blood vessels or tissues that may cause damage to the lungs, heart, kidneys, and other organs. Here, we present a rare case of EGPA with cardiac involvement that presented with acute heart failure. Clinical findings: A 44-year-old woman with a history of bronchial asthma and sinusitis pre-sented with fever, shortness of breath, fatigue, unintentional weight loss, and polyarthritis. Physical examination revealed a fine basal crepitation and mononeuritis multiplex. Diagnosis: The peripheral film revealed dimorphic features, an elevated eosinophil count, low hemoglobin (Hb), and abnormally high lactate dehydrogenase levels. The cardiac enzyme levels were elevated upon admission. Cardiac magnetic resonance imaging (CMR) revealed global hypokinesia and features suggestive of myocarditis. Echocardiography showed a low ejection fraction of 25%. Thus, the patient diagnosed with EPGA and myocarditis presented with acute heart failure. Interventions: The patient was administered high-dose corticosteroids (intravenous bolus methylprednisolone 500 mg for three days, followed by 1 mg/kg of prednisolone) and cyclo-phosphamide 750 mg intravenously. Outcome: After one months, the patient showed a marked improvement in clinical and labora-tory parameters. The ejection fraction improved to 30-40%, the eosinophil count returned to normal, and the hemolytic anemia resolved. The patient was sent home with mycophenolate mofetil 1 g twice a day as maintenance therapy. Conclusion: Patients with EGPA have a higher morbidity and mortality rate when they have cardiac in-volvement. The pathophysiological mechanism of cardiac involvement in EGPA warrants con-sideration of immunosuppressive therapy in addition to standard heart failure treatment.

Based on the nonlinear failure criterion and modified tangential technique, the upper bound solutions of supporting pressure on the deep tunnel face were obtained under pore water pressure conditions. The influence of parameters on the supporting pressure and collapse range was investigated according to the unlimited block failure mechanism. It is found that the upper bound solutions of supporting pressure increase with the growth of the nonlinear coefficient and pore water pressure coefficient. The collapse range of the tunnel face scales out with the increase of the nonlinear coefficient and shrinks when increasing the pore water pressure coefficient. Moreover, with the increase of the nonlinear coefficient, the impact strength on supporting pressure and collapse range declines gradually. According to the calculating results, it is manifest that both the pore water pressure and nonlinear criterion factors have negative impacts on the stability of the tunnel face. Thus, more attention should be paid to these parameters to ensure face stability in deep tunnel construction.

Drug-induced liver disease represents one of the main problems in the therapeutic field. As with most pathologies, also in this case various risk factors can be recognised, such as age, sex, but also the gut microbiota. Therefore all drugs on the market can, in fact, cause hepatotoxicity of varying degrees. Drugs used in the treatment of IBD can also cause these adverse effects and even lead to DILI. In this review, the various classes of drugs used in the treatment of IBD were taken into consideration and the various adverse effects on the liver were illustrated. In particular, a major role has emerged regarding hepatotoxicity of immunosuppressants. Biological drugs, however, seem to be responsible for these complications to a much lesser extent.

Background/Objectives: Remote monitoring (RM) of cardiac implantable electronic devices for adults offers improved patient outcomes. However, bedside transmitters utilized so far are not optimal due to limited patient adherence. The goal of this study was to evaluate the efficacy of RM regarding the connectivity of smartphone app-based solutions, adherence to planned automatic follow-ups, and occurrence of alert-based events. Methods: We evaluated the adult heart failure (HF) population with implanted cardiac resynchronization therapy defibrillator (CRT-D) divided into two arms: with app-based RM (abRM) and without app-based RM (control). Results: A total of 81 patients (median age of 69.0) were included in our study. 65 patients received a CRT-D with abRM functionality, and 16 did not. 12 patients had no smartphone, and 2 provided no consent, resulting in their transfer to the control group. Finally abRM arm consisted of 51 patients, while 30 patients were in the control group. Median period of follow-up lasted 12 months. Among abRM patients, 98.0% successfully transmitted their first scheduled follow-up, and 80.4% were continuously monitored. Alert-based events were mainly related to arrhythmic events and device functionality with significantly shorter median time to notification (1 day vs. 101 days; p&lt;0.0001) in the abRM group. Conclusions: Our study showed a high level of compliance with timely initial transmission and adherence to scheduled remote follow-ups. Patient enrollment eligibility was a major challenge due to the limited accessibility of smartphones in the population. App-based RM demonstrated an accurate notification of events and patient-initiated transmissions in emergencies, regardless of location.

Rationale: Post-hepatectomy liver failure (PHLF) remains a significant risk for patients undergoing partial hepatectomy (PHx). Reliable prognostic markers and treatments to enhance liver regeneration are lacking. Plasma nanoparticles, including lipoproteins, exosomes, and extracellular vesicles (EVs), can reflect systemic and tissue-wide proteostasis and stress, potentially aiding liver regeneration. However, their role in PHLF is still unknow. Methods: Our study included 9 patients with hepatocellular carcinoma (HCC) undergoing PHx: 3 patients with PHLF, 3 patients undergoing the Associating Liver Partition and Portal vein Ligation for Staged hepatectomy (ALPPS) procedure and three matched controls without complications after PHx. Patient plasma was collected before (PRE), 1 and 5 days (POD1, POD5) after PHx. EVs were isolated by ultracentrifugation and extracted proteins subjected to quantitative mass spectrometry using a super-SILAC mix prepared from primary and cancer cell-lines. Results: We identified 2625 and quantified 2570 proteins in EVs in PHx patients. Among these, 53 proteins were significantly upregulated and 32 were downregulated in patients with PHLF compared to those without PHLF. Furthermore, 110 proteins were upregulated and 78 were downregulated in PHLF compared to patients undergoing ALPPS. The EV-proteomic signature in PHLF indicates significant disruptions in protein translation, proteostasis, intracellular vesicle biogenesis, as well as alterations in proteins involved in extracellular matrix (ECM) remodeling, metabolic and cell cycle pathways, present already before PHx. Conclusion: Longitudinal proteomic analysis of EV´s circulating in human patient plasma undergoing PHx uncovers proteomic signatures associated with PHLF which reflect dying hepatocytes and endothelial cells and are present before PHx already. Our results support EVs as potential biomarkers and therapeutic targets for liver regeneration and failure.

Congestion not only represents a cardinal sign of heart failure but is also now recognized as the primary cause for hospital admissions, rehospitalizations, and mortality among patients with acute heart failure. Congestion can manifest through various heart failure phenotypes in acute settings: volume overload, volume redistribution, or both. Recognizing the congestion phenotype is paramount, as it implies different therapeutic strategies for decongestion. Complete decongestion is hardly achieved among patients with acute heart failure, as more than half still have residual congestion at discharge. Residual congestion is one of the strongest predictors of future cardiovascular events and poor outcomes. Through this review, we try to provide a better understanding of the congestion phenomenon among patients with acute heart failure by highlighting insights into the pathophysiology mechanisms behind congestion and new diagnostic and management tools to achieve and maintain efficient decongestion.

Hybrid reinforcement in a composite material (CM), in many situations, allows better govern material mechanical properties. Polymer matrix CM plate is reinforced with small particles and macro-fibers. Particles are oil shale ash (OSA) powder, macro-fibers – basalt fiber threads im-pregnated by matrix material. With the goal to find out elastic properties of the matrix- polymer with OSA, samples with its different concentrations were experimentally fabricated and their elastic properties were experimentally measured. Obtained data were used in numerical model-ling. Was observed polymer matrix composite slab, reinforced with OSA and three-dimensional (3D) basalt fiber fabric. Fabric are forming threads impregnated by matrix (polymer resin mixed with OSA particles). Damage accumulation in the stretched slab was modelled. Impregnated thread, in the modelling, is observed as a macro-fiber (MF) with averaged elastic properties. With the load increase MF in the material began to break. At first, appeared isolated single breaks. A probabilistic sequential MF rupture accumulation model was accepted and numerical-ly realized. The geometry of the reinforcing knitted fabric was modeled using the Leaf and Glaskin approach. In the knitted fabric highly, stressed MF cross-sections are observed as po-tential location where thread breakage can occur. If one thread breaks, the cross-sections of the adjacent threads experience the overload caused by this rupture. More overloaded crossection in the adjacent overloaded thread breaks and we obtain two adjacent broken MF designated as a defect with the size j=2. The probabilities of obtaining defect consisting of at least 2, 3, … j adjacent broken MF in the plate were calculated. The calculations continued until the rupture process becomes unstable (j→∞). The overstresses on adjacent threads in the CM were calculat-ed using the FEM three-dimensional numerical approach. Analytical and stochastic methods were used for the load-carrying capacity determination and different size defects accumulation in the hybrid composite material (HCM) plate. Also, was calculated the probability of the plate rupture.

The article evaluates the use of machine learning methods to predict valve plate failures in hydraulic pumps. To conduct this assessment, a laboratory setup was developed that allowed the creation of a training dataset containing both the normal operating state of the pump and the operating state with three different valve plate damages. Five different predictive models were evaluated, including three composite models based on decision trees: Random Forest, Gradient-Boosted Trees, and Rotation Forest, as well as the kNN algorithm and a neural network. The analysis showed that neural networks achieved the highest prediction accuracy, enabling a prediction accuracy level of 89%. The kNN algorithm ranked second, and tree-based algorithms performed 4% worse than the neural network. Additionally, the attribute importance analysis revealed that leak flow, pressure output together with output flow, are the most important parameters for accurate prediction.

Electromagnetic coil is the key component of rotating equipment, and its reliability is very important for the normal operation of the equipment. In order to accurately evaluate the health status of electromagnetic coil, a health evaluation and anomaly detection method based on Mahalanobis distance (MD) and Box-Cox transformations is proposed. With the help of accelerated fatigue experiment, the whole life electrical data of high, medium and low frequency spectrum of electromagnetic coil is collected, and the low and medium frequency spectrum data are constructed as the initial feature set. And then, the initial feature set is mahalanized, and Mahalanobis distance is taken as the feature to evaluate the health state of the electromagnetic coil. With the help of Box-Cox transformations, MD is transformed into normal distribution form, and the electromagnetic coil fault early warning is realized according to 3 σ criterion. The results show that MD can accurately evaluate the degradation state of the electromagnetic coil and realize early warning.

Addressing the issue of compromised performance and stability in distributed drive electric vehicles during high-speed operation in the event of motor failure. A fault-tolerant control strategy for distributed drive electric vehicles is proposed, based on Model Reference Adaptive Control (MRAC). First, a seven-degree-of-freedom vehicle dynamics reference model is established, from which the output torque of each wheel during stable operation is determined. Secondly, based on the compensation principle that maintains constant longitudinal speed and total torque before and after the fault, the output torque of the remaining wheels is determined to ensure normal vehicle operation in the event of a single motor failure. To improve torque distribution accuracy, an MRAC controller that takes into account the output hysteresis of the motor is designed. The transfer functions of both the reference model and the actual model are derived. Using Lyapunov's second method, the adaptation rate of the MRAC system is formulated, ensuring that the state of the actual model converges to that of the reference model, thereby achieving adaptive regulation of system parameters and global stability. Finally, simulation experiments are conducted under high-speed dual-lane conditions. The results indicate that, in the case of a single motor failure with constant vehicle speed, the yaw rate and lateral displacement of the vehicle's center of mass decrease, thereby validating the effectiveness of the proposed fault-tolerant control strategy.

Abstract A multiple number of studies provide evidence that vasopressin (AVP) and steroid hormones are frequently secreted together and closely cooperate in the regulation of blood pressure, metabolism, water-electrolyte balance, and behavior, securing thereby survival and comfort of life. Vasopressin interacts with hormones of the hypothalamo-pituitary-adrenal axis (HPA) at several levels through regulation of release of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone ACTH, and multiple steroid hormones, as well as through interactions with steroids in the target organs. The interactions are facilitated by positive and negative feedbacks occurring between specific components of the HPA axis with engagement of other regulatory molecules. Altogether AVP and HPA cooperate closely as a coordinated functional AVP-HPA system. It has been shown that cooperation between AVP and steroid hormones may be affected by the cellular stress combined with hypoxia, and by metabolic, cardiovascular and respiratory disorders, neurogenic stress and inflammation. Growing evidence indicates that central and peripheral interactions of AVP and steroid hormones are reprogrammed in cardiovascular diseases and that the rearrangements play either beneficial or harmful effects. The present review highlights specific mechanisms of interactions of AVP and steroids at cellular and systemic levels and analyses consequences of inappropriate cooperation between various components of the AVP-HPA system for the regulation of the cardiovascular system and energy balance in cardiovascular and metabolic diseases.

Background: Hurricanes and other wind events are significant disturbances that affect coastal urban forests around the world. Past research has led to the creation of wind resistance ratings for different tree species which can be used in urban forest management efforts to mitigate the effects of these storms. While useful, these ratings have been limited to species common to one global region (Florida, USA).Methods: Drawing on past ratings and data from a global literature review on tropical storm research, we created a machine learning model to broaden both the geographic coverage and the variety of species currently assessed for their resistance to wind.Results: We were able to assign wind resistance ratings to 281 new species based on the available data and our modelling efforts. The model accuracy and agreement with the original ratings when applied to the testing data set was high with 91% accuracy.Conclusions: The resulting list of wind resistance ratings has been adapted into a spreadsheet-based decision aid for managers, allowing them to assess the overall susceptibility of their urban forest to wind events like hurricanes.

Background: Heart failure (HF) remains a challenging healthcare issue, necessitating innovative therapies like cardiac resynchronization-defibrillation therapy (CRT-D). However, defining CRT-D responders lacks uniformity, impeding effective clinical evaluation. This study explores diverse CRT-D responder definitions, encompassing functional, echocardiographic, and laboratory criteria. Materials & Methods: A single-center study involving 132 CRT-D patients scrutinized responder criteria, including NYHA stage, LVEF increase, and proBNP decrease. Statistical analyses, such as Kaplan–Meier curves and Cox hazard regression, were employed to evaluate responder characteristics and survival outcomes. Results: Responder rates varied across criteria, revealing nuanced patient profiles. CRT-D responders, defined by NYHA decrease, LVEF increase, or proBNP decrease, exhibit improved survival rates after 2 and 3 years (p < 0.050). Young age, absence of recent myocardial infarction, and normal right ventricular, echocardiographic parameters emerge as predictors for positive response. In part, drug-based HF therapy correlates with increased responder rates. Cox regression identified LVEF ≥ 5% and proBNP decrease ≥ 25% as independent predictors of extended survival. Conclusions: CRT-D responder definitions exhibit considerable variability, emphasizing the need for a nuanced, patient-centered approach. Factors like right ventricular function, drug therapy, atrial fibrillation, and renal function influence responses. The study enriches our understanding of CRT-D response, contributing to the foundation for personalized HF management.

This paper introduces innovative sensitivity indices based on Cliff's Delta for global sensitivity analysis of structural reliability. These indices build on Sobol's method, using binary outcomes (success or failure), but avoid the need to calculate failure probability Pf and the associated distributional assumptions of resistance R and load F. Cliff's Delta, originally for ordinal data, evaluates the dominance of resistance over load without specific assumptions. The mathematical formulations for computing Cliff's Delta between R and F quantify structural reliability by assessing the random realizations of R > F using a double-nested-loop approach. The derived sensitivity indices, based on the squared value of Cliff's Delta​, exhibit properties analogous to those in Sobol's sensitivity analysis, including first-order, second-order, and higher-order indices. This provides a comprehensive framework for evaluating the contributions of input variables and their interactions on structural reliability. This method is particularly significant for FEM applications, where repeated simulations of R or F are computationally intensive. The double-nested-loop algorithm of Cliff's Delta maximizes the extraction of information about structural reliability from these simulations. However, the high computational demand of Cliff's Delta is a disadvantage. Future research should optimize computational demands, especially for small Pf​, where the inner loop may often be unnecessary.

Heart failure with preserved ejection fraction (HFpEF) is a multifariousness syndrome, account-ing for over half of heart failure (HF) patients receiving clinical treatment. The prevalence of HFpEF is rapidly increasing in the coming decades as the global population ages. It is becoming clearer that HFpEF has a lot of different causes, which makes it challenging to find effective treatments. Currently, there are no proven treatments for people with deteriorating HF, or HFpEF. Although the pathophysiologic foundations of HFpEF are complex, excessive reactive oxygen species (ROS) generation and increased oxidative stress caused by mitochondrial dys-function seem to play a critical role in the pathogenesis of HFpEF. Emerging evidence from an-imal models and human myocardial tissues from failed hearts shows that mitochondrial aberra-tions cause a marked increase in mitochondrial ROS (mtROS) production and oxidative stress. Furthermore, studies have reported that common HF medications like beta blockers, angioten-sin receptor blockers, angiotensin-converting enzyme inhibitors, and mineralocorticoid receptor antagonists indirectly reduce the production of mtROS. Despite the harmful effects of ROS on cardiac remodelling, maintaining mitochondrial homeostasis and cardiac functions requires small amounts of ROS. In this review, we will provide an overview and discussion of recent findings on mtROS production, its threshold for imbalance, and the subsequent dysfunction that leads to related cardiac and systemic phenotypes in the context of HFpEF. We will also focus on newly discovered cellular and molecular mechanisms underlying ROS dysregulation, current therapeutic options, and future perspectives for treating HFpEF by targeting mtROS and associ-ated signal molecules.

Objective. This study aimed to determine the correlation of colour M-mode velocity propagation in the assessment of left ventricular diastolic function among acute decompensated heart failure patients with preserved ejection fraction (HFpEF). Materials and Methods. This research is an observational analytical study using a cross–sectional study design conducted from April to June 2022. The subjects of this study were patients diagnosed with acute HFpEF and treated at Dr. Soetomo General Academic Hospital, Surabaya. Patients with heart rhythm disturbances, moderate to severe valvular heart disease, and congenital heart defects were excluded from this study. Patients were measured for diastolic function including mitral valve early mitral inflow velocity (MV E Velocity), mitral peak velocity of early filling (E’) (E' Septal and E' Lateral), left atrial volume index (LAVI), The maximal tricuspid regurgitation velocity (TR V Max), Vp, the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/E'), the ratio between early and late ventricular filling velocity (E/A) and E/Vp Ratio. N-terminal-pro hormone B-type natriuretic peptide (NT–ProBNP) examination was also performed on study subjects as an additional diagnosis of acute heart failure. Results. There were 33 patients who met the inclusion and exclusion criteria and were included in our study. There were 26 patients (78.8%) with grade I diastolic dysfunction, 4 patients (12.1%) with grade II diastolic dysfunction, and 3 patients (9.1%) with grade III diastolic dysfunction. There is a strong positive correlation between Vp with parameters E' Septal (p = &lt; 0.001; r = 0.636) and E' Lateral (p = &lt; 0.001; r = 0.650). Vp is negatively correlated with the ratio E/E' (p = 0.029; r = –0.37). The PCWP estimate with E/Vp ratio had a strong correlation with the NT–Pro BNP value &gt; 300 pg/ml in acute HFpEF patients (p = &lt; 0.001; r = 0.726) compared to the PCWP estimate with E/E' (p = &lt; 0.001; r = 0.549). Conclusion. There is no correlation between Vp value and degree of diastolic dysfunction in patients with acute HFpEF.

Cardiovascular disease is a leading cause of morbidity and mortality. New research elucidates in-creasingly complex relationships between cardiac and metabolic health, giving rise to new possible therapeutic targets. Sphingolipids are a heterogenous class of bioactive lipids with critical roles in normal human physiology. They have also been shown to play both protective and deleterious roles in the pathogenesis of cardiovascular disease. This review will explore the roles of Sphingolipids in vascular, cardiac, and metabolic pathologies and will evaluate the therapeutic potential in targeting Sphingolipids with the aim of prevention and reversal of cardiovascular disease, in order to improve long-term cardiovascular outcomes.

Background: The increase in the prevalence of obesity in South Africa is a problem and weight management play an important role in the treatment of the high prevalence. For this purpose, a quantitative study was carried out using a structured questionnaire to assess predictors of attempt and failure to lose weight. Methods: One thousand and fifty adults were enrolled in the study and 54% (n=562) were overweight and obese (BMI &gt;/25kg/m2). Descriptive statistics were analysed. Inferential statistical tests (chi-square tests, logistic regression, and Pearson’s correlation coefficients) were used to determine the relationship between variables. Results: The results revealed that age, sex, marital status, educational level, employment status, income level, area of residence, ethnic groups, and self-perceived BMI (normal weight, overweight, and obese) were predictors of attempt and failure to lose weight. There was a positive correlation between self-perceived BMI and the attempt and failure to lose weight. Conclusion: Weight management is important in the realm of public health and can be regarded as an investment in the population, as it leads people toward weight control strategies grounded in empirical evidence. Additionally, the findings can inform public health policies and interventions to improve weight management strategies at the population level.

Background: Despite tremendous advances in medicine, infective endocarditis (IE) continues to be a challenge for physicians due to increasing morbidity and unchanged high mortality. Objectives: Our aim was to evaluate clinical outcomes in patients with IE and to identify predictors of in-hospital mortality. Material and methods: The study was retrospective, single-centered, and included 270 patients diagnosed with IE, for the period 2005-2021 (median age 65 (51–74), man 177 (65.6%). Results: Native IE (NVIE) was found in 180 (66.7%), prosthetic IE (PVIE) in 88 (33.6%) and cardiac device-related IE (CDRIE) in 2 (0.7%), significantly more in the non-survivors group. Healthcare associated IE (HAIE) was 72 (26.7%), the most common pathogen were Staphylococci and the proportion of Gram-negative bacteria (GNB) non-HACEK were significantly higher in non-survivor’s vs survivors (11 (15%) vs 9 (4.5%), p=0.004). Overall, early surgery was performed in 54 (20%) patients, with a significant difference between deceased/alive (3 (4.5%) vs 51 (25.1%, p=0.000). The all-cause in-hospital mortality rate was 24.8% (67). The risk factors identified that increased the risk of death were septic shock (OR – 83 1; 95% CI (17.0-405.2), p=0.000) and acute heart failure (OR –24.6; 95% CI (9.2-65.0), p=0.000). Early surgery (OR – 0.03, 95% CI (0.01-0.16), p=0.000) and low Charlson comorbidity index (OR – 0.85, 95% CI (0.74-0.98, p=0.026) in turn reduce this risk. Conclusion: We found that acute heart failure and septic shock are independent predictors of in-hospital mortality. Low Charlson comorbidity index and early surgery increased survival. Knowing the predictors of death would change the therapeutic approach to a more aggressive one and improve the near and long-term prognosis of patients with IE.

Overhydration (OH) is a prevalent medical problem occuring in patients with kidney failure, but a specific marker has still not been found. Currently, clinicians employ techniques such as bioimpedance spectroscopy (BIS), ultrasound (US) markers of fluid overload or markers of heart and kidney function such as NT-pro-BNP, GFR or creatinine levels. New serum markers, including but not limited to Ca-125, Galectin-3 (Gal-3), Adrenomedullin (AMD) and Urocortin-2 (UCN-2), are presently under research, displaying promising results. The necessity to ascertain a more precise marker of overhydration is urgent mainly because physical examination is exceptionally imprecise. Signs and symptoms of fluid overload, like edema or gradual increase of body mass, are not always present, notably in patients with chronic kidney disease. This review paper summarizes actual knowledge of a patient's hydration status estimation, focusing specifically on kidney diseases.

Background: Chronic heart failure (CHF) often necessitates the use of high doses of diuretics, which can lead to side effects such as worsening renal function and electrolyte imbalances. Methods: A total of 102 patients (median age 75 years) were included in the study and divided into two groups based on the level of diuretic therapy. The diuretic group received the following average doses: furosemide — 39.1 ± 22.1 mg, torasemide — 7.4 ± 3 mg, and spironolactone — 42 ± 12.4 mg. Biochemical analyses were performed on days 1 and 7 of hospitalization, with measure-ments of sodium, potassium, glucose, urea, and plasma osmolality (eOSM). Results: By day 7, the plasma osmolality in the diuretic group increased from 300 [297; 304] to 302.2 [298.3; 305.8] mOsm/L (p = 0.039). Urea levels in the diuretic group rose to 7.95 [5.65; 9.90] mmol/L by day 7, while remaining stable in the non-diuretic group at 5.90 [5.05; 7.50] mmol/L (p = 0.012). The proportion of urea to plasma osmolality (PropUrea/eOSM) in the diuretic group in-creased to 2.63% [1.89; 3.28] compared to 2.00% [1.70; 2.50] in the non-diuretic group (p = 0.011). The proportion of sodium to plasma osmolality (PropNa/eOSM) in the diuretic group decreased to 46.46% [46.02; 46.74], compared to 46.68% [46.33; 46.89] in the non-diuretic group (p = 0.050). Analysis of PropNa/eOSM and PropUrea/eOSM on day 7 without considering salt intake yielded statistically significant results, though they were less robust compared to models including salt intake. For example, in the PropUrea/eOSM model, the odds ratio (OR) was 3.01 (95% CI 1.74, 5.89; p < 0.001), and in the PropNa/eOSM model, the OR was 0.19 (95% CI 0.07, 0.43; p < 0.001). Conclusion: The study confirmed that high salt intake and active diuretic therapy significantly influence the biochemical parameters of patients with chronic heart failure (CHF), contributing to the develop-ment of the aestivation phenomenon. This is characterized by an increase in nonionic osmolytes such as urea, which may represent a physiological adaptation to stress. Patients receiving diuret-ics and following a high-salt diet exhibited significant changes in plasma osmolality and urea levels, indicating a physiological adaptation that may worsen prognosis by increasing the risk of sarcopenia and cachexia. Further research is needed to better understand these mechanisms and develop strategies to mitigate the negative effects.

Background: Pleural effusion (PE) is often classified as either a transudative or an exudative process. The aim of the study was to examine the causes of pleural effusions and the short- and long-term survival in the older patients hospitalized in the acute geriatric and internal medicine wards. Methods: Patients aged ≥ 65 years, who underwent thoracentesis, were included in this retrospective study. To distinguish between exudate and transudate PE, the Light’s criteria were applied. We compared medical indices and mortality in patients with exudate PE to those with transudate effusion according two age groups (65 - 85 vs. > 85 years). Results: The rates of the main etiologies of PE were congestive heart failure (CHF), 46%, lung infections, 25%, and malignancy, 12%, of the whole study population. Lung infections accounted for 53% of the exudate PE patients, with a higher presence among the >85 group of patients. The etiology of transudate PE was primarily CHF, more common among the patients of the >85 group. In malignancy, CHF and lung infections patients, the chances of dying within one year were 80.3%, 63.2%, and 45.5%, respectively. In transudate PE patients, ten-year survival of the 65-85 group of patients was significantly higher. In the exudate PE patients, there was no difference in survival between the two age groups. Right-sided and bilateral pleural effusions were associated with worse prognosis. Conclusion: Clinicians encountering patients with PE should be aware of their heightened mortality risks, and should carefully monitor their underlying etiology and employ appropriate optimal management.

Diabetes markedly increases susceptibility to adverse cardiovascular events, including heart failure (HF), leading to heightened morbidity and mortality rates. Elevated levels of natriuretic peptides (NPs), notably B-type natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP), correlate with cardiac structural and functional abnormalities, aiding in risk stratification and treatment strategies in individuals with diabetes. This article reviews the intricate relationship between diabetes and HF, emphasizing the role of NPs in risk assessment and guiding therapeutic strategies, particularly in individuals with type 2 diabetes mellitus (T2DM). It also explores the challenges and prospects of natriuretic peptide-guided therapy in managing cardiovascular risk in patients with diabetes.

Embryo’s Implantation is a question that we are not in the position to answer in full details. We know that it depends on embryo’s quality and uterine receptivity. It is possible to access uterine cavity before in vitro fertilisation by a variety of tools, however hysteroscopy is the gold standard in evaluation of uterine cavity and potential pathology. The frequencies of unrecognised uterine pathology revealed by hysteroscopy are 18-50% and 40-43% in patients undergoing in vitro fertilisation or after recurrent implantation failure respectively. Data is inconclusive regarding the role of hysteroscopy on pregnancy outcome after in vitro fertilisation. This review aims to evaluate the validity of office hysteroscopy in subfertile population before or after IVF treatment

Heart failure with preserved ejection fraction (HFpEF) is increasing at an alarming rate worldwide, with limited effective therapeutic interventions in patients. Sudden cardiac death (SCD) and ventricular arrhythmias present substantial risks for the prognosis of these patients. Obesity is a risk factor for HFpEF and life-threatening arrhythmias. Obesity and its associated metabolic dysregulation, leading to metabolic syndrome, are an epidemic that poses a significant public health problem. More than one-third of the world population is overweight or obese, leading to an enhanced risk of incidence and mortality due to cardiovascular disease (CVD). Obesity predisposes patients to atrial fibrillation and ventricular and supraventricular arrhythmias—conditions that are caused by dysfunction in the electrical activity of the heart. To date, current therapeutic options for cardiomyopathy of obesity are limited, suggesting that there is considerable room for the development of therapeutic interventions with novel mechanisms of action that will help normalize sinus rhythms in obese patients. Emerging candidates for modulation by obesity are cardiac ion channels and Ca-handling proteins. However, the underlying molecular mechanisms of the impact of obesity on these channels/Ca-handling proteins remain incompletely understood. Obesity is marked by the accumulation of adipose tissue, which is associated with a variety of adverse adaptations, including dyslipidemia (or abnormal systemic levels of free fatty acids), increased secretion of pro-inflammatory cytokines, fibrosis, hyperglycemia, and insulin resistance, which cause electrical remodeling and, thus, predispose patients to arrhythmias. Furthermore, adipose tissue is also associated with the accumulation of subcutaneous and visceral fat, which is marked by distinct signaling mechanisms. Thus, there may also be functional differences in the outcome of regional distribution of fat deposits on ion channel/Ca-handling protein expression. Evaluating alterations in their functional expression in obesity will lead to progress in the knowledge about the mechanisms responsible for obesity-related arrhythmias. These advances are likely to reveal new targets for pharmacological modulation. The objective of this study is to review cardiac ion channel/Ca-handling protein remodeling in the predisposition to metabolic HFpEF and arrhythmias. Understanding how obesity and related mechanisms lead to cardiac electrical remodeling is likely to have a significant medical and economic impact.

Acute pancreatitis (AP) is a potentially fatal organ disease that is widespread globally. Although significant progress has been made in the previous decade, the study of mechanisms and therapeutic strategies is still far from being completed. Xanthine oxidase (XO) is an enzyme that generating urate and also responsible to produce reactive oxygen species (ROS). Considerable clinical and mechanical research has been conducted over many decades to explore the function of XO in AP and its promising therapeutic applications. Unquestionably, XO is a key part of starting and progressing AP by ROS production. Not fully known, though, are XO's many other functions besides ROS resource in both local and global processes, such as its role in cellular signaling or metabolism regulation. This review seeks to summarize the function of XO in AP pathophysiology by analyzing the inherent biological and chemical properties of XO, and lastly provide fresh concepts for future research.

Systemic inflammation and coronary microvascular endothelial dysfunction are essential pathophysiological factors in heart failure with preserved ejection fraction (HFpEF) that support the use of statins. The pleiotropic properties of statins, such as anti-inflammatory, antihypertrophic, antifibrotic, and antioxidant effects, are generally accepted and may be beneficial in HF, especially in HFpEF. Numerous observational clinical trials have consistently shown a beneficial prognostic effect of statins in patients with HFpEF, while the results of two larger trials in patients with HFrEF have been controversial. Such differences may be related to a more pronounced impact of the pleiotropic properties of statins on the pathophysiology of HFpEF and pro-inflammatory comorbidities (arterial hypertension, diabetes mellitus, obesity, chronic kidney disease) that are more common in HFpEF. This review discusses the potential mechanisms of statin action that may be beneficial for patients with HFpEF, as well as clinical trials that have evaluated the statin effects on left ventricular diastolic function and clinical outcomes in patients with HFpEF.

Objective: This study aims to construct an early risk warning model to predict the risk of treatment failure in patients undergoing sequential High-Flow Nasal Cannula (HFNC) oxygen therapy following mechanical ventilation weaning. Methods: A retrospective analysis was conducted on clinical data from 145 patients who received HFNC treatment in the Emergency Intensive Care Unit of the Third People's Hospital of Bengbu City from June 2018 to June 2023. A wide range of indicators including general information, comorbidities, laboratory test results, vital signs, disease-related scores, and oxygenation data were collected. Data analysis was performed using R software, starting with the Lasso regression to filter features related to treatment outcomes. Patients were divided into a training set (70%) and a validation set (30%) using random grouping software. The Random Forest algorithm was then employed to evaluate and rank the important features related to outcome indicators. The predictive efficiency and stability of the model were assessed through the Receiver Operating Characteristic (ROC) curve, calibration curve, and decision curve analysis, culminating in the construction of an early risk warning nomogram. Results: The study found that the Random Forest model exhibited high predictive accuracy in the training set (AUC=0.98) and good stability in the validation set (AUC=0.84). Key feature variables identified by the model, such as APACHE II score, BNP, NLR, mROX, and SOFA, were found to significantly impact the prediction of HFNC treatment failure. Based on these variables, an early warning nomogram was further developed, providing clinicians with a convenient and effective risk assessment tool. Conclusion: This study has constructed an early risk warning model based on the Random Forest algorithm, capable of effectively predicting the risk of HFNC treatment failure. The model's high predictive efficiency and stability offer strong support for clinical decision-making, contributing to personalized treatment and improved patient outcomes. Future research should aim to expand the sample size, perform multicenter validation, and explore the integration of the model into Clinical Decision Support Systems for real-time risk assessment and intervention.

Background According to some authors, a single isolated measurement of serum BNP executed on hospital admission would not be a sufficiently accurate method to predict the outcome of patients with ADHF. Aims For verifying this assumption, a retrospective study was conducted on patients hospitalized for ADHF. Our main objective was to ascertain whether there was any difference in midterm mortality among patients with rising BNP at discharge as compared to those with decreasing BNP at discharge. Methods Medical records were examined so as to make a partition of the ADHF patient population into two groups, the former characterized by a rise in BNP during hospitalization, and the latter exhibiting a decrease in BNP in the measurement taken at hospital discharge. Results 177 patients were enrolled in a retrospective study. Among them, 53 patients (29.94%) had increased BNPs at the time of discharge, whereas 124 (70.06%) showed decreases in serum BNP during their hospital stay. The group with patients who exhibited BNP increases at the time of discharge had higher degree of congestion evident in the higher frequency of persistent jugular venous distention and persistent orthopnea at discharge. Moreover, patients with increased BNP at the time of discharge had a lower reduction in inferior vena cava maximum diameter [1.58 ± 2.2 mm vs. 6.32 ± 1.82 mm; p (one-way ANOVA)=0.001]. In contrast, there was no significant difference in weight loss when patients with increased BNP at discharge were compared to those with no such increase. A total of 14 patients (7.9%) died during the six-month follow-up period. Cox proportional hazard analysis revealed that BNP increase at the time of discharge was an independent predictor of six-month all-cause mortality after adjustment for age, sodium at discharge, creatinine at discharge and New York Heart Association (NYHA) class at discharge (hazard ratio 34.49; 95% confidence intervals: 4.55–261.06; P =0.001). Conclusions Among patients with history of ADHF, more elevated BNP levels at the time of discharge from the hospital compared to those detected at admission identify a patient subset with higher grade of congestion and higher six-month mortality.

The increasing frequency of urban flooding, driven by global climate change, poses significant threats to the safety and resilience of urban rail transit systems. This study systematically examines the cascading failure processes and resilience of these networks under flood conditions, with a specific focus on the Shanghai Metro. A comprehensive resilience evaluation model was developed by integrating geographic information, static network characteristics, and dynamic passenger flow indicators. This study employs an improved Coupled Map Lattice (CML) model to simulate cascading failures, considering the coupling effects of station centrality, geographic elevation, and passenger flow dynamics. Results indicate that stations with higher degree centrality are more likely to trigger rapid cascading failures across the network. However, incorporating dynamic passenger flow and geographic elevation data helps mitigate these effects, emphasizing the need for multi-dimensional resilience strategies. The findings provide valuable insights for urban transit management, offering a scientific foundation for developing targeted disaster response strategies to enhance network resilience against floods. This study advances the understanding of the vulnerability of urban rail transit systems and offers practical guidance for improving disaster preparedness in urban transportation infrastructure.

Cardiovascular disease (CVD) is a major global health concern. The number of people with CVD is expected to rise due to aging populations and increasing risk factors such as obesity and diabetes. Identifying new molecular markers is crucial for early diagnosis and treatment. Among these, plasma levels of some miRNAs specifically expressed in cardiac and skeletal muscle known as myomiRs, has gained attention for their roles in cardiovascular health. This study analyzed the plasma levels of myomiR-133a, -133b, and -206 in the pathogenesis of cardiovascular diseases. Exploiting of a case-control study design with patients recruited from several nursing homes form Calabria (Southern Italy) characterized by different types of CVD compared to non-CVD controls, we found downregulation of miR-133a in heart failure and miR-133b in stroke, along with the overall decreased expression of miR-133b and miR-206 in CVD patients. In silico functional characterization of their targets and signaling pathways revealed their involvement in critical cardiovascular processes. Although further research is necessary to fully elucidate their mechanisms and clinical utility, the results here reported support the idea that myomiRs could serve not only as biomarkers but also as therapeutic targets, offering new avenues for managing and potentially preventing CVD progression.

Fatigue performance and self-repairing activity of asphalt binders are two properties that highly influence the fatigue cracking response of asphalt pavement. There are still numerous gaps of knowledge to fill linked with these two characteristics. For instance, current parameters fail to fully accommodate these two bitumen phenomena. This study aims to propose a new procedure to address this issue utilizing the linear amplitude sweep (LAS) test, LAS with rest period (RP) (LASH) test, and simplified viscoelastic continuum damage (S-VECD) model. This research work used four different types of asphalt binders: neat asphalt (NA), self-healing thermoplastic polyurethane (STPU)-modified bitumen (STPB), self-healing poly (dimethyl siloxane) crosslinked with urea bond (IPA1w)-modified bitumen (IPAB), and styrene–butadiene–styrene (SBS)-modified bitumen (SBSB). Before the testing process, all the materials were subjected to short-term and long-term aging. The new procedure showed a superior capacity to analyze and accommodate all bitumen fatigue performances and self-repairing activities compared to the current method. Another finding proved that asphalt binders with higher self-restoration behavior failed to show better fatigue performance. A breakthrough finding demonstrated that asphalt binder fatigue response augmented when the RP was applied at a higher damage intensity (S) value. STPBs and IPABs reached their highest increments of fatigue response, containing 1.0% of STPU and 0.5% of IPA1w, respectively. Those augmentations were 207.54% and 232.64%, respectively.

This case study was conducted to disentangle the stories of unsuccessful LET examinees, their responses to failure, and their perspectives of the factors that contributed to their failure. The results demonstrate five themes related to the failure experience. Factors related to the physical environment, psychological well-being, and preparedness influenced the performance of the examinees. Contributory factors to failure provided several implications to teacher education practice. Educators have a responsibility to identify, inform, and intervene with students who are at high risk of failing the LET, and this responsibility could be executed capably. However, the role should be extended beyond graduation. The responsibility to help graduates transition from failure to licensure is the final step of successful undergraduate teacher education.

This paper proposes a novel hybrid model that integrates Failure Mode and Effects Analysis (FMEA), Rank Order Centroid (ROC) and COmbined COmpromise SOlution (COCOSO) to improve risk assessment and prioritization of failure modes. A case study in the healthcare sector will be conducted to validate the effectiveness of the proposed model. ROC is used to assign weights to the FMEA criteria (severity, occurrence and detectability). COCOSO is then applied to create a robust ranking of failure modes by considering multiple criteria simultaneously. The results of the case study show that the hybrid FMEA-ROC-COCOSO model improves the accuracy and objectivity of risk prioritization. It effectively identifies critical failure modes, outperforming traditional FMEA. The hybrid approach not only improves risk management decision making, leading to better mitigation strategies and higher system reliability, but also reduces the complexity typically found in FMEA hybrid models. This model provides a more comprehensive risk assessment tool suitable for application in different industries.

Elevated blood glucose levels, known as glycemia, play a significant role in sudden cardiac arrest, often resulting in sudden cardiac death, particularly among those with diabetes. Understanding the internal mechanisms has been a challenge for healthcare professionals, leading many research groups to investigate the relationship between blood glucose levels and cardiac electrical activity. Our hypothesis suggests that glucose-sensing biophysics mechanisms in cardiac tissue could clarify this connection. To explore this, we adapted a single-compartment, computational model of the human atrial node's action potential. We incorporated glucose-sensing mechanisms with voltage-gated sodium ion channels using ordinary differential equations. Parameters for the model were based on existing experimental studies to mimic the impact of glucose levels on atrial node action potential firing. Simulations using voltage clamp and current clamp techniques showed that elevated glucose levels decreased sodium ion channel currents, leading to a reduction in the sinoatrial node action potential frequency. In summary, our mathematical model provides a cellular-level understanding of how high glucose levels can lead to bradycardia and sudden cardiac death.

More and more works are using machine learning techniques while adopting supervisory control and data acquisition (SCADA) system for wind turbine anomaly or failure detection. While parameter selection is important for modelling a wind turbine’s health condition, only a few papers have been published focusing on this issue and in those papers interconnections among sub-components in a wind turbine are used to address this problem. However, merely the interconnections for decision making sometimes is too general to provide a parameter list considering the differences of each SCADA dataset. In this paper, a method is proposed to provide more detailed suggestions on parameter selection based on mutual information. Moreover, after proving that Copula, a multivariate probability distribution for which the marginal probability distribution of each variable is uniform is capable of simplifying the estimation of mutual information, an empirical copula based mutual information estimation method (ECMI) is introduced for an application. After that, a real SCADA dataset is adopted to test the method, and the results show the effectiveness of the ECMI in providing parameter selection suggestions when physical knowledge is not accurate enough.

Nowadays recurrent implantation failure (RIF) after invitro fertilization is common problem that reproductive specialists usually faced. The phenomenon of thin endometrium in RIF patients has yet not completely understood and properly treated. This study aimed to reveal significantly dysregulated selected genes expression between RIF patients with thin endometrium and fertile women. Endometrial samples were collected in the implantation window days (LH+7 – LH+10) of the natural menstrual cycle from RIF patients (n=20) and fertile women (n=14). Ten genes were chosen as target genes regarding their possible relations with the implantation process. Endometrial gene expression levels showed differences in RIF samples compared to fertile samples. The significant downregulation was observed for CXCL1 (p=0.005) and C4BPA (p=0.03) genes. There was no statistically significant difference between the RIF groups and the fertile group in the expression of 8 genes: CXCL8, HPRT1, MMP10, INFG, VEGFB, HAND2, IL15 and TNC (p&gt;0.05). The use of a combination of two markers (C4BPA + CXCL1) allows for good discrimination of RIF patients from fertile women (AUC 0.806).

Health care is currently showing a fall in heart failure (HF) prevalence and incidence particularly in developed countries, but with only a subset receiving appropriate therapy to protect the heart against maladaptive processes such as fibrosis and hypertrophy. Appropriate markers of advanced HF are still needed, which should help choosing the most suitable therapy and avoid major compliance problems. Speckle tracking echocardiography (STE) is a good choice, being a non-invasive imaging technique and is able to assess cardiac deformation in a variety of conditions. Several multicenter studies and meta-analyses have demonstrated its clinical applications and accuracy in early and late stages of HF, as well as its association with both left ventricular (LV) filling pressures and myocardial oxygen consumption, the two are important parameters in the evaluation of HF patients. Also, STE assists in assessing right ventricular free-wall longitudinal strain (RVFWLS) which is a solid predictor of right ventricle failure (RVF) following LV assist device (LVAD) implantation. Despite its limitations, STE plays an essential role in the clinical evaluation of patients with HF, early and advanced, in explaining symptoms and signs and also as an accurate prognosticator. The aim of this review is to examine the advantages of STE in early evaluation of myocardial dysfunction and their correlation with right heart catheterization (RHC) parameters, which should have a significant clinical relevance in the management of HF patients.

Prostate cancer is the most common non-cutaneous malignancy in men, with the majority of newly diagnosed patients eligible for active surveillance. Despite definitive treatment, a considerable percentage of men will experience biochemical recurrence and even regional and distant metastatic recurrence after radiation therapy or radical prostatectomy. Salvage prostatectomy, while oncologically effective, poses significant morbidity with poor functional outcomes. Salvage cryotherapy has emerged as a promising alternative for localized recurrence, demonstrating safety and efficacy. This review examines the oncologic and functional outcomes of whole-gland and focal salvage cryotherapy, including disease-free survival, cancer-specific survival, and overall survival. The crucial role of multiparametric prostate MRI and evolving role of next-generation PSMA-targeted PET imaging is also examined. Comparison of outcomes of cryotherapy to other salvage ablation modalities, such as high-intensity focused ultrasound (HIFU) is also explored.

In this paper, a continuous power management for a decentralized DC microgrid (DCMG) is proposed to achieve voltage regulation and power balance even under system uncertainty and voltage sensor failure. The DCMG system achieves a continuous power management through only the primary controller to reduce the computational burden of each power agent. To enhance the reliability and resilience of the DCMG system under voltage sensor failure, a DC bus voltage (DCV) sensor fault detection algorithm is proposed. In this algorithm, the DCV sensor failure is detected by comparing the measured DCV with the estimated DCV. When the power agent identifies the DCV sensor failure, it changes the operation properly according to the proposed control mode decision algorithm to maintain the stability of the DCMG system. When uncertain conditions such as the power variation of the distributed generations, sudden grid disconnection, DCV sensor failure, electricity price change, and critical battery status occur, the DCMG system is changed to transitional operation modes. These transitional operation modes are employed to transmit the power agent information to other agents without digital communication links (DCLs) and to accomplish power sharing even under such uncertain conditions. In the transitional operation modes of the DCMG system, the DCV levels are temporarily shifted to an appropriate level, enabling each power agent to detect the uncertainty conditions, and subsequently to determine its operation modes based on the DCV levels. Simulation and experimental results under different test conditions confirm the reliability and effectiveness of the proposed control scheme.

The chronic high fat dysbiosis diet (HFD) instigates cardiac remodeling, dysfunction and chronic heart failure (CHF). The therapeutic approaches focusing oxidative stress, inflammation and hyperlipidemia have not yielded significant positive clinical outcomes. Recent studies report that although mitochondrial ATP citrate lyase (ACLY) supports cardiac function, however, decreases more in human HFpEF than HFrEF. Interestingly, the ACLY synthesizes lipids and creates hyperlipidemia. Epigenetically, ACLY acetylates histone. The mechanism(s) are unknown. One hypothesis is that the HFD induces epigenetic folate 1-carbon metabolism (FOCM), heperhomocysteinemia (HHcy, a cause of abrogation of sleep-time dipping in blood pressure and hypertension) and heart failure. Interestingly, the probiotics utilizes the fat/lipids post-biotically, and increases the mitochondrial bioenergetics and attenuates the HFD induced heart failure. We suggest a novel and paradigm-shift epigenetic mitochondrial sulfur transsulfuration pathways that selectively target HFD-induced CHF. The HFD via transport and metabolomic pathways instigates cardiac remodeling and dyfunction. Previous studies from our laboratory, using a single cell analysis, revealed increase in transporter (SLC25A) of s-adenosine-methionine (SAM) during elevated levels of homocysteine (Hcy, i.e., hyperhomocysteinemia, HHcy), a consequence of impaired epigenetic recycling of Hcy back to methionine by increase in FOCM methylation of H3K4, K9, H4K20 and gene writer (DNMT) and decrease in eraser (TET/FTO). The Hcy transported to mitochondria by SLC7A for clearance via sulfur metabolomic transsulfuration by 3-mercaptopyruvate sulfur transferase (3MST). Interestingly, the HHcy decreases ATP, OCR, H₂S, PGC1α, TFAM, and increase in fission/fusion ratio, causing mitochondria dysfunction. We suggest that gut dysbiosis by HFD disrupts rhythmic epigenetic memory via FOCM and increase in DNMT1 and creates HHcy, leading to decrease mitochondrial transsulfuration and bioenergetics. The treatment with a probiotic, lactobacillus will eat the fat/lipids post-biotically and bi-directionally will produce folic acid and lactone-ketone body that will mitigate the HFD-induced mitochondrial remodeling and heart failure.

Bioimpedance analysis (BIA) is a validated non-invasive technique already proven to be useful for the diagnosis, prognosis, and management of body fluids in subjects with heart failure (HF) and chronic kidney disease (CKD). Although BIA has been widely employed for research purposes, its clinical application is still not fully widespread. The aim of this review is to provide a comprehensive overview of the state of art of BIA utilization by analysing the clinical benefits, limitations, and the potential future developments in this clinically unexplored field.

This paper employs the Finite Element Method (FEM) to simulate and analyze the effects of corrosion defect parameters on the stress and failure pressure of pipelines. It investigates how the boundary conditions of the pipeline model influence stress and examines the sensitivity of failure pressure to corrosion defect parameters. A nonlinear regression equation has been developed from a dataset obtained through simulation experiments to predict the failure pressure of corroded pipelines. To validate the effects of corrosion defect parameters on failure pressure, a hydrostatic test platform for an API 5L X65 pipeline with corrosion defects was established to measure stress levels and failure pressures across varying corrosion defects. The study reveals that failure pressure is negatively correlated with corrosion length and depth, while positively correlated with corrosion width. Among these parameters, corrosion depth exerts a more significant influence on the pipeline's failure pressure than corrosion length and width. Within the range of corrosion defect parameters examined, the maximum deviation of the prediction equation's results from the simulation results is 8.71%, with an average deviation of 5.81%. The standard deviation of the fitted residuals is 0.01837. Additionally, the maximum deviation between the predicted results and experimental measurements is 8.39%, with an average deviation of 7.77%. The strong agreement between the predicted results from the equation and the actual measured data underscores the effectiveness of the nonlinear regression equation.

Background: Hypertrophic Cardiomyopathy (HCM) is the most common inherited Cardiomyopathy. The hallmark of HCM is myocardial fibrosis which contributes to heart failure, arrhythmias, and sudden cardiac death (SCD). Objective: To identify the factors implicated in heart failure symptoms and functional capacity of patients with HCM. Methods: In this cohort study, 43 patients with HCM were recruited. According to functional capacity and symptoms presentation, patients were categorized according to NYHA classification, and echocardiographic measurements of left ventricle systolic and diastolic function have been conducted. The echocardiographic assessment of right vetriculo-arterial coupling (RVAC) has been made by calculating the tricuspid annular peak systolic tissue Doppler velocity (TASV)/estimated RV systolic pressure (RVSP) ratio. Results: Almost half, 22 (51%) of our study population present symptoms of heart failure and were categorized as the symptomatic group - NYHA 2 or higher. Maximum LVOT gradient, RVSP, and the ratio of E/e’ were higher in the “symptomatic” compared to the “asymptomatic” group. TASV was lower in the “symptomatic” compared to the asymptomatic group (11±1cm/sex vs. 13±2cm/sec, p=0.04). However, there was no difference in other potentially influential factors, such as heart rate or systemic blood pressure. The SCD risk score does not differ between the two studied groups. The RVAC (estimated with the TASV/RVSP ratio) was lower in the “symptomatic” compared with the “asymptomatic” group (0.32±0.09 vs. 0.46±0.11, p<0.001). Conclusion: A low RVAC (as TASV/RVSP ratio) value could represent an echocardiographic marker of right ventricular-arterial uncoupling in patients with HCM and may impaired functional status.

Background and objective: Iliopsoas abscess (IPA) is a rare condition with varied symptomology and etiology. Less than one-third of patients with IPA present on the emergency department (ED) admission with the traditional triad of fever, back pain, and restricted hip motion (or limp), leading to delays in diagnosis and management. This case report aims to bring awareness among healthcare professionals regarding the atypical presentation and introduce a potential differential diagnosis when evaluating patients with fever and back pain. The intention is to provide insights into the signs and symptoms that may indicate the presence of an iliopsoas abscess and prompt additional investigations. Case report: Here, we describe a case of primary iliopsoas abscess associated with drug-induced acute liver failure in our ED. The patient complained of pain in the left lumbar region and fatigue that started two weeks before this presentation, claiming that, during the previous night, the pain suddenly worsened. She had a fever, pain at palpation in the right hypochondriac and left lumbar regions, accompanied by fever and vomiting, jaundiced skin, and sclera at the examination in ED. On abdominal ultrasonography, the diagnosis of acute cholangitis was suspected. The laboratory test shows leukocytosis with neutrophilia, thrombocytosis, hepatocytolysis syndrome, and hyperbilirubinemia with the predominance of indirect bilirubin. We performed then abdominal and pelvic computed tomography, which confirmed the diagnosis of cholelithiasis observed with the diameter of the bile duct within normal limits but also showed an abscess-like collection fused to the interfibrillar level of the left iliopsoas muscle; a diagnosis we most likely would have been missed. After that, the patient was hospitalized in the General Surgery Department, and surgery drainage of the abscess was performed. The patient's evolution was excellent; she was discharged after 11 days. Conclusions: The case presented here exemplifies how iliopsoas abscess, a rare cause of back pain, can quickly go unrecognized, especially in the emergency department. Our experiences will raise awareness among doctors in emergency departments about this uncommon but essential diagnosis. With advancements in diagnostic tools and techniques, we aspire that more cases of iliopsoas abscess will be accurately diagnosed.

Background: Heart failure (HF) with preserved ejection fraction (pEF) has lacked effective 23 treatments for reducing mortality. However, previous studies have found an association between 24 statin use and decreased mortality in patients with HFpEF. The aim of this study was to analyze 25 whether statin therapy is associated with a reduction in mortality in these patients and whether the 26 effect differs according to presence or absence of ischemic heart disease (IHD). Methods: We ana- 27 lyzed data from the National Registry of Heart Failure, a prospective study including patients ad- 28 mitted for HF in Internal Medicine units nationwide. Patients with HFpEF were classified according 29 to the use of statins and differences between two groups were analyzed. A multivariate analysis 30 was performed using Cox regression to assess factors independently related to mortality. Results: 31 2788 patients with HFpEF were included, 63% of them were women with a mean age of 80.1(±7.8) 32 years. The statin-treated group (40.2%) was younger, with better functional status, and had a more 33 common diagnosis of vascular disease and lower frequency of atrial fibrillation. The most frequent 34 etiology of HF in both groups was the hypertensive one. Nevertheless, ischemic HF was more com- 35 mon in those who received statins (24.8% vs. 9.6%; p<0.001). Multivariate analysis showed lower 36 mortality at 1-year follow-up in statin-treated patients (OR:0.74; 95%CI:0.61-0.89; p=0.002). This as- 37 sociation was observed in patients without IHD (p<0.001), but not in those with IHD (p=0.11). Con- 38 clusion: Statins are associated with a decrease in total mortality in patients with HFpEF. This benefit 39 occurs mainly in those without IHD.

Background: Liver failure profoundly affects the immune system, leading to dysregulation of innate and adaptive immune responses. Body: This review explores the intricate relationship between liver function and immune homeostasis. The role of the liver as a central hub in immune response initiation is elucidated, emphasizing its involvement in hepatic inflammation induction and subsequent systemic inflammation. Cytokines, chemokines, growth factors, and lipid mediators orchestrate these immune processes, serving as both prognostic biomarkers and potential therapeutic targets in liver failure-associated immune dysregulation. Furthermore, the review delves into the mechanisms underlying immunosuppression in liver failure, encompassing alterations in innate immune cell functions such as neutrophils, macrophages, and natural killer cells (NK cells), as well as perturbations in adaptive immune responses mediated by B and T cells. Conclusion: Understanding the immunological consequences of liver failure is crucial for developing targeted therapeutic interventions and improving patient outcomes in liver disease management.

Technology-enabled maintenance via sensors and the internet of things (IoT) technologies is seen as the “new maintenance strategy”. The aim is to use these technologies to focus on unnecessary breakdowns and increase levels of asset availability where the existing of a dedicated team to maintain or data on asset condition is limited, useless or full of noise. This paper presents the integration of various sensing nodes within an automated laser cutting machine for monitoring of critical components’ conditions. The integrated system provides a centralised platform for data collection from various sensors and provides early failure detection mechanism based on specified set points with alert mechanisms utilising a custom dashboard for data visualisation. The research highlights the required stages for the identification of the appropriate components and sensory devices for the development of efficient monitoring environment.

Over the past few decades, the landscape for multiple myeloma (MM) therapy has significantly advanced, largely due to the approval and introduction of new-generation proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs). Despite these advancements, MM remains incurable. In March 2021, the U.S. FDA approved the chimeric antigen receptor T-cell (CAR-T) therapy idecabtagene vicleucel (ide-cel) for relapsed/refractory multiple myeloma (R/R MM), heralding the advent of cellular therapies for R/R MM. However, due to factors such as the downregulation or loss of tumor antigen expression, T-cell exhaustion, and the influence of the tumor immune microenvironment, most R/R MM patients inevitably experience relapse following CAR-T cell therapy. Consequently, salvage therapy in the post-CAR-T setting has emerged as a critical area of research. This review discusses the potential factors leading to CAR-T therapy failure in R/R MM patients and discusses subsequent salvage therapeutic strategies, offering recommendations for addressing treatment failure in this context.

Especially in the last two decades, due to the developments in durable mechanical circulatory support (MCS) technology and applications, left ventricular assist (LVAD) implantation has become used in more fragile end-stage heart failure patients with higher risk. Despite advances in technology and patient care processes, right heart failure remains the leading cause of morbidity and mortality after durable LVAD implantation. It is difficult to make decisions about the type and duration of MCS during preoperative evaluation, and many clinical, hemodynamic, biochemical and echocardiographic criteria must be taken into account when evaluating the right ventricle. Complex quantitative scoring systems, including measurements of different risk factors for postimplant right ventricular failure, and composite variables, including the anatomical and functional status of the right ventricle, have been used to decide between left or biventricular assist device implantation. The successful use of artificial intelligence (AI) and machine learning (ML) in various applications in the medical field has paved the way for the idea of using it to better predict possible conditions such as right heart failure after LVAD implantation. This review aims to evaluate the current situation of risk prediction models using AI and ML technology, which have become popular in recent years, and possible future developments in predicting right heart failure after the application of durable MCS systems.

In the current study, the failure behavior of retrofitted steel structures was studied experimentally and theoretically with steel/CFRP double strap joints (DSJs) under quasi-static tensile loading. A series of DSJs with different bonding lengths are also considered and examined to experimentally assess the effective bond length. To predict the failure load values of the tested specimens, a new stress-based criterion, namely the point stress (PS) criterion is proposed. Although some theoretical predictive modelling for the strength between steel/CFRP joints under various loading conditions has been presented, in this work by using the new proposed approach, one can calculate rapidly and conveniently the failure loads of the steel/CFRP specimens. Furthermore, to assess the validity of the new proposed criterion, further experimental data on steel/CFRP DSJs available in the open literature are predicted using the PS criterion. Finally, it was found that a good agreement exists between the experimental results and the theoretical predictions based on the PS criterion.

A study was conducted to predict failure stresses, failure locations, and their paths of initiation of perforated polymethyl methacrylate (PMMA) specimens as they were loaded using pins inserted into the holes. First, a series of experiments were conducted for perforated PMMA coupons. There were six different types of coupons. The test specimens had three different widths with a circular hole of a diameter of 8 mm, which was placed at two different locations along the specimen length. All the specimens were loaded using a pin inserted into the hole with three different pins of nominal diameters of 8 mm, 6 mm, and 5 mm, respectively. To predict the failure and compare the results against the experimental data, the recently proposed universal failure criterion was used in the study using finite element analyses. The failure criteria gave acceptable results as compared to the experimental data.

In the presented work, on the example of thin-walled specimens made by selective laser melting technology from AlSi10Mg subjected to preliminary heat treatment, it is shown that there is a critical point of transition from the elastic-plastic region of the engineering stress-strain diagram to the yield and fracture stresses. It was found that the critical point has a strong statistically significant correlation (0.83 by Spearman and 0.93 by Pearson) with the strain hardening coeffi-cient calculated in the section from yield strength to fracture strength. A regression equation linking the critical transition point to the strain hardening coefficient was obtained. It is shown that with increasing plasticity of thin-walled samples obtained by selective laser melting of AlSi10Mg leads to a change in the type of stress distribution in the elastic-plastic region (the Weibull distribution changes to a normal distribution) and the contribution of the probability density of stress distribution described by the Cauchy distribution with a mode near the fracture stress to the full probability density of fracture increases.

Heart failure is associated with a significant mortality rate, and an elevated prevalence of this condition has been noted among hypertensive patients. The identification of predictive factors for heart failure progression in hypertensive individuals is crucial for early intervention and improved patient outcomes. In this study, we aimed to identify these predictive factors utilizing medical history data for hypertension patients. Specifically, we focused solely on utilizing medical data preceding the diagnosis of hypertension to enable patients to anticipate the onset of potential heart failure at the time of hypertension diagnosis. Age-specific and ICD system-specific predictive factors were identified utilizing the MIMIC-IV database through the application of two analytical approaches: chi-square tests and XGBoost modeling. Our findings reveal 21 overall predictive factors, encompassing conditions such as atrial fibrillation, the use of anticoagulants, kidney failure, obstructive pulmonary disease, and anemia. These factors were assessed through a comprehensive review of the existing literature. We anticipate that the results will offer valuable insights for the risk assessment of heart failure in hypertensive patients.

The development of Artificial Intelligence-based tools is having a big impact on industry. In this context, the maintenance operations of important assets and industrial resources are deeply changing both from a theoretical and a practical perspective, even in the field of ship propulsion systems. Namely, conventional preventive maintenance schedules audits and checks at fixed times by using statistics on component failures, but it can be improved by a predictive maintenance based on the real component health status, which is inspected by proper sensors. In this way, time and costs are saved. More in details, data-driven models, through Machine Learning (ML) algorithms, generate the expected values of monitored variables for comparison with real measurements coming from the asset, hence for a diagnosis based on the difference between expectations and observations. Then, a ML-based fault detection starts with the choice of the ML algorithm. This process is often not the consequence of an in-depth deep analysis of the different algorithms available in the literature. For that reason, the authors propose a simple procedure to support a first implementation stage of the so-called Condition Based Maintenance (CBM): a quick benchmarking of the most suitable ML algorithms useful for fault detection. The algorithms are compared by taking into account not only the algorithm output error, shown by the Mean Squared Error between predictions and data, but also the response time, which is a crucial variable for maintenance purpose.

Three-phase induction motors play a key role in industrial operations. However, their failure can result in serious operational problems. This study focuses on the early identification of faults through accurate diagnosis and classification of faults in three-phase induction motors, using artificial intelligence techniques, by analyzing current, temperature, and vibration signals. Experiments were conducted on a test bench, simulating real operating conditions, including stator phase unbalance, bearing damage and shaft unbalance. To classify the faults, an Auto-Regressive Neural Network with Exogenous Inputs (NARX) was developed. The parameters of this network were determined through a process of selecting the best network, using the scanning method with multiple training and validation iterations, with the introduction of new data. The results of these tests showed that the network had excellent generalization in all the situations evaluated, achieving the following accuracy rates: Motor without fault = 94.2%, Unbalance fault = 95%, Bearings with fault =98% and Stator with fault = 95%.

Buildings are subject to intrinsic and extrinsic failures at all stages of the construction process, i.e., design to occupancy (i.e., use) as several failure types can affect them. There are three basic steps for researching building failures: listing, cataloging, and solving/deciding whether highlighting the least invasive and lowest cost intervention. Therefore, this research presents some methods used in construction for the intervention prioritization and seeks to illustrate the most suitable methodology for different settings failure x diagnosis x intervention. Therefore, the most traditional tools are shown: BASICO, SWIFT, FEMEA, AAF, and GUT matrix, where a critical assessment of the strengths and weaknesses is carried out. After that, a case study on maintenance services for the moisture on the building facades was performed. Finally, the GUT matrix and the FMEA method are the best results

Ascites is a term that describes a pathological accumulation of fluid in a peritoneal cavity. It is generally a rare occurrence in a pediatric population and is most commonly associated with liver failure and cirrhosis. In that case, a diuretic treatment is usually implemented to relieve the ascites as it forms in the mechanism of water retention and water leakage from the portal venous system due to portal hypertension. It is important to note however that many other issues may cause ascites in children. Those require a catered approach suited to the pathomechanism of ascites formation in those underlying conditions. That is why a complex diagnostic process ought to be run in pediatric patients with ascites to correctly identify a condition causing it and provide the patient with adequate and thorough care.

Background: Chronic Heart failure (CHF)constitutes a major health problem, representing the leading cause of hospitalization in people over 65 years old. Several studies have associated the Mediterranean diet with a cardioprotective function, improving prognosis in patients with high cardiovascular risk. Our main objective is to determine whether greater adherence to the Mediterranean diet is associated with a lower severity of CHF, depending on the number of heart failure decompensations and complications of the disease. Methods: The study was a single-center restrospective cohort study conducted at the Virgen del Rocío Hospital (Seville). Adherence to a Mediterranean diet was determined by the Mediterranean Diet Adherence Screener (MEDAS) in patients with chronic heart failure in a state of clinical stability, and their cardiac and analytical profiles were evaluated. Results: Seventy-two patients were included (35 with high adherence to the Mediterranean diet and 37 with low adherence). The average age was 81.29 ± 0.86 years. A trend towards fewer cardiac decompensations (1,49 ± 0,14 vs 1,92 ± 0,17), p= 0,054) and lower NT-proBNP values 2897,02 ± 617,16 vs 5227,96 ± 1047,12; p = 0,088) was observed in patients with high adherence compared to those with low adherence to the Mediterranean diet. Conclusions: Our results suggest that patients with CHF and high adherence to the Mediterranean diet have a tendency towards improved cardiac profile, indicated by fewer decompensations and lower NT-proBNP levels. Future clinical trials are needed to substantiate these hypotheses.

Trees in residential landscapes provide many benefits, but can injure persons and damage property when they fail. In hurricane-prone regions like Florida, USA, the regular occurrence of hurricanes has provided an opportunity to assess factors that influence the likelihood of wind-induced tree failure and develop species failure profiles. We assessed open-grown trees in Naples, Florida, following the passage of Hurricane Irma in September 2017 to determine the effect of relevant factors on the degree of damage sustained by individual trees. Of 4,034 assessed individuals (n = 15 species), 74% sustained no damage, 4% sustained only minor damage (i.e., minimal corrective pruning needed), 6% sustained significant damage (i.e., major corrective pruning needed), and 15% were whole tree failures (i.e., overturned trees or trees requiring removal). The proportion of individuals in each damage category varied among species, stem diameter at 1.4 m above ground, and the presence of utility lines, which was a proxy for maintenance. We compared our results with the findings of seven previous hurricanes in the region to explore species’ resilience in hurricanes.

This study reveals the essential load-bearing characteristics of the steel-concrete composite floor system under fire conditions applying structural stressing state theory. Firstly, the strain data in the entire process of the fire test are modeled as state variables which can present the slab’s stressing state evolution characteristics; Then, the state variables are used to build the stressing state mode and the parameter characterizing the mode. Further, the Mann-Kendall criterion is adopted to detect the leap points in the evolution curves of the characteristic parameters during the entire fire exposure process. Also, the evolution curves of the stressing state modes are investigated to verify the leap profiles around the leap/characteristic points; Finally, the detected leap points are defined as the failure starting points and elastoplastic branching points, which is unseen in the past researches focusing on the failure endpoint defined at the ultimate load-bearing state of the composite floor system. The failure starting point and the elastoplastic branching point are the embodiment of natural law from quantitative change to quality change of a system rather than an empirical and statistical judgment. Hence, both characteristic points avoidably exist in the strain data of the composite floor system undergoing the fire process, which can be revealed through the proper modeling methods and update the existing theories and methods on structural analysis and design in fire.

In this study, the elastic properties of composite materials are investigated, considering the effects of separation of fiber-matrix joint boundary and matrix failure. In this method, by assuming periodic microstructure and using a linear approximation of the displacement field by applying continuity and equilibrium conditions, the composite fiber composite relation is determined. The effect of separation is assumed by introducing tangential and normal scalar parameters in the equations by assuming the displacement field jump at the common boundary. In order to express the effect of matrix micro-cracks, the fracture mechanics framework of continuous environments was used and the micro-cracks parallel to the fibers, perpendicular to the fibers and in the thickness direction with scalar parameters were expressed. At the end of the effect of these parameters the results are presented in graphs. The results show that the presence of defective joint at the joint boundary and the matrix micro-components reduce the hardness of the composite and thus it’s bearing load, which is more significant at the defective joint state.

Heart transplantation (HT) is the gold standard therapy for advanced heart failure (AHF) and LVAD as destination therapy are an option in non-HT candidates. Most patients with AHF never receive a HT or a LVAD, so alternative strategies are needed. Intermittent levosimendan can reduce HF hospitalizations in AHF patients in the short term. It is uncertain whether the results of the comparison of inotropes with older generation LVAD would have the same outcomes in the current era of less sick but older, AHF treated with levosimendan patients. In this paper we compare the use of two therapeutic strategies for end-stage HF in patients not candidates for HT: Repetitive intermittent Levosimendan vs. LVAD as destination therapy. To do so we compare two multicentre cohorts of real-life patients from Spain: the LEVO-D Registry and the REGALAD registry. 715 patients coming from the 2 registries where found, 403 from the LEVO-D and 312 from the REGALAD. Non-adjusted median survival was shorter for LEVO-D patients; with the benefit for the LVAD seen only after the first year of therapy. The survival advantage for the LVAD cohort was also true after analysis of the matched cohort but, as in the non-matched analysis, the survival benefit was mainly shown after one year of follow up. We conclude that in elderly AHF non-HT-candidates, LVAD therapy offers significantly better long-term outcomes when compared to intermittent levosimendan; thus, it should be considered in carefully selected candidates. On the other hand, in poor LVAD candidates or highly comorbid patients, intermit-tent inotropic support with levosimendan could be a reasonable alternative to LVAD as 1-year outcomes are similar.

The structural performance of reinforced concrete relies heavily on the bond between reinforcement and concrete. In nonlinear finite element analyses, bond is either modelled by merged, also called perfect bond, or coincident with slip, also called bond-slip, approaches. Here, the performance of these two approaches for the modelling of failure of reinforced concrete was investigated using a damage-plasticity constitutive model in LS-DYNA. Firstly, the influence of element size on the response of tension-stiffening analyses with the two modelling approaches was investigated. Then, the results of the two approaches were compared for plain and fibre reinforced tension stiffening and a drop weight impact test. It was shown that only the coincident with slip approach provided mesh insensitive results. However, both approaches were capable of reproducing the overall response of the experiments in the form of load and displacements satisfactorily for the meshes used.

Rock materials failures are accompanied by the co-existence of various failure mechanisms, in-cluding rock fracturing, shearing, and compaction yield. These mechanisms manifest macro-scopically as multiple failure modes and nonlinear strength characteristics related to stress levels. Considering the limitations of current rock mechanics strength theories, which are primarily derived from single failure mechanisms, this study evaluates the applicability of alternative strength theories. Based on the extensional-strain criterion and the PMC (Paul-Mohr-Coulomb) model, a piecewise linear strength model was proposed that is suitable for analyzing multiple failure mechanisms in rocks and revealing the intrinsic mechanisms of multi-mechanism rock material failure. A multiple failure mechanism strength model in the form of inequalities was proposed, using the generalized shear stress, mean stress, and stress Lode angle as parameters. Strength tests conducted on sandstone and granite rock material samples under different stress conditions revealed distinct piecewise linear strength characteristics for both rock types, vali-dating the rationality and applicability of the multiple failure mechanism model. The findings construct a multi-mechanism failure model for rocks, providing enhanced predictive capabilities and aiding in the prevention of rock structural failures.

Fibroblasts are differentiated to myofibroblasts and produce collagen and other extracellular matrix when the heart is exposed to stresses. Myocardial infarction and pressure overload-induced hypertrophy are major stresses to induce differentiation of fibroblasts. Since collagen can compensate the missing tissue due to injury, appropriate production of collagen is beneficial for the injured heart against rupture. However, excessive deposition of collagen is called fibrosis and causes cardiac dysfunction. After fibroblasts are differentiated to myofibroblasts, myofibroblasts can further change their phenotypes. In addition, myofibroblasts are found to have a new function other than collagen production. Myofibroblasts have macrophage-like functions that engulf dead cells and secrete anti-inflammatory cytokines. So far, research on fibroblasts has been delayed due to the lack of available markers for selective isolation of fibroblasts. In recent years, it has become possible to genetically label fibroblasts, sequence the cells at single cell levels, and manipulate function or the number of cells. Based on new technologies, the origin of fibroblasts and myofibroblasts, time-dependent changes of fibroblast states after injury, and heterogeneity have been demonstrated. Here, I will introduce recent advances in fibroblasts and myofibroblasts.

Congestive heart failure (CHF) is a major cause of morbidity and mortality with an increasing prevalence in human and canine populations. Similar to humans, overactivation of the renin-angiotensin aldosterone system is involved in the pathophysiology of CHF in dogs. Current therapeutic strategies for the management of canine CHF include the use of RAAS inhibitors, diuretics and inodilators. The present review summarizes data from our own research on the modulation of the renin-angiotensin cascade in dogs in dogs, together with new findings (including novel therapeutic targets) from the veterinary and the human literature.

The polymer cures as it enters the ballast, forming a three-dimensional geo-composite reinforcing cage. Although there will be some adherence to the ballast in dry conditions, the polymer's primary job is to construct this reinforcing cage. Polymer penetration is controlled by altering the rheology of the polymer. The method is also said to include a built-in safety system, with the track reverting to a ballast state in the event of a polymer or geo-composite failure. Many of the sites were considered unmaintainable before the polymer was put. The design method was utilized to forecast track behaviour before and after treatment, allowing the most appropriate polymer rheology, polymer distribution, and loading levels to be designed in order to achieve optimum performance and confirm that the procedure worked. This method can be utilized to tackle these types of long-standing problems by displaying actual polymer application profiles at a typical important location.

Modified mRNAs (modRNAs) are an emerging delivery method for gene therapy. In particular, the modRNA-based COVID-19 vaccines have proven that modRNA is a safe and effective therapeutic tool. Moreover, modRNA has the potential to treat various human diseases including cardiac dysfunction. Acute myocardial infarction (MI) is a major cardiac disorder that currently lacks curative treatment options. MI is commonly accompanied by fibrosis and impaired cardiac function. Our group previously demonstrated that the matricellular protein CCN5 inhibits cardiac fibrosis (CF) and improves cardiac dysfunction. However, it remains elusive whether the early intervention of CF under stress conditions is beneficial or more detrimental due to potential adverse effects such as left ventricular (LV) rupture. To obtain acute CCN5 expression, we used modRNA-mediated gene transfer in a mouse MI model. To evaluate CCN5 activity, we established two independent experimental schemes: 1) preventive intervention and 2) therapeutic intervention. Cardiac function and structural changes were measured by echocardiography and magnetic resonance imaging. Finally, fibrosis and the underlying molecular pathway were analyzed by western blotting, quantitative real-time polymerase chain reaction, and immunohistochemistry. The modRNA-CCN5 gene transfer successfully ameliorated CF and enhanced cardiac function in both preventive and therapeutic interventions without LV rupture or any adverse cardiac remodeling. Conclusively, early intervention in CF by modRNA-CCN5 gene transfer is an efficient and safe therapeutic modality for treating MI-induced heart failure without adverse structural remodeling.

In the paper analyzes of Francis turbine failures for a powerful Pumped Hydraulic Energy Storage (PHES) are conducted. The structure is part of the PHES Chaira, Bulgaria (HA4 - Hydro-Aggregate 4). The aim is assessment of the structure-to-concrete embedment for possible cause of damages and destructions of the HA4 Francis spiral casing units. The embedment methods applied in the practice for decades are discussed and compared to that used for HA4. An innovative virtual prototype is built based on the finite element method to clarify the influence of workloads under generator mode. The stages of the simulation include:- complete structural analysis of the spiral case and the concrete under loads in generator mode;- complete structural analysis of the spiral case under loads in generator mode but without the concrete.Both procedures of simulations (with and without the concrete) are of major importance. Since a failure of the surface between the turbine, the spiral case and the concrete is observed the effect of the increasing contact gap (no contact) is analyzed. The stresses, strains and displacements of the turbine units are simulated followed by important analysis for reliability. The conclusions reveal the possible reasons for cracks and destruction in the main elements of the structure.

Implants are increasingly used in dentistry. Nevertheless, several factors can cause treatment failure. To assess initial wound healing, various indices have been developed. The purpose of this study was to assess the relationship between early wound healing and implant success. Fifty single implants (25 in women and 25 in men) were placed in patients meeting the inclusion. The implants (Ticare®) were placed via the two-stage technique. Patients were assessed at 24 hours, one week, one month, two months and one week postimplantation. At the final evaluation, implantation failure or success was recorded. Postoperative pain in these patients at one week after placement was assessed with a visual analogue scale (VAS), and the Wachtel soft tissue early healing index was used to measure healing. Two months after implant placement, the success rate was 92%. No statistically significant relationship was found between the Wachtel index and short-term implant success or failure. Additionally, there was no relationship between implant success or failure and variables such as smoking, diabetes status, age, sex or guided bone regeneration (GBR). Neither the Wachtel index nor any of the other variables studied is a predictor of early implantation success.

A set of polymer composite bolted T-joints with novel configuration consisting of internal skeleton and external skin was fabricated using a prepreg-RTM co-curing molding process. Experiments were conducted to study their mechanical properties under bending load. A finite element model with a polymer resin area between the skin and skeleton was established and verified by the experimental results. Then, the damage propagation process and failure mechanism of the joint and the influence of three factors related to the layer characteristics of the skin and skeleton were investigated by the validated models. The results show that the bending stiffness and the yield limit load of the novel composite T-joint are 0.81 times and 1.65 times that of the 2A12 aluminum T-joint respectively, while at only 55.4% of its weight. The damage of the joint initiates within the resin area and leads to a degradation of the joint bending performances. The preferred stacking sequence of the skeleton is [0/+45/90/-45]ns when primarily subjected to bending loads. The decrease in bending performances is within 5% with the inclining angle of the skeleton less than 12 degrees. The more layers of 90° in the skin, the better bending performances of the joints, while the more layer of 0°, the poorer bending performances.

Chronic renal failure (CRF) is a major public health problem worldwide. In this work, we investigated the effects of a purified Laminaria japonica polysaccharide (LJP61A) on the renal function using adenine-induced CRF mice model. Results exhibited that adenine treatment caused serious renal pathological damages and elevation of serum creatinine and blood urea nitrogen of mice. However, these changes could be significantly reversed by the administration of LJP61A in a dose-dependent manner. Additionally, LJP61A could dramatically reduce the weight loss, improve the urine biochemical index, and regulate the electrolyte disturbance of CRF mice. These results suggested that the renal functions of adenine-induced CRF mice could be improved by LJP61A, which might be developed to a potential therapeutic agent for CRF patients.

The main objective of this study focuses on designing and testing body protection systems using advanced materials based on aramid fibers, for high impact speeds of up to 410...430 m/s. The investigation of the failure mechanisms identifies issues of protective materials, major challenges and technological problems for efficient development of these systems. The authors presents an investigation on the failure processes and destructive stages of a ballistic package made of succesive layers of LFT SB1plus, taking into account the particular test conditions from NIJ Standard-0101.06 Ballistic Resistance of Body Armor. The main parameter of interest was the backface signature (BFS), but also details of projectile arrest and SEM investigaton could offer arguments in using this material for individual protection.

With the development of computer science and software engineering, software becomes more and more complex. Traditional software reliability assurance techniques including software testing and evaluation can't ensure software reliable execution after being deployed. Software failure prediction techniques based on failure indicators can predict software failures according to abnormal indicator values. The latter can be collected using runtime monitoring techniques. An essential part of this method is finding proper indicators which have strong correlation with software failures. We propose a novel type of indicators in this work named software runtime entropy, which takes both software module execution time and call times into consideration. Three common open source software, grep, flex and gzip are used as study cases for finding the relationships between the indicators and software failures. Firstly, a series of fault injection experiments are conducted on those three software respectively. The decision tree algorithm is used to train those data to build the correlation models between software runtime entropy and software failures. Several common measures in machine learning domains such as accuracy, recall rates, and F-measure are used to evaluate the models. The decision tree models can be used as failure mechanisms to assist the failure prediction work. One can examine the value of runtime entropy and make a warning report when it ranges from the normal interval to abnormal one.

Preserving natural biodiversity of forest ecosystems is one of the greatest challenges of modern, multifunctional forest management. Among the many different groups of forest organisms trees are of major importance as they often act as the so-called foundation species, i.e. species that create conditions on which the existence of virtually all other organisms depends, either directly or indirectly. The essential condition for trees to permanently play this role is their demographic sustainability, which is reflected in the balanced proportions of individuals representing different developmental stages (from seedlings and saplings to mature trees). The main goal of this study was to assess the possibility of tree species occurring in the Białowieża Forest (important biodiversity hotspot) to maintain the role of foundation species in a sustainable manner. Comparison of species-specific, equilibrium vs. actual size distributions revealed that almost half of all trees growing in the Białowieża Forest represent "inappropriate", i.e. occurring in excess compared to the balanced model, species and/or diameter ranges. Similarly high was also the amount of deficits, concerning primarily the smallest trees. It is suggested that, in order to permanently preserve a high biological diversity of the Białowieża Forest, active actions should be taken to bring the current tree diameter distributions as close as possible to the desired sustainable model.