Pressure Research Articles

A new theoretical approach to determine the air outlet temperature of an air-to-ground heat exchanger

In this study, the control volume method is used to determine the air temperature at the outlet of an air-to-ground heat exchanger. Its implementation consists in dividing the duct of the ground-air heat exchanger into micro-volumes of identical size. An energy balance is then established for each micro-volume. The input parameters used to implement this model are related to the city of Yaoundé in the equatorial zone. The results show that when the total length of the air-to-ground heat exchanger duct varies between 0 and 100 m, the air temperature at the outlet also varies between 34.5 and 24 °C. The air-to-ground heat exchanger operates in cooling mode. As the length of the air-to-ground heat exchanger duct increases, the temperature of the air at the outlet of the air-to-ground heat exchanger decreases, approaching that of the ground. Based on the results obtained using the control volume model, the minimum total length of air-to-ground heat exchanger duct recommended for this zone is 40 m. Admittedly, air pressure drops, air humidity and the geometry of the air-to-ground heat exchanger are aspects that have not yet been taken into account in the implementation of this model. Nevertheless, the control volume method can be used to optimise the parameters influencing the thermal performance of an air-to-ground heat exchanger.•The control volume method is implemented here by dividing the air-to-ground heat exchanger duct into identical micro-volumes and then establishing an energy balance for each micro-volume;•In this work, the control volume method was used to optimise the total length of the duct of a ground air heat exchanger installed in an equatorial zone;•Some important aspects such as air pressure drops, air humidity, and the geometry of the air-to-ground heat exchanger are not yet taken into account in the implementation of the control volume method.

Effects of General Anesthesia on Noninvasively Measured Central and Peripheral Blood Pressure: A Prospective, Observational-based Cross-over Study

Abstract Background: Blood pressure (BP) monitoring is the basic hemodynamic parameter necessary to monitor the hemodynamic changes occurring under general anesthesia (GA) to maintain adequate perfusion to major organs such as the heart, brain, and kidneys. Physicians heavily rely upon peripheral hemodynamic measurements despite availability of devices suitable for measurement of central blood pressure through non-invasive manner paving a gap in the literature concerning the effects of GA on central pressure. Aims and Objective: In this comparative cross-over study, authors have aimed to find out the degree of changes in central and peripheral BP after the introduction of GA among adult patients of different age groups scheduled for routine surgical procedures with an objective to maintain vital functions more precisely – considering the fact that vital organ perfusions (heart, brain etc.,) depend more on the required values of CBP than that of PBP. Material & Methods: Following approval from IEC, sixty adult patients with ASA physical status 1 or 2 undergoing routine surgical procedures under general anesthesia were enrolled in this prospective cross-over study where each patient was case as well control for measurement and comparison of his/her central and peripheral blood pressure. Patients, being divided into three groups as per age range - 20-40 years (Group A), 40-60 years (Group B), and 60-80 years (Group C) had their normal Riva Rocci BP cuff (Space Lab Inc. USA) placed in one arm for peripheral BP measurement and special Riva Rocci (Uscom Ltd., Australia).) BP cuff for on another arm for Central BP measurement. After patient’s arrival into operation theatre, baseline hemodynamic parameters were taken followed by sequential measurements of CBP and PBP with an interval of 2 minutes till 30-40 mins of operation. There were alternative measurements of these pressures with recording of data from either of the devices as mentioned for further comparison and analysis. Results: From baseline values, it was found that all the three groups were comparable in respect of age, height, weight, PBP and CBP. When measured pressure of all groups combined, that there was a fall in both Central and Peripheral SBP as well as DBP after giving intravenous induction agent (propofol) and rise in both central and peripheral SBP and DBP after laryngoscopy and intubation. Degree of systolic blood pressure change in both peripheral & central that is fall of BP in 3rd reading & rise of BP in 5th reading was greatest in group C, followed by group B, then group A [p - 0.005]. While comparing three subgroups, the baseline Augmentation Index (AI) was highest in group C and lowest in group A. Following the administration of general anesthesia (GA), the change in Augmentation Index (ΔAI), was most pronounced in the third reading corresponding to the time after the administration of the induction agent. Conclusion: Measurement of CBP through peripheral placement of cuff is a unique feasible method to detect real changes of circulation with actual pressure in vital organs. Thus, the study suggests that central blood pressure measurements can provide a more accurate reflection of hemodynamic changes during general anesthesia, especially in older individuals or those with different cardiovascular conditions allowing better vital management of body circulation.

Cerebellar ferroptosis of hypertension mice following lead exposure

Exploring the changes in cerebellar ferroptosis in hypertensive mice after lead exposure. Twenty-five healthy C57 male mice were selected to construct a hypertensive model by intraperitoneal injection of angiotensin II(Ang II) at a concentration of 0.05 mg/kg for 7 consecutive days. After a systolic blood pressure of 140 mmHg, 20 hypertensive mice were randomly divided into a hypertensive control group and a hypertensive lead exposure group. Twenty C57 mice with normal blood pressure were randomly divided into a blood pressure normal control group and a blood pressure normal lead exposure group. The mice in the normal blood pressure control group and the hypertensive control group drank water freely. Mice in the lead exposure group with normal blood pressure and the lead exposure group with hypertension drank lead acetate water containing 250 mg/L. Ang II was injected intraperitoneally every two days in the hypertensive control group and hypertensive lead exposed group mice. Each group of mice was poisoned for 12 weeks. Using open field experiments and balance beam experiments to detect motor dysfunction in mice. Using a reagent kit to detect the levels of divalent iron(Fe~(2+)), malondialdehyde(MDA), and glutathione(GSH) in the cerebellum of different groups of mice. Western blot was used to determine the protein expression of member 11 of the solute carrier family 7(SLC7A11), glutathione peroxidase 4(GPX4), nuclear receptor coactivator 4(NCOA4), microtubule associated protein 1 light chain 3B(LC3B), and ferritin heavy chain 1(FTH1) in mouse cerebellar tissue. The result of the open field experiment showed that the activity distance(1013.04 cm) of mice in the hypertensive lead exposure group was significantly lower than that of the hypertensive control group(1351.18 cm) and the lead exposure group with normal blood pressure(1287.35 cm). And the lead exposure group with hypertension also extended the time through the balance beam, which was 29.40 seconds(P<0.05). In addition, the Fe~(2+)content in the cerebellum of mice in the hypertensive lead exposure group was 3.33 μmol/g prot, which was 1.54 times that of the hypertensive control group and 1.14 times that of the lead exposure group with normal blood pressure. The MDA content was 4.71 nmol/mg prot, higher than that of the hypertensive control group and the lead exposure group with normal blood pressure. The GSH content was 5.36 μmol/g prot, lower than that of the hypertensive control group and the lead exposure group with normal blood pressure(P<0.05). Western blot result showed that compared with the hypertensive control group and the lead exposure group with normal blood pressure, the protein expression of SLC7A11 and GPX4 in the hypertensive lead exposure group was significantly reduced(P<0.05). In addition, compared with the control group with normal blood pressure, the expression of NCOA4 and LC3B proteins in the cerebellum of mice in the hypertension control group and lead exposure group with normal blood pressure increased, while the expression of FTH1 protein decreased(P<0.05). The expression of NCOA4 and LC3B proteins in the hypertensive lead exposure group was higher than that in the hypertensive control group and the lead exposure group with normal blood pressure, while the expression of FTH1 protein decreased(P<0.05). Lead exposure can exacerbate iron death in the cerebellar tissue of hypertensive mice, and iron autophagy may be involved in its occurrence and development.

Association of Aortic Stiffness and Pressure Pulsatility With Noninvasive Estimates of Hepatic Steatosis and Fibrosis: The Framingham Heart Study.

Arterial stiffening may contribute to the pathogenesis of metabolic dysfunction-associated steatotic liver disease. We aimed to assess relations of vascular hemodynamic measures with measures of hepatic steatosis and fibrosis in the community. Our sample was drawn from the Framingham Offspring, New Offspring Spouse, Third Generation, Omni-1, and Omni-2 cohorts (N=3875; mean age, 56 years; 54% women). We used vibration-controlled transient elastography to assess controlled attenuation parameter and liver stiffness measurements as measures of liver steatosis and liver fibrosis, respectively. We assessed noninvasive vascular hemodynamics using arterial tonometry. We assessed cross-sectional relations of vascular hemodynamic measures with continuous and dichotomous measures of hepatic steatosis and fibrosis using multivariable linear and logistic regression. In multivariable models adjusting for cardiometabolic risk factors, higher carotid-femoral pulse wave velocity (estimated β per SD, 0.05 [95% CI, 0.01-0.09]; P=0.003), but not forward pressure wave amplitude and central pulse pressure, was associated with more liver steatosis (higher controlled attenuation parameter). Additionally, higher carotid-femoral pulse wave velocity (β=0.11 [95% CI, 0.07-0.15]; P<0.001), forward pressure wave amplitude (β=0.05 [95% CI, 0.01-0.09]; P=0.01), and central pulse pressure (β=0.05 [95% CI, 0.01-0.09]; P=0.01) were associated with more hepatic fibrosis (higher liver stiffness measurement). Associations were more prominent among men and among participants with obesity, diabetes, and metabolic syndrome (interaction P values, <0.001-0.04). Higher carotid-femoral pulse wave velocity, but not forward pressure wave amplitude and central pulse pressure, was associated with higher odds of hepatic steatosis (odds ratio, 1.16 [95% CI, 1.02-1.31]; P=0.02) and fibrosis (odds ratio, 1.40 [95% CI, 1.19-1.64]; P<0.001). Elevated aortic stiffness and pressure pulsatility may contribute to hepatic steatosis and fibrosis.

Climatology and circulation conditions of potential foehn occurrence in the Polish Tatra Mountains

AbstractFoehn wind occurrence has generated great interest among researchers because of the destructive power and impact on the local climate. Based on anemometric data provided by a high-mountain station on Kasprowy Wierch in the Polish Tatra Mountains, the characteristics of the potential occurrence of foehn wind (referred to as halny in the Polish Tatras) are presented, including its speed and duration, as well as the frequency of occurrence on a multiannual, annual and daily basis. Halny winds occur most frequently in the cold period of the year (Oct–Feb), with the frequency peaking in November, and sporadically in the summer. The occurrence of foehn winds is strongly dependent on the synoptic situation. Therefore, the main aim of the study was to identify the circulation conditions conducive to their occurrence on the Polish side of the Tatra Mountains. Circulation conditions responsible for foehn formation were analysed using gridded sea level pressure (SLP) data from the NCEP-DOE (National Centers for Environmental Prediction-Department of Energy) reanalyses. The occurrence of foehn wind in the Tatra Mountains is associated with a low pressure system over north-western Europe, and above normal pressure over south-eastern Europe. The location and intensity of the centres of atmospheric influence on foehn days can vary, as indicated by the three types of pressure systems favouring the occurrence of the phenomenon, distinguished by the hierarchical grouping method. In type 1, the cyclonic centre spreads over northern Europe, in type 2 over western Europe and in type 3 over north-western Europe. In types 1 and 3, the air masses come from the south-west, and in type 2 more from the south. Type 3 is characterised by the greatest horizontal pressure gradients among the three circulation types and with the greatest SLP anomalies.

Remission to normal blood pressure in older adults with hypertension who did not receive antihypertensive medication: analysis of data from two longitudinal cohorts

How often hypertensive patients could achieve remission to normal blood pressure (BP) (i.e., <140/90mmHg) in the absence of antihypertensive drugs, which is important for the management of hypertension, remains largely unknown. This observational study aimed to investigate the change of BP in older adults with hypertension who did not take antihypertensive drugs and preliminarily examine whether the remission from hypertension to normal BP observed in this setting was associated with lower risk of cardiovascular disease (CVD). 2760 participants aged 33-99 years (median 60 years, interquartile 54-68 years) from the Health and Retirement Study (wave 2006 to wave 2018) and the English Longitudinal Study of Ageing (wave 1998 to wave 2016), who had no major CVD, were hypertensive, and were not on antihypertensive drugs at the time of baseline BP measurement, and had at least one follow-up BP measurement before which no antihypertensive drugs were taken, were included for analysis. The main outcome was the proportion of patients who achieved remission of hypertension at the last wave of measurement. During a median follow-up of six years, 52% of the participants showed a reduction of ≥6mmHg in systolic BP and 60% a reduction of ≥3mmHg in diastolic BP. 1171 participants (42%, 95% CI: 41-44%) achieved remission at the last measurement, and by that time 67%, 43%, and 29% of them had maintained the normotensive state for around 4, 8, and 12 years, respectively. Various supplementary analyses that aimed to examine the impact of chance and bias yielded similar results. Preliminary analyses showed that being non-smokers at baseline, achieving a normal body mass index during follow-up, and quitting alcohol drinking during follow-up, among others, were associated with the remission of hypertension. Compared with the participants who remained hypertensive, those who achieved remission had a lower CVD risk (adjusted hazard ratio 0.66, 95% CI: 0.47-0.92). In many of this study population, hypertension could be reversed without the intervention of drug treatment in the first few years after diagnosis. This finding may have implications for more individualized management of hypertension. Further studies to identify the factors or algorithms predictive of such hypertension remission are warranted. The Chinese University of Hong Kong (7106452; 7105959),Shenzhen Science and Technology Program (KQTD20190929172835662), Strategic Priority Research Program of Chinese Academy of Sciences (XDB 38040200), National Institute on Aging(R01AG017644; NIA U01AG009740).

Meteorological parameters and hospital-acquired falls—A multicenter retrospective study based on 10 years of adverse events reporting system data

Objective and rationaleHospital-acquired falls are common and serious adverse events in medical institutions, with high incidence and injury rates. Studying the occurrence patterns of hospital-acquired falls is important for preventing falls in hospitalized patients. However, the effect of meteorological factors on hospital-acquired falls has not been elucidated. Therefore, this study explored the impact of meteorological parameters on hospital-acquired falls in Chongqing, China, and provided new ideas for the clinical prevention of falls in patients. MethodsCorrelation analysis and distributed lag nonlinear models were employed to analyze the relationship between 3890 cases of hospital-acquired falls and meteorological data in 13 hospitals in 11 districts and counties in Chongqing from January 2013 to April 2023. ResultsThe number of hospital-acquired falls demonstrated a nonlinear correlation with the daily average relative humidity and negatively correlated with sunshine duration; however, temperature, air pressure, and wind speed were not correlated. Compared to the reference humidity (87 %), the immediate effects of daily average relative humidity (65–68 % and 90–97 %) increased the risk of hospital-acquired falls on the same day (relative risk [RR]:1.027–1.243). When the daily average relative humidity was 95–97 %, lags of 0–1 d and 8–12 d had greater effects on falls (RR:1.073–1.243). The daily average relative humidities of 62–74 % and 91–97 % were statistically significant at cumulative relative risk (CRR)of 4, 7, 10, and 14 d with a cumulative lag (CRR: 1.111–4.277). On sex and age stratification, the lag and cumulative effects of relative humidity more significantly impacted falls in women and patients aged ≥65 years. ConclusionDaily average relative humidity had a nonlinear correlation and lag effect on hospital-acquired falls; therefore, medical institutions should pay attention to the effect of relative humidity on hospital-acquired falls in patients, especially old and female patients.

Experimental and chemical kinetic analysis to evaluate CO2 dilution on laminar combustion characteristics of C2H5OH/air blends under normal pressure

Based on a constant volume combustion system, the effect of dilution ratio changes on the laminar combustion characteristics of C2H5OH/air mixture was studied under an initial pressure of 1 bar, initial temperatures of 370 K, 400 K, 450 K, and equivalence ratios of 0.7–1.4. A chemical kinetic mechanism for ethanol-carbon dioxide was established, and the combined physical and chemical effects of carbon dioxide were separated. An independent parameter control method was proposed, introducing virtual species FN2, ICO2, FCO2, and KCO2, to isolate the dilution effect, thermal effect, direct reaction effect, third-body effect, and transport effect. Simulation analysis using the modified chemical kinetic mechanism revealed that various impacts of CO2 reduce the peak progress rate and sensitivity coefficient of key elementary reactions. Furthermore, the dilution effect of CO2 has the greatest influence on the sensitivity coefficients and net progress rates of important elementary reactions. Based on the results of the chemical kinetic simulations, a new global reaction pathway analysis method was created, overcoming the limitations of the Chemkin-pro method. The decomposition pathway of C2H5OH throughout the combustion process was calculated as C2H5OH → SC2H4OH → CH3CHO → CH3CO → CH3 → CH2O → HCO → CO → CO2. Changes in initial temperature and dilution ratio do not alter the main decomposition pathway of C2H5OH. Detailed chemical kinetics and free radical behavior analysis indicate that the LBV of the C2H5OH/CO2/air blends has a linear correlation with [H + O + OH]max.

Studying the breakdown electric field in uniform and non-uniform air gaps

High voltage is essential in power grids, but it inevitably leads to high electrical stress and the associated risk of electrical discharges. Due to the complexity of the phenomena involved in electrical discharges, there are no analytical formulas for predicting the electric field strength at which they initiate, so experimental data and numerical methods are required for this purpose. According to many sources, electrical discharges can occur in air at normal pressure and temperature when the electric field strength is approximately 3 kV mm−1 or greater. This paper analyzes and discusses this threshold in detail by examining relevant electrode geometries used in high voltage applications from experimental data found in the scientific literature and using 2D finite element analysis simulations. Uniform, quasi-uniform, and non-uniform field gaps are analyzed to help students draw conclusions and gain insight into the nature of gas breakdown and the applicability of the 3 kV mm−1 threshold. The approach proposed in this paper is well suited for a practical session or group project for undergraduate or even graduate courses. Despite the important effects and design implications of electrical discharges on high voltage equipment, apparatus and systems, this topic is often not covered in sufficient detail in regular courses.

Status of elevated blood pressure among Chinese children and adolescents aged 7-17 from 2016 to 2017 according to 4 different references

To describe and analysis the detection rate of high normal blood pressure and high blood pressure among Chinese children and adolescents aged 7-17 years from 2016 to 2017 according to the clinical practice guideline for screening and management of high blood pressure in Children and Adolescents published by the American Academy of Pediatrics(the AAP reference), the international blood pressure references among Children and Adolescents aged 6 to 17 years(the international reference), health industry standard of the People&apos;s Republic of China "Reference of screening for elevated blood pressure among children and adolescents aged 7 to 18 years(WS/T 610-2018)"(the industry reference) and updating blood pressure references for Chinese children aged 3 to 17 years(the guideline reference). Data was from the China Nutrition and Health Surveillance of Children and Lactating Women(2016-2017), in which the multistage stratified whole group random sampling method was used to draw participants from 275 surveillance sites in 31 provinces(autonomous regions and municipalities). In total, 67 231 participants were included according to the inclusion and exclusion criteria. Blood pressure was measured three times by trained staff using a validated oscillometric blood pressure monitor at the same point. The average blood pressure was calculated for the three measurements for SBP and DBP. To match the sampling design methodology, all values were weighted to represent the total population of Chinese children and adolescents 7-17 years of age considering sampling weights for each stratification based on the sixth population census data provided by the National Bureau of Statistics. The detection rate varied greatly under different references. The detection rate of high normal blood pressure was ranked from high to low according to the AAP reference(20.15%) &gt; the guideline reference(17.29%) &gt; the industry reference(13.14%) &gt; the international reference(12.66%); the detection rate of high blood pressure in descending order is the guideline reference(24.31%) &gt; the international reference(21.34%) &gt; the AAP reference(20.59%) &gt; the industry reference(19.96%). Although the consistency between the AAP references and international references and our national two references were medium to high, the difference in detection rate obtained by analysis was large. Considering the differences of demographic characteristics in the reference population, caution should be taken when applying foreign references to judge the blood pressure status of children and adolescents in China.

Abnormal blood pressure and pediatric obesity phenotype: Red flags for clinical practice

Background and aimssystolic and diastolic blood pressure values identify different subtypes of Primary Hypertension. In pediatric age, hypertension is often related to obesity. Characterization of an individual's Blood Pressure (BP) status needs multiple measurements in the course of time, but this is rarely the case, principally in everyday pediatrics. Thus, the finding of abnormal BP values even in a single routine check visit should need a special attention. The aim of this study was to evaluate if even a single abnormal measurement could be a marker of metabolic risk, according to clinical and/or metabolic phenotype and subtypes of hypertension in a population of overweight/obese children and adolescents. Methods and resultsWe reviewed data from 489 overweight-obese children and adolescents. BP values were classified according to American Academy of Pediatrics Guidelines (2017). Considering study design, we used the term “Abnormal” instead of “High” BP. Data on lipid profile, glucose metabolism and ultrasonographic pattern of the liver were recorded. Mean age was 9.4 ± 2.5 years: 76.9% had normal BP values. Children with Abnormal BP harbored more frequently an unfavorable metabolic profile. Children with Abnormal Systolic-Diastolic BP values had higher BMI z-score and Waist to Height ratio (p = 0.022 and p = 0.032). Hepatic Steatosis was detected in 4.5%, 14.8 % and 17.6 % of children with normal, abnormal systolic and abnormal systo-diastolic blood pressure, respectively. (p < 0.001). ConclusionIdentification of abnormal BP subtypes even in a single measurement could be useful for identification of specific clinical-metabolic phenotypes allowing an individual targeted management of obesity-related comorbidities.

Triad of benign fleck retina with keratoconus with myopia – A rare case report

A 24-year-old male presented with a complaint of frequent change of glasses in both eyes. His best corrected visual acuity was 20/20 OD and 20/30 OS with a correction of − 6 DS/−3.75 DC @ 50° and − 4.5 DS/−3.25 DC @140°, respectively. Anterior-segment examination revealed a thin steep cornea with normal intraocular pressure in both eyes. Dilated fundus examination showed multiple yellow-white flecked lesions involving the entire fundus but sparing the fovea with pigmented lattices in both eyes. The flecks appeared as localized elevation at the RPE-Bruch’s membrane complex on optical coherence tomography. Corneal topography was suggestive of keratoconus. Examination of his family members did not reveal any abnormalities. Electroretinogram (ERG), electrooculogram, and color vision testing in both eyes were normal. The diagnosis of benign fleck retina with myopia with keratoconus was made. ERG helps distinguish benign familial fleck retina from other flecked retina syndromes to educate the patient about their visual prognosis. To the best of our knowledge, no such case has been reported in Indian literature till now.

Myelomeningocele operated in utero and the incontinent bladder pattern: Mid-term follow up of a prospective study

In-utero myelomeningocele repair is the gold standard treatment after the publication of the MOMS trial. We have performed a retrospective analysis from our prospective in-utero myelomeningocele closure database (started in 2011), and selected only patients with the incontinent bladder pattern according to the Leal da Cruz categorization (Leal da Cruz, etal. J Urol 2015) to review mid-term clinical outcomes. We identified 30 patients with leaking pressure under 40 cmH20 (incontinent pattern) at first urodynamic evaluation (UE) from the whole cohort of 129 patients who underwent in-utero myelomeningocele closure. We selected patients with a minimum active follow-up of 48 weeks (4 years) to provide mid-term data. Patients were followed according to the same protocol with the proposal of yearly sonogram and UE. All clinical and radiological data were reviewed. We found 11 patients, with a mean age of 10.2 years old, median age at diagnosis of 19 weeks, surgery performed at 25.6 weeks and birth at 33.2 weeks. The mean follow-up was 81.73 months (6.81 years). Mean age at first urological evaluation was 5 months, and UE was 5.6 months. Febrile UTI incidence in the whole observation period was 27.3%. The average initial DLPP was 30 cmH2O. 71.4% of the patients had bladder capacity less than 50% of the expected age. Bladder compliance could not be determined in 63.7% of cases due to leakage. A total of 5.7 urodynamic studies per patient were performed. Surgery was recommended for 8 patients and done in 4 (36.3%). Surgery consisted of Macedo catheterizable reservoir and Macedo-Malone ACE, associated with urethral sling (2 patients) and bladder neck closure (2). It took an average of 5 UE before the final surgical decision was confirmed. Last urodynamic study showed persistent leakage and low DLPP in 3 patients, normal bladder pressure in 2 (under CIC and anticholinergics), and 1 patient changed his bladder pattern into a high risk group. All operated patients are fully continent (urinary >4hs) and fecal. Despite initially presenting a low risk for the most patients, we found surgery in 36.3% (4/11) and if we considered all cases with surgery indication proposed to treat urinary incontinence it would be even higher (72.7%).

Coinherited Hemoglobin Lansing-Ramathibodi/Southeast Asian Deletional α0-thalassemia and Hemoglobin E Causing Falsely Low Oxygen Saturation on Pulse Oximetry

OBJECTIVE Hemoglobin (Hb) variants resulting from mutations in globin genes and leading to qualitative abnormalities of globin proteins can result in a spectrum of clinical presentations. Herein we describe a case of a 10-year-old boy with an Hb variant, Hb Lansing-Ramathibodi (HBA1:c.264C&gt;G, codon 87 His&gt;Gln), who was incidentally found to have low pulse oximetry oxygen saturation readings (low SpO2). Laboratory investigations revealed mild microcytic anemia. Arterial blood gas showed normal partial pressure of oxygen (PaO2) and arterial oxygen saturation (SpO2) values, indicating an oxygen saturation gap. Subsequent Hb analysis identified an abnormal peak, prompting further molecular studies which confirmed the coinheritance of Hb Lansing-Ramathibodi, Southeast Asian deletional α0-thalassemia and the Hb E trait. The patient’s mother, carrying the Hb Lansing-Ramathibodi and Hb E traits without Southeast Asian deletional α 0-thalassemia, was asymptomatic. This case underscores the importance of identifying and characterizing rare Hb variants presenting with an oxygen saturation gap for informed clinical management and genetic counseling. KEYWORDS alpha-thalassemia, coinheritance, hemoglobin Lansing- Ramathibodi, low SpO2, oxygen saturation

Fecal incontinence patients categorized based on anal pressure and electromyography: Anal sphincter damage and clinical symptoms.

Disruption of external anal sphincter muscle (EAS) is an important factor in the multifactorial etiology of fecal incontinence (FI). We categorize FI patients into four groups based on the location of lesion in neuromuscular circuitry of EAS to determine if there are differences with regards to fecal incontinence symptoms severity (FISI) score, age, BMI, obstetrical history, and anal sphincter muscle damage. Female patients (151) without any neurological symptoms, who had undergone high-resolution manometry, anal sphincter EMG, and 3D ultrasound imaging of the anal sphincter were assessed. Patients were categorized into four groups: Group 1 (normal)-normal cough EMG (>10 μV), normal squeeze EMG (>10 μV), and normal anal squeeze pressure (>124 mmHg); Group 2 (cortical apraxia, i.e., poor cortical activation)-normal cough EMG, low squeeze EMG, and low anal squeeze pressure; Group 3 (muscle damage)-normal cough EMG, normal squeeze EMG, and low anal squeeze pressure; and Group 4 (pudendal nerve damage)-low cough EMG, low squeeze EMG, and low anal squeeze pressure. The four patient groups were not different with regards to the patient's age, BMI, parity, and FISI scores. 3D ultrasound images of the anal sphincter complex revealed significant damage to the internal anal sphincter, external anal sphincter, and puborectalis muscles in all four groups. The FI patients are a heterogeneous group; majority of these patients have significant damage to the muscles of the anal sphincter complex. Whether biofeedback therapy response is different among different patient groups requires study.

Relationship Between the High Blood Pressure and Cholesterol in the Women

Blood pressure that is higher than customer is point out to as high blood pressure, or hypertension. Women in their 20s, 30s, 40s, and 50s can have high blood pressure; however, the risk increases with age. Exercise on a regular basis has been suggested as a key behavior in blood pressure control. . when controlling blood pressure regulation, it aids in preventing harm to the kidneys, eyes, brain, blood vessels, and heart .usually the patients unable to feel elevated blood pressure, the warning indicators Hot flashes are fluid retention, headaches, impaired vision, low energy, fatigue, and chest pain are a few of them. Objective: The purpose of this study was to compare the blood pressure levels of women with high cholesterol of those women to the women has normal cholesterol and blood pressure. Methods: The women patients hospitalized to the hospital over a three-month period (December 2023 to February 2024) were 60 women have high level of cholesterol and 30 healthy women. The case data for every patient was gathered and documented. Samples for the lab were collected following a 12-hour fast. The measured Total Cholesterol , triglycerides , high-density lipoprotein cholesterol (HDL-c), low density lipoprotein (LDL), systolic and diastolic blood pressure (SBP and DBP). To examine how blood pressure is impacted on the levels of triglycerides and total cholesterol. Results: This result suggests that the women's age had a substantial and powerful impact on their blood pressure, blood cholesterol, low levels of physical activity, and hormonal changes, in that order. According to this study, women patients had higher blood pressure and LDL cholesterol levels than healthy controls, but their HDL cholesterol levels were lower. These findings put the patients at higher risk of coronary heart disease (CHD).

Synoptic-Scale Meteorological Patterns Associated with Heavy Rainfall in the Minnesota Region

Abstract Situated in the Upper Midwest, Minnesota’s midcontinental location places it in a climate transition zone between eastern U.S. humid conditions and western semiarid conditions as well as between warm, moist air from the Gulf of Mexico to the south and drier, polar air to the north. Potential adverse impacts on ecosystems due to changing climate and precipitation patterns, together with ongoing flash flooding risks, indicate that heavy rainfall occurrence and distribution are important considerations for Minnesota. This research used ERA5 reanalysis data with 0.25° grid spacing during May–September 1959–2021 to investigate the synoptic-scale drivers of Minnesota heavy rainfall. The study utilized a neural network, self-organizing map (SOM) technique to identify sea level pressure patterns and precipitation patterns associated with heavy rainfall and used composite analysis to explore the relationships between synoptic-scale conditions and environmental parameters during heavy rain hours. Six sea level pressure patterns were identified, three of which represented advancing surface cyclones and accounted for &gt;70% of the heavy rain hours. The spatial distribution of heavy rainfall was represented by six precipitation patterns. The greatest frequency of heavy rain hours was associated with the northwest precipitation pattern, followed by the southwest and southeast patterns. Analysis of the frequency of pressure and heavy rain precipitation pattern pairs revealed that the top five most frequent pairs were associated with advancing surface cyclones and &gt;26% of the total heavy rain hours. Composite analysis of environmental parameters showed that favorable conditions related to moisture and lift were associated with heavy rainfall.

A Numerical Study of Tropical Cyclone and Ocean Responses to Air‐Sea Momentum Flux at High Winds

AbstractThe relationship between minimum sea level pressure (MSLP) and maximum wind speed, is a commonly employed metric for assessing tropical cyclone (TC) forecast skill. However, accurately reproducing this relationship in TC forecasts is challenging. By introducing a new air‐sea momentum flux scheme considering both wave state and saturation (decrease) effect at high winds into a fully coupled atmosphere‐ocean‐wave model, our numerical results reveal that the maximum wind speed and MSLP respond oppositely to the air‐sea momentum flux change. The simulated wind‐pressure relationship aligns well with observations when the new flux scheme is used. This study highlights the large sensitivity of wind‐pressure relationship to the air‐sea momentum flux parameterization at high winds. Furthermore, the air‐sea momentum flux has a significant effect on ocean wave characteristics and sea surface temperature (SST) cooling in TC simulations.

Asian summer monsoon responses under RCP4.5 and RCP8.5 scenarios in CESM large ensemble simulations

The response of the Asian Summer Monsoon (ASM) circulation to the Representative Concentration Pathway 4.5 and 8.5 (RCP4.5 and RCP8.5) forcing scenarios is examined using the CESM1 state-of-the-art global circulation model from 2021 to 2050. The projections show that monsoon precipitation will increase over East Asia, the North Pacific Ocean, the Indian Peninsula, and the Bay of Bengal under the RCP4.5 scenario. Conversely, the South Indian Ocean, West Asia, the Middle East, and the Central Pacific Ocean exhibit a decreasing trend in precipitation. Under the RCP8.5 scenario, precipitation is projected to increase over a wider swath of the Indian Ocean and the Middle East Asia. In the RCP4.5 scenario, the low-level wind circulation is likely to strengthen over the entire northern Indian Ocean, extending to the South China Sea, thereby increasing moisture transport from the Indian Ocean to peninsular India and the South China Sea. Conversely, in the RCP8.5 scenario, easterly winds strengthen over the South Indian Ocean, leading to an increase in moisture transport from the equatorial West Pacific Ocean to the Indian Ocean. A weak (strong) cyclonic circulation in response to the east-centered (west-centered) low sea level pressure trend over the North Pacific in RCP4.5 (RCP8.5) scenario is projected to help maintaining a strong (weak) ASM circulation from the India to east Asia. Internal climate variability is also calculated, revealing that the North Pacific Ocean near the Bering Sea is likely to play a dominating role and contribute significantly to the future ASM dynamics. In both scenarios, internal variability is found to substantially contribute to changes in monsoon circulation over the Indian Ocean.

Integrated Barometric Pressure Sensors on Legged Robots for Enhanced Tactile Exploration of Edges

Integrated Barometric Pressure Sensors on Legged Robots for Enhanced Tactile Exploration of Edges