Early Identification of Unbalanced Freight Traffic Loads Based on Wayside Monitoring and Artificial Intelligence

The identification of instability problems in freight trains circulation such as unbalanced loads is of particular importance for railways management companies and operators. The early detection of unbalanced loads prevents significant damages that may cause service interruptions or derailments with high financial costs. This study aims to develop a methodology capable of automatically identifying unbalanced vertical loads considering the limits proposed by the reference guidelines. The research relies on a 3D numerical simulation of the train-track dynamic response to the presence of longitudinal and transverse scenarios of unbalanced vertical loads and resorting to a virtual wayside monitoring system. This methodology is based on measured data from accelerometers and strain gauges installed on the rail and involves the following steps: (i) feature extraction, (ii) features normalization based on a latent variable method, (iii) data fusion, and (iv) feature discrimination based on an outlier and a cluster analysis. Regarding feature extraction, the performance of ARX and PCA models is compared. The results prove that the methodology is able to accurately detect and classify longitudinal and transverse unbalanced loads with a reduced number of sensors.

Modeling aortic stenosis progression: impact on follow-up, treatment and survival

Background

Aortic stenosis (AS) is one of the main valvular heart diseases in developed countries. Degenerative fibrocalcific aortic stenosis is a progressive disease of the valve and ultimately of the myocardium, which can be fatal when symptomatic. There is no medical treatment that can halt or delay its progression. AS does not evolve linearly over time, and not every patient has the same progression rate.

Aims

The aim of this study is to 1) compare different mathematical models of aortic stenosis progression, 2) cluster patients into rapid and slow progressors and explore possible predictors, 4) evaluate the impact of different progression rates on cardiac structure and function, and 5) evaluate survival and optimal timing for follow-up and treatment.

Methods

We retrospectively studied consecutive patients with aortic peak velocities from 2012 to 2020. Follow-up echocardiograms, seriated biomarker assessment, and clinical records were consulted, providing a multiparametric data frame for longitudinal and dynamic modeling of aortic stenosis progression and its consequences.

Results

This study included 9583 studies from 752 patients with a median total follow-up of 4.26 years (interquartile range: 1.28 to 7.24 years). A logistic model was selected with the best accuracy to predict the rate of AS progression. Patients were categorized into slow and rapid progressors in a ratio of 5:1. Multiparametric analysis showed no association between these profiles and clinical variables. However, anti-hypertensive drugs before and after adjustment for blood pressure control (Calcium Channel Blockers, p=0.013, OR 0.50) were associated with slower progression. Meanwhile, elevated inflammatory markers (erythrocyte sedimentation rate, p=0.01) were associated with faster AS progression. Despite no survival difference between these groups, higher rates of valvular intervention were registered in rapid progressors (p<0.001). Moreover, faster progressors were associated with earlier cardiac damage (as demonstrated by early onset of moderate mitral and tricuspid valve regurgitation, left auricle dilation, and left ventricle hypertrophy, p<0.05).

Conclusions

These results can potentially modify follow-up times and deliver more personalized and individualized health care to different AS patients, thereby optimizing resources.

Funding Acknowledgement

Type of funding sources: None.

The gut microbiota profile in psoriasis: a Brazilian case-control study

The pathogenesis of psoriasis, an immune-mediated chronic inflammatory skin disease, remains unclear. Studies have shown an association between psoriasis and intestinal inflammation; in this context, the influence of the gut microbiota on the immune response of psoriasis has become a focus of recent research. The present research evaluated the composition and diversity of the gut microbiota of 21 participants with psoriasis from a Brazilian referral dermatology service compared to 24 healthy controls. A stool sample was collected from each participant at the time of inclusion in the study, and the samples were analysed by sequencing the 16S rRNA gene. The recruitment of research participants involved matching between groups by sex, age, body mass index, comorbidities and smoking and the exclusion of several criteria that could potentially influence the gut microbiota and the interpretation of the data. There was an increase in the Dialister genus and Prevotella copri species in patients with psoriasis compared to the control group. A reduction in the Ruminococcus, Lachnospira and Blautia genera, as well as in the Akkermansia muciniphila species, was also verified in the psoriasis group compared to the control group. Furthermore, patients with psoriasis exhibited less gut microbiota diversity than controls.

Measurement of the lamella thickness during droplet impact onto differently wettable smooth surfaces using an extension of the LASER Pattern Shift Method with naturally occurring patterns

This study shows that the LASER Pattern Shift Method (LPSM) is a powerful measurement technique for film thickness measurements. In this paper, the approach of the LPSM is extended, which is now able to measure the lamella thickness during droplet impacts on smooth surfaces using the naturally occurring air bubble shadows. With the help of this rather new measurement technique, the influence of different experimental parameters on the lamella thickness could be systematically assessed, e.g., the influence of impact velocity, liquid properties, and surface wettability. Upon comparing the obtained results to an analytical correlation in the literature, good agreement could be found for its validity range.

Cross-cultural adaptation and validation of the VISA-P questionnaire for Portuguese-speaking (Portugal) patients with patellar tendinopathy

Introduction Patellar tendinopathy is a condition frequently verified in individuals who practice regular physical activity, therefore functional evaluation is crucial to monitor symptoms. The VISA-P was developed for English-speaking population to evaluate patients with this condition, and there is a need to adapt this tool to Portuguese (Portugal).

Objectives To cross-cultural adapt and validate the VISA-P questionnaire for Portuguese-speaking (Portugal) patellar tendinopathy patients

Methodology The VISA-P questionnaire was translated and cross-culturally adapted into Portuguese (VISA-P-Por) according to specific guidelines, using six steps: Translation, synthesis, back translation, expert committee review, pretesting (n = 10), and appraisal of the adaptation process. The resulting VISA-P-Por was then subjected to an analysis of the psychometric properties (construct validity, reproducibility [agreement and reliability], internal consistency and floor and ceiling effects) in 73 patellar tendinopathy patients and 73 asymptomatic people. Participants completed the questionnaire at baseline and after a minimum interval of 48 hours.

Results The Visa-P-Por questionnaire revealed a high level of agreement, presenting semantic and content validity. Construct validity showed differences between both groups (p < 0,001) and the questionnaire exhibited very good internal consistency, with an excellent α Cronbach (0,91). Concerning reproducibility, agreement levels were considered optimal which can be proven by the Bland Altman graph, the standard error of measurement (5,74) and the minimally important change (15,91 points), as well as the excellent ICC value (0,92). There were no ceiling and floor effects detected.

Conclusion The VISA-P-Por questionnaire is a valid and reliable tool, with psychometric properties comparable with the original version. Thus, it can be recommended as a robust tool for measuring clinical severity and functional impact of patellar tendinopathy in Portuguese-speaking (Portugal) patients.

THU0147 CARDIOVASCULAR RISK IN RHEUMATOID ARTHRITIS: DO WE ALREADY HAVE A SENSITIVE AND SPECIFIC INSTRUMENT?

Background:

Rheumatoid Arthritis (RA) is a chronic systemic inflammatory disorder with high cardiovascular (CV) risk due to both classic and specific disease risk factors. According to EULAR’s recommendations, all patients should carry out an assessment of their CV risk, however, there are no specific evaluation algorithm’s for RA.

Objectives:

To assess the efficacy to predict CV risk in RA patients using the Systematic Coronary Risk Evaluation model (SCORE), Modified SCORE (mSCORE), Framingham Risk Score (FRS), Modified Framingham Risk Score (mFRS) and the American College of Cardiology/American Heart Association algorithm (ACC/AHA).

Methods:

Cross-sectional observational study including patients fulfilling 2010 ACR/EULAR classification criteria for RA and followed in the Rheumatology Department at Guarda Local Health Unit. Clinical records were reviewed and sociodemographic, classic CV risk factors and disease related factors, previous history of CV events and current treatment were collected. Individual CV risk was calculated using aforementioned models. Patients were divided in two groups: group 1 (without CV event history) and group 2 (with a history of CV event). Discriminative capacity tests, sensitivity and specificity were asserted and the different models were compared.

Results:

A total of 107 patients were included in the study and 10 suffered a CV event. Of 107 patients, 78% are women, the average age is 55.97± 6,78 and the average body mass index is 26,44± 4,43 kg/m2(Table 1). Models evaluated revealed reasonable discriminative capacity with areas under the curve between 0.73 and 0.88 (Figure 1). Regarding sensitivity and specificity we found that SCORE calculator fail to identified high risk in all patients with a CV event, however it presented a specificity of 94%. Others CV risk calculators showed the following sensitivities and specificities: mSCORE 63%, 88%; ACC/AHA 88%, 84%; FRS 63%, 88%; mFRS 88%, 76%.

Table 1.

Patient characteristics

Patients with RA (N=107)Patients with RA without CVDPatients with RA with CVD (N=10)pAge (years), mean±SD56 ± 6,855,7 ± 6,958,5±5,60,240Female, n(%)83 (77,6)79 (81,4)4 (40)0,003Rheumatoid factor positivity, n(%)36 (37,5)33 (37,9)3 (33,3)0,787Anti-CCP positivity, n (%)34 (37)29 (34,9)5 (55,6)0,226Smoking, n (%)4 (3,7)3 (4,1)1 (10)0,031BMI (weight(Kg)/height(m)2), mean±SD26,4±4,426,2±4,429,7±4,10,040Treatment with statins (%)342890<0,001Figure 1.

Receiver operating characteristic curves of the different risk prediction algorithms

Conclusion:

The five models tested in this study have a relative discriminative capacity. SCORE did not identify any CV event, which may compromise its ability to assess the CV risk in this patients.

The most sensitive and specific model was the ACC/AHA, a very restricted model. When applying the multiplication factor of 1.5 recommended by EULAR, there is an improvement in sensitivity, however the specificity decreases.

This study proves the limitations of CV risk calculators designed for the general population when applied to patients with RA. In conclusion, CV risk assessment is extremely important and there is still no ideal calculator, which is both sensitive and specific, and easily applicable in a clinical context.

References:

[1]Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJL, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2016;76(1):17–28.

Disclosure of Interests:

None declared

3077Load dependency of left ventricular longitudinal strain by 2D-speckle tracking echocardiography: myth or reality?

Background

2D-speckle tracking echocardiography (2D-STE) derived strain measurements has been proposed as a non-invasive measure of myocardial deformation and function. However, the effects of left ventricular (LV) loading conditions on 2D-STE derived LV longitudinal strain (GLS) have not been totally elucidated and the results of some studies regarding the load dependency of GLS are controversial.

Purpose

To characterize the effects of acute load change (preload increase) on LV GLS.

Methods and results

We evaluated the variation of LV GLS by 2D-STE, in response to a preload increasing maneuver (leg lifting maneuver – LLM), in a population of 30 healthy individuals. Clinical, demographic and echocardiographic parameters (including LV longitudinal mechanics obtained with 2D-STE before and after LLM) were described. The population had a mean age of 27±4 years and 73% were women. Increased preload to the heart with LLM was confirmed by an increase in the maximal diameter of the inferior vena cava (16±3.5 vs 22±3.3 mm, p<0.01). No significant changes in left atrial volume, LV ejection volume and LV ejection fraction were observed in response to the LLM. There was a significant variation of global LV GLS (−21.9±2.3 vs −23.2±1.6%, p<0.001, Δ 1.25%, 95% CI 0.5–1.91) – figure. An increase in right ventricular longitudinal function with LLM (TAPSE 22.5±5.4 vs 25.5±0.5 mm, p=0.005, Δ 2.9, 95% CI 0.9–4.8) was also observed.

Conclusion

To our knowledge this is the first study performed to assess the effect of preload increase in GLS using the LLM in healthy individuals. In this study, the absolute LV GLS value increased significantly in response to preload increase (LLM). The dependence of GLS on preload is in accordance with the Frank-Starling Law, in which an increase in preload in a healthy individual lead to an increase in myocardial contractility. These findings suggest that LV GLS is a sensitive parameter for detecting subtle changes in LV longitudinal function.

Demographic, psychological and relationship factors are associated with resource loss among pregnant women

Objectives: This study analysed the association between demographic, psychological and relationship factors and resource loss in pregnant women. Methods: Quantitative descriptive correlational study. Depressive mood, social support, relationship intimacy and resource loss were assessed in a sample of 200 pregnant women recruited from public primary-care clinics. Results: Hierarchical regression showed that being younger, having lower yearly income, and having stronger depressive mood, little relationship intimacy and little satisfaction with social support were the main factors associated with resource loss. Depressive mood accounted for most resource loss after controlling for demographic risk factors. The models show the combined influence of demographic, psychological and relationship factors in shaping resource loss. Conclusions and implications: Depressive mood was a major risk factor for resource loss among pregnant women, whereas social support and relationship intimacy had a protective role. The results highlight the importance of screening for depressive mood and level of resources during routine prenatal care, in order to identify pregnant women at risk of depression. The findings point to interventions that foster patient's emotions to help them protect resources.

Sudden cardiac death: the finish line as a beginning: a true endurance race in a case report

Background

The benefits of exercise are well documented. Intensive exercise for more than 4 h per week is associated with cardiovascular remodelling, including increases in ventricular dimensions, wall thickness, and left ventricular mass. These changes are influenced by sex, ethnicity, and type and duration of exercise. In highly trained endurance athletes, exercise is often associated with electrocardiographic changes at rest.

Case summary

A well-trained endurance athlete underwent cardiac investigation after his 33-year-old brother died while jogging. A resting 12-lead electrocardiogram showed significant first degree atrioventricular block (AVB), and longer monitoring revealed advanced AVB. This led to further testing and exercise restrictions.

Discussion

Although most electrocardiographic changes are related to athletic performance, the distinction between normal variants, often exaggerated by the physiology of the conditioned athlete, and myocardial or electrical disease may be challenging. Athletes should undergo comprehensive cardiovascular evaluation, with management based on these results.

Associação entre estados afetivos negativos e comportamentos sexuais de risco

O presente trabalho teve como objetivo analisar, através da revisão da literatura, a associação entre estados afetivos negativos (e.g., depressão, ansiedade) e comportamentos sexuais de risco. Verificou-se que alguns estudos indicam uma associação entre problemas ao nível da saúde mental e/ou estados afetivos negativos e comportamentos sexuais de risco. Através da revisão da literatura concluiu-se que os estados afetivos negativos como a depressão, a ansiedade, e as experiências traumáticas se encontram associadas com comportamentos sexuais de risco e têm sido alvo de pouca atenção por parte da comunidade científica.    

Predictors of emotional distress in pregnant women: the mediating role of relationship intimacy

Background: Assessment and treatment of emotional distress during pregnancy show that worries during pregnancy and interpersonal relationships with partners are the important factors determining psychological health.Aims: The present study aimed to investigate the impact of worries during pregnancy, relationship intimacy, and marital satisfaction on anxiety, depression, and stress symptoms in pregnant women, as well as to analyse the mediating effect of relationship intimacy between marital satisfaction and emotional distress.Method: During their second and third trimester of pregnancy, 200 Portuguese women were recruited during childbirth preparation consultations and completed the Cambridge Worry Scale (CWS), the Personal Assessment of Intimacy in Relationships Scale (PAIR), the Marital Life Areas Satisfaction Evaluation Scale (MLASES), and the Depression, Anxiety, and Stress Scale (DASS-21).Results: Hierarchical multiple regression analyses showed that being unemployed or on sick leave, being younger, having a history of miscarriage, having more worries during pregnancy, and declaring low-relationship intimacy were the main predictors of emotional distress. Relationship intimacy mediated the relation of marital satisfaction to anxiety and depression symptoms.Conclusions: This study highlights the importance of the worries during pregnancy and relationship intimacy in shaping pregnant women's emotional distress, and identifies both as targets of intervention.

Note: Influence of pH on the Extraction Yield and Functional Properties of Macadamia (Macadamia Integrofolia) Protein Isolates

Three protein isolates from de-fatted macadamia nut kernel flour were prepared by extraction at acidic (pH2.0), neutral (pH7.2 with 0.2M phosphate buffer containing 0.5MNaCl) and alkaline (pH12.0) conditions. Extraction at pH2.0 solubilised nearly 52.0% of the proteins present in defatted macadamia flour, while extraction with buffer (pH7.2) and alkaline pH (12.0) solubilised about 83.0% of proteins. The yield of isoelectrically precipitated protein from acidic extract (pH2.0, isolate A) was about 65.2% and from neutral (isolate B) and alkaline extracts (isolate C) was slightly over 83.0% which accounted for 33.7, 69.1 and 69.4% of the proteins present in defatted flour. The protein content of the isolates was 80.1, 92.1 and 92.0% in A, B and C isolates respectively. The functional properties of these isolates were significantly different. Isolate A presented better solubility at pH below isoelectric pH, isolate C at pH above isoelectric pH and isolate B intermediate solubility at the pH range studied. Isolate B showed best water and oil absorption capacities followed by isolate C and least by isolate A. For each isolate, the emulsifying properties were also significantly different at different pH values.

Peroxisome morphology in pathology

Peroxisomes are remarkably dynamic and versatile organelles that are essential for human health and development. They respond to physiological changes in the cellular environment by adapting their morphology, number, enzyme content and metabolic functions accordingly. With the discovery of the first key peroxisomal morphology proteins, the investigation of peroxisomal shape, distribution and dynamics has become an exciting new field in cell biology and biomedical sciences because of its relation to organelle functionality and its impact on developmental and physiological processes. In this review, we summarize recent findings on peroxisome biology, dynamics and the modulation of peroxisome morphology, especially in mammals. Furthermore, we discuss the roles of peroxisome dynamics and morphology in cell pathology and present recent examples for alterations in peroxisome morphology under disease conditions. Besides defects in the peroxisomal morphology machinery, we also address peroxisome biogenesis disorders, alterations of peroxisome number during carcinogenesis and liver cirrhosis, and morphological alterations of peroxisomes during viral infection.

Benign or malignant? Case report

INTRODUCTION

Necrotizing sialometoplasia (NS) is a disease in which the clinical and sometimes even histological features can be confused with those of a malignant tumor, but which is in fact a self-limited inflammatory lesion of the salivary glands.

CASE REPORT

The authors present a case study of a 43-year-old female patient who came to the ENT Emergency Department with a painful ulcerated lesion of the hard palate. The lesion was 8 days old and had appeared after an abdominoplasty. Given the clinical need to rule out a malignant neoplasm, a biopsy was performed: the histological result was NS.

DISCUSSION/CONCLUSION

The authors make a literature review and stress the importance of differentiating between NS and salivary gland neoplasia. Histology is essential in case of ulcerated neoformation of the oral cavity, to adapt treatment, avoiding unsuitable approaches.

Removal of phosphorus from water using active barriers: Al2O3 immobilized on to polyolefins

Phosphorus is known to contribute to eutrophication of fresh water systems, as generally it is the limiting nutrient controlling algae growth. Laboratory studies were conducted to develop and test active barriers composed of aluminium oxide immobilized on to polyolefins to remove phosphorus from water. For this purpose, flat plates of polyethylene and polyethylene grafted with maleic anhydride were prepared and tested. The adsorption mechanism of phosphorus on to aluminium oxide was described by the Freundlich isotherm. The optimum pH interval for phosphorus removal was between 5.2 and 7.8, which includes the pH of natural waters. The maximum phosphorus removal capacity was around 11.1 microg/cm2 for both active barriers. Both barriers removed more than 90% of phosphorus from a 100 mirog/L solution in a static batch experiment carried out for 90 d. The in situ implementation of the active barriers developed in the present study might be a valuable strategy to sequester phosphate and thus to control eutrophication in natural ecosystems, though further work is required to evaluate possible interferences coming from other substances present in the water.

Small mammals in a fragment and adjacent matrix in southeastern Brazil

Between May 2002 and May 2003, we studied a small mammal community from an Atlantic forest fragment surrounded by a coffee plantation in the municipality of Santa Teresa, Espírito Santo state, Brazil. We obtained a total of 300 captures of 114 individuals belonging to 11 mammal species. Seventy three percent of the species captured in the forest also used the coffee plantation, mainly males (90%) and young (80%) individuals of Marmosops incanus. The exceptionally low recapture rate in the coffee plantation suggests that it functions as a corridor between fragments, rather than as a habitat for these species. Understanding the role of matrix habitat use in fragmented landscapes is an important factor in small mammal conservation, as it asymmetrically affects the rate and mode of individual movements of different species.

Regards Through Adolescence: Comparison Between an Adolescent’s Suicidal Behaviour Consultation and an Adolescence Consultation

The aim of this study is a comparison between two different adolescents’ consultations: NES Consultation, which assists youngsters from 11 to 21 years old with self-destructive behaviours and Adolescence Consultation, which assists adolescents from 13 to 21 years old, without any specific diagnose or psychopathology.

Our sample it is composed of 100 youngsters, 15 males and 35 females from NES C (average age 15.5) and 14 males and 36 females from AC group (average age 15.6).

Data was collected from semi-structure interviews (at the assessment moment) and clinical documentation forms, analysed with SPSS program, through qui-square test (nominal variables).

Major findings: absence of significant differences between youngsters who cut themselves in the two consultations; in reported difficulties category, the hypothesis that there would be significant differences between the two groups was not fully confirm, it figured to be only true for school difficulties sub-category; significant differences found on depressive syndromatic diagnose sub-category; the results on source of reference category showed a significant difference between the groups we studied; the number of adolescents from the AC who have previously had suicidal ideation, although significantly different from NES C, can't be disregard. Inquiring about suicidal ideas and thoughts whenever attending an adolescent in difficulties should be the standard, not the exception, recognizing that we will not be able to bring to an end suicide but listening and understanding the suffering adolescent, we can win some time, and at the meantime, plenty of things can change.

Gonococcal endocarditis: a rare complication of a common disease

This report describes a case of gonococcal endocarditis in a 28 year old male patient with no history of previous valvular heart disease. More cases of gonococcal endocarditis (a rare complication of gonorrhoea) may occur with the increase in the incidence of gonorrhoea and the increase in resistance to ciprofloxacin, which is currently used as the first line agent for the treatment of gonorrhoea in 75% of genitourinary medicine clinics.

Liver transplantation in pigs with small-for-size grafts: effect of portocaval shunt

Small-for-size livers are associated with graft dysfunction, probably due to portal hyperperfusion. Modulation of the recipient portal inflow is a new option in these cases. This article sought to analyze the effect of portocaval shunt in small-for-size liver grafts in pigs. Twelve liver transplants were performed in white pigs. The donors' mean weight was 10 kg and the recipient's mean weight was 34 kg. In all cases a standard technique was utilized. A portocaval shunt was added on the back-table in six cases. One hour after the procedure, the livers were sent for histologic examination. In all six cases without a portocaval shunt, the livers showed hemorrhagic necrosis, which was not observed in any of the six livers with a portocaval shunt. In small-for-size liver grafts in pigs, a portocaval shunt prevents hemorrhagic necrosis.

Extraocular light exposure does not suppress plasma melatonin in humans

Light affects the circadian axis in at least two ways. It can cause the acute suppression of pineal melatonin synthesis, and/or a phase-shift of the circadian oscillator. As recent evidence has suggested that extraocular light exposure may cause phase-shifts of the circadian clock, we have investigated whether suppression of melatonin can be induced by the same type of light exposure. In the first study subjects' eyes were exposed to white light (2250 lux for 30 mins) via a fibre optic cable. As expected, suppression of nighttime plasma melatonin levels (61 +/- 6%) was observed. In the second study, light of the same quality but higher intensity (14,000 or 67,500 lux for 180 mins) was delivered in the same manner to the popliteal region behind the subjects' knees, whilst shielding their eyes. No suppression of plasma melatonin levels (4 +/- 7%) was detected in any of the subjects. Thus, extraocular photoreception, if it exists in mammals, does not affect the suprachiasmatic nucleipineal pathway.