Fuzzy Multi-Regional Fractional PID controller for Pressurized Water nuclear Reactor

The paper presents the methodology for the synthesis of a Fuzzy Multi-Regional Fractional Order PID controller (FMR-FOPID) used to control the average thermal power of a PWR nuclear reactor in the load following mode. The controller utilizes a set of FOPID controllers and the fuzzy logic Takagi-Sugeno reasoning system. The proposed methodology is based on two optimization parts. The first part is devoted to finding the optimal parameters of local FOPID controllers and in the second part, the optimal membership functions of the fuzzy reasoning system are designed. During the controller designing and comparison phase, the two validated nodal models of a nuclear reactor are used, simplified model and extended model respectively. The proposed approach has been verified by computer simulations that confirm its effectiveness.

The effects of CD4 nadirs on vessel stiffness in HIV patients undergoing antiretroviral therapy

BACKGROUND

There are many factors associated with human immunodeficiency virus (HIV) patients having a greater risk of cardiovascular diseases (CVD). HIV damages vessel endothelium through chronic inflammation, which, combined with dys-lipidaemia, arterial hypertension, and antiretroviral therapy leads to the progression of atherosclerotic changes.

AIM

Our goal was to determine if a CD4 nadir along with immunological, inflammatory, biochemical, and metabolic mark-ers can be associated with higher vessel stiffness and therefore an increased risk of CVD in patients undergoing antiretroviral therapy for HIV.

METHODS

Endothelial damage was evaluated in 20 patients (including four female) during successful antiretroviral therapy. We assessed the endothelial stiffness by recording the reactive hyperaemia of peripheral arteries using an Endo-PAT2000 (ITAMAR®) device. This device allowed us to measure the arterial tonometry and to determine the augmentation index for a pulse rate of 75/min (AI@75). We set the normal value for vessel stiffness at reactive hyperaemia index (RHI) > 1.67, as recommended by the manufacturer. Additionally, we recorded the length of antiretroviral therapy, number of CD4 lymphocytes, CD4 nadir, HIV viremia, and biochemical and immunologic results. Finally, we compared patients with normal and dysfunctional endothelium.

RESULTS

The only parameter significantly differentiating between the group with and group without endothelium dysfunction was platelet count (p = 0.012).

CONCLUSIONS

We were not able to confirm the significance of a CD4 nadir in the progression of endothelial stiffness in HIV patients. However, platelet values could be an important complementary marker for assessing the risk for CVD amongst HIV patients undergoing antiretroviral treatment.

Prevalence of Erectile Dysfunction in Atrial Fibrillation Patients: A Cross-Sectional, Epidemiological Study

BACKGROUND

Sexual dysfunctions, especially erectile dysfunction (ED), are a major problem in cardiovascular patients. They are caused by cardiovascular risk factors including low-grade inflammation process, endothelial dysfunction, oxidative stress, and hemodynamic and vascular alterations. The same mechanisms are some of the main causes and/or consequences of atrial fibrillation (AF). To this day, literature provides no cross-sectional data on the prevalence of sexual dysfunction in AF. The study aimed to determine the prevalence of sexual dysfunction in consecutive, young male patients with AF.

MATERIAL AND METHODS

A cross-sectional survey of adult male patients with a primary diagnosis of AF was conducted at University Cardiology Departments, during the period of July 2013 to July 2014. During the enrollment process, the study participants were either electively hospitalized with a primary diagnosis of AF, or had a scheduled outpatient visit. Sexual dysfunctions were assessed using the International Index of Erectile Function.

RESULTS

A total of 129 consecutive AF patients (mean age 57.0 ± 11.8 years) were analyzed. Hypertension was present in 60.5%, diabetes in 22.5% of patients, 46.5% had dyslipidemia, 18.6% were current smokers, and 45.7% had a family history of cardiovascular disease. At least one kind of sexual dysfunction was found in 86.8% of patients. ED was present in 57.4% of patients, 44.2% of patients had orgasmic dysfunction, 69.0% had lowered sexual desire, 65.1% had lowered intercourse satisfaction, and 55.8% had lowered overall satisfaction.

CONCLUSIONS

Sexual dysfunctions are highly prevalent in AF patients and are not only limited to ED, but also include dysfunction of orgasmic function, desire, or general satisfaction. In part, the presence of the sexual dysfunctions is probably caused by classical cardiovascular risk factors highly prevalent in AF patients, but the impact of AF itself cannot be underestimated.

Evaluation of endothelial function and arterial stiffness in HIV-infected patients: a pilot study

BACKGROUND

In the era of combination antiretroviral therapy (cART), life expectancy of HIV-infected patients is the same as that of the general population, resulting in increasing prevalence of cardiovascular disease in this patient group.

AIM

To assess the prevalence of endothelial dysfunction in HIV-infected patients and to identify factors which affect endothelial function and arterial stiffness.

METHODS

Thirty-seven adult HIV-infected patients, regardless of the fact and the type of cART, were enrolled into the study. In patient, reactive hyperaemia peripheral arterial tonometry assessment was performed using the Endo-PAT2000 device (ITAMAR®). This method allows evaluation of endothelial function ant arterial stiffness.

RESULTS

Final analysis included 37 patients (median age 38 years, range 32-45 years), including 89.2% men. Endothelial dysfunction was found in 13 (35.1%) HIV-infected patients. We found no differences in demographic and clinical characteristics, laboratory data, and cardiovascular drug therapy between patients with or without endothelial dysfunction, except for platelet count which was higher in patients with endothelial dysfunction (174 [119-193] × 10³/mm3 vs. 222 [168-266] × 10³/mm³, p = 0.03). No demographic or clinical variables were identified as predictors of endothelial dysfunction in HIV-infected patients. In addition, no association was found between factors related to HIV infection, chronic drug therapy and the risk of endothelial dysfunction. Statistically significant correlations were found between arterial stiffness and age (rs = 0.53, p < 0.001), red blood cell count (rs = -0.39, p = 0.018), and platelet count (rs = 0.42, p = 0.009). CD4+ and CD8+ lymphocyte count and viral load were similar in patients with or without endothelial dysfunction. Arterial stiffness was significantly higher in patients with higher viral load (rs = -0.39, p = 0.0018) and in those with established AIDS (9.5 [1.0-16.0] vs. -5 [-10-5], p = 0.009). cART had no effect on endothelial dysfunction, while arterial stiffness was higher in patients treated with cART (10 [0-15] vs. -5 [-10-3], p = 0.014).

CONCLUSIONS

Endothelial dysfunction is common in HIV-infected patients. In general, none of the analysed factors had an effect on endothelial function but cART had a negative effect on arterial stiffness.

The prevalence of sexual dysfunction before myocardial infarction in population of Polish men: a retrospective pilot study

BACKGROUND AND AIM

To assess the frequency of sexual dysfunction in men before myocardial infarction (MI).

METHODS

Sixty-two men with cardiovascular disease risk factors who were admitted to the hospital because of a first MI, were asked to fill the IIEF-15 questionnaire to assess sexual dysfunction before MI.

RESULTS

Erectile dysfunction (ED), decreased orgasmic function, decreased sexual desire, decreased intercourse satisfaction, and decreased overall satisfaction were reported by 51.6%, 14.5%, 50%, 69.4%, and 48.4% of men, respectively. Men with ED had significantly higher serum C-reactive protein (CRP) levels than men without ED (5.8 mg/L, 95% confidence interval [CI] 8.3-21.7) vs. 4.6 mg/L, 95% CI 3.0-11.3; p = 0.01). Men with decreased orgasmic function had significantly higher serum triglyceride levels (259.5 mg/dL, 95% CI 176.9-362.1 vs. 150 mg/dL, 95% CI 146.8-187.4; p = 0.01), and men with normal sexual desire had significantly higher serum high-density lipoprotein (HDL) cholesterol levels than men with decreased sexual desire (41 mg/dL, 95% CI 39.9-47.8 vs. 36 mg/dL, 95% CI 34.1-40.5; p = 0.01). Men with decreased sexual desire had significantly higher serum CRP levels (7 mg/L, 95% CI 7.7-21.4 vs. 5 mg/L, 95% CI 3.6-12.1; p = 0.03).

CONCLUSIONS

1. ED was present in more than half of men before MI and it may be the first symptom of coronary artery disease. 2. Men with ED and decreased sexual desire have higher serum CRP levels in the acute peri-infarction period. 3. Serum triglyceride level is a factor that significantly affects orgasmic function, and serum HDL cholesterol level is a factor that significantly affects sexual desire.

Clinical characteristics, aetiology and occurrence of type 2 acute myocardial infarction

BACKGROUND

Cardiovascular diseases are the leading cause of death worldwide. One of the most important diseases in this group is myocardial infarction (MI). According to the universal definition developed by the European Society of Cardiology (ESC), MI is divided into five main types based on its cause. Type 2 MI is secondary to ischaemia due to either increased demand or decreased supply of oxygen (for example due to coronary artery spasm, anaemia, arrhythmia, coronary embolism, hypertension, or hypotension).

AIM

To assess the occurrence and aetiology of type 2 acute MI (AMI), and to describe the clinical characteristics and prognosis of study patients.

METHODS

Into a retrospective study, we enrolled 2,882 patients in the Cardiology Department with an initial diagnosis of AMI between 2009 and 2012. Diagnosis of AMI was made based on ESC criteria. In all patients, coronary angiography was performed in order to exclude haemodynamically significant coronary lesions.

RESULTS

Among 2,882 patients hospitalised in the described time period, 58 (2%) patients were diagnosed with type 2 AMI.The mean age of the study group was 67.3 ± 13.2 years; and the majority of the study group, 60.3%, were women. Out of them, 23 (39.6%) patients experienced AMI due to coronary artery spasm, 15 (25.9%) due to arrhythmias, 11 (19%) due to severe anaemia, and nine (15.5%) due to hypertension, without significant coronary artery disease. 42 (72.4%) patients, were diagnosed as non-ST-segment elevation MI, 14 (24.1%) as ST-segment elevation MI, and two (3.5%) as AMI in the presence of ventricular paced rhythm. History of classical cardiovascular risk factors including hypertension, diabetes, dyslipidaemia, family history of heart diseases, and smoking was reported in 42 (72.4%), 14 (24.1%), 23 (39.7%), 24 (41.4%), and 16 (27.6%) cases, respectively. All-cause 30-day mortality rate was 5.2%, and six-month was 6.9%.

CONCLUSIONS

Type 2 AMI patients were more often female, and they were more often diagnosed as non-ST-segment elevation MI. The prevalence of classical cardiovascular risk factors in this subgroup of patients was very high. The leading cause of AMI was coronary artery spasm.

Obstructive sleep apnea, atrial fibrillation, and erectile dysfunction: are they only coexisting conditions or a new clinical syndrome? The concept of the OSAFED syndrome

Patients rarely suffer from only 1 disease. Most of them have several conditions with common risk factors and etiology, and which often increase the severity of each other. The phenotypes linked to 1 condition are often linked to many others. We describe 3 patients with obstructive sleep apnea (OSA), atrial fibrillation (AF), and erectile dysfunction (ED), all of which are highly prevalent in the general population. OSA is one of the most common sleep disorders, affecting approximately 24% of men and 9% of women between 30 and 60 years of age. AF is one of the most common arrhythmias, present in approximately 2% of the population, and erectile dysfunction can be found in 18% to 40% of the male population older than 20 years. The presence of these 3 conditions in the same patient may be not only a coincidence but rather a new clinical syndrome. We present data which allow one to consider OSA, AF, and ED as parts of a clinical syndrome: OSAFED (obstructive sleep apnea, atrial fibrillation, and erectile dysfunction), with a larger effect on the cardiovascular risk profile than those 3 conditions taken alone. Introducing the OSAFED acronym into everyday clinical practice would have the tremendous advantage of reminding health care workers to screen every patient with either OSA, AF, or ED for the remaining 2 diseases. This would result in an early diagnosis and break the vicious circle of mutual disease exacerbation.

Long QT interval in a patient after out-of-hospital cardiac arrest with hypocalcaemia, undergoing therapeutic hypothermia

A 53-year-old woman was hospitalized after out-of-hospital cardiac arrest due to ventricular fibrillation. Initial electrocardioagram showed sinus rhythm of 117 beats per minute, 452 ms QTc interval, ST-segment depression up to 1 mm in V(2)-V(6), and ST-elevation in lead aVR. Patient was treated with primary coronary angioplasty and therapeutic hypothermia, during which QTc interval prolonged up to 616 ms and Osborn wave was seen in lead V(4), along with elevation of ST-segment in I, II, III, aVF, V(5) and V(6); negative T waves in I, II, aVL, aVF, and V(2)-V(6). Laboratory test results showed hypocalcaemia. After rewarming and ion correction QT abnormalities resolved.

[Sexual dysfunction in men in the first 9 months after myocardial infarction]

OBJECTIVES

The aim of the study is to assess the frequency of sexual dysfunction in men after myocardial infarction (MI).

METHODS

62 men were asked to fill IIEF 15 to assess sexual dysfunction 3 and 9 months after MI. RESULTS. Erectile dysfunction (ED), orgasmic dysfunction, decreased sexual desire, decreased intercourse satisfaction, decreased overall satisfaction were recognized respectively by: 61.3%, 24.2%, 62.9%, 71%, 54.8% of men 3 months after MI, and 51.6%, 17.7%, 58.1%, 77.4%, 59.7% of men 9 months after MI. Men with ED had higher serum CRP (5.8 vs. 3.8; p = 0.04) and creatinine (1 vs. 0.9; p = 0.04) levels in the peri-infarction period and higher serum BNP (47.4 vs. 24.6; p = 0.04) measured 3 months after MI than men without ED. They had also higher serum testosterone levels than men without ED (12.6 vs. 10.6; p = 0.03). Men with decreased sexual desire had significantly lower serum DHEAs (dehydroepiandrosterone sulfate) levels in the peri-infarction period than men with normal sexual desire (191.1 vs. 224.3; p = 0.044). Men with ED 9 months after MI had higher serum CRP levels in the peri-infarction period (7.5 vs. 4.6; p = 0.0371). Men with orgasmic dysfunction had lower left ventricular ejection fraction (EF) measured in the peri-infarction period (0.4 vs. 0.5; p = 0.0318).

CONCLUSIONS

1. Men with ED have higher serum CRP and creatinine levels in the peri-infarction period. 2. DHEAs level has an influence on sexual desire and on erectile function after MI. 3. BNP level in post-MI patients affects erectile function. 4. EF has an impact on orgasmic function.

Low temperature induced defence gene expression in winter wheat in relation to resistance to snow moulds and other wheat diseases

Cold hardening of winter wheat at 2 °C for 1-6 wks increased resistance to the snow mould pathogens LTB, Typhula incarnata, and Microdochium nivale as well as to powdery mildew (Blumaria graminis f. sp. graminis) and stripe rust (Puccinia striiformis). Using microarrays and hardening of winter wheat for 0.25, 0.5, 1, 7, 21 and 49 d, an upregulation of a wide range of stress-response genes that include defence-related and abiotic stress-related genes, transcription factors including several lipoxygenases and ethylene responsive factors, and WRKY genes was observed. For the majority of these genes, the upregulation occurred later in the 21-49 d hardening treatments and coincided with the highest expression levels of snow mould resistance. Defence-related sequences were upregulated to a greater extent and were more numerous in the snow mould resistant line CI14106 compared to cold hardy DH+268. Transcript profiling of candidate defence and other stress-related genes under prolonged conditions at -3 °C with or without snow mould infection showed that there was a decline in transcripts of the defence-related genes PR1.1b and NPR3 during the 12wks incubation. Additionally, 14 d hardening was insufficient to permit full expression of the jasmonic acid synthesis gene, allene oxide synthase (AOS) and the fructan degrading enzyme β-fructofuranosidase compared the 42 d hardening treatment. The snow mould resistant line CI14106 was able to maintain higher transcript levels of AOS for longer conditions compared to the susceptible line Norstar under artificial snow mould conditions. These results explain the nature of cold-induced resistance to snow moulds and provide direction on establishing selection criteria for improving resistance and cold tolerance in winter wheat.

[Cardiac tamponade as the initial symptom of lung cancer]

We report a case of a 55 year-old woman in whom cardiac tamponade was first symptom of lung cancer. The pericardium is involved in about 12% of patients with malignant disease. Cardiac tamponade is life-threatening situation. In our case diagnosis was made on clinical symptoms and echocardiography. Only urgent pericardiocentesis performed under echocardiograhic guidance can save patient's life. In described case final diagnosis was made on histological examination. We should take into the consideration lung cancer in differentiation causes of cardiac tamponade.

Development of a PCR marker for rapid identification of the Bt-10 gene for common bunt resistance in wheat

In western Canada, the Bt-10 resistance gene in wheat (Triticum aestivum) is effective against all the known races of common bunt caused by Tilletia tritici and T laevis. The genotypes of 199 F2 plants, originated from a cross between BW553 containing Bt-10 and the susceptible spring wheat cultivar 'Neepawa,' were established in greenhouse and field inoculation studies. A ratio of 1:2:1 resistant : heterozygous : susceptible was observed for bunt reaction, indicating that Bt-10 was expressed in a partially dominant fashion. A polymorphic DNA fragment, amplified using RAPD, and previously shown to be linked to Bt-10 was sequenced and SCAR (sequence characterized amplified region) primers devised. However, SCAR primers failed to amplify the polymorphic fragment. Restriction of PCR products with DraI revealed a polymorphic fragment of 490 bp resulting from a single base pair difference between lines possessing Bt-10 and those lacking the gene. As per the base pair difference, FSD and RSA primers were designed to generate a 275-bp polymorphic DNA fragment. Both 275- and 490-bp polymorphic fragments were present in all of the 22 cultivars known to carry Bt-10, and absent in all 16 cultivars lacking Bt-10. A 3:1 ratio was observed for presence: absence of the 275-bp marker in the F2 population. Using Southern analysis, the 490-bp fragment was effective in differentiating homozygous resistant plants from those heterozygous for Bt-10, based on its presence and the hybridization signal strength. A 1:2:1 resistant : heterozygous : susceptible ratio was also observed for the molecular marker and corresponded to 88% of the phenotypes deduced from the original F2 population. The molecular marker was estimated to be between 1.1 cM and 6.5 cM away from the Bt-10 resistance gene, based on the segregation analysis. Segregation analyses of Bt-10 and the 275-bp marker, evaluated in three different Canada Prairie Spring (CPS) wheat populations, demonstrated a segregation ratio of 3:1 for the molecular marker in two of the populations. These results demonstrated that the PCR marker system using the FSD and RSA primer pair permitted a rapid and reliable identification of individual lines carrying the Bt-10 gene for resistance to common bunt.

Siderophore activity in Rhizobium species isolated from different legumes

Rhizobium strains isolated from nodules of the different legumes including wild-growing plants were examined for their siderophore activity. Fifteen of the 84 screened rhizobial strains were able to grow under conditions of limited iron supply. Nine of them gave orange halos in the assay with Chrom azurol S. Among these strains were Rhizobium sp. (Ononis) and Rhizobium (Genista), producing hydroxamates and phenolates. These compounds could promote the growth of siderophore-negative bacteria on iron-deficient media. The results imply that the hydroxamates from G1 and O1 strains may belong to the monohydroxamate class of siderophores.