The role of humoral mediators in immunological reactions to streptokinase

Streptokinase is now a commonly administered thrombolytic agent in AMI patients. One of the main disadvantages of its administration is that as a foreign antigen it may provoke hypersensitivity reactions due to previous streptococcal infections, and' pre-existing antibodies may reduce efficacy of treatment. The aim of this study was to look at role of humoral immunity to streptokinase. To this end three areas were studied; 1) Specific anti-streptokinase antibodies .2) Role of complement and 3) Role of the immune complex removal. ELISA's were developed to measure the levels of IgG, IgA, IgM, IgE and neutralising anti-streptokinase antibodies in a noraial population. Only a small proportion of the normal individuals had elevated levels of anti-streptokinase antibodies (IgG 1.68%, IgA 2.7%, IgM 9.9% and neutralising anti-streptokinase antibodies 0.4%). The levels of anti-streptokinase antibodies in 20 patients with AMI (10 patients treated with streptokinase and 10 with r-tPA) were compared to the normals. Administration of streptokinase in 10 patients studied, resulted in an immediate fall in level of anti-streptokinase antibodies and developed a specific response. The levels of anti-streptokinase antibodies in patients treated with streptokinase and reperfused early were within the normal ranges, and levels rose in the late reperfusion or non reperfusion groups. Of the 10 patients given streptokinase, one patient with elevated levels of IgG and IgA developed serum sickness. The levels of specific IgM anti-streptokinase antibodies in patients with rheumatoid arthritis were significantly elevated. This did not correlate with IgG anti-mycobacterium heat shock protein 65 (mHSP65). In patients with Henoch Schonlein Purpura there was a correlation between IgG anti-mHSP65 levels and IgG, IgA and neutralising anti-streptokinase antibodies levels. The interactions of complement system and immune complexes was studied by measurement of complement activation products Cls:Cl-INH, C3b-P and C5b-9 using modified techniques introduced by Auda et al 1990. An indirect ELISA for measuring serum C3d levels and a modified ELISA for detecting erythrocyte (E) with bound C3d were developed to evaluate the relationship of bound C3d and the levels of free complement components. Patients treated with r-tPA did not generate complement activation products. All the ten patients administered streptokinase generated Cls:Cl-INH and only one patient had increased levels of C3b-P and C5b-9. The extent of complement activation correlated with the pre-treatment levels of anti-streptokinase antibodies. In vitro effects of the ICs on complement activation showed that the presence of erythrocytes did not modulate significantly C3d or Cls:Cl-INH levels generated by the ICs, however, they exerted an influence on C3b-P through the actions of CRL The kinetics and dose response of streptokinase ICs, C3c and C3d binding to erythrocytes (E's) were studied by flow cytometry and its relationship with free complement activation was determined by measuring the free complement activation products in the accompanying supernatants. This study showed that the binding of ICs to E's depended significantly on the extent of complement activation (p IgG2b >IgG2a) was consistent with the pattern of CD 16 (isoforms A and B) and CD64 (isoform A). These findings indicate the presence of FcyR on the erythrocytes, which may play an important role in handling of immune complexes

Kalman filter-based FDD for an Air Handling Unit (AHU)

We propose to improve the energy efficiency of commercial HVAC systems by implementing a Kalman filter based fault detection and diagnosis (FDD) scheme to accurately identify certain categories of abnormal conditions that are the most prevalent in hot, humid climates like the UAE. The general approach used to deal with drift in system state includes the following tasks: 1) Determine possible model specifications, 2) Use a Kalman filter to determine time-varying parameters of the specified models, 3) Perform fault detection using a statistical process control and, 4) Perform fault diagnosis by formulating qualitative rules and comparing with those derived from decision trees. The model is built using from normal and faulty data that was generated during ASHRAE Project RP-1312 in which several Air Handling Unit (AHU) faults were artificially introduced and the resulting operational data recorded at 1-minute intervals. The results show that the Kalman filter is well-suited to detecting changes in mean level and the rules derived from the parameter estimates perform as well as those derived from decision trees

Data Extraction as Input for the Energy analysis of an urban district with UMI.

The energy usage of an urban district has become a major subject of study and interest since we observed a significant expansion of cities caused by the movement of inhabitants. Sustainability of urban areas is mainly related to interactions between street patterns and building distances. Monitoring these connections in terms of energy flows creates possibilities of optimizing building construction and retrofitting. There are many tools used to make this possible.In this paper, we want to demonstrate how it is possible to import the 3D structure of an urban area recorded in an SHP file into the Urban Modeling Interface software. The data extraction protocol we developed to this aim principally consists in approximating clusters of XYZ coordinates into a set of boxes with minimum loss in geometry, orientation, and position of buildings. Estimations of energy consumption and CO2 are among the outcomes we were able to obtain from imported data into UMI. Using the developed data extraction strategy, we can potentially analyze the energy usage of an entire city

International Journal of Smart Grid and Clean Energy Sensitivity analysis of demand-side management impact on Abu-Dhabi's electricity consumption

Abstract The difficulty to accurately assess the impact of energy efficiency retrofits and the impact of energy efficiency policies is a widely recognized barrier to the wider deployment of Demand-Side Management (DSM). The task is complicated by the dynamic nature and coupled interaction of the sub-system and the high correlation with weather and other perturbations. A regression-based model of the load is estimated using measured data from the pre-DSM period for the city of Abu Dhabi, UAE, and is then used to generate proxies representing the main characteristics of the Abu Dhabi urban buildings which impact the cooling load. The sensitivity analysis to variations of the most important proxies that drive cooling load was performed, and the impact assessed for the aggregate urban area of Abu Dhabi municipality. Well targeted DSM interventions can achieve an average 20% improvement of the cooling process in Abu-Dhabi. The present study estimates that an emirate-wide program could result in a peak load relief of 6.6% and annual energy conservation of 9.2% (respectively 450 MW and 3,600 GWh based on 2010 emirate-wide electricity use statistics)

International Journal of Smart Grid and Clean Energy Sensitivity analysis of demand-side management impact on Abu-Dhabi's electricity consumption

Abstract The difficulty to accurately assess the impact of energy efficiency retrofits and the impact of energy efficiency policies is a widely recognized barrier to the wider deployment of Demand-Side Management (DSM). The task is complicated by the dynamic nature and coupled interaction of the sub-system and the high correlation with weather and other perturbations. A regression-based model of the load is estimated using measured data from the pre-DSM period for the city of Abu Dhabi, UAE, and is then used to generate proxies representing the main characteristics of the Abu Dhabi urban buildings which impact the cooling load. The sensitivity analysis to variations of the most important proxies that drive cooling load was performed, and the impact assessed for the aggregate urban area of Abu Dhabi municipality. Well targeted DSM interventions can achieve an average 20% improvement of the cooling process in Abu-Dhabi. The present study estimates that an emirate-wide program could result in a peak load relief of 6.6% and annual energy conservation of 9.2% (respectively 450 MW and 3,600 GWh based on 2010 emirate-wide electricity use statistics)

Evaluation of Smart Shading Structures in Mitigating Urban Heat Island in a district of a Hot Arid Climate City (Abu Dhabi).

Nowadays we observe that the world population is concentrating in the cities converting natural areas into urbanized areas by changing the thermal properties also. As the cities evolve the local climate changes as well. And this change is shown perfectly in the urban heat island (UHI) phenomenon. Indirectly the UHI increases the energy consumption used for the cooling systems inside the buildings. This is translated in additional cost and one step back into the main target of having a sustainable city. In this paper, we describe how we can analyze one alternative strategy in hot and arid urban environments (like Abu Dhabi) with the help of Urban Modeling Interface (UMI), EnergyPlus (EP), and Ecotect. The energy simulations are divided in two groups. The first group includes the current energy consumption of the different typologies of buildings placed in an urban district and the results are taking into consideration the surrounding environment. The second group of energy simulation analyses the same districts taking into consideration smart shading devices spread into the different districts according to the shading butterfly provided from Ecotect. By proposing this intervention of the necessary shading in the different districts, there is a possibility to moderate the temperatures inside the buildings and as a result the energy consumption by improving in the same time the outdoor quality. The innovation stands in the application of this smart shading structures in this type of city and the measurement tools used for such proposal. Part of the work for the energy simulation is the preparation of different templates for the selected building categories, the weather data for the hot arid climate, the use of the shoebox model and experimenting Part as a new tool that makes this kind of simulation possible. The simulation results will be then compared with the field observation data for the different building typologies taken into consideration. This comparison helps keeping the results near to the real energy consumption conditions

Sustainable neighborhoods. An energy analysis at urban scale on 5 different typical districts of Abu Dhabi Main Island.

By the passing of the years, the world population is concentrating in the cities converting natural areas into urbanized areas by modifying also the thermal properties of the area. The local climate is under continuous change while the cities evolve. And this change is shown perfectly in the Urban Heat Island (UHI) phenomenon. The cooling load inside the buildings is increased indirectly by the UHI phenomenon. This would bring additional cost and bring one step back into the main target of having a sustainable city. Sustainable city start with sustainable neighborhoods. This paper provides an overview on how with the help of different tools such as ENVI-met, UMI, Energyplus and Ecotect we can have the results of the energy consumption of 5 different districts in Abu Dhabi, a city with hot arid climate. The idea is to analyze each district that is characterized by different building typology. On a second step, after using Ecotect to locate the areas that were exposed to the sun within the district there is an intervention proposal. Placing urban shading devices and vegetation in form of parks not only would improve the outdoor quality but also can reduce the cooling load in the building by reducing the temperatures and improving the airflow. This is the main aim of this study. Several simulations before and after the proposals will show this energy saving. The shading devices proposed are complying with the traditional concept but adapted to a new technology. The main material would be wood and a specific type of fabric. Even though for the tools used in the energy simulations the important parameters are connected to the materials only. Special openings and details are not recognized. Even though, thru the two main tools we can show that requalifying the neighbors bring direct and indirect savings and helps in having a sustainable neighborhoods

Urban Smart Shading Devices based on Traditional Gulf Design. Case study located in a district of a hot-arid climate city (Abu Dhabi).

In a city with hot arid weather such as Abu Dhabi, creating outdoor shading is a main concern. This not only a strategy to improve the outdoor comfort but also a very efficient solution to mitigate the urban heat island effect. In previous studies, we analyzed the extensive deployment of shading devices in 5 different districts in the main island of Abu Dhabi. In the present study, our aim is to show how innovation and tradition can be merged. Innovation is all encompassing concept but in our case the basis of innovation is its tradition. In the past, the Gulf countries built cities with narrow streets covering some of them partially. The Mashrabiya is a well-known concept used in the traditional architecture. If an innovative intervention is made in an urban context it has to be connected to the culture of the city and its roots. A system of smart shading devices based on traditional geometric design is a sustainable solution and also contributes to the education of younger generations. The proposed smart shading devices are made of tent with Photovoltaic (PV) cells integrated in it. This choice stems from the flexibility in shape that such a material can offer. We will establish a comparison between current commercially materials and our solution in terms of efficiency and life-cycle energy/cost. The market offers mainly tent made of PTFE with steel structure. A random design used in specific parking lots and small parks areas downtown Abu Dhabi. In this paper we bring alternative solutions in terms of efficiency and flexibility and also describe the different design options that we tested and how the optimal design was selected

Evaluation of Airway Management Proficiency in Pre-Hospital Emergency Setting; a Simulation Study

Introduction: Infrequency and low exposure to critically ill patients requiring airway management will lead to reduction in the skills and performance of the Emergency Medical Technicians (EMTs) over time. The present study was conducted primarily aiming to evaluate airway management in stationary ambulance simulations and identify the factors affecting Endotracheal Intubation (ETI) success rate.Method: This is a simulation study. The study population comprised of active EMTs in prehospital emergency bases in Hamadan province. The participants were placed at the back of an ambulance to perform the airway management scenario, which had already been prepared. To investigate the factors affecting the success (≤3 attempts) or failure rate of intubation, both unadjusted and adjusted odds ratios (95% confidence intervals) for univariate and multivariate regressions were reported.Results: 184 subjects with the mean age of 33.91+6.25 years and the median work experience of 8 years were studied (54.3% with a history of training in the past year).  The median number of previous intubations performed by technicians in the last year was 7 times (IQR 4-9). The total success rate at ventilation, intubation and back-up airway were 50.67%, 53.29%, and 50.0%, respectively. Out of the total 552 attempts for ETI placement, 58.2% of the technicians were able to perform ETI within 3 attempts. Univariate analysis showed that age (OR=1.06, P=0.022), previous number of ETIs (OR=2.49, P<0.001), work experience (OR=1.13, P<0.001), and previous ETI training (OR=1.85, P=0.041) were significantly associated with ETI success rate. After adjustment, previous number of ETIs (OR=2.66, P<0.001) was the most effective factor on ETI success rate.Conclusion: Success rate in airway management, especially ETI, is low. Therefore, improvement in modifiable factors such as increasing the number of ETIs performed and gaining experience in the same conditions as pre-hospital emergency is necessary