Cardiovascular risk prediction using physical performance measures in COPD: results from a multicentre observational study

Funder: National Institute for Health Research; FundRef: http://dx.doi.org/10.13039/501100000272Funder: Health Data Research UKFunder: NIHR Cambridge Comprehensive Biomedical Research CentreFunder: NIHR Nottingham BRC respiratory themeObjectives: Although cardiovascular disease (CVD) is a common comorbidity associated with chronic obstructive pulmonary disease (COPD), it is unknown how to improve prediction of cardiovascular (CV) risk in individuals with COPD. Traditional CV risk scores have been tested in different populations but not uniquely in COPD. The potential of alternative markers to improve CV risk prediction in individuals with COPD is unknown. We aimed to determine the predictive value of conventional CVD risk factors in COPD and to determine if additional markers improve prediction beyond conventional factors. Design: Data from the Evaluation of the Role of Inflammation in Chronic Airways disease cohort, which enrolled 729 individuals with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II–IV COPD were used. Linked hospital episode statistics and survival data were prospectively collected for a median 4.6 years of follow-up. Setting: Five UK centres interested in COPD. Participants: Population-based sample including 714 individuals with spirometry-defined COPD, smoked at least 10 pack years and who were clinically stable for >4 weeks. Interventions: Baseline measurements included aortic pulse wave velocity (aPWV), carotid intima–media thickness (CIMT), C reactive protein (CRP), fibrinogen, spirometry and Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) Index, 6 min walk test (6MWT) and 4 m gait speed (4MGS) test. Primary and secondary outcome measures: New occurrence (first event) of fatal or non-fatal hospitalised CVD, and all-cause and cause-specific mortality. Results: Out of 714 participants, 192 (27%) had CV hospitalisation and 6 died due to CVD. The overall CV risk model C-statistic was 0.689 (95% CI 0.688 to 0.691). aPWV and CIMT neither had an association with study outcome nor improved model prediction. CRP, fibrinogen, GOLD stage, BODE Index, 4MGS and 6MWT were associated with the outcome, independently of conventional risk factors (p<0.05 for all). However, only 6MWT improved model discrimination (C=0.727, 95% CI 0.726 to 0.728). Conclusion: Poor physical performance defined by the 6MWT improves prediction of CV hospitalisation in individuals with COPD. Trial registration number: ID 11101

Heat Transfer Enhancement of Flat Plate Solar Collectors for Water Heating in Iraq Climatic Conditions

This work presents an experimental and numerical study to investigate the heat transfer enhancement of flat plat collector (FPC) using three types of twisted tapes (single twisted tape (ST), double twisted tape (DT) and mixed twisted tape (SDT)) which are compared with plain tube with twist ratios (TR=2). The study are considered under fully developed turbulent flow with solar radiation heat gain are changing with time. The designed FPC consists of four pipes with 1.25cm in diameter and 1mm thick are placed above the plate to act as a heat removal fluid passage ways. The system consists of two collectors, each one has (40cm x 160cm x 15cm) and connected to two tanks, each one is 20 liters. The amount of heat gain from solar radiation depends on many effective parameters are used; type of twisted tape are using, type of collectors plate metal (aluminum or copper), value of Reynolds number, amount of sun rays available at the site, number of glass covers and orientation of the collectors with respect to the south direction. From the experimental results was obtained which are demonstrate that the DT are more efficient than ST and SDT, since the heat transfer enhancement which increases the output temperature of the working fluid. The experimental study also show that the temperature of outlet water from mixed twisted tape collector is higher than the other type of plain tube collector by 10°C. The outlet water temperature of collector made from cupper is more than the collector made of aluminum about 6°C. The outlet water temperature from collector which has Reynolds number of 5000 less than 5°C for copper collector and less than 4°C for aluminum collector from the other with Re number is 10000. Increasing of the temperature of the outlet water in the collector which has two glass cover is about 4°C from one glass cover. The numerical analysis was based on finite volume numerical techniques to solve the governing partial differential equations in three dimensions, using ANSYS FLUENT commercial CFD software, to study the effect of Reynolds number and twisted tape types on the heat transfer enhancement and friction factor. The comparison between the experimental and numerical results shows a high agreement, and the maximum error was 8.3% occurred with mixed twisted tape

القابلية لإنتاج الأنزيمات والحساسية للمضادات الحيوية في زيباكنزيم أسينس وبروبيو نيباكنزيم قراتيولوزم المعزولة من المصابين بحب الشباب والأشخاص الأصحاء

Seventeen strains of Propionibacterium acnes and ten strains of P. granulosum were isolated from acne patients, in addition to ten isolates of each species from healthy persons. All strains were examined for their enzymatic activity and antibiotic susceptibility to ten antibiotics. Percentage of lipase, lecithinase and casenase production by strains of both species from acne lesions was higher than that from healthy persons in contrast to gelatinase. Haemolysin was produced almost by all strains. All isolates were resistant to ampicillin, penicillin and tetracycline. Strains of both species from healthy persons were more susceptible to the remaining antibiotics than those from acne lesions with significant differences at various levels.عزلت سبعة عشرة سلالة من propionibacteriun acnes وعشرة سلالات من P.granulosum من المرضى المصابين بحب الشباب كما عزلت عشرة سلالات من كل نوع من الأشخاص الأصحاء. فحصت جميع العزلات لمعرفة قابليتها لإنتاج الأنزيمات وحساسيتها تجاه عشرة مضادات حيوية. كانت النسبة المئوية لإنتاج أنزيمات اللايبيز واللسثتيز والكازينيز لسلالات كل النوعين من لطخة حب الشباب أعلى من تلك المعزولة من الأشخاص الأصحاء . وهذا عكس ما وجد بالنسبة لأنزيم الجيلاتينيز. أنتج أنزيم الهيمو لايسين من قبل جميع السلالات تقريبا، أظهرت جميع العزلات مقاومة تجاه الأمبسيلين والبنسلين والتتراسايكلين وكانت سلالات كل النوعين المعزولة من الأشخاص الأصحاء أكثر حساسية لبقية المضادات الحيوية من تلك المعزولة من لطخة حب الشباب بفروق معنوية عند مستويات مختلفة