Atrial ejection force and brain natriuretic peptide as markers for mortality in sepsis

Background: In early stages of septic shock, impaired myocardial function plays an important prognostic role. AEF and Plasma BNP level may be a valuable prognostic factor for patients with sepsis. Objective: We aimed also to evaluate the value of atrial ejection force (AEF) B-type natriuretic peptide (BNP) in predicting the outcome of sepsis, severe sepsis and septic shock patients. Methods: 40 patients presenting with sepsis, severe sepsis or septic were included in the study. The patients had undergone transthoracic Echocardiographic examinations and BNP measurements on the 1st and 3rd day of admission. The patients were retrospectively divided into survivors and non survivors. Results: There was a significant statistical difference in BNP level (P = 0.0001) between the two groups. BNP showed a statistically significant rise in the non survival group from day 1 to day 3 (p = 0.002) and a statistically significant decrease from day 1 to day 3 in the survived group (p = 0.001). As regards the echo findings there was a statistically significant difference AEF 3rd day between survivors and non survivors (P = 0.0001). The ROC curve showed that BNP 1st day, 3rd day are good tests for prediction of mortality in patients with sepsis. Conclusion: Atrial ejection force on the first day of admission, unlike BNP level, might not be used as an independent predictor of mortality in patients with sepsis. BNP level correlates with the severity of sepsis. According to our study, AEF in the third day may be a good predictor for survival of patients presenting with sepsis

Impact of Location and Insulation Material on Energy Performance of Residential Buildings as per Saudi Building Code (SBC) 601/602 in Saudi Arabia

In hot and humid climates, a significant part of the energy is used to cool the building. There are several ways to reduce this air conditioning load, but one standout is through the selection and design of the right building envelope and its components. The thermal characteristics of the building envelope, in particular the thermal resistance of the insulation used, have an impact on the thermal and energy performance of building structures. Thermal conductivity, which indicates the ability of heat to move through a material given a temperature difference, is the primary factor affecting the performance of a thermal insulation material. Both temperature and humidity changes can affect a material’s thermal conductivity value, which can then change. In fact, due to the fluctuating ambient air temperature and solar radiation, thermal insulation in buildings is susceptible to significant and continuous temperature variations. Thermal insulation used in building walls and roofs helps to reduce the energy demand of the building. It improves thermal comfort and, if used correctly, reduces the operational cost of the building. The present study has focused on the effects of location and insulation material on the energy performance of a residential building by considering five climatic locations in the Kingdom of Saudi Arabia (KSA). Five commonly used insulation materials with different thermal characteristics, namely polyurethane board (PU), expanded polystyrene (EPS), glass wool (GW), urea-formaldehyde foam (UFF), and expanded perlite (EP), were analyzed under various climatic zones as per the Saudi Building Code 601/602. The selected cities were categorized based on cooling degree days (CDD) and outdoor dry bulb temperature (DBT) as hot, very hot, and extremely hot climatic zones. Insulation improves thermal comfort and, if used correctly, reduces running costs. Experiments were conducted to determine the thermal conductivity, and the energy simulation was performed by employing IES-VE software for various insulation options. The findings indicate that the location has a significant impact on the energy performance of the insulating materials. The energy saving potential of polyurethane board (PU) insulation is more attractive in cities with higher DBTs and CDDs than in cities with lower DBTs and CDDs. The benefit of installing insulation ranged from a 2 to 14% decrease in energy demand for the climate zones studied. The sensitivity analysis showed that the energy saving potential of the insulation materials is sensitive to the set-point temperature (ST) band