Association of Nightly Fasting, Meal Frequency, and Skipping Meals with Metabolic Syndrome among Kuwaiti Adults

Mounting evidence suggests that meal timing and frequency are associated with cardiometabolic health by influencing circadian rhythms. However, the evidence is inconsistent and limited, especially in non-Western cultures. This cross-sectional study aims to investigate the association between temporal habits of dietary intake, such as nightly fasting duration and meal frequency, and metabolic syndrome among Kuwaiti adults. A 24-hour recall was used to assess temporal habits of dietary intake. Meal frequency was defined as the number of daily eating episodes. The study included a total of 757 adults aged 20 years and older. The participants\u27 mean age was 37.8 ± 12.3 years. After adjusting for all confounders, higher meal frequency was found to be associated with a lower prevalence of metabolic syndrome in adults (OR, 0.43; 95%CI, 0.19-0.96) and a lower prevalence of elevated triglycerides in men only (OR, 0.23; 95%CI, 0.09-0.60). No association was found between nightly fasting and metabolic syndrome, but a longer fasting duration was associated with a lower prevalence of elevated triglycerides (OR, 0.19; 95%CI, 0.06-0.63). The findings suggest that having frequent meals and longer durations of nightly fasting may help decrease the risk of metabolic syndrome and elevated triglycerides

Comparative environmental footprint analysis of ultra-high-performance concrete using Portland cement and alkali-activated materials

Considering the ambitious greenhouse gas emission reduction and efficient use of resource targets set by the Sustainable Development Goals and the importance of concrete structures to achieve these goals, there is an increasing need to study the environmental performance of different concrete production alternatives. Cement is one of the main building materials that contribute significantly to global warming; therefore, studying the environmental performance of innovative binders that can substitute the use of cement is highly recommended. This article investigates the climate, material, energy, and water footprints of four innovative mixtures of ultra-high-performance concrete (UHPC) with a binder made of alkali-activated materials in comparison with the one made of Portland cement. Footprint analysis is carried out within cradle-to-grave life cycle assessment boundaries. Within the life cycle assessment, the functional unit defines the quantification of the final product or service. The functional units of the UHPC were adapted for the comparability of concrete mixtures with different compressive strengths. The results show that UHPC made with an alkali-activated material has 32%–45% better performance in terms of a climate footprint and 19%–33% better performance in terms of material footprints, whereas a trade-off can be seen regarding 44%–83% higher energy footprints and 75%–146% higher water footprints. The disadvantages in energy and water footprints are caused by waterglass. When allocation is considered, mixtures with high silica fume content have higher environmental footprints

Left Main Coronary Artery Revascularization in Patients with Impaired Renal Function: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting

Introduction: The evidence about the optimal revascularization strategy in patients with left main coronary artery (LMCA) disease and impaired renal function is limited. Thus, we aimed to compare the outcomes of LMCA disease revascularization (percutaneous coronary intervention [PCI] vs. coronary artery bypass grafting [CABG]) in patients with and without impaired renal function. Methods: This retrospective cohort study included 2,138 patients recruited from 14 centers between 2015 and 2,019. We compared patients with impaired renal function who had PCI (n= 316) to those who had CABG (n = 121) and compared patients with normal renal function who had PCI (n = 906) to those who had CABG (n = 795). The study outcomes were in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE). Results: Multivariable logistic regression analysis showed that the risk of in-hospital MACCE was significantly higher in CABG compared to PCI in patients with impaired renal function (odds ratio [OR]: 8.13 [95% CI: 4.19–15.76], p < 0.001) and normal renal function (OR: 2.59 [95% CI: 1.79–3.73]; p < 0.001). There were no differences in follow-up MACCE between CABG and PCI in patients with impaired renal function (HR: 1.14 [95% CI: 0.71–1.81], p = 0.585) and normal renal function (HR: 1.12 [0.90–1.39], p = 0.312). Conclusions: PCI could have an advantage over CABG in revascularization of LMCA disease in patients with impaired renal function regarding in-hospital MACCE. The follow-up MACCE was comparable between PCI and CABG in patients with impaired and normal renal function

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Modeling and Simulation the Impacts of STATCOMs on Distance Protection and Developing a Microgrid Energy Management Scheme for a Pacific Northwest City

This thesis has two research topics. The large focus of this thesis is the development of a microgrid model. However, the first topic studies the impact of a static synchronous compensator (STATCOM) on distance protection in a transmission line. The power system and a STATCOM device are modeled and simulated by using an emtp-type program. In addition, a distance relay model is used in order to calculate the effective impedance seen by the relay with and without the presence of the STATCOM. The results show that the distance relay performance is affected by the fault location relative to the location of the STATCOM. During a capacitive current injection by the STATCOM, the simulation results show that the mho relay underreaches for faults applied beyond the STATCOM location on the line. The second topic is the development of a microgrid energy management scheme for a Pacific Northwest City. An emtp-type model is used to represent the power system and the control systems of the microgrid. The microgrid model includes hydroelectric generators, a photovoltaic (PV) system, a storage system, and variable loads. Several cases examine the microgrid during both seasonal and hourly variation. Generation and load profiles are compared with a storage system profile in order to characterize the shortage during islanded mode. Simulation results are presented. Suggested solutions and planning considerations are discussed for managing the power and energy inside the microgrid.Thesis (M.S., Electrical and Computer Engineering) -- University of Idaho, 201

Resource and climate footprint assessment of constructions from conventional approach to building information modelling

Zugleich: Dissertation, Universität Kassel, 202

Environmental Assessment of Carbon Concrete Based on Life-Cycle Wide Climate, Material, Energy and Water Footprints

Gefördert durch den Publikationsfonds der Universität Kasse

Comparative Analysis of Resource and Climate Footprints for Different Heating Systems in Building Information Modeling

Buildings play an important role to meet Sustainable Development Goals, especially regarding the use of resources and greenhouse gas emissions. They are increasingly designed with energy-efficient solutions regarding their operations, while the related use of natural resources is still insufficiently considered. In this article, a methodology in Building Information Modeling is proposed to measure the resource and climate footprints of buildings&rsquo; heating systems. The methodology is applied to a case study building in Germany. The studied heating systems include a gas condensing boiler, ground-source heat pump, ground-source heat pump with a photo-voltaic system and air-source heat pump backed up with a gas boiler. Next to the operational energy, the production and transport of the heating systems were also studied. Results show that heating system operations have the largest impact and that the variant of ground-source heat pump combined with photovoltaics (GSHP + PV) has the lowest impact. In comparison with the gas boiler (GB), savings of 75%, 47%, 80%, and 84% are addressed to climate, material, energy, and land footprints, respectively, while the water footprint of GSHP + PV is 73% higher than that of GB

Comparative Analysis of Resource and Climate Footprints for Different Heating Systems in Building Information Modeling

Gefördert durch den Publikationsfonds der Universität Kasse

Environmental Assessment of Ultra-High-Performance Concrete Using Carbon, Material, and Water Footprint

There is a common understanding that the environmental impacts of construction materials should be significantly reduced. This article provides a comprehensive environmental assessment within Life Cycle Assessment (LCA) boundaries for Ultra-High-Performance Concrete (UHPC) in comparison with Conventional Concrete (CC), in terms of carbon, material, and water footprint. Environmental impacts are determined for the cradle-to-grave life cycle of the UHPC, considering precast and ready-mix concrete. The LCA shows that UHPC has higher environmental impacts per m3. When the functionality of UHPC is considered, at case study level, two design options of a bridge are tested, which use either totally CC (CC design) or CC enhanced with UHPC (UHPC design). The results show that the UHPC design could provide a reduction of 14%, 27%, and 43% of carbon, material, and water footprint, respectively