Case Presentation for Hypertrophic Cardiomyopathy

CASE HISTORY: The patient is a 21-year-old African American male basketball player. The patient has been involved with sports and athletics since his elementary years without suffering any cardiovascular issues. The patient had no significant issues in his medical history including any heart-related problems in his past. PHYSICAL EXAM: The patient initially presented no significant findings regarding his physical health until pre-participation exams identified cardiac abnormalities. DIFFERENTIAL DIAGNOSES: Hypertrophic cardiomyopathy; myocarditis, coronary artery disease; mitral valve prolapse; aortic stenosis. TESTS & RESULTS: The patient had an EKG and echocardiogram done, which detected hypertrophic cardiomyopathy. FINAL DIAGNOSIS: Hypertrophic cardiomyopathy. DISCUSSION: Hypertrophic cardiomyopathy(HCM) is a condition of the heart characterized by the thickening of the interventricular septum. Sudden cardiac death due to HCM-related causes is most prevalent in young African-American male athletes. Most patients with risk factors in these categories are strongly recommended to abstain from participating in sports with high physical demands. This case presents a 21-year-old African-American male athlete playing Division 1 basketball diagnosed with HCM, that did not report any symptoms related to a cardiac illness. OUTCOME OF THE CASE: Considering the athlete’s medical history, and understanding the probabilities of a HCM-related episode occurring, the decision was made to implant an ICD prior to returning to athletic participation. An ICD is an Implantable Cardioverter Defibrillator, which is a device embedded underneath the skin to record and track the heartbeat. If the ICD detects an irregular heart rhythm, it will send an electrical shock to restore the heart’s normal activity. The patient had the ICD implanted and returned to full participation by the start of the basketball season. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: He visited the cardiologist for a follow-up 6 months after the ICD implantation. Other treatments included periodic BP and pulse rate monitoring during physical activity and gradual physical conditioning before the preseason started

Steam - oxygen gasification of refuse derived fuel in fluidized beds: Modelling and pilot plant testing

A one-dimensional kinetic model for steam‑oxygen gasification of refuse derived fuel in a bubbling fluidized bed reactor has been developed. The model incorporates the reaction network of steam‑oxygen gasification within the fluid dynamics of a fluidized bed to predict waste and tars conversion, gas composition and overall gasification performance. The model was validated by comparing outlet products composition and temperature profile with experimental data from a pilot-scale fluidized bed gasifier, operated at different conditions. The model showed accurate predictive capability and ease of computation. The effects of the operating conditions on gas yield and process efficiency were evaluated and the most appropriate fuel feeding height, equivalent ratio and the relative amount of steam to inject were identified

Preliminary Assessment of Sorption Capacity on Solid CO2-Sorbents at Conditions for Sorption-Enhanced Processes

This work aims to assess solid sorbent capacity to operate CO2 capture under industrial conditions relevant to biogas/bio-syngas upgrading systems to green H2 and food-grade CO2 through Sorption-Enhanced Water Gas Shift (SEWGS) technologies. The pursued degree of innovation is the process intensification to remove CO2 in a more sustainable industrial practice reducing the CO2 footprint of a potential H2 production process. A lab-scale apparatus is appropriately designed and built to operate at relevant industrial scale conditions. The core of the system is a fixed-bed reactor equipped with mass flow meters/controllers and online gas analyzers. CO2 capture experiments were carried out to investigate the effect of pressure (1.0-1.4 MPa) on different commercial and synthesized solid sorbent materials (hydrotalcite-like compounds). The best sorbent is a commercial hydrotalcite impregnated with 20 wt% of K2CO3, with an average sorption capacity of 0.85 mmolCO2/gad at 1.4 MPa and 623 K. The explored conditions are compatible with an industrial operation where syngas is available at low-to-moderate pressure

Vitamin D Association with Renal Health and Filtration in Healthy Individuals Free of Cardiometabolic Diseases: A Pilot Study

The effect of vitamin D (VITD) on bone, muscle, and over health is well know in renal failure and chronic kidney disease (CKD). However, the influence of VITD on renal health and filtration (RHF) in healthy individuals is unclear. Currently, only serum creatinine concentration (sCr) methods are used to assess renal status in health individuals. However, newer biomarkers like serum Cystatin C (CyC) and urine epidermal growth factor (uEGF) show promise in evaluating baseline RHF. The impact of Vitamin D on filtration in healthy individuals of various ages is still unknown. PURPOSE: To determine the impact of VITD on RHF in healthy individuals of middle-aged status. METHODS: Thirty-six participants (n = 22 men; n = 14 women; age 37.6 + 12.4 yr; BF% 19.2 + 7.1%) agreed to participate in the research study. Blood and urine samples were obtained under standardized conditions for all individuals. VITD, CyC, uEGF, urine creatinine (uCr), uCr/uEGF ratio, sCR, and multiple estimates of glomerular filtration rate (eGFR) - modification of diet in renal disease (MDRD), CKD-EPI, CyC equations (CyC only and CyC combined with sCr) were assessed as a whole cohort and grouped (young = 20-39 yrs. (n = 22), older = 40-60 yrs. (n = 14)). Analysis was done using a paired sample t-tests, Pearson Correlation to compare VITD concentrations and markers of RHF. Linear regression analyses was performed to examine the relationship between VITD ability to predict RHF. All analyses were performed using SPSS (v. 28.0.1.1). RESULTS: There was no significant correlations found between VITD and markers of RHF in the entire cohort. Therefore, no predictive model was performed. The younger group showed strong negative correlation between VITD and MDRD (r = -0.575, p = 0.008), and that VITD was able to predict MDRD (R2 = 0.331, p = 0.008). No significant correlation observed in older group. CONCLUSIONS: VITD was correlated and able to predict a marker of RHF in healthy younger individuals, but not in older individuals. Based on the sample size and overall outcomes, continued research is needed to more accurately determine VITD effects on RHF in healthy populations

A dual process account of creative thinking

This article explicates the potential role played by type 1 thinking (automatic, fast) and type 2 thinking (effortful, logical) in creative thinking. The relevance of Evans's (2007) models of conflict of dual processes in thinking is discussed with regards to creative thinking. The role played by type 1 thinking and type 2 thinking during the different stages of creativity (problem finding and conceptualization, incubation, illumination, verification and dissemination) is discussed. It is proposed that although both types of thinking are active in creativity, the extent to which they are active and the nature of their contribution to creativity will vary between stages of the creative process. Directions for future research to test this proposal are outlined; differing methodologies and the investigation of different stages of creative thinking are discussed. © Taylor & Francis Group, LLC

The personal norm of reciprocity

Reciprocity is here considered as an internalized social norm, and a questionnaire to measure individual differences in the internalized norm of reciprocity is presented. The questionnaire, Personal Norm of Reciprocity (PNR), measures three aspects of reciprocity: positive reciprocity, negative reciprocity, and beliefs in reciprocity. The PNR has been developed and tested in two cultures, British and Italian, for a total of 951 participants. A cross-cultural study provides evidence of good psychometric properties and generalizability of the PNR. Data provide evidence for criterion validity and show that positive and negative reciprocators behave in different ways as a function of the valence (positive or negative) of the other's past behaviour, the type of feasible reaction (reward versus punishment), and the fairness of their reaction. Copyright (C) 2002 John Wiley Sons, Ltd

The Effect of Fish Oil Supplementation on Resistance Training-induced Adaptations

Background: Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may aug-ment RET-induced adaptations. However, few studies have been conducted on young, healthy adults. Methods: A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapen-taenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3 days·week−1). Body composition was measured by dual- energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum bar-bell back squat (1RMSQT) and bench press (1RMBP) at PRE (week 0) and POST (10 weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α- level of 0.05 was used to determine statistical significance and Cohen’s d was used to quantify effect sizes (ES). Results: Twenty-one of 28 male and female participants (FOS, n = 10 [4 withdrawals]; PL, n = 11 [3 withdrawals]) completed the 10- week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p\u3c .001) and did not change in the PL group (+1.3%, p = .938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p = .457), FM (FOS: −5.2%, PL: 0.0%, p = .092), and %BF (FOS: −5.9%, PL: −2.5%, p = .136) were observed, although, the between- group ES was considered large for FM (d = 0.84). Absolute and relative (kg·kg [body mass]−1) 1RMBP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p = .047; FOS: +17.6% vs. PL: +7.3%, p = .011; respectively), whereas absolute 1RMSQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p = .191). Relative 1RMSQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p = .045). Conclusions: When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults