Parameter identification for soil simulation based on the discrete element method and application to small scale shallow penetration tests

The Discrete Element Method (DEM) is well-established and widely used in soil-tool interaction related applications. As for all simulation tools, a proper calibration of the model parameters is crucial. In this contribution, we present the parametrization procedure of the DEM software GRAnular Physics Engine (GRAPE), developed and implemented at Fraunhofer ITWM, and attempt to use two parametrized soil samples for the simulation of small scale shallow penetration tests. The results are compared to laboratory measurements

Association of thyroid function with arterial pressure in normotensive and hypertensive euthyroid individuals: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Overt hypothyroidism has been associated with arterial hypertension and increased arterial stiffness. Results in euthyroid individuals have been conflicting. We investigated associations of thyroid function with systolic (SAP) and diastolic (DAP) arterial pressure in euthyroid subjects.</p> <p>Methods</p> <p>311 euthyroid individuals (185 women, mean age 43.9 ± 9) without a history of diabetes attending a preventive medicine program were examined. Subjects receiving thyroxine (10.6%) were excluded; 19.3% had hypertension, 43% had a family history for hypertension. TSH, fT4, thyroid autoantibodies, insulin, glucose were measured. The "fT4.TSH product", which has been suggested as a T4 resistance-index, was calculated.</p> <p>Results</p> <p>TSH range was 0.1–8, median 1.4 mU/L, fT4 range was 11.5–25.2 pmol/L, median 17.4. TSH and the "fT4.TSH product" were positively associated with DAP (p < 0.03, for both associations). In the subgroup of individuals with TSH levels 0.36–2.5 mU/L, both TSH and the "fT4.TSH product" were positively correlated with SAP (r = +0.133 p = 0.044, r = +0.152 p = 0.026) and DAP (r = +0.243 p < 0.001, r = +0.252 p < 0.001 respectively); in multivariate analysis the "fT4.TSH product" was a significant predictor of DAP independently of HOMA-IR and BMI (p < 0.001). Similar associations were found when only the non-hypertensive subjects were analysed (p = 0.004). Hypertensive patients had higher TSH levels (p = 0.02) and belonged more frequently to the subgroup with TSH > 2 mU/L (35.3% vs 21.3%, p = 0.045).</p> <p>Conclusion</p> <p>In euthyroid individuals the association of thyroid function with diastolic arterial pressure remains significant even when a stricter "normal range" for TSH levels is considered. The "freeT4.TSH" product appears to be an even stronger predictor of DAP, independently of HOMA insulin resistance index and obesity.</p

Interrelated modulation of endothelial function in Behcet's disease by clinical activity and corticosteroid treatment

Corticosteroids are commonly used in empirical treatment of Behçet's disease (BD), a systemic inflammatory condition associated with reversible endothelial dysfunction. In the present study we aimed to dissect the effects of clinical disease activity and chronic or short-term corticosteroid treatment on endothelial function in patients with BD. In a case-control, cross-sectional study, we assessed endothelial function by endothelium dependent flow mediated dilatation (FMD) at the brachial artery of 87 patients, who either were or were not receiving chronic corticosteroid treatment, and exhibiting variable clinical disease activity. Healthy individuals matched for age and sex served as controls. Endothelial function was also assessed in a prospective study of 11 patients before and after 7 days of treatment with prednisolone given at disease relapse (20 mg/day). In the cross-sectional component of the study, FMD was lower in patients than in control individuals (mean ± standard error: 4.1 ± 0.4% versus 5.7 ± 0.2%, P = 0.003), whereas there was a significant interaction between the effects of corticosteroids and disease activity on endothelial function (P = 0.014, two-factor analysis of variance). Among patients with inactive BD, those who were not treated with corticosteroids (n = 33) had FMD comparable to that in healthy control individuals, whereas those treated with corticosteroids (n = 15) had impaired endothelial function (P = 0.023 versus the respective control subgroup). In contrast, among patients with active BD, those who were not treated with corticosteroids (n = 20) had lower FMD than control individuals (P = 0.007), but in those who were receiving corticosteroids (n = 19) the FMD values were comparable to those in control individuals. Moreover, FMD was significantly improved after 7 days of prednisolone administration (3.7 ± 0.9% versus 7.6 ± 1.4%, P = 0.027). Taken together, these results imply that although corticosteroid treatment may impair endothelial function per se during the remission phase of the inflammatory process, it restores endothelial dysfunction during active BD by counteracting the harmful effects of relapsing inflammation

Lack of effects of pioglitazone on cardiac function in patients with type 2 diabetes and evidence of left ventricular diastolic dysfunction: a tissue doppler imaging study

<p>Abstract</p> <p>Background</p> <p>Thiazolidinediones, used for the treatment of patients with type 2 diabetes mellitus (DM2), are associated with an increased incidence of heart failure. We sought to investigate the effects of pioglitazone on novel echocardiographic indices of left ventricular (LV) diastolic function in DM2 patients with LV diastolic dysfunction (LVDD).</p> <p>Methods</p> <p>Eighty-eight asymptomatic DM2 patients on metformin and/or sulfonylureas, aged 64.5 ± 7.7 years, without known cardiovascular disease, with normal LV systolic function and evidence of LVDD were randomly assigned to pioglitazone 30 mg/day (n = 42) or an increase in dose of other oral agents (n = 39) for 6 months. All patients underwent transthoracic conventional and Tissue Doppler Imaging echocardiography at baseline and follow-up. The primary end-point was change in early diastolic velocity of the mitral annulus (E').</p> <p>Results</p> <p>Improvement of glycaemic control was similar in the 2 groups. A significant difference (p < 0.05) between the 2 groups was found in the treatment-induced changes in fasting insulin, the insulin resistance index HOMA, HDL cholesterol, triglycerides, diastolic blood pressure (all in favor of pioglitazone) and in body weight (increase with pioglitazone). No significant changes were observed in any echocardiographic parameter in either group and did not differ between groups (p = NS for all). E' increased non-significantly and to a similar extent in both groups (p = NS).</p> <p>Conclusions</p> <p>In asymptomatic DM2 patients with LVDD, the addition of pioglitazone to oral conventional treatment for 6 months does not induce any adverse or favorable changes in LV diastolic or systolic function despite improvements in glycaemic control, insulin sensitivity, lipid profile, and blood pressure.</p

A Lyophilized Form of Saccharomyces Boulardii Enhances the Helicobacter pylori Eradication Rates of Omeprazole-Triple Therapy in Patients With Peptic Ulcer Disease or Functional Dyspepsia

Background: Saccharomyces boulardii prevents antibiotic-induced diarrhea and exerts anti-H.pylori effects in vitro and in vivo. Aim: To assess whether S. boulardii enhances the efficacy of classic triple therapy in eradicating H. pylori. Methods: Seventy patients with peptic ulcer or functional dyspepsia according to Rome III criteria and H. pylori infection were treated with omeprazole 20 mg bid, clarithromycin 500 mg bid and amoxicillin 1 g bid for 14 days. A total of 36 out of 70 (51%) patients were randomized to S. boulardii [Ultralevure®, two capsules tid for 14 days (group A) and 34 (49%) on no intervention (group B). H. pylori eradication was assessed by a 13C-Urea Breath Test. Results: At baseline there were no significant differences between the two groups in any patient or disease characteristics. H. pylori was eradicated in 30/36 (83.4%) patients in group A vs 20/34 (58.8%) in group B (P=0.034, 95% CI 4.4% to 43.6%). Seven patients in group B (20.6%) and 1 patient in group A stopped treatment because of diarrhea (95% CI 3.3% to 32.7%, P=0.026). Multi-factorial analysis did not reveal any patient or disease related parameter linked to treatment outcome except for the use of the probiotic. Conclusion: S. boulardii enhanced the effect of classic triple therapy mainly by preventing antibiotic- and/or proton pump inhibitor-induced diarrhea

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (&lt;50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, &lt;50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

Forecasting economic activity in sectors of the Cypriot economy

Εconomic Research Center PublicationThe aim of this paper is to apply single equation dynamic models together with information from a large dataset of predictors in the construction of short-term growth forecasts for the production-side components of the national accounts, i.e. Gross Value Added of sectors, and import duties plus Value Added Tax. To summarise the information content in a large number of predictors, we employ techniques such as common factors and forecast combinations. Aggregate and component forecasts are computed under two approaches to forecasting GDP growth, namely a direct and a bottom-up approach. In the direct approach, unconstrained models for GDP growth are estimated to compute forecasts for the aggregate, while constrained component models are used to obtain the disaggregate forecasts, which add up to the GDP growth forecasts computed directly. In the bottom-up approach, unconstrained component models are estimated to compute growth forecasts for the components as well as for GDP growth by adding up the unconstrained component forecasts. The performance of aggregate and disaggregate forecasts from the two approaches is assessed via pseudo outof-sample exercises. The results show that the use of macroeconomic and financial predictors improves on the accuracy of the naïve forecasts for most production-side components and the aggregate, under both the direct and bottom-up approaches. GDP growth forecasts from the direct approach are somewhat superior to those from the bottom-up approach. Both approaches result in gains in forecasting growth in industry, construction, trade, financial activities and duties. In the sector of professional services gains are limited for both constrained and unconstrained forecasts. In the sectors of agriculture and public administration, education and health, neither the unconstrained models nor the constrained sectoral models significantly improve on the naïve benchmark. Compared to the unconstrained component forecasts, gains attained through constrained forecasts are slightly lower, but more widespread across components and horizons

Forecasting economic activity in sectors of the Cypriot economy

Εconomic Research Center PublicationThe aim of this paper is to apply single equation dynamic models together with information from a large dataset of predictors in the construction of short-term growth forecasts for the production-side components of the national accounts, i.e. Gross Value Added of sectors, and import duties plus Value Added Tax. To summarise the information content in a large number of predictors, we employ techniques such as common factors and forecast combinations. Aggregate and component forecasts are computed under two approaches to forecasting GDP growth, namely a direct and a bottom-up approach. In the direct approach, unconstrained models for GDP growth are estimated to compute forecasts for the aggregate, while constrained component models are used to obtain the disaggregate forecasts, which add up to the GDP growth forecasts computed directly. In the bottom-up approach, unconstrained component models are estimated to compute growth forecasts for the components as well as for GDP growth by adding up the unconstrained component forecasts. The performance of aggregate and disaggregate forecasts from the two approaches is assessed via pseudo outof-sample exercises. The results show that the use of macroeconomic and financial predictors improves on the accuracy of the naïve forecasts for most production-side components and the aggregate, under both the direct and bottom-up approaches. GDP growth forecasts from the direct approach are somewhat superior to those from the bottom-up approach. Both approaches result in gains in forecasting growth in industry, construction, trade, financial activities and duties. In the sector of professional services gains are limited for both constrained and unconstrained forecasts. In the sectors of agriculture and public administration, education and health, neither the unconstrained models nor the constrained sectoral models significantly improve on the naïve benchmark. Compared to the unconstrained component forecasts, gains attained through constrained forecasts are slightly lower, but more widespread across components and horizons