Energy Efficiency of the Vulcanization Process of a Bicycle Tyre

The production of tyres is one of the most energy consuming manufacturing activities in the rubber sector. In the production cycle of a tyre, the curing operation has the maximum energy loss. This is mostly due to the extensive use of steam as a source of heat and pressure in the vulcanization process. To the author’s knowledge, no scientific work is available in the literature where the energy efficiency of a tyre vulcanization press is estimated by means of a comprehensive model of all main components, including the moulds, the press with its heated plates, the bladder and, of course, the tyre. The present work aims at filling this gap. First, the press used for developing the model is described, along with its components and its typical product, a bicycle tyre. The instruments used for measuring flow rates, temperatures and pressures are also listed. Then, a numerical model is presented, that predicts the energy transfers occurring in the vulcanization press during a full process cycle. The numerical model, developed with the software Simcenter Amesim 2021.1, has been validated by means of measurements taken at the press. The results indicate that the amount of energy which is actually consumed by the tyre for its reticulation process amounts to less than 1% of the total energy expenditure. The paper demonstrates that the tyre industry is in urgent need of an electrification conversion of the traditional steam-based processes

Diagnosis and Treatment of Incident Hypertension Among Patients with Diabetes: a U.S. Multi-Disciplinary Group Practice Observational Study

BACKGROUND: Early hypertension control reduces the risk of cardiovascular complications among patients with diabetes mellitus. There is a need to improve hypertension management among patients with diabetes mellitus. OBJECTIVE: We aimed to evaluate rates and associations of hypertension diagnosis and treatment among patients with diabetes mellitus and incident hypertension. DESIGN: This was a 4-year retrospective analysis of electronic health records. PARTICIPANTS: Adults ≥18 years old (n = 771) with diabetes mellitus, who met criteria for incident hypertension and received primary care at a large, Midwestern academic group practice from 2008 to 2011 were included MAIN MEASURES: Cut-points of 130/80 and 140/90 mmHg were used to identify incident cases of hypertension. Kaplan-Meier analysis estimated the probability of receiving: 1) an initial hypertension diagnosis and 2) antihypertensive medication at specific time points. Cox proportional-hazard frailty models (HR; 95 % CI) were fit to identify associations of time to hypertension diagnosis and treatment. KEY RESULTS: Among patients with diabetes mellitus who met clinical criteria for hypertension, 41 % received a diagnosis and 37 % received medication using the 130/80 mmHg cut-point. At the 140/90 mmHg cut-point, 52 % received a diagnosis and 49 % received medication. Atrial fibrillation (HR 2.18; 1.21–4.67) was associated with faster diagnosis rates; peripheral vascular disease (HR 0.18; 0.04–0.74) and fewer primary care visits (HR 0.93; 0.88–0.98) were associated with slower diagnosis rates. Atrial fibrillation (HR 3.07; 1.39–6.74) and ischemic heart disease/congestive heart failure (HR 2.16; 1.24–3.76) were associated with faster treatment rates; peripheral vascular disease (HR 0.16; 0.04–0.64) and fewer visits (HR 0.93; 0.88–0.98) predicted slower medication initiation. Diagnosis and treatment of incident hypertension were similar using cut-points of 130/80 and 140/90 mmHg. CONCLUSIONS: Among patients with diabetes mellitus, even using a cut-point of 140/90 mmHg, approximately 50 % remained undiagnosed and untreated for hypertension. Future interventions should target patients with multiple comorbidities to improve hypertension and diabetes clinical care

Delivering clinical trials at home: protocol, design and implementation of a direct-to-family paediatric lupus trial

Introduction Direct-to-family clinical trials efficiently provide data while reducing the participation burden for children and their families. Although these trials can offer significant advantages over traditional clinical trials, the process of designing and implementing direct-to-family studies is poorly defined, especially in children with rheumatic disease. This paper provides lessons learnt from the design and implementation of a self-controlled, direct-to-family pilot trial aimed to evaluate the effects of a medication management device on adherence to hydroxychloroquine in paediatric SLE.Methods Several design features accommodate a direct-to-family approach. Participants meeting eligibility criteria from across the USA were identified a priori through a disease registry, and all outcome data are collected remotely. The primary outcome (medication adherence) is evaluated using electronic medication event-monitoring, plasma drug levels, patient questionnaires and pill counts. Secondary and exploratory endpoints include (1) lupus disease activity measured by a remote SLE Disease Activity Index examination and the Systemic Lupus Activity Questionnaire; and (2) hydroxychloroquine pharmacokinetics and pharmacodynamics. Recruitment of the initial target of 20 participants was achieved within 10 days. Due to initial recruitment success, enrolment was increased to 26 participants. Additional participants who were interested were placed on a waiting list in case of dropouts during the study.Discussion and dissemination Direct-to-family trials offer several advantages but present unique challenges. Lessons learnt from the protocol development, design, and implementation of this trial will inform future direct-to-family trials for children and adults with rheumatic diseases. Additionally, the data collected remotely in this trial will provide critical information regarding the accuracy of teleresearch in lupus, the impact of adherence to hydroxychloroquine on disease activity and a pharmacokinetic analysis to inform paediatric-specific dosing of hydroxychloroquine.Trial registration number ClinicalTrials.gov Registry (NCT04358302)