Long-term observation of the patient after CABG with asymptomatic high-grade aortic regurgitation – a clinical case study

Introduction: The aortic valve regurgitation (AR) is a heart defect consisting of the retrograde flow of blood from the aorta to the left ventricle due to the improper closure of the aortic valve leaflets. It occurs approximately in 13% of men and 8.5% of women, and the incidence increases with age. A crucial issue in regards to a patient with asymptomatic AR, especially of a high degree, is determination of the time of qualification for invasive treatment. Aim: To draw attention to the necessity of holistic approach to a patient with asymptomatic high-grade aortic regurgitation. Moreover, the complications of delayed implementation of invasive treatment were discussed. Case report: A clinical case of a 62-year-old patient with a history of coronary artery bypass grafting and with AR – stage II, accidentally detected two years later in a control echocardiogram, was presented. Despite gradual progress of regurgitation, none of the disturbing symptoms were noted, whereas cardiac parameters were systematically monitored using ECG, ECHO and CT imaging. Beta blockers, ACE inhibitors, loop diuretics and aspirin were used as conservative treatment. After 10-year transthoracic echocardiographic follow-up due to progression of AR and development of heart failure, the patient was qualified to surgical replacement of the aortic valve. This procedure significantly improved the patient's quality of life. Summary: The key element in the treatment of chronic asymptomatic AR is the individualization of the therapy. An essential role is played by appropriate pharmacotherapy, precise monitoring using transthoracic echocardiography, which is recommended as the first-line imaging strategy. Delaying in the implementation of surgical treatment may result in failure of the therapy and the onset of serious complications

The ESCAPE project : Energy-efficient Scalable Algorithms for Weather Prediction at Exascale

In the simulation of complex multi-scale flows arising in weather and climate modelling, one of the biggest challenges is to satisfy strict service requirements in terms of time to solution and to satisfy budgetary constraints in terms of energy to solution, without compromising the accuracy and stability of the application. These simulations require algorithms that minimise the energy footprint along with the time required to produce a solution, maintain the physically required level of accuracy, are numerically stable, and are resilient in case of hardware failure. The European Centre for Medium-Range Weather Forecasts (ECMWF) led the ESCAPE (Energy-efficient Scalable Algorithms for Weather Prediction at Exascale) project, funded by Horizon 2020 (H2020) under the FET-HPC (Future and Emerging Technologies in High Performance Computing) initiative. The goal of ESCAPE was to develop a sustainable strategy to evolve weather and climate prediction models to next-generation computing technologies. The project partners incorporate the expertise of leading European regional forecasting consortia, university research, experienced high-performance computing centres, and hardware vendors. This paper presents an overview of the ESCAPE strategy: (i) identify domain-specific key algorithmic motifs in weather prediction and climate models (which we term Weather & Climate Dwarfs), (ii) categorise them in terms of computational and communication patterns while (iii) adapting them to different hardware architectures with alternative programming models, (iv) analyse the challenges in optimising, and (v) find alternative algorithms for the same scheme. The participating weather prediction models are the following: IFS (Integrated Forecasting System); ALARO, a combination of AROME (Application de la Recherche a l'Operationnel a Meso-Echelle) and ALADIN (Aire Limitee Adaptation Dynamique Developpement International); and COSMO-EULAG, a combination of COSMO (Consortium for Small-scale Modeling) and EULAG (Eulerian and semi-Lagrangian fluid solver). For many of the weather and climate dwarfs ESCAPE provides prototype implementations on different hardware architectures (mainly Intel Skylake CPUs, NVIDIA GPUs, Intel Xeon Phi, Optalysys optical processor) with different programming models. The spectral transform dwarf represents a detailed example of the co-design cycle of an ESCAPE dwarf. The dwarf concept has proven to be extremely useful for the rapid prototyping of alternative algorithms and their interaction with hardware; e.g. the use of a domain-specific language (DSL). Manual adaptations have led to substantial accelerations of key algorithms in numerical weather prediction (NWP) but are not a general recipe for the performance portability of complex NWP models. Existing DSLs are found to require further evolution but are promising tools for achieving the latter. Measurements of energy and time to solution suggest that a future focus needs to be on exploiting the simultaneous use of all available resources in hybrid CPU-GPU arrangements

The ESCAPE project: Energy-efficient Scalable Algorithms for Weather Prediction at Exascale

Abstract. In the simulation of complex multi-scale flows arising in weather and climate modelling, one of the biggest challenges is to satisfy strict service requirements in terms of time to solution and to satisfy budgetary constraints in terms of energy to solution, without compromising the accuracy and stability of the application. These simulations require algorithms that minimise the energy footprint along with the time required to produce a solution, maintain the physically required level of accuracy, are numerically stable, and are resilient in case of hardware failure. The European Centre for Medium-Range Weather Forecasts (ECMWF) led the ESCAPE (Energy-efficient Scalable Algorithms for Weather Prediction at Exascale) project, funded by Horizon 2020 (H2020) under the FET-HPC (Future and Emerging Technologies in High Performance Computing) initiative. The goal of ESCAPE was to develop a sustainable strategy to evolve weather and climate prediction models to next-generation computing technologies. The project partners incorporate the expertise of leading European regional forecasting consortia, university research, experienced high-performance computing centres, and hardware vendors. This paper presents an overview of the ESCAPE strategy: (i) identify domain-specific key algorithmic motifs in weather prediction and climate models (which we term Weather & Climate Dwarfs), (ii) categorise them in terms of computational and communication patterns while (iii) adapting them to different hardware architectures with alternative programming models, (iv) analyse the challenges in optimising, and (v) find alternative algorithms for the same scheme. The participating weather prediction models are the following: IFS (Integrated Forecasting System); ALARO, a combination of AROME (Application de la Recherche à l'Opérationnel à Meso-Echelle) and ALADIN (Aire Limitée Adaptation Dynamique Développement International); and COSMO–EULAG, a combination of COSMO (Consortium for Small-scale Modeling) and EULAG (Eulerian and semi-Lagrangian fluid solver). For many of the weather and climate dwarfs ESCAPE provides prototype implementations on different hardware architectures (mainly Intel Skylake CPUs, NVIDIA GPUs, Intel Xeon Phi, Optalysys optical processor) with different programming models. The spectral transform dwarf represents a detailed example of the co-design cycle of an ESCAPE dwarf. The dwarf concept has proven to be extremely useful for the rapid prototyping of alternative algorithms and their interaction with hardware; e.g. the use of a domain-specific language (DSL). Manual adaptations have led to substantial accelerations of key algorithms in numerical weather prediction (NWP) but are not a general recipe for the performance portability of complex NWP models. Existing DSLs are found to require further evolution but are promising tools for achieving the latter. Measurements of energy and time to solution suggest that a future focus needs to be on exploiting the simultaneous use of all available resources in hybrid CPU–GPU arrangements

New Concept of Hybrid Propulsion with Hydrostatic Gear for Inland Water Transport

The article presents the development of author’s concept of a diesel/hydraulic propulsion system for inland watercraft. Due to specific nature of vessel navigation on rivers, classical propulsion systems with shaft lines can be effectively replaced by systems with hydraulic power transmission. A solution is also presented of a hybrid design with extra electric port having the form of a pumping system driven from a battery of accumulators. Strong and weak points of the proposed solution are discussed and its energy efficiency is assessed

Intelligent security system in residential buildings

Celem artykułu jest przedstawienie systemu zabezpieczeń połączonych razem z system inteligentnego zarządzania domem na przykładzie struktury sieci Fibaro. Została zaprezentowana problematyka dotycząca projektowania, doboru i montażu urządzeń systemów zabezpieczeń. Na podstawie zamieszczonych danych możliwe jest również porównanie działania stosowanych systemów w celu analizy skuteczności poszczególnych zabezpieczeń.The paper presents the security system connected to the intelligent home management system on the example of the Fibaro network structure. Issues related to the design, selection and installation of security system devices were presented. On the basis of the data provided, it is also possible to compare the operation of the systems used to analyze the effectiveness of individual protections

Experimental Research on the Energy Efficiency of a Parallel Hybrid Drive for an Inland Ship

The growing requirements for limiting the negative impact of all modes of transport on the natural environment mean that clean technologies are becoming more and more important. The global trend of e-mobility also applies to sea and inland water transport. This article presents the results of experimental tests carried out on a life-size, parallel diesel-electric hybrid propulsion system. The efficiency of the propulsion system was analysed for two modes of operation (electric and diesel) and for different engine speeds and loads. Analysis of the impact of using a hybrid propulsion system on fuel consumption was carried out on a case study vessel and for six actual journeys. The use of hybrid propulsion in “zero emission” mode enables up to four times higher energy efficiency when compared to a conventional drive, while reducing CO2 emissions and air pollution to zero, as well as a hundred-fold reduction in noise emissions. High flexibility in the operation of such a drive enables the use of intelligent power control technology (smart propulsion). This article shows that the use of hybrid propulsion reduces the negative impact on the environment to a minimum and allows for a significant reduction in the vessel’s operating costs

Assessing the potential replacement of mineral oil with environmentally acceptable lubricants in a stern tube bearing: an experimental analysis of bearing performance

This study compares the performance of a plain bearing, with a similar structure to a tail shaft stern bearing, lubricated with either mineral oil or an environmentally acceptable lubricant (EAL). The main characteristic of the bearing is its length/diameter ratio of <1. Measurements are carried out with the bearing operating under loads from 0.5 to 1 MPa and seven speeds ranging from 1 to 11 rev/s. The bearing lubricated with either mineral oil with a viscosity grade of 100 or an environmentally acceptable lubricant (EAL) with a viscosity grade of 100 or 150 is investigated according to the ISO standard. Bearing wear is simulated by increasing the clearance circle by 0.1 mm. According to the results obtained, the use of an EAL in place of mineral oil does not cause significant changes in the bearing performance, regardless of the value of the clearance radius. The pressure distribution in the oil film, bearing load carrying capacity, eccentricity and friction coefficient have similar values for the entire load and speed ranges considered, and the discrepancies in the results are within the range of the measurement errors. Only an increase in EAL viscosity causes significant changes in bearing performance and these changes comply with the general theory of lubrication

Influence of chronic stress in pregnant women on development of eating habits in their offspring in postnatal life

Współcześnie stres stał się integralną częścią życia ludzkiego i towarzyszy mu od momentu poczęcia aż do chwili śmierci. Efekty jego działania na organizm ludzki w bardzo dużym stopniu zależą od zaprogramowanych już w okresie prenatalnym wzorców reakcji. Negatywne bodźce prowadzą do aktywacji osi podwzgórze-przysadka-nadnercza, a także znacznego pobudzenia autonomicznego układu nerwowego. Przewlekłe napięcie skutkuje istotnym podwyższeniem poziomu hormonów „stresu”, które przełamując naturalną, enzymatyczną barierę płodowo-łożyskową wnikają do krwiobiegu płodu, przyczyniając się do powstania istotnych zaburzeń w kształtowaniu zachowań żywieniowych. Konsekwencją tego stanu jest znaczne ryzyko rozwoju nadwagi oraz otyłości w życiu postnatalnym u dzieci matek, które poddawane były chronicznemu stresowi w okresie ciąży. Ekspozycja ciężarnej kobiety na bodźce stresowe wywiera także istotne implikacje na kształtujący się ośrodkowy układ nerwowy. Zaburzenia w rozwoju szlaków przekaźnictwa w obrębie mózgu, a zwłaszcza podwzgórza jako narządu sprawującego wiodącą rolę w centralnej regulacji przyjmowania pokarmu, mogą w istotny sposób wpływać na ilość oraz kaloryczność wybieranych produktów żywnościowych. Podjęcie próby wyjaśnienia złożonych mechanizmów między chronicznym stresem w życiu prenatalnym oraz nadwagą i otyłością w okresie postnatalnym stanowi nadrzędną kwestię z uwagi na narastający w zatrważającym tempie odsetek osób z tymi schorzeniami, głównie wśród dzieci i młodzieży, a także mnogość powikłań obejmujących niemal wszystkie układy organizmu ludzkiego.Nowadays, stress became an integral part of human life and accompanies it from conception to death. Effects of its influence on human organism are mainly dependent on patterns of reaction programmed already in prenatal period. Negative stimuli lead to activation of hypothalamic– pituitary–adrenal axis and autonomic nervous system. Chronic tension results in significant increase in the level of stress hormones which break natural and enzymatic placental barrier and permeate to fetus’ bloodstream thus contributing to significant disorders in development of eating habits. A consequence of this situation is considerable risk of overweight in postnatal life of children of those mothers who were subjected to chronic stress during pregnancy. Exposition of pregnant woman to stress stimuli also has significant implications on developing central nervous system. Disorders in brain transmission pathways, especially of hypothalamus as an organ which has a major role in central regulation of food intake, may significantly influence amount and calorific value of chosen foods. Attempt to explain complex mechanisms between chronic stress in prenatal period and excessive weight in postnatal period is paramount because of rapidly increasing percentage of people with such affliction, mainly among children and teenagers, and multitude of complications involving all systems of human organism

Badania wytrzymałości mechanicznej wybranych lin alpinistycznych wykorzystywanych w PSP ze względu na uszkodzenia powstające w działaniach ratowniczych

The paper deals with the issue of mechanical strength of climbing ropes. These ropes are exposed to the influence of exploitation factors both during training and in rescue operations. Among others, they may sustain mechanical, thermal and chemical damage. The study attempted to provide an evaluation of the effect this damage has on the mechanical strength and extensibility of ropes. The tests were carried out in laboratory conditions, and the courses of force in the function of deformation and impact of force on deformation were recorded. An unfavourable influence of some types of damage on the strength and extensibility of ropes was demonstrated. Mechanical and thermal stresses mainly cause damage to the rope sheath. Their effect on endurance is similar. The remaining strength of the rope is slightly above the minimum allowable tensile strength. On the other hand, the chemical treatment did not cause a noticeable decrease in the rope’s strength.W pracy podjęto problematykę wytrzymałości mechanicznej lin alpinistycznych. Line te narażone są na oddziaływanie czynników eksploatacyjnych w warunkach ćwiczeń i działań ratowniczych. Mogą powstawać m.in. uszkodzenia mechaniczne, termiczne i chemiczne. W pracy oceniono wpływ uszkodzeń na wytrzymałość mechaniczną i rozciągliwość lin. Badania wykonano w warunkach laboratoryjnych, rejestrowano przebiegi siły w funkcji odkształcenia oraz pracę siły na odkształceniu. Wykazano niekorzystny wpływ niektórych typów uszkodzeń na wytrzymałość i rozciągliwość lin. Narażenia mechaniczne i termiczne uszkadzają głównie oplot liny. Ich wpływ na wytrzymałość jest podobny. Pozostała wytrzymałość liny w niewielkim stopniu przewyższa minimalną dopuszczalną wytrzymałość na rozciąganie. Natomiast działanie środkiem chemicznym nie spowodowało zauważalnego spadku wytrzymałości liny

Impact of the Development of the Design of Firefighter Helmets on the Mechanical Shock Absorption Capacity

A firefighter's helmet is used as a basic personal protective equipment item. The purpose of the helmet is to absorb a part of mechanical impact acting towards the rescuer's cervical spine, which may lead to its injury. The aim of the study was to determine the effect of changes in the helmet design on the threshold passive forces transferred to the firefighter's cervical spine. The test subjects were firefighter’s helmets compliant with the European standard for helmets used by fire brigades. The study was carried out under model conditions, using special equipment with a head model and an additional force sensor placed under it, where the cervical spine is anatomically located. The central impact energy was assumed to be 60 J. A semi-spherically ended beater was used. The experimentally determined force-displacement characteristics revealed two phases of force increase. Using polyurethane foam as a cushioning insert instead of the expanded polyester used in older designs reduced values of forces in the first phase of the characteristic. There were many cases where the critical passive force value was exceeded, which would have resulted in the cervical spine injury. Modifications in material selection and component manufacturing technology affect the protective capabilities of firefighter’s helmets and result in their improvement. Nevertheless, helmets that are currently in use are still affected by forces whose values exceed the ones that are considered to be safe for a firefighter