Study of noise reduction characteristics of double-wall panels

The noise reduction characteristics of general aviation type, flat, double-wall structures were investigated. The experimental study was carried out on 20-by-20 inch panels with an exposed area of 18 by 18 inches. A frequency range from 20 to 5000 Hz was covered. The experimental results, in general, follow the expected trends. At low frequencies the double-wall structures are no better than the single-wall structures. However, for depths normally used in the general aviation industry, the double-wall panels are very attractive. The graphite-spoxy skin panels have higher noise reduction at very low frequencies ( 100 Hz) than the Kevlar skin panels. But the aluminum panels have higher noise reduction in the high frequency region, due to their greater mass. Use of fiberglass insulation is not effective in the low frequency region, and at times it is even negative. But the insulation is effective in the high-frequency region. The theoretical model for predicting the transmission loss of these multilayered panels is also discussed

Research-based versus clinical serum creatinine measurements and the association of acute kidney injury with subsequent kidney function: findings from the Chronic Renal Insufficiency Cohort study.

Background:Observational studies relying on clinically obtained data have shown that acute kidney injury (AKI) is linked to accelerated chronic kidney disease (CKD) progression. However, prior reports lacked uniform collection of important confounders such as proteinuria and pre-AKI kidney function trajectory, and may be susceptible to ascertainment bias, as patients may be more likely to undergo kidney function testing after AKI. Methods:We studied 444 adults with CKD who participated in the prospective Chronic Renal Insufficiency Cohort (CRIC) Study and were concurrent members of a large integrated healthcare delivery system. We estimated glomerular filtration rate (eGFR) trajectories using serum creatinine measurements from (i) the CRIC research protocol (yearly) and (ii) routine clinical care. We used linear mixed effects models to evaluate the associations of AKI with acute absolute change in eGFR and post-AKI eGFR slope, and explored whether these varied by source of creatinine results. Models were adjusted for demographic characteristics, diabetes status and albuminuria. Results:During median follow-up of 8.5 years, mean rate of eGFR loss was -0.31 mL/min/1.73 m2/year overall, and 73 individuals experienced AKI (55% Stage 1). A significant interaction existed between AKI and source of serum creatinine for acute absolute change in eGFR level after discharge; in contrast, AKI was independently associated with a faster rate of eGFR decline (mean additional loss of -0.67 mL/min/1.73 m2/year), which was not impacted by source of serum creatinine. Conclusions:AKI is independently associated with subsequent steeper eGFR decline regardless of the serum creatinine source used, but the strength of association is smaller than observed in prior studies after taking into account key confounders such as pre-AKI eGFR slope and albuminuria

Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry.

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291

ROOT RESORPTION DURING LEVELING AND ALIGNING PHASE OF ORTHODONTIC TREATMENT – A RADIOGRAPHIC STUDY

Aim: This study aims to evaluate the root resorption (RR) during the leveling and aligning phase in patients undergoing fixed orthodontic treatment. Objective: This study helps in evaluating RR of anterior teeth during leveling and aligning phase of orthodontic treatment. Methods: This study involves 12 patients undergoing fixed appliance mechanotherapy. The roots of the anterior teeth root were evaluated for RR in each of these patients at 2 time intervals (a) at the start of fixed orthodontic treatment and (b) at the end of leveling and alignment with the help of either two-dimensional digital radiograph or three-dimensional cone-beam computed tomography. Results: Computerized evaluation of apical RR showed that the mean averaged RR was 0.53 mm (standard deviation [SD] 0.47) for all four incisors; the average for the central incisors was 0.48 mm (SD 0.53). Conclusions: RR can be detected even in the early leveling stages of orthodontic treatment. About 25% of patients have an average resorption of up to 2 mm of the four maxillary incisors, in the leveling and alignment phase of fixed appliance therapy. Although teeth with long, narrow, and deviated roots are at increased risk of resorption during this early stage, the explained variance of these risk factors is <25%

ScanSavant: Malware Detection for Android Applications with Explainable AI

Mobile devices face SQL injection, malware, and web-based threats. Current solutions lack real-time detection. This paper introduces an Android app with advanced algorithms for real-time threat scanning. During testing, our application detected 94% of SQL injection attempts, outperforming the 86% average detection rate in similar studies. For malware analysis, it achieved a 97% detection accuracy on a dataset of infected files, higher than the industry standard of 93%. Additionally, our app can detect 85 malware variants and assign 15 attributes (Trojan.Gen.8, Worm.Autorun, Adware.Elex, Spyware.Zbot, Ransom.Cryptolocker, Rootkit.ZeroAccess, Exploit.CVE-2017-0143, Virus.MSIL.CoinMiner, Trojan.Emotet, Backdoor. DarkComet, PUP.Optional.Conduit, Adware.MyWebSearch, Virus.Win32.Sality, Trojan.Win32. Necurs, and Ransom.WannaCry) to some malwares, providing detailed analysis for better threat management. The application effectively scans both EXE and APK files, ensuring comprehensive protection. When assessing website links, the application identified security risks with 96% accuracy, demonstrating its capability in managing web-based threats. This app detects SQL injections, analyses malware, and assesses website security, bolstering cyber defence with user-friendly features and top-notch threat mitigation

A Comprehensive Integrated Security Model with Advanced Access Control for Enhancing WSN Computing in IoT Frameworks

Wireless Sensor Network (WSN) Computing has emerged as a pivotal intermediary process addressing latency challenges inherent in Cloud-oriented Internet of Things (IoT) services. However, this advancement brings forth significant security and privacy concerns exacerbated by the proliferation of network nodes and the vast volumes of real-time data generated within IoT frameworks. To mitigate these issues, this research proposes an Integrated Security Model with Advanced Access Control (ISM-AAC) Mechanism. The ISM-AAC integrates Functional Encryption (FE) and Role-Based Access Control (RBAC) to fortify communication security. The model employs a comprehensive approach encompassing Access Control Processes, Integrated Encryption Processes, and Re-Encryption Processes to enhance data confidentiality and integrity. The detailed framework includes phases such as system initialization, user management, and access permission administration, ensuring robust security throughout data transactions. Evaluation of the model's efficacy is conducted based on various security metrics pertinent to WSN computing environments. This study contributes to the advancement of secure computing in IoT by proposing a sophisticated ISM-AAC framework that not only addresses current security challenges but also anticipates future threats in the landscape of WSN computing. The findings underscore the model's effectiveness in safeguarding sensitive IoT data and lay the groundwork for future enhancements in IoT security protocols

Assessment of the accuracy of 3D printed medical models through reverse engineering

The dimensional accuracy of additively manufactured (3D printed) medical models can be affected by various parameters. Although different methods are used to evaluate the accuracy of additively manufactured models, this study focused on the investigation of the dimensional accuracy of the medical model based the combination of reverse engineering (RE) and additive manufacturing (AM) technologies. Human femur bone was constructed from CT images and manufactured, using Fortus 450mc Industrial material extrusion 3D Printer. The additive manufactured femur bone was subsequently 3D scanned using three distinct non-contact 3D scanners. MeshLab was used for mesh analysis, while VX Elements was used for post-processing of the point cloud. A combination of the VX Inspect environment and MeshLab was used to evaluate the scanning performance. The deviation of the 3D scanned 3D models from the reference mesh was determined using relative metrics and absolute measurements. The scanners reported deviations ranging from −0.375 mm to 0.388 mm, resulting in a total range of approximately 0.763 mm with average root mean square (RMS) deviation of 0.22 mm. The results indicate that the additively manufactured model, as measured by 3D scanning, has a mean deviation with an average range of approximately 0.46 mm and an average mean value of around 0.16 mm.publishedVersio

A research program to reduce interior noise in general aviation airplanes. Influence of depressurization and damping material on the noise reduction characteristics of flat and curved stiffened panels

Some 20 x 20 aluminum panels were studied in a frequency range from 20 Hz to 5000 Hz. The noise sources used were a swept sine wave generator and a random noise generator. The effect of noise source was found to be negligible. Increasing the pressure differential across the panel gave better noise reduction below the fundamental resonance frequency due to an increase in stiffness. The largest increase occurred in the first 1 psi pressure differential. The curved, stiffened panel exhibited similar behavior, but with a lower increase of low frequency noise reduction. Depressurization on these panels resulted in decreased noise reduction at higher frequencies. The effect of damping tapes on the overall noise reduction values of the test specimens was small away from the resonance frequency. In the mass-law region, a slight and proportional improvement in noise reduction was observed by adding damping material. Adding sound absorbtion material to a panel with damping material beneficially increased noise reduction at high frequencies

Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease

Background: Treatment with angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) is used to reduce proteinuria and retard the progression of chronic kidney disease (CKD). However, resolution of proteinuria may be incomplete with these therapies and the addition of an aldosterone antagonist may be added to further prevent progression of CKD. This is an update of a Cochrane review first published in 2009 and updated in 2014. Objectives: To evaluate the effects of aldosterone antagonists (selective (eplerenone), non-selective (spironolactone or canrenone), or non-steroidal mineralocorticoid antagonists (finerenone)) in adults who have CKD with proteinuria (nephrotic and non-nephrotic range) on: patient-centred endpoints including kidney failure (previously know as end-stage kidney disease (ESKD)), major cardiovascular events, and death (any cause); kidney function (proteinuria, estimated glomerular filtration rate (eGFR), and doubling of serum creatinine); blood pressure; and adverse events (including hyperkalaemia, acute kidney injury, and gynaecomastia). Search methods: We searched the Cochrane Kidney and Transplant Register of Studies up to 13 January 2020 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal, and ClinicalTrials.gov. Selection criteria: We included randomised controlled trials (RCTs) and quasi-RCTs that compared aldosterone antagonists in combination with ACEi or ARB (or both) to other anti-hypertensive strategies or placebo in participants with proteinuric CKD. Data collection and analysis: Two authors independently assessed study quality and extracted data. Data were summarised using random effects meta-analysis. We expressed summary treatment estimates as a risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, or standardised mean difference (SMD) when different scales were used together with their 95% confidence interval (CI). Risk of bias were assessed using the Cochrane tool. Evidence certainty was evaluated using GRADE. Main results: Forty-four studies (5745 participants) were included. Risk of bias in the evaluated methodological domains were unclear or high risk in most studies. Adequate random sequence generation was present in 12 studies, allocation concealment in five studies, blinding of participant and investigators in 18 studies, blinding of outcome assessment in 15 studies, and complete outcome reporting in 24 studies. All studies comparing aldosterone antagonists to placebo or standard care were used in addition to an ACEi or ARB (or both). None of the studies were powered to detect differences in patient-level outcomes including kidney failure, major cardiovascular events or death. Aldosterone antagonists had uncertain effects on kidney failure (2 studies, 84 participants: RR 3.00, 95% CI 0.33 to 27.65, I² = 0%; very low certainty evidence), death (3 studies, 421 participants: RR 0.58, 95% CI 0.10 to 3.50, I² = 0%; low certainty evidence), and cardiovascular events (3 studies, 1067 participants: RR 0.95, 95% CI 0.26 to 3.56; I² = 42%; low certainty evidence) compared to placebo or standard care. Aldosterone antagonists may reduce protein excretion (14 studies, 1193 participants: SMD -0.51, 95% CI -0.82 to -0.20, I² = 82%; very low certainty evidence), eGFR (13 studies, 1165 participants, MD -3.00 mL/min/1.73 m², 95% CI -5.51 to -0.49, I² = 0%, low certainty evidence) and systolic blood pressure (14 studies, 911 participants: MD -4.98 mmHg, 95% CI -8.22 to -1.75, I² = 87%; very low certainty evidence) compared to placebo or standard care. Aldosterone antagonists probably increase the risk of hyperkalaemia (17 studies, 3001 participants: RR 2.17, 95% CI 1.47 to 3.22, I² = 0%; moderate certainty evidence), acute kidney injury (5 studies, 1446 participants: RR 2.04, 95% CI 1.05 to 3.97, I² = 0%; moderate certainty evidence), and gynaecomastia (4 studies, 281 participants: RR 5.14, 95% CI 1.14 to 23.23, I² = 0%; moderate certainty evidence) compared to placebo or standard care. Non-selective aldosterone antagonists plus ACEi or ARB had uncertain effects on protein excretion (2 studies, 139 participants: SMD -1.59, 95% CI -3.80 to 0.62, I² = 93%; very low certainty evidence) but may increase serum potassium (2 studies, 121 participants: MD 0.31 mEq/L, 95% CI 0.17 to 0.45, I² = 0%; low certainty evidence) compared to diuretics plus ACEi or ARB. Selective aldosterone antagonists may increase the risk of hyperkalaemia (2 studies, 500 participants: RR 1.62, 95% CI 0.66 to 3.95, I² = 0%; low certainty evidence) compared ACEi or ARB (or both). There were insufficient studies to perform meta-analyses for the comparison between non-selective aldosterone antagonists and calcium channel blockers, selective aldosterone antagonists plus ACEi or ARB (or both) and nitrate plus ACEi or ARB (or both), and non-steroidal mineralocorticoid antagonists and selective aldosterone antagonists. Authors' conclusions: The effects of aldosterone antagonists when added to ACEi or ARB (or both) on the risks of death, major cardiovascular events, and kidney failure in people with proteinuric CKD are uncertain. Aldosterone antagonists may reduce proteinuria, eGFR, and systolic blood pressure in adults who have mild to moderate CKD but may increase the risk of hyperkalaemia, acute kidney injury and gynaecomastia when added to ACEi and/or ARB

Heart Failure-Type Symptom Score Trajectories in CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

RATIONALE & OBJECTIVE: Quality of life in chronic kidney disease (CKD) is impaired by a large burden of symptoms including some that overlap with the symptoms of heart failure (HF). We studied a group of individuals with CKD to understand the patterns and trajectories of HF-type symptoms in this setting. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 3,044 participants in the Chronic Renal Insufficiency Cohort (CRIC) without prior diagnosis of HF. PREDICTORS: Sociodemographics, medical history, medications, vital signs, laboratory values, echocardiographic and electrocardiographic parameters. OUTCOME: Trajectory over 5.5 years of a HF-type symptom score (modified Kansas City Cardiomyopathy Questionnaire [KCCQ] Overall Summary Score with a range of 0-100 wheresymptoms). ANALYTICAL APPROACH: Latent class mixed models were used to model trajectories. Multinomial logistic regression was used to model relationships of predictors with trajectory group membership. RESULTS: Five trajectories of KCCQ score were identified in the cohort of 3,044 adults, 45% of whom were female, and whose median age was 61 years. Group 1 (41.7%) had a stable high score (minimal symptoms, average score of 96); groups 2 (35.6%) and 3 (15.6%) had stable but lower scores (mild symptoms [average of 81] and clinically significant symptoms [average of 52], respectively). Group 4 (4.9%) had a substantial worsening in symptoms over time (mean 31-point decline), and group 5 (2.2%) had a substantial improvement (mean 33-point increase) in KCCQ score. A majority of group 1 was male, without diabetes or obesity, and this group had higher baseline kidney function. A majority of groups 2 and 3 had diabetes and obesity. A majority of group 4 was male and had substantial proteinuria. Group 5 had the highest proportion of baseline cardiovascular disease (CVD). LIMITATIONS: No validation cohort available, CKD management changes in recent years may alter trajectories, and latent class models depend on the missing at random assumption. CONCLUSIONS: Distinct HF-type symptom burden trajectories were identified in the setting of CKD, corresponding to different baseline characteristics. These results highlight the diversity of HF-type symptom experiences in individuals with CKD