Effects of a comprehensive rehabilitation program on quality of life in patients with chronic heart failure

This evaluation was performed to assess the effects of a new, comprehensive outpatient rehabilitation program on generic and disease-specific quality of life related to exercise tolerance in stable chronic heart failure patients. Fifty-one patients (aged 59+/-11 years; 84% men) were treated for 12 weeks. Patients underwent optimized drug treatment, exercise training, and counseling and education. At baseline and at the end of the program, functional status, exercise capacity, and quality of life were assessed using the Medical Outcomes Study 36-item Short-Form Health Survey and the Minnesota Living with Heart Failure Questionnaire. Left ventricular ejection fraction and New York Heart Association functional class, as well as measures of physical fitness and walking distance covered in 6 minutes, improved significantly (by 11%-20% and by 58% on average, respectively). Physical functioning (effect size, 0.38; p<0.0001), role functioning (effect size, 0.17; p<0.05), and mental component score (effect size, 0.47; p<0.0001) on the questionnaire improved significantly. Disease-specific quality of life improved in sum score (effect size, 0.24; p<0.0001) and physical component score (effect size, 0.35; p<0.0001). The latter was inversely correlated to improvement in peak power output (r= -0.31; p<0.05). In patients with stable chronic heart failure, significant improvements in both generic and disease-specific quality of life related to improved exercise tolerance can be achieved within 12 weeks of comprehensive rehabilitation.

Training in hypoxia and its effects on skeletal muscle tissue

It is well established that local muscle tissue hypoxia is an important consequence and possibly a relevant adaptive signal of endurance exercise training in humans. It has been reasoned that it might be advantageous to increase this exercise stimulus by working in hypoxia. However, as long-term exposure to severe hypoxia has been shown to be detrimental to muscle tissue, experimental protocols were developed that expose subjects to hypoxia only for the duration of the exercise session and allow recovery in normoxia (live low-train high or hypoxic training). This overview reports data from 27 controlled studies using some implementation of hypoxic training paradigms. Hypoxia exposure varied between 2300 and 5700 m and training duration ranged from 10 days to 8 weeks. A similar number of studies was carried out on untrained and on trained subjects. Muscle structural, biochemical and molecular findings point to a specific role of hypoxia in endurance training. However, based on the available data on global estimates of performance capacity such as maximal oxygen uptake (VO2max) and maximal power output (Pmax), hypoxia as a supplement to training is not consistently found to be of advantage for performance at sea level. There is some evidence mainly from studies on untrained subjects for an advantage of hypoxic training for performance at altitude. Live low-train high may be considered when altitude acclimatization is not an option.

High-volume FES-cycling partially reverses bone loss in people with chronic spinal cord injury

Spinal cord injury (SCI) leads to severe bone loss in the paralysed limbs and to a resulting increased fracture risk thereof. Since long bone fractures can lead to comorbidities and a reduction in quality of life, it is important to improve bone strength in people with chronic SCI. In this prospective longitudinal cohort study, we investigated whether functional electrical stimulation (FES) induced high-volume cycle training can partially reverse the loss of bone substance in the legs after chronic complete SCI. Eleven participants with motor-sensory complete SCI (mean age 41.9+/-7.5 years; 11.0+/-7.1 years post injury) were recruited. After an initial phase of 14+/-7 weeks of FES muscle conditioning, participants performed on average 3.7+/-0.6 FES-cycling sessions per week, of 58+/-5 min each, over 12 months at each individual's highest power output. Bone and muscle parameters were investigated in the legs by means of peripheral quantitative computed tomography before the muscle conditioning (t1), and after six (t2) and 12 months (t3) of high-volume FES-cycle training. After 12 months of FES-cycling, trabecular and total bone mineral density (BMD) as well as total cross-sectional area in the distal femoral epiphysis increased significantly by 14.4+/-21.1%, 7.0+/-10.8% and 1.2+/-1.5%, respectively. Bone parameters in the femoral shaft showed small but significant decreases, with a reduction of 0.4+/-0.4% in cortical BMD, 1.8+/-3.0% in bone mineral content, and 1.5+/-2.1% in cortical thickness. These decreases mainly occurred between t1 and t2. No significant changes were found in any of the measured bone parameters in the tibia. Muscle CSA at the thigh increased significantly by 35.5+/-18.3%, while fat CSA at the shank decreased by 16.7+/-12.3%. Our results indicate that high-volume FES-cycle training leads to site-specific skeletal changes in the paralysed limbs, with an increase in bone parameters at the actively loaded distal femur but not the passively loaded tibia. Thus, we conclude that high-volume FES-induced cycle training has clinical relevance as it can partially reverse bone loss and thus may reduce fracture risk at this fracture prone site.

A TWO-STAGE MICROBIAL FUEL CELL SYSTEM TO CONVERT SOLID ORGANIC WASTE TO ELECTRICITY

Microbial fuel cell (MFC) research has focused mostly on producing electricity using soluble organic and inorganic substrates. This study focused on converting solid organic waste into electricity using a two-stage MFC process. In the first stage, a hydrolysis reactor produced soluble organic substrates from solid organic waste. The soluble substrates from the hydrolysis reactor were pumped to the second stage reactor: a continuous-flow, air-cathode MFC. Maximum power output (Pmax) of the MFC was 296 mW/m3 at a current density of 25.4 mA/m2 while being fed only leachate from the first stage reactor. Addition of phosphate buffer increased Pmax to 1,470 mW/m3 (89.4 mA/m2), although this result could not be duplicated with repeated polarization testing. The minimum internal resistance achieved was 77 Omega with leachate feed and 17 Omega with phosphate buffer. The low coulombic efficiency (

COMPUTATIONAL ANALYSIS OF THE AEROELASTIC DYNAMICS OF A WIND TURBINE BLADE WITH VARIABLE-SPEED STALL CONTROL

The accuracy of simulating the aerodynamics and structural properties of the blades is crucial in the wind-turbine technology. Hence the models used to implement these features need to be very precise and their level of detailing needs to be high. With the variety of blade designs being developed the models should be versatile enough to adapt to the changes required by every design. We are going to implement a combination of numerical models which are associated with the structural and the aerodynamic part of the simulation using the computational power of a parallel HPC cluster. The structural part models the heterogeneous internal structure of the beam based on a novel implementation of the Generalized Timoshenko Beam Model Technique.. Using this technique the 3-D structure of the blade is reduced into a 1-D beam which is asymptotically equivalent. This reduces the computational cost of the model without compromising its accuracy. This structural model interacts with the Flow model which is a modified version of the Blade Element Momentum Theory. The modified version of the BEM accounts for the large deflections of the blade and also considers the pre-defined structure of the blade. The coning, sweeping of the blade, tilt of the nacelle and the twist of the sections along the blade length are all computed by the model which aren’t considered in the classical BEM theory. Each of these two models provides feedback to the other and the interactive computations lead to more accurate outputs. We successfully implemented the computational models to analyze and simulate the structural and aerodynamic aspects of the blades. The interactive nature of these models and their ability to recompute data using the feedback from each other makes this code more efficient than the commercial codes available. In this thesis we start off with the verification of these models by testing it on the well-known benchmark blade for the NREL-5MW Reference Wind Turbine, an alternative fixed-speed stall-controlled blade design proposed by Delft University, and a novel alternative design that we proposed for a variable-speed stall-controlled turbine, which offers the potential for more uniform power control and improved annual energy production.. To optimize the power output of the stall-controlled blade we modify the existing designs and study their behavior using the aforementioned aero elastic model.

A Physiological Controller for Turbodynamic Ventricular Assist Devices Based on a Measurement of the Left Ventricular Volume

The current article presents a novel physiological control algorithm for ventricular assist devices (VADs), which is inspired by the preload recruitable stroke work. This controller adapts the hydraulic power output of the VAD to the end-diastolic volume of the left ventricle. We tested this controller on a hybrid mock circulation where the left ventricular volume (LVV) is known, i.e., the problem of measuring the LVV is not addressed in the current article. Experiments were conducted to compare the response of the controller with the physiological and with the pathological circulation, with and without VAD support. A sensitivity analysis was performed to analyze the influence of the controller parameters and the influence of the quality of the LVV signal on the performance of the control algorithm. The results show that the controller induces a response similar to the physiological circulation and effectively prevents over- and underpumping, i.e., ventricular suction and backflow from the aorta to the left ventricle, respectively. The same results are obtained in the case of a disturbed LVV signal. The results presented in the current article motivate the development of a robust, long-term stable sensor to measure the LVV.

Hypoxia refines plasticity of mitochondrial respiration to repeated muscle work.

PURPOSE We explored whether altered expression of factors tuning mitochondrial metabolism contributes to muscular adaptations with endurance training in the condition of lowered ambient oxygen concentration (hypoxia) and whether these adaptations relate to oxygen transfer as reflected by subsarcolemmal mitochondria and oxygen metabolism in muscle. METHODS Male volunteers completed 30 bicycle exercise sessions in normoxia or normobaric hypoxia (4,000 m above sea level) at 65% of the respective peak aerobic power output. Myoglobin content, basal oxygen consumption, and re-oxygenation rates upon reperfusion after 8 min of arterial occlusion were measured in vastus muscles by magnetic resonance spectroscopy. Biopsies from vastus lateralis muscle, collected pre and post a single exercise bout, and training, were assessed for levels of transcripts and proteins being associated with mitochondrial metabolism. RESULTS Hypoxia specifically lowered the training-induced expression of markers of respiratory complex II and IV (i.e. SDHA and isoform 1 of COX-4; COX4I1) and preserved fibre cross-sectional area. Concomitantly, trends (p < 0.10) were found for a hypoxia-specific reduction in the basal oxygen consumption rate, and improvements in oxygen repletion, and aerobic performance in hypoxia. Repeated exercise in hypoxia promoted the biogenesis of subsarcolemmal mitochondria and this was co-related to expression of isoform 2 of COX-4 with higher oxygen affinity after single exercise, de-oxygenation time and myoglobin content (r ≥ 0.75). Conversely, expression in COX4I1 with training correlated negatively with changes of subsarcolemmal mitochondria (r < -0.82). CONCLUSION Hypoxia-modulated adjustments of aerobic performance with repeated muscle work are reflected by expressional adaptations within the respiratory chain and modified muscle oxygen metabolism.

Influence of Loudness Compression on Hearing with Bone Anchored Hearing Implants

Bone Anchored Hearing Implants (BAHI) are routinely used in patients with conductive or mixed hearing loss, e.g. if conventional air conduction hearing aids cannot be used. New sound processors and new fitting software now allow the adjustment of parameters such as loudness compression ratios or maximum power output separately. Today it is unclear, how the choice of these parameters influences aided speech understanding in BAHI users. In this prospective experimental study, the effect of varying the compression ratio and lowering the maximum power output in a BAHI were investigated. Twelve experienced adult subjects with a mixed hearing loss participated in this study. Four different compression ratios (1.0; 1.3; 1.6; 2.0) were tested along with two different maximum power output settings, resulting in a total of eight different programs. Each participant tested each program during two weeks. A blinded Latin square design was used to minimize bias. For each of the eight programs, speech understanding in quiet and in noise was assessed. For speech in quiet, the Freiburg number test and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL were used. For speech in noise, the Oldenburg sentence test was administered. Speech understanding in quiet and in noise was improved significantly in the aided condition in any program, when compared to the unaided condition. However, no significant differences were found between any of the eight programs. In contrast, on a subjective level there was a significant preference for medium compression ratios of 1.3 to 1.6 and higher maximum power output.

Longitudinal Changes in Response to a Cycle-Run Field Test of Young Male National "Talent identification" and Senior Elite Triathlon Squads.

This study investigated the changes in cardiorespiratory response and running performance of 9 male ?Talent Identification? (TID) and 6 male Senior Elite (SE) Spanish National Squad triathletes during a specific cycle-run test. The TID and SE triathletes (initial age 15.2±0.7 vs. 23.8±5.6 years, p=0.03; tests through the competitive period and the preparatory period, respectively, of two consecutive seasons: Test 1 was an incremental cycle test to determine the ventilatory threshold (Thvent); Test 2 (C-R) was 30 min constant load cycling at the Thvent power output followed by a 3-km time trial run; and Test 3 (R) was an isolated 3-km time trial control run, in randomized counterbalanced order. In both seasons the time required to complete the C-R 3-km run was greater than for R in TID (11:09±00:24 vs. 10:45±00:16 min:ss, pmenor que 0.01; and 10:24±00:22 vs. 10:04±00:14, p=0.006, for season 2005/06 and 2006/07, respectively) and SE (10:15±00:19 vs. 09:45±00:30, pmenor que 0.001 and 09:51±00:26 vs. 09:46±00:06, p= 0.02 for season 2005/06 and 2006/07, respectively). Compared to the first season, completion of the time trial run was faster in the second season (6.6%, pmenor que 0.01 and 6.4%, pmenor que 0.01, for C-R and R test, respectively) only in TID. Changes in post-cycling run performance were accompanied by changes in pacing strategy but only slight or non-significant changes in the cardiorespiratory response. Thus, the negative effect of cycling on performance may persist, independently of the period, over two consecutive seasons in TID and SE triathletes; however A improvements over time suggests that monitoring running pacing strategy after cycling may be a useful tool to control performance and training adaptations in TID. O2max 77.0±5.6 vs. 77.8±3.6 mL·kg-1·min-1, NS) underwent three TE D EP C C

Sound of lasers (SOL) - An audiovisual approach to semiconductor laser dynamics

We present an educational software addressed to the students of optical communication courses, for a simple visualization of the basic dynamic processes of semiconductor lasers. The graphic interface allows the user to choose the laser and the modulation parameters and it plots the laser power output and instantaneous frequency versus time. Additionally, the optical frequency variations are numerically shifted into the audible frequency range in order to produce a sound wave from the computer loudspeakers. Using the proposed software, the student can simultaneously see and hear how the laser intensity and frequency change, depending on the modulation and device parameters.

Flow and wakes in large wind farms in complex terrain and offshore

Power losses due to wind turbine wakes are of the order of 10 and 20% of total power output in large wind farms. The focus of this research carried out within the EC funded UPWIND project is wind speed and turbulence modelling for large wind farms/wind turbines in complex terrain and offshore in order to optimise wind farm layouts to reduce wake losses and loads.

Flow and wakes in complex terrain and offshore. Model development and verification in UPWIND

The paper presents research conducted in the Flow workpackage of the EU funded UPWIND project which focuses on improving models for flow within and downwind of large wind farms in complex terrain and offshore. The main activity is modelling the behaviour of wind turbine wakes in order to improve power output predictions.

Análisis de la aplicación de Soldadura de acero de calidad "A" mediante láser de Neodimio-YAG en construcción naval

El proceso de soldadura por láser desarrollado en los últimos años ha puesto de manifiesto las posibilidades de aplicación de esta tecnología en diferentes sectores productivos, principalmente en la industria automovilística, en la cual se han demostrado sus ventajas en términos de productividad, eficiencia y calidad. El uso de la tecnología láser, ya sea híbrida o pura, reduce el input térmico al limitar la zona afectada por el calor, sin crear deformaciones y, por tanto, disminuye los re-trabajos post-soldadura necesarios para eliminarlas. Asimismo, se aumenta la velocidad de soldadura, incrementando la productividad y calidad de las uniones. En la última década, el uso de láseres híbridos, (láser + arco) de gran potencia de Neodimio YAG, (Nd: YAG) ha sido cada vez más importante. La instalación de este tipo de fuentes de láser sólido de gran potencia ha sido posible en construcción naval debido a sus ventajas con respecto a las instalaciones de láser de C02 existentes en los astilleros que actualmente utilizan esta tecnología. Los láseres de C02 están caracterizados por su gran potencia y la transmisión del haz a través de espejos. En el caso de las fuentes de Nd:YAG, debido a la longitud de onda a la cual se genera el haz láser, su transmisión pueden ser realizada a través de fibra óptica , haciendo posible la utilización del cabezal láser a gran distancia de la fuente, aparte de la alternativa de integrar el cabezal en unidades robotizadas. El proceso láser distribuye el calor aportado de manera uniforme. Las características mecánicas de dichas uniones ponen de manifiesto la adecuación de la soldadura por láser para su uso en construcción naval, cumpliendo los requerimientos exigidos por las Sociedades de Clasificación. La eficiencia energética de los láseres de C02, con porcentajes superiores al 20%, aparte de las ya estudiadas técnicas de su instalación constituyen las razones por las cuales este tipo de láser es el más usado en el ámbito industrial. El láser de gran potencia de Nd: YAG está presente en el mercado desde hace poco tiempo, y por tanto, su precio es relativamente mayor que el de C02, siendo sus costes de mantenimiento, tanto de lámparas como de diodos necesarios para el bombeo del sólido, igualmente mayores que en el caso del C02. En cambio, el efecto de absorción de parte de la energía en el plasma generado durante el proceso no se produce en el caso del láser de Nd: YAG, utilizando parte de esa energía en estabilizar el arco, siendo necesaria menos potencia de la fuente, reduciendo el coste de la inversión. En función de la aplicación industrial, se deberá realizar el análisis de viabilidad económica correspondiente. Dependiendo de la potencia de la fuente y del tipo de láser utilizado, y por tanto de la longitud de onda a la que se propaga la radiación electromagnética, pueden existen riesgos para la salud. El láser de neodimio se propaga en una longitud de onda, relativamente cercana al rango visible, en la cual se pueden producir daños en los ojos de los operadores. Se deberán establecer las medidas preventivas para evitar los riesgos a los que están expuestos dichos operadores en la utilización de este tipo de energía. La utilización del láser de neodimio: YAG ofrece posibilidades de utilización en construcción naval económicamente rentables, debido su productividad y las buenas características mecánicas de las uniones. Abstract The laser welding process development of the last years shows broad application possibilities in many sectors of industry, mostly in automobile production. The advantages of the laser beam process produce higher productivity, increasing the quality and thermal efficiency. Laser technology, arc-hybrid or pure laser welding, reduces thermal input and thus a smaller heat-affected zone at the work piece. This means less weldment distortion which reduces the amount of subsequent post-weld straightening work that needs to be done. A higher welding speed is achieved by use of the arc and the laser beam, increasing productivity and quality of the joining process. In the last decade use of hybrid technology (laser-GMA hybrid method) with high power sources Nd:YAG lasers, gained in importance. The installation of this type of higher power solid state laser is possible in shipbuilding industrial applications due to its advantages compare with the C02 laser sources installed in the shipyards which use this technology. C02 lasers are characterised by high power output and its beam guidance is via inelastic system of mirrors. In the case of Nd:YAG laser, due to its wavelength, the laser beam can be led by means of a flexible optical fibre even across large distances, which allows three dimensional welding jobs by using of robots. Laser beam welding is a process during which the heat is transferred to the welded material uniformly and the features of the process fulfilled the requirements by Classification Societies. So that, its application to the shipbuilding industry should be possible. The high quantum efficiency of C02 laser, which enabled efficiency factors up to 20%, and relative simple technical possibilities of implementation are the reasons for the fact that it is the most important laser in industrial material machining. High power Nd: YAG laser is established on the market since short time, so that its price is relatively high compared with the C02 laser source and its maintenance cost, lamp or diode pumped solid state laser, is also higher than in the case of C02 lasers. Nevertheless effect of plasma shielding does not exist with Nd:YAG lasers, so that for the gas-shielding welding process the optimal gases can be used regarding arc stability, thus power source are saved and the costs can be optimised. Each industrial application carried out needs its cost efficiency analysis. Depending on the power output and laser type, the dangerousness of reflected irradiation, which even in some meters distance, affects for the healthy operators. For the YAG laser process safety arrangements must be set up in order to avoid the laser radiation being absorbed by the human eye. Due to its wavelength of radiation, being relatively close to the visible range, severe damage to the retina of the eye is possible if sufficient precautions are not taken. Safety aspects are of vital importance to be able to shield the operator as well as other personal. The use of Nd:YAG lasers offers interesting and economically attractive applications in shipbuilding industry. Higher joining rates are possible, and very good mechanical/technological parameters can be achieved.

Comparison of numerical models for vibro-acoustic analysis of structural panels in low modal density range engaging air layers

During launch, satellite and their equipment are subjected to loads of random nature and with a wide frequency range. Their vibro-acoustic response is an important issue to be analysed, for example for folded solar arrays and antennas. The main issue at low modal density is the modelling combinations engaging air layers, structures and external fluid. Depending on the modal density different methodologies, as FEM, BEM and SEA should be considered. This work focuses on the analysis of different combinations of the methodologies previously stated used in order to characterise the vibro-acoustic response of two rectangular sandwich structure panels isolated and engaging an air layer between them under a diffuse acoustic field. Focusing on the modelling of air layers, different models are proposed. To illustrate the phenomenology described and studied, experimental results from an acoustic test on an ARA-MKIII solar array in folded configuration are presented along with numerical results.

The radiation impedance of electrodynamics tethers in a polar Jovian orbit

Juno, the second mission in the NASA New Frontiers Program, will both be a polar Jovian orbiter, and use solar arrays for power, moving away from previous use of radioisotope power systems (RPSs) in spite of the weak solar light reaching Jupiter. The power generation at Jupiter is critical, and a conductive tether could be an alternative source of power. A current-carrying tether orbiting in a magnetized ionosphere/plasmasphere will radiate waves. A magnitude of interest for both power generation and signal emission is the wave impedance. Jupiter has the strongest magnetic field in the Solar Planetary System and its plasma density is low everywhere. This leads to an electron plasma frequency smaller than the electron cyclotron frequency, and a high Alfven velocity. Unlike the low Earth orbit (LEO) case, the electron skin depth and the characteristic size of plasma contactors affect the Alfven impedance.