Bulletin of Computer Science and Electrical Engineering (BCSEE)
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The unique pathophysiological features of diabetes mellitus secondary to total pancreatectomy: proposal for a new classification distinct from diabetes of the exocrine pancreas
No full textDiabetes of the exocrine pancreas (DEP; a.k.a. pancreatic diabetes or pancreatogenic diabetes or type 3c diabetes mellitus or T3cDM) refers to different diabetes types resulting from disorders of the exocrine pancreas. DEP is characterized by the structural and functional loss of glucose-normalizing insulin secretion in the context of exocrine pancreatic dysfunction. Among these forms, new-onset diabetes mellitus secondary to total pancreatectomy (TP) has unique pathophysiological and clinical features, for which we propose a new nomenclature such as post-total pancreatectomy diabetes mellitus (PTPDM).TP results in the complete loss of pancreatic parenchyma, with subsequent absolute insulinopenia and lifelong need for exogenous insulin therapy. Patients with PTPDM also exhibit deficiency of glucagon, amylin and pancreatic polypeptide. These endocrine abnormalities, coupled with increased peripheral insulin sensitivity, deficiency of pancreatic enzymes and TP-related modifications of gastrointestinal anatomy, can lead to marked glucose variability and increased risk of iatrogenic (insulin-induced) severe hypoglycemic episodes ('brittle diabetes').We believe that diabetes mellitus secondary to TP should not be included in the DEP spectrum in light of its peculiar pathophysiological and clinical features. Therefore, we propose a new classification for this entity, that would likely provide more accurate prognosis and treatment strategies
343 Dupilumab efficacy on itch and skin lesions in adult patients with prurigo nodularis may be observed concurrently or independently over 24 weeks: results from two phase 3 trials
No full textAbstract Prurigo nodularis (PN) is a chronic inflammatory and pruritic skin disease. Clinically it is characterized by intense pruritus accompanied by hyperkeratotic nodules often associated with a very low quality of life including sleep disruption. The FDA has recently approved dupilumab as the only treatment for PN, but it is unknown to what extent within-patient categorical improvements in itch and skin lesions occurred concurrently or independently. Two phase 3 clinical trials, LIBERTY-PN PRIME and PRIME2, demonstrated dupilumab efficacy and safety in patients with PN. To report the efficacy of dupilumab on signs and symptoms in adult patients with PN who did and did not achieve the multicomponent endpoint. LIBERTY-PN PRIME (NCT04183335) and PRIME2 (NCT04202679) were randomized, double-blind, placebo-controlled, multicentre, parallel-group, phase 3 trials in adult patients with PN with ≥20 PN lesions and severe itch, inadequately controlled with topical prescription therapies or for whom these are inadvisable. Here, data were pooled from the two studies. Patients received 300 mg dupilumab subcutaneously (600 mg loading dose; n = 153) or matched placebo (n = 158) every 2 weeks for 24 weeks. This abstract assesses efficacy in patients who did and those who did not achieve the stringent multicomponent endpoint of ≥4-point improvement from baseline in Worst Itch Numerical Rating Scale (WI-NRS, range: 0–10) and Investigator’s Global Assessment PN Stage (IGA PN-S, score range: 0–4) score 0 or 1 (clear or almost clear; defined as 5 or fewer nodules) at week 24. Endpoints include a proportion of patients with concomitant ≥4-point reduction in WI-NRS from baseline and IGA PN-S score 0 or 1 at week 24; the proportion of patients with ≥4-point reduction in WI-NRS from baseline or IGA PN-S score 0 or 1 at week 24; and proportion of patients not achieving ≥4-point reduction in WI-NRS from baseline and IGA PN-S score 0 or 1 at week 24. Safety was also assessed. Baseline demographic and clinical characteristics were generally balanced between subgroups. The proportion of patients treated with dupilumab and placebo who achieved the multicomponent endpoints was 35.3% and 8.9%, respectively; and who achieved WI-NRS reduction of ≥4 points from baseline or IGA PN-S score 0 or 1 at week 24 was 69.9% and 27.2%, respectively. Among multicomponent nonresponders in the dupilumab group (n = 99), 36.4% achieved WI-NRS reduction of ≥4 points and 17.2% achieved IGA PN-S score 0 or 1; in the placebo group (n = 144), corresponding values were 11.1% and 9.0%, respectively. In the dupilumab group, 23.5% achieved only WI-NRS ≥4-point reduction from baseline at week 24, and 11.1% achieved only IGA PN-S score 0 or 1 at week 24. In the placebo group, corresponding data were 10.1%, and 8.2%, respectively. Safety findings were consistent with the known dupilumab safety profile. More than one-third of dupilumab-treated patients achieved the multicomponent endpoint at week 24, constituting concurrent responses on both itch and skin lesions. However, more than two-thirds had clinically meaningful improvement by week 24, defined as either ≥4-point reduction in WI-NRS from baseline, IGA PN-S score 0/1, or both. Almost one-quarter of dupilumab-treated patients met only WI-NRS ≥4-point improvement at week 24, suggesting that skin lesion improvement may lag behind the improvement of itch. Conversely, one-ninth met only IGA PN-S score of 0 or 1 at week 24 suggesting that, in addition to the overlapping mechanisms by which dupilumab ameliorates pruritus and skin lesions, there are independent treatment effects on itch and skin remodelling. Safety was consistent with the known safety profile of dupilumab across approved indications
Staying hydrated in sea water
No full textReduction of intestinal lumen osmotic pressure by formation of Ca(Mg)CO
, "ichthyocarbonate", is essential for osmoregulation by the only vertebrate group, ray-finned fishes, widely capable of hydrating by ingesting seawater. Ichthyocarbonate formation and excretion is under elaborate physiological control and plays an important, yet still poorly defined, role in the oceanic carbon cycle
Effect of Variation in the Number of Blades on Turbine Rotation and Output Power at PLTPH (Picohydro Power Plant) Using a Kaplan Turbine
No full textThe turbine can be a component that plays an important role as an energy converter that produces power in a picohydro power plant (PLTPH). The turbine used in this study is the Kaplan Turbine. The Kaplan turbine is a type of reaction turbine with a head of 1.58 m. This research examines the effect of variations in the number of blades on turbine rotation and output power in pico-hydro power plants (PLTpH) using Kaplan turbines so that voltage, current, power can be generated which affect the torque value and the efficiency obtained in the PLTpH prototype. This study aims to obtain a turbine runner with the number of blades that can produce the highest efficiency, so a variation of the Kaplan turbine runner is made with a number of blade runner variations, namely 4 blades, 6 blades, and 8 blades. The results showed that the addition of the number of blades produced the highest output with the number of blades 6 which produced a turbine rotation of 218.1 Rpm, generator rotation of 2433 Rpm, generator voltage of 19 volts, generator power of 1900 watts, and torque of 17.5 Nm. Nilai efesiensi yang dihasilkan yaitu 26,62 %. The results of this research are expected to be a reference and help improve human resources to develop power plants in rural areas, and open up opportunities for the community to develop small-scale power plants, namely pico-hydro power plants
Investigation of the Dark Web Illegal Activities using Data Mining Approach
No full textThe rapid advancements in internet technology have opened up various avenues for illicit activities targeting users. These nefarious activities are carried out by anonymous individuals or groups, making identification and tracking a challenging task. Periodical updates to the content of the dark web are common, with alterations to concealed data often escaping detection. Consequently, the primary arduous tasks concerned the data mining framework and its impact on the classification accuracy with regards to illegal activities. In contemporary times, the constraint of dealing with considerations pertaining to the academia and the business environment has emerged as a crucial phenomenon. This paper encompasses an analysis of a web crawler designed for the dark web. The crawler is proficient not only in data collection and cleansing but also in storage, making use of a data-driven approach. Data mining is a potent technique that enables thorough investigation through exhaustive exploration of data, often revealing evidence of illicit activity. Consequently, the crawler has emerged as a focal point for enforcing automated classification of the amassed web pages into five distinct categories. The classification process involved the utilization of classifiers, specifically the Linear Support Vector Classifier (SVC) and Naïve Bayes (NB) for the categorization of pages. Furthermore, as per the probationary findings, the Support Vector Classifier (SVC) and the Naive Bayes (NB) algorithm demonstrated precision rates of 91% and 84%, respectively, in the presented sequence
Sargassum removal and carbon insetting pilot program in Guanahacabibes National Park, Cuba
No full textThe Ocean Foundation (TOF) is the only community foundation for the ocean. TOF hosts a range of programs that work regionally to ensure lasting outcomes related to ocean health, climate change mitigation, and coastal community livelihoods. The goal of this project was to develop a workshop and training held November 15-19, 2022 in Guanahacabibes National Park (GNP), Cuba. This workshop focused on Sargassum removal, carbon insetting and the creation of compost for coastal communities building resilience. This program was first piloted in the Dominican Republic and is now being introduced to Cuba. The main objective of the internship was (1) to help coordinate and manage the workshop in GNP, (2) determine the viability of the project in this location, the impacts it will have on local residents, as well as their interest and necessity for this project, and (3) how to expand this into a regional or international model starting with other Caribbean islands and Mexico. We concluded the GNP was an ideal location for this project, with 100% of the workshop participants who responded to surveys expressing interest in involvement either through direct participation or supportive roles. Study site relevance and availability was optimal, ecological impact is high, and local participants expressed clear statements of need. We were also able to map out the process step-by-step with low tech, low cost equipment making this a model that is easily replicated and modified for different areas
Long‐Term Offshore Borehole Fluid‐Pressure Monitoring at the Northern Cascadia Subduction Zone and Inferences Regarding the State of Megathrust Locking
No full textThe Cascadia subduction megathrust off the Pacific Northwest follows an “end member” seismogenic behavior, producing large (up to moment magnitude 9) but infrequent (every several hundred years) earthquakes and tsunamis. Crustal deformation associated with the ongoing plate convergence has been characterized by land‐based geodetic observations, but the state of locking across the full breadth of the seismogenic fault is poorly constrained. We report results of offshore monitoring of borehole fluid pressure, as a proxy for formation volumetric strain, at a site ∼20 km landward of the Cascadia subduction deformation front since 2010. The multi‐depth pressure records were plagued by hydrologic noise, but noise at the deepest monitoring level (303 m sub‐seafloor) abated in 2015. Subsequently, including at the times of regional large earthquakes that caused significant dynamic stressing, no persistent pressure transients are present above a threshold of 0.08 kPa imposed by unremovable oceanographic signals, corresponding to a strain detection limit of ∼16 nanostrain. Simple dislocation models using local megathrust geometry suggest a resolvable slip of <1 cm along a trench‐normal corridor beneath the borehole for a range of slip‐patch dimensions. A large slip patch can be well resolved even at considerable along‐strike distances from the borehole; for instance, ∼10 cm slip is detectable over a 200‐km strike range for a slip‐patch radius of ∼50 km. This high sensitivity for detecting slip, along with the lack of observed events, stands in stark contrast to observations at other subduction zones, and suggests that the Northern Cascadia megathrust is most likely fully locked.
Plain Language Summary
Subduction thrust faults can produce Earth's largest earthquakes and tsunamis. Estimating the seismic and tsunami potential requires knowing how complete the fault locking is. The Cascadia subduction zone is known to have hosted very large earthquakes, but with the existing measurements of deformation being on land, the state of locking of the shallow sub‐marine portion of the fault remains unclear. Addressing this question requires offshore deformation measurements directly above the shallow fault. In this study, we report results of formation fluid pressure measurement—as a volumetric strain indicator—from a deep‐ocean borehole off Vancouver Island near the deformation front of Cascadia. While data from shallow monitoring depths suffer from noise likely caused by formation gas dynamics, the record from the deepest level (300 m beneath the seafloor) has been sufficiently quiet since mid‐2015 to allow detection of any slip‐triggered pressure variations. Lack of such variations, together with deformation modeling, limits local slip events to be <1 cm. This suggests that the slip deficit of the plate convergence is being accumulated at a substantial rate and it may be released in the next megathrust earthquake. This contrasts with other subduction margins where slip‐related pressure transients have been frequently detected.
Key Points
8‐year formation pressure records from northern Cascadia suggest a lack of tectonic transients despite occasional large dynamic stressing
Noise level of the record defines a detection threshold of 0.08 kPa, equivalent to 16 nanostrain for shallow accretionary prism sediment
Deformation modeling shows that the data would resolve local slip down to <1 cm, and thus suggests a fully locked state of the megathrus
Electrogram morphology recurrence guided catheter ablation for repeat ablation of persistent atrial fibrillation
No full textBACKGROUNDThere are no standard mapping approaches for patients with persistent atrial fibrillation (PeAF), particularly after failed prior catheter ablation (CA). In this study, we assess the feasibility of using Electrogram Morphology Recurrence (EMR) to guide ablation. METHODSTen patients with recurrent PeAF after prior CA underwent detailed mapping of both atria during PeAF using the PentaRay (4 mm interelectrode spacing) and 3D mapping with CARTO. At each site, 15 s recordings were made. Custom software identified each electrogram and cross-correlation was used to identify the most recurrent electrogram morphology from which the % recurrence and cycle length of the most repeatable morphology (CLR) was calculated. Sites of shortest CLR and sites within 5 ms of shortest CLR with recurrence ≥ 80% were used to inform CA strategy. RESULTSA mean of 342.9 ± 131.9 LA and 328.6 ± 91.5 RA sites were recorded per patient. Nine had PV reconnection. Shortest CLR sites guided ablation in 6/10 patients while 1 patient failed to fulfill shortest CLR criteria, and another 3 did not undergo CA guided by shortest CLR due to operator preference. On 12-month follow-up, all 4 patients without shortest CLR guided CA had recurrent PeAF. Of the 6 patients with shortest CLR guided CA, 5 patients did not have recurrent PeAF (p = 0.048), although 1 had paroxysmal AF and 2 had atypical atrial flutter. CONCLUSIONEMR is a feasible, novel technique to guide CA in patients with PeAF. Further evaluation is needed to provide an electrogram-based method for mapping guided targeted ablation of key areas
