Cardiovascular disease (CVD) affects millions of people worldwide. Many of these people require treatment for their condition, and for roughly a million individuals each year, this treatment includes coronary artery bypass graft (CABG) surgery - a procedure that aims to restore proper blood flow to the arteries of the heart. Although the physical impact of CVD and CABG surgery are well-known, their cognitive impact has not been clearly established. Recent studies suggest that both CVD and CABG surgery may have a detrimental effect on neuropsychological functioning. The first goal of the present study was to cognitively assess patients with severe, chronic CVD to determine the association of heart disease with neuroopsychological functioning. The second goal was to then continue monitoring these patients once they had undergone CABG surgery to establish what cogntive effect this treatment has. CABG surgery has traditionally been performed with the aid of a cardiopulmonary bypass (CPB) machine, but in the past decade, another technique, in which the heart remains beating, has been developed. Some have argued that this beating heart surgery (BHS) may be a superior alternative to the CPB procedure. Consequently, the third goal of the present study was to compare outcomes in patients undergoing these two surgical procedures. The present study had a prospective, double blind design. Patients were randomly assigned to either CPB surgery (CPBS) or BHS. Sixty-three patients were recruited and underwent a comprehensive neuropsychological assessment preoperatively and 6 days, 6 weeks and 30 weeks postoperatively. Despite including a higher risk group than previous comparative studies, there were virtually no differences between the CPBS and BHS groups. When the groups were combined and the sample was examined as a whole, the patients were cognitively impaired even before their surgery. Given that their premorbid abilities were estimated to be in the average range, their pre-surgery deficits were likely to be the result of a long-standing history of CVD. Immediately after surgery (Day 6), the neuropsychological performance of the sample decreased further, but they had significantly improved by Week 6 and this improvement increased further by the Week 30 time-point (with many scores in the average range). This postoperative recovery suggests that the decline these patients exhibit preoperatively may be reversible and that rather than causing cognitive deficits, CABG surgery may ultimately improve both cardiac and cognitive health. Psychologically, patients in the present sample reported the highest level of anxious and depressive symptoms, and the lowest quality of life, pre-surgically, but their psychological health gradually improved over the course of the postoperative period. Compared to other samples, however, the present sample were generally psychologically healthy.

This research aims at evaluating a new ventilation concept: personal displacement ventilation (PDV) for improving indoor air quality. The new ventilation method combines room displacement ventilation with task ventilation, the latter being directed at controlling air quality and comfort in the microenvironment where the building occupant is working, with the premise that such directed ventilation will maintain air quality where it matters. This approach could lead to improved ventilation system design that could even provide individual control of indoor microclimate. The effectiveness of PDV was studied by using computational fluid dynamics (CFD) modeling and rigorous validation experiments. First, a small office setup was built in a controlled environmental chamber. Three PDV cases with different locations of contaminant source and one general displacement ventilation (DV) case were investigated. Spatial distributions of airflow, temperature, and hypothetical pollutant distributions were measured. The measured data were then used to evaluate the performance of PDV against defined indoor air quality and thermal comfort criteria, and to validate the CFD model. The validated CFD program was further used to study PDV under various conditions. This study found that basic equipped PDV acts no different from DV from airflow pattern?s point of view. Due to the lack of heat generation around occupant?s legs, local buoyancy effect is not strong enough to attract supply air, which is generated from diffuser nearby, to join in the plume around occupant. However, auxiliary activities adjusting the direction of supply air and adding high panels around person can improve the fraction of supply air to join the plume around person or decrease the average contaminant concentration in breathing zone.

Coronary Artery Bypass Grafting (CABG) is an effective and invasive cardiac surgery to salvage blocked coronary artery. Cardiopulmonary bypass (CPB) is usually applied to support circulation during temporary cardiac arrest. Studies have demonstrated that cardiac injury, inflammation, and oxidative stress could be induced during CABG with CPB. We conducted two studies to investigate the release of cardiac biochemical markers and inflammatory response as well as to compare the effect of different coating biomaterial of CPB on the induction of inflammation and oxidative stress during CPB. We investigated the release patterns and the serum levels of cardiac markers as well as inflammatory markers in patients undergoing elective CABG at different time points after initiation of CPB. In this study, we demonstrated that cardiac markers such as creatine kinase isoenzyme MB (CK-MB), and cardiac troponin I (cTnI) and inflammatory markers such as tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP) were highly elevated after CPB. Moreover, we confirmed that cTnI is still a better biochemical marker for cardiac injury than others following CABG with CPB. Other nonspecific but highly sensitive markers such as lactate dehydrogenase (LDH), lactate, TNF-alpha, IL-6, and hsCRP could be potential surrogate markers for evaluation of cardiac injury following CPB. Based on these findings, we conducted a further investigation to demonstrate our hypothesis that different biocompatible materials used in CPB may affect the inflammation and oxidative stress differently. Biocompatible materials are thinly coated on CPB tubes to provide similar environment like endothelial cells during cardiac surgery. There are several biocompatible materials available in the market. Each of them has unique characteristics. Inflammatory response is one of the bodys fundamental defense mechanisms against foreign invaders. However, inappropriate or excessive response can lead to harmful, potentially life-threatening consequences due to severe inflammatory tissue destruction. CPB-induced inflammatory response can be one of the factors, which can affect surgical outcomes. Depending on the presence of different biocompatible materials in CPB circuits, the degree of immunoreactions can be varied. In this study, we analyzed hsCRP, an acute phase protein, and tau protein, a marker of neurocognitive deficiency. Furthermore we analyzed inflammatory cytokines including TNF-alpha, IL-6, IL-10, and interferon-gamma (IFN-gamma) to evaluate the levels of inflammation. Serum levels of oxidized nitric oxide as a marker of oxidative stress were also assessed. We demonstrated that different biocompatible material has different impacts on inflammation and oxidative stress. In the aspect of anti-inflammation, heparin-coated biocompatible material is better than others whereas surface-modifying additives biocompatible material is worse than others. Overall, different coating biomaterial of CPB results in various inflammatory response. In terms of oxidative stress, we did not observe significant difference between different biomaterial-coated CPB.

Technology replaces newer technology with improved efficiency. Solar technology is going to draw out a new life to make a green change in the terms of energy. As a result energy from the sunlight is being changed into electric energy by using solar cell. But still its efficiency could not be able to make a sense as a depending energy technology. In order to look up the solution, solar technology is changing rapidly to get maximum output. To take up this new challenge solar technology is trying to change its building component that are used to make solar cell, for example solar cell material, bypass diode system, blocking diode system etc.   Now-a-days, solar energy system is designed as a hybrid system that can make electricity and hot water at the same time. In the hybrid solar system, photovoltaic and solar thermal systems are integrated at the same system and as a result heat and electricity are produced simultaneously at the same area. Solar cells are attached with both top and the bottom side of the module and the collectors are set up inside the module. By using collector inside the module, rejected heat from the solar cell is absorbed by the water that flows through the collectors. But a problem arises at the midday or after midday because the reflector of this system cannot reflect sunlight properly on the bottom side of the module. That’s why shading is occurred on the bottom side which reduce the total electrical output of this system.   To work out this shading problem, a bypass diode is connected in parallel with the group of solar cells. Schottky diodes are being used as bypass diodes inside in the most of the solar cells. Schottky diode forward voltage drop is almost 0.45 Volt which is an important cause of reducing the output power as well as the efficiency of this hybrid system. To solve this problem, new lossless diode is attached inside the hybrid solar system instead of schottky diode which can work with a very low forward voltage drop roughly 50mV at 10amp.   To make a comparison between the performance of PVT system with the schottky diode and the new lossless diode, many data has been collected from the outdoor test. After getting the output result, it is clear that the output power and efficiency is going to be changed for using the new lossless diode. For using the lossless diode, the efficiency of the bottom side of the module was increased by 0.31 %.

Coronary Artery Bypass Grafting (CABG) is an effective and invasive cardiac surgery to salvage blocked coronary artery. Cardiopulmonary bypass (CPB) is usually applied to support circulation during temporary cardiac arrest. Studies have demonstrated that cardiac injury, inflammation, and oxidative stress could be induced during CABG with CPB. We conducted two studies to investigate the release of cardiac biochemical markers and inflammatory response as well as to compare the effect of different coating biomaterial of CPB on the induction of inflammation and oxidative stress during CPB. We investigated the release patterns and the serum levels of cardiac markers as well as inflammatory markers in patients undergoing elective CABG at different time points after initiation of CPB. In this study, we demonstrated that cardiac markers such as creatine kinase isoenzyme MB (CK-MB), and cardiac troponin I (cTnI) and inflammatory markers such as tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP) were highly elevated after CPB. Moreover, we confirmed that cTnI is still a better biochemical marker for cardiac injury than others following CABG with CPB. Other nonspecific but highly sensitive markers such as lactate dehydrogenase (LDH), lactate, TNF-alpha, IL-6, and hsCRP could be potential surrogate markers for evaluation of cardiac injury following CPB. Based on these findings, we conducted a further investigation to demonstrate our hypothesis that different biocompatible materials used in CPB may affect the inflammation and oxidative stress differently. Biocompatible materials are thinly coated on CPB tubes to provide similar environment like endothelial cells during cardiac surgery. There are several biocompatible materials available in the market. Each of them has unique characteristics. Inflammatory response is one of the bodys fundamental defense mechanisms against foreign invaders. However, inappropriate or excessive response can lead to harmful, potentially life-threatening consequences due to severe inflammatory tissue destruction. CPB-induced inflammatory response can be one of the factors, which can affect surgical outcomes. Depending on the presence of different biocompatible materials in CPB circuits, the degree of immunoreactions can be varied. In this study, we analyzed hsCRP, an acute phase protein, and tau protein, a marker of neurocognitive deficiency. Furthermore we analyzed inflammatory cytokines including TNF-alpha, IL-6, IL-10, and interferon-gamma (IFN-gamma) to evaluate the levels of inflammation. Serum levels of oxidized nitric oxide as a marker of oxidative stress were also assessed. We demonstrated that different biocompatible material has different impacts on inflammation and oxidative stress. In the aspect of anti-inflammation, heparin-coated biocompatible material is better than others whereas surface-modifying additives biocompatible material is worse than others. Overall, different coating biomaterial of CPB results in various inflammatory response. In terms of oxidative stress, we did not observe significant difference between different biomaterial-coated CPB.

The present Master thesis is written in connection with the E4 Stockholm bypass, which is a future motorway linking northern and southern Stockholm, and will mostly run through tunnels. The bypass will cross the Lake Mälaren in the Lambarfjärden area, where a fault is indicated on the geological maps, which would create risks for tunneling. Several geological and geophysical studies and measurements have been carried out in connection with the bypass project. These include surface mapping, drillings (core logging and water-loss measurements) and geophysical measurements (reflection and refraction seismics). The objectives of this thesis are to interpret the available geological and geophysical data, integrate the reports and the results of these studies and finally to create a structural model of the Lambarfjärden area affected by the tunnel. The available data provided a great opportunity to examine the area. The core logging and geophysical measurements supported the existence of the fault indicated on the geological maps. The core logging revealed that this pre-existing deformation zone was reactivated, possibly as dextral strike-slip, and the orientations of the subsurface fractures corresponded well with the Riedel structures occurring in such shear zone. The field work has found evidence for ductile sinistral movement which, together with the results of the core logging, could indicate a conjugate deformation zone in the area. The water-loss measurements showed several intervals along the boreholes where significant water-loss took place. Furthermore, the thesis calls the attention to both opening and closure of differently oriented weaknesses, fractures. As the thesis highlights possible risks for the tunneling, its findings could be very useful during the construction of the bypass. / Reviewer: Karin Högdahl, Senior lecturer in Solid Earth Geology at the Department of Earth Sciences, Uppsala University.

Zugl.: Aachen, Techn. Hochsch., Diss., 2009

Introduktion/Bakgrund: Övervikt och fetma är kraftigt växande problem världen över och inverkar negativt på individers fysiska, psykiska och sociala livskvalitet. En metod för att behandla fetma är viktminskningskirurgi. Syfte: Syftet med litteraturöversikten var att belysa individers livskvalitet efter genomförd viktminskningskirurgi, för att skapa förståelse för individernas omvårdnadsbehov. Metod: En litteraturöversikt genomfördes för att studera problemområdet. Datainsamling utfördes genom sökning i databaserna CINAHL, PsycInfo och PubMed. Efter kvalitetsbedömning inkluderades 18 artiklar. Data analyserades genom ett induktivt förfaringssätt. Resultat: Analysen resulterade i sex kategorier som illustrerar individernas positiva och negativa förändringsprocess och ambivalens efter viktminskningskirurgi. Operationen skapade en ny livssituation med nya möjligheter och bidrog till förnyad livskvalitet innehållande förbättrad hälsa, relation till mat samt fysisk, social och psykisk funktion. Operationen resulterade även i komplikationer som utgjorde begränsningar och påverkade individernas livskvalitet negativt. Diskussion: Resultatet tyder på att livskvalitet efter viktminskningskirurgi varierar och är individuell. Sjuksköterskan har ett ansvar att stödja och motivera patienter till livsstilsförändringar samt individanpassa vården. Slutsats: För att ytterligare optimera vården och skapa djupare förståelse för patienter som genomgått viktminskningskirurgi, rekommenderas vidare kvalitativ forskning som fokuserar på negativa aspekter.

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Antalet vuxna som lever med fetma har enligt WHO fördubblats sedan 1980. Kirurgiskt ingrepp såsom gastric bypass är den metod som leder till hållbar viktminskning. Syftet med studien var att undersöka hur patienter som genomgått viktminskningskirurgi kan uppleva stödet före, under och efter operation. Studien har en narrativ fenomenologisk ansats, berättelserna har analyserats genom meningskoncentrering, strukturering och tolkning. Studien innefattar berättelser från fem informanter som valdes genom handplockat urval. Resultatet visar att de flesta informanter upplever ett fint stöd från omgivningen under processen. Missnöjet riktar sig mot sjukvården och det först efter operationen. Informanterna upplever sig som ensamma och saknar sjukvårdens förståelse. Den bristfälliga uppföljningen genererar i svårigheter för patienterna att med tiden följa de kostrekommendationer som angavs. En samtalskontakt som stöd för hållbar viktminskning och för undvikande av bristsjukdomar är att rekommendera.