Prevalence of non-alcoholic fatty liver disease in patients with nephrotic syndrome:A population-based study

BACKGROUND Non-alcoholic fatty liver disease(NAFLD) is a global health concern with a prevalence of about 25% amongst United States adults. Its increased prevalence is attributed to increase in patients with obesity and metabolic syndrome, partly due to similar mechanisms of injury. Nephrotic syndrome(NS) is a clinical entity resulting from extensive proteinuria leading to hypoalbuminemia, hyperlipidemia, edema, and other complications. Given its association with hyperlipidemia, there is concern that patients with NS may be at increased risk of NAFLD.AIM To perform a cross-sectional population-based study to investigate the prevalence and risk factors of NAFLD in patients with NS.METHODS A large multicenter database(Explorys Inc., Cleveland, OH, United States) was utilized for this retrospective cohort study. A cohort of 49700 patients with a diagnosis of “Non-Alcoholic fatty liver disease” using the Systematized Nomenclature of Medicine-Clinical Terms(SNOMED-CT) between 1999-2022 was identified. Inclusion criteria were age ≥ 18 years, presence of NAFLD, presence of NS. There were no specific exclusion criteria. Univariate and multivariate analysis were performed to adjust for multiple risk factors including age, gender, Caucasian race, NS, type Ⅱ diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease. Statistical analysis was conducted using R, and for all analyses, a 2-sided P value of < 0.05 was considered statistically significant.RESULTS Among the 78734750 individuals screened in this database, there were a total of 49700 subjects with NAFLD. In univariate analysis, the odds of having NAFLD in patients with NS, type 2 diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease were 14.84 [95% confidence interval(95%CI) 13.67-16.10], 17.05(95%CI 16.78-17.32), 6.99(95%CI 6.87-7.11), 13.61(95%CI 13.38-13.84), 19.19(95%CI 18.89-19.50), 29.09(95%CI 28.26--29.95), and 9.05(95%CI 8.88-9.22), respectively. In multivariate analysis, the odds of having NAFLD amongst patients with NS were increased to 1.85(95%Cl 1.70-2.02), while the odds were also remained high in patients that have type 2 diabetes mellitus [odds ratio(OR) 3.84], hypothyroidism(OR 1.57), obesity(OR 5.10), hyperlipidemia(OR 3.09), metabolic syndrome(OR 3.42) and chronic kidney disease(OR 1.33).CONCLUSION Patients with NS are frequently found to have NAFLD, even when adjusting for common risk factors. Hence, clinicians should maintain a high index of suspicion regarding presence of NAFLD in patients with NS.

Effect of wire mesh interlayer in explosive cladding of dissimilar grade aluminum plates

Explosive cladding of Al 5052–Al 1100 plate, interfaced with a stainless steel wire mesh interlayer, is attempted. Loading ratio and standoff distance were varied. An increase in loading ratio (R) and standoff distance (S) enhances the plate velocity (Vp), dynamic bend angle (β) and pressure developed (P). The interface morphology of the explosive clads confirms strong metallurgical bond between the wire mesh and aluminum plates. Further, a smooth transition from straight to undulating interlayered topography is witnessed. The introduction of a wire mesh, as interlayer, leads to an improvement in mechanical strength with a slender reduction in overall corrosion resistance of the “explosive clads”.

Prevalence of hypothyroidism and effect of thyroid hormone replacement therapy in patients with non-alcoholic fatty liver disease:A population-based study

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is currently considered as the most common cause of chronic liver disease worldwide.Risk factors for NAFLD have been well-described,including obesity,type 2 diabetes mellites(T2DM),dyslipidemia(DLP)and metabolic syndrome.Hypothyroidism has been identified as an independent risk factor for the development of NAFLD,although the literature is inconsistent AIM To evaluate the prevalence of hypothyroidism in patients with NAFLD,assess if it is an independent risk factor and explore the effect of thyroxine replacement therapy.METHODS Our cohort’s data was obtained using a validated,large,multicenter database(Explorys Inc,Cleveland,OH,United States)aggregated from pooled outpatient and inpatient records of 26 different healthcare systems,consisting of a total of 360 hospitals in the United States,and utilizing Systematized Nomenclature of Medicine-Clinical Terms for coding.We evaluated a cohort of patients with hypothyroidism and NAFLD.Multivariate analysis was performed to adjust for confounding risk factors including hypertension(HTN),T2DM,DLP,obesity and metabolic syndrome.SPSS version 25,IBM Corp was used for statistical analysis,and for all analyses,a 2-sided P value of<0.05 was considered statistically significant.Exclusion criteria were limited to age<18 years.RESULTS Among the 37648180 included individuals in this database who are above the age of 18 years,there were a total of 2320 patients with NAFLD(6.16 per 100000)in the last five years(2015-2020),amongst which 520 patients(22.4%)had hypothyroidism.Baseline characteristics of patients in this database are described in Table 1.Patients with NAFLD were also more likely to have obesity,T2DM,DLP,HTN,and metabolic syndrome(Table 2).While males and females were equally affected,patients in the age group 18-65 years as well as Caucasians seem to be at a higher risk.There was an increased risk of NAFLD among patients with hypothyroidism(OR=1.587).Furthermore,thyroid hormone replacement was not associated with a decreased risk for developing NAFLD(OR=1.106,C=0.952-1.285,P=0.303).CONCLUSION Hypothyroidism seems to be an independent risk factor for the development of NAFLD.Thyroid hormone replacement did not provide a statistically significant risk reduction.Further studies are needed to evaluate the effect of thyroid hormone replacement and assess if being euthyroid while on thyroid replacement therapy affects development and/or progression of NAFLD.

Myanmar-Andaman-Sumatra Subduction Margin Revisited:Insights of Arc-Specific Deformations

We address the role of the concave and convex arcs （as observed from the subducting plate） on the deformation occurring along the Myanmar-Andaman-Sumatra margin. We categorize the pre- and post-seismic deformations of the lithosphere using earthquake database occurring either prior to 26th December 2004 Mw 9.3 off-Sumatra mega-event or after the incidence. Analysis under pre-seismic domain shows that area near Sumatra records highest seismicity, which largely drops in the area past the North Andaman, and further increases towards north. Shallowest depth and mini- mum dip of the subducting lithosphere is recorded at the central segment where the arc transformed into concave shape. The annual moment energy release during earthquake decreases to more than two orders of magnitude past the North Andaman towards north under post-seismic deformation phase. Higher depths of continuity of events are presumably associated with more dipping Benioff zones in both the Indo-Myanmar and Andaman-Nicobar convex arcs. These observations obviously account for tectonic subdivision of the margin near concave shape arc around the central part. Absence of vol- canism, presence of splay faults in the back-arc, sharp reduction in seismicity near central segment are interpreted to be caused by major tectonic impact of the NNE-ward converging buoyant Ninety-east Ridge against the Asian Plate. Shallowest dip, small elastic thickness, weak converging Indian litho- sphere, and evidences of series of en-echelon blocks off the eastern side of the broken northern Ninety- east Ridge might be incapable of generating great earthquake in this area.

Dynamic analysis and identification of unbalance and misalignment in a rigid rotor with two offset discs levitated by active magnetic bearings:a novel trial misalignment approach

Rotating machinery is an essential and crucial component of numerous mechanical systems in modern industries,transport vehicles,and in several other applications.Excessive vibrations on rotating equipment due to multiple faults may cause catastrophic failure in machines and lead to hazardous accidents.So,there is a need for perceiving the dynamic nature and identifying the faults for the safe,smooth and effective operation of machines.This paper proposes a novel trial misalignment approach to estimate the misalignment with a similar concept as the trial unbalance in the rotor balancing.Active magnetic bearing(AMB)misalignment with the rotor has been investigated with residual misalignment and additional trial misalignment cases.Additional trial misalignments are provided in addition to the unknown misalignments of the residual misalignment case.For the execution of this methodology,the dynamic model of a four-degree-of-freedom unbalanced and misaligned rigid rotor with two offset discs supported by two active magnetic bearings has been mathematically developed.The offset discs result in the gyroscopic effect at high rotor speeds.Equations of motion of the rotor-AMB system have been derived and solved to generate the time domain rotor displacement and controlling current responses at AMB positions.A fast Fourier transform technique has been utilized to convert the time domain responses into the frequency domain for estimation of unbalance eccentricities and phases together with force-displacement and forcecurrent stiffnesses of misaligned AMBs as well as AMB's constant forces using the developed identification algorithm.Identified values of AMB's parameters for both residual and additional trial misalignment cases are evaluated to estimate the four unknown misalignments.Testing of the algorithm has also been carried out at multiple spin speeds against measurement signal noise in rotor responses and bias errors in rotor system parameters to check its effectiveness and robustness.The algorithm is found to be exhibiting excellent.