Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

A recoverable stress testing algorithm for compression and encryption cards

This study proposes a recoverable stress testing algorithm （RSTA） for such special devices as compression/decompression card and encryption/deeryption card. It uses a chaos function to generate a random sequence, and then, according to the random sequence, generates an effective command sequence. The dispatch of command obeys a special schedule strategy we designed for such devices, i.e., the commands are sent according to the command sequence, and the complete commands are put in a buffer for further result check. RSTA is used to test the HIFN compression acceleration card SAICHI-1000. Test results show that RSTA can make the card work continuously and adequately.

Preoperative nuclear stress testing in the very old patient population

BACKGROUND Elderly patients awaiting moderate to high-risk surgery may undergo nuclear stress testing(NST)in order to evaluate their cardiovascular risk.The prognostic utility of such testing in the very elderly(≥85 years)has yet to be fully evaluated.Octogenarians and nonogenarians frequently have a number of concurrent conditions including a high rate of coronary disease,and therefore the prognostic value of NST for their preoperative risk assessment has been questioned.Our evaluation assesses the ability of nuclear stress testing to predict peri-operative cardiac outcomes in this patient population.AIM To investigate the ability of NST to predict peri-operative cardiac outcomes in elderly patients awaiting moderate to high-risk surgery.METHODS Patients≥85 years undergoing pre-operative NST were retrospectively evaluated.Patients undergoing low-risk surgery were excluded.Major adverse cardiac events(MACE)were considered any adverse event that occurred prior to discharge and included acute heart failure,arrhythmia,acute myocardial infarction,unstable angina,or death.Associations between patient risk factors,MACE,and the obtained results of the pre-operative stress testing,ejection fraction(<40%or≥40%),summed stress score(≤8,≥9),and the summed difference score(≤0,>0)were analyzed.RESULTS A total of 69 patients(mean age 88±2.6 years,31 males)underwent nuclear stress testing prior to surgery.There were 41(60%)patients found to have an abnormal NST.Sixteen(23%)patients were noted to experience post-operative MACE.No significant associations between risk factors and MACE were noted.Patients with an abnormal NST and/or a summed stress score≥9 weresignificantly(P<0.01)more likely to develop peri-operative MACE.CONCLUSION Indicated preoperative NST is useful to assess pre-operative risk in elderly patients≥85 years undergoing moderate to high-risk surgery.

Research on Stress Testing of OSPF Protocol Implementation

The stability and robustness of routing protocol implementations (RPI) in a router are becoming more and more important with the growth of Internet scale. A novel approach named stress testing is proposed to test the properties of RPI. Compared with some traditional test techniques, stress testing is remarkably necessary to inspect and analyze RPI. The test environment is proposed and the test process of OSPF RPI is illustrated by a stochastic Petri Net model with large-scale route simulation and OSPF protocol emulation. Based on this model, the integrated performance tester (IP-TEST) is designed and developed, with which we test a CISCO2600 router. With mathematical methods, we find that the computational complexity of OSPF implementation in this router is O((lnN) 4)to the number of its routing table entries. This experiment shows that this technique can inspect the stability, the computational complexity and the scalability of RPI. Furthermore, it can also be widely used with other routing protocols, such as RIP and BGP.

Shortness of breath in clinical practice: A case for left atrial function and exercise stress testing for a comprehensive diastolic heart failure workup

The symptom cluster of shortness of breath(SOB) contributes significantly to the outpatient workload of cardiology services. The workup of these patients includes blood chemistry and biomarkers, imaging and functional testing of the heart and lungs. A diagnosis of diastolic heart failure is inferred through the exclusion of systolic abnormalities, a normal pulmonary function test and normal hemoglobin, coupled with diastolic abnormalities on echocardiography. Differentiating confounders such as obesity or deconditioning in a patient with diastolic abnormalities is difficult. While the most recent guidelines provide more avenues for diagnosis, such as incorporating the left atrial size, little emphasis is given to understanding left atrial function, which contributes to at least 25% of diastolic left ventricular filling; additionally, exercise stress testing to elicit symptoms and test the dynamics of diastolic parameters, especially when access to the "gold standard" invasive tests is lacking, presents clinical translational gaps. It is thus important in diastolic heart failure work up to understand left atrial mechanics and the role of exercise testing to build a comprehensive argument for the diagnosis of diastolic heart failure in a patient presenting with SOB.

Experimental study on temperature stress calculation and temperature control optimization of concrete based on early age parameters

Temperature control curve is the key to achieving temperature control and crack prevention of high concrete dam during construction,and its rationality depends on the accurate measurement of temperature stress.With the simulation testing machine for the temperature stress,in the present study,we carried out the deformation process tests of concrete under three temperature curves:convex,straight and concave.Besides,we not only measured the early-age elastic modulus,creep parameters and stress process,but also proposed the preferred type.The results show that at early age,higher temperature always leads to greater elastic modulus and smaller creep.However,the traditional indoor experiments have underestimated the elastic modulus and creep development at early age,which makes the calculated value of temperature stress too small,thus increasing the cracking risk.In this study,the stress values of the three curves calculated based on the strain and early-age parameters are in good agreement with the temperature stress measured by the temperature stress testing machine,which verifies the method accuracy.When the temperature changes along the concave curve,the law of stress development is in consistent with that of strength.Under this condition,the stress fluctuation is small and the crack prevention safety of the concave type is higher,so the concave type is better.The test results provide a reliable basis and support for temperature control curve design and optimization of concrete dams.

Nondestructive Testing and Characterization of Residual Stress Field Using an Ultrasonic Method

To address the difficulty in testing and calibrating the stress gradient in the depth direction of mechanical components, a new technology of nondestructive testing and characterization of the residual stress gradient field by ultrasonic method is proposed based on acoustoelasticity theory. By carrying out theoretical analysis, the sensitivity coefficients of different types of ultrasonic are obtained by taking the low carbon steel（12%C） as a research object. By fixing the interval distance between sending and receiving transducers, the mathematical expressions of the change of stress and the variation of time are established. To design one sending-one receiving and oblique incidence ultrasonic detection probes, according to Snell law, the critically refracted longitudinal wave（LCR wave） is excited at a certain depth of the fixed distance of the tested components. Then, the relationship between the depth of LCR wave detection and the center frequency of the probe in Q235 steel is obtained through experimental study. To detect the stress gradient in the depth direction, a stress gradient LCR wave detection model is established, through which the stress gradient formula is derived by the relationship between center frequency and detecting depth. A C-shaped stress specimen of Q235 steel is designed to conduct stress loading tests, and the stress is measured with the five group probes at different center frequencies. The accuracy of ultrasonic testing is verified by X-ray stress analyzer. The stress value of each specific depth is calculated using the stress gradient formula. Accordingly, the ultrasonic characterization of residual stress field is realized. Characterization results show that the stress gradient distribution is consistent with the simulation in ANSYS. The new technology can be widely applied in the detection of the residual stress gradient field caused by mechanical processing, such as welding and shot peening.

SYNTHETIC STRESSLIFE TESTING OF MECHATRONIC PRODUCTS UNDER VARIABLE STRESS SPECTRUM

Mechatronic products usually endure the variable stress spectrum when they operate in certain operational condition and environmental condition, which obey the Weibull distribution. In accordance with the features of mechatronic product, this paper analyzes the failure mode, its corresponding sensitive stress and the design principles of life testing profiles. Based on the above analyses, this paper presents a synthetic stress life testing method based on the hybrid Weibull distribution and its statistical method under variable stress spectrum to evaluate the reliability and life indices of mechatronic products. Because the mechatronic products have many characteristics such as high price, long life and small testing samples, the synthetic stress life testing method under variable load spectrum can simulate the real various spectra, decrease the life testing time and reduce the testing samples. So it is effective to carry out the life testing to mechatronic products. The application results of hydraulic pumps indicate that this method can easily handle the experimental data under variable amplitude spectrum, obtain the high precision parameters point estimation and confidence interval estimation and reduce the testing cost greatly.

Predicting major adverse cardiovascular events after orthotopic liver transplantation using a supervised machine learning model:A cohort study

BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress testing loses accuracy when applied to pre-LT cirrhotic patients.AIM To assess the feasibility and accuracy of a machine learning model used to predict post-LT MACE in a regional cohort.METHODS This retrospective cohort study involved 575 LT patients from a Southern Brazilian academic center.We developed a predictive model for post-LT MACE(defined as a composite outcome of stroke,new-onset heart failure,severe arrhythmia,and myocardial infarction)using the extreme gradient boosting(XGBoost)machine learning model.We addressed missing data(below 20%)for relevant variables using the k-nearest neighbor imputation method,calculating the mean from the ten nearest neighbors for each case.The modeling dataset included 83 features,encompassing patient and laboratory data,cirrhosis complications,and pre-LT cardiac assessments.Model performance was assessed using the area under the receiver operating characteristic curve(AUROC).We also employed Shapley additive explanations(SHAP)to interpret feature impacts.The dataset was split into training(75%)and testing(25%)sets.Calibration was evaluated using the Brier score.We followed Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis guidelines for reporting.Scikit-learn and SHAP in Python 3 were used for all analyses.The supplementary material includes code for model development and a user-friendly online MACE prediction calculator.RESULTS Of the 537 included patients,23(4.46%)developed in-hospital MACE,with a mean age at transplantation of 52.9 years.The majority,66.1%,were male.The XGBoost model achieved an impressive AUROC of 0.89 during the training stage.This model exhibited accuracy,precision,recall,and F1-score values of 0.84,0.85,0.80,and 0.79,respectively.Calibration,as assessed by the Brier score,indicated excellent model calibration with a score of 0.07.Furthermore,SHAP values highlighted the significance of certain variables in predicting postoperative MACE,with negative noninvasive cardiac stress testing,use of nonselective beta-blockers,direct bilirubin levels,blood type O,and dynamic alterations on myocardial perfusion scintigraphy being the most influential factors at the cohort-wide level.These results highlight the predictive capability of our XGBoost model in assessing the risk of post-LT MACE,making it a valuable tool for clinical practice.CONCLUSION Our study successfully assessed the feasibility and accuracy of the XGBoost machine learning model in predicting post-LT MACE,using both cardiovascular and hepatic variables.The model demonstrated impressive performance,aligning with literature findings,and exhibited excellent calibration.Notably,our cautious approach to prevent overfitting and data leakage suggests the stability of results when applied to prospective data,reinforcing the model’s value as a reliable tool for predicting post-LT MACE in clinical practice.

基于动态Vine Copula模型的金融市场风险溢出效应研究

随着金融全球化进程的加速,国际金融市场间的联系日益紧密,深入分析国际金融市场对中国金融市场的风险溢出效应具有重要意义。本文首先基于高维动态Vine Copula模型构建高维金融市场的联合分布函数,然后运用条件在险价值方法测度国际原油市场、国际黄金市场以及国际外汇市场对中国股票市场的风险溢出效应,最后采用压力测试方法从多市场情景压力的视角进行稳健性检验。研究显示:国际金融市场对中国金融市场具有显著的风险溢出效应,但不同国际金融市场的风险溢出强度存在显著差异;国际金融市场对中国金融市场的上行风险溢出效应显著大于下行风险溢出效应,风险溢出强度呈现出非对称性特征;基于高维动态Vine Copula模型的压力测试方法可以有效度量多个金融市场对单一金融市场的风险溢出效应。本文针对投资者、风险管理者以及监管者提出了相应的政策建议。

Stress test and analysis based on SMS fiber structure with high sensitivity

Single mode-multimode-single mode （SMS） sensor is widely used for parameters measurement, such as bending, dis-placement, temperature, strain, refractive index, etc. Generally, SMS sensor has advantages of simple structure, low cost and easy layout, therefore it has become a research hotspot in recent years. In this paper, the multimode fiber with large core is used for manufacturing SMS structure with high sensitivity. Firstly, the multimode fiber with core/cladding diameters of 105/ 125 jitm has access to the system by means of single mode optical fiber. Secondly, SMS device structure is manufactured by welding the eccentric shaft of multimode optical fiber. Afterwards, mode interference effect and spectral response characteristics of the structure of single mode-multimode-single mode optical fiber are analyzed theoretically. Finally, with the help of a wide spectrum light source and a spectrum analyzer, the transmission spectra characteristics of SMS optical fiber with strain is tested. By observing the curve that the wave changes with stress, the sensitivity is calculated and it is consistent with theoretical value .

Uniqueness of rate-dependency, creep and stress relaxation behaviors for soft clays

This work focuses on the uniqueness of rate-dependency, creep and stress relaxation behaviors for soft clays under one-dimensional condition. An elasto-viscoplastic model is briefly introduced based on the rate-dependency of preconsolidation pressure. By comparing the rate-dependency formulation with the creep based formulation, the relationship between rate-dependency and creep behaviors is firstly described. The rate-dependency based formulation is then extended to derive an analytical solution for the stress relaxation behavior with defining a stress relaxation coefficient. Based on this, the relationship between the rate-dependency coefficient and the stress relaxation coefficient is derived. Therefore, the uniqueness between behaviors of rate-dependency, creep and stress relaxation with their key parameters is obtained. The uniqueness is finally validated by comparing the simulated rate-dependency of preconsolidation pressure, the estimated values of secondary compression coefficient and simulations of stress relaxation tests with test results on both reconstituted Illite and Berthierville clay.

New artificial neural networks for true triaxial stress state analysis and demonstration of intermediate principal stress effects on intact rock strength

Simulations are conducted using five new artificial neural networks developed herein to demonstrate and investigate the behavior of rock material under polyaxial loading. The effects of the intermediate principal stress on the intact rock strength are investigated and compared with laboratory results from the literature. To normalize differences in laboratory testing conditions, the stress state is used as the objective parameter in the artificial neural network model predictions. The variations of major principal stress of rock material with intermediate principal stress, minor principal stress and stress state are investigated. The artificial neural network simulations show that for the rock types examined, none were independent of intermediate principal stress effects. In addition, the results of the artificial neural network models, in general agreement with observations made by others, show （a） a general trend of strength increasing and reaching a peak at some intermediate stress state factor, followed by a decline in strength for most rock types; （b） a post-peak strength behavior dependent on the minor principal stress, with respect to rock type; （c） sensitivity to the stress state, and to the interaction between the stress state and uniaxial compressive strength of the test data by the artificial neural networks models （two-way analysis of variance; 95% confidence interval）. Artificial neural network modeling, a self-learning approach to polyaxial stress simulation, can thus complement the commonly observed difficult task of conducting true triaxial laboratory tests, and/or other methods that attempt to improve two-dimensional （2D） failure criteria by incorporating intermediate principal stress effects.

Study on Swell Pressure Stress of Bentonite in Geosynthetic Clay Liners

The geosynthetic clay liner （GCL） is a kind of waterproofing material used widely in engineering. The waterproof mechanism is understood in terms of bentonite particles becoming water-obstruct colloid layers after they sorb water and swell. The swell pressure stress, however, has not been determined directly till now. In our experiment, swell pressure stress of the GCL under saturated water-sorbing condition was measured directly using a custom-made instrument. The results show that （1） the instrument designed by the authors performs satisfactorily and the test results are reproducible; and （2） the trend line of swell pressure stress variation with time can be divided into three segments. The first segment is characterized by a quick increase of the swell force in the first 0-50 hours. The swell pressure stress increases by 7.00×10^-4-1.00×10^-3 MPa/h. The second segment shows a slow increase of the swell pressure stress from the 50th to 1730th hour. The swell force increases by 7.54×10^-6-2.02×10^-5 MPa/h. The third segment is characterized by a little variation in swell pressure stress after 1730 hours. In this segment, the average value of the swell pressure stress measurements is 0.0719 MPa and the maximum value is 0.0729 MPa. It is suggested that the swell pressure stress is mainly raised by water entering pores among montmorillonite particles and interstitial layers in individual montmorillonite crystals, leading to an increase of volume.

Stress corrosion cracking of EV31A in 0.1 M Na_(2)SO_(4) saturated with Mg(OH)_(2)

This paper studied the stress corrosion cracking(SCC)of EV31A in 0.1 M Na 2 SO 4 saturated with Mg(OH)2 using linearly increasing stress tests,compared with pure Mg and WE43B.All three materials were susceptible to SCC.SCC susceptibility increased with decreasing applied stress rate.The threshold stress was 0.3×(yield stress)for pure Mg,0.6×(yield stress)for EV31A,and 0.8×(yield stress)for WE43B.The SCC velocities at an applied stress rate of 7.3×10^(-4)MPa s^(-1)were 7.2×10^(-8)m s^(−1)for pure Mg,5.6×10^(-9)m s^(-1)for WE43B,and 1.5×10^(-9)m s^(-1)for EV31A.

Detonator stepping stress acceleration life test

Through the failure mechanism analysi s and simulation test of a certain kind of detonator,this paper confirms the str ess level of the stepping stress acceleration life test of the detonator,and t hen e stablishes the data processing mathematical model and storage life forecasting m ethod.At last,according to the result of the stepping stress acceleration lif e test of the detonator,this paper forecasts the reliable storage life of the detonator under the normal stress level.

The Extension Rate of the Medial Collateral Ligament of the Knee Joint during the Valgus Stress Test: Two Case Reports

This study aimed to evaluate the influence of measuring the length of the medial collateral ligament (MCL) to compare the MCL burden when the knee joint is placed under valgus stress in the open and closed and closed kinetic chain. Two examiners conducted the examination. The MCL length was measured using ultrasonography. Two subjects were measured in unload bearing and load-bearing positions, with and without valgus stress test at the knee joint extension and 30° flexion, under eight different measurement conditions. The MCL of the subject was delineated in the longitudinal direction using an ultrasound system. The attachment points of the medial femoral and tibial condyle of the MCL were identified, and the ligament length was measured. The MCL rate before and after the valgus stress test in the loading and unloading positions was calculated. The MCL length increased by an average of 8.9% when the external stress test was performed in the non-weight bearing and knee extension positions and by an average of 17.0% when external stress was applied in the non-weight bearing and knee flexion positions. The MCL length increased by an average of 12.2% when the external stress test was performed in the load-bearing and knee extension positions and an average of 8.9% when the valgus stress test was applied in load-bearing and knee flexion positions. In conclusion, the effect of valgus stress on the MCL differs between load-bearing and non-load-bearing positions. It is considered that the dynamic stabilization mechanism works in the knee joint flexion position in the load position and works simultaneously as the static stabilization mechanism, which limits the knee joint valgus and reduces the extension rate of MCL. Therefore, this study reconsiders the shifting of traditional therapy from open kinetic chain to close kinetic chain.

Parameter Estimation Based on Censored Data under Partially Accelerated Life Testing for Hybrid Systems due to Unknown Failure Causes

In general,simple subsystems like series or parallel are integrated to produce a complex hybrid system.The reliability of a system is determined by the reliability of its constituent components.It is often extremely difficult or impossible to get specific information about the component that caused the system to fail.Unknown failure causes are instances in which the actual cause of systemfailure is unknown.On the other side,thanks to current advanced technology based on computers,automation,and simulation,products have become incredibly dependable and trustworthy,and as a result,obtaining failure data for testing such exceptionally reliable items have become a very costly and time-consuming procedure.Therefore,because of its capacity to produce rapid and adequate failure data in a short period of time,accelerated life testing(ALT)is the most utilized approach in the field of product reliability and life testing.Based on progressively hybrid censored(PrHC)data froma three-component parallel series hybrid system that failed to owe to unknown causes,this paper investigates a challenging problem of parameter estimation and reliability assessment under a step stress partially accelerated life-test(SSPALT).Failures of components are considered to follow a power linear hazard rate(PLHR),which can be used when the failure rate displays linear,decreasing,increasing or bathtub failure patterns.The Tempered random variable(TRV)model is considered to reflect the effect of the high stress level used to induce early failure data.The maximum likelihood estimation(MLE)approach is used to estimate the parameters of the PLHR distribution and the acceleration factor.A variance covariance matrix(VCM)is then obtained to construct the approximate confidence intervals(ACIs).In addition,studentized bootstrap confidence intervals(ST-B CIs)are also constructed and compared with ACIs in terms of their respective interval lengths(ILs).Moreover,a simulation study is conducted to demonstrate the performance of the estimation procedures and the methodology discussed in this paper.Finally,real failure data from the air conditioning systems of an airplane is used to illustrate further the performance of the suggested estimation technique.

Autonomic Function in Individuals with Slow Heart Rate Response following an Exercise Stress Test

Objective: To examine the autonomic function using HRV measures in apparently healthy individuals undergoing exercise stress test (EST) and demonstrating slow HRR response. Methods: HRV was measured with 12 lead ECGs during graded EST and analyzed via a post-processing method. Autonomic function was determined by Power Spectral Analysis of the very low frequency (VLF), low frequency (LF), high frequency (HF), and the ratio of LF/HF. We correlated HRV indices with resting, exercise, and recovery data. Results: No differences were found in anthropometric measurements, peak EST HR, and METS between individuals with slow HRR (below 18 b/min) compared with controls (HRR > 18 b/min). Only the VLF component of the HRV indices was statistically different (p = 0.03) at one-minute post-exercise compared with controls. Additionally, a significant correlation between HRR and resting LF and HF indices was found in the individuals with slow HRR but not in the controls. Conclusion: In apparently healthy individuals with slow HRR post-EST, autonomic function did not demonstrate any differences at any phase of the EST, including at one minute of recovery. However, a significant correlation was found between resting LF and HF powers and HRR in individuals with slow vagal reactivation post-exercise. The clinical and prognostic implications of such observation deserve further investigation.

Effects of Strain Rate on Stress Corrosion of S355 Steel in 3.5% NaCl Solutions

The stress corrosion of S355 steel in 3.5% NaCl solution under the different strain rates was analyzed with the slow strain rate test（SSRT）, the stress corrosion cracking（SCC） behaviors of S355 steel under the different strain rates in the solution were investigated, and the fracture morphologies and compositions of corrosion products under the different strain rates were analyzed with scanning electron microscopy（SEM） and energy dispersive spectrometerry（EDS）, respectively. The experimental results show that the SCC sensitivity index is the highest when the strain rate is 2×10-6, and the medium corrosion is the main reason resulting in the highest SCC sensitivity index. The SCC sensitivity index is the least when the strain rate is 5×10-6, and the stress is the main reason resulting in the stress corrosion. The SCC sensitivity index is the middle when the strain rate is 9×10-6, the interaction of stress and medium is the stress corrosion fracture mechanism.