Syncope as a health risk for soldiers: Influence of medical history and clinical findings on the sensitivity of head-up tilt table testing

Background: Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine whether signs such as prodromal symptoms, co-morbidity, frequency of syncopal events, body length, body mass index, and electrocardiography(ECG) abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.Methods: Data from 100 patients with histories of syncope or pre-syncope, who were diagnosed using head-up tilt table testing, were retrospectively analyzed in a cross-sectional analysis. The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation. Results: Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms, such as dizziness and sweating, significantly more often. The patients reported more injuries resulting from syncopal events and more previous syncopal events, and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing. An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension. However, patients with pathological reaction patterns during tilt table testing were significantly taller. This finding was detected for both females and males. No significant predictors were found in the ECG patterns of patients showing syncope during tilt table testing.Conclusions: Frequency of prior syncope and prodromal symptoms, and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis. In particular, if these factors are present, tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.

Syncope as a health risk for soldiers-influence of medical history and clinical findings on the sensitivity of head-up tilt table testing

Background:Syncope is a relevant health problem in military environments.Reliable diagnosis is challenging.Tilt table testing is an important tool for syncope diagnosis.The aim of this study was to determine whether signs such as prodromal symptoms,co-morbidity,frequency of syncopal events,body length,body mass index,and electrocardiography abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.Methods:Data from 100 patients with histories of syncope or pre-syncope,who were diagnosed using head-up tilt table testing,were retrospectively analyzed in a cross-sectional analysis.The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation.Results:Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms,such as dizziness and sweating,significantly more often.The patients reported more injuries resulting from syncopal events and more previous syncopal events,and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing.An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension.However,patients with pathological reaction patterns during tilt table testing were significantly taller.This finding was detected for both females and males.No significant predictors were found in the electrocardiogram patterns of patients showing syncope during tilt table testing.Conclusions:Frequency of prior syncope and prodromal symptoms,and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis.In particular,if these factors are present,tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.

Cardiac index (CI) versus cardio ankle vascular index (CAVI) at different degrees of head-up tilt (HUT) in healthy subjects

The cardio-ankle vascular index (CAVI) is a new index of arterial stiffness that can be measured with a VaSera VS-1000 device. An association between certain arterial stiffness indices and cardiac function has been found but has not yet been validated. The aim of this study was to establish whether any significant relationship exists between cardiac index (CI) and CAVI. Twenty healthy male volunteers with a mean age of 30 ± 5 years and a mean BMI of 23.1 ± 1.1 kg/m2 participated in the study. CO was estimated using a Doppler technique, and CAVI was measured with a VaSeraVS-1000 device. A motorised tilting table was used to achieve head-up tilt (HUT) angles of 0°, 30°and 60°, to modify the peripheral sympathetic outflow. We found that there was a significant inverse correlation between CI and the degree of head-up tilt, ( for 0°and 30°;for 0° and 60°, p for both;for 30° and 60°, ). CAVI showed a significant positive correlation relative with the degree of HUT, ( for 0° and 30°;for 0° and 60°;for 30° and 60°, for all). A significant negative correlation was found between CI and CAVI r = - 0.47, p Additionally, a significant p increase in PVR values was observed for increasing HUT values. In conclusion: An inverse relationship between CI and CAVI was shown;a decrease in cardiac output is associated with an increase in CAVI values at different degrees of HUT. This association provides further insight into the postural link between cardiac output and arterial compliance.

The Changes of Baroreflex Sensitivity During Head-up Tilt Test and Its Clinical Significance in the Patients with Vasovagal Syncope

Objective To study thechanges of baroreflex sensitivity (BRS) during head - up tilt test (HUT) in patients with vasovagal syncope (VS), and to examine the relationship between baroreflex sensitivity and neurohormonal factors. Furthermore, to investigate the effects of the changes of BRS on VS. Methods Forty - two patients with unexplained syncope (Among the 42 patients, there were 22 patients with positive HUT and 20 patients with negative HUT respectively) and 20 healthy volunteers (with negative HUT) underwent passive head - up tilt testing, Ante-cubital vein blood samples were taken before and after HUT, or at syncope. The fasting plasma endothelin , serum nitric oxide (NO), serum NE were measured, the BRS was assessed on the basis of the linear regression slope the RR interval versus systolic arterial blood pressure during the increment in blood pressure after intravenous administration of phenylephrine. Results (1) During the syncope, the BRS significantly reduced in HUT(+) group than baseline. At the end of tilt, the level of plasma ET, serum NO in patients with positive HUT significantly increased compared with baseline or normal controls, and the plasma concentration of NE also had the trend of increase. (2) By multiple regression analysis, a significant negative correlation was found between baroreceptor sensitivity and the plasma ET, NO at the end of HUT in patients with positive HUT, but there was no relationship between BRS and NE. Conclusions During the syncope occure, the BRS in patients with VS decreased significantly compared with normal controls. The abnormal plasma ET, NO concen-tration might contribute to the mechanism of VS.

Age and Sex Distribution of Patients with Vasovagal Syncope Undergoing Head-up Tilt Table Test: 7-Year Audit

To investigate age and sex distribution of vasovagal syncope （VVS） patients undergoing head-up tilt table test （HUTT） at a tertiary hospital. The details of syncope patients who underwent HUTT at our department of cardiac function from January 2004 to December 2010 were reviewed. Of the 1 799 patients who underwent the HUTT, 854 tested positive, of which 558 （65.3%） were women, which were more than the women in the negative group （450, 47.6%） （p〈0.05）. VVS patients showed a bimodal age distribution between 11 and 20 years of age and in the fourth decade. In almost all age groups, mixed response was the highest compared with vasodepressor and cardioinhibitory. VVS patients who underwent HUTT indicate bimodal distribution peaking before the second decade and the fourth decade. The incidence of females was twice that of males before the sixth decade, and old age occupies a small percentage of VVS with no other comorbidities.

The Changes of Heart Rate Power Spectral Density during Head-up Tilt Test

To study the role of autonomic nervous system in the period of developing syncope induced by head-up tilt test(HUT), we analysed the changes of heart rate power spectral density(HRPSD) in 50 patients with unexplained syncope, including 15 positive patients (Group 1) and 35 negative patients(Group 2), and 15 negative healthy persons(Group 3) in 5 minute periods before and after tilting and 5 minutes before the end of test. HRPSD and their changes in total(T), very low-frequence(VLF), low-frequence(LF), high-frequence(HF) and the ratio of low/high frequence(LF/HF) were similar (P>0.05) 5 minutes before and after tilting among three groups. Five minutes before the end of test, Group 1 had obvious increase of T, VLF, LF and LF/HF while Group 2 and 3 had not such significant changes. There was significant difference(P<0.01) compared Group 1 with Group 2, 3. The results showed that the abnormal regulatory function of autonomic nervous system played an important role in the mechanism of symcope induced by HUT, the positive group had abnormal increase of sympathetic tone and imbalance of sympathetic/parasympathetic neural tone before syncope appeared.

基于伪磁梯度张量混合方向tilt梯度的磁源定位方法及其应用:以内蒙古塔木素铀矿床为例

斜磁化磁源的准确定位是磁法勘探有效圈定场源分布及划分断裂构造的重要依据.但受磁化方向影响,总磁异常与地质体分布并无明显对应关系.为此,本文从总磁异常垂向积分出发,推导出了伪磁梯度张量,定义了伪磁梯度张量的混合方向tilt梯度及混合方向解析信号振幅,提出了基于伪磁梯度张量混合方向tilt梯度水平导数组合的场源定位方法.模型试验表明,相对于解析信号振幅、tilt梯度的总水平导数及方向tilt梯度的总水平导数模这3种受磁化方向影响较小的方法,本文提出的磁源定位方法能够更有效地反映出不同磁化方向的磁源位置,具有更强的识别能力和定位精度.在内蒙古塔木素铀矿床的航磁资料应用中,新方法较好地展示出了已知断裂带的展布及出露岩浆岩的分布,同时有效地提取了塔木素铀矿床上方的弱磁异常信息,处理结果为研究区圈定隐伏岩体、划分隐伏断裂及扩大铀矿找矿靶区提供了依据.

基于多CNN的分块镜piston和tip-tilt误差同步检测方法研究

绝大多数大型望远镜采用分块镜的设计方案,为了获得优质的成像效果,需要控制分块望远镜系统的piston和tip-tilt误差。神经网络误差检测方法相较于传统的检测方法具有一定优势,但存在仅检测单一类型误差的局限性。本文提出一种基于卷积神经网络的piston和tip-tilt误差同步检测方法,通过在出瞳面设置具有离散孔的光阑,引发分段镜反射的子波发生干涉-衍射现象,构建包含丰富piston和tip-tilt误差信息的数据集。通过粗测网络和精测网络级联,满足大范围和高精度同步检测的需求。结果表明,该方法实现了对输入光源相干长度内纳米级的piston误差检测,并对10μrad范围内的tip-tilt误差实现了亚微弧度检测;对40 dB的CCD噪声表现出良好的抗干扰性,对面形误差的允差为0.05λ0RMS(λ0=600 nm),同时对六子镜系统具有可扩展性。本文方法光路简单,操作便利,具有实际意义。

Tilt-up建筑波纹钢板屋盖平面内抗震设计方法研究

Tilt-up建筑体系是一种由钢筋混凝土墙板、屋盖、内部承重柱组成的“盒式”受力体系。屋盖作为重要的结构构件,不仅承受平面外荷载,还承受由地震作用产生的水平力。论文分析了屋盖平面内受力机理,介绍了美国ASCE 7规范、IBC规范中Tilt-up结构波纹钢板屋盖平面内抗震设计方法,对华盛顿地区某Tilt-up建筑波纹钢板屋盖进行了设计研究,为我国引入Tilt-up建筑体系提供参考。

Analytical solution for the effective elastic properties of rocks with the tilted penny-shaped cracks in the transversely isotropic background

Seismic prediction of cracks is of great significance in many disciplines,for which the rock physics model is indispensable.However,up to now,multitudinous analytical models focus primarily on the cracked rock with the isotropic background,while the explicit model for the cracked rock with the anisotropic background is rarely investigated in spite of such case being often encountered in the earth.Hence,we first studied dependences of the crack opening displacement tensors on the crack dip angle in the coordinate systems formed by symmetry planes of the crack and the background anisotropy,respectively,by forty groups of numerical experiments.Based on the conclusion from the experiments,the analytical solution was derived for the effective elastic properties of the rock with the inclined penny-shaped cracks in the transversely isotropic background.Further,we comprehensively analyzed,according to the developed model,effects of the crack dip angle,background anisotropy,filling fluid and crack density on the effective elastic properties of the cracked rock.The analysis results indicate that the dip angle and background anisotropy can significantly either enhance or weaken the anisotropy degrees of the P-and SH-wave velocities,whereas they have relatively small effects on the SV-wave velocity anisotropy.Moreover,the filling fluid can increase the stiffness coefficients related to the compressional modulus by reducing crack compliance parameters,while its effects on shear coefficients depend on the crack dip angle.The increasing crack density reduces velocities of the dry rock,and decreasing rates of the velocities are affected by the crack dip angle.By comparing with exact numerical results and experimental data,it was demonstrated that the proposed model can achieve high-precision estimations of stiffness coefficients.Moreover,the assumption of the weakly anisotropic background results in the consistency between the proposed model and Hudson's published theory for the orthorhombic rock.

Research on Transmission Line Tower Tilting and Foundation State Monitoring Technology Based onMulti-Sensor Cooperative Detection and Correction

The transmission line tower will be affected by bad weather and artificial subsidence caused by the foundation and other factors in the power transmission.The tower’s tilt and severe deformation will cause the building to collapse.Many small changes caused the tower’s collapse,but the early staff often could not intuitively notice the changes in the tower’s state.In the current tower online monitoring system,terminal equipment often needs to replace batteries frequently due to premature exhaustion of power.According to the need for real-time measurement of power line tower,this research designed a real-time monitoring device monitoring the transmission tower attitude tilting and foundation state based on the inertial sensor,the acceleration of 3 axis inertial sensor and angular velocity raw data to pole average filtering pre-processing,and then through the complementary filtering algorithm for comprehensive calculation of tilt angle,the system meets the demand for inclined online monitoring of power line poles and towers regarding measurement accuracy,with low cost and power consumption.The optimization multi-sensor cooperative detection and correction measured tilt angle result relative accuracy can reach 1.03%,which has specific promotion and application value since the system has the advantages of unattended and efficient calculation.

Analysis and Research on Aerodynamic Characteristics of Quad Tilt Rotor Aircraft

For the quad tilt rotor aircraft, a computational fluid dynamics method based on multiple reference frames (MRF) was used to analyze the influence of aerodynamic layout parameters on the aerodynamic characteristics of the quad tilt rotor aircraft. Firstly, a numerical simulation method for the interference flow field of the quad tilt rotor aircraft is established. Based on this method, the aerodynamic characteristics of isolated rotors, rotor combinations at different lateral positions on the wing, and rotor rotation directions under different inflow velocities were calculated and analyzed, in order to grasp their aerodynamic interference laws and provide reference for the design and control theory research of such aircraft.

Tilt Angle Optimality Criteria for Stand Alone PV Systems

The conventional approach to optimizing tilt angles for fixed solar panels aims to maximize energy generation over the entire year. However, in the context of a supply controlled electric grid, where solar energy availability varies, this criterion may not be optimal. This study explores two alternative optimization criteria focused on maximizing baseload supply potential and minimizing required storage capacity to address seasonality in energy generation. The optimal tilt angles determined for these criteria differed significantly from the standard approach. This research highlights additional factors crucial for designing solar power systems beyond gross energy generation, essential for the global transition towards a fully renewable energy-based electric grid in the future.

基于改进tilt梯度的三维磁异常解释技术

当工区存在强剩磁或范围较大时,化极处理很难获得满意结果。为此,本文基于tilt梯度,推广得到可以突出x、y方向信息的tilt梯度分量,并根据这两个分量的水平导数,提出了改进tilt梯度水平总梯度的三维磁异常解释技术。该方法可以直接计算三维磁异常,无需化极。理论模型实验表明,相对于其他常用的磁数据处理方法,本文方法可以有效识别不同磁化方向下的长方体边界及球体质心的水平位置,具有更高的分辨率和精度。将该方法应用于中国内蒙塔木素地区航磁数据,解释结果与地质资料及地震推断结果对应较好,为研究区圈定隐伏磁性体提供了依据。

基于TILT的网络教程BJUTILT的分析与思考

TILT是美国德克萨斯州立大学数字图书馆开发的在线信息素质教程,堪称为信息素质教育网络教程的典范。基于此,北京工业大学图书馆信息咨询部于2005年10月完成了本校的信息素质教程BJUTILT。本文比较了TILT与BJUTILT,分析了BJUTILT的特点与存在的问题,总结了BJUTILT制作过程中的经验与得失,给出了信息素质教育网络教程建设的几点建议。

Deceleration Capacity--A Novel Measure for Autonomic Nervous System in Patients with Vasovagal Syncope on Tilt-table Testing

This study was to investigate the changes of autonomic nerve function and hemodynamics in patients with vasovagal syncope(VVS) during head-up tilt-table testing(HUT). HUT was performed in 68 patients with unexplained syncope and 18 healthy subjects served as control group. According to whether bradycardia, hypotension or both took place during the onset of syncope, the patients were divided during the test into three subgroups: vasodepressor syncope(VD), cardioinhibitory syncope(CI) and mixed syncope(MX) subgroups. Heart rate, blood pressure, heart rate variability(HRV), and deceleration capacity(DC) were continuously analyzed during HUT. For all the subjects with positive responses, the normalized low frequency(LFn) and the LF/HF ratio markedly decreased whereas normalized high frequency(HFn) increased when syncope occurred. Syncopal period also caused more significant increase in the power of the DC in positive groups. These changes were more exaggerated compared to controls. All the patients were indicative of a sympathetic surge in the presence of withdrawal vagal activity before syncope and a sympathetic inhibition with a vagal predominance at the syncopal stage by the frequency-domain analysis of HRV. With the measurements of DC, a decreased vagal tone before syncope stage and a vagal activation at the syncopal stage were observed. The vagal tone was higher in subjects showing cardioinhibitory responses at the syncopal stage. DC may provide an alternative method to understand the autonomic profile of VVS patients.

Tilt梯度及其水平导数提取重磁源边界位置

探讨了用于探测异常源边界和形状的Tilt梯度及其水平导数的方法及其性质.通过模型试算,论证了Tilt梯度及其水平导数的有效性,并从理论上给予了证明.Tilt梯度及其水平导数的方法及其性质可广泛用于区域重磁异常的构造解释之中.

Tilt骨盆骨折研究进展

随着交通业、建筑业的迅猛发展,骨盆骨折的发生率逐年提高。Tile根据骨折移位方向及稳定程度将骨盆骨折分为3型,其中Tile B2.1型(同侧型)骨折即为Tilt骨盆骨折。切开复位内固定是Tilt骨盆骨折的常用治疗方法,但创伤大、耗时长、术后不良反应多。随着影像学及计算机技术的不断发展,经皮微创技术逐渐成为可能,这也为Tilt骨盆骨折的治疗提供了新思路。该文就Tilt骨盆骨折研究进展作一综述。

利用Tilt-depth求取埋藏深度及其与边界位置的关系研究

对斜导数方法理论进行了研究,编写了利用斜导数方法来提取异常体边界和利用Tilt-depth方法来确定异常体顶面埋深的MATLAB程序,并实现了MATLAB与C#的混合编程.另外对深度点的三维可视化显示进行了研究,显示效果理想.理论模型试算结果表明,斜导数方法能够有效圈定异常体的边界,对异常体的顶面埋深计算较准确.实际资料的试算也取得了理想的结果,表明该方法具有良好的应用前景.

美国在线信息素质教育指南的典范——TILT的介绍和剖析

TILT是目前美国最成功的在线信息素质教育指南之一 ,本文在对 TILT进行调研的基础上总结了 TILT内容选择和安排的原则、提供的多种功能以及指南开发和利用的特点。