Clinical and Therapeutic Evaluation of Hypertensives According to the Practice of Ambulatory Blood Pressure Measurement (ABPM) at the Bel Air International Clinic in Conakry from January 1, 2019 to November 30, 2022

Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese subjects, those with secondary hypertension or resistant, diabetics, subjects with metabolic syndrome or sleep apnea syndrome. The objective of this study was to evaluate the contribution of ABPM in the diagnosis and evaluation of the level of control of hypertension under treatment at the Bel Air international clinic. Materials and Methods: This is a retrospective, cross-sectional and descriptive study, carried out at the Bel Air International Clinic in Conakry (Guinea) between January 2019 and November 30, 2022. It included a consecutive series of 180 consenting patients recruited through an ambulatory measurement of 24-hour blood pressure from a FUGADA brand device. Results: We collected 180 patients, with a male predominance (sex-ratio M/F = 2.46). The mean age of the patients was 48.48 ± 14.23 years. The most represented age group was that of 32 to 42 years with 50 cases (27.8%) followed by that of 43 to 52 years with 42 cases or 23.3%. The indication was for diagnostic purposes in 106 cases 58.9%, the therapeutic evaluation in 58 patients (32.2%). The examination was prescribed by a cardiologist in 98 cases (54.4%), a general practitioner in 71 cases (39.4%), a neurologist in 11 cases (6.1%). In the therapeutic evaluation, high blood pressure was controlled in 24 patients (13.3%) and uncontrolled in 34 cases (18.9%). In the diagnostic indication, high blood pressure was confirmed in 79 cases (43.9%) with a statistically significant link (Chi2 = 4.57 and p-value = 0.032). The nycthemeral mean was 187.27 ± 26.22 mmHg for systolic blood pressure (SBP) and 110.37 ± 19.06 mmHg for diastolic blood pressure (DBP), during the day, 151.64 ± 21.45 mmHg for SBP and 71.59 ± 8.67 mmHg for diastolic blood pressure. During the study 65 patients (36.1%) were identified as dippers and 115 patients (63.9%) were no-dipping. The antihypertensive protocol used was monotherapy in 68 cases (37.8%), dual therapy in 46 cases (25.6%), triple therapy in 17 cases (9.4%). However 39 patients or 21.7% were not taking any antihypertensive. Conclusion: This preliminary study, despite the modest sample size, showed the importance of ABPM as a tool for diagnosis, monitoring of hypertensive patients and therapeutic adaptation. A large-scale national study would be necessary for the rational use of ambulatory blood pressure measurement in our context in order to improve the management of hypertensive patients.

Numerical analysis of stress distribution in the upper arm tissues under an inflatable cuff：Implications for noninvasive blood pressure measurement

An inflatable cuff wrapped around the upper arm is widely used in noninvasive blood pressure measurement.However, the mechanical interaction between cuff and arm tissues, a factor that potentially affects the accuracy of noninvasive blood pressure measurement, remains rarely addressed. In the present study, finite element（FE） models were constructed to quantify intra-arm stresses generated by cuff compression, aiming to provide some theoretical evidence for identifying factors of importance for blood pressure measurement or explaining clinical observations. Obtained results showed that the simulated tissue stresses were highly sensitive to the distribution of cuff pressure on the arm surface and the contact condition between muscle and bone. In contrast, the magnitude of cuff pressure and small variations in elastic properties of arm soft tissues had little influence on the efficiency of pressure transmission in arm tissues. In particular, it was found that a thickened subcutaneous fat layer in obese subjects significantly reduced the effective pressure transmitted to the brachial artery, which may explain why blood pressure overestimation occurs more frequently in obese subjects in noninvasive blood pressure measurement.

Experimental Tibetan monkey domestication and its application for intraocular pressure measurement

AIM: To train Tibetan monkey (Macaca thibetana) for intraocular pressure (IOP) measurement in conscious state and obtain normal IOP in conscious Tibetan Macaque. METHODS: The training was based on award-conditioned behavior. Food stimulation and human-animal interaction were used in this training. RESULTS: Trained Tibetan monkeys calmly accepted IOP measurement by the TonoVete (R) rebound tonometer without sedation or anesthesia and their IOP values were similar to other primates. CONCLUSION: Human-cultivated Thibetan monkeys are tamable, and can be used for biomedical research such as ophthalmic research without anesthesia.

An improved outer pipe method for expansive pressure measurement of static cracking agents

Static cracking agent(SCA)is actively investigated as an alternative to explosive blasting for rock breakage due to its immense expansion property.SCA can eliminate the negative effects of shock,noise and harmful gases encountered in explosive blasting processes.Accurate measurement and deep understanding of the expansive properties of SCAs are important in their industrial application.An improved outer pipe method(OPM),termed the upper end surface method(UESM),is proposed in this paper to overcome the shortcomings of the OPM in the expansive pressure measurement of SCAs.Numerical simulation is used to proof the concept and a mathematical model established to relate the internal pressure and the radial strains at different positions in the upper end surface method test equipment.The new equipment is calibrated using oil pressure and strain measurements.The calibrated equipment is then used to measure the expansion pressure of SCA at three different water contents to proof its potential.The differences in the measurements with OPM and UESM at three different moisture contents are less than 4%.The experimental results confirm the accuracy and applicability of the more user friendly and less expensive UESM in the measurement of the expansive pressures of SCAs.

Wireless contactless pressure measurement of an LC passive pressure sensor with a novel antenna for high-temperature applications

In this paper, a novel antenna is proposed for high-temperature testing, which can make the high-temperature pressure characteristics of a wireless passive ceramic pressure sensor demonstrated at up to a temperature of 600℃. The design parameters of the antenna are similar to those of the sensor, which will increase the coupling strength between the sensor and testing antenna. The antenna is fabricated in thick film integrated technology, and the properties of the alumina ceramic and silver ensure the feasibility of the antenna in high-temperature environments. The sensor, coupled with the ceramic antenna, is investigated using a high-temperature pressure testing platform. The experimental measurement results show that the pressure signal in a harsh environment can be detected by the frequency diversity of the sensor.

A Deep Learning-Based Continuous Blood Pressure Measurement by Dual Photoplethysmography Signals

This study proposed a measurement platform for continuous blood pressure estimation based on dual photoplethysmography(PPG)sensors and a deep learning(DL)that can be used for continuous and rapid measurement of blood pressure and analysis of cardiovascular-related indicators.The proposed platform measured the signal changes in PPG and converted them into physiological indicators,such as pulse transit time(PTT),pulse wave velocity(PWV),perfusion index(PI)and heart rate(HR);these indicators were then fed into the DL to calculate blood pressure.The hardware of the experiment comprised 2 PPG components(i.e.,Raspberry Pi 3 Model B and analog-todigital converter[MCP3008]),which were connected using a serial peripheral interface.The DL algorithm converted the stable dual PPG signals acquired from the strictly standardized experimental process into various physiological indicators as input parameters and finally obtained the systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP).To increase the robustness of the DL model,this study input data of 100 Asian participants into the training database,including those with and without cardiovascular disease,each with a proportion of approximately 50%.The experimental results revealed that the mean absolute error and standard deviation of SBP was 0.17±0.46 mmHg.The mean absolute error and standard deviation of DBP was 0.27±0.52 mmHg.The mean absolute error and standard deviation of MAP was 0.16±0.40 mmHg.

A pilot study of the precision of digital intraocular pressure measurement during vitrectomy

AIM:To evaluate the precision of digital intraocular pressure(IOP)measurement in silicone oil(SO)filled eyes during vitrectomy.METHODS:This is a retrospective,single-blind study.Patients who were diagnosed with retinal detachment and scheduled for vitrectomy with SO injection were consecutively enrolled.During the vitrectomy,IOP was digitally measured and then by a rebound tonometer(Icare PRO).The rebound tonometer readings were masked to the surgeons.The digitally measured IOP and that of rebound tonometer were compared,and the inter-methods agreement was assessed.The absolute deviation in IOP values between these two methods(△IOP)was also calculated,and correlations between△IOP and refractive status,lens status and levels of surgeons’experience were analyzed.RESULTS:A total of 131 patients(131 eyes)were recruited,with a mean age of 51.0±16.1 y.There was no significant difference in IOPs between digital measurement and the rebound tonometer(15.6±4.3 vs 15.7±5.1 mm Hg;t=0.406,P=0.686).Intraclass correlation coefficients(ICC)analysis indicated a strong correlation between these two measurements(ICC=0.830,P<0.001).The mean△IOP was 2.0±1.9 mm Hg(range:0-12.8 mm Hg),with 98 eyes(74.8%)had the△IOP within 3 mm Hg.△IOP was found to be negatively correlated with levels of surgeons’experience(r=-0.183;P=0.037),but not with the refractive status or lens status of the patients(both P>0.05).CONCLUSION:For experienced surgeons,the digital IOP measurement may be an acceptable technique for IOP measurement in SO filled eyes during vitrectomy.However,its use by inexperienced surgeons should be taken with caution.

Wide-Temperature-Range Dielectric Permittivity Measurement under High Pressure

Two measurement systems are developed for in-situ dielectric property measurement under high pressure in a wide-temperature range from 77K to 1273 K. The high-temperature system ranging from room temperature up to 1273K is equipped with a hexahedron anvils press, while the low-temperature system ranging from liquid nitrogen temperature to normal condition is equipped using the piston cylinder setup with a specially designed sample chamber. Using these configurations, the dielectric property measurement of ferroelectrie BaTiO3 and multiferroie Tm0.5Gd0.5MnO3 compounds are demonstrated, which proves the validity of the systems through the tuning of the polarization and phase transition boundary by high pressure. These two systems will be equally applicable to a wide variety of electronic and transport property measurements of insulators, semiconductors, as well as battery materials.

Non-Contact Blood Pressure Measurement Based on IPPG

Blood pressure is an important physiological parameter to reflect human vital signs.In order to achieve the non-contact dynamic blood pressure acquisition based on ordinary optical camera,a theoretical understanding of the functional relationship between blood pressure and pulse wave signal conduction time.And through imaging photoelectric plethysmography(IPPG),pulse wave signal conduction time of forehead and hand was obtained with ordinary optical camera.First,the pulse wave conduction time was obtained by recording the video with an ordinary optical camera.Second,real-time blood pressure values were collected.Finally,based on the relationship between blood pressure and pulse wave conduction time,a non-contact blood pressure measurement prediction model was obtained through neural network fitting.So that non-contact blood pressure measurement with optical camera could be completed.The method in this paper has several advantages,such as low requirements on measuring equipment,low cost,and simple operation.It can let people get rid of the discomfort caused by measuring equipment such as cuff and can measure blood pressure at any time.The predicted blood pressure results were compared with an Omron wrist electronic sphygmomanometer.The calculated error of systolic blood pressure is-9.28%~3.16%,and the error of diastolic blood pressure is-9.84~4.35%.

Spectral Measurement of Atmospheric Pressure Plasma by Means of Digital Camera

A digital camera measuring system has been used successfully to measure the space fluctuation behaviors of Induced Dielectric Barrier Discharge (IDBD) plasma at atmospheric pres- sure. The experimental results showed that: (1) The uniformity of electron temperature in space depends on discharge condition and structure of web electrode. For a certain web electrode the higher the discharge voltage is, the more uniform distribution of electron temperature in space will be. For a certain discharge the finer and denser the holes on web electrode are, the more uniform distribution of electron temperature in space will be (2). Digital camera is an available equipment to measure some behaviors of the plasma working at atmospheric pressure.

Investigation on the relationship between overpressure and sub-harmonic response from encapsulated microbubbles

Sub-harmonic component generated from microbubbles is proven to be potentially used in noninvasive blood pressure measurement. Both theoretical and experimental studies are performed in the present work to investigate the dependence of the sub-harmonic generation on the overpressure with different excitation pressure amplitudes and pulse lengths. With 4-MHz ultrasound excitation at an applied acoustic pressure amplitude of 0.24 MPa, the measured sub-harmonic amplitude exhibits a decreasing change as overpressure increases; while non-monotonic change is observed for the applied acoustic pressures of 0.36 MPa and 0.48 MPa, and the peak position in the curve of the sub-harmonic response versus the overpres- sure shifts toward higher overpressure as the excitation pressure amplitude increases. Furthermore, the exciting pulse with long duration could lead to a better sensitivity of the sub-harmonic response to overpressure. The measured results are ex- plained by the numerical simulations based on the Marmottant model. The numerical simulations qualitatively accord with the measured results. This work might provide a preliminary proof for the optimization of the noninvasive blood pressure measurement through using sub-harmonic generation from microbubbles.

SUP-ADDITIVE METRIC PRESSURE OF DIFFEOMORPHISMS

In this paper,we study the pressure of C^(1)-smooth partially hyperbolic diffeomorphisms with sup-additive potentials.We give several definitions of the so called unstable(measure theoretic)pressure in terms of Bowen’s picture and the capacity picture.We show that all such unstable metric pressures of a given ergodic measure equals the corresponding unstable measure theoretic entropy plus the Lyapunov exponent of the potentials with respect to the ergodic measure.

Grid Convergence Property of Three-Dimensional Measurement-Integrated Simulation for Unsteady Flow behind a Square Cylinder with Karman Vortex Street

The purpose of this study was to clarify grid convergence property of three-dimensional measurement-integrated (3D-MI) simulation for a flow behind a square cylinder with Karman vortex street. Measurement-integrated (MI) simulation is a kind of the observer in the dynamical system theory by using CFD scheme as a mathematical model of the system. In a former study, two-dimensional MI (2D-MI) simulation with a coarse grid system showed a fairly good result in comparison with a 2D ordinary (2D-O) simulation, but the results were degraded with grid refinement. In this study, 3D-MI simulation and three-dimensional ordinary (3D-O) simulation were performed with three grid systems of different grid resolutions, and their grid convergence properties were compared. As a result, all 3D-MI simulations reproduced the vortex shedding frequency identical to that of the experiment, and the flow fields obtained were very close, within 5% difference between the results, while the results of the 3D-O simulations showed variation of the solution under convergence. It is shown that the grid convergence property of 3D-MI simulation is monotonic and better than that of 3D-O simulation, whereas those of 2D-O and 2D-MI simulations for streamwise velocity fluctuation are divergent. The solution of 3D-MI simulation with a relatively coarse grid system properly reproduces the basic three-dimensional structure of the wake flow as well as the drag and lift coefficients.

Nondestructive measurement of thermal contact resistance for the power vertical double-diffused metal-oxide-semiconductor

To obtain thermal contact resistance（TCR） between the vertical double-diffused metal-oxide-semiconductor（VDMOS） and the heat sink, we derived the relationship between the total thermal resistance and the contact force imposed on the VDMOS. The total thermal resistance from the chip to the heat sink is measured under different contact forces, and the TCR can be extracted nondestructively from the derived relationship. Finally, the experimental results are compared with the simulation results.

Experimental and numerical investigation of a self-supplementing dual-cavity plasma synthetic jet actuator

The primary issue regarding the plasma synthetic jet actuator(PSJA)is its performance attenuation at high frequencies.To solve this issue,a self-supplementing,dual-cavity,plasma synthetic jet actuator(SD-PSJA)is designed,and the static properties of the SD-PSJA are investigated through experiments and numerical simulations.The pressure measurement shows that the SD-PSJA has two saturation frequencies(1200 Hz and 2100 Hz),and the experimental results show that both the saturation frequencies decrease as the volume of the bottom cavity of the SD-PSJA increases.As the size of the supplement hole increases,the first saturation frequency increases continuously,while the second saturation frequency shows a trend of first decreasing and then increasing.Numerical simulations show that the working process of the SD-PSJA is similar to that of the PSJA,but the volume of the cavity in the SD-PSJA is smaller than that of the PSJA;the SD-PSJA can supplement air to the top cavity through two holes,thus reducing the refresh time and effectively improving the jet intensity of the actuator at high frequencies.

Endoscopic ultrasound-guided vascular interventions: An expanding paradigm

Endoscopic ultrasound(EUS)has expanded its arena from a mere diagnostic modality to an essential therapeutic tool in managing gastrointestinal(GI)diseases.The proximity of the GI tract to the vascular structures in the mediastinum and the abdomen has facilitated the growth of EUS in the field of vascular interventions.EUS provides important clinical and anatomical information related to the vessels'size,appearance and location.Its excellent spatial resolution,use of colour doppler with or without contrast enhancement and ability to provide images“real-time”helps in precision while intervening vascular structures.Additionally,structures such as venous collaterals or varices can be dealt with optimally using EUS.EUS-guided vascular therapy with coil and glue combination has revolutionized the management of portal hypertension.It also helps to avoid radiation exposure in addition to being minimally invasive.These advantages have led EUS to become an upcoming modality to complement traditional interventional radiology in the field of vascular interventions.EUS-guided portal vein(PV)access and therapy is a new kid on the block.EUS-guided portal pressure gradient measurement,injecting chemotherapy in PV and intrahepatic portosystemic shunt has expanded the horizons of endo-hepatology.Lastly,EUS has also forayed into cardiac interventions allowing pericardial fluid aspiration and tumour biopsy with experimental data on access to valvular apparatus.Herein,we provide a comprehensive review of the expanding paradigm of EUS-guided vascular interventions in GI bleeding,portal vein access and its related therapeutic interventions,cardiac access,and therapy.A synopsis of all the technical details involving each procedure and the available data has been tabulated,and the future trends in this area have been highlighted.

THE INTERACTION BETWEEN SHOCK WAVES AND SOLID SPHERES ARRAYS IN A SHOCK TUBE

When a shock wave interacts with a group of solid spheres,non-linear aerodynamic behaviors come into effect.The complicated wave reflections such as the Mach reflection occur in the wave propagation process.The wave interactions with vortices behind each sphere's wake cause fluctuation in the pressure profiles of shock waves.This paper reports an experimental study for the aerodynamic processes involved in the interaction between shock waves and solid spheres.A schlieren photography was applied to visualize the various shock waves passing through solid spheres.Pressure measurements were performed along different downstream positions.The experiments were conducted in both rectangular and circular shock tubes.The data with respect to the effect of the sphere array, size,interval distance,incident Mach number,etc.,on the shock wave attenuation were obtained.

Real-time human blood pressure measurement based on laser self-mixing interferometry with extreme learning machine

In this paper, we present a method based on self-mixing interferometry combing extreme learning machine for real-time human blood pressure measurement. A signal processing method based on wavelet transform is applied to extract reversion point in the self-mixing interference signal, thus the pulse wave profile is successfully reconstructed. Considering the blood pressure values are intrinsically related to characteristic parameters of the pulse wave, 80 samples from the MIMIC-II database are used to train the extreme learning machine blood pressure model. In the experiment, 15 measured samples of pulse wave signal are used as the prediction sets. The results show that the errors of systolic and diastolic blood pressure are both within 5 mm Hg compared with that by the Coriolis method.

An ultralow power wireless intraocular pressure monitoring system

This paper describes an ultralow power wireless intraocular pressure （IOP） monitoring system that is dedicated to sensing and transferring intraocular pressure of glaucoma patients. Our system is comprised of a capac- itive pressure sensor, an application-specific integrated circuit, which is designed on the SMIC 180 nm process, and a dipole antenna. The system is wirelessly powered and demonstrates a power consumption of 7.56 μW at 1.24 V during continuous monitoring, a significant reduction in active power dissipation compared to existing work. The input RF sensitivity is -13 dBm. A significant reduction in input RF sensitivity results from the reduction of mis- match time of the ASK modulation caused by FM0 encoding. The system exhibits an average error of-4- 1.5 mmHg in measured pressure. Finally, a complete IOP system is demonstrated in the real biological environment, showing a successful reading of the pressure of an eye.

Micro packaged MEMS pressure sensor for intracranial pressure measurement

This paper presents a micro packaged MEMS pressure sensor for intracranial pressure measurement which belongs to BioMEMS. It can be used in lumbar puncture surgery to measure intracranial pressure. Minia- turization is key for lumbar puncture surgery because the sensor must be small enough to allow it be placed in the reagent chamber of the lumbar puncture needle. The size of the sensor is decided by the size of the sensor chip and package. Our sensor chip is based on silicon piezoresistive effect and the size is 400 × 400 μm2. It is much smaller than the reported polymer intracranial pressure sensors such as liquid crystal polymer sensors. In terms of package, the traditional dual in-line package obviously could not match the size need, the minimal size of recently reported MEMS-based intracranial pressure sensors after packaging is 10 × 10 mm2. In this work, we are the first to introduce a quad flat no-lead package as the package form of piezoresistive intracranial pressure sensors, the whole size of the sensor is minimized to only 3 × 3 mm2. Considering the liquid measurement environment, the sensor is gummed and waterproof performance is tested; the sensitivity of the sensor is 0.9 × 10-2 mV/kPa.