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This study predominantly focuses on the design, fabrication and performance of a dual-axis sun-tracking solar system. The whole construction of the dual axis rotating solar panel is divided into two sub-division, i.e. electrical system design and mechanical system design. The components of electrical and mechanical design system contribute individually for the efficient working of the dual axis light-sensitive rotating solar system. Solar energy is immense, open in the environment, sparkling from contamination and renewable basis of electricity. The dual axis light-sensitive solar tracking system is an outcome of this mission. In this present study the aforesaid system is built and tested based on both the solar map and light-sensor-based continuous tracking mechanism. The power gain and system power consumption are compared with a static solar tracking system. It is found that power gain of this system has attested to be more proficient and beneficial than its fixed equivalents. The consequence exposed that the solar system with dual-axis tracking is further effective paralleled to that fixed solar system. [ABSTRACT FROM AUTHOR]

The incidence and prevalence of obesity have been rising in the United States, negatively impacting the population's overall health. This study seeks to better understand the impact of obesity on patients presenting with acute alcoholic pancreatitis (AAP). Data collected using the National Inpatient Sample (NIS) from the fourth quarter of 2015 to 2019 with a principal diagnosis of AAP and secondary obesity were analyzed. Confounders were adjusted for multivariate regression analysis using a multitude of factors. A total of 229,510 patients were identified with a diagnosis of AAP, among which 14,150 were also identified as obese. A majority of the sample, both obese and non-obese patients with AAP, were middle-aged white females. The average comorbidity index (CCI) was lower in the non-obese cohort compared to the obese cohort. Compared to non-obese patients, patients with AAP who were obese had higher hospital charges and a longer LOS (p<0.05. Additionally, compared to non-obese patients, obese patients with AAP had higher odds of mortality and adverse events, such as acute renal failure and respiratory failure (p<0.05). Current research supports these complications, which have shown an association with increased visceral fat in or around the pancreas that can ultimately worsen acute pancreatitis outcomes and aggravate AAP by damaging the intestinal mucosal barrier. These findings should be considered when treating obese patients who develop AAP. Strategies to increase surveillance of such patients should be implemented to reduce complications and mortality in this population., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Pellegrini et al.)

Background: The presence of permanent pacemakers (PPM) is common among the elderly population. Trauma literature has shown that the inability to augment cardiac output by at least 30% after injury portends a higher mortality. The presence of a PPM may be a surrogate marker to identify patients who are unable to increase cardiac output. We aimed to evaluate the association between the presence of PPM and clinical outcomes in elderly patients presenting with traumatic injuries., Methods: A total of 4505 patients aged ≥65 years admitted with acute trauma from 2009 to 2019 at our Level I Trauma center were evaluated and stratified into two groups using propensity matching on age, sex, injury severity score (ISS), and year of admission based on the presence of PPM. Logistic regression was performed to analyze the impact of the presence of PPM on mortality, surgical intensive care unit (SICU) admission, operative intervention, and length of stay. Prevalence of cardiovascular comorbidities was compared using χ 2 analysis., Results: Data from 208 patients with PPM and 208 propensity-matched controls were evaluated. Charlson Comorbidity Index, mechanism of injury, intensive care unit admission, and rate of operative intervention were comparable in the two groups. PPM patients had more coronary artery disease (p=0.04), heart failure with reduced ejection fraction (p=0.003), atrial fibrillation (AF, p<0.0001), and antithrombotic use (p<0.0001). We found no association between mortality amongst the groups after controlling for influencing variables (OR=2.1 (0.97 to 4.74), p=0.061). Patient characteristics associated with survival included female sex (p=0.009), lower ISS (p<0.0001), lower revised trauma score (p<0.0001), and lower SICU admission (p=0.001)., Conclusion: Our study shows no association between mortality among patients with PPM admitted for treatment of trauma. Presence of a PPM may be an indicator of cardiovascular disease, but this does not translate into increased risk in the modern era of trauma management in our patient population., Level of Evidence: Level III., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

To gain understanding of the burden of cardiac arrhythmias in patients with acutely decompensated diabetes mellitus (ADDM) on a large scale, we reviewed data on ADDM patients and subtypes of arrhythmias from the National Inpatient Sample from 2010 to 2014. The frequency and prevalence of cardiac arrhythmias were measured, as well as outcomes. Among 874,107 hospitalized ADDM patients identified, 87,970 (10.1%) developed arrhythmias. The ADDM-arrhythmia cohort showed higher all-cause mortality (1.4% vs 0.3%; adjusted odds ratio 2.58, 95% confidence interval 2.39-2.79, P < 0.001), prolonged hospital stays (4.2 ± 4.8 vs 3.3 ± 3.4 days), and higher hospital charges ($32,609 vs $23,741) compared to those without arrhythmias ( P < 0.001). The prevalence of supraventricular arrhythmia (atrial fibrillation, supraventricular tachycardia, and atrial flutter) and ventricular arrhythmia (ventricular tachycardia and ventricular fibrillation) was 2965 and 446 per 100,000 ADDM-related hospitalizations, respectively. The prevalence of any arrhythmias and atrial fibrillation in ADDM patients increased by 20.4% and 38.1%, respectively. The highest increase in the prevalence of arrhythmia among ADDM patients was observed in adults aged 18 to 44 years (22.5%)., (Copyright © 2021 Baylor University Medical Center.)

Our study aims to establish trends and frequencies of ventricular tachyarrhythmia (VTA) among patients with chronic coronary total occlusion (CCTO). We identified CCTO hospitalizations with and without VTA using the National Inpatient Sample. A total of 911,579 CCTO-related hospitalizations were identified, with 92,450 (10.1%) encounters associated with VTA. The CCTO-VTA cohort showed higher all-cause mortality (adjusted odds ratio [aOR] = 4.45, P <  0.001), longer hospital stays (6.8 vs 4.6 days; P <  0.001), and higher hospital charges ($117,382 vs $75,419; P <  0.001) compared to the CCTO non-VTA group. Rates and odds of cardiogenic shock (aOR = 4.19), venous thromboembolism (aOR = 2.09), respiratory failure (aOR = 2.85), and requirement of mechanical ventilation (aOR = 4.23) were higher in the CCTO-VTA group ( P <  0.001). Over time, there was an increase in VTA (9.2% in 2010 to 12.1% in 2014) and all-cause mortality (7.5% in 2010 to 12.4% in 2014; P <  0.001). Trends in VTA among patients with CCTO increased by 4.8% for undergoing percutaneous coronary intervention and by 2.5% for undergoing both percutaneous coronary intervention and coronary artery bypass grafting ( P <  0.001). Occurrence of VTA among CCTO patients is associated with worse outcomes and higher resource utilization., (Copyright © 2021 Baylor University Medical Center.)