Aerospace Engineering: Research @ Brunel

Articles (co)authored by MAE Brunel staff

Below are recent articles (co-)authored by Brunel academic staff. Please click the title of the article to access the full-text.

  • Testosterone therapy reduces insulin resistance in men with adult-onset testosterone deficiency and metabolic syndrome. Results from the Moscow Study, a randomized controlled trial with an open-label phase
    Tishova, Y. et al
    Diabetes Obesity & Metabolism, [Early Access], (Mar 2024)
    Aims: To describe changes in homeostasis model assessment of insulin resistance index (HOMA-IR) following testosterone therapy in men with hypogonadism and metabolic syndrome (MetS).Materials and Methods. A randomized, placebo-controlled, double-blind randomized controlled trial (RCT) comprising 184 men with MetS and hypogonadism (testosterone undecanoate [TU]: 113 men, placebo: 71 men) was conducted. This was followed by an open-label phase in which all men were given TU. We focused on men who were not receiving antiglycaemic agents (TU: 81 men; placebo: 54 men) as these could affect HOMA-IR. Inter-group comparison of HOMA-IR was restricted to the RCT (30 weeks), whilst intra-group comparison was carried out on men provided TU during the RCT and open-label phases (study cohort) and men given placebo during the RCT and then switched to TU during the open-label phase (confirmatory cohort). Regression analysis was performed to identify factors associated with change in HOMA-IR ( increment HOMA-IR). Results: The median HOMA-IR was significantly reduced at almost every time point (after 18 weeks) compared to baseline in men receiving TU in both the study and confirmatory cohorts. There was a significant decrease in median values of fasting glucose (30 weeks: -2.1%; 138 weeks: -4.9%) and insulin (30 weeks: -10.5%; 138 weeks: -35.5%) after TU treatment. Placebo was not associated with significant increment HOMA-IR. The only consistent predictor of HOMA-IR decrease following TU treatment was baseline HOMA-IR (r2 >= 0.64). Conclusions: Baseline HOMA-IR predicted Delta HOMA-IR, with a greater percentage change in insulin than in fasting glucose. In men with MetS/type 2 diabetes (T2DM) not on antiglycaemic therapy, improvements in HOMA-IR may be greater than suggested by change in fasting glucose. Our results suggest that hypogonadism screening be included in the management of men with MetS/T2DM.

  • Complete revascularization is associated with higher mortality in patients with ST-elevation myocardial infarction, multi-vessel disease and shock defined by hyperlactataemia: results from the Harefield Shock Registry incorporating explainable machine learning
    Tindale, A. et al
    European Heart Journal-Acute Cardiovascular Care, Vol 12, No 9, p.615-623 (Jun 2023)
    Aims Revascularization strategy for patients with ST-elevation myocardial infarction (STEMI) and multi-vessel disease varies according to the patient's cardiogenic shock status, but assessing shock acutely can be difficult. This article examines the link between cardiogenic shock defined solely by a lactate of >= 2 mmol/L and mortality from complete vs. culprit-only revascularization in this cohort. Methods and results Patients presenting with STEMI, multi-vessel disease without severe left main stem stenosis and a lactate >= 2 mmol/L between 2011 and 2021 were included. The primary endpoint was mortality at 30 days by revascularization strategy for shocked patients. Secondary endpoints were mortality at 1 year and over a median follow-up of 30 months. Four hundred and eight patients presented in shock. Mortality in the shock cohort was 27.5% at 30 days. Complete revascularization (CR) was associated with higher mortality at 30 days [odds ratio (OR) 2.1 (1.02-4.2), P = 0.043], 1 year [OR 2.4 (1.2-4.9), P = 0.01], and over 30 months follow-up [hazard ratio (HR) 2.2 (1.4-3.4), P < 0.001] compared with culprit lesion-only percutaneous coronary intervention (CLOP). Mortality was again higher in the CR group after propensity matching (P = 0.018) and inverse probability treatment weighting [HR 2.0 (1.3-3.0), P = 0.001]. Furthermore, explainable machine learning demonstrated that CR was behind only blood gas parameters and creatinine levels in importance for predicting 30-day mortality. Conclusion In patients presenting with STEMI and multi-vessel disease in shock defined solely by a lactate of >= 2 mmol/L, CR is associated with higher mortality than CLOP.

  • Investigation of the temporal behavior of desiccant disk for use in dehumidifiers and air conditioners
    Sphicas, P. et al
    Results in Engineering, Vol 21, Art No. 101801 (Mar 2024)
    The majority of household energy is consumed in heating and air conditioning. Desiccant disks are a way to harvest renewable solar energy or waste heat for air conditioning. In the literature there is a gap in the investigation of start-up of desiccant dehumidifiers, which this paper attempts to covers. For this work, a desiccant disk was designed, manufactured, and tested. To reduce the cost, off-the-shelf components were used as structure materials. And as adsorption material, widely available materials were used. Input heat was simulated by an electrical heater and power to auxiliary motors was provided in the form of DC power. Temperature and humidity were recorded at various locations using DHT11 sensors. The system was turned off and tested at a start of operation mode. The performance of the desiccant disk was quantified by the coefficient of performance and the dehumidification efficiency. Results showed gradual increase of the desiccant disk efficiency with a maximum COP value of 0.4 reached within 10 min of the start of operation. Time delays were attributed to heating of the disk. Further work is required to fully understand the transient operation.

  • Design and Development of a Novel Force-Sensing Robotic System for the Transseptal Puncture in Left Atrial Catheter Ablation
    Zeidan, A. M. et al
    IEEE Int. Conf. on Robot. and Automa., London, U.K. 29 May-2 Jun 2023, p. 6851-6858 (2023)
    Transseptal puncture (TSP) is a prerequisite for left atrial catheter ablation for atrial fibrillation, requiring access from the right side of the heart. It is a demanding procedural step associated with complications, including inadvertent puncturing and application of large forces on the tissue wall. Robotic systems have shown great potential to overcome such challenges by introducing force-sensing capabilities and increased precision and localization accuracy. Therefore, this work introduces the design and development of a novel robotic system developed to perform TSP. We integrated optoelectronic sensors into the tools' fixtures, measuring tissue contact and puncture forces along one axis. The novelty of this design is in the system's ability to manipulate a Brockenbrough (BRK) needle and dilator-sheath simultaneously and measure tissue contact and puncture forces. In performing puncture experiments on anthropomorphic tissue models, an average puncture force of 3.97 ± 0.45 N (1SD) was established - similar to the force reported in literature on the manual procedure. This research highlights the potential for improving patient safety by enforcing force constraints, paving the way to more automated and safer TSP.

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