: Sarcopenic obesity (SO) is the combination of excess fat, skeletal muscle and muscular strength/function deficit. The ESPEN/EASO have proposed new diagnostic criteria, but the SO prevalence in ...patients with severe obesity remains to be established. The aim of this study was to establish the SO prevalence in a large cohort of inpatients with obesity, considering sex, age, BMI, type, and number of concomitant diseases.
: Patient data of both genders aged between 18 and 90 years with a body mass index (BMI) of ≥30 kg/m
underwent hospital evaluation including bioelectrical impedance analysis (BIA) and handgrip strength (HS). QoL scores were obtained by the Psychological General Well-Being Index questionnaire. The study was approved by the institutional Ethic Committee.
: Among the 3858 patients, 444 (11.51%) exhibited a strength deficit, while 3847 (99.71%) had skeletal muscle mass deficit. The prevalence of SO was then 11.48%, with higher rates in women (12.39%), in individuals aged >70 years (27%), and in those reporting a 'poor' QoL (12.6%). No significant difference in SO prevalence was found when stratifying by BMI (30-40 kg/m
vs. >40 kg/m
,
= 0.1710). In SO patients, osteoarticular diseases (57%), hypertension/heart failure (38%), type 2 diabetes mellitus (34%), and obstructive sleep apnea (32%) were the more frequent comorbidities.
: The application of ESPEN/EASO-SO criteria in a cohort of inpatients with severe obesity revealed 11.48% SO prevalence, which was associated with age (particularly > 70 years), gender (women), but not BMI, as determinants. Disease staging and QoL screening may improve the identification of SO high-risk patients.
Phase angle (PhA) is a recently proposed marker of nutritional status in many clinical conditions. Its use in patients with obesity presents different critical concerns due to the higher variability ...of the two measured parameters (resistance, R, and reactance, Xc) that contribute to the determination of PhA. Controversial is the relation between PhA and BMI that might vary with graded levels of obesity due to the variation in fat and free fat mass. Obesity is frequently associated with metabolic, hepatic, cardiovascular and kidney diseases that introduce variations in PhA values, in relation to multimorbidity and severity degree of these diseases. It is reported that the improvement of clinical condition is associated with a positive change in PhA. Also, the treatment of obesity with weight loss might confirm this effect, but with different responses in relation to the type and duration of the intervention applied. In fact, the effect appears not only related to the percentage of weight loss but also the possible loss of free fat mass and the nutritional, metabolic and structural modifications that might follow each therapeutic approach to decrease body weight. We can conclude that the PhA could be used as marker of health status in patients with obesity supporting an appropriate weight loss intervention to monitor efficacy and fat free mass preservation.
Objective: Non-dipping status has been associated with increased risk of heart failure and cardiovascular events. However, its reproducibility when evaluated by means of ambulatory blood pressure ...monitoring (BPM) is often suboptimal. Wearable devices (WD) and home BPM devices equipped with nocturnal measurement function (HBPMN) offer the opportunity of estimating dipping status over different days thus potentially increasing precision owing to statistical averaging. We aimed to determine the reproducibility of nocturnal BP dipping estimated through a combined use of WD and HBPMN devices for daytime and night-time BP estimation within one week. Design and method: We recruited treated and untreated adult patients with hypertension. Patients underwent one week of home BP monitoring through a HBPMN device (NightView, OMRON Healthcare, HEM9601T-E3) and with an oscillometric WD (HeartGuide, OMRON Healthcare, HEM-6411T-MAE). Patients were asked to measure BP over one week with WD according to ESH-HBPM guidelines for daytime measurements and with HBPMN according to standard device settings for night-time measurements. Interclass correlation coefficient (ICC) was calculated to evaluate reproducibility. Results: 76 patients were included in the study. The main characteristics are summarised as follows: age (61±11.84 years), 32 (42%) females, BMI (28.12±4.90 Kg/m2). Most of them (98%) were treated hypertensives. Office systolic and diastolic BP were 134±4.43 mmHg and 80±4.84 mmHg, respectively. The average one-week systolic BP dipping was 16.14±9.44%. When we considered patients who had dipping assessment over at least the first 5 days (37 patients), intra-individual variability in the categorical definition of dipping status was observed (Figure 1) with a suboptimal reproducibility of average nocturnal BP fall (ICC 0.60). Conclusions: Nocturnal BP dipping estimated as continuous variable through the combined use of WD and HBPMN exhibits suboptimal reproducibility resulting in a variable day-by-day classification of patients according to their dipping status. Whether this reflects technical issues, or rather depends on the physiological variability of BP and sleeping patterns needs to be determined by future studies.
The widespread use of distributed generation (DG), which is installed in medium-voltage distribution networks, impacts the future development of modern electrical systems that must evolve towards ...smart grids. A fundamental topic for smart grids is automatic distributed voltage control (ADVC). The voltage is now regulated at the MV busbar acting on the on-load tap changer of the HV/MV transformer. This method does not guarantee the correct voltage value in the network nodes when the distributed generators deliver their power. In contrast, the ADVC allows control of the voltage acting on a single generator; therefore, a better voltage profile can be obtained. In this paper, an approach based on sensitivity theory is shown to control the node voltages regulating the reactive power injected by the generators. After the theoretical analysis, a numerical example is presented to validate the theory. The proposed voltage regulation method has been developed in collaboration with Enel Distribuzione S.p.A. (the major Italian DSO), and it will be applied in the Smart Grids POI-P3 pilot project, which is financed by the Italian Economic Development Ministry. Before the real field application in the pilot project, a real-time digital simulation has been used to validate the algorithm presented. Moving in this direction, Enel Distribuzione S.p.A. built a new test center in Milan equipped with a real-time digital simulator (from RTDS Technologies).
In order to study new technologies, in sight of smart grids, and for new regulation, protection, and control devices homologation tests, it becomes essential to use a real-time digital simulator ...(RTDS). This calculator offers the possibility to analyze the behavior of the aforementioned devices in any electrical grid condition, especially those hardly reproducible on the real field. In this paper, the analysis of two types of Petersen Coil Regulators will be discussed, focusing on the experimental results reached, useful to gain an optimized electrical distribution grid management.
Due to the development of Distributed Generation (DG), which is installed in Medium-Voltage Distribution Networks (MVDNs) such as generators based on renewable energy (e.g., wind energy or solar ...energy), voltage control is currently a very important issue. The voltage is now regulated at the MV busbars acting on the On-Load Tap Changer of the HV/MV transformer. This method does not guarantee the correct voltage value in the network nodes when the distributed generators deliver their power. In this paper an approach based on Sensitivity Theory is shown, in order to control the node voltages regulating the reactive power exchanged between the network and the dispersed generators. The automatic distributed voltage regulation is a particular topic of the Smart Grids.
The widespread of the Distributed Generation (DG) impacts the future development of modern electrical distribution systems that must to evolve towards Smart Grids. Fundamental topics of the Smart ...Grid context are the Distributed Voltage Automation and the Advanced Network Automation based on fast communication channels. In order to analyze the behavior of a network which evolves in Smart Grid, real time digital simulation, using a closed loop system, is an indispensable approach because allow to study normal and critical situations that can happen in the grid. Besides the interaction with real devices can be performed, in order to verify their correct operation. In this paper, after a general description of the real time simulation in the Smart Grid context, the behavior analysis of an interface protection device is performed using the Real Time Digital Simulator (RTDS) installed in the Enel Distribuzione S.p.A. test centre.
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