The effects of green tea (GT) in obese subjects have been evaluated in different studies, but no consensus has been obtained due to the heterogeneity of the results. The dosage, the type of extract, and the duration of the intervention are the main contributors to the heterogeneity of the results. Therefore, the present systematic review and meta-analysis aimed to evaluate the efficacy and dose-response relationship of GT. Several databases were searched from inception to September 2019 to identify clinical trials that examined the influence of GT supplements on obesity indices in humans. Combined results using the random-effects model indicated that body weight (WMD: −1.78 kg, 95% CI: −2.80, −0.75, p = .001) and body mass index (BMI) (WMD: −0.65 kg/m 2 , 95% CI: −1.04, −0.25, p = .001) did change significantly following GT administration. The reduction in waist circumference (WC) after GT consumption was significant in subjects in trials employing GT ≥800 mg/day (WMD: −2.06 cm) and with a treatment duration <12 weeks (WMD: −2.39 cm). Following the dose-response evaluation, GT intake did alter body weight, with a more important reduction when the GT dosage was <500 mg/day and the treatment duration was of 12 weeks. The results of present meta-analysis study support the use of GT for the improvement of obesity indices. Thus, we suggest that the use of GT can be combined with a balanced and healthy diet and regular physical exercise in the management of obese patients. K E Y W O R D S body mass index, dose-response, green tea, meta-analysis, obesity, weight 1 | INTRODUCTION Obesity is an important public health problem and a major contributor to the health burden globally (OECD, 2019). The presence of obesity significantly increases one's risk of non-communicable diseases, for example, diabetes mellitus, cardiovascular disease and cancer (Gaman, Epingeac, & Gaman, 2019; Goossens, 2017). According to the World Health Organization (WHO), obesity is characterized by an abnormal or excessive fat accumulation and is diagnosed clinically based on values of the body mass index (BMI) (kg/m 2) > 30 kg/m 2 (WHO, 2018). Since 1975, the prevalence of obesity has nearly tripled, with almost one-third of the world population being obese (Forse & Kissee, 2020). In 2016, 39% of the adults aged >18 years were reportedly overweight and 13% were obese (WHO, 2018). Obesity is a multifactorial chronic disease whose development results from an imbalance between the energy intake and expenditure
The axial blood pump with a magnetically suspended impeller is superior to other artificial blood pumps because of its small size. In this article, the distributions of velocity, path line, pressure, and shear stress in the straightener, the rotor, and the diffuser of the axial blood pump, as well as the gap zone were obtained using the commercial software, Fluent (version 6.2). The main focus was on the flow field of the blood pump. The numerical results showed that the axial blood pump could produce 5.14 L/min of blood at 100 mm Hg through the outlet when rotating at 11,000 rpm. However, there was a leakage flow of 1.06 L/min in the gap between the rotor cylinder and the pump housing, and thus the overall flow rate the impeller could generate was 6.2 L/min. The numerical results showed that 75% of the scalar shear stresses (SSs) were less than 250 Pa, and 10% were higher than 500 Pa within the whole pump. The high SS region appeared around the blade tip where a large variation of velocity direction and magnitude was found, which might be due to the steep angle variation at the blade tip. Because the exposure time of the blood cell at the high SS region within the pump was relatively short, it might not cause serious damage to the blood cells, but the improvement of blade profile should be considered in the future design of the axial pump.
Left ventricular diastolic dysfunction (LVDD) remains challenging to be assessed by echocardiography. We sought to explore the relationship between left atrial strain and left ventricular (LV) diastolic function in patients with normal left ventricular ejection fraction (LVEF) by invasive left-heart catheterization. 55 consecutive individuals with LVEF > 50% underwent LV catheterization. Standard transthoracic echocardiography was performed during 12 h before or after the procedure. Left atrial (LA) strain were obtained by speckle tracking echocardiography. When LVEF ≥ 50%, the group with elevated left ventricular end-diastolic pressure (LVEDP) (n = 35) showed decreased left atrial reservoir strain (LASr) (35.2 ± 7.7% vs 21.3 ± 7.2%, p < 0.001), left atrial conduit strain (LASct) (17.6 ± 6.3% vs 11.9 ± 4.1%, p < 0.001), left atrial contraction strain (LAScd) (16.6 ± 7.2% vs 9.5 ± 5.0%, p < 0.001) and increased E/e′ ration(8.9 ± 2.6 vs 10.1 ± 3.5, p = 0.17). LVEDP negatively correlated with LASr (R = 0.662, p < 0.001), LASct (R = 0.575, p < 0.001) and LAScd (R = 0.456, p < 0.001), but not with E/e′. LASr, LASct and LAScd were all independent predictors of elevated LVEDP (p < 0.05), with a higher C-statistic for the model including LASr (0.95, 0.86 and 0.93 respectively). The area under the curve (AUC) for LASr is 0.914 (cutoff value is 26.7%, sensitivity is 90%, specificity is 82.9%). In patients with normal LV ejection fraction, left atrial strain presented good correlation with LVEDP, and LASr was superior to LASct and LAScd to predict LVEDP. LA strain demonstrated better agreement with the invasive reference than E/e′.
A magnetically suspended axial flow blood pump is studied experimentally in this article. The pump casing enclosed a three-blade straightener, a two-blade impeller shrouded by a permanent magnet-embedded cylinder, and a three-blade diffuser. The internal flow fields were simulated earlier using computational fluid dynamics (CFD), and the pump characteristic curves were determined. The simulation results showed that the internal flow field was basically streamlined, except the diffuser region. Particle image velocimetry (PIV) measurement of the 1:1 pump model was conducted to validate the CFD result. In order to ensure the optical access, an acrylic prototype was fabricated with the impeller driven by a servomotor instead, as the magnet is opaque. In addition to the transparent model, the blood analog fluid with the refractive index close to that of acrylic was used to avoid refraction. According to the CFD results, the axial flow blood pump could generate adequate pressure head at the rotating speed of 9500rpm and flow rate of 5L/min, and the same flow condition was applied during the PIV measurement. Through the comparisons, it was found that the experimental results were close to those obtained by CFD and had thus validated the CFD model, which could complement the limitation of the measurement in assessing the more detailed flow fields of the axial flow pump.
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