Search results for: left bundle branch block
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2663

Search results for: left bundle branch block

2303 Epicardial Fat Necrosis in a Young Female: A Case Report

Authors: Tayyibah Shah Alam, Joe Thomas, Nayantara Shenoy

Abstract:

Presenting a case that we would like to share, the answer is straight forward but the path taken to get to the diagnosis is where it gets interesting. A 31-year-old lady presented to the Rheumatology Outpatient department with left-sided chest pain associated with left-sided elbow joint pain intensifying over the last 2 days. She had been having a prolonged history of chest pain with minimal intensity since 2016. The pain is intermittent in nature. Aggravated while exerting, lifting heavy weights and lying down. Relieved while sitting. Her physical examination and laboratory tests were within normal limits. An electrocardiogram (ECG) showed normal sinus rhythm and a chest X-ray with no significant abnormality was noted. The primary suspicion was recurrent costochondritis. Cardiac blood inflammatory markers and Echo were normal, ruling out ACS. CT chest and MRI Thorax contrast showed small ill-defined STIR hyperintensity with thin peripheral enhancement in the anterior mediastinum in the left side posterior to the 5th costal cartilage and anterior to the pericardium suggestive of changes in the fat-focal panniculitis. Confirming the diagnosis as Epicardial fat necrosis. She was started on Colchicine and Nonsteroidal anti-inflammatory drugs for 2-3 weeks, following which a repeat CT showed resolution of the lesion and improvement in her. It is often under-recognized or misdiagnosed. CT scan was collectively used to establish the diagnosis. Making the correct diagnosis prospectively alleviates unnecessary testing in favor of conservative management.

Keywords: EFN, panniculitis, unknown etiology, recurrent chest pain

Procedia PDF Downloads 97
2302 A More Powerful Test Procedure for Multiple Hypothesis Testing

Authors: Shunpu Zhang

Abstract:

We propose a new multiple test called the minPOP test for testing multiple hypotheses simultaneously. Under the assumption that the test statistics are independent, we show that the minPOP test has higher global power than the existing multiple testing methods. We further propose a stepwise multiple-testing procedure based on the minPOP test and two of its modified versions (the Double Truncated and Left Truncated minPOP tests). We show that these multiple tests have strong control of the family-wise error rate (FWER). A method for finding the p-values of the proposed tests after adjusting for multiplicity is also developed. Simulation results show that the Double Truncated and Left Truncated minPOP tests, in general, have a higher number of rejections than the existing multiple testing procedures.

Keywords: multiple test, single-step procedure, stepwise procedure, p-value for multiple testing

Procedia PDF Downloads 84
2301 A Contribution to the Polynomial Eigen Problem

Authors: Malika Yaici, Kamel Hariche, Tim Clarke

Abstract:

The relationship between eigenstructure (eigenvalues and eigenvectors) and latent structure (latent roots and latent vectors) is established. In control theory eigenstructure is associated with the state space description of a dynamic multi-variable system and a latent structure is associated with its matrix fraction description. Beginning with block controller and block observer state space forms and moving on to any general state space form, we develop the identities that relate eigenvectors and latent vectors in either direction. Numerical examples illustrate this result. A brief discussion of the potential of these identities in linear control system design follows. Additionally, we present a consequent result: a quick and easy method to solve the polynomial eigenvalue problem for regular matrix polynomials.

Keywords: eigenvalues/eigenvectors, latent values/vectors, matrix fraction description, state space description

Procedia PDF Downloads 472
2300 Information Technology Approaches to Literature Text Analysis

Authors: Ayse Tarhan, Mustafa Ilkan, Mohammad Karimzadeh

Abstract:

Science was considered as part of philosophy in ancient Greece. By the nineteenth century, it was understood that philosophy was very inclusive and that social and human sciences such as literature, history, and psychology should be separated and perceived as an autonomous branch of science. The computer was also first seen as a tool of mathematical science. Over time, computer science has grown by encompassing every area in which technology exists, and its growth compelled the division of computer science into different disciplines, just as philosophy had been divided into different branches of science. Now there is almost no branch of science in which computers are not used. One of the newer autonomous disciplines of computer science is digital humanities, and one of the areas of digital humanities is literature. The material of literature is words, and thanks to the software tools created using computer programming languages, data that a literature researcher would need months to complete, can be achieved quickly and objectively. In this article, three different tools that literary researchers can use in their work will be introduced. These studies were created with the computer programming languages Python and R and brought to the world of literature. The purpose of introducing the aforementioned studies is to set an example for the development of special tools or programs on Ottoman language and literature in the future and to support such initiatives. The first example to be introduced is the Stylometry tool developed with the R language. The other is The Metrical Tool, which is used to measure data in poems and was developed with Python. The latest literature analysis tool in this article is Voyant Tools, which is a multifunctional and easy-to-use tool.

Keywords: DH, literature, information technologies, stylometry, the metrical tool, voyant tools

Procedia PDF Downloads 153
2299 Modification of Aliphatic-Aromatic Copolyesters with Polyether Block for Segmented Copolymers with Elastothemoplastic Properties

Authors: I. Irska, S. Paszkiewicz, D. Pawlikowska, E. Piesowicz, A. Linares, T. A. Ezquerra

Abstract:

Due to the number of advantages such as high tensile strength, sensitivity to hydrolytic degradation, and biocompatibility poly(lactic acid) (PLA) is one of the most common polyesters for biomedical and pharmaceutical applications. However, PLA is a rigid, brittle polymer with low heat distortion temperature and slow crystallization rate. In order to broaden the range of PLA applications, it is necessary to improve these properties. In recent years a number of new strategies have been evolved to obtain PLA-based materials with improved characteristics, including manipulation of crystallinity, plasticization, blending, and incorporation into block copolymers. Among the other methods, synthesis of aliphatic-aromatic copolyesters has been attracting considerable attention as they may combine the mechanical performance of aromatic polyesters with biodegradability known from aliphatic ones. Given the need for highly flexible biodegradable polymers, in this contribution, a series of aromatic-aliphatic based on poly(butylene terephthalate) and poly(lactic acid) (PBT-b-PLA) copolyesters exhibiting superior mechanical properties were copolymerized with an additional poly(tetramethylene oxide) (PTMO) soft block. The structure and properties of both series were characterized by means of attenuated total reflectance – Fourier transform infrared spectroscopy (ATR-FTIR), nuclear magnetic resonance spectroscopy (¹H NMR), differential scanning calorimetry (DSC), wide-angle X-ray scattering (WAXS) and dynamic mechanical, thermal analysis (DMTA). Moreover, the related changes in tensile properties have been evaluated and discussed. Lastly, the viscoelastic properties of synthesized poly(ester-ether) copolymers were investigated in detail by step cycle tensile tests. The block lengths decreased with the advance of treatment, and the block-random diblock terpolymers of (PBT-ran-PLA)-b-PTMO were obtained. DSC and DMTA analysis confirmed unambiguously that synthesized poly(ester-ether) copolymers are microphase-separated systems. The introduction of polyether co-units resulted in a decrease in crystallinity degree and melting temperature. X-ray diffraction patterns revealed that only PBT blocks are able to crystallize. The mechanical properties of (PBT-ran-PLA)-b-PTMO copolymers are a result of a unique arrangement of immiscible hard and soft blocks, providing both strength and elasticity.

Keywords: aliphatic-aromatic copolymers, multiblock copolymers, phase behavior, thermoplastic elastomers

Procedia PDF Downloads 140
2298 Asthma Nurse Specialist Improves the Management of Acute Asthma in a University Teaching Hospital: A Quality Improvement Project

Authors: T. Suleiman, C. Mchugh, H. Ranu

Abstract:

Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

Procedia PDF Downloads 379
2297 Gas Separation Membranes Using Stability Improved Ion Gels

Authors: Y. H. Hwang, J. Won, Y. S. Kang

Abstract:

Since ionic liquids have a special interaction with gas specially CO2 and/or olefin, supported ionic liquids membrane (SILM) are fabricated for practical gas separation. However, SILM has a problem in practical application due to the low mechanical stability under high pressure for gas separation. In order to improve the mechanical strength of the selective ionic liquid layer, we prepared supported ion gel membrane by the formation of gel on the surface of Nylon support. The ion gel was prepared by the addition of poly(styrene-block-ethyleneoxide-block-styrene) triblock copolymer in four tricyanomethanide ionic liquids have different cation; 1-ethyl-3-methlyimidazolium tricyanomethanide, 1-butyl-3-methlyimidazolium tricyanomethanide, 1-butyl-1-methylpyrrolidinium tricyanomethanide, 1-butyl-4-methylpyridinium tricyanomethanide using methylenechloride as a solvent. The characters of ion gel with different cation were studied. Four different gases (CO2, N2, O2, and CH4) permeance were measured at room temperature by bubble flow meter and cation effect of tricyanomethanide ionic liquids investigated.

Keywords: membrane, ionic liquid, ion gel, nanostructure

Procedia PDF Downloads 345
2296 Preparation of Magnetothermally Responsive Polymer Multilayer Films for Controlled Release Applications from Surfaces

Authors: Eda Cagli, Irem Erel Goktepe

Abstract:

Externally triggered and effective release of therapeutics from polymer nanoplatforms is one of the key issues in cancer treatment. In this study, we aim to prepare polymer multilayer films which are stable at physiological conditions (little or no drug release) but release drug molecules at acidic pH and via application of AC magnetic field. First, novel stimuli responsive diblock copolymers composed of pH- and temperature-responsive blocks were synthesized. Then, block copolymer micelles with pH-responsive core and temperature responsive coronae will be obtained via pH-induced self-assembly of these block copolymers in aqueous environment. A model anticancer drug, e.g. Doxorubicin will be loaded in the micellar cores. Second, superparamagnetic nanoparticles will be synthesized. Magnetic nanoparticles and drug loaded block copolymer micelles will be used as building blocks to construct the multilayers. To mimic the acidic nature of the tumor tissues, Doxorubicin release from the micellar cores will be induced at acidic conditions. Moreover, Doxorubicin release from the multilayers will be facilitated via magnetothermal trigger. Application of AC magnetic field will induce the heating of magnetic nanoparticles resulting in an increase in the temperature of the polymer platform. This increase in temperature is expected to trigger conformational changes on the temperature-responsive micelle coronae and facilitate the release of Doxorubicin from the surface. Such polymer platform may find use in biomedical applications.

Keywords: layer-by-layer films, magnetothermal trigger, smart polymers, stimuli responsive

Procedia PDF Downloads 364
2295 The Planning Criteria of Block-Unit Redevelopment to Improve Residential Environment: Focused on Redevelopment Project in Seoul

Authors: Hong-Nam Choi, Hyeong-Wook Song, Sungwan Hong, Hong-Kyu Kim

Abstract:

In Korea, elements that decide the quality of residential environment are not only diverse, but show deviation as well. However, people do not consider these elements and instead, they try to settle the uniformed style of residential environment, which focuses on the construction development of apartment housing and business based plans. Recently, block-unit redevelopment is becoming the standout alternative plan of standardize redevelopment projects, but constructions become inefficient because of indefinite planning criteria. In conclusion, the following research is about analyzing and categorizing the development method and legal ground of redevelopment project district, plan determinant and applicable standard. The purpose of this study is to become a basis in compatible analysis of planning standards that will happen in the future.

Keywords: shape restrictions, improvement of regulation, diversity of residential environment, classification of redevelopment project, planning criteria of redevelopment, special architectural district (SAD)

Procedia PDF Downloads 485
2294 Microscopic Examination of the Pre-Hatching Development of the Chicken Ovary

Authors: Mohamed Alsafy, Samir El-Gendy, Ashraf Karkoura, Doha Shokry

Abstract:

The purpose of the current study was to investigate the development of the chicken ovary. One hundred fertilized egg of Alexandria breed of chicken used. The whole embryo has undergone the light microscopic examination at HH20 (E.3), HH21 (E.3.5), HH23 (E.4), HH29 (E.6) and HH34 (E.8). The ovary has undergone the light microscopic examination at HH38 (E.12) and HH42 (E.16), SEM at HH26 (E.5), HH29 (E.6), HH36 (E.10), HH38 (E.12), HH39 (E.13) and HH42 (E.16), TEM at HH38 (E.12) and HH42 (E.16). The genital ridge appeared by a thickening of the coelomic epithelium medioventral surface of the developing mesonephroi at HH20 (E.3). The boundaries of the undifferentiating gonads defined clearly separated from the mesonephroi. The undifferentiated gonads bulged as a distinct organ in the coelomic cavity at HH23 (E.4). At the initial stages of the gonadogenesis, the germinal epithelium was stratified squamous epithelium. The PGCs appeared at the genital ridge at HH21 (E.3.5). The PGCs observed at the dorsal mesentery with few microvilli and showed positive PAS reaction due to the glycogen content in their cytoplasm. The left-right gonadal asymmetry firstly detected by the number of PGCs migrating toward the left gonadal ridge more than the right at HH20 (E.3) and the macroscopic examination of gonadal asymmetry began at HH34 (E.8). The left ovary appeared a smooth rod-shape, its stroma showed lipid droplets, and its parenchyma showed an extensive arrangement of interstitial cords at HH42 (E.16).

Keywords: ovary, Alexandria chicken, light microscopy, SEM, TEM

Procedia PDF Downloads 317
2293 Relationship between Right Brain and Left Brain Dominance and Intonation Learning

Authors: Mohammad Hadi Mahmoodi, Soroor Zekrati

Abstract:

The aim of this study was to investigate the relationship between hemispheric dominance and intonation learning of Iranian EFL students. In order to gain this goal, 52 female students from three levels of beginner, elementary and intermediate in Paradise Institute, and 18 male university students at Bu-Ali Sina University constituted the sample. In order to assist students learn the correct way of applying intonation to their everyday speech, the study proposed an interactive approach and provided students with visual aid through which they were able to see the intonation pattern on computer screen using 'Speech Analyzer' software. This software was also used to record subjects’ voice and compare them with the original intonation pattern. Edinburg Handedness Questionnaire (EHD), which ranges from –100 for strong left-handedness to +100 for strong right-handedness was used to indicate the hemispheric dominance of each student. The result of an independent sample t-test indicated that girls learned intonation pattern better than boys, and that right brained students significantly outperformed the left brained ones. Using one-way ANOVA, a significant difference between three proficiency levels was also found. The posthoc Scheffer test showed that the exact difference was between intermediate and elementary, and intermediate and beginner levels, but no significant difference was observed between elementary and beginner levels. The findings of the study might provide researchers with some helpful implications and useful directions for future investigation into the domain of the relationship between mind and second language learning.

Keywords: intonation, hemispheric dominance, visual aid, language learning, second language learning

Procedia PDF Downloads 519
2292 Communication Experience and the Perception of Media Richness among Parents Working Overseas and Their Children Left-behind in the Philippines

Authors: Dennis Caasi

Abstract:

This study analyzed four knowledge-building elements of channel expansion theory namely: communication media, communication content, communication partner, and communication influence vis-à- vis media richness dimensions among parents working overseas and their left-behind children in the Philippines. Results reveal that both parents and children consumed four out of six mediated communications tested in this research, spent one to four days a week connecting, between 30 minutes to 3 hours per engagement, and media consumption is dependent on the message content and media literacy of parents. Family, academic, household, and health were the common communication topics and parents dictate which channel to use. All six medium tested received high ratings based on the media richness constructs.

Keywords: channel expansion theory, computer-mediated communication, media richness theory, overseas Filipino worker

Procedia PDF Downloads 343
2291 Primary Fallopian Tube Carcinoma: A Case Report

Authors: Mary Abigail T. Ty, Mary Jocelyn Yu-Laygo, Jocelyn Z. Mariano

Abstract:

This is a case of L.S.T., a 61 year old, G6P4 (3124) who presented with a one month history of intermittent, brownish, watery, non foul smelling vaginal discharge. There were no other accompanying symptoms. On rectovaginal examination, a palpable adnexal mass on the left was appreciated, with the lower border measuring 3 cm. The mass was non-tender, had irregular borders and solid areas. On transvaginal sonography, it revealed a left pelvic mass measuring 3 x 4 x 2 cm, with a Sassone score of 9. It had vascularization. The primary consideration was Ovarian Newgrowth, probably malignant in nature. CA-125 results were slightly elevated at 43.2 u/ml (NV: 0-35 u/ml). After intraoperative evaluation, the left fallopian tube was converted into a 9 x 4.5 x 3 cm bulbous cystic mass with solid areas. On cut section, the ampullary portion of the fallopian tube contained necrotic and friable looking tissues. Specimen was sent for frozen section and results revealed adenocarcinoma of the left fallopian tube. Patient subsequently underwent complete surgical staging with unremarkable post-operative course. The Surg Ico pathologic diagnosis was G6P4 (3124) Fallopian tube serous cystadenocarcinoma stage 1. The mean incidence of PFTC is 3.6 per million women yearly. This is associated with a generally low survival rate. The primary diagnosis is very difficult to establish because only 0–10% of patients suffering from PFTC are diagnosed pre-operatively. Symptoms play a very important role in the discovery of this disease, because there will be no presentation to the hospital without symptoms. The most common of which may be vaginal bleeding, abdominal pain, a palpable mass and ascites. A conglomerate of manifestations may be encountered, but not at all times. This is termed hydrops tubae profluens where there is presence of colicky pain with relief from intermittent passage of serosanguinous vaginal discharge. The significance of this report is to emphasize the rarity of the case and how the dilemma in the diagnosis is almost always present despite ancillary procedures.

Keywords: fallopian tube carcinoma, prognosis, rare, risk factors

Procedia PDF Downloads 321
2290 Synchronous Carcinoma Cervix with Vulvar Carcinoma in situ: A Case Report

Authors: Bhushan Bhalgat, Suresh Singh, Phanindra Swain, Kamal Kishore Lakhera

Abstract:

Carcinoma of cervix and carcinoma of vulva have been associated with common predisposing factors like human papillomavirus and smoking. Skip metastases and metachronous appearance of both these tumours have been reported. There is no case report showing synchronous appearance of these tumours in English literature. We herewith report a case report of a middle aged female patient who presented with per vaginal bleeding, and on examination, a cervical mass was palpable. Also, a proliferative growth was seen over her left vulva. Biopsy of both lesions came out to be squamous cell carcinoma and carcinoma in situ, respectively. A radical hysterectomy and bilateral pelvic and paraaortic lymph nodal dissection was performed along with left simple vulvectomy. This thereby underscores that any lesion over vulva appearing during or after treatment of cervical carcinoma should be biopsied to rule out vulvar carcinoma.

Keywords: carcinoma of cervix, carcinoma of vulva, synchronous tumours, gynecological oncology

Procedia PDF Downloads 175
2289 Atherosclerosis Prevalence Within Populations of the Southeastern United States

Authors: Samuel P. Prahlow, Anthony Sciuva, Katherine Bombly, Emily Wilson, Shiv Dhiman, Savita Arya

Abstract:

A prevalence cohort study of atherosclerotic lesions within cadavers was performed to better understand and characterize the prevalence of atherosclerosis among Georgia residents within body donors in the Philadelphia College of Osteopathic Medicine (PCOM) - Georgia body donor program. We procured specimens from cadavers used for medical students, physical therapy students, and biomedical science students cadaveric anatomical dissection at PCOM - South Georgia and PCOM - Georgia. Tissues were prepared using hematoxylin and eosin (H&E) stainas histological slides by Colquitt Regional Medical Center Laboratory Services. One section from each of the following arteries was taken after cadaveric dissection at the site of most calcification palpated grossly (if present): left anterior descending coronary artery, left internal carotid artery, abdominal aorta, splenic artery, and hepatic artery. All specimens were graded and categorized according to the American Heart Association’s Modified and Conventional Standards for Atherosclerotic Lesions using x4, x10, x40 microscopic magnification. Our study cohort included 22 cadavers, with 16 females and 6 males. The average age was 72.54, and the median age was 72, with a range of 52 to 90 years old. The cause of death determination listing vascular and/or cardiovascular causes was present on 6 of the 22 death certificates. 19 of 22 (86%) cadavers had at least a single artery grading > 5. Of the cadavers with at least a single artery graded at greater than 5, only 5 of 19 (26%) cadavers had a vascular or cardiovascular cause of death reported. Malignancy was listed as a cause of death on 7 (32%) death certificates. The average atherosclerosis grading of the common hepatic, splenic and left internal carotid arteries (2.15, 3.05, and 3.36 respectively) were lower than the left anterior descending artery and the abdominal aorta (5.16 and 5.86 respectively). This prevalence study characterizes atherosclerosis found in five medium and large systemic arteries within cadavers from the state of Georgia.

Keywords: pathology, atherosclerosis, histology, cardiovascular

Procedia PDF Downloads 216
2288 Early and Mid-Term Results of Anesthetic Management of Minimal Invasive Coronary Artery Bypass Grafting Using One Lung Ventilation

Authors: Devendra Gupta, S. P. Ambesh, P. K Singh

Abstract:

Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.

Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube

Procedia PDF Downloads 425
2287 Performance, Scalability and Reliability Engineering: Shift Left and Shift Right Approach

Authors: Jyothirmayee Pola

Abstract:

Ideally, a test-driven development (TDD) or agile or any other process should be able to define and implement performance, scalability, and reliability (PSR) of the product with a higher quality of service (QOS) and should have the ability to fix any PSR issues with lesser cost before it hits the production. Most PSR test strategies for new product introduction (NPI) include assumptions about production load requirements but never accurate. NPE (New product Enhancement) include assumptions for new features that are being developed whilst workload distribution for older features can be derived by analyzing production transactions. This paper talks about how to shift left PSR towards design phase of release management process to get better QOS w.r.t PSR for any product under development. It also explains the ROI for future customer onboarding both for Service Oriented Architectures (SOA) and Microservices architectures and how to define PSR requirements.

Keywords: component PSR, performance engineering, performance tuning, reliability, return on investment, scalability, system PSR

Procedia PDF Downloads 76
2286 Performance Evaluation of Various Displaced Left Turn Intersection Designs

Authors: Hatem Abou-Senna, Essam Radwan

Abstract:

With increasing traffic and limited resources, accommodating left-turning traffic has been a challenge for traffic engineers as they seek balance between intersection capacity and safety; these are two conflicting goals in the operation of a signalized intersection that are mitigated through signal phasing techniques. Hence, to increase the left-turn capacity and reduce the delay at the intersections, the Florida Department of Transportation (FDOT) moves forward with a vision of optimizing intersection control using innovative intersection designs through the Transportation Systems Management & Operations (TSM&O) program. These alternative designs successfully eliminate the left-turn phase, which otherwise reduces the conventional intersection’s (CI) efficiency considerably, and divide the intersection into smaller networks that would operate in a one-way fashion. This study focused on the Crossover Displaced Left-turn intersections (XDL), also known as Continuous Flow Intersections (CFI). The XDL concept is best suited for intersections with moderate to high overall traffic volumes, especially those with very high or unbalanced left turn volumes. There is little guidance on determining whether partial XDL intersections are adequate to mitigate the overall intersection condition or full XDL is always required. The primary objective of this paper was to evaluate the overall intersection performance in the case of different partial XDL designs compared to a full XDL. The XDL alternative was investigated for 4 different scenarios; partial XDL on the east-west approaches, partial XDL on the north-south approaches, partial XDL on the north and east approaches and full XDL on all 4 approaches. Also, the impact of increasing volume on the intersection performance was considered by modeling the unbalanced volumes with 10% increment resulting in 5 different traffic scenarios. The study intersection, located in Orlando Florida, is experiencing recurring congestion in the PM peak hour and is operating near capacity with volume to a capacity ratio closer to 1.00 due to the presence of two heavy conflicting movements; southbound and westbound. The results showed that a partial EN XDL alternative proved to be effective and compared favorably to a full XDL alternative followed by the partial EW XDL alternative. The analysis also showed that Full, EW and EN XDL alternatives outperformed the NS XDL and the CI alternatives with respect to the throughput, delay and queue lengths. Significant throughput improvements were remarkable at the higher volume level with percent increase in capacity of 25%. The percent reduction in delay for the critical movements in the XDL scenarios compared to the CI scenario ranged from 30-45%. Similarly, queue lengths showed percent reduction in the XDL scenarios ranging from 25-40%. The analysis revealed how partial XDL design can improve the overall intersection performance at various demands, reduce the costs associated with full XDL and proved to outperform the conventional intersection. However, partial XDL serving low volumes or only one of the critical movements while other critical movements are operating near or above capacity do not provide significant benefits when compared to the conventional intersection.

Keywords: continuous flow intersections, crossover displaced left-turn, microscopic traffic simulation, transportation system management and operations, VISSIM simulation model

Procedia PDF Downloads 311
2285 How Tattoos and Brands Impact the Recovery of Sex Trafficking Victim: An Exploratory Study of Sex Trafficking Survivors.

Authors: Jeremy Berry, Shannon Rodrigue, Caroline Norris

Abstract:

This study explores the impact of tattoos and/or brands on the recovery of sex trafficking survivors. Many victims of sex trafficking are forced or coerced to take markings of ownership while in the sex trafficking trade in the form of painful tattoos or brands. As a result, victims who are rescued and in recovery often must live with permanent reminders of their traumatic experiences or are left to resort to expensive cosmetic or cover-up jobs, which for many are out of reach. As is often true of domestic violence victims who are left with scars from their abusers, the impact of these permanent markers can delay the healing process and contribute to post-traumatic stress. This study tells the story from the perspectives of the survivors of sex trafficking, how these specific permanent reminders impacted their healing. The study employs a thematic analysis of interviews with sex trafficking victims via focus group interviews.

Keywords: sex trafficking, tattoos, trauma, healing

Procedia PDF Downloads 191
2284 A Practice Model for Quality Improvement in Concrete Block Mini Plants Based on Merapi Volcanic Sand

Authors: Setya Winarno

Abstract:

Due to abundant Merapi volcanic sand in Yogyakarta City, many local people have utilized it for mass production of concrete blocks through mini plants although their products are low in quality. This paper presents a practice model for quality improvement in this situation in order to supply the current customer interest in good quality of construction material. The method of this research was to investigate a techno economic evaluation through laboratory test and interview. Samples of twenty existing concrete blocks made by local people had only 19.4 kg/cm2 in average compression strength which was lower than the minimum Indonesian standard of 25 kg/cm2. Through repeat testing in laboratory for fulfilling the standard, the concrete mix design of water cement ratio should not be more than 0.64 by weight basis. The proportion of sand as aggregate content should not be more than 9 parts to 1 part by volume of Portland cement. Considering the production cost, the basic price was Rp 1,820 for each concrete block, comparing to Rp 2,000 as a normal competitive market price. At last, the model describes (a) maximum water cement ratio is 0.64, (b) maximum proportion of sand and cement is 1:9, (c) the basic price is about Rp. 1,820.00 and (d) strategies to win the competitive market on mass production of concrete blocks are focus in quality, building relationships with consumer, rapid respond to customer need, continuous innovation by product diversification, promotion in social media, and strict financial management.

Keywords: concrete block, good quality, improvement model, diversification

Procedia PDF Downloads 516
2283 The Effects of Kicking Leg Preference on the Bilateral Balance Ability Asymmetries in Collegian Football Players

Authors: Mehmet Yildiz, Mehmet Kale

Abstract:

The primary aim of the present study was to identify the bilateral balance asymmetries when comparing the dominant (DL) vs. the non-dominant leg (NDL) in the collegian soccer players. The secondary aim was to compare the inter-limb asymmetry index (ASI) when differentiating by kicking preference (right-dominant vs. left-dominant). 34 right-dominant leg (RightDL) (age:21.12±1.85, height:174.50±5.18, weight:69.42±6.86) and 23 left-dominant leg (LeftDL), (age:21.70±2.03, height:176.2±6.27, weight:68.73±5.96) collegian football players were tested for bilateral static and dynamic balance. Balance ability was assessed by measuring centre of pressure deviation on a single leg. Single leg static and dynamic balance scores and inter-limb asymmetry index (ASI) were determined. Student t tests were used for the comparison of dominant and nondominant leg balance scores and RightDL and LeftDL football players’ inter-limb asymmetry index of the balance scores. The results showed that there were significant differences in the dynamic balance scores in favour of the nondominant leg, (DL:738±211 vs. NDL:606±226, p < 0.01). Also, it has been seen that LeftDL players have significantly higher inter-limb asymmetry index when compared with rightDL players for both static (rightDL:-7.07±94.91 vs. leftDL:-183.19±354.05, p < 0.01) and dynamic (rightDL: 1.73±49.65 vs. leftDL:27.08±23.34, p < 0.05) balance scores. In conclusion, bilateral dynamic balance asymmetries may be affected using single leg predominantly in the mobilization workouts. Because of having higher inter-limb asymmetry index, left-dominant leg players may be screened and trained to minimize balance asymmetry.

Keywords: bilateral balance, asymmetries, dominant leg, leg preference

Procedia PDF Downloads 427
2282 The Genetic Architecture Underlying Dilated Cardiomyopathy in Singaporeans

Authors: Feng Ji Mervin Goh, Edmund Chee Jian Pua, Stuart Alexander Cook

Abstract:

Dilated cardiomyopathy (DCM) is a common cause of heart failure. Genetic mutations account for 50% of DCM cases with TTN mutations being the most common, accounting for up to 25% of DCM cases. However, the genetic architecture underlying Asian DCM patients is unknown. We evaluated 68 patients (female= 17) with DCM who underwent follow-up at the National Heart Centre, Singapore from 2013 through 2014. Clinical data were obtained and analyzed retrospectively. Genomic DNA was subjected to next-generation targeted sequencing. Nextera Rapid Capture Enrichment was used to capture the exons of a panel of 169 cardiac genes. DNA libraries were sequenced as paired-end 150-bp reads on Illumina MiSeq. Raw sequence reads were processed and analysed using standard bioinformatics techniques. The average age of onset of DCM was 46.1±10.21 years old. The average left ventricular ejection fraction (LVEF), left ventricular diastolic internal diameter (LVIDd), left ventricular systolic internal diameter (LVIDs) were 26.1±11.2%, 6.20±0.83cm, and 5.23±0.92cm respectively. The frequencies of mutations in major DCM-associated genes were as follows TTN (5.88% vs published frequency of 20%), LMNA (4.41% vs 6%), MYH7 (5.88% vs 4%), MYH6 (5.88% vs 4%), and SCN5a (4.41% vs 3%). The average callability at 10 times coverage of each major gene were: TTN (99.7%), LMNA (87.1%), MYH7 (94.8%), MYH6 (95.5%), and SCN5a (94.3%). In conclusion, TTN mutations are not common in Singaporean DCM patients. The frequencies of other major DCM-associated genes are comparable to frequencies published in the current literature.

Keywords: heart failure, dilated cardiomyopathy, genetics, next-generation sequencing

Procedia PDF Downloads 243
2281 Cutaneous Sarcoidosis Treated with Narrow Band Ultraviolet B (NBUVB) Phototherapy

Authors: Hannah Riva, Sarah Mazal, Jessica L. Marquez, Michael Rains

Abstract:

A 70-year-old female with a Fitzpatrick skin phenotype II presented with a 13-year history of a scaly rash located on the left breast and bilateral pretibial regions. The patient’s past medical history was otherwise unremarkable, with the exception of surgery involving the left breast. Physical examination revealed infiltrative hyperpigmented scaly plaques and nodules located on the left breast and pretibial regions bilaterally. A negative systemic workup excluded organ involvement. A clinical diagnosis of cutaneous sarcoidosis was made. Prior treatments included triamcinolone 0.1% topical cream and clobetasol 0.05% ointment, which failed to show improvement. Full-body narrow-band UVB (NBUVB) treatment was performed on a tri-weekly basis for eight months. NBUVB dosage was slowly titrated from 300 mJ/cm2 to a final dose of 1800 mJ/cm2 to prevent discomfort and burning sensations. Throughout the duration of her treatment, the patient adhered to a regimen of clobetasol 0.05% topical ointment applied twice daily in two-week intervals. Improvement was noticed after two months, with continued improvement up to eight months. The patient is continuing NBUVB phototherapy treatments for maintenance. In our case, NBUVB phototherapy treatment demonstrated promising results with improvement after two months of treatment. Physicians should consider NBUVB phototherapy as an effective option for patients presenting with cutaneous sarcoidosis.

Keywords: dermatology, sarcoidosis, phototherapy, ultraviolet

Procedia PDF Downloads 74
2280 Determinants of Non-Performing Loans: An Empirical Investigation of Bank-Specific Micro-Economic Factors

Authors: Amir Ikram, Faisal Ijaz, Qin Su

Abstract:

The empirical study was undertaken to explore the determinants of non-performing loans (NPLs) of small and medium enterprises (SMEs) sector held by the commercial banks. Primary data was collected through well-structured survey questionnaire from credit analysts/bankers of 42 branches of 9 commercial banks, operating in the district of Lahore (Pakistan), for 2014-2015. Selective descriptive analysis and Pearson chi-square technique were used to illustrate and evaluate the significance of different variables affecting NPLs. Branch age, duration of the loan, and credit policy were found to be significant determinants of NPLs. The study proposes that bank-specific and SME-specific microeconomic variables directly influence NPLs, while macroeconomic factors act as intermediary variables. Framework exhibiting causal nexus of NPLs was also drawn on the basis of empirical findings. The results elaborate various origins of NPLs and suggest that they are primarily instigated by the loan sanctioning procedure of the financial institution. The paper also underlines the risk management practices adopted by the bank at branch level to averse the risk of loan default. Empirical investigation of bank-specific microeconomic factors of NPLs with respect to Pakistan’s economy is the novelty of the study. Broader strategic policy implications are provided for credit analysts and entrepreneurs.

Keywords: commercial banks, microeconomic factors, non-performing loans, small and medium enterprises

Procedia PDF Downloads 260
2279 Optimal Image Representation for Linear Canonical Transform Multiplexing

Authors: Navdeep Goel, Salvador Gabarda

Abstract:

Digital images are widely used in computer applications. To store or transmit the uncompressed images requires considerable storage capacity and transmission bandwidth. Image compression is a means to perform transmission or storage of visual data in the most economical way. This paper explains about how images can be encoded to be transmitted in a multiplexing time-frequency domain channel. Multiplexing involves packing signals together whose representations are compact in the working domain. In order to optimize transmission resources each 4x4 pixel block of the image is transformed by a suitable polynomial approximation, into a minimal number of coefficients. Less than 4*4 coefficients in one block spares a significant amount of transmitted information, but some information is lost. Different approximations for image transformation have been evaluated as polynomial representation (Vandermonde matrix), least squares + gradient descent, 1-D Chebyshev polynomials, 2-D Chebyshev polynomials or singular value decomposition (SVD). Results have been compared in terms of nominal compression rate (NCR), compression ratio (CR) and peak signal-to-noise ratio (PSNR) in order to minimize the error function defined as the difference between the original pixel gray levels and the approximated polynomial output. Polynomial coefficients have been later encoded and handled for generating chirps in a target rate of about two chirps per 4*4 pixel block and then submitted to a transmission multiplexing operation in the time-frequency domain.

Keywords: chirp signals, image multiplexing, image transformation, linear canonical transform, polynomial approximation

Procedia PDF Downloads 414
2278 The Fibonacci Network: A Simple Alternative for Positional Encoding

Authors: Yair Bleiberg, Michael Werman

Abstract:

Coordinate-based Multi-Layer Perceptrons (MLPs) are known to have difficulty reconstructing high frequencies of the training data. A common solution to this problem is Positional Encoding (PE), which has become quite popular. However, PE has drawbacks. It has high-frequency artifacts and adds another hyper hyperparameter, just like batch normalization and dropout do. We believe that under certain circumstances, PE is not necessary, and a smarter construction of the network architecture together with a smart training method is sufficient to achieve similar results. In this paper, we show that very simple MLPs can quite easily output a frequency when given input of the half-frequency and quarter-frequency. Using this, we design a network architecture in blocks, where the input to each block is the output of the two previous blocks along with the original input. We call this a Fibonacci Network. By training each block on the corresponding frequencies of the signal, we show that Fibonacci Networks can reconstruct arbitrarily high frequencies.

Keywords: neural networks, positional encoding, high frequency intepolation, fully connected

Procedia PDF Downloads 99
2277 Automatic LV Segmentation with K-means Clustering and Graph Searching on Cardiac MRI

Authors: Hae-Yeoun Lee

Abstract:

Quantification of cardiac function is performed by calculating blood volume and ejection fraction in routine clinical practice. However, these works have been performed by manual contouring,which requires computational costs and varies on the observer. In this paper, an automatic left ventricle segmentation algorithm on cardiac magnetic resonance images (MRI) is presented. Using knowledge on cardiac MRI, a K-mean clustering technique is applied to segment blood region on a coil-sensitivity corrected image. Then, a graph searching technique is used to correct segmentation errors from coil distortion and noises. Finally, blood volume and ejection fraction are calculated. Using cardiac MRI from 15 subjects, the presented algorithm is tested and compared with manual contouring by experts to show outstanding performance.

Keywords: cardiac MRI, graph searching, left ventricle segmentation, K-means clustering

Procedia PDF Downloads 400
2276 Study of the Persian Gulf’s and Oman Sea’s Numerical Tidal Currents

Authors: Fatemeh Sadat Sharifi

Abstract:

In this research, a barotropic model was employed to consider the tidal studies in the Persian Gulf and Oman Sea, where the only sufficient force was the tidal force. To do that, a finite-difference, free-surface model called Regional Ocean Modeling System (ROMS), was employed on the data over the Persian Gulf and Oman Sea. To analyze flow patterns of the region, the results of limited size model of The Finite Volume Community Ocean Model (FVCOM) were appropriated. The two points were determined since both are one of the most critical water body in case of the economy, biology, fishery, Shipping, navigation, and petroleum extraction. The OSU Tidal Prediction Software (OTPS) tide and observation data validated the modeled result. Next, tidal elevation and speed, and tidal analysis were interpreted. Preliminary results determine a significant accuracy in the tidal height compared with observation and OTPS data, declaring that tidal currents are highest in Hormuz Strait and the narrow and shallow region between Iranian coasts and Islands. Furthermore, tidal analysis clarifies that the M_2 component has the most significant value. Finally, the Persian Gulf tidal currents are divided into two branches: the first branch converts from south to Qatar and via United Arab Emirate rotates to Hormuz Strait. The secondary branch, in north and west, extends up to the highest point in the Persian Gulf and in the head of Gulf turns counterclockwise.

Keywords: numerical model, barotropic tide, tidal currents, OSU tidal prediction software, OTPS

Procedia PDF Downloads 133
2275 The Research of Students Internet in Choosing the Technical and Professional Course in Izeh: Educational Year 2001-2002

Authors: Seyyed Kavous Abbasi

Abstract:

Technical and professional branch is a subcategory of high school educational system. It deals with the programs which have been designed for the promotion of applied science and necessary skill and growth of potential talents in students. The purpose of performance of this branch is preparing of preponderance of in police in different section of industries and service. The aim of this research is the survey of group relation family, economic, educational and individual factors and the student's tendency toward technical professional courses. The method of the study is descriptive survey. 195 subjects were chosen randomly from all the male and female students of technical and professional school in Izeh. Instrument for this research was research-made questionnaire consisting of 22 questions on the base of likers spectrum. The reliability of this questionnaire has been estimated 0.8. Analyses of research data has been performed in two levels of descriptive and inferential statistics. Analyses of data has shown that the family factors with average of 3.12, individual factors 3.95, economic factors 3.92 and educational factors 3.57 more than middle level have more effects , in comparison with the factor of group relation with average of 2.79 less than average level in tendency the technical and professional course . Comparison of effective factors in tendency to technical and professional course has shown that individual factors had the most effects and the group relation factors had the least effects. Comparison between male and female subject's ideas showed that there is a different between their ideas about economics and family factors.

Keywords: high school, relation family, individual factors, analysis interest

Procedia PDF Downloads 247
2274 Effect of Tai-Chi and Cyclic Meditation on Hemodynamic Responses of the Prefrontal Cortex: A Functional near Infrared Spectroscopy

Authors: Singh Deepeshwar, N. K. Manjunath, M. Avinash

Abstract:

Meditation is a self-regulated conscious process associated with improved awareness, perception, attention and overall performance. Different traditional origin of meditation technique may have different effects on autonomic activity and brain functions. Based on this quest, the present study evaluated the effect of Tai-Chi Chuan (TCC, a Chines movement based meditation technique) and Cyclic Meditation (CM, an Indian traditional based stimulation and relaxation meditation technique) on the hemodynamic responses of the prefrontal cortex (PFC) and autonomic functions (such as R-R interval of heart rate variability and respiration). These two meditation practices were compared with simple walking. Employing 64 channel near infrared spectroscopy (NIRS), we measured hemoglobin concentration change (i.e., Oxyhemoglobin [ΔHbO], Deoxyhemoglobin [ΔHbR] and Total hemoglobin change [ΔTHC]) in the bilateral PFC before and after TCC, CM and Walking in young college students (n=25; average mean age ± SD; 23.4 ± 3.1 years). We observed the left PFC activity predominantly modulates sympathetic activity effects during the Tai-Chi whereas CM showed changes on right PFC with vagal dominance. However, the changes in oxyhemoglobin and total blood volume change after Tai-Chi was significant higher (p < 0.05, spam t-maps) on the left hemisphere, whereas after CM, there was a significant increase in oxyhemoglobin (p < 0.01) with a decrease in deoxyhemoglobin (p < 0.05) on right PFC. The normal walking showed decrease in Oxyhemoglobin with an increase in deoxyhemoglobin on left PFC. The autonomic functions result showed a significant increase in RR- interval (p < 0.05) along with significant reductions in HR (p < 0.05) in CM, whereas Tai-chi session showed significant increase in HR (p < 0.05) when compared to walking session. Within a group analysis showed a significant reduction in RR-I and significant increase in HR both in Tai-chi and walking sessions. The CM showed there were a significant improvement in the RR - interval of HRV (p < 0.01) with the reduction of heart rate and breath rate (p < 0.05). The result suggested that Tai-Chi and CM both have a positive effect on left and right prefrontal cortex and increase sympathovagal balance (alertful rest) in autonomic nervous system activity.

Keywords: brain, hemodynamic responses, yoga, meditation, Tai-Chi Chuan (TCC), walking, heart rate variability (HRV)

Procedia PDF Downloads 308