Search results for: M. Vakili

Authors: Seyed Amin Vakili, Sahar Sadat Vakili, Seyed Ehsan Vakili, Nader Abdoli Yazdi

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The main purpose of this paper is to present the Modified Newmark Method of buckling analysis frame considering the effect of the axial load. The discussion will be restricted to plane frameworks containing a constant cross-section for each element. In addition, it is assumed that the frames are prevented from out-of-plane deflection. In this method, stiffness matrix of the structure is considered to be constant. The most important advantage of such a method is that it obtains both upper and lower critical loads. The advanced of the present method is fast convergence, ability to use computer simulations, and ability to model structures with semi-rigid support conditions using linear and rotational spring.

Keywords: buckling, stability, frame, modified newmark method

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Authors: Seyed Amin Vakili, Sahar Sadat Vakili, Seyed Ehsan Vakili, Nader Abdoli Yazdi

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The aim of this paper is to examine the behavior of elastic stability of reinforced and composite concrete struts with axial loads. The objective of this study is to verify the ability of the Modified Newmark Method to include geometric non-linearity in addition to non-linearity due to cracking, and also to show the advantage of the established method to reconsider an ignored minor parameter in mathematical modeling, such as the effect of the cracking by extra geometric bending moment Ny on cross-section properties. The purpose of this investigation is not to present some new results for the instability of reinforced or composite concrete columns. Therefore, no kinds of non-linearity involved in the problem are considered here. Only as mentioned, it is a part of the verification of the new established method to solve two kinds of non-linearity P- δ effect and cracking together simultaneously. However, the Modified Newmark Method can be used to solve non-linearity of materials and time-dependent behavior of concrete. However, since it is out of the scope of this article, it is not considered.

Keywords: stability, buckling, modified newmark method, reinforced

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Authors: Seyed Amin Vakili, Sahar Sadat Vakili, Seyed Ehsan Vakili, Nader Abdoli Yazdi

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The purpose of this article is to analyze the finite displacement of Columns by applying the Modified Newmark Method. This research will be performed on Columns subjected to compressive axial load, therefore the non-linearity of the geometry is also considered. If the considered strut is perfect, the governing differential equation contains a branching point in the solution path. Investigation into the Elastica is a part of generalizing the developed method. It presents the ability of the Modified Newmark Method in treating non-linear differential equations Derived from elastic strut stability problems. These include not only an approximate polynomial solution for the Elastica problems, but can also recognize the branching point and the stable solution. However, this investigation deals with the post-buckling response of elastic and pin ended columns subjected to central or equally eccentric axial loads.

Keywords: columns, structural modeling, structures & structural stability, loads

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Authors: Seyed Amin Vakili, Sahar Sadat Vakili, Seyed Ehsan Vakili, Nader Abdoli Yazdi

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The main purpose of this paper is to present the Modified Newmark Method as a method of non-linear frame analysis by considering the effect of the axial load (second order analysis). The discussion will be restricted to plane frameworks containing a constant cross-section for each element. In addition, it is assumed that the frames are prevented from out-of-plane deflection. This part of the investigation is performed to generalize the established method for the assemblage structures such as frameworks. As explained, the governing differential equations are non-linear and cannot be formulated easily due to unknown axial load of the struts in the frame. By the assumption of constant axial load, the governing equations are changed to linear ones in most methods. Since the modeling and the solutions of the non-linear form of the governing equations are cumbersome, the linear form of the equations would be used in the established method. However, according to the ability of the method to reconsider the minor omitted parameters in modeling during the solution procedure, the axial load in the elements at each stage of the iteration can be computed and applied in the next stage. Therefore, the ability of the method to present an accurate approach to the solutions of non-linear equations will be demonstrated again in this paper.

Keywords: nonlinear, stability, buckling, modified newmark method

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Authors: Seyed Amin Vakili, Sahar Sadat Vakili, Seyed Ehsan Vakili, Nader Abdoli Yazdi

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Differential equations are of fundamental importance in engineering and applied mathematics, since many physical laws and relations appear mathematically in the form of such equations. The equilibrium state of structures consisting of one-dimensional elements can be described by an ordinary differential equation. The response of these kinds of structures under the loading, namely relationship between the displacement field and loading field, can be predicted by the solution of these differential equations and on satisfying the given boundary conditions. When the effect of change of geometry under loading is taken into account in modeling of equilibrium state, then these differential equations are partially integrable in quartered. They also exhibit instability characteristics when the structures are loaded compressively. The purpose of this paper is to represent the ability of the Modified Newmark Method in analyzing flexural-torsional instability of struts for both bifurcation and non-bifurcation structural systems. The results are shown to be very accurate with only a small number of iterations. The method is easily programmed, and has the advantages of simplicity and speeds of convergence and easily is extended to treat material and geometric nonlinearity including no prismatic members and linear and nonlinear spring restraints that would be encountered in frames. In this paper, these abilities of the method will be extended to the system of linear differential equations that govern strut flexural torsional stability.

Keywords: instability, torsion, flexural, buckling, modified newmark method stability

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Authors: Pouya Vakili

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The aim of present paper is to have a rough comparison between language proficiency and communicative competence, moreover, how different scholars in the field of second language acquisition/assessment have defined competence in different paradigms. Researchers differ, however, in how they view 'competence'. Those who are dealing with generative tradition associated with Chomsky have defined it as linguistic competence (knowledge of the grammar of L2). Other researchers have adopted a broader perspective that is examining how learners acquire communicative competence (knowledge of both the L2 grammar and of how this system is put to use in actual communication).

Keywords: communicative competence, competence, language proficiency, linguistic competence

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Authors: Pouya Vakili

Abstract:

Since computers were first introduced into educational facilities, foreign language educators have been faced with the problem of integrating high-tech multimedia techniques into a traditional text-based curriculum. As studies of language teaching have pointed out, ‘Language teaching tends in practice to be eclectic…. There are not only exceptionally many paths and educational means for arriving at a given educational goal, but there are also many types of educational materials which can be used to achieve that goal’. For language educators who are trying to incorporate technology into their curricula, the choices seem endless. Yet the quantity, as well as the limitations, of available computer programs does not guarantee that these programs can be successfully integrated into a curriculum.

Keywords: curriculum, language teaching, learning, multimedia, technology

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Authors: Reza Vakili

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The aim of this experiment was to optimize the effect of moisture, the production rate, grain particle size and steam conditioning temperature on pellet quality in broiler feed using Taguchi method and a 43 fractional factorial arrangement was conducted. Production rate, steam conditioning temperatures, particle sizes and moisture content were performed. During the production process, sampling was done, and then pellet durability index (PDI) and hardness evaluated in broiler feed grower and finisher. There was a significant effect of processing parameters on PDI and hardness. Based on the results of this experiment Taguchi method can be used to find the best combination of factors for optimal pellet quality.

Keywords: broiler, feed physical quality, hardness, processing parameters, PDI

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Authors: Armin Rahmatfam, Mohammad Zehsaz, Farid Vakili Tahami, Nasser Ghassembaglou

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In this paper the thermal ratcheting, kinematic hardening parameters C, γ, isotropic hardening parameters and also k, b, Q combined isotropic/kinematic hardening parameters have been obtained experimentally from the monotonic, strain controlled cyclic tests at room and elevated temperatures of 20°C, 100°C, and 400°C. These parameters are used in nonlinear combined isotropic/kinematic hardening model to predict better description of the loading and reloading cycles in the cyclic indentation as well as thermal ratcheting. For this purpose, three groups of specimens made of Aluminum 7075-T6 have been investigated. After each test and using stable hysteretic cycles, material parameters have been obtained for using in combined nonlinear isotropic/kinematic hardening models. Also the methodology of obtaining the correct kinematic/isotropic hardening parameters is presented.

Keywords: combined hardening model, kinematic hardening, isotropic hardening, cyclic tests

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Authors: Alireza Vakili, Shahab Ehtesham, Mohsen Danesh Mesgaran

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The objective of this study was use different levels of spent mushroom substrate as a suitable substitute for wheat straw in the ration of male lambs. In this study 20 male lambs with the age of 90 days and initial average weight of 33± 1.7 kg were used. The animals were divided separately into single boxes with four treatments (control treatment, spent mushroom substrate 15%, spent mushroom substrate 25% and spent mushroom substrate 35%) and five replications. The experiment period was 114 days being 14 days adaptation and 90 days for breeding. On the days 36 and 94, blood samples were taken from the jugular vein. In order to carry out the trial, 20 male lambs received the four experimental diets in completely randomized design. The statistical analyses were carried out by using the GLM procedure of SAS 9.1. Means among treatments were compared by Tukey test. The results of the study showed that there was no significant differences between the serum biochemical and hematological contents of the lambs in the four treatments (p>0.05). It was concluded that spent mushroom substrate consumption has no harmful effect on the blood parameters of Kurdish male lambs.

Keywords: alternative food, nutrition, sheep performance, spent mushroom substrate

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Authors: Farzad Vakili-Farahani, Joern Lungershausen, Kilian Wasmer

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Wobbled laser beam welding, fast oscillations of a tiny laser beam within a designed path (weld geometry) during the laser pulse illumination, opens new possibilities to improve the marco-to micro-manufacturing process. The present work introduces the wobbled laser beam welding as a robust welding strategy for improving macro-to micro-fabrication process, e.g., the laser processing for gap-bridging and packaging industry. The typical requisites and relevant equipment for the development of a wobbled laser processing unit are addressed, including a suitable laser source, light delivery system, optics, proper beam deflection system and the design geometry. In addition, experiments have been carried out on titanium plate to compare the results of wobbled laser welding with conventional pulsed laser welding. As compared to the pulsed laser welding, the wobbled laser welding offers a much greater fusion area (i.e. additional molten material) while minimizing the HAZ and provides a better confinement of the material microstructural changes.

Keywords: wobbled laser beam welding, wobbling function, beam oscillation, micro welding

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Authors: Alireza Vakili, Shahab Ehtesham, Mohsen Danesh Mesgaran, Mahdi Paktinat

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The goal of this study is to determine the chemical compounds of brown Iranian propolis(BIP) extracts and to show flavonoids and phenol effects on nitrogen ammonia (NH3-N) in in vitro. Experimental samples were including two diets with different concentrate: forage ratio (80:20 and 60:40) with eight treatments (1:Control diet 60:40 without BIP,2: 60:40 diet with 25% BIP, 3:60:40 diet with 50% BIP, 4: 60:40 diet with 75% BIP,5: Control diet 80:20 without BIP,6: 80:20 diet with 25% BIP,7: 80:20 diet with 50% BIP and 8: 80:20 diet with 75% BIP) and eight repeats. The trial was analyzed considering a completely randomized design by the GLM procedure of SAS 9.1. Means among treatment were compared by Tukey test. The results of this study showed that in food with 80:20 (concentrate: forage), adding BIP 25% did not statistically change NH3-N (p > 0.05) compared to the control treatment but there was a significant difference (p < 0.05) between the effect of BIP 50% on NH3-N compared to the BIP 25% and the control. In diet with 60:40 (concentrate: forage), there was no significant difference between the effect of BIP 25% on NH3-N and the control, nor was there a significant difference between the effect of BIP 50% and 75%, while a significant difference (p < 0.05) between BIP 50% and 75% and the rest was observed. The propolis extract makes nitrogen ammonia decrease. This may help the nitrogen retain longer in ruminants.

Keywords: brown Iranian propolis, in vitro, nitrogen ammonia, ruminant

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Authors: Mohsen Danesh Mesgaran, Ali Hodjatpanah Montazeri, Alireza Vakili, Mansoor Tahmasbei

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To compare peppermint essential oil versus a mixture of formic and propionic acids a study was conducted to their effects on volatile fatty acid proportion and VFA score of corn silage. Chopped whole crop corn (control) was treated with peppermint essential oil (240 mg kg-1 DM) or a mixture of formic and propionic acids (2:1) at 0.4% of fresh forage weight, and ensiled for 30 days. Then, silage extract was provided and the concentration of each VFA was determined using gas chromatography. The VFA score was calculated according to the patented formula proposed by Dairy One Scientific Committee. The score is calculated based on the positive impact of lactic and acetic acids versus the negative effect of butyric acid to achieve a single value for evaluating silage quality. The essential oil declined pH and increased the concentration of lactic and acetic acids in the silage extract. All corn silages evaluated in this study had a VFA score between 6 through 8. However, silage with peppermint essential oils had lower volatile fatty acids score than those of the other treatments. Both of applied additives caused a significant improvement in silage aerobic stability.

Keywords: peppermint, essential oil, corn silage, VFA (volatile fatty acids)

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Authors: Azim Khodadadi, Sahar Sadaat Vakili, Ebrahim Babaei

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This study presents a numerical method to optimize the failure rate and repair time of a typical radial distribution system. Failure rate and repair time are effective parameters in customer and energy based indices of reliability. Decrease of these parameters improves reliability indices. Thus, system stability will be boost. The penalty functions indirectly reflect the cost of investment which spent to improve these indices. Constraints on customer and energy based indices, i.e. SAIFI, SAIDI, CAIDI and AENS have been considered by using a new method which reduces optimization algorithm controlling parameters. Imperialist Competitive Algorithm (ICA) used as main optimization technique and particle swarm optimization (PSO), simulated annealing (SA) and differential evolution (DE) has been applied for further investigation. These algorithms have been implemented on a test system by MATLAB. Obtained results have been compared with each other. The optimized values of repair time and failure rate are much lower than current values which this achievement reduced investment cost and also ICA gives better answer than the other used algorithms.

Keywords: imperialist competitive algorithm, failure rate, repair time, radial distribution network

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Authors: Misagh Irandoost Shahrestani, Mehdi Ashjaee, Shahrokh Zandieh Vakili

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In this paper, partially premixed laminar methane/air co-flow flame is studied experimentally. Methane-air flame was established on an axisymmetric coannular burner. The fuel-air jet flows from the central tube while the secondary air flows from the region between the inner and the outer tube. The aim is to investigate the flame features and to develop a nonintrusive method for temperature measurement of methane/air partially premixed flame using Mach-Zehnder interferometry method. Different equivalence ratios and Reynolds numbers are considered. Flame generic visible appearance was also investigated and its various structures were studied. Three distinguished flame regimes were seen based on its appearance. A double flame structure can be seen for the equivalence ratio in the range of 1<Φ<2.1. By adding air to the mixture up to Φ=4 the flame has the characteristics of both premixed and non-premixed flames. Finally for 4<Φ<∞ the flame mainly becomes non-premixed like and the luminous sooting region on its tip is the obvious feature of this type of flames. The Mach-Zehnder method is used to obtain temperature field of a transparent fluid by means of index of refraction. Temperature obtained from optical techniques was compared with that of obtained from thermocouples in order to validate the results. Good agreement was observed for these two methods.

Keywords: flame structure, Mach-Zehnder interferometry, partially premixed flame, temperature field

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Authors: Amir Hossein Haji, Nabeel Al-Rawahi, Gholamreza Vakili-Nezhaad

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An innovative design has been examined for a gas-oil separator based on pressure reduction over an airfoil surface. The primary motivations are to shorten the release trajectory of the bubbles by minimizing the thickness of the oil layer as well as improving uniform pressure reduction zones. Restricted airflow over an airfoil is investigated for its effect on the pressure drop enhancement and the maximum attainable attack angle prior to the stall condition. Aerodynamic separation is delayed based on numerical simulation of Wortmann FX 63137 Airfoil in a confined domain using FLUENT 6.3.26. The proposed set up results in higher pressure drop compared with the free stream case. With the aim of optimum power consumption we have pursued further restriction to an air jet case over the airfoil. Then, a curved strip model is suggested for the air jet which can be applied as an analysis/design tool for the best performance conditions. Pressure reduction is shown to be inversely proportional to the curvature of the upper airfoil profile. This reduction occurs within the tracking zones where the air jet is effectively attached to the airfoil surface. The zero slope condition is suggested to estimate the onset of these zones after which the minimum curvature should be searched. The corresponding zero slope curvature is applied for estimation of the maximum pressure drop which shows satisfactory agreement with the simulation results.

Keywords: airfoil, air jet, curved fluid flow, gas-oil separator

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Authors: Leili Iranirad, Mohammad Saleh Sadeghi, Seyed Fakhreddin Hejazi, Negar Vakili Razlighi

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Objective: Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) is an unknown acute kidney injury (AKI) occurring after exposure to contrast media (CM). Contrast agents are most often used for diagnostic procedures or therapeutic angiographic interventions. Recently, Na/K citrate as a urine alkalinization has been evaluated for the prevention of CIN. We conducted this experiment to evaluate the efficiency of Na/K citrate on CIN in high-risk patients treated with cardiac catheterization. Methods: A prospective randomized clinical trial was conducted on 400 patients having moderate to high-risk factors for CIN treated with elective percutaneous coronary intervention (PCI) and were assigned randomly to the control group or the Na/K citrate group. The Na/K citrate group (n=200) received 5 g Na/K citrate solution, which was diluted in 200 mL water two h before and four hours after the first administration and intravenous hydration for two h prior to and six h after the procedure, while the control group (n=200) only received intravenous hydration. Serum creatinine (SCr) was calculated prior to the contrast exposure and after 48 h. CIN was described as a 25% increase in creatinine of serum (SCr) or >0.5 mg/dl 48 h after contrast administration. Results: CIN was observed in 33 patients (16.5%) in the control group and in 6 patients (3%) in the Na/K citrate group. A significant variation was recorded in the CIN incidence between the two groups 48 h after the radiocontrast agent administration (p < 0.001). Conclusion: Our results show that Na/K citrate is useful and substantially reduces the incidence of CIN.

Keywords: contrast media, citrate, PCI

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Authors: Waqar Ahmad Butt, Gholamreza Vakili Nezhaad, Ali Soud Al Bemani, Yahya Al Wahaibi

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Miscible gas injection processes as secondary recovery methods can be applied to a huge number of mature reservoirs to improve the trapped oil displacement. Successful miscible gas injection processes require an accurate estimation of the minimum miscibility pressure (MMP) to make injection process feasible, economical, and effective. There are several methods of MMP determination like slim tube approach, vanishing interfacial tension and rising bubble apparatus but slim tube is the deployed experimental technique in this study. Slim tube method is assumed to be non-standardized for MMP determination with respect to both operating procedure and design. Therefore, 25 slim tube runs were being conducted with three different coil lengths (12, 18 and 24 m) of constant diameter using three different injection rates (0.08, 0.1 and 0.15 cc/min) to evaluate uniqueness and repeatability of determined MMP. A trend of decrease in MMP with increase in coil length was found. No unique trend was found between MMP and injection rate. Lowest MMP and highest recovery were observed with highest coil length and lowest injection rate. It shows that slim tube measured MMP does not depend solely on interacting fluids characteristics but also affected by used coil selection and injection rate choice. Therefore, both slim tube design and procedure need to be standardized. It is recommended to use lowest possible injection rate and estimated coil length depending upon the distance between injections and producing wells for accurate and reliable MMP determination.

Keywords: coil length, injection rate, minimum miscibility pressure, multiple contacts miscibility

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Authors: Waqar Ahmad Butt, Gholamreza Vakili Nezhaad, Ali Soud Al Bemani, Yahya Al Wahaibi

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Minimum miscibility pressure (MMP) plays a great role in determining the displacement efficiency of different gas injection processes. Experimental techniques for MMP determination include industrially recommended slim tube, vanishing interfacial tension (VIT) and rising bubble apparatus (RBA). In this paper, MMP measurement study using slim tube and VIT experimental techniques for two different crude oil samples (M and N) both in live and stock tank oil forms is being presented. VIT measured MMP values for both 'M' and 'N' live crude oils were close to slim tube determined MMP values with 6.4 and 5 % deviation respectively. Whereas for both oil samples in stock tank oil form, VIT measured MMP showed a higher unacceptable deviation from slim tube determined MMP. This higher difference appears to be related to high stabilized crude oil heavier fraction and lack of multiple contacts miscibility. None of the different nine deployed crude oil and CO2 MMP computing correlations could result in reliable MMP, close to slim tube determined MMP. Since VIT determined MMP values for both considered live crude oils are in close match with slim tube determined MMP values, it confirms reliable, reproducible, rapid and cheap alternative for live crude oil MMP determination. Whereas VIT MMP determination for stock tank oil case needed further investigation about stabilization / destabilization mechanism of oil heavier ends and multiple contacts miscibility development issues.

Keywords: minimum miscibility pressure, interfacial tension, multiple contacts miscibility, heavier ends

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Authors: R. Vasireddi, J. Kruse, M. Vakili, M. Trebbin

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Here we present a gas dynamic virtual nozzle (GDVN) based microfluidic jetting devices for spinning of nano/microfibers. The device is fabricated by soft lithography techniques and is based on the principle of a GDVN for precise three-dimensional gas focusing of the spinning solution. The nozzle device is used to produce micro/nanofibers of a perfluorinated terpolymer (THV), which were collected on an aluminum substrate for scanning electron microscopy (SEM) analysis. The influences of air pressure, polymer concentration, flow rate and nozzle geometry on the fiber properties were investigated. It was revealed that surface properties are controlled by air pressure and polymer concentration while the diameter and shape of the fibers are influenced mostly by the concentration of the polymer solution and pressure. Alterations of the nozzle geometry had a negligible effect on the fiber properties, however, the jetting stability was affected. Round and flat fibers with differing surface properties from craters, grooves to smooth surfaces could be fabricated by controlling the above-mentioned parameters. Furthermore, the formation of surface roughness was attributed to the fast evaporation rate and velocity (mis)match between the polymer solution jet and the surrounding air stream. The diameter of the fibers could be tuned from ~250 nm to ~15 µm. Because of the simplicity of the setup, the precise control of the fiber properties, access to biocompatible nanofiber fabrication and the easy scale-up of parallel channels for high throughput, this method offers significant benefits compared to existing solution-based fiber production methods.

Keywords: gas dynamic virtual nozzle (GDVN) principle, microfluidic device, spinning, uniform nanofibers

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Authors: Reza Vakili, Xiaolei Fan, Alex Walton

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The first near ambient pressure (NAP)-XPS study of CO oxidation over Pt nanoparticles (NPs) incorporated into Zr-based UiO (UiO for Universitetet i Oslo) MOFs was carried out. For this purpose, the MOF-based Catalysts were prepared by wetness impregnation (WI-PtNPs@UiO-67) and linker design (LD-PtNPs@UiO-67) methods along with PtNPs@ZrO₂ as the control catalyst. Firstly, the as-synthesized catalysts were reduced in situ prior to the operando XPS analysis. The existence of Pt(II) species was proved in UiO-67 by observing Pt 4f core level peaks at a high binding energy of 72.6 ± 0.1 eV. However, by heating the WI-PtNPs@UiO-67 catalyst in situ to 200 °C under vacuum, the higher BE components disappear, leaving only the metallic Pt 4f doublet, confirming the formation of Pt NPs. The complete reduction of LD-PtNPs@UiO-67 is achieved at 250 °C and 1 mbar H₂. To understand the chemical state of Pt NPs in UiO-67 during catalytic turnover, we analyzed the Pt 4f region using operando NAP-XPS in the temperature-programmed measurements (100-260 °C) with reference to PtNPs@ZrO₂ catalyst. CO conversion during NAP-XPS experiments with the stoichiometric mixture shows that LD-PtNPs@UiO-67 has a better CO turnover frequency (TOF, 0.066 s⁻¹ at 260 °C) than the other two (ca. 0.055 s⁻¹). Pt 4f peaks only show one chemical species present at all temperatures, but the core level BE shifts change as a function of reaction temperature, i.e., Pt 4f peak from 71.8 eV at T < 200 °C to 71.2 eV at T > 200 °C. As this higher BE state of 71.8 eV was not observed after in situ reductions of the catalysts and only once the CO/O₂ mixture was introduced, we attribute it to the surface saturation of Pt NPs with adsorbed CO. In general, the quantitative analysis of Pt 4f data from the operando NAP-XPS experiments shows that the surface chemistry of the Pt active phase in the two PtNPs@UiO-67 catalysts is the same, comparable to that of PtNPs@ZrO₂. The observed difference in the catalytic activity can be attributed to the particle sizes of Pt NPs, as well as the dispersion of active phase in the support, which are different in the three catalysts.

Keywords: CO oxidation, heterogeneous catalysis, MOFs, Metal Organic Frameworks, NAP-XPS, Near Ambient Pressure X-ray Photoelectron Spectroscopy

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Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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