Search results for: heart failure

Authors: Denys Sebov, Viktoriia Korotaieva, Kateryna Markina

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The clinical advantage of the multipill combination drugs administration (polypill-strategy) over single-component drugs (monopill-strategy) has been established in patients with comorbid arterial hypertension, heart failure, chronic coronary syndrome, diabetes. It was found that polypill-strategy provides better treatment adherence in 33.4% of the patients. It was proven a significant decrease in systolic and diastolic blood pressure, as well as a decrease in dispersion index due to the stability of the blood pressure profile in patients with the polypill-strategy treatment.

Keywords: polypill, artetial hypertension, cardiovascular disease, compliance

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Authors: Edite Kulmane, Mara Pilmane, Romans Lacis

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Introduction: Acquired heart diseases remain one of the leading health care problems in the world. Changes in myocardium of the diseased hearts are complex and pathogenesis is still not fully clear. The aim of this study was to identify appearance and distribution of apoptosis, homeostasis regulating factors, and innervation and ischemia markers in right atrial tissue in different acquired heart diseases. Methods: During elective open heart surgery were taken right atrial tissue fragments from 12 patients. All patients were operated because of acquired heart diseases- aortic valve stenosis (5 patients), coronary heart disease (5 patients), coronary heart disease and secondary mitral insufficiency (1 patient) and mitral disease (1 patient). The mean age was (mean±SD) 70,2±7,0 years (range 58-83 years). The tissues were stained with haematoxylin and eosin methods for routine light-microscopical examination and for immunohistochemical detection of protein gene peptide 9.5 (PGP 9.5), human atrial natriuretic peptide (hANUP), vascular endothelial growth factor (VEGF), chromogranin A and endothelin. Apoptosis was detected by TUNEL method. Results: All specimens showed degeneration of cardiomyocytes with lysis of myofibrils, diffuse vacuolization especially in perinuclear region, different size of cells and their nuclei. The severe invasion of connective tissue was observed in main part of all fragments. The apoptotic index ranged from 24 to 91%. One specimen showed region of newly performed microvessels with cube shaped endotheliocytes that were positive for PGP 9.5, endothelin, chromogranin A and VEGF. From all fragments, taken from patients with coronary heart disease, there were observed numerous PGP 9.5-containing nerve fibres, except in patient with secondary mitral insufficiency, who showed just few PGP 9.5 positive nerves. In majority of specimens there were regions observed with cube shaped mixed -VEGF immunoreactive endocardial and epicardial cells. Only VEGF positive endothelial cells were observed just in few specimens. There was no significant difference of hANUP secreting cells among all specimens. All patients operated due to the coronary heart disease moderate to numerous number of chromogranin A positive cells were seen while in patients with aortic valve stenosis tissue demonstrated just few factor positive cells. Conclusions: Complex detection of different factors may indicate selectively disordered morphopathogenetical event of heart disease: decrease of PGP 9.5 nerves suggests the decreased innervation of organ; increased apoptosis indicates the cell death without ingrowth of connective tissue; persistent presence of hANUP proves the unchanged homeostasis of cardiomyocytes probably supported by expression of chromogranins. Finally, decrease of VEGF detects the regions of affected blood vessels in heart affected by acquired heart disease.

Keywords: heart, apoptosis, protein-gene peptide 9.5, atrial natriuretic peptide, vascular endothelial growth factor, chromogranin A, endothelin

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Authors: Munirah Ismail, Joon Hock Yeo

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Babies born with Tetralogy of Fallot, a congenital heart defect, are required to undergo reconstruction surgery to create a valved conduit. As the child matures, the partially reconstructed pulmonary conduit increases in diameter, while the size of the reconstructed valve remains the same. As a result, follow up surgery is required to replace the undersized valve. Thus, in this project, we evaluated the in-vitro performance of a bi-leaflet valve design in terms of percentage regurgitation with increasing artery (conduit) diameters. Results revealed percentage regurgitations ranging from 13% to 34% for conduits tested. It was observed that percentage of regurgitation increased exponentially with increasing diameters. While the amount of regurgitation may seem severe, it is deemed acceptable, and this valve could potentially reduce the frequency of re-operation in the lifetime of pediatric patients.

Keywords: pulmonary heart valve, tetralogy of fallot, expanded polytetrafluoroethylene valve, pediatric heart valve replacement

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Authors: B. Engel, Sara Salman Hassan Al-Maeeni

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Human consumption of the Earth's resources increases the need for a sustainable development as an important ecological, social, and economic theme. Re-engineering of machine tools, in terms of design and failure analysis, is defined as steps performed on an obsolete machine to return it to a new machine with the warranty that matches the customer requirement. To understand the future fatigue behavior of the used machine components, it is important to investigate the possible causes of machine parts failure through design, surface, and material inspections. In this study, the failure modes of the shaft of the rotary draw bending machine are inspected. Furthermore, stress and deflection analysis of the shaft subjected to combined torsion and bending loads are carried out by an analytical method and compared with a finite element analysis method. The theoretical fatigue strength, correction factors, and fatigue life sustained by the shaft before damaged are estimated by creating a stress-cycle (S-N) diagram. In conclusion, it is seen that the shaft can work in the second life, but it needs some surface treatments to increase the reliability and fatigue life.

Keywords: failure analysis, fatigue life, FEM analysis, shaft, stress analysis

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Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

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Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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Authors: Elizabeth Laguaite, Alexandria Purdy

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Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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Authors: A. Siva, R. Senthil, R. Banupriya, R. Saravanakumar

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Cold-formed steel sheets are widely used as primary tension reinforcement in composite slabs. It also performs as formwork for concreting and better ceiling surface. The major type of failure occurring in composite slab is shear failure. When the composite slab is flexurally loaded, the longitudinal shear is generated and transferred to the steel sheet concrete interface. When the load increases, the interface slip occurs. The slip failure can be resisted by mechanical interface interlock by shear studs. In this paper, the slip failure has been resisted by shear connectors and geometry of the steel sheet alone. The geometry of the sheet is kept constant for all the specimens and the type of shear connectors has been varied. Totally, three types of shear connectors (viz., straight headed, U and J) are bolted to the trapezoidal profile sheet and the concrete is casted over it. After curing, the composite slab is subjected to flexure load and the test results are compared with the numerical results analysed by ABAQUS software. The test result shows that the U-shaped bolted stud has higher flexure strength than the other two types of shear connectors.

Keywords: cold formed steel sheet, headed studs, mechanical interlock, shear connectors, shear failure, slip failure

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Authors: Abdolrasoul Daneshjoo

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The purpose of this research was to study the effect of aerobic exercises with 75% heart beats on the amount of urea, uric acid and creatine in blood of Iranian soccer national U-23 players. 27 players were selected according to the following demographic specifications: age: 21.4±1.60 years old; weight: 68±9.4 kg; height: 174.2±8.6 cm. Urea, uric acid and creatine in blood are considered as dependent variations where as 40 minutes running on a track with maximum 75% heart beats are independent variations. Heart beat and blood pressure in rest time, age, height, and weight are considered as the controlled variations. Maximum heart beats are recorded under maximum exercises (8 minutes and 150-250 watt energy) on ergo meter. Then, in order to determine independent variations, 75% maximum heart beats are considered for each player. Blood is taken twice (before and after determining independence variation). Moreover, the players are given a few instructions to be fulfilled 24 hours before the main exercises. Laboratory analysis method for blood urea sample is deacetyl ammoniom, for uric acid Karvy test and for creatine pyric acid. 'T' formula is applied for analyzing statistical data in dependent groups with degree of freedom 7 (d.f=7) urea and uric acid contain P>0.01 and P>0.05 for creatine. 1. Aerobic exercise can effect on the concentration of urea of blood as well as uric acid and creatine in blood serum and increase the amount of them. 2. Urea of blood serum increases from 26.75±2.59 to 28.9±2.67 (25%) with 40 minutes running and 75% heart beat. 3. Aerobic exercise causes uric acid increase 12.5% from 5.7±0.52 (before exercise) to 6.1±0.71 (after exercise). Creatine of blood serum increases from 1.36±0.27 (before exercise) to 1.85±0.49 (after exercise). We came to this result that during aerobic exercise catabolism of protein substrate increases. Moreover, augmentation of urea, uric acid and creatine in blood serum as metabolic poisons causes disorder in kidney. Also, tendons and joints are affected by these poisons. Appropriate diet and exercise can prevent production of these poisons resulted from heavy exercise.

Keywords: aerobic exercise, urea, uric acid, creatine, blood, soccer national players

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Authors: Samaneh Rahsepar, Mehrzad Moghadasi

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To evaluate the effect of Test Pump supplement on the physiological and functional performance of futsal women, twenty female futsal subjects were divided into two groups: placebo (n = 10) and supplement (n = 10) and were given buccal tablets for 7 days and 12 g daily supplement each day. The placebo group used starch powder during this period. Speed, agility with ball, agility without ball and dribbling time were measured before and after supplementation. In addition, the rate of heart rate and blood pressure changes were measured before and after the YOYO test. The results showed that the test pump had no significant effect on improving speed, agility with ball, agility without ball, dribbling time and heart rate changes and diastolic blood pressure, and only affect the maximum oxygen consumption and systolic blood pressure (P <0.05). In general, the use of the test-pump supplement does not have a significant effect on the physiological and functional performance of futsal women. The results of this study showed that the use of supplementary pump tests on women's futsal heart rate changes after loading period had a significant difference between the two groups in resting heart rate with heart rate after exercise and 5 minutes after exercise. However, it did not have a significant effect on the increase in heart rate. Supplementation significantly increased systolic blood pressure after exercise compared to resting blood pressure, as well as a significant increase in systolic blood pressure after exercise compared to resting systolic blood pressure and 5 minutes after exercise in both groups from the loading period. On the other hand, there was a significant difference in systolic blood pressure in both placebo and supplemented groups.

Keywords: test pump supplement, women, speed, dribble, agility, maximum oxygen consumption, cardiovascular

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Authors: D. De-León-Escobedo, D. J. Delgado-Hernández, S. Pérez

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A probabilistic formulation to assess the slopes safety under the hazard of strong storms is presented and illustrated through a slope in Mexico. The formulation is based on the classical safety factor (SF) used in practice to appraise the slope stability, but it is introduced the treatment of uncertainties, and the slope failure probability is calculated as the probability that SF<1. As the main hazard is the rainfall on the area, statistics of rainfall intensity and duration are considered and modeled with an exponential distribution. The expected life-cycle cost is assessed by considering a monetary value on the slope failure consequences. Alternative mitigation measures are simulated, and the formulation is used to get the measures driving to the optimal one (minimum life-cycle costs). For the example, the optimal mitigation measure is the reduction on the slope inclination angle.

Keywords: expected life-cycle cost, failure probability, slopes failure, storms

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Authors: Min-Tsai Lai, Taqwa Hariguna

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This paper presents a periodical replacement model for a system, considering the concept of single and cumulative repair cost limits simultaneously. The failures are divided into two types. Minor failure can be corrected by minimal repair and serious failure makes the system breakdown completely. When a minor failure occurs, if the repair cost is less than a single repair cost limit L1 and the accumulated repair cost is less than a cumulative repair cost limit L2, then minimal repair is executed, otherwise, the system is preventively replaced. The system is also replaced at time T or at serious failure. The optimal period T minimizing the long-run expected cost per unit time is verified to be finite and unique under some specific conditions.

Keywords: repair-cost limit, cumulative repair-cost limit, minimal repair, periodical replacement policy

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Authors: Abhigyan Hedau, Priya Shelke, Riddhi Mirajkar, Shreyash Chaple, Mrunali Gadekar, Himanshu Akula

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The heart is the coordinating centre of the major endocrine glandular structure of the body, which produces hormones that profoundly affect the operations of the body, and diagnosing cardiovascular disease is a difficult but critical task. By extracting knowledge and information about the disease from patient data, data mining is a more practical technique to help doctors detect disorders. We use a variety of machine learning methods here, including logistic regression and support vector classifiers (SVC), K-nearest neighbours Classifiers (KNN), Decision Tree Classifiers, Random Forest classifiers and Gradient Boosting classifiers. These algorithms are applied to patient data containing 13 different factors to build a system that predicts heart disease in less time with more accuracy.

Keywords: logistic regression, support vector classifier, k-nearest neighbour, decision tree, random forest and gradient boosting

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Authors: Hana Gebremariam Liliso

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This study investigates the factors contributing to the deterioration of thick asphalt pavements, such as rutting and cracking. We focus on the combined influence of traffic loads and pavement structure. This study uses a three-dimensional finite element model with a Mohr-Coulomb failure criterion to analyze the stress levels near the pavement's surface under realistic conditions. Our model considers various factors, including tire-pavement contact stresses, asphalt properties, moving loads, and dynamic analysis. This research suggests that cracking tends to occur between dual tires. Some key discoveries include the risk of cracking increases as temperatures rise; surface cracking at high temperatures is associated with distortional deformation; using a uniform contact stress distribution underestimates the risk of failure compared to realistic three-dimensional tire contact stress, particularly at high temperatures; the risk of failure is higher near the surface when there is a negative temperature gradient in the asphalt layer; and debonding beneath the surface layer leads to increased shear stress and premature failure around the interface.

Keywords: asphalt pavement, surface failure, 3d finite element model, multiaxial stress states, Mohr-Coulomb failure criterion

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Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Marwan Jarrah, Nadia Nugrush, Sukainah Ali, Areej Allawzi

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This research article investigates how illnesses (different types and severity) are expressed in Arabic discourse with a particular focus on input coming from Colloquial Jordanian Arabic (CJA). Drawing on a corpus of naturally occurring conversations, this article offers evidence that illnesses are predominantly expressed through two different sets of expressive strategies, namely direct expressive strategies (DES) and indirect expressive strategies (IES). The latter are exclusively used when cancer and mental health disorders are targeted. IES include the substitution of the name of the illness with some religious expressions (e.g., ʔallah ʔijdʒi:rna ‘May Allah keeps us safe’) or certain terms especially when cancer is meant (e.g., haðˤa:k ʔil-maraðˤ ‘that disease’). On the other hand, DES are used in conjunction with other illnesses (e.g., heart, kidneys, diabetes, etc.), regardless of their severity. DES include specific formulas that remarkably mention the name of the inflicted organ (e.g., [with-SOMEONE the ORGAN] as in ʕinduh ʔil-qalb ‘lit. with-him the heart’ meaning ‘He has a heart disease). We discuss the effects of religious beliefs and local norms and values in determining the use of these strategies.

Keywords: Illnesses, pragmatics, expressive strategies, religion

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Authors: Sung-Sik Park, Han Chang, Kyung-Hun Chae, Sae-Byeok Lee

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In this study, a three-dimensional (3D) Particle method without using grid was developed for analyzing large deformation of soils instead of using ordinary finite element method (FEM) or finite difference method (FDM). In the 3D Particle method, the governing equations were discretized by various particle interaction models corresponding to differential operators such as gradient, divergence, and Laplacian. The Mohr-Coulomb failure criterion was incorporated into the 3D Particle method to determine soil failure. The yielding and hardening behavior of soil before failure was also considered by varying viscosity of soil. First of all, an unconfined compression test was carried out and the large deformation following soil yielding or failure was simulated by the developed 3D Particle method. The results were also compared with those of a commercial FEM software PLAXIS 3D. The developed 3D Particle method was able to simulate the 3D large deformation of soils due to soil yielding and calculate the variation of normal and shear stresses following clay deformation.

Keywords: particle method, large deformation, soil column, confined compressive stress

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Authors: Zhuang Hou, Xiaolei Cao

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The general public and medical professionals recognized the importance of accurately measuring and storing blood oxygen levels and heart rate during the COVID-19 pandemic. The demand for accurate contactless devices was motivated by the need for cross-infection reduction and the shortage of conventional oximeters, partially due to the global supply chain issue. This paper evaluated a contactless mini program HealthyPai’s heart rate (HR) and oxygen saturation (SpO2) measurements compared with other wearable devices. In the HR study of 185 samples (81 in the laboratory environment, 104 in the real-life environment), the mean absolute error (MAE) ± standard deviation was 1.4827 ± 1.7452 in the lab, 6.9231 ± 5.6426 in the real-life setting. In the SpO2 study of 24 samples, the MAE ± standard deviation of the measurement was 1.0375 ± 0.7745. Our results validated that HealthyPai utilizing the Integrated Image Deep Learning Solution (IIDLS) framework, can accurately measure HR and SpO2, providing the test quality at least comparable to other FDA-approved wearable devices in the market and surpassing the consumer-grade and research-grade wearable standards.

Keywords: remote photoplethysmography, heart rate, oxygen saturation, contactless measurement, mini program

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Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

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Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

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Authors: Cóndor C. José, Rodrigues E. Camila, Noronha L. Irene, Dos Santos Fernando, Irigoyen M. Claudia, Andrade Lúcia

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Sepsis induces alterations in hemodynamics and autonomic nervous system (ASN). The autonomic activity can be calculated by measuring heart rate variability (HRV) that represents the complex interplay between ASN and cardiac pacemaker cells. Wharton’s jelly mesenchymal stem cells (WJ-MSCs) are known to express genes and secreted factors involved in neuroprotective and immunological effects, also to improve the survival in experimental septic animals. We hypothesized, that WJ-MSCs present an important role in the autonomic activity and in the hemodynamic effects in a cecal ligation and puncture (CLP) model of sepsis. Methods: We used flow cytometry to evaluate WJ-MSCs phenotypes. We divided Wistar rats into groups: sham (shamoperated); CLP; and CLP+MSC (106 WJ-MSCs, i.p., 6 h after CLP). At 24 h post-CLP, we recorded the systolic arterial pressure (SAP) and heart rate (HR) over 20 min. The spectral analysis of HR and SAP; also the spontaneous baroreflex sensitivity (measure by bradycardic and tachycardic responses) were evaluated after recording. The one-way ANOVA and the post hoc Student– Newman– Keuls tests (P< 0.05) were used to data comparison Results: WJ-MSCs were negative for CD3, CD34, CD45 and HLA-DR, whereas they were positive for CD73, CD90 and CD105. The CLP group showed a reduction in variance of overall variability and in high-frequency power of HR (heart parasympathetic activity); furthermore, there is a low-frequency reduction of SAP (blood vessels sympathetic activity). The treatment with WJ-MSCs improved the autonomic activity by increasing the high and lowfrequency power; and restore the baroreflex sensitive. Conclusions: WJ-MSCs attenuate the impairment of autonomic control of the heart and vessels and might therefore play a protective role in sepsis. (Supported by FAPESP).

Keywords: baroreflex response, heart rate variability, sepsis, wharton’s jelly-derived mesenchymal stem cells

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Authors: Nilesh Pancholi, Mangal Bhatt

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This paper highlights comparative results of traditional FMECA and multi-factor decision-making approach based on “Technique for Order Preference by Similarity to Ideal Solution (TOPSIS)” for aluminum wire rolling mill plant. The suggested study is carried out to overcome the limitations of FMECA by assigning the scores against each failure modes in crisp values to evaluate the criticalities of the failure modes without uncertainty. The primary findings of the paper are that sudden impact on the rolls seems to be most critical failure cause and high contact stresses due to rolling & sliding action of mesh to be least critical failure cause. It is suggested to modify the current control practices with proper maintenance strategy based on achieved maintainability criticality index (MCI). The outcome of the study will be helpful in deriving optimized maintenance plan to maximize the performance of continuous process industry.

Keywords: reliability, maintenance, FMECA, TOPSIS, process industry

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Authors: Kamal Bahrin Jaafar

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The study area is located at Bukit Kukus, Penang where the construction of twin road project in ongoing. A landslide event has occurred on 19th October 2018, which causes fatal deaths. The purpose of this study is to figure out the causes of failure, the estimated volume of failure, and its balance. The study comprises of unmanned aerial vehicle (UAV) sensing and resistivity survey. The resistivity method includes spreading three lines of 200m length resistivity survey with the depth of penetration in the subsurface not exceeding 35m. The result of UAV shows the current view of the site condition. Based on resistivity result, the dominant layer in the study area consists of residual soil/filling material with a thickness of more than 35m. Three selected cross sections from construction drawing are overlain with the current cross sections to understand more on the condition of the subsurface profile. By comparison, there is a difference between past and present topography. The combination of result from the previous data and current condition shows the calculated volume of failure is 85,000 m³, and its balance is 50,000 m³. In conclusion, the failure occurs since the contractor has conducted the construction works without following the construction drawing supplied by the consultant. Besides, the cause of failure is triggered by the geology condition, such as a fault that should be considered prior to the commencement of work.

Keywords: UAV, landslide, resistivity survey, cause of failure

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Authors: Mohd. A. M. Rahim, Yahaya Hassan, Mathumalar L. Fahrni

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Second line antiretroviral therapy (ART) regimen is used when patients fail their first line regimen. There are many factors such as non-adherence, drug resistance as well as virological and immunological failure that lead to second line highly active antiretroviral therapy (HAART) regimen treatment failure. This study was aimed at determining predictor factors to treatment failure with second line HAART and analyzing median survival time. An observational, retrospective study was conducted in Sungai Buloh Hospital (HSB) to assess current status of HIV patients treated with second line HAART regimen. Convenience sampling was used and 104 patients were included based on the study’s inclusion and exclusion criteria. Data was collected for six months i.e. from July until December 2013. Data was then analysed using SPSS version 18. Kaplan-Meier and Cox regression analyses were used to measure median survival times and predictor factors for treatment failure. The study population consisted mainly of male subjects, aged 30-45 years, who were heterosexual, and had HIV infection for less than 6 years. The most common second line HAART regimen given was lopinavir/ritonavir (LPV/r)-based combination. Kaplan-Meier analysis showed that patients on LPV/r demonstrated longer median survival times than patients on indinavir/ritonavir (IDV/r) based combination (p<0.001). The commonest reason for a treatment to fail with second line HAART was non-adherence. Based on Cox regression analysis, other predictor factors for treatment failure with second line HAART regimen were age and mode of HIV transmission.

Keywords: adherence, antiretroviral therapy, second line, treatment failure

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Authors: Nenny Harijani, Dhandy Koesoemo Wardhana

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The aim of this study is to know the bacteriocin as antimicrobial activity produced by Lactic Acid Bacteria (LAB) as Antibacterial of Sub Clinic Mastitis on Dairy Cows. The antimicrobial is produced by LAB which isolates from cattle intestine can inhibit the growth Staphylococcus aureus, Steptocococcus agalactiae an Escherichia coli which were caused by dairy cattle subclinical mastitis. The failure of this bacteria growth was indicated by the formation of a clear zone surrounding the colonies on Brain Heart Infusion Agar plate. The bacteriocin was produced by Lactic Acid Bacteria (LAB) as antimicrobial, which could inhibit the growth of indicator bacteria Staphylococcus aureus, S.aglactiae and E.coli. This study was also developed bacteriocin to be used as a therapeutic of subclinical mastitis on dairy cows. The method used in this study was isolation, selection and identification of LAB using Mann Rogosa Sharp Medium, followed by characterization of the bacteriocin produced by LAB. The result of the study showed that bacteriocin isolated from beef cattle’s intestine could inhibit the growth Staphylococcus aureus, S. agalactiae, an Escherichia coli, which was indicated by clear zone surrounding the colonies on Brain Heart Infusion Agar plate. Characteristics of bacteriocin were heat-stable exposed to 80 0C for 30 minutes and 100 ⁰C for 15 minutes and inactivated by proteolytic enzymes such as trypsin. This approach has suggested the development of bacteriocin as a therapeutic agent for subclinical mastitis in dairy cattle.

Keywords: lactic acid bacteria, bacteriocin, staphylococcus aureus, S. agalactiae, E. coli, sub

Procedia PDF Downloads 102

Authors: A. Uludağ, F. G. Tufekci, N. Ceviz

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Aim: The research has been carried out in order to evaluate caregiver burden, life satisfaction and received social support level of the parents whose children have congenital heart disease; to examine the relationship between the social supports received by them and caregiver burden and life satisfaction. Material and Method: The research which is descriptive and which is searching a relationship has been carried out between the dates June 7, 2012- June 30, 2014, in Erzurum Ataturk University Research and Application Hospital, Department of Pediatrics and Children Cardiology Polyclinic. In the research, it was collaborated with the parents (N = 157) who accepted to participate in, of children who were between the ages of 3 months- 12 years. While gathering the data, a questionnaire, Zarit Caregiver Burden, Life Satisfaction and Social Support Scales have been used. The statistics of the data acquired has been produced by using percentage distribution, mean, and variance and correlation analysis. Ethical principles are followed in the research. Results: In the research, caregiver burden, life satisfaction and social support level received from family (p < 0.05), have been determined higher in the parents whose children have serious congenital heart disease than that of parents whose children have slight disease and social support received from friends has been found lower. It has been determined that there is a strong relation (p < 0.001) through negative direction between both social support levels and caregiver burden of parents; and that there is a strong relation (p < 0.001) through positive direction between both support levels and life satisfaction. Conclusion: That Social Support is in a strong relation with Caregiver Burden through a negative direction and a strong relation with Life Satisfaction through positive direction in parents of all the children who have congenital heart disease requires social support systems to be reinforced. Parents can be led or guided so as to prompt social support systems more.

Keywords: congenital heart disease, child, parents, caregiver burden, life satisfaction, social support

Procedia PDF Downloads 269

Authors: Aw Adi Arryansyah

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Using electronic stethoscope for detecting heartbeat sound, and breath sounds, are the effective way to investigate cardiovascular diseases. On the other side, technology is growing towards mobile. Almost everyone has a smartphone. Smartphone has many platforms. Creating mobile applications also became easier. We also can use HTML5 technology to creating mobile apps. Android is the most widely used type. This is the reason for us to make a wireless electronic stethoscope based on Android mobile. Android based Wireless Electronic Stethoscope designed by a simple system, uses sound sensors mounted membrane, then connected with Bluetooth module which will send the heart auscultation voice input data by Bluetooth signal to an android platform. On the software side, android will read the voice input then it will translate to beautiful visualization and release the voice output which can be regulated about how much of it is going to be released. We can change the heart beat sound into BPM data, and heart beat analysis, like normal beat, bradycardia or tachycardia.

Keywords: wireless, HTML 5, auscultation, bradycardia, tachycardia

Procedia PDF Downloads 318

Authors: Qianhui Li, Christoph H. Bruecker

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Atherosclerotic plaques are typically found where flow separation and variations of shear stress occur. Although helical flow patterns and flow separations have been recorded in the aorta, their relation has not been clearly clarified and especially in the condition of artificial heart valve prostheses. Therefore, an experimental study is performed to investigate the hemodynamic performance of different mechanical heart valves (MHVs), i.e. the SJM Regent bileaflet mechanical heart valve (BMHV) and the Lapeyre-Triflo FURTIVA trileaflet mechanical heart valve (TMHV), in a transparent model of the human aorta under a physiological pulsatile right-hand helical flow condition. A typical systolic flow profile is applied in the pulse-duplicator to generate a physiological pulsatile flow which thereafter flows past an axial turbine blade structure to imitate the right-hand helical flow induced in the left ventricle. High-speed particle image velocimetry (PIV) measurements are used to map the flow evolution. A circular open orifice nozzle inserted in the valve plane as the reference configuration initially replaces the valve under investigation to understand the hemodynamic effects of the entered helical flow structure on the flow evolution in the aortic arch. Flow field analysis of the open orifice nozzle configuration illuminates the helical flow effectively delays the flow separation at the inner radius wall of the aortic arch. The comparison of the flow evolution for different MHVs shows that the BMHV works like a flow straightener which re-configures the helical flow pattern into three parallel jets (two side-orifice jets and the central orifice jet) while the TMHV preserves the helical flow structure and therefore prevent the flow separation at the inner radius wall of the aortic arch. Therefore the TMHV is of better hemodynamic performance and reduces the pressure loss.

Keywords: flow separation, helical aortic flow, mechanical heart valve, particle image velocimetry

Procedia PDF Downloads 143

Authors: Ghiwa Dandach

Abstract:

By challenging the anti-failure bias and contributing to the theoretical territory of the attribution theory, this thesis develops a comprehensive process for entrepreneurial learning from failure. The practical implication of the findings suggests assisting entrepreneurs (current, failing, and nascent) in effectively anticipating and reflecting upon failure. Additionally, the process is suggested to enhance the level of institutional and private (accelerators and financers) support provided to entrepreneurs, the implications of which may improve future opportunities for entrepreneurial success. Henceforth, exploring learning from failure is argued to impact the potential survival of future ventures, subsequently revitalizing the economic contribution of entrepreneurship. This learning process can be enhanced with the cognitive development of causal ascriptions for failure, which eventually impacts learning outcomes. However, the mechanism with which entrepreneurs make sense of failure, reflect on the journey, and transform experience into knowledge is still under-researched. More specifically, the cognitive process of failure attribution is under-explored, majorly in the context of developing economies, calling for a more insightful understanding on how entrepreneurs ascribe failure. Responding to the call for more thorough research in such cultural contexts, this study expands the understanding of the dimensions of failure attributions as perceived by entrepreneurs and the impact of these dimensions on learning outcomes in the Lebanese context. The research adopted the exploratory interpretivism paradigm and collected data from interviews with industry experts first, followed by narratives of entrepreneurs using the qualitative multimethod approach. The holistic and categorical content analysis of narratives, preceded by the thematic analysis of interviews, unveiled how entrepreneurs ascribe failure by developing minor and major dimensions of each failure attribution. The findings have also revealed how each dimension impacts the learning from failure when accompanied by emotional resilience. The thesis concludes that exploring in-depth the dimensions of failure attributions significantly determines the level of learning generated. They are moving beyond the simple categorisation of ascriptions as primary internal or external unveiled how learning may occur with each attribution at the individual, venture, and ecosystem levels. This has further accentuated that a major internal attribution of failure combined with a minor external attribution generated the highest levels of transformative and double-loop learning, emphasizing the role of personal blame and responsibility on enhancing learning outcomes.

Keywords: attribution, entrepreneurship, reflection, sense-making, emotions, learning outcomes, failure, exit

Procedia PDF Downloads 180

Authors: Ke Ma

Abstract:

Through the long course of history, Buddhism has captivated generations of brilliant minds with its enlightening but elusive discernment. Far from religious dogmas, Buddhism not only represents spiritual revelation, but also logical reasoning.Among all of Buddhism’s concepts, emptiness is the most famous, and abstruse one. This word resulted from an inaccurate translation confuses both Buddhists and religious scholars who understand Heart Sutra based on its English version. In this essay, the idea of “emptiness” will be reinterpreted as “information,” leading not only to a clarification of the ideology of Buddhism, but also to greater correspondence between Buddhism concepts and cognitive science.

Keywords: religion, cognitive science, psychology, Buddhism

Procedia PDF Downloads 245

Authors: Mohammadreza Nezamirad, Nasim Sabetpour, Azadeh Yazdi, Amirmasoud Hamedi

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In this study OpenFOAM 4.4.2 was used to investigate flow inside the coronary artery of the heart. This step is the first step of our future project, which is to include conjugate heat transfer of the heart with three main coronary arteries. Three different velocities were used as inlet boundary conditions to see the effect of velocity increase on velocity, pressure, and wall shear of the coronary artery. Also, three different fluids, namely the University of Wisconsin solution, gelatin, and blood was used to investigate the effect of different fluids on flow inside the coronary artery. A code based on Reynolds Stress Navier Stokes (RANS) equations was written and implemented with the real boundary condition that was calculated based on MRI images. In order to improve the accuracy of the current numerical scheme, hex dominant mesh is utilized. When the inlet velocity increases to 0.5 m/s, velocity, wall shear stress, and pressure increase at the narrower parts.

Keywords: CFD, simulation, OpenFOAM, heart

Procedia PDF Downloads 111

Authors: Sujay Kotwale, Ramasubba Reddy M.

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Electrocardiogram (ECG) is a non-invasive technique used to study and analyze various heart diseases. Cardiac arrhythmia is a serious heart disease which leads to death of the patients, when left untreated. An early-time detection of cardiac arrhythmia would help the doctors to do proper treatment of the heart. In the past, various algorithms and machine learning (ML) models were used to early-time detection of cardiac arrhythmia, but few of them have achieved better results. In order to improve the performance, this paper implements principal component analysis (PCA) along with XGBoost model. The PCA was implemented to the raw ECG signals which suppress redundancy information and extracted significant features. The obtained significant ECG features were fed into XGBoost model and the performance of the model was evaluated. In order to valid the proposed technique, raw ECG signals obtained from standard MIT-BIH database were employed for the analysis. The result shows that the performance of proposed method is superior to the several state-of-the-arts techniques.

Keywords: cardiac arrhythmia, electrocardiogram, principal component analysis, XGBoost

Procedia PDF Downloads 88