Search results for: internal pudendal artery

Authors: K. H. Reeta, Bhavana Prasher, Mitali Mukerji, Dhwani Dholakia, Sangeeta Khanna, Archana Vats, Shivam Pandey, Sandeep Seth, Subir Kumar Maulik

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Introduction Research has demonstrated a connection between coronary artery disease (CAD) and genetics. We did a deep literature mining using both bioinformatics and manual efforts to identify the susceptible polymorphisms in coronary artery disease. Further, the study sought to validate these findings in an Asian population. Methodology In first phase, we used an automated pipeline which organizes and presents structured information on SNPs, Population and Diseases. The information was obtained by applying Natural Language Processing (NLP) techniques to approximately 28 million PubMed abstracts. To accomplish this, we utilized Python scripts to extract and curate disease-related data, filter out false positives, and categorize them into 24 hierarchical groups using named Entity Recognition (NER) algorithms. From the extensive research conducted, a total of 466 unique PubMed Identifiers (PMIDs) and 694 Single Nucleotide Polymorphisms (SNPs) related to coronary artery disease (CAD) were identified. To refine the selection process, a thorough manual examination of all the studies was carried out. Specifically, SNPs that demonstrated susceptibility to CAD and exhibited a positive Odds Ratio (OR) were selected, and a final pool of 324 SNPs was compiled. The next phase involved validating the identified SNPs in DNA samples of 96 CAD patients and 37 healthy controls from Indian population using Global Screening Array. ResultsThe results exhibited out of 324, only 108 SNPs were expressed, further 4 SNPs showed significant difference of minor allele frequency in cases and controls. These were rs187238 of IL-18 gene, rs731236 of VDR gene, rs11556218 of IL16 gene and rs5882 of CETP gene. Prior researches have reported association of these SNPs with various pathways like endothelial damage, susceptibility of vitamin D receptor (VDR) polymorphisms, and reduction of HDL-cholesterol levels, ultimately leading to the development of CAD. Among these, only rs731236 had been studied in Indian population and that too in diabetes and vitamin D deficiency. For the first time, these SNPs were reported to be associated with CAD in Indian population. Conclusion: This pool of 324 SNP s is a unique kind of resource that can help to uncover risk associations in CAD. Here, we validated in Indian population. Further, validation in different populations may offer valuable insights and contribute to the development of a screening tool and may help in enabling the implementation of primary prevention strategies targeted at the vulnerable population.

Keywords: coronary artery disease, single nucleotide polymorphism, susceptible SNP, bioinformatics

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Authors: Madala Venkateswara Rao

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The major blood supply to the long bones occurs through the nutrient arteries, which enters through the nutrient foramina. This is the study of nutrient Foramina in the shaft of upper limb long bones taken from the department of Anatomy at Narayana medical college nellore. Nutrient foramina play an important role in nutrition and growth of the bones. Most of the nutrient arteries follow the rule, 'to the elbow I go, from the knee I flee' but they are very variable in position. Their number, location, direction & its importance in the growing end of long bones were studied in the long bones of upper limb. The present study has variations in the position & direction of long bones especially in the radius & ulna, as most of the nutrient foramina are found in anterior surface of upper 1/3rd and middle 1/3rd of these bones. The study of nutrient foramina is not only of academic interest but also in medico-legal practice in relation to their position. Careful observation has also been made on the position of nutrient foramina in relation to upper end of long bones. This study also gives importance of length long bones to know the height of an individual. With the knowledge of variations in the nutrient foramen, placement of internal fixation devices can be appropriately done.

Keywords: nutrient artery, nutrient foramina, shaft of long bones, upper limb bones

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Authors: Arun Prasath Subramanian

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The turbine Inlet Temperature is an important parameter which determines the efficiency of a gas turbine engine. The increase in this parameter is limited by material constraints of the turbine blade.The modern Gas turbine blade has undergone a drastic change from a simple solid blade to a modern multi-pass blade with internal and external cooling techniques. This paper aims to introduce the reader the concept of turbine blade cooling, the classification of techniques and further explain some of the important internal cooling technologies used in a modern gas turbine blade along with the various factors that affect the cooling effectiveness.

Keywords: gas turbine blade, cooling technologies, internal cooling, pin-fin cooling, jet impingement cooling, rib turbulated cooling, metallic foam cooling

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Authors: I. Kurashvili, G. Darsavelidze, G. Bokuchava, A. Sichinava, I. Tabatadze

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The impact of boron doping on the internal friction (IF) and shear modulus temperature spectra of Si_1-xGe_x(x≤0,02) monocrsytals has been investigated by reverse torsional pendulum oscillations characteristics testing. At room temperatures, microhardness and indentation modulus of the same specimens have been measured by dynamic ultra microhardness tester. It is shown that boron doping causes two kinds effect: At low boron concentration (~10¹⁵ cm^-3) significant strengthening is revealed, while at the high boron concentration (~10¹⁹ cm^-3) strengthening effect and activation characteristics of relaxation origin IF processes are reduced.

Keywords: boron, doping, internal friction, si-ge alloys, thermal treatment

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Authors: Shazia Anwer Bukhari, Madiha Javeed Ghani, Muhammad Ibrahim Rajoka

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Objective: Biochemical, environmental, physical and genetic factors have a strong effect on the development of coronary disease (CAD). Plasma homocysteine (Hcy) level and DNA damage play a pivotal role in its development and progression. The aim of this study was to investigate the predictive strength of an oxidative stress, clinical biomarkers and total antioxidant status (TAS) in CAD patients to find the correlation of homocysteine, TOS and oxidative DNA damage with other clinical parameters. Methods: Sixty confirmed patients with CAD and 60 healthy individuals as control were included in this study. Different clinical and laboratory parameters were studied in blood samples obtained from patients and control subjects using commercially available biochemical kits and statistical software Results: As compared to healthy individuals, CAD patients had significantly higher concentrations of indices of oxidative stress: homocysteine (P=0.0001), total oxidative stress (TOS) (P=0.0001), serum cholesterol (P=0.04), low density lipoprotein cholesterol (LDL) (P=0.01), high density lipoprotein-cholesterol (HDL) (P=0.0001), and malondialdehyde (MDA) (P=0.001) than those of healthy individuals. Plasma homocysteine level and oxidative DNA damage were positively correlated with cholesterol, triglycerides, systolic blood pressure, urea, total protein and albumin (P values= 0.05). Both Hcy and oxidative DNA damage were negatively correlated with TAS and proteins. Conclusion: Coronary artery disease patients had a significant increase in homocysteine level and DNA damage due to increased oxidative stress. In conclusion, our study shows a significantly increase in lipid peroxidation, TOS, homocysteine and DNA damage in the erythrocytes of patients with CAD. A significant decrease level of HDL-C and TAS was observed only in CAD patients. Therefore these biomarkers may be useful diagnosis of patients with CAD and play an important role in the pathogenesis of CAD.

Keywords: antioxidants, coronary artery disease, DNA damage, homocysteine, oxidative stress, malondialdehyde, 8-Hydroxy-2’deoxyguanosine

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Authors: Mustafa Kirisci

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Arms embargoes have not been adequately examined in terms of their effects on conflict duration. Prior research on arms embargoes has generally investigated the effect of arms embargoes on arms import/export practices and violations in arms embargoes, but it says little about the effect on conflict duration. This paper attempts to fill this gap and aims to investigate the effect of arms embargoes on conflict duration throughout the world. More precisely, the purpose of the paper is to understand how arms embargoes affect the duration of both internal and interstate conflicts. Given the theoretical framework, the main hypothesis of the paper is arms embargoes will have no reduction effect on conflict duration when arms transfer and region are controlled. This hypothesis is tested by using OLS regression. Results indicate that arms embargoes have no effect on both internal and interstate conflict duration. Another crucial result is that both small and major arms transfers made by the embargoed countries during the internal conflict increase the duration of the conflict, but no effect on interstate conflict duration. The final part concludes and provide explanations on what these results imply for finishing the conflict and bringing the peace.

Keywords: arms embargo, arms transfer, internal conflict, international conflict

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Authors: Amar Sabih, James Nemes

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The occurrence of internal ductile failure within the Adiabatic Shear Band (ASB) in cold-headed products presents a significant barrier in the fast-expanding cold-heading (CH) industry. The presence of internal ductile failure in cold-headed products may lead to catastrophic fracture under tensile loads despite the ductile nature of the material causing expensive industrial recalls. Therefore, this paper presents a new workability criterion that uses stress instability as an indicator to accurately reveal the locus of initiation of internal ductile failures. The concept of the instability criterion is to use the stress ratio at failure as a weighting function to indicate the initiation of ductile failure inside the ASBs. This paper presents a comprehensive experimental, metallurgical, and finite element simulation study to calculate the material constants used in this criterion.

Keywords: adiabatic sher band, ductile failure, stress instability, workability criterion

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Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

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Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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Authors: D. Zhang, H. Y. Du, G. W. Li, J. Zeng, D. W. Zuo, Y. P. You

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For the difficult issues of process selection, case-based reasoning technology is applied to computer aided process planning system for cold form tapping of internal threads on the basis of similarity in the process. A model is established based on the analysis of process planning. Case representation and similarity computing method are given. Confidence degree is used to evaluate the case. Rule-based reuse strategy is presented. The scheme is illustrated and verified by practical application. The case shows the design results with the proposed method are effective.

Keywords: case-based reasoning, internal thread, cold extrusion, process planning

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Authors: Saifon Chongthub

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The purpose of this research is to synthesize adsorbent foam for CO2 adsorption. The polymer was prepared from poly High Internal Phase Emulsion (PolyHIPE) using styrene as monomer and divinylbenzene as comonomer. Its morphology was determined by Scanning Electron Microscopy (SEM). To further increased CO2 adsorption of the prepared polyHIPE, the layer by layer (LbL) technique was applied, which alternated polyelectrolyte injection between layers of Poly(styrenesulfonate) (PSS) and Poly(diallyldimetyl-ammonium chloride)(PDADMAC) as primary layer, and layers of PSS and polyetyleneimine (PEI) as secondary layer.

Keywords: high internal phase emulsion, polyHIPE, surface modification, layer by layer technique, CO2 adsorption

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Authors: Jian Wang, Lu Yang, Jiong Peng

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Internal circulation two-platen clamping system for injection molding machine (IMM) has many potential advantages on energy-saving. In order to estimate its properties, experiments in this paper were carried out. Displacement and pressure of the components were measured. In comparison, the model of hydraulic clamping system was established by using AMESim. The related parameters as well as the energy consumption could be calculated. According to the analysis, the hydraulic system was optimized in order to reduce the energy consumption.

Keywords: AMESim, energy-saving, injection molding machine, internal circulation

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Authors: Amar Sabih, James Nemes

Abstract:

The occurrence of internal ductile failure within the Adiabatic Shear Band (ASB) in cold-headed products presents a significant barrier in the fast-expanding cold-heading (CH) industry. The presence of internal ductile failure in cold-headed products may lead to catastrophic fracture under tensile loads despite the ductile nature of the material causing expensive industrial recalls. Therefore, this paper presents a workability criterion that uses stress instability as an indicator to accurately reveal the locus of initiation of internal ductile failures. The concept of the instability criterion is to use the stress ratio at failure as a weighting function to indicate the initiation of ductile failure inside the ASBs. This paper presents a comprehensive experimental, metallurgical, and finite element simulation study to calculate the material constants used in this criterion.

Keywords: adiabatic shear band, workability criterion, ductile failure, stress instability

Procedia PDF Downloads 56

Authors: Azizollah Arbabisarjou, Leila Safabakhsh, Mozhgan Jahantigh, Mahshid Nazemzadeh, Shahindokht Navabi

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Background: Health promotion is an essential strategy for reduction of health disparities. Health promotion includes all activities that encourage optimum physical, spiritual, and mental function. The aim of this study was to determine the impact of a Health Promotion Program (HPP) on behavior in terms of the dimensions of the Health Promoting Lifestyle Profile (HPLP) in patients after Coronary Artery Bypass Graft (CABG). Methods and Materials: In this clinical trial study, 80 patients who had undergone CABG surgery (2011-2012) were selected and randomly divided in two groups: Experimental and Control that investigated by (HPLP II). Then the experimental group was educated about diet, walking and stress management. The program process was followed up for 3months and after that all variables were investigated again. The overall score and the scores for the six dimensions of the HPLP (self-actualization, health responsibility, exercise, nutrition, interpersonal support and stress management) were measured in the pre- and post-test periods. Statistical analysis was performed using Student's t-test and paired t-test. Results: Results showed that Score of stress management (p=.036), diet (p=.002), Spiritual Growth (p=.001) and interrelationship (p=002) increase in experimental group after intervention .Average scores after 3 months in the control group had no significant changes; except responsibility for health (p < .05). Results of the study revealed that comparison the scores of the experimental group were significantly different from the control group in all lifestyle aspects except for spiritual growth. Conclusion: This study showed that Health promoting program on lifestyle and health promotion in patients who suffer from CAD could enhance patient's awareness of healthy behaviors and improves the quality of life.

Keywords: coronary artery bypass graft, health promotion, lifestyle, education

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Authors: Mehrdad Sheikhvatan, Mohammad Ali Boroumand, Mehrdad Behmanesh, Shayan Ziaee

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Contradictory results have been obtained regarding the role of integrin, beta 3 (ITGB3) gene polymorphisms in occurrence of acute myocardial infarction (MI) in patients with coronary artery disease (CAD). Hence, we aimed to assess the association between 1565C/T polymorphism of ITGB3 gene and increased risk for acute MI in patients who suffered premature CAD in Iranian population. Our prospective study included 1000 patients (492 men and 508 women aged 21 to 55 years) referred to Tehran Heart center during a period of four years from 2008 to 2011 with the final diagnosis of premature CAD and classified into two groups with history of MI (n = 461) and without of MI (n = 539). The polymorphism variants were determined by PCR-RFLP technique by entering 10% of randomized samples and then genotyping of the polymorphism was also conducted by High Resolution Melting (HRM) method. Among study samples, 640 were followed with a median follow-up time 45.74 months for determining association of long-term major adverse cardiac events (MACE) and genotypes of polymorphisms. There was no significant difference in the frequency of 1565C/T polymorphism between the MI and non-MI groups. The frequency of wild genotype was 69.2% and 72.2%, the frequency of homozygous genotype was 21.3% and 18.4%, and the frequency of mutant genotype was 9.5% and 9.5%, respectively (p=0.505). Results were also similar when adjusted for covariates in a multivariate logistic regression model. No significant difference was also found in total-MACE free survival rate between the patients with different genotypes of 1565C/T polymorphism in both MI and non-MI group. The carriage of the 1565C/T polymorphism of ITGB3 gene seems unlikely to be a significant risk factor for the development of MI in Iranian patients with premature CAD. The presence of this ITGB3 gene polymorphism may not also predict long-term cardiac events.

Keywords: coronary artery disease, myocardial infarction, gene, integrin, beta 3, polymorphism

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Authors: Alexey Yu. Martynov, Sulejman Bayramov

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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.

Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina

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Authors: Svetlana V. Topolyanskaya, Tatyana A. Eliseeva, Olga N. Vakulenko, Leonid I. Dvoretski

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Introduction: Limited data are available on osteoporosis in centenarians. Therefore, we evaluated bone mineral density in long-living patients with coronary artery disease (CAD). Methods: 202 patients hospitalized with CAD were enrolled in this cross-sectional study. The patients' age ranged from 90 to 101 years. The majority of study participants (64.4%) were women. The main exclusion criteria were any disease or medication that can lead to secondary osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Normal lumbar spine BMD was observed in 40.9%, osteoporosis – in 26.9%, osteopenia – in 32.2% of patients. Normal proximal femur BMD values were observed in 21.3%, osteoporosis – in 39.9%, and osteopenia – in 38.8% of patients. Normal femoral neck BMD was registered only in 10.4% of patients, osteoporosis was observed in 60.4%, osteopenia in 29.2%. Significant positive correlation was found between all BMD values and body mass index of patients (p < 0.001). Positive correlation was registered between BMD values and serum uric acid (p=0.0005). The likelihood of normal BMD values with hyperuricemia increased 3.8 times, compared to patients with normal uric acid, who often have osteoporosis (Odds Ratio=3.84; p = 0.009). Positive correlation was registered between all BMD values and body mass index (p < 0.001). Positive correlation between triglycerides levels and T-score (p=0.02), but negative correlation between BMD and HDL-cholesterol (p=0.02) were revealed. Negative correlation between frailty severity and BMD values (p=0.01) was found. Positive correlation between BMD values and functional abilities of patients assessed using Barthel index (r=0,44; p=0,000002) and IADL scale (r=0,36; p=0,00008) was registered. Fractures in history were observed in 27.6% of patients. Conclusions: The study results indicate some features of BMD in long-livers. In the study group, significant relationships were found between bone mineral density on the one hand, and patients' functional abilities on the other. It is advisable to further study the state of bone tissue in long-livers involving a large sample of patients.

Keywords: osteoporosis, bone mineral density, centenarians, coronary artery disease

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Authors: Latha Subbiah, Dhanalakshmi Samiappan

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In this paper, we propose denoising Common Carotid Artery (CCA) B mode ultrasound images by a decomposition approach to curvelet thresholding and automatic segmentation of the intima media thickness and adventitia boundary. By decomposition, the local geometry of the image, its direction of gradients are well preserved. The components are combined into a single vector valued function, thus removes noise patches. Double threshold is applied to inherently remove speckle noise in the image. The denoised image is segmented by active contour without specifying seed points. Combined with level set theory, they provide sub regions with continuous boundaries. The deformable contours match to the shapes and motion of objects in the images. A curve or a surface under constraints is developed from the image with the goal that it is pulled into the necessary features of the image. Region based and boundary based information are integrated to achieve the contour. The method treats the multiplicative speckle noise in objective and subjective quality measurements and thus leads to better-segmented results. The proposed denoising method gives better performance metrics compared with other state of art denoising algorithms.

Keywords: curvelet, decomposition, levelset, ultrasound

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Authors: Sushma Tejwani, Shoruba Dinakaran, Kushal Kacha, K. Bhujang Shetty

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Introduction and aim: It is not unusual to find patients with glaucomatous damage and normal intraocular pressure, and to label a patient as Normal tension glaucoma (NTG) majority of clinicians depend on office Intraocular pressures (IOP) recordings; hence, the concern is that whether we are missing the late night or early morning spikes in this group of patients. Also, ischemia to the optic nerve is one of the presumed causes of damage in these patients, however demonstrating the same has been a challenge. The aim of this study was to evaluate IOP variations and patterns in a series of patients with open angles, glaucomatous discs or fields but normal office IOP, and in addition to identify ischemic factors for true NTG patients. Materials & Methods: This was an observational cross- sectional study from a tertiary care centre. The patients that underwent full day DVT from Jan 2012 to April 2014 were studied. All patients underwent IOP measurement on Goldmann applanation tonometry every 3 hours for 24 hours along with a recording of the blood pressure (BP). Further patients with normal IOP throughout the 24- hour period were evaluated with a cardiologist for echocardiography and carotid Doppler. Results: There were 47 patients and a maximum number of patients studied was in the age group of 50-70 years. A biphasic IOP peak was noted for almost all the patients. Out of the 47 patients, 2 were excluded from analysis as they were on treatment.20 patients (42%) were diagnosed on DVT to have an IOP spike and were then diagnosed as open angle glaucoma and another 25 (55%) were diagnosed to have normal tension glaucoma and were subsequently advised a carotid Doppler and a cardiologists consult. Another interesting finding was that 9 patients had a nocturnal dip in their BP and 3 were found to have carotid artery stenosis. Conclusion: A continuous 24-hour monitoring of the IOP and BP is a very useful albeit mildly cumbersome tool which provides a wealth of information in cases of glaucoma presenting with normal office pressures. It is of great value in differentiating between normal tension glaucoma patients & open angle glaucoma patients. It also helps in timely diagnosis & possible intervention due to referral to a cardiologist in cases of carotid artery stenosis.

Keywords: carotid artery disease in NTG, diurnal variation of IOP, ischemia in glaucoma, normal tension glaucoma

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Authors: Liu Yao, B. T. Wan Maseri, Wan Mohd, B. T. Nurul Izzah, Mohd Shah, Wei Wei

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Effectively managing knowledge has become a vital weapon for businesses to survive or to succeed in the increasingly competitive market. But do they perform environmental analysis when managing knowledge? If yes, how is the level and significance? This paper established a conceptual framework covering the basic knowledge management activities (KMA) to examine their contribution towards organizational performance (OP). Environmental analysis (EA) was then investigated from both internal and external aspects, to identify its effects on that contribution. Data was collected from 400 Chinese SMEs by questionnaires. Cronbach's α and factor analysis were conducted. Regression results show that the external analysis presents higher level than internal analysis. However, the internal analysis mediates the effects of external analysis on the KMA-OP relation and plays more significant role in the relation comparing with the external analysis. Thus, firms shall improve environmental analysis especially the internal analysis to enhance their KM practices.

Keywords: knowledge management, environmental analysis, performance, mediating, small sized enterprises, medium sized enterprises

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Authors: Mohammad Al- Rawi, Ahmad Al- Jumaily

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This paper investigates the effect of developing arterial blockage at the abdominal aorta on the blood pressure waveform at an externally accessible location suitable for invasive measurements such as the brachial and the femoral arteries. Arterial blockages are created surgically within the abdominal aorta of healthy Wistar rats to create narrowing resemblance conditions. Blood pressure waveforms are measured using a catheter inserted into the right femoral artery. Measurements are taken at the baseline healthy condition as well as at four different severities (20%, 50%, 80% and 100%) of arterial blockage. In vivo and in vitro measurements of the lumen diameter and wall thickness are taken using Magnetic Resonance Imaging (MRI) and microscopic techniques, respectively. These data are used to validate a 3D computational fluid dynamics model (CFD) which is developed to generalize the outcomes of this work and to determine the arterial stress and strain under the blockage conditions. This work indicates that an arterial blockage in excess of 20% of the lumen diameter significantly influences the pulse wave and reduces the systolic blood pressure at the right femoral artery. High wall shear stress and low circumferential strain are also generated at the blockage site.

Keywords: arterial blockage, pulse wave, atherosclerosis, CFD

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Authors: Tsung Chin Wu, Yu Chen Tsai, Rhay Hung Weng, Weir Sen Lin

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In recent years, nursing staff’s lower job satisfaction has led to higher turnover rates, and high turnover rates not only cause medical institution costs to increase but also the quality of medical care to decrease. From the perspective of internal marketing, institution staffs are internal customers, and institutions should focus and meet the needs of staff, so that staff will strive to meet the needs of external customers and provide them with the required care. However, few previous studies have investigated the impact of internal staff satisfaction on external customers. Therefore, this study aimed to conduct job satisfaction surveys on internal staff to investigate the relationship between job satisfaction and quality of medical care through statistical analysis of the study results. The related study results may serve as a reference for healthcare managers. This study was conducted using a questionnaire and the subjects were nursing staff from four hospitals. A total of 600 questionnaires were distributed and 577 valid questionnaires were returned with a response rate of 96.1%. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The impact of internal marketing and job satisfaction on turnover intention of nursing staff was analyzed using descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. The study results showed that there was a significant difference between nursing staff’s job title and ‘professional participation’ and ‘shifts’. There was a significant difference between salary and ‘shifts’ and ‘turnover intention’, as well as between marriage and ‘remuneration’ and ‘turnover intention’. A significant difference was found between professional advancement and ‘professional growth’ and ‘type of leave’, as well as between division of service and ‘shifts’ and ‘turnover intention’. Pearson correlation analysis revealed a significant negative correlation between turnover intention and ‘internal marketing’, ‘interaction’, ‘professional participation’, ‘grasp of environment’, ‘remuneration’ and ‘shifts’, meaning that the higher the satisfaction, the lower the turnover intention. It is recommended that hospitals establish a comprehensive internal marketing mechanism to enhance staff satisfaction and in turn, reduce intention to resign, and the key to increasing job satisfaction is by establishing effective methods of internal communication.

Keywords: internal marketing, job satisfaction, turnover intention, nursing staff

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Authors: Ryan M. Monti, Bijal Mehta

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In cases of massive pulmonary embolism, defined as acute pulmonary embolism presenting with systemic hypotension or right ventricular dysfunction and impending failure, there is indication that unconventional therapies, such as phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs may decrease the morbidity and mortality. Based on the premise that dilating the pulmonary artery will decrease the pulmonary vascular pressure, while simultaneously decreasing the aggregation of platelets, it can be hypothesized that increased blood flow through the pulmonary artery will decrease right heart strain and subsequent morbidity and mortality. While this theory has yet to be formally studied, the recommendations for treating massive pulmonary embolism with phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs in conjunction with the current standards of care in massive pulmonary embolism should be formally studied. In particular, patients with massive PE who are unable to undergo thrombolysis/surgical intervention may be the ideal population to study the use of these treatments to determine any decrease in mortality and morbidity (short term and long term).

Keywords: acute pulmonary thromboembolism, treatment of pulmonary embolism, use of phosphodiesterase inhibitors, endothelin receptor antagonists, prostacyclin analogs in PE

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Authors: Hua Tan, David Salamon

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In this study, γ-Al2O3 powders doped with various amounts of iron were sintered via SPS process. Two heating modes – auto and manual mode were applied to observe the role of electrical induction on heating. Temperature, electric current, and pulse pattern were experimented with grade iron γ-Al2O3 powders. Phase transformation of γ to α -Al2O3 serves as a direct indicator of internal temperature, independently on measured outside temperature. That pulsing in SPS is also able to induce internal heating due to its strong electromagnetic field when dopants are conductive metals (e.g., iron) is proofed during SPS. Density and microstructure were investigated to explain the mechanism of induction heating. In addition, the role of electric pulsing and strong electromagnetic field on internal heating (induction heating) were compared and discussed. Internal heating by iron doping within electrically nonconductive samples is able to decrease sintering temperature and save energy, furthermore it is one explanation for unique features of this material fabrication technology.

Keywords: spark plasma sintering, induction heating, alumina, microstructure

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Authors: Mohammad Java Esmaeily

Abstract:

Background: We evaluate the effects of tissue and organ perfusion during and after coronary artery bypass graft surgery with either colloid (Voluven) or crystalloid (Lactated ringers) as a prime solution. Materials and Methods: In this prospective randomized-controlled trial study, 70 patients undergoing on-pump coronary artery bypass graft surgery were randomly assigned to receive either colloid (Voluven) or crystalloid (Lactated ringer's) as a prime solution for initiation of cardiopulmonary bypass machine procedure. Tissue and organ perfusion markers, including lactate, troponin I, liver and renal function tests and electrolytes, were measured sequentially before induction (T1) to the second days after surgery (T5). Results: With the exception of chloride and potassium levels, no significant differences were detected in other measurements, and laboratory results were identical entirely in the two groups. Conclusion: Voluven® (hydroxyethyl starch, HES 130/0.4) has a not significant difference in comparison with crystalloid (Lactated ringer's) as priming solution on the basis of organ and tissue perfusion tests assessment.

Keywords: prime, colloid, crystalloid, lactate, troponin, hydroxyethyl starch

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Authors: Cheng-Chi Yu, Chi-Shiun Chiou

Abstract:

This study developed a plug-in hybrid powertrain system which consisted of two continuous variable transmissions. By matching between the engine, motor, generator, and dual continuous variable transmissions, this integrated power system can take advantages of the components. The hybrid vehicle can be driven by the internal combustion engine, or electric motor alone, or by these two power sources together when the vehicle is driven in hard acceleration or high load. The energy management of this integrated hybrid system controls the power systems based on rule-based control strategy to achieve better fuel economy. When the vehicle driving power demand is low, the internal combustion engine is operating in the low efficiency region, so the internal combustion engine is shut down, and the vehicle is driven by motor only. When the vehicle driving power demand is high, internal combustion engine would operate in the high efficiency region; then the vehicle could be driven by internal combustion engine. This strategy would operate internal combustion engine only in optimal efficiency region to improve the fuel economy. In this research, the vehicle simulation model was built in MATLAB/ Simulink environment. The analysis results showed that the power coupled efficiency of the hybrid powertrain system with dual continuous variable transmissions was better than that of the Honda hybrid system on the market.

Keywords: plug-in hybrid power system, fuel economy, performance, continuously variable transmission

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Authors: Feisal Khudher Mahmood, Abdul Samad Rahman Sultan

Abstract:

Iraq had been a diverse society with races, cultures and religions that peacefully coexistence. The phenomenon of internal displacement occurred after April 2003, because of political instability as will as the deterioration of the political and security situation as a result of United States of America occupation. Biggest internal displacement have occurred (and keep happening) since 10th of June 2014 due to rise of Islamic State of Iraq and Syria (ISIS) and it’s occupation of one third of country territories. This crisis effected directly 3,275,000 people and reflected negatively on the social fabric of Iraq community and led to waves of sectorial violence that swept the country. Internal displaced communities are vulnerable, especially under non functional and weak government, that led to lose of essential human rights and dignity. Using Geographic Information System (GIS) and Geospatial Techniques, two types of internal displacement have been found; voluntary and forced. Both types of displacement are highly influenced by location, race and religion. The main challenge for Iraqi government and NGOs will be after defeating ISIS. Helping the displaced to resettle within their community and to re-establish the coexistence. By spatial-statical analysis hot spots of future conflicts among displaced community have been highlighted. This will help the government to tackle future conflicts before they occur. Also, it will be the base for social conflict early warning system.

Keywords: internal displacement, Iraq, ISIS, human security, human rights, GIS, spatial-statical analysis

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Authors: Sanghoon Park, Ki-Jin Kim, Kwang-Ho Ahn

Abstract:

This paper discusses the undesirable charge transfer by the parasitic capacitances of the input transistors in a voltage sense amplifier. Due to its intrinsic rail-to-rail voltage transition, the input sides are inevitably disturbed. It can possible disturb the stabilities of the reference voltage levels. Moreover, it becomes serious in multi-channel systems by altering them for other channels, and so degrades the linearity of the systems. In order to alleviate the internal node voltage transition, the internal node stabilization technique is proposed by utilizing an additional biasing circuit. It achieves 47% and 43% improvements for node stabilization and input referred disturbance, respectively.

Keywords: voltage sense amplifier, voltage transition, node stabilization, biasing circuits

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Authors: Derrick Boakye Boadu, Zahra Fakhri

Abstract:

Transformational leaders are the catalyst of change and focus more importantly on members or followers. Involvement of transformational leadership style in organizational structures can provide interesting nuances to the implementation and enhancement of citizen and customer participation mechanisms in an organization regardless of the time consuming, cost, and delaying process of analyzing the feedback of workers and citizens/customers which stifles good outcome of organization’s department performance. It posits that transformational leadership has a positive direct effect on organization-departmental performance and the intervening role of citizen and customer participation and internal communication. Using the NASP-IV 2007 data, the article finds support for the five hypotheses in a structural equation model, and the findings show that transformational leadership does have a direct impact on organizational-departmental performance a partial mediation effect of the relationship through the role of internal communication and citizen and customer participation.  

Keywords: transformational leaders, departmental performance, internal communication, citizen/customer participation

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Authors: Christen Kutz

Abstract:

Objective: The aim of this study is to review a case series of 4 high-level Olympic and Division 1 wrestlers who experienced debilitating posterior circulation ischemic strokes during or after a competitive wrestling event and to identify risk factors, etiology and outcomes of stroke in young, healthy elite wrestlers. Background: Stroke occurs in one in 10,000 people under age 64. In young adults, the most common causes of stroke are cardiac embolism, hypercoagulable state, and vasculopathy. One-third of these strokes occur in young, fit individuals. There is little published literature about ischemic strokes that occur in wrestlers. Based on the nature of wrestling, the risk of injury or dissection to neurovascular structures may be a possible theory, but very few case reports exist. Methodology: 4 wrestlers under the age of 44 with a known history of ischemic stroke participated in individual interviews either in person or virtually. Each of the wrestlers provided their demographic information, wrestling background, clinical presentation at the time of stroke, imaging results, identification of potential risk factors, acute treatment and recovery. Results: 3 white male Division 1 wrestlers (2 Lehigh University, 1 Lock Haven University) and 1 black male 2008 Olympian experienced posterior circulation strokes. Case #1 felt a “pop” while wrestling (lateral medullary infarct, possible vertebral artery dissection); Case #2 awoke with severe vertigo, sweating, and vomiting after wrestling the previous day (left cerebellar infarct, (+) protein S deficiency); Case #3 severe vertigo, ataxia, and sensation of impending doom after wrestling earlier that week (left cerebellar infarct, hypoplastic left vertebral artery (+) anti-cardiolipin antibodies). Case #4 severe dizziness, confusion (left cerebellar stroke, vertebral artery dissection, small PFO). Conclusion: 3 wrestlers were started on anti-platelet therapy, risk factors were modified, and returned to their sport. 1 wrestler was placed on anti-coagulation and retired from competition.

Keywords: stroke, wrestling, Olympic, posterior circulation

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Authors: Khalid A. Alotaibi

Abstract:

To assess the students, there are different strategies adopted by teachers and all are important while taking their scope into consideration. Teachers may face some obstacles that prevent them using the assessment for learning. These obstacles can be internal or external. The present study has been collected from two regions (Riyadh and Hotat Bani Tamim) of Saudi Arabia, with sample size of 174 teachers. The results of the study have shown that the significant factors that can prevent teachers using assessment for learning are; the way of introducing the new form of assessment, lack of teachers' training, clarity of the regulations and size of students in the class. Additionally, other elements have also shown in this paper.

Keywords: teachers, assessment, assessment for learning, internal factors and external factors

Procedia PDF Downloads 422