Search results for: left bundle branch block

Authors: K. Padmavathi, K. Sri Ramakrishna

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This study describes a procedure for the detection of Left and Right Bundle Branch Block (LBBB and RBBB) ECG patterns using spectral Coherence(SC) technique and LM Neural Network. The Coherence function finds common frequencies between two signals and evaluate the similarity of the two signals. The QT variations of Bundle Blocks are observed in lead V1 of ECG. Spectral Coherence technique uses Welch method for calculating PSD. For the detection of normal and Bundle block beats, SC output values are given as the input features for the LMNN classifier. Overall accuracy of LMNN classifier is 99.5 percent. The data was collected from MIT-BIH Arrhythmia database.

Keywords: bundle block, SC, LMNN classifier, welch method, PSD, MIT-BIH, arrhythmia database

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Authors: Jyotismita Talukdar

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In this paper, a study has been made on the possibility and accuracy of early prediction of several Heart Disease using Artificial Neural Network. (ANN). The study has been made in both noise free environment and noisy environment. The data collected for this analysis are from five Hospitals. Around 1500 heart patient’s data has been collected and studied. The data is analysed and the results have been compared with the Doctor’s diagnosis. It is found that, in noise free environment, the accuracy varies from 74% to 92%and in noisy environment (2dB), the results of accuracy varies from 62% to 82%. In the present study, four basic attributes considered are Blood Pressure (BP), Fasting Blood Sugar (FBS), Thalach (THAL) and Cholesterol (CHOL.). It has been found that highest accuracy(93%), has been achieved in case of PPI( Post-Permanent-Pacemaker Implementation ), around 79% in case of CAD(Coronary Artery disease), 87% in DCM (Dilated Cardiomyopathy), 89% in case of RHD&MS(Rheumatic heart disease with Mitral Stenosis), 75 % in case of RBBB +LAFB (Right Bundle Branch Block + Left Anterior Fascicular Block), 72% for CHB(Complete Heart Block) etc. The lowest accuracy has been obtained in case of ICMP (Ischemic Cardiomyopathy), about 38% and AF( Atrial Fibrillation), about 60 to 62%.

Keywords: coronary heart disease, chronic stable angina, sick sinus syndrome, cardiovascular disease, cholesterol, Thalach

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Authors: Vadim A. Kuznetsov, Anna M. Soldatova, Tatyana N. Enina, Elena A. Gorbatenko, Dmitrii V. Krinochkin

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The aim of the study was to evaluate potential parameters related with super-response to CRT. Methods: 60 CRT patients (mean age 54.3 ± 9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class, left ventricular ejection fraction < 35% were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7 ± 15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥ 30%) and non-SR (n=32; reduction in LVESV < 30%). Results: At baseline groups differed in age (58.1 ± 5.8 years in SR vs 50.8 ± 11.4 years in non-SR; p=0.003), gender (female gender 32.1% vs 9.4% respectively; p=0.028), width of QRS complex (157.6 ± 40.6 ms in SR vs 137.6 ± 33.9 ms in non-SR; p=0.044). Percentage of LBBB was equal between groups (75% in SR vs 59.4% in non-SR; p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only difference in left ventricular pre-ejection period (LVPEP) was statistically significant (153.0 ± 35.9 ms vs. 129.3 ± 28.7 ms p=0.032). NT-proBNP level was lower in SR (1581 ± 1369 pg/ml vs 3024 ± 2431 pg/ml; p=0.006). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002). Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P = 0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI 1.009-1.168; P=0.30) were independent predictors for CRT super-response. ROC curve analysis demonstrated sensitivity 71.9% and specificity 82.1% (AUC=0.827; p < 0.001) of this model in prediction of super-response to CRT. Conclusion: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level, and age at baseline can be used as independent predictors of CRT super-response.

Keywords: cardiac resynchronisation therapy, superresponse, congestive heart failure, left bundle branch block

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Authors: Vaclav Sadilek, Miroslav Vorechovsky

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The paper deals with the classical fiber bundle model of equal load sharing, sometimes referred to as the Daniels' bundle or the democratic bundle. Daniels formulated a multidimensional integral and also a recursive formula for evaluation of the strength cumulative distribution function. This paper describes three algorithms for evaluation of the recursive formula and also their implementations with source codes in high-level programming language Python. A comparison of the algorithms are provided with respect to execution time. Analysis of orders of magnitudes of addends in the recursion is also provided.

Keywords: equal load sharing, mpmath, python, strength of Daniels' bundle

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Authors: Huirui Han, Chao Zhang

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The rod bundle is used in the fuel assembly of the supercritical water-cooled nuclear reactor. In the rod bundle, the coolant absorbs the heat contributed by the fission process. Because of the dramatic variations in the thermophysical properties of water at supercritical conditions, it is essential to investigate the heat transfer characteristics of supercritical water in the rod bundle to ensure the safety of the nuclear power plant. In this study, the effects of the flow direction, including horizontal, upward, and downward, on the fluid flow and heat transfer of the supercritical water in the rod bundle were studied numerically. The results show the possibility of gap vortices in the flow subchannels of the rod bundle. In addition, the distributions of the circumferential wall temperature show differences in different flow direction conditions. It was also found that the circumferential cladding surface temperature distribution in the upward flow condition is extremely non-uniform, and there is a large difference between the maximum wall temperatures for different fuel rods.

Keywords: heat transfer, rod bundle, supercritical water, wall temperature

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Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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Authors: P. G. Romeo

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A Lie group is a highly sophisticated structure which is a smooth manifold whose underlying set of elements is equipped with the structure of a group such that the group multiplication and inverse-assigning functions are smooth. This structure was introduced by the Norwegian mathematician So- phus Lie who founded the theory of continuous groups. The Lie groups are well developed and have wide applications in areas including Mathematical Physics. There are several advances and generalizations for Lie groups and Lie groupoids is one such which is termed as a "many-object generalization" of Lie groups. A groupoid is a category whose morphisms are all invertible, obviously, every group is a groupoid but not conversely. Definition 1. A Lie groupoid G ⇒ M is a groupoid G on a base M together with smooth structures on G and M such that the maps α, β: G → M are surjective submertions, the object inclusion map x '→ 1x, M → G is smooth, and the partial multiplication G ∗ G → G is smooth. A bundle is a triple (E, p, B) where E, B are topological spaces p: E → B is a map. Space B is called the base space and space E is called total space and map p is the projection of the bundle. For each b ∈ B, the space p−1(b) is called the fibre of the bundle over b ∈ B. Intuitively a bundle is regarded as a union of fibres p−1(b) for b ∈ B parametrized by B and ’glued together’ by the topology of the space E. A cross-section of a bundle (E, p, B) is a map s: B → E such that ps = 1B. Example 1. Given any space B, a product bundle over B with fibre F is (B × F, p, B) where p is the projection on the first factor. Definition 2. A principal bundle P (M, G, π) consists of a manifold P, a Lie group G, and a free right action of G on P denoted (u, g) '→ ug, such that the orbits of the action coincide with the fibres of the surjective submersion π : P → M, and such that M is covered by the domains of local sections σ: U → P, U ⊆ M, of π. Definition 3. A Lie group bundle, or LGB, is a smooth fibre bundle (K, q, M ) in which each fibre (Km = q−1(m), and the fibre type G, has a Lie group structure, and for which there is an atlas {ψi: Ui × G → KUi } such that each {ψi,m : G → Km}, is an isomorphism of Lie groups. A morphism of LGB from (K, q, M ) to (K′, q′, M′) is a morphism (F, f ) of fibre bundles such that each Fm: Km → K′ is a morphism of Lie groups. In this paper, we will be discussing the Lie groupoid bundles. Here it is seen that to a Lie groupoid Ω on base B there is associated a collection of principal bundles Ωx(B, Ωx), all of which are mutually isomorphic and conversely, associated to any principal bundle P (B, G, p) there is a groupoid called the Ehresmann groupoid which is easily seen to be Lie. Further, some interesting properties of the category of Lie groupoids and bundles will be explored.

Keywords: groupoid, lie group, lie groupoid, bundle

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Authors: C. Román, M. Guevara, P. Salas, D. Duclap, J. Houenou, C. Poupon, J. F. Mangin, P. Guevara

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Diffusion Magnetic Resonance Imaging (dMRI) allows the non-invasive study of human brain white matter. From diffusion data, it is possible to reconstruct fiber trajectories using tractography algorithms. Our previous work consists in an automatic method for the identification of short association bundles of the superficial white matter (SWM), based on a whole brain inter-subject hierarchical clustering applied to a HARDI database. The method finds representative clusters of similar fibers, belonging to a group of subjects, according to a distance measure between fibers, using a non-linear registration (DTI-TK). The algorithm performs an automatic labeling based on the anatomy, defined by a cortex mesh parcelated with FreeSurfer software. The clustering was applied to two independent groups of 37 subjects. The clusters resulting from both groups were compared using a restrictive threshold of mean distance between each pair of bundles from different groups, in order to keep reproducible connections. In the left hemisphere, 48 reproducible bundles were found, while 43 bundles where found in the right hemisphere. An inter-hemispheric bundle correspondence was then applied. The symmetric horizontal reflection of the right bundles was calculated, in order to obtain the position of them in the left hemisphere. Next, the intersection between similar bundles was calculated. The pairs of bundles with a fiber intersection percentage higher than 50% were considered similar. The similar bundles between both hemispheres were fused and symmetrized. We obtained 30 common bundles between hemispheres. An atlas was created with the resulting bundles and used to segment 78 new subjects from another HARDI database, using a distance threshold between 6-8 mm according to the bundle length. Finally, a laterality index was calculated based on the bundle volume. Seven bundles of the atlas presented right laterality (IP_SP_1i, LO_LO_1i, Op_Tr_0i, PoC_PoC_0i, PoC_PreC_2i, PreC_SM_0i, y RoMF_RoMF_0i) and one presented left laterality (IP_SP_2i), there is no tendency of lateralization according to the brain region. Many factors can affect the results, like tractography artifacts, subject registration, and bundle segmentation. Further studies are necessary in order to establish the influence of these factors and evaluate SWM laterality.

Keywords: dMRI, hierarchical clustering, lateralization index, tractography

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Authors: Seyeh Hassan Eftekhar Afzali, Hamid Mohammadi

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Pistachio is like almond but the second cycle of growth (third phase) has rather fast growth. This is caused to add final mass of product. When the germ grows, it and its cover are reached to the final size during six week period. As starting the second phase, the lignifications of pericarp is begun and continued for 4 or 6 weeks. Physiological maturity or easy separation of green from scutum is specified. This test was done according to random blocks of 6 orchards in the type of Ahmad Aghaie with 4 iterations. Vegetative properties of branch are investigated. The results of the bunch numbers on the growth of branch in current year are shown that the most growth of branch is happened by trimming of one and two bunches of the branch and the most diameter of the branch is happened by trimming of one to four bunches of branch. Trimming of a bunch is caused the most number of pistachio products in the bunch.

Keywords: pistachio, cluster, bud, fruit, branch

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Authors: Asaad Alhabsi, Alyaqdan Algafri

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Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.

Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty

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Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

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Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

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Authors: Kerkouri Abdelkadir

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Numerical calculations of turbulent flows are one of the most prominent modern interests in various engineering applications. Due to the difficulty of predicting, following up and studying this flow for computational fluid dynamic (CFD), in this paper, we simulated numerical study of a flow past in a staggered tube bundle, using CFD Code ANSYS FLUENT with several models of turbulence following: k-ε, k-ω and SST approaches. The flow is modeled based on the experimental studies. The predictions of mean velocities are in very good agreement with detailed LDA (Laser Doppler Anemometry) measurements performed in 8 stations along the depth of the array. The sizes of the recirculation zones behind the cylinders are also predicted. The simulations are conducted for Reynolds numbers of 12858. The Reynolds number is set to depend experimental results.

Keywords: flow, tube bundle, ANSYS Fluent, CFD, turbulence, LDA, RANS (k-ε, k-ω, SST)

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Authors: Gagnesh Kumar, Prashant Gupta

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This paper investigates the performance of the bundle of single wall carbon nanotubes (SWCNT) for low-power and high-speed interconnects for future VLSI applications. The power dissipation, delay and power delay product (PDP) of SWCNT bundle interconnects are examined and compared with that of the Cu interconnects at 22 nm technology node for both intermediate and global interconnects. The results show that SWCNT bundle consume less power and also faster than Cu for intermediate and global interconnects. It is concluded that the metallic SWCNT has been regarded as a viable candidate for intermediate and global interconnects in future technologies.

Keywords: carbon nanotube, SWCNT, low power, delay, power delay product, global and intermediate interconnects

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Authors: Yuying Zhu

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Left-behind children in rural areas are vulnerable groups with the course of our country’s urbanization. Left-behind young children in rural area separate from their parents in their early childhood, vicegerent guardian’s care are less sensitive and careful than children’s parents; they give less concern to children’s verbal development, this makes the verbal problem of the left-behind children to be ubiquitous problem. This study chooses four kindergartens from the east the middle and the west of the Henan Province, explore the verbal development differences between the left-behind young children and the non-left-behind young rural children through the McCarthy Scales of Children's Abilities (MSCA) and self-made questionnaires. The study shows that there is no significant difference between the left-behind young children and the non-left-behind young rural children in the verbal development, though the marks in primary class and middle class the non-left-behind young rural children is higher, but, the top class in the kindergarten is not. What’s more, the emergent reading and the economy have significant influence on young children’s verbal ability.

Keywords: left-behind children, non-left-behind children, regional difference, verbal development

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Authors: S. K. Verma, S. L. Sinha, D. K. Chandraker

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The Advanced Heavy Water Reactor (AHWR) is a vertical pressure tube type, heavy water moderated and boiling light water cooled natural circulation based reactor. The fuel bundle of AHWR contains 54 fuel rods arranged in three concentric rings of 12, 18 and 24 fuel rods. This fuel bundle is divided into a number of imaginary interacting flow passage called subchannels. Single phase flow condition exists in reactor rod bundle during startup condition and up to certain length of rod bundle when it is operating at full power. Prediction of the thermal margin of the reactor during startup condition has necessitated the determination of the turbulent mixing rate of coolant amongst these subchannels. Thus, it is vital to evaluate turbulent mixing between subchannels of AHWR rod bundle. With the remarkable progress in the computer processing power, the computational fluid dynamics (CFD) methodology can be useful for investigating the thermal–hydraulic characteristics phenomena in the nuclear fuel assembly. The present report covers the results of simulation of pressure drop, velocity variation and turbulence intensity on single rod bundle with 54 rods in circular arrays. In this investigation, 54-rod assemblies are simulated with ANSYS Fluent 15 using steady simulations with an ANSYS Workbench meshing. The simulations have been carried out with water for Reynolds number 9861.83. The rod bundle has a mean flow area of 4853.0584 mm2 in the bare region with the hydraulic diameter of 8.105 mm. In present investigation, a benchmark k-ε model has been used as a turbulence model and the symmetry condition is set as boundary conditions. Simulation are carried out to determine the turbulent mixing rate in the simulated subchannels of the reactor. The size of rod and the pitch in the test has been same as that of actual rod bundle in the prototype. Water has been used as the working fluid and the turbulent mixing tests have been carried out at atmospheric condition without heat addition. The mean velocity in the subchannel has been varied from 0-1.2 m/s. The flow conditions are found to be closer to the actual reactor condition.

Keywords: AHWR, CFD, single-phase turbulent mixing rate, thermal–hydraulic

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Authors: Sayed Ahmed El Sayed, Osama M. Mesalhy, Mohamed A. Abdelatief

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A numerical study has been conducted to clarify fluid flow characteristics, pressure distributions, and skin friction coefficient over a wing-shaped tubes bundle in staggered arrangement with the placement of longitudinal fins (LF) at downstream position of the tube. The air-side Rea were at 1.8 x 103 to 9.7 x 103. The tubes bundle were employed with various fin height [hf] and fin thickness (δ) from (2 mm ≤ hf ≤ 12 mm) and (1.5 mm ≤ δ ≤ 3.5 mm) respectively at the considered Rea range. The flow pattern around the staggered wing-shaped tubes bundle was predicted using the commercial CFD FLUENT 6.3.26 software package. The distribution of average skin friction coefficient around wing-shaped tubes bundle is studied. Correlation of pressure drop coefficient Pdc and skin friction coefficient (Cf) in terms of Rea, design parameters for the studied cases were presented. Results indicated that the values of Pdc for hf = 6 mm are lower than these of NOF and hf = 2 mm by about 11 % and 13 % respectively for considered Rea range. Cf decreases as Rea increases. LFTH with hf = 6 mm offers lower form drag than that with hf = 12 mm and that of NOF. The lowest values of the pumping power are achieved for arrangements of hf = 6 mm for the considered Rea range. δ has negligible effect on skin friction coefficient, while has a slightly variation in ∆Pa. The wing-shaped tubes bundle heat exchanger with hf = 6 mm has the lowest values of ∆Pa, Pdc, Cf, and pumping power and hence the best performance comparing with the other bundles. Comparisons between the experimental and numerical results of the present study and those obtained by similar previous studies showed good agreements.

Keywords: longitudinal fins, skin friction, flow characteristics, FLUENT, wing-shaped tubes

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Authors: Jiawei Liang

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Against the backdrop of China's burgeoning migration from rural to urban areas, a demographic group has emerged in China, which is called left-behind children. Due to many reasons, including the issue of the rural-urban education gap, the education of left-behind children has been below the national education average. In this situation, the issue has attracted the attention of researchers and policymakers. In order to gain a comprehensive understanding of this issue, this paper adopts an analytical approach to studying the rural-urban education gap and left-behind children in rural China. The paper first introduces the current situation of migration, the education gap, and left-behind children within China. Then, it further explores the causes of these two questions and barriers as well as the consequences for left-behind children. Finally, the study offers some suggestions to alleviate the urban-rural gap and the current situation of education for left-behind children in rural areas, which will hopefully shed light on the issue of left-behind children in China and the urban-rural education gap.

Keywords: left-behind children, rural China, education improvement, Hukou policy, rural-urban education gap

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Authors: Deepa, Yashbir Singh, Shi Yi Wu, Michael Friebe, Joao Manuel R. S. Tavares, Hu Wei-Chih

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Cardiovascular disease can be detected by measuring the regional and global wall motion of the left ventricle (LV) of the heart; In this study, we designed a dynamic simulation tool using Computed Tomography (CT) images to assess the difference between actual and simulated left ventricular functions. Thirteen healthy subjects were involved in the study with actual and simulated left ventricular functions. In this research, we found the high correlation between actual left ventricular wall motion and simulated left ventricular wall motion. Our results confirm that our simulation tool is feasible for simulating left ventricular motion.

Keywords: cardiac imaging, left-ventricular remodeling, cardiac wall motion, myocardial functions

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Authors: Megan Weisbart

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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

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Authors: M. S. M. El-Bady

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Water quality and heavy metals pollution of the Damietta Nile Branch at Damietta governorate were investigated in the current work. Fourteen different sampling points were selected along the Damietta Nile branch from Ras EL-Bar (sample 1) to Sheremsah (sample 14). Physical and chemical parameters and the concentrations of Cd, Cr, Cu, Ni, Fe, Al, Hg, Pb and Zn were investigated for water quality assessment of Damietta Nile Branch at Damietta Governorate. Most of the samples show that the water is suitable for drinking and irrigation purposes. All locations of samples near the sea are unsuitable water but the samples in the south direction away from the sea are suitable or good water for drinking and irrigation.

Keywords: water quality indices, Damietta Governorate, Nile river, pollution

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Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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Authors: Yuri Seu, Seong-Kyu Choi, Hyun Jin Park, Jin Seo Park, HongtaeKim, Mi-Sun Hur

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The aim of this study was to clarify the attachments of the distal oblique membrane (DOM) and distal oblique bundle (DOB) of the interosseous membrane of the forearm. The distal oblique membrane was investigated in the 21 specimens of 11 Korean cadavers. The muscles in the forearms were removed to observe the DOB. The DOB was found in 13 of 21 specimens (61.9 %). The DOB was attached to the distal radioulnar joint capsule and the septum between the tendons of the extensor digiti minimi (EDM) and extensor carpi ulnaris (ECU) as well as the radius and ulna. In the cases that the DOB was absent, a part of the DOM extended to the distal radioulnar joint capsule and the septum between the tendons of the EDM and ECU, as well as the radius and ulna in all specimens (100%). The DOM, including the DOB, was arranged obliquely in the anteroposterior direction, whereas the intermediate part of the interosseous membrane was arranged in the same plane between the radius and ulna. The extension of the DOM and DOB to the wrist region may stabilize the distal radioulnar joint during supination and pronation. These data will be useful when performing reconstructive surgeries.

Keywords: distal oblique membrane, distal oblique bundle, distal radioulnar joint capsule, interosseous membrane

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Authors: Maciej Major, Izabela Major

Abstract:

The aim of this paper is a numerical analysis of three-layered block design to walls construction subjected to the dynamic load. The block consists of the layers: concrete with rubber pads in shape of crosses, space filled with air and concrete with I-shape rubber pads. The main purpose of rubber inserts embedded during the production process is additional protection against the transversal dynamic load. For the analysis, as rubber, the Zahorski hyperelastic incompressible material model was assumed. A concentrated force as dynamic load applied to the external block surface was investigated. The results for the considered block observed as the stress distribution plot were compared to the results obtained for the solid concrete block. In order to estimate the percentage damping of proposed composite, rubber-concrete block in relation to the solid block the numerical analysis with the use of finite element method based on ADINA software was performed.

Keywords: dynamics, composite, rubber, Zahorski

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Authors: F. B. Masok, S. S Songdeg, R. R. Dawam

Abstract:

Vision is an important process for learning and communication as man depends greatly on vision to sense his environment. Prevalence and variation of refractive errors conducted between December 2010 and May 2011 in Jos, revealed that 735 (77.50%) out 950 subjects examined for refractive error had various refractive errors. Myopia was observed in 373 (49.79%) of the subjects, the error in the right eyes was 263 (55.60%) while the error in the left was 210(44.39%). The mean myopic error was found to be -1.54± 3.32. Hyperopia was observed in 385 (40.53%) of the sampled population comprising 203(52.73%) of the right eyes and 182(47.27%). The mean hyperopic error was found to be +1.74± 3.13. Astigmatism accounted for 359 (38.84%) of the subjects, out of which 193(53.76%) were in the right eyes while 168(46.79%) were in the left eyes. Presbyopia was found in 404(42.53%) of the subjects, of this figure, 164(40.59%) were in the right eyes while 240(59.41%) were in left eyes. The number of right eyes and left eyes with refractive errors was observed in some age groups to increase with age and later had its peak within 60 – 69 age groups. This pattern of refractive errors could be attributed to exposure to various forms of light particularly the ultraviolet rays (e.g rays from television and computer screen). There was no remarkable differences between the mean Myopic error and mean Hyperopic error in the right eyes and in the left eyes which suggest the right eye and the left eye are similar.

Keywords: left eye, refractive errors, right eye, variation

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Authors: Hae-Yeoun Lee

Abstract:

Mosaic refers to a technique that makes image by gathering lots of small materials in various colours. This paper presents an automatic algorithm that makes the photomosaic image using photos. The algorithm is composed of four steps: Partition and feature extraction, block matching, redundancy removal and colour adjustment. The input image is partitioned in the small block to extract feature. Each block is matched to find similar photo in database by comparing similarity with Euclidean difference between blocks. The intensity of the block is adjusted to enhance the similarity of image by replacing the value of light and darkness with that of relevant block. Further, the quality of image is improved by minimizing the redundancy of tiles in the adjacent blocks. Experimental results support that the proposed algorithm is excellent in quantitative analysis and qualitative analysis.

Keywords: photomosaic, Euclidean distance, block matching, intensity adjustment

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Authors: Young-Hun Ko, Seung-Jun Kim, Khaqan Baluch, Hyung- Sik Yang

Abstract:

In this study, the polymer gel was used as coupling material in a blasting hole and its comparison was made with other coupling materials like sand, water, and air. Trazul lead block test and AUTODYN numerical analysis were conducted to analyze the effects of the coupling materials on the intensity of the explosion, as well as the verification tests were conducted by using concrete block test. The emulsion explosives were used in decoupling conditions, sand, water, and polymer gel were used as the coupling materials. The lead block test and the numerical analysis showed that the expansion of the blast hole in the lead block was similar to that of the water and gelatin and followed by sand and air conditions. The validation of concrete block test result showed the similar result as Trazul lead block test and the explosion strength was measured at 0.8 for polymer gel, 0.7 for sand, and 0.6 for no coupling material, in comparison to the full charge (1.0) case.

Keywords: Trazul lead block test, AUTODYN numerical analysis, coupling material, polymer gel, soil covering concrete block explosion test

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Authors: Khairil I. Othman, Mahfuzah Mahayaddin, Zarina Bibi Ibrahim

Abstract:

We develop and demonstrate a computationally efficient numerical technique to solve first order stiff differential equations. This technique is based on block method whereby three approximate points are calculated. The Cholistani of varied step sizes are presented in divided difference form. Stability regions of the formulae are briefly discussed in this paper. Numerical results show that this block method perform very well compared to existing methods.

Keywords: block method, divided difference, stiff, computational

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Authors: Khairil Iskandar Othman, Nadhirah Kamal, Zarina Bibi Ibrahim

Abstract:

Block methods for solving stiff systems of ordinary differential equations (ODEs) are based on backward differential formulas (BDF) with PE(CE)2 and Newton method. In this paper, we introduce Modified Newton as a new strategy to get more efficient result. The derivation of BBDF using modified block Newton method is presented. This new block method with predictor-corrector gives more accurate result when compared to the existing BBDF.

Keywords: modified Newton, stiff, BBDF, Jacobian matrix

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Authors: Paul M. H. J. Roekaerts

Abstract:

In recent years, it became clear that much intensive care (ICU) survivors develop a post-intensive care syndrome (PICS) consisting of psychiatric, cognitive and physical problems for a prolonged period after their ICU stay. Physical inactivity and delirium during the ICU stay are the main determinants of the post-ICU PICS. This presentation will focus on delirium, its epidemiology, prevalence, effect on outcome, risk factors and the current standard of care for managing delirium. Because ICU delirium is a predictor of prolonged length-of-stay in the ICU and of death, the use of a delirium prevention bundle (DPB) becomes mandatory in every ICU. In this presentation, a DPB bundle will be discussed consisting of six components: pain, sedation, sleep, sensory and intellectual stimulation, early mobilization, and hydration. For every of the six components, what to do and what not to do will be discussed. The author will present his own institutional policy on pharmacological and non-pharmacological interventions in the management of delirium. The component ‘early mobilization’ will be discussed more in detail, as this component is extremely important in the prevention of delirium as well as in the prevention of the PICS. The author will conclude his presentation with the remaining areas of uncertainties/work and research to be done.

Keywords: delirium, delirium prevention bundle, early mobilisation in intensive care (ICU), post-intensive care syndrome (PICS)

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Authors: A. M. Sagir

Abstract:

The aim of this paper is to investigate the performance of the developed linear multistep block method for solving first order initial value problem of Ordinary Differential Equations (ODEs). The method calculates the numerical solution at three points simultaneously and produces three new equally spaced solution values within a block. The continuous formulations enable us to differentiate and evaluate at some selected points to obtain three discrete schemes, which were used in block form for parallel or sequential solutions of the problems. A stability analysis and efficiency of the block method are tested on ordinary differential equations involving practical applications, and the results obtained compared favorably with the exact solution. Furthermore, comparison of error analysis has been developed with the help of computer software.

Keywords: block method, first order ordinary differential equations, linear multistep, self-starting

Procedia PDF Downloads 272