Transient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope or presncope and good left ventricular systolic function and the left ventricular ejection fraction (LVEF ≥55%). Left bundle branch block was found in 28 (66.71%) patients, while right bundle branch block were found in,14 (33.3) of them, the result of the EPS was find the cut of HV interval for pacing which represent that that the threshold at level of 75 have a sensitivity of 91% and specificity of 80%. The greater HV intervals gave more successful results for pacing. Pacemaker was implanted in 27 (64.3%) of the patients, with significant relation between pacing and syncope disappeared after pacemaker implantation (p value 000) and in 15 (35.7%) no pacemaker was implanted with persistent symptoms. Pacing were more between patients with coronary artery disease and LBBB with abnormal EPS finding. Permanent pacemaker implantation can implant directly in those old patients with syncope and bifascicular block that associated with LBBB and coronaries artery diseases without or before EP study
This paper proposes a novel finite-time generalized proportional integral observer (FTGPIO) based a sliding mode control (SMC) scheme for the tracking control problem of high order uncertain systems subject to fast time-varying disturbances. For this purpose, the construction of the controller consists of two consecutive steps. First, the novel FTGPIO is designed to observe unmeasurable plant dynamics states and disturbance with its higher time derivatives in finite time rather than infinite time as in the standard GPIO. In the FTGPO estimator, the finite time convergence rate of estimations is well achieved, whereas the convergence rate of estimations by classical GPIO is asymptotic and slow. Secondly, on the basis of the finite and fast e
... Show MoreObjectives The strategies of tissue-engineering led to the development of living cell-based therapies to repair lost or damaged tissues, including periodontal ligament and to construct biohybrid implant. This work aimed to isolate human periodontal ligament stem cells (hPDLSCs) and implant them on fabricated polycaprolactone (PCL) for the regeneration of natural periodontal ligament (PDL) tissues. Methods hPDLSCs were harvested from extracted human premolars, cultured, and expanded to obtain PDL cells. A PDL-specific marker (periostin) was detected using an immunofluorescent assay. Electrospinning was applied to fabricate PCL at three concentrations (13%, 16%, and 20% weight/volume) in two forms, which were examined through field emission
... Show MoreThis article presents a new cascaded extended state observer (CESO)-based sliding-mode control (SMC) for an underactuated flexible joint robot (FJR). The control of the FJR has many challenges, including coupling, underactuation, nonlinearity, uncertainties and external disturbances, and the noise amplification especially in the high-order systems. The proposed control integrates the CESO and SMC, in which the CESO estimates the states and disturbances, and the SMC provides the system robustness to the uncertainty and disturbance estimation errors. First, a dynamic model of the FJR is derived and converted from an underactuated form to a canonical form via the Olfati transformation and a flatness approach, which reduces the complexity of th
... Show MoreThe present study aims to get experimentally a deeper understanding of the efficiency of carbon fiber-reinforced polymer (CFRP) sheets applied to improve the torsional behavior of L-shaped reinforced concrete spandrel beams in which their ledges were loaded in two stages under monotonic loading. An experimental program was conducted on spandrel beams considering different key parameters including the cross-sectional aspect ratio (
The flexible joint robot manipulators provide various benefits, but also present many control challenges such as nonlinearities, strong coupling, vibration, etc. This paper proposes optimal second order integral sliding mode control (OSOISMC) for a single link flexible joint manipulator to achieve robust and smooth performance. Firstly, the integral sliding mode control is designed, which consists of a linear quadratic regulator (LQR) as a nominal control, and switching control. This control guarantees the system robustness for the entire process. Then, a nonsingularterminal sliding surface is added to give a second order integral sliding mode control (SOISMC), which reduces chartering effect and gives the finite time convergence as well. S
... Show MoreMachine learning has a significant advantage for many difficulties in the oil and gas industry, especially when it comes to resolving complex challenges in reservoir characterization. Permeability is one of the most difficult petrophysical parameters to predict using conventional logging techniques. Clarifications of the work flow methodology are presented alongside comprehensive models in this study. The purpose of this study is to provide a more robust technique for predicting permeability; previous studies on the Bazirgan field have attempted to do so, but their estimates have been vague, and the methods they give are obsolete and do not make any concessions to the real or rigid in order to solve the permeability computation. To
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