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
هناك دائما حاجة إلى طريقة فعالة لتوليد حل عددي أكثر دقة للمعادلات التكاملية ذات النواة المفردة أو المفردة الضعيفة لأن الطرق العددية لها محدودة. في هذه الدراسة ، تم حل المعادلات التكاملية ذات النواة المفردة أو المفردة الضعيفة باستخدام طريقة متعددة حدود برنولي. الهدف الرئيسي من هذه الدراسة هو ايجاد حل تقريبي لمثل هذه المشاكل في شكل متعددة الحدود في سلسلة من الخطوات المباشرة. أيضا ، تم افتراض أن مقام النواة
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In this paper, an exact stiffness matrix and fixed-end load vector for nonprismatic beams having parabolic varying depth are derived. The principle of strain energy is used in the derivation of the stiffness matrix.
The effect of both shear deformation and the coupling between axial force and the bending moment are considered in the derivation of stiffness matrix. The fixed-end load vector for elements under uniformly distributed or concentrated loads is also derived. The correctness of the derived matrices is verified by numerical examples. It is found that the coupling effect between axial force and bending moment is significant for elements having axial end restraint. It was found that the decrease in bending moment was
in the
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Among the metaheuristic algorithms, population-based algorithms are an explorative search algorithm superior to the local search algorithm in terms of exploring the search space to find globally optimal solutions. However, the primary downside of such algorithms is their low exploitative capability, which prevents the expansion of the search space neighborhood for more optimal solutions. The firefly algorithm (FA) is a population-based algorithm that has been widely used in clustering problems. However, FA is limited in terms of its premature convergence when no neighborhood search strategies are employed to improve the quality of clustering solutions in the neighborhood region and exploring the global regions in the search space. On the
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This paper addresses the use of adaptive sliding mode control for the servo actuator system with friction. The adaptive sliding mode control has several advantages over traditional sliding mode control method. Firstly, the magnitude of control effort is reduced to the minimal admissible level defined by the conditions for the sliding mode to exist. Secondly, the upper bounds of uncertainties are not required to be known in advance. Therefore, adaptive sliding mode control method can be effectively implemented. The numerical simulation via MATLAB 2014a for servo actuator system with friction is investigated to confirm the effectiveness of the proposed robust adaptive sliding mode control scheme. The results clarify, after
... Show MoreMoisture damage is one of the most significant troubles that destroy asphaltic pavement and reduces road serviceability. Recently, academics have noticed a trend to utilize fibers to enhance the efficiency of asphalt pavement. This research explores the effect of low-cost ceramic fiber, which has high tensile strength and a very high thermal insulation coefficient, on the asphalt mixture's characteristics by adding three different proportions (0.75%, 1.5%, and 2.25%). The Marshall test and the Tensile Strength Ratio Test (TSR) were utilized to describe the impact of ceramic fiber on the characteristics of Marshall and the moisture susceptibility of the hot mix asphalt mixture. The Field Emission Scanning Electron Microsc
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Alginate is one of the natural biopolymers that is widely used for drug formulations, combination of alginate with other polymers, such as gum acacia, pectin, and carrageenan can increase mechanical strength, therefore, can reduce leakage of the encapsulated active pharmaceutical ingredient from the polymer matrix. Interaction of alginate and these polymers can occur via intermolecular hydrogen bonds causing synergism, which is determined from the viscosity of polymer mixture.
Alginate was combined with gum acacia/pectin/carrageenan in different blending ratios (100:0, 75:25, 50:50, 25:75, and 0:100) with and without addition of CaCl2. The synergism effect is obtained from the design of experimental (DoE), and calculati
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Background: Prolactin is a hormone, as well as a cytokine which is synthesized and secreted from the anterior pituitary gland and various extra pituitary sites including immune cells under control of a superdistal promoter that contains a single nucleotide polymorphism -1149 G/T. Rheumatoid Arthritis has been associated with increased serum prolactin levels.Objectives: To investigate the association of the extra pituitary -1149 G/T promoter polymorphism among Iraqi rheumatoid arthritis patients and prolactin levels.Methods: We tested 73 patients with rheumatoid arthritis and 40 healthy individuals. The DNA samples were genotyped using the Polymerase Chain Reaction-Restriction fragment Length Polymorphism method and the levels of prolacti
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