A novel approach for treating resistant hypertension using a controlled-pump accumulator relief device

Hypertension contributes to cardiovascular morbidity and mortality worldwide. While many hypertensive patients respond to drug therapy, a growing number of these cases are called resistant hypertension (RH), when patients cannot control their blood pressure to goal levels despite the use of multiple antihypertensive medications. While current interventional treatments for RH are based on dealing with the nervous system, there is no existing procedure that considers altering the way in which blood is pumped into the aorta such that to reduce blood pressure. We hypothesize that RH may be controlled by altering the way in which blood is pumped into the aorta. We introduce a novel idea of implementing what we called the accumulator device, which may be classified as a mechanical assist device for the cardiac system. A lumped-parameter model describing the cardiovascular system is presented and validated. The novel idea of accumulator device is also modeled and incorporated with the cardiovascular system model using analogies between the circulatory system, hydraulic systems, and electric circuits. The simulation work of the proposed accumulator device idea reveals promising preliminary results. It shows an ability to significantly decrease the systolic pressure by regulating the way in which blood is pumped into the aorta during the cardiac cycle, without reducing the cardiac output. It is our hope that this novel approach provides a transformational alternative to existing methods for treating RH, becomes a successful treatment option in the future, and improves life for millions of RH patients.Includes bibliographical reference

A study investigating the level of satisfaction with the health services provided by the Pharmacist at ENT hospital, Eastern Region Alahsah, Kingdom of Saudi Arabia

AbstractThe current study aims to evaluate the patient’s level of satisfaction with health care services provided by the pharmacist at Aljaber ENT hospital, Eastern Region Alahsah, Kingdom of Saudi Arabia. A cross sectional study was planned from 1st March 2011 until 31st May 2011. A 27 item questionnaire was used, scoring of the responses was done to classify the patient satisfaction into sublevels. The maximum possible score was 36; those scoring less than twenty were graded as poor satisfaction level followed by moderate satisfaction level 21–25, good satisfaction level 26–30 and high satisfaction level 31–36. Statistical package for social science version 13® was used to analyze data, One-way ANOVA and independent sample t-test were applied to see the differences in the level of satisfaction. Every third patient visiting pharmacy was given a chance to participate in this study. A total of N=991 patients were randomized using the pharmacy appointment number. Of whom 657 patients have shown willingness to participate in this study. The response rate of this study was 66.30%, most of the respondents 383 (58.1%) were male ranging from the age group of 21–40years with a mean age of 32years SD 9.73. The mean score for all patients was 26.15 SD ±3.4. Among all the demographic variables a significant difference in satisfaction level was found among in terms of age (df=8, F=8.36, p=<0.001∗), gender (t=−4.089, df=656, p=<0.001∗) and race (df=2, F=8.47, p=<0.001. The satisfaction level among Saudi nationals was least in comparison to Egyptians and others. In general, it is seen that respondents of age 56–60years were most satisfied with the healthcare services provided by the pharmacist. In addition, the satisfaction level was higher among female patients in comparison to men

Proportioning manufactured sand in flowable concrete

Manufactured sand has started to be used in concrete due to its availability and low cost. However, it has different shape properties, gradations, and mineralogy in comparison to the natural sand, and these differences can impact the performance of the concrete. This work quantifies the shape properties of manufactured sands and natural sands using sophisticated tests such as the AIMS II and more practical lab tests such as the Uncompacted Voids Content (ASTM C1257 -Method A). A correlation between these two measurements is presented. Next, concrete mixtures are proportioned with different amounts and gradations of manufactured sand at a variety of paste volumes, and their influence on the concrete workability is measured. Adjustments are also made to the Tarantula Curve Mixture Design tool to accommodate the different characteristics of manufactured sands in a concrete mixture for flowable concrete that must be finished. Further, this work investigates the impacts of manufactured sand on the pumping pressures. The workability and pumping pressure for three different manufactured sand sources and one natural sand are compared. Recommendations are made for the usage of manufactured sand in pumpable concrete mixtures. Also, the fine sand content and the combined uncompacted voids content of blended fine aggregates (natural sand and manufactured sand) are shown to be significant for concrete pumpability. Further, suggested changes are made to the fine sand content minimum limit on the Tarantula Curve to be 27% to keep pumping pressures manageable

Modelling and analyzing adaptive self-assembling strategies with Maude

Building adaptive systems with predictable emergent behavior is a challenging task and it is becoming a critical need. The research community has accepted the challenge by introducing approaches of various nature: from software architectures, to programming paradigms, to analysis techniques. We recently proposed a conceptual framework for adaptation centered around the role of control data. In this paper we show that it can be naturally realized in a reflective logical language like Maude by using the Reflective Russian Dolls model. Moreover, we exploit this model to specify and analyse a prominent example of adaptive system: robot swarms equipped with obstacle-avoidance self-assembly strategies. The analysis exploits the statistical model checker PVesta

Quantitative Evaluation in the Box Test and Evaluation of Field Mixtures by the Tarantula Curve

In this research project, a proposed evaluation technique of the surface voids concentrations in the Box Test was introduced. This was done by the development of a point count template that can allow critical surface voids to be identified and the evaluation to be more systematic. This method showed reliable results with low variability and can be considered as a useful tool in the Box Test surface voids assessment. Vibrators consolidate the concrete by removing unwanted air voids from its matrix. Frequency of a vibrator is one of the key parameters that impacts the vibration effort. An investigation was made to determine the effect of changing the vibrator’s frequency on the consolidation degree of concrete in terms of the amount of surface voids concentrations by the use of the Box Test. Results showed that a reduction in the frequency level could dramatically increase the surface voids concentrations at the sides of a Box Test sample. Finally, the Tarantula Curve, which is a new aggregate gradation technique that gives recommendations of aggregate gradations used in designing concrete mixtures. Hundreds of field mixtures that were made and placed and utilized in different states were compared to the suggested recommendations. Results showed that there were high agreement between the evaluated aggregate gradations and the Tarantula limits.Civil Engineerin

The Translation of God's Names in the Quran: A Descriptive Study

This thesis explores the translation of God’s names in the Quran. It centres around many of the common issues that the translators of divine attributes face. Since these are sensitive cultural items, translators should ideally give special treatment to divine designations. God’s names are not just stock names but rather they are nominalized adjectives with a descriptive content. As such divine names can enter into a variety of semantic relations such as synonymy, polysemy, hyponymy and hyperonymy (also termed ‘hypernymy’ and ‘superordinateness’). Divine names’ highly-nuanced semantic, syntactic and morphological makeup means that they require delicate treatment on the part of translators. Quran translators realize that God’s names are culture-bound terms and employ different techniques to give faithful renditions. Often they make use of an amalgamation of strategies to accurately reflect their meaning(s) and offset any loss thereof. By and large, literal translation seems to take a rather safe precedence over any other strategy, which gives a safeguard against any misrepresentation of divine attributes. Sometimes the presence of recognized or cultural equivalents is a sufficient warrant to depart from literal matches. This thesis shows how selected Quran translators exhibit varying degrees of consistency in their renditions of divine names, which may be attributable to the absence of hard-and-fast rules for the interlingual transfer of culturally laden lexemes. A convoluted issue that Quran translators face is how to tackle near-synonymous expressions. The situation is aggravated when they deal with divine names where near-synonymy exists in abundance. Quite often, the selected translators in this study have not been able to successfully replicate the more pronounced differences between near-synonymous divine names. Finding matchable polysemous items between languages is a familiar quandary that interpreters have to grapple with. Data in this study demonstrates how it is a taxing task trying to find a single item in English that bears the īe range of senses that a polysemous divine name has. Quran translators are often confronted with the task of picking up a single sense out of the multiple senses that the divine name can designate; the onus in such a pursuit is typically on the Quran exegeses. Usually, the primary (or literal) sense is the translators’ first port of call to the exclusion of any other secondary sense. It is uncommon to find a translator who is keen on conveying the semantic polyvalence of God’s appelations. In this way, Quran translators, inadvertently, do not do justice to the richness of the Quran text despite many readers’ eagerness to become illuminated about the various meanings of their Sacred Book. It is perhaps translators’ proclivity for brevity that is the overriding factor that has stopped them in their tracks. It is reasonable to assume that the brushing aside of (intended) secondary meanings of divine names by many Quran translators to chase ‘structural fidelity’ has come at the expense of more accurate glosses

Application of Universal Distribution Factors for Real-Time Complex Power Flow Calculation

Complex power flow distribution factors, which relate line complex power flows to the bus injected complex powers, have been widely used in various power system planning and analysis studies. In particular, AC distribution factors have been used extensively in the recent power and energy pricing studies in free electricity market field. As was demonstrated in the existing literature, many of the electricity market related costing studies rely on the use of the distribution factors. These known distribution factors, whether the injection shift factors (ISF's) or power transfer distribution factors (PTDF's), are linear approximations of the first order sensitivities of the active power flows with respect to various variables. This paper presents a novel model for evaluating the universal distribution factors (UDF's), which are appropriate for an extensive range of power systems analysis and free electricity market studies. These distribution factors are used for the calculations of lines complex power flows and its independent of bus power injections, they are compact matrix-form expressions with total flexibility in determining the position on the line at which line flows are measured. The proposed approach was tested on IEEE 9-Bus system. Numerical results demonstrate that the proposed approach is very accurate compared with exact method

On security analysis of periodic systems: expressiveness and complexity

Development of automated technological systems has seen the increase in interconnectivity among its components. This includes Internet of Things (IoT) and Industry 4.0 (I4.0) and the underlying communication between sensors and controllers. This paper is a step toward a formal framework for specifying such systems and analyzing underlying properties including safety and security. We introduce automata systems (AS) motivated by I4.0 applications. We identify various subclasses of AS that reflect different types of requirements on I4.0. We investigate the complexity of the problem of functional correctness of these systems as well as their vulnerability to attacks. We model the presence of various levels of threats to the system by proposing a range of intruder models, based on the number of actions intruders can use

The impact of armed conflict on cancer among civilian populations in low- and middle-income countries: a systematic review

Commitee On Publication Ethics ecancermedicalscience Submit article Articles Editorials Special issues Author interviews Category Sub-category Article type Volume Keyword Bookmark and Share Article metrics: 204 views https://doi.org/10.3332/ecancer.2020.1039 Abstract | Full Article | PDF Review The impact of armed conflict on cancer among civilian populations in low- and middle-income countries: a systematic review Mohammed Jawad1, Christopher Millett1, Richard Sullivan2, Fadel Alturki3, Bayard Roberts4 and Eszter P Vamos1 1Public Health Policy Evaluation Unit, Imperial College London, Hammersmith, London W6 8RP, UK 2Institute of Cancer Policy, Cancer Epidemiology, Population and Global Health, King's College London and Guy's & St Thomas' NHS Trust, London, UK 3Faculty of Medicine, American University of Beirut, Lebanon 4Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK Abstract Background: Armed conflicts are increasingly impacting countries with a high burden of cancer. The aim of this study is to systematically review the literature on the impact of armed conflict on cancer in low- and middle-income countries (LMICs). Methods: In November 2019, we searched five medical databases (Embase, Medline, Global Health, PsychINFO and the Web of Science) without date, language or study design restrictions. We included studies assessing the association between armed conflict and any cancer among civilian populations in LMICs. We systematically re-analysed the data from original studies and assessed quality using the Newcastle-Ottawa Scale. Data were analysed descriptively by cancer site. Results: Of 1,543 citations screened, we included 20 studies assessing 8 armed conflicts and 13 site-specific cancers (total study population: 70,172). Two-thirds of the studies were of low methodological quality (score <5) and their findings were often conflicting. However, among outcomes assessed by three or more studies, we found some evidence that armed conflict was associated with increases in the incidence and mortality of non-specific cancers, breast cancer and cervical cancer. Single studies reported a positive association between armed conflict and the incidence of stomach and testicular cancers, some as early as 3 years after the onset of conflict. Some studies reported a post-conflict impact on time to diagnosis. Conclusion: Our findings support the need for more rigorous longitudinal and cohort studies of populations in and immediately post-conflict to inform the development of basic packages of cancer services, and post-conflict cancer control planning and development

Extending the Real-Time Maude Semantics of Ptolemy to Hierarchical DE Models

This paper extends our Real-Time Maude formalization of the semantics of flat Ptolemy II discrete-event (DE) models to hierarchical models, including modal models. This is a challenging task that requires combining synchronous fixed-point computations with hierarchical structure. The synthesis of a Real-Time Maude verification model from a Ptolemy II DE model, and the formal verification of the synthesized model in Real-Time Maude, have been integrated into Ptolemy II, enabling a model-engineering process that combines the convenience of Ptolemy II DE modeling and simulation with formal verification in Real-Time Maude.Comment: In Proceedings RTRTS 2010, arXiv:1009.398