Successful surgical intervention of total anomalous pulmonary venous drainage in the third decade of life

Total anomalous pulmonary venous drainage (TAPVD) accounts for approximately 1.5% of all congenital heart diseases. It is usually diagnosed in the neonatal period and is rarely seen in adults. We report an unusual case of a patient with TAPVD who was successfully treated at the age of 28 years. We believe that this is the oldest person in the South Asian literature to undergo surgical correction of TAPVD

Driving Cycle Analysis for Fuel Economy and Emissions in Kuala Terengganu during Peak Time

Number of vehicles grows rapidly in Kuala Terengganu by year. This increment is troubled by the performance of the vehicle regarding pollutants generated. Plug-in hybrid electric vehicles (PHEV) are widely considered to be the most promising vehicles instead of the traditional engine vehicles to reduce fuel consumption and exhaust gas emission. The objectives of this paper are to develop driving cycle of Kuala Terengganu and to analyse the fuel economy and emissions in Kuala Terengganu during peak time. Driving cycle is where PHEV is used as the main apparatus to determine the driving cycle data. In this study, the on-road measurement method is used to collect the data, along with the global positioning system. This technique involves recording speedtime dataset in the real-world driving cycle. Three main methods to identify the best driving cycle are route selection, data collection and data analysis. The data were analysed to get the best driving cycle using a computer program, which is Mathematical Laboratory (MATLAB), along with validated parameters

PROTOTYPE WEB-BASED EXPERT SYSTEM FOR OPTIMIZING THE ROAD NETWORK OF DEVELOPING COUNTRIES

Traffic road users encounter numerous problems while travelling on roads. Expected problems can range from mildly disruptive to catastrophic events. When attempting to optimize a road network and alleviate problems, it is vital to select appropriate solutions. This paper defines prototype web-based expert knowledge system improvement that can be utilized to optimize the road network of developing countries. Deciding on appropriate controlling measures is a crucial task because expected problems range from mildly disruptive to catastrophic. Experts can provide solutions to these problems only by using their previous experience. The ultimate task in optimizing road network problems is to select appropriate solutions. Although experts can regulate and resolve these problems by means of their silent knowledge and experience, novice engineers cannot, but expertise transfer from experts to novices is challenging in the traffic road area. Therefore, this body of knowledge needs to be stored in a computer system. Identifying the causes of traffic problems and applying appropriate actions and solutions to these problems could help control or prevent them. Therefore, the web-based expert system for optimizing the road network of developing countries that was developed in this study, Expert System to Control Problems in Traffic (TRSys), is a method concept. Knowledge was provided in the form of rules and coded in software through PHP programming. Web pages supporting the user interface were produced using a framework made up of HTML, CSS and J-Query. TRSys was verified and validated with extensive testing methods. Unit and integrated testing were performed during coding to correct the code and ensure that each unit performs its function and that all units work together correctly and efficientl

Cardiac fibrosis in aging mice

Dystrophic cardiac calcinosis (DCC), also called epicardial and myocardial fibrosis and mineralization, has been detected in mice of a number of laboratory inbred strains, most commonly C3H/HeJ and DBA/2J. In previous mouse breeding studies between these DCC susceptible and the DCC-resistant strain C57BL/6J, 4 genetic loci harboring genes involved in DCC inheritance were identified and subsequently termed Dyscalc loci 1 through 4. Here, we report susceptibility to cardiac fibrosis, a sub-phenotype of DCC, at 12 and 20 months of age and close to natural death in a survey of 28 inbred mouse strains. Eight strains showed cardiac fibrosis with highest frequency and severity in the moribund mice. Using genotype and phenotype information of the 28 investigated strains, we performed genome-wide association studies (GWAS) and identified the most significant associations on chromosome (Chr) 15 at 72 million base pairs (Mb) (P < 10(-13)) and Chr 4 at 122 Mb (P < 10(-11)) and 134 Mb (P < 10(-7)). At the Chr 15 locus, Col22a1 and Kcnk9 were identified. Both have been reported to be morphologically and functionally important in the heart muscle. The strongest Chr 4 associations were located approximately 6 Mb away from the Dyscalc 2 quantitative trait locus peak within the boundaries of the Extl1 gene and in close proximity to the Trim63 and Cap1 genes. In addition, a single-nucleotide polymorphism association was found on chromosome 11. This study provides evidence for more than the previously reported 4 genetic loci determining cardiac fibrosis and DCC. The study also highlights the power of GWAS in the mouse for dissecting complex genetic traits.The authors thank Jesse Hammer and Josiah Raddar for technical assistance. Research reported in this publication was supported by the Ellison Medical Foundation, Parker B. Francis Foundation, and the National Institutes of Health (R01AR055225 and K01AR064766). Mouse colonies were supported by the National Institutes of Health under Award Number AG025707 for the Jackson Aging Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Jackson Laboratory Shared Scientific Services were supported in part by a Basic Cancer Center Core Grant from the National Cancer Institute (CA34196).This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s00335-016-9634-

Sustainable Planning and Technologies

info:eu-repo/semantics/publishe

Surgical rescue of embolized amplatzer devices.

Background and Aim: Transcatheter closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) with Amplatzer septal/duct occluder (ASO/ADO) is an established, safe, and efficient procedure with high success. However, device embolization remains a major complication requiring immediate intervention (either percutaneous or surgical) for retrieval and correction of the heart defect. The aim of this study is to share the experience of managing embolized ASO/ADO. Methods: Of the 284 cases of device closure performed from October 2002 to December 2010, four Patients (1.4%) had device embolization requiring immediate surgical retrieval. Two adult female Patients with secundum ASD had ASO device implanted. One embolized to the right ventricle and the other into the ascending aorta. An eight-month-old boy and a four-year-old girl with hypertensive PDA had device closure. Device embolization occurred into the descending aorta and right pulmonary artery, respectively. Results: All four devices were retrieved and the defects closed successfully with a low morbidity and no mortality. Conclusion: Careful consideration should be given to surgical or transcatheter closure of a heart defect. Life-threatening complications although rare can occur. Our experience strongly suggests that these devices should only be inserted in facilities where cardiac surgical support is immediately available

Patients with Congenital Atrial Septal Defects: Effect of Age at Repair and Defect Size on Pulmonary Artery Pressures Prior to Repair

Background: Pulmonary arterial hypertension (PAH) is a major complication of atrial septal defect (ASD) and can be responsible for significant functional limitations and early mortality. Various factors have been shown to predispose ASD Patients to the development of PAH. Our study aimed to determine the association between the size of the ASD, the age of the Patient and the increase in pulmonary artery pressures. Methods: Data from 74 ASD Patients was retrospectively reviewed, including the Patients\u27 presenting symptoms, vital parameters, comorbidities, as well as their preoperative diagnostic workup. Echocardiography findings were used to determine the type and size of the ASD, and pulmonary artery pressures were evaluated using tricuspid regurgitation velocity as assessed by echocardiography or based on cardiac catheterization data. All Patients underwent ASD repair either surgically or via percutaneous repair. Univariate and multivariate linear regression was performed to analyze the effect of age and defect size on pulmonary artery pressures. Model adequacy check was also done for the final model. Postoperative morbidity/mortality was additionally evaluated. Results: The study sample comprised 44.6% males and 55.4% females. The most prominent presenting features were shortness of breath (70.3%), chest pain (43.2%), and palpitations (33.8%), and arterial hypertension was the commonest morbidity. Using multiple linear regression analysis, age and size of ASD were found to be independently associated with pulmonary artery pressure. We found that for every 1 mm increase in the size of the ASD, pulmonary artery systolic pressure (PASP) increased by 0.32 mmHg (

Smoke Free Policy in Engineering Vocational Department of Universitas Gadjah Mada: an Implementation Research

Tujuan: Penelitian ini bertujuan untuk mengeksplorasi program advokasi peraturan Kawasan Tanpa Asap Rokok (KTR) di Sekolah Vokasi Departemen Teknik Mesin UGM dengan melihat proses, penerimaan (acceptable) dan adopsi (adoption) terhadap program. Method: Penelitian ini menggunakan metode kualitatif dilakukan dengan teknik observasi dan wawancara terhadap informan yang meliputi stakeholder, dosen, karyawan dan mahasiswa. Results: Proses penyusunan peraturan dalam program advokasi peraturan Kawasan Tanpa Rokok dapat dikatakan berjalan cukup baik dengan melihat aspek penilaian seperti tanggapan positif dari stakeholder, dosen, karyawan dan mahasiswa selama proses sosialisasi awal dan penyusunan peraturan. Hal tersebut yang memudahkan terbentuknya peraturan KTR dan pemberlakuan peraturan setelahnya. Kemudian setelah peraturan diterapkan, terjadi Perubahan pada perilaku merokok mahasiswa yakni bahwa mahasiswa mengurangi perilaku merokok di kampus pada jam aktif meskipun beberapa masi terlihat merokok di pojok kantin tetapi di luar jam aktif kampus yaitu mulai pukul 16.00 WIB keatas. Hasil penelitian ini juga menunjukkan penerimaan dan dukungan yang positif dan terhadap keberadaan peraturan KTR. Sebagai bentuk tindak lanjut, stakeholder selaku pengelola akan memasang tanda KTR dilingkungan kampus dan inisiatif untuk menegur apabila ditemui mahasiswa yang merokok dilingkungan kampus pada jam perkuliahan. Kemudian hambatan yang mungkin muncul dalam pemberlakuan peraturan penerapan KTR yang baru adalah lekatnya budaya merokok sebagai perilaku yang sudah ada dan menjadi hal yang biasa, serta keberadaan dosen-dosen perokok yang menjadi alasan mahasiswa untuk tetap dapat merokok di kampus. Disamping itu, dengan adanya dukungan dan penerimaan positif terhadap peraturan Kawasan Tanpa Asap Rokok yang diberikan oleh stakeholder diharapkan dapat menjadi modal sosial yang penting terhadap adanya peningkatan sikap positif terhadap perilaku merokok dan keberlanjutan peraturan KTR di waktu mendatang. Conclusion: Tercapainya penerimaan (acceptable) dan adopsi (adoption) terhadap program advokasi kebijakan Kawasan Tanpa Rokok dengan diterbitkannya Peraturan Penerapan Kawasan Tanpa Rokok secara khusus di Departemen Teknik Mesin Sekolah Vokasi UGM

Cardiac disease in beta-thalassaemia major: is it reversible?

Introduction The aim of this study was to evaluate the spectrum of cardiac involvement and its outcome in beta-thalassaemia major. Methods There were 75 patients with a mean age of 13.8 (+/- 5.5) years, of whom 33 were male and 42 were female. Clinical history, examination and laboratory investigations were assessed. Electrocardiograms, chest radiographs and echocardiograms were reviewed. Results 44 patients had cardiac involvement in the form of left ventricular systolic dysfunction in 17, diastolic dysfunction in 22, pericardial effusion in 12 and pulmonary hypertension in 12 patients. With intense chelation therapy and cardiac medications, the condition of 13 of 17 patients with systolic dysfunction, and four of 22 with diastolic dysfunction, improved. Conclusion Cardiac disease is a common complication of siderotic disease in thalassaemia major and it can be prevented with regular chelation. This study has shown improved systolic function after regular chelation therapy