Deep conv-attention model for diagnosing left bundle branch block from 12-lead electrocardiograms

Cardiac resynchronization therapy (CRT) is a treatment that is used to compensate for irregularities in the heartbeat. Studies have shown that this treatment is more effective in heart patients with left bundle branch block (LBBB) arrhythmia. Therefore, identifying this arrhythmia is an important initial step in determining whether or not to use CRT. On the other hand, traditional methods for detecting LBBB on electrocardiograms (ECG) are often associated with errors. Thus, there is a need for an accurate method to diagnose this arrhythmia from ECG data. Machine learning, as a new field of study, has helped to increase human systems' performance. Deep learning, as a newer subfield of machine learning, has more power to analyze data and increase systems accuracy. This study presents a deep learning model for the detection of LBBB arrhythmia from 12-lead ECG data. This model consists of 1D dilated convolutional layers. Attention mechanism has also been used to identify important input data features and classify inputs more accurately. The proposed model is trained and validated on a database containing 10344 12-lead ECG samples using the 10-fold cross-validation method. The final results obtained by the model on the 12-lead ECG data are as follows. Accuracy: 98.80+-0.08%, specificity: 99.33+-0.11 %, F1 score: 73.97+-1.8%, and area under the receiver operating characteristics curve (AUC): 0.875+-0.0192. These results indicate that the proposed model in this study can effectively diagnose LBBB with good efficiency and, if used in medical centers, will greatly help diagnose this arrhythmia and early treatment

Advanced Natural Gas Reciprocating Engine: Parasitic Loss Control through Surface Modification

This report presents results of our investigation on parasitic loss control through surface modification in reciprocating engine. In order to achieve the objectives several experimental and corresponding analytical models were designed and developed to corroborate our results. Four different test rigs were designed and developed to simulate the contact between the piston ring and cylinder liner (PRCL) contact. The Reciprocating Piston Test Rig (RPTR) is a novel suspended liner test apparatus which can be used to accurately measure the friction force and side load at the piston-cylinder interface. A mixed lubrication model for the complete ring-pack and piston skirt was developed to correlate with the experimental measurements. Comparisons between the experimental and analytical results showed good agreement. The results revealed that in the reciprocating engines higher friction occur near TDC and BDC of the stroke due to the extremely low piston speed resulting in boundary lubrication. A Small Engine Dynamometer Test Rig was also designed and developed to enable testing of cylinder liner under motored and fired conditions. Results of this study provide a baseline from which to measure the effect of surface modifications. The Pin on Disk Test Rig (POD) was used in a flat-on-flat configuration to study the friction effect of CNC machining circular pockets and laser micro-dimples. The results show that large and shallow circular pockets resulted in significant friction reduction. Deep circular pockets did not provide much load support. The Reciprocating Liner Test Rig (RLTR) was designed to simplifying the contact at the PRCL interface. Accurate measurement of friction was obtained using 3-axis piezoelectric force transducer. Two fiber optic sensors were used to measure the film thickness precisely. The results show that the friction force is reduced through the use of modified surfaces. The Shear Driven Test Rig (SDTR) was designed to simulate the mechanism of the piston ring pass through the liner. Micro PIV system was provided to observing the flow of lubricant in the cavity (pocket). The Vorticity-Stream Function Code was developed to simulate the incompressible fluid flow in the rectangular cavity

Comparison of cytotoxic effect of β-cyclodextrin and dextran micelles loaded with doxorubicin in KG-1 cells

زمینه و هدف: آنتراسیکلین ها درمان اصلی لوسمی حاد میلوژنز می باشند، اما استفاده از آن ها به دلیل عوارض جاننی محدود شده است. استفاده از میسل های پلیمری برای دارورسانی هدفمند دوکسوروبیسین توسط گیرنده های فولات برای لوسمی حاد میلوژنز می تواند این عوارض را کاهش دهد. این مطالعه با هدف مقایسه سمیت سلولی میسل های تهیه شده از بتاسیکلودکسترین و دکستران حاوی دوکسوروبیسین بر رده ی سلولی KG-1 انجام شده است. روش بررسی: در این مطالعه تجربی آزمایشگاهی، کونژوگه های رتینوئیک اسید/ سیکلودکسترین/ فولیک اسید و رتینوئیک اسید/ دکستران/ فولیک اسید به روش استریفیکاسیون تهیه شدند. بارگیری دارو در میسل ها به روش انحلال مستقیم انجام شد. نانوذرات میسلی بهینه سازی شده براساس اندازه ذره ای، پتانسیل زتا، اندکس پلی دیسپرسیتی، کارایی بارگیری و کارآیی رهش دوکسوروبیسین انتخاب شدند. جهت مطالعه اثر ممانعت از رشد سلولی بر رده سلولی KG-1 از روش رنگ سنجی MTT استفاده شد. یافته ها: دوکسوروبیسین بارگیری شده در نانو ذرات بهینه تهیه شده از کونژوگه ی رتینوئیک اسید/ سیکلودکسترین/ فولیک اسید در غلظت g/mlµ377/0، دارای اثر ممانعت از رشد سلولی حدود 5/10 برابر دوکسوروبیسین آزاد، 3 برابر دوکسوروبیسین بارگیری شده در میسل های رتینوئیک اسید/ سیکلودکسترین و 3/8 برابر دوکسوروبیسین بارگیری شده در میسل های رتینوئیک اسید/ دکستران/ فولیک اسید بود (05/0>P). دوکسوروبیسین بارگیری شده در نانو ذرات بهینه تهیه شده از کونژوگه رتینوئیک اسید/ دکستران/ فولیک اسید در غلظت g/mlµ377/0، دارای اثر ممانعت از رشد سلولی حدود 3/1 برابر دوکسوروبیسین آزاد و 2/1 برابر دوکسوروبیسین بارگیری شده در میسل های رتینوئیک اسید/ دکستران بود (05/0>P). نتیجه گیری: نانو ذرات تهیه شده از سیکلودکسترین حاوی دوکسوروبیسین اثربخشی بیشتری علیه سلول های سرطانی KG-1 نسبت به نانو ذرات تهیه شده از دکستران حاوی دوکسوروبیسین و داروی آزاد دارد

Retinoic Acid Decorated Albumin-Chitosan Nanoparticles for Targeted Delivery of Doxorubicin Hydrochloride in Hepatocellular Carcinoma

Retinoic acid (R) grafted chitosan (C) copolymers with different degree of substitution of retinoic acid on the chitosan were synthesized. Retinoic acid targeted chitosan-albumin nanoparticles were prepared for targeted delivery of doxorubicin in hepatocellular carcinoma by coacervation method. Physical properties of nanoparticles including particle size, zeta potential, drug loading efficiency, and drug release profiles were studied. TEM micrographs were taken to see the morphology of nanoparticles. The cytotoxicity of doxorubicin-loaded nanoparticles was studied on HepG2 cells using MTT assay and their cellular uptake by fluorescence microscopy. FTIR and 1HNMR spectra confirmed successful production of RC conjugate which was used in production of the targeted RC-albumin nanoparticles. IC50 of drug loaded in these nanoparticles reduced to half and one-third compared to nontargeted nanoparticles and free drug, respectively

Remotely Powered Wireless Strain Telemeter

This paper presents a wirelessly powered strain telemeter for mechanical health monitoring applications. The telemter is integrated with a rectenna tuned at 2.4 GHz. The rectenna is comprised by a resonant printed dipole antenna, microstrip transmission line filters and commercially available high-frequency diodes. The experimental results demonstrate that the rectenna is able to deliver 8 mW of DC power to the wireless telemeter when illuminated by a 10-W Yagi transmitter with a gain of 15 dB placed at a distance of over 2.5 m

Effect of adjuvant sleep hygiene psychoeducation and lorazepam on depression and sleep quality in patients with major depressive disorders: results from a randomized three-arm intervention

Sleep disturbances are a common co-occurring disturbance in patients with major depressive disorders (MDDs) and accordingly deserve particular attention. Using a randomized design, we investigated the effects of three different adjuvant interventions on sleep and depression among patients with MDD: a sleep hygiene program (SHP), lorazepam (LOR), and their combination (SHP-LOR).; A total of 120 outpatients with diagnosed MDD (mean age: 48.25 years; 56.7% females) and treated with a standard SSRI (citalopram at 20-40 mg at therapeutic level) were randomly assigned to one of the following three conditions: SHP (n=40), LOR (1 mg/d; n=40), SHP-LOR (1 mg/d; n=40). At the beginning and at the end of the study 8 weeks later, patients completed two questionnaires, the Pittsburgh Sleep Quality Index to assess sleep and the Beck Depression Inventory to assess symptoms of depression.; Sleep disturbances decreased over time and in all groups. No group differences or interactions were observed. Symptoms of depression decreased over time and in all three groups. Reduction in symptoms of depression was greatest in the SHP-LOR group and lowest in the LOR group.; The pattern of results suggests that all three adjuvant treatments improved symptoms of sleep disturbances and depression, with greater benefits for the SHP-LOR for symptoms of depression, but not for sleep. Nevertheless, risks and benefits of benzodiazepine prescriptions should be taken into account

Psychometric Properties of the Preschool Age Psychiatric Assessment (PAPA) in Farsi: Based on DSM-5

ObjectivesThe first onset of many psychiatric disorders usually occurs inchildhood or adolescence. The structured interview of Preschool Age Psychiatric Assessment (PAPA) was developed in response to the need for a standardized and reliable method to assess psychiatric disorders in preschool-age children. This study aimed to translate DSM-5-based PAPA into Farsi and evaluate its face and content validity and reliability.Materials & MethodsThe procedure was a forward translation of PAPA to Farsi, evaluation for face and content validity, finalization of items within the expert panel, backward translation to English, matching the original PAPA with randomly selected items from the backward translation version, and revision as needed, and finally evaluation for the validity of the changes for localization and cultural considerations. The interviews based on the final Farsi version were performed on thirty parents of children from two to five years old (chosen from Tabriz health centers) to determine the reliability and were repeated at an interval of two weeks. ResultsThe mean of CVI=0.91 and Modified Kappa=0.90 were obtained, and reliability with Cronbach’s alpha was 0.89.ConclusionThe Farsi version of the DSM-5-based PAPA diagnostic interview has good face and content validity and reliability

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions