Effect of exercise training on the quality of life and echocardiography parameter of systolic function in patients with chronic heart failure: a randomized trial.

BACKGROUND Ejection fraction promotion in heart failure patients reduces mortalities and limitations. OBJECTIVES This study was to investigate the effect of exercise on ejection fraction of chronic heart failure patients. PATIENTS AND METHODS The present study was conducted on patients with chronic heart failure. 66 patients were divided randomly into two experimental and control groups of 33 each. The subjects were male and female. The patients in experimental group followed an exercise program three sessions per week for 24 weeks. Echocardiography and quality of life questionnaire were used to gather data. The data were analyzed by SPSS 18 through pair and independent t-test. RESULTS The results indicated a significant difference in left ventricular diameter (LV-ESD, LV-EDD) and ejection fraction at the end of exercise program in experimental group and 24 weeks after in control group. There was a significant difference in quality of life in physical performance, activity limitation following physical problems, energy and fatigue, social performance, physical pain, and public health (P < 0.05 for all) between two groups. CONCLUSIONS Exercise program increases ejection fraction and quality of life in chronic heart failure patients, associated with management of disease by health team

The effects of problem-based learning and lecturing on the development of Iranian nursing students’ critical thinking

Objective: The present study aimed to consider the effects of problem-based learning (PBL) and lecturing approaches on the development of students’ critical thinking. Methodology: A total of 40 second-year nursing students participated: 20 students in the PBL group and 20 students in the traditional lecture (control) group. The students underwent a one-semester course using the two methods of education. The California Critical Thinking Disposition Inventory (CCTDI) was used to measure the students’ critical thinking. Results: Compared with lecture students, PBL students showed significantly greater improvement in overall CCTDI. In terms of critical thinking, a significant relationship was found among the PBL and lecture groups. Conclusion: The present study suggests a significant difference between PBL and traditional lecture groups so that a positive learning attitude was observed in the PBL group and learning motivation is higher in the PBL than in the traditional-based method of learning

Seawater Desalination: A Review of Forward Osmosis Technique, Its Challenges, and Future Prospects

Currently over 845 million people are believed to be living under severe water scarcity, and an estimated 2.8 billion people across the globe are projected to come under serious water scarcity by the year 2025, according to a United Nations (UN) report. Seawater desalination has gained more traction as the solution with the most potential for increasing global freshwater supplies amongst other solutions. However, the economic and energy costs associated with the major desalination technologies are considered intrinsically prohibitive largely due to their humongous energy requirements alongside the requirements of complex equipment and their maintenance in most cases. Whilst forward osmosis (FO) is being touted as a potentially more energy efficient and cost-effective alternative desalination technique, its efficiency is challenged by draw solutes and the draw solutes recovery step in FO applications alongside other challenges. This paper looks at the present situation of global water scarcity, and a brief leap into the major desalination technologies employed. A closer look at the key drivers of FO as a seawater desalination technique in their individual domain and its outlook as an technology are further highlighted

Appropriateness of referrals for single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in a developing community: A comparison between 2005 and 2009 versions of ACCF/ASNC appropriateness criteria

Appropriateness of referrals for myocardial perfusion imaging (MPI) in developing countries has not been extensively studied. Our study was conducted to describe the ordering practices of physicians and appropriateness of MPI referrals in Iran. We prospectively applied 2005 and 2009 versions of the Appropriateness Use Criteria published by the American College of Cardiology Foundation (ACCF) and the American Society of Nuclear Cardiology (ASNC) to 291 consecutive patients (age 55.3 ± 10.3 years) who underwent SPECT-MPI. For this purpose, we convened a panel, consisting of two academic cardiologists, one academic clinician in internal medicine, and one academic clinician in nuclear medicine. The panelists were invited for a face-to-face meeting to judge appropriateness of SPECT-MPI and independently assign a specific indication (scenario), whenever possible, for each case in accordance with ACCF/ASNC appropriateness scenarios. Based on the 2005 ACCF/ASNC criteria, SPECT-MPI studies were judged appropriate for 211 (72.5%), uncertain for 36 (12.4%), inappropriate for 32 (11.0%), and unclassifiable for 12 (4.1%) referrals. The same figures based on the 2009 version were 219 (75.3%), 15 (5.2%), 49 (16.8%), and 8 (2.7%) patients, respectively. Overall agreement between the 2005 and 2009 versions was good (κ 0.63). Lack of chest pain and age below 60 years were significant indicators increasing the likelihood of inappropriate referrals by 2.9-3.4 fold. Absence of diabetes mellitus and hypertension, a normal lipid profile, lack of a past history of myocardial infarction or cardiovascular interventions (CABGs or PCI), as well as lack of application and exercise ECG stress test as the gate keeper (keeping abnormal ETT or inability of the patient to perform exercise as the appropriate indication for SPECT-MPI referral) were significant indicators, decreasing the odds of appropriate referrals. Generally a higher percentage of referrals with inappropriate indications had normal MPI. Our study provides an evidence for the fact that SPECT-MPI ordering practices in our developing community largely parallel the ACCF/ASNC recommendations. The implementation of appropriateness criteria is feasible in clinical settings and might provide an alternative to utilization management. © 2011 American Society of Nuclear Cardiology

Application of streamline simulation to gas displacement processes

Performance evaluation of miscible and near-miscible gas injection processes is available through conventional finite difference (FD) compositional simulation. Streamline methods have also been developed in which fluid is transported along the streamlines instead of using the finite difference grid. In streamline-based simulation, a 3D flow problem is decoupled into a set of 1D problems solved along streamlines. This reduces simulation time relative to FD simulation, and suppresses the numerical dispersion errors that are present in FD simulations. Larger time steps and higher spatial resolution can be achieved in these simulations. Thus, streamline-based reservoir simulation can be orders of magnitude faster than the conventional finite difference methods. Streamline methods are traditionally only applied to incompressible flow processes. In this paper, the method is adopted and assessed for application to compressible flow processes. A detailed comparison is given between the results of conventional FD simulation and the streamline approach for gas displacement processes. Finally, some guidelines are given on how the streamline method can potentially be used to good effect for gas displacement processes

Homeland and Hostland Iranian Press in Canada

Millions of Iranians left their country after the coming to power of the Islamic Republic in February 1979. Some twenty years later, the urge to leave the country is as strong as it was in the early post-revolutionary years. In a world that is less hospitable to refugees, some Iranians risk their lives in search of a hostland. For many emigrating Iranians, the hostland does not readily turn into a new homeland. In fact, Iran is often present, or rather reproduced, in the memory, language, way of life, and the network of relationships that remain in place despite physical distance

Deep-Learning for Classification of Colorectal Polyps on Whole-Slide Images

Histopathological characterization of colorectal polyps is an important principle for determining the risk of colorectal cancer and future rates of surveillance for patients. This characterization is time-intensive, requires years of specialized training, and suffers from significant inter-observer and intra-observer variability. In this work, we built an automatic image-understanding method that can accurately classify different types of colorectal polyps in whole-slide histology images to help pathologists with histopathological characterization and diagnosis of colorectal polyps. The proposed image-understanding method is based on deep-learning techniques, which rely on numerous levels of abstraction for data representation and have shown state-of-the-art results for various image analysis tasks. Our image-understanding method covers all five polyp types (hyperplastic polyp, sessile serrated polyp, traditional serrated adenoma, tubular adenoma, and tubulovillous/villous adenoma) that are included in the US multi-society task force guidelines for colorectal cancer risk assessment and surveillance, and encompasses the most common occurrences of colorectal polyps. Our evaluation on 239 independent test samples shows our proposed method can identify the types of colorectal polyps in whole-slide images with a high efficacy (accuracy: 93.0%, precision: 89.7%, recall: 88.3%, F1 score: 88.8%). The presented method in this paper can reduce the cognitive burden on pathologists and improve their accuracy and efficiency in histopathological characterization of colorectal polyps, and in subsequent risk assessment and follow-up recommendations

A comparative analysis of particle tracking in a mixer by discrete element method and positron emission particle tracking

Characterisation of particle flow using Positron Emission Particle Tracking (PEPT) is based on tracking the position of a single particle in a dynamic system. Recent developments in PEPT have facilitated tracking multiple particles aiming at improvements in data representation. Nevertheless for systems with a wide residence time distribution and/or dead zone, the conditions for getting representative data which could reflect the bulk behaviour of the powders need to be analysed and specified. In the present work, an attempt is made to simulate PEPT experiments for a paddle mixer using Discrete Element Method (DEM), with a view to investigate the effect of increasing the number of tracers on their time-averaged velocity distribution and whether it can represent the data on whole population of particles. The time averaged velocity distribution of the individual tracer particles (resembling simulated PEPT) is obtained and compared with the time averaged data on entire particle population. The DEM results indicate that for the investigated paddle mixer, it takes 251. s for one tracer to travel adequately in all the active space of the system. The instantaneous tracer velocity fluctuates around the average value obtained for all the particles, suggesting that the average tracer velocity is adequately representative of the average particle velocity in the system. The data of the PEPT experiment with one tracer with those of DEM with one tracer are in good agreement; however, DEM simulation suggests that increasing the number of tracers in the paddle mixer system does not influence the average velocity distribution. Furthermore, the velocity for all particles in the DEM shows a smooth distribution with a peak frequency of the velocity distribution that is lower than PEPT and DEM tracer. When tracking a single tracer in DEM or PEPT, it may not be detected to have zero velocity at any instant of time, whilst the data for all particles show that about 0.3% of particles are stagnant

Estimation of Dulling Rate and Bit Tooth Wear Using Drilling Parameters and Rock Abrasiveness

NoOptimisation of the drilling operations is becoming increasingly important as it can significantly reduce the oil well development cost. One of the major objectives in oil well drilling is to increase the penetration rate by selecting the optimum drilling bit based on offset wells data, and adjust the drilling factors to keep the bit in good condition during the operation. At the same time, it is important to predict the bit wear and the time to pull out the bit out of hole to prevent fishing jobs. Numerous models have been suggested in the literature for predicting the time to pull the bit out to surface rather than predict or estimate the bit wear rate. Majority of the available models are largely empirical and can be applied for limited conditions, and do not include all the drilling parameters such as the formation abrasiveness and bit hydraulic. In this paper, a new approach is presented to improve the drill bit wear estimation that consists of a combination of both Bourgoyne and Young (BY) drilling rate model and theory of empirical relation for the effects of rotary speed (RPM), and weight on bit (WOB) on drilling arte (ROP) and rate of tooth wear. In addition to the drilling parameters, the formation abrasiveness and the effect of the jet impact force of the mud have also been accounted to estimate the bit wear. The proposed model enables estimation of the rock abrasiveness, and that lead to calculate the dynamic dulling rate of the bit while drilling that used in more accurate to assess the bit tooth wear compared with the mechanical specific energy (MSE). Then the estimated dulling rate at the depth of pulling out is used to determine the dull grade of the bit. The technique is validated in five wells located in two different oil fields in Libya. All studied wells in this showed a good agreement between the actual bit tooth wear and the estimated bit tooth wear