An Entire Coronary System Arising from Right Coronary Cusp: A Rare Anomaly

The prevalence of coronary artery anomalies is approximately 0.6% in individuals undergoing angiography. Most of the anomalies are benign, but some can lead to myocardial infarction, cardiomyopathy, and sudden cardiac death. It is very rare to have an entire coronary circulation that arises from the right coronary cusp. We present a case of a 57-year-old male who presented with complaints of chest pain and dyspnea on exertion. An invasive angiogram revealed all the three coronary arteries originating from the right coronary cusp. It is crucial to define coronary anatomy as anomalies dictate which cardiac intervention should be attempted in cases of ischemia

CT CBV Perfusion Mapping As A Sign of Futility In Acute Ischemic Stroke

Ischemic strokes constitute 80% of all strokes nationwide, but an imaging technique for predicting patient outcome is yet to be determined. This study effectively tests whether the Cerebral Blood Volume (CBV) imaging modality is a parameter of perfusion calculated from multiple CT images following contrast injection. 13,000 CT perfusion scans performed on identical scanners and paradigms from 2000 to 2010 were reviewed. A total of 451 showed measurable changes of perfusion/ischemia. CBV values were calculated and compared with final infarct size, calculated from CT (217) and MRI (234) scans performed 24+ hours after the initial infarct. Patient outcomes were divided into three categories based on hospital discharge: hospice/death, discharge to rehabilitation facility, or healthy discharge to home. Strokes represent a significant social and economic burden. Understanding the viability of tissue in acute ischemic strokes can allow physicians to better plan treatment paradigms and predict outcome. Time, effort, and money can be allocated more efficiently, as medical resources and procedures can be used on the patients who need them most.Our multi-site study shows that CBV can be used as an effective predictor of completed stroke (futility) and that the value of CBV is an excellent predictor of patient clinical outcome.Biochemistr

Impact of Leader-Member Exchange Relationship and Job design on Counterproductive Work Behavior (CWB): The Role of Job Burnout

The aim of this study is to synthesize the effect of Leader-member exchange relationship (LMX) and Job design on Counterproductive work behavior (CWB) through the mediating lens of all three dimensions of Job Burnout that based upon Conservation of Resource (COR) theory. A sample size of 350 respondents was used for collecting data with the help of research survey by distributing questionnaires to the employees who are working in public sector universities of higher education sector that are currently based in twin cities (Islamabad and Rawalpindi) of Pakistan. Techniques of Simple and Multiple linear regressions were carried out for accessing mediation analysis via SPSS version 21.0 and AMOS version 27.0.  Findings of this study has revealed that LMX relationship is significantly but negatively related to Counterproductive work behavior (CWB) and Job design is significantly and positively related to (CWB). Also Job Burnout is a significant variable that mediates between Leader-member exchange for developing quality exchange relationships, job design and counterproductive work behaviors. This study gave into new insights and results into the existing body of knowledge along with practical implications and outcomes. Limitations for this study along with future directions of research are also discussed at the end

Performance Analysis of Switches in High Speed LAN

© ASEE 2009This paper presents an analysis of switches in high speed LAN. In order to support our analysis, this paper provides both analytical and mathematical models. The proposed analytical model is based on a finite state Markov model developed for analyzing networks with virtual channels in a switched LAN. Our proposed mathematical model provides a mean to quantify different critical parameters such as end-to-end delay, short and long message latency, channel bandwidth, and utilization in switched LAN. Simulation is performed using OPNET that based on the mathematical expressions derived in the mathematical model. In addition, simulation results of this paper compare the performance of high speed LAN with respect to the utilization of both switches and hub. Finally, based on the simulation results, we provide a performance analysis that indicates the role of each critical parameter in the overall perfor

Current Approaches to Improve Balance in Down Syndrome Population-A Systematic Review

Down syndrome is one of the most common chromosomal disorders in pediatrics characterized by variable intellectual disability, generalized joint laxity, and hypotonia that compromises their function and causes a delay in developing gross motor skills, poor balance, and coordination. Thus, this study aims to determine the current yet effective treatment approaches to improve balance in the Down syndrome population. The studies were explored across seven electronic databases that include MEDLINE, PubMed, Cochrane Library, Google Scholar, Scopus, PEDro, and Web of Science from inception till October 2020 comprised of experimental studies published in English language investigating the effects on balance in children and adults diagnosed with DS considering different interventions. A total of 1,570 records were retrieved from seven electronic databases published between the year's tenure of 2013-2020. 144 full-text papers were extracted to be reviewed, of which only 18 experimental studies were selected on the basis of inclusion criteria that involved 493 Down syndrome patients, investigated the effects of therapeutic exercises, manual therapy techniques, and patient-related instructions on standardized balance scales/tests. It was concluded that all the included trials demonstrated significantly profound effects in improving the static and dynamic balance of Down syndrome patients. Therefore, none of the interventions is declared as superior to another in terms of obtained results. Furthermore, these diverse interventions need to be investigated more for better understating and generalizability of outcomes

Image-Based Quantification of Benzoporphyrin Derivative Uptake, Localization, and Photobleaching in 3D Tumor Models, for Optimization of PDT Parameters

Photodynamic therapy (PDT) is a light-based treatment modality in which wavelength specific activation of a photosensitizer (PS) generates cytotoxic response in the irradiated region. PDT response is critically dependent on several parameters including light dose, PS dose, uptake time, fluence rate, and the mode of light delivery. While the systematic optimization of these treatment parameters can be complex, it also provides multiple avenues for en- hancement of PDT efficacy under diverse treatment conditions, provided that a rational framework is established to quantify the impact of parameter selection upon treatment re- sponse. Here we present a theranostic technique, combining the inherent ability of the PS to serve simultaneously as a therapeutic and imaging agent, with the use of image-based treatment assessment in three dimensional (3D) in vitro tumor models, to comprise a platform to evaluate the impact of PDT parameters on treatment outcomes. We use this approach to visualize and quantify the uptake, localization, and photobleaching of the PS benzoporphyrin derivative monoacid ring-A (BPD) in a range of treatment conditions with varying uptake times as well as continuous and fractionated light delivery regimens in 3D cultures of AsPC-1 and PANC-1 cells. Informed by photobleaching patterns and correlation with cytotoxic re- sponse, asymmetric fractionated light delivery at 4 hours BPD uptake was found to be the most effective regimen assessed. Quantification of the spatial profile of cell killing within multicellular nodules revealed that these conditions also achieve the highest depth of cyto- toxicity along the radial axis of 3D nodules. The framework introduced here provides a means for systematic assessment of PDT treatment parameters in biologically relevant 3D tumor models with potential for broader application to other systems

Impact of Treatment Response Metrics on Photodynamic Therapy Planning and Outcomes in a Three-Dimensional Model of Ovarian Cancer

Common methods to characterize treatment efficacy based on morphological imaging may misrepresent outcomes and exclude effective therapies. Using a three-dimensional model of ovarian cancer, two functional treatment response metrics are used to evaluate photodynamic therapy (PDT) efficacy: total volume, calculated from viable and nonviable cells, and live volume, calculated from viable cells. The utility of these volume-based metrics is corroborated using independent reporters of photodynamic activity: viability, a common fluorescence-based ratiometric analysis, and photosensitizer photobleaching, which is characterized by a loss of fluorescence due in part to the production of reactive species during PDT. Live volume correlated with both photobleaching and viability, suggesting that it was a better reporter of PDT efficacy than total volume, which did not correlate with either metric. Based on these findings, live volume and viability are used to probe the susceptibilities of tumor populations to a range of PDT dose parameters administered using 0.25, 1, and 10 μM benzoporphyrin derivative (BPD). PDT with 0.25 μM BPD produces the most significant reduction in live volume and viability and mediates a substantial shift toward small nodules. Increasingly sophisticated bioengineered models may complement current treatment planning approaches and provide unique opportunities to critically evaluate key parameters including metrics of therapeutic response