Interventional techniques in the management of persistent atrial fibrillation

Atrial fibrillation (AF) is a common cardiac rhythm problem experienced by patients and comprises an increasing demand on healthcare systems. AF is characterised by advanced neurohormonal remodelling in the atria resulting in dilation and variable degree of atrial fibrosis that can be measured by imaging techniques with difficulty in developing methods of identifying and quantifying left atrial (LA) fibrosis. LA fibrosis can be estimated by measuring LA scar using non-invasive imaging methods such as strain imaging in advanced echocardiography and in cardiac magnetic resonance (CMR) imaging. Achieving rhythm control strategy utilising catheter ablation (CA) has shown to be advantageous in improving quality of life (QOL) in patients with paroxysmal AF. The most effective method in management of AF has remained elusive in non-paroxysmal AF. Thoracoscopic surgical ablation (TSA) has been developed over the last decade by experienced surgeons with some promising early results but has not been investigated in long-standing persistent AF (LSPAF). I have attempted to answer some of the relevant questions that have remained in management of LSPAF by conducting a multicentre randomised control trial comparing efficacy between CA and TSA (CASA-AF RCT) and improvements in quality of life indices. In a sub-study, I measured LA volumes using echocardiography and CMR to determine reverse remodelling and LA function using tissue Doppler imaging and strain imaging to predict AF recurrence. In a CMR sub-study, a novel automatic LA segmentation algorithm was used to quantify LA fibrosis before and after ablation. I was able to quantify the response of the autonomic nervous system to targeted ganglionic plexi (GP) ablation as part of TSA compared to CA by measuring heart rate variability. I am hopeful that the knowledge gained from this thesis will help with an appropriate selection that will improve the management of patients with LSPAF.Open Acces

Production of Indigenous and Enriched Khyber Pakhtunkhwa Coal Briquettes: Combustion and Disintegration Strength Analysis

Khyber Pakhtun Khwa province of Pakistan has considerable amounts of low ranked coal. However, due to the absence of any centrally administered power generation system there is a need to explore indigenous methods for effectively using this valuable energy resource. In the present study an indigenous coal briquetting technology has been developed and evaluated in terms of combustion characteristics such as moisture content, volatile matter, ash, fixed carbon and calorific value of the resulting coal briquette and disintegration strength using polyvinyl acetate (PVA) in combination with calcium carbonate (sample no 3 with highest disintegration strength value of 2059N). Comparison of test samples with the commercially available coal briquettes revealed improved combustion characteristics for the PVA bonded (sample no 1 and 5) coal briquettes having higher fixed carbon content and calorific value, lower ash contents as well as lower initial ignition time

Social media usage in academic research

Recently researchers have used “conversation prism” and “social media prisma”, to consolidate social medias with respect to their use. Although both identified 25 types, having average five examples each, they did not identify contribution of each type in academic research. Moreover some of mentioned social services had been suspended or changed. In this paper we attempt to access each social media mentioned in conversation prism in order to first, identify services that are operational to date, services which have suspended and those which have changed during course of time. Second, we compare number of publications associated with each social media, in order to identify which social media has contributed most to academic research. Third, we attempt to find correlation between number of publications and development tools provided by respective social applications. Fourth, social medias are ranked with respect to number of times other social medias share content with respective social application. It was found that out of 168 social applications, 10% changed their service objective while 13% were suspended. Among all social application, AMAZON had highest i.e. 147,000 number of citations on Google scholar whereas 90.7% of total citations were contributed by top 30 social medias. For developers, 22 out of top 30 social medias provided developer options in form of either application programming interface (API) or software development kits (SDK) and Facebook was found to be most cross referred social media based on content sharing. Finally conclusion and future work of study is presented

Conduction System Disorders Associated With Valvular Heart Disease and Interventions

The aging population of the Western world will lead to an increase in cardiac pathologies. Valvular disorders include a spectrum of progressive diseases that confers mechanical and functional impairment, including issues with the cardiac conduction system. Pacemakers are a therapeutic standard to reinstate the synchrony of cardiac contraction. Permanent pacemakers are often required for severe, chronic presentations and have been effective in nullifying symptoms and improving cardiac function. Yet, these devices impart new risks and complications that require additional interventions. However, recent advancements in leadless pacemakers and cardiac resynchronization therapy provide a novel approach to applying pacemaker technology and have been shown to reduce associated risks and improve patient outcomes

Betalogger: Smartphone Sensor-based Side-channel Attack Detection and Text Inference Using Language Modeling and Dense MultiLayer Neural Network

With the recent advancement of smartphone technology in the past few years, smartphone usage has increased on a tremendous scale due to its portability and ability to perform many daily life tasks. As a result, smartphones have become one of the most valuable targets for hackers to perform cyberattacks, since the smartphone can contain individuals' sensitive data. Smartphones are embedded with highly accurate sensors. This article proposes BetaLogger, an Android-based application that highlights the issue of leaking smartphone users' privacy using smartphone hardware sensors (accelerometer, magnetometer, and gyroscope). BetaLogger efficiently infers the typed text (long or short) on a smartphone keyboard using Language Modeling and a Dense Multi-layer Neural Network (DMNN). BetaLogger is composed of two major phases: In the first phase, Text Inference Vector is given as input to the DMNN model to predict the target labels comprising the alphabet, and in the second phase, sequence generator module generate the output sequence in the shape of a continuous sentence. The outcomes demonstrate that BetaLogger generates highly accurate short and long sentences, and it effectively enhances the inference rate in comparison with conventional machine learning algorithms and state-of-the-art studies

Digital-Twins-Based Internet of Robotic Things for Remote Health Monitoring of COVID-19 Patients

The deadly coronavirus disease (COVID-19) has highlighted the importance of remote health monitoring (RHM). The digital-twins (DTs) paradigm enables RHM by creating a virtual replica that receives data from the physical asset, representing its real-world behavior. However, DTs use passive Internet of Things (IoT) sensors, which limit their potential to a specific location or entity. This problem can be addressed by using the Internet of Robotic Things (IoRT), which combines robotics and IoT, allowing the robotic things (RTs) to navigate in a particular environment and connect to IoT devices in the vicinity. Implementing DTs in IoRT, creates a virtual replica [virtual twin (VT)] that receives real-time data from the physical RT [physical twin (PT)] to mirror its status. However, DTs require a user interface for real-time interaction and visualization. Virtual reality (VR) can be used as an interface due to its natural ability to visualize and interact with DTs. This research proposes a real-time system for RHM of COVID-19 patients using the DTs-based IoRT and VR-based user interface. It also presents and evaluates robot navigation performance, which is vital for remote monitoring. The VT operates the PT in the real environment (RE), which collects data from the patient-mounted sensors and transmits it to the control service to visualize in VR for medical examination. The system prevents direct interaction of medical staff with contaminated patients, protecting them from infection and stress. The experimental results verify the monitoring data quality (accuracy, completeness, and timeliness) and high accuracy of PT's navigation.- Qatar National Library - Qatar University Internal Gran

Conduction system pacing on track to replace CRT? Review of current evidence and prospects of conduction system pacing

Conduction system pacing (CSP) has been emerging over the last decade as a pacing option instead of conventional right ventricular (RV) pacing and biventricular (BiV) pacing. Numerous case reports, some observational studies and a few randomized control trials have looked at optimum pacing strategies for heart failure (HF) with left bundle branch block (LBBB) or cases where left ventricular (LV) dysfunction is anticipated due to chronic RV pacing (RVP). Evolution of pacing strategies from standard RVP to septal RVP, BiV pacing and now CSP have shown improving hemodynamic responses and possible ease of implantation of CSP systems. In this review article, we review the literature on the evolution of CSP and common scenarios where it might be beneficial

Effects of Hepatitis C on Hematological Parameters in local areas of Mirpurkhas

Introduction: Various diseases have emerged as a major cause of morbidity and mortality in patients with human immunodeficiency virus (HIV) and hepatitis B virus (HCV) confection, now that antiretroviral therapies become more effective e and has prolonged life expectancy in HIV-infected patients1. One of the most frequently identified extra-hepatic abnormalities often seen at the time of diagnosis of HIV is the hematological abnormalityObjective: To determine possible effects of Hepatitis C in local Population of MirpurkhasMethodology:140 diagnosed patients of Hepatitis C were selected from OPD/Ward MMCH and Civil Hospital Mirpurkhas, Patients of Hypertension, Heart Failure, Renal diseases and respiratory disease were excluded Their ALT, GGT, Alk Sodium was determined by kit method. Their RBC count, TLC, Platelet Count was counted and ESR was determinedResults: It was a prospective study and out of 140 hepatitis C patients 86 were male and 54 were female. The mean age was 54.77 ± 14.046 years. The mean height was 159.42 ± 11.188 cm and the mean weight was 53.69±10.604 Kgs. The mean BMI was calculated as 21.235 ± 5.0607 kgs/m2 (Table.1). The mean Hemoglobin was estimated as 10.639± 2.6924 gm% the mean RBC count was found 3.832 ± .8460 millions/cmm. The mean total leukocyte count was 9111.63 ± 4612.845 per cmm and the mean Platelet count was 160447.67 ± 93788.194 /dl. the mean ESR was 51.70 ± 26.320 (Table.2) The mean Alkaline phosphatase was 273.76± 96.818 IU, the mean GGT was 83.40 ± 102.650 IU and the mean ALT was 74.98 ± 58.614 IU. (Table.3.) The Correlation of hepatitis C was estimated by Pearson’s correlation using SPSS 15 and found that hepatitis has a significant correlation with Hemoglobin, RBC count, TLC and Platelet count (r=.167, .165, .181, 238 and p=.092̽*, .031*, 018* and .002** respectively) and it has an inverse correlation with ESR (r=-.213, p=.005**)Conclusion: Our data shows that hepatitis C has positive correlation with Hb, RBC Count, TLC and Platelet count while the hepatitis has a significant inverse correlation with ESR. More work is required to establish criteria regarding correlation between Hepatitis C and Hematological parameter