Malignant pheochromocytoma with widespread bony and pulmonary metastases

Pheochromocytoma is a rare benign tumor of the adrenal gland. A select few cases may be malignant, and metastatic cases are exceedingly rare. It often presents with symptoms of catecholamine excess, such as sweating, palpitations, headaches, and characteristic paroxysmal hypertension. Due to its diffuse symptoms, it is difficult to diagnose and is often diagnosed late. We describe the unique case of a 44-year-old female patient who presented with uncontrolled hypertension and vomiting, accompanied by lower back pain. She was diagnosed with malignant pheochromocytoma with multiple metastases to the lungs, vertebrae, scapulae, and skull. Because of the advanced state of her disease, the patient was started on treatment with the chemotherapeutic combination of cyclophosphamide, vincristine, and dacarbazine. However, she had a complicated hospital course and died because of aspiration pneumonia and sepsis

A Pervasive Computational Intelligence based Cognitive Security Co-design Framework for Hype-connected Embedded Industrial IoT

The amplified connectivity of routine IoT entities can expose various security trajectories for cybercriminals to execute malevolent attacks. These dangers are even amplified by the source limitations and heterogeneity of low-budget IoT/IIoT nodes, which create existing multitude-centered and fixed perimeter-oriented security tools inappropriate for vibrant IoT settings. The offered emulation assessment exemplifies the remunerations of implementing context aware co-design oriented cognitive security method in assimilated IIoT settings and delivers exciting understandings in the strategy execution to drive forthcoming study. The innovative features of our system is in its capability to get by with irregular system connectivity as well as node limitations in terms of scares computational ability, limited buffer (at edge node), and finite energy. Based on real-time analytical data, projected scheme select the paramount probable end-to-end security system possibility that ties with an agreed set of node constraints. The paper achieves its goals by recognizing some gaps in the security explicit to node subclass that is vital to our system’s operations

Clinical outcomes of surgically corrected atrial septal defects

Objective: To examine the outcomes of surgical repair of atrial septal defects in paediatric and adult patients. Methods: The retrospective study comprised data of 84 patients who had undergone surgical correction of atrial septal defect at the Aga Khan University Hospital, Karachi, between June 2006 and December 2011. All patients with isolated atrial septal defect (ostium secundum, ostium primum and sinus venosus with or without partial anomalous pulmonary venous connection) were included. Clinical and transthoracic echocardiographic data was reviewed. SPSS 17 was used for statistical analysis. Results: There were no deaths in the study population. The mean time for follow-up was 6.5±9.9 months. Most of the patients (n=80; 95.2%) were in New York Heart Association class I at follow-up, while the remaining 4(4.8%) were in New York Heart Association class II. Post-operatively, 8 (9.5%) patients developed brief episodes of arrhythmias. There were 3 (3.57%) patients who were re-admitted within 30 days; 2 (66.7%) had superficial wound infection, while 1 (33.3%) had to be re-opened because of cardiac tamponade. Conclusion: Surgical repair of atrial septal defects is a safe procedure which is associated with excellent results and low morbidity

Practice and Innovations in Sustainable Transport

The book continues with an experimental analysis conducted to obtain accurate and complete information about electric vehicles in different traffic situations and road conditions. For the experimental analysis in this study, three different electric vehicles from the Edinburgh College leasing program were equipped and tracked to obtain over 50 GPS and energy consumption data for short distance journeys in the Edinburgh area and long-range tests between Edinburgh and Bristol. In the following section, an adaptive and robust square root cubature Kalman filter based on variational Bayesian approximation and Huber’s M-estimation is proposed to accurately estimate state of charge (SOC), which is vital for safe operation and efficient management of lithium-ion batteries. A coupled-inductor DC-DC converter with a high voltage gain is proposed in the following section to match the voltage of a fuel cell stack to a DC link bus. Finally, the book presents a review of the different approaches that have been proposed by various authors to mitigate the impact of electric buses and electric taxis on the future smart grid

Tetralogy of Fallot with absent pulmonary valve syndrome; appropriate surgical strategies

Abstract OBJECTIVE: To evaluate patients presenting with Tetralogy of Fallot with absent pulmonary valve syndrome to a tertiary care hospital and their surgical management. METHODS: The retrospective study was conducted at Congenital Cardiac Services, Aga Khan University Hospital, Karachi, Pakistan, and comprised data of Tetralogy of Fallot patients between April 2007 and June 2012. Data was analysed together with follow-up echocardiography. Variables assessed included demographics, imaging, operative technique, complications, post-operative recovery and follow-up echocardiography. SPSS 17 was used for statistical analysis. RESULTS: Of the 204 patients, 6 (3%) had undergone surgical correction for Tetralogy of Fallot with absent pulmonary valve syndrome. All 6(100%) patients underwent complete repair. Median age for surgery was 8.5 years (range: 0.5-29 years). Of the different surgical strategies used, Contegra and Bioprosthetic valve placement had satisfactory outcome with minimal gradient at Right Ventricular Outflow Tract, good ventricular function and mild valvular regurgitation. One (16.6%) patient with Trans Annular Patch developed post-operative Right Ventricle Outflow Tract gradient of 80mmHg with moderate pulmonary regurgitation. One (16.6%) patient with monocusp valve developed free pulmonary regurgitation at 6 months. The other 4(66.6%) patients are currently free from any complications or re-intervention. CONCLUSIONS: Early surgery is preferred in symptomatic patients. The repair depends upon achieving integrity of pulmonary circulation which is best achieved by using right ventricle to pulmonary artery conduit or inserting a pulmonary valve

Energy consumption and modelling of the climate control system in the electric vehicle

With the introduction of electric vehicles in the automobile market, limited information is available on how the battery’s energy consumption is distributed. This paper focuses on the energyconsumption of the vehicle when the heating and cooling system is in operation. On average, 18 and 14% for the battery’s energy capacity is allocated to heating and cooling requirements, respectively. The conventional internal combustion engine vehicle uses waste heat from its engine to provide for passenger thermal requirements at no cost to the vehicle’s propulsion energy demands. However, the electric vehicle cannot avail of this luxury to recycle waste heat. In order to reduce the energy consumed by the climate control system, an analysis of the temperature profile of a vehicle’s cabin space under various weather conditions is required. The present study presents a temperature predicting algorithm to predict temperature under various weather conditions. Previous studies have limited consideration to the fluctuation of solar radiation space heating to a vehicle’s cabin space. This model predicts solar space heating with a mean bias error and root mean square error of 0.26 and 0.57C, respectively. This temperature predicting model can potentially be developed with further research to predict the energy required by the vehicle’s primary lithium-ion battery to heat and cool the vehicle’s cabin space. Thus, this model may be used in a route planning application to reduce range anxiety when drivers undertake a journey under various ambient weather conditions while optimising theenergy consumption of the electric vehicle

A novel teaching program for inter-surface radiation exchange

The present article describes a possible pedagogical approach for delivering a module in inter-surface radiation exchange that will encompass the following applications and will also lend to other potential applications which may be identified by the reader: (i) building heating and cooling load, and (ii) energy balance of solar thermal air-and water collectors. The basic cases for inter-surface radiation exchange that are presented here are: (a) surfaces that may share a common edge, i.e. surfaces or extension of surfaces that are at an angle to each other, and (b) parallel surfaces. This article will not only present solutions to the above-mentioned problems but will also be accompanied by MS-Excel/VBA codes for readers' use

Potential for renewable energy–assisted harvesting of potatoes in Scotland

Depleting energy resources, enhancing energy security and energy access and approaching climate change related challenges are some of the present day challenges. Against this backdrop, renewable energy (RE)-based farming has been a topic of serious discussion within Great Britain and Scotland. There are multiple advantages in the development and applications of RE micro-grids for farming communities as often they are located in areas that are quite remote and hence their energy sustainability provides security of supply. In the present article, a large-scale RE system that included solar photovoltaic and wind turbine has been critically analyzed with respect to its fractional contribution toward the total energy budget of a potato farm that produces 8000 tons of crops annually, with 4500 tons of the produce in cold storage for up to 8 months. The findings and recommendations from these case studies will help renewable energy practitioners in erecting and analyzing similar installations

Efficient Routines for Obtaining Radiation View-Factor for Non-Uniform Horizons

There are a large number of engineering applications wherein estimation of radiation exchange between surfaces is required. One important part of the latter procedure is to obtain the so-called ‘view factor’ of the emitter–receiver combination. The principal aim of this article is to present finite-element based procedures to obtain view factor with good time efficiency. As such routines presented here compute the view factor between a non-uniform emitter field and the receiving surface. An example of this is ground-reflected solar radiation to thermal or photovoltaic collectors, the foreground itself being composed of surfaces that have wide-ranging reflectivities. Four routines have been presented here: one based on a uniform grid for emitting and receiving surfaces using a brute force approach (Uniform Populous Grid (UPG)), and another that used non-uniform grid for the receiving surface, where cells’ sizes increased in arithmetic progression as one withdraws from the common edge (Non Uniform Grid Populous (NUGP)). The last two routines used combinations of the first two approaches with Monte-Carlo approach (Uniform Grid Monte-Carlo (UGMC) and Non Uniform Grid Monte-Carlo (NUGMC)). It was found that the NUGP algorithm was the most efficient to reduce the calculation error for the same number of computations, it was about 450 times (430 for non-uniform reflectivity) more accurate than UPG, 160 (125) times more than UGMC and 70 (60) times more than NUGMC. Finally a comparison of advantages and disadvantages of all four considered routines was added, using the following criteria: ease of programming, computational execution time, accuracy of results obtained, and predictability of the error