Acute right heart failure in a patient with right heart thrombus and pulmonary thromboembolism

Right Heart Thrombus (RiHT) management is really controversial, and appropriate guidelines are not present for the management. In patients referring with RiHT and Pulmonary Embolism (PE), there are three ways of managing these patients. Out of the three one is thrombectomy which is with high risk taking in mind the comorbidities these patients have. The other is using thrombolytic which, in many cases is contraindicated or with high risk. The other less effective way is full anticoagulation. It is really controversial to choose between these ways of management and no clear approach is present. The case presented is a 44-year-old morbid obese male with history of dyspnea on exertion (functional Class II) and foot oedema or the last three months, who was transferred to the emergency department with respiratory distress and hypoxia. Echocardiography was done for the patient which showed moderate Right Ventricular (RV) dysfunction with severe RV enlargement and a severe Tricuspid Regurgitation (TR) with TR gradient of 70mmHg. He also had a semi-mobile large pedunculated mass in favour of a clot in his RV cavity. With the impression of PE heparin was administered to the patient and he was admitted in the coronary care unit. Pulmonary Computed Tomography (CT) angiography showed sub-segmental Pulmonary Thromboendarterectomy (PTE) in the left lung. He had negative cardiac markers and stable vital signs and so full anticoagulation was chosen for his treatment. His clinical course was uneventful and after 10 days of treatment the RV size and function improved significantly. On follow-up after a month he was doing well. Although recent Guidelines of European Society of Cardiology in management of acute PE stated that RiHT, particularly mobile, are associated with a significantly increased early mortality risk in patients with acute PE. Immediate therapy is mandatory, but optimal treatment is controversial in the absence of controlled trials. Thrombolysis and embolectomy are probably both effective while anticoagulation alone seems to be less effective. � 2016, Journal of Clinical and Diagnostic Research. All rights reserved

FracDetect: A novel algorithm for 3D fracture detection in digital fractured rocks

Fractures have a governing effect on the physical properties of fractured rocks, such as permeability. Accurate representation of 3D fractures is, therefore, required for precise analysis of digital fractured rocks. However, conventional segmentation methods fail to detect and label the fractures with aperture sizes near or below the resolution of 3D micro-computed tomographic (micro-CT) images, which are visible in the greyscale images, and where greyscale intensity convolution between different phases exists. In addition, conventional methods are highly subjective to user interpretation. Herein, a novel algorithm for the automatic detection of fractures from greyscale 3D micro-CT images is proposed. The algorithm involves a low-level early vision stage, which identifies potential fractures, followed by a high-level interpretative stage, which enforces planar continuity to reject false positives and more reliably extract planar fractures from digital rock images. A manually segmented fractured shale sample was used as the groundtruth, with which the efficacy of the algorithm in 3D fracture detection was validated. Following this, the proposed and conventional methods were applied to detect fractures in digital fractured coal and shale samples. Based on these analyses, the impact of fracture detection accuracy on the analysis of fractured rocks' physical properties was inferred

Ganoderma lucidum: A promising anti-inflammatory medicinal plant

Inflammation is a complex process and part of the host immune defense against invading micro-organism or trauma. Over production of some pro-inflammatory mediators can lead to chronic diseases of the inflammatory origin. Medicinal Plants which are used as anti-inflammatory agents, mainly act affecting various stages of the process of inflammation. In general they can inhibit formation of a wide of mediators such as cytokines by immune cells to prevent the inflammatory reaction cascade from starting. The use of most of the medicinal plants in treatment of chronic disease of the inflammatory origin is based on clinical and pharmacological trials. Meanwhile, the use of most of them is based on their longstanding traditional use in folk medicine. In this review, we report some of anti-inflammatory effects of G. lucidum as an ancient Chinese herbal medicine

Digital and experimental rock analysis of proppant injection into naturally fractured coal

Proppant-laden fluid injection has been applied to many low permeability reservoirs, such as coal seams, to enhance permeability and thus production. While there are several laboratory-scale experimental studies on proppant placement in hydraulic fractures, the possible infiltration of proppant into natural fractures and its effect on overall permeability has received little attention. We study proppant injection into a naturally fractured coal sample by a combination of experimental and digital rock technologies. The sample was imaged using a helical X-ray computed tomography (micro-CT) scanner in as-received condition. Then, proppants of different size ranges were gradually injected into the sample, using a purpose-built X-ray transparent core flooding system, and the permeability was measured at different effective stresses. Subsequently, the propped sample was re-imaged and registered to the as-received image to map the internal changes. The experimental results indicated almost no permeability change of the sample after proppant injection. While proppant collection in the outlet proved passage of the proppant through the sample, observation of the sample indicated that some of the proppants were accumulated on the inlet face of the core and created a filter leading to no permeability increment. Micro-CT images confirmed that proppants were effectively placed in the sample and kept the fractures open. Numerical computation of permeability, using the digital coal sample in which accumulated proppants at the coal surface were excluded, indicated a significant increase in the sample permeability. Such an increase resulted from the opening of the fractures, particularly in the outlet region. This demonstrated the significance of proppant size selection for coal seam hydraulic fracturing. While proppants were successfully placed in the fractures, the experiment measured the permeability of the system, including proppants accumulated on the inlet, and could not effectively map the internal changes. This, therefore, needs to be considered when an experimental program for proppant injection is executed. To accurately monitor the internal changes, application of digital rock technology is recommended for such experiments

Microbiologically influenced corrosion of cable bolts in underground coal mines: The effect of Acidithiobacillus ferrooxidans

Reports on corrosion failure of cable bolts, used in mining and civil industries, have been increasing in the past two decades. The previous studies found that pitting corrosion on the surface of a cable bolt can initiate premature failure of the bolt. In this study, the role of Acidithiobacillus ferrooxidans (A. ferrooxidans) bacterium in the occurrence of pitting corrosion in cable bolts was studied. Stressed coupons, made from the wires of cable bolts, were immersed in testing bottles containing groundwater collected from an underground coal mine and a mixture of A. ferrooxidans and geomaterials. It was observed that A. ferrooxidans caused pitting corrosion on the surface of cable bolts in the near-neutral environment. The presence of geomaterials slightly affected the pH of the environment; however, it did not have any significant influence on the corrosion activity of A. ferrooxidans. This study suggests that the common bacterium A. ferrooxidans found in many underground environments can be a threat to cable bolts’ integrity by creating initiation points for other catastrophic failures such as stress corrosion cracking

Can public-private partnership (PPP) improve hospitals' performance indicators?

Background: This study was conducted to compare the main performance indicators of Hasheminejad hospital before and after implementing PPP model. Methods: This cross sectional study was conducted in Iran in 2015. Performance indicators of Hasheminejad hospital, the only Iranian unit that implemented PPP model, were applied. Data were collected based on a researcher-designed checklist after ensuring its validity and reliability. Data were analyzed applying SPSS21, and the Shapiro-Wilk test was used to examine the relevant data normalization. After confirming the normality of the data, descriptive statistics and paired t test were used to analyze the data at a significant level of 0.05. Results: Dramatic variations were observed in the status of the studied indicators after the implementation of PPP in Hasheminejad hospital, and the changes were statistically significant in all these indicators (p < 0.05). Conclusion: It seems that implementing PPP in Hasheminejad hospital can be considered as a successful experience in Iran's health sector. The significant improvement in this hospital's performance indicators can emphasize the effective role of PPP in administration of this hospital. However, service quality and patient satisfaction should be considered as qualitative indicators, along with the present quantitative indicators because better judgment about the changes was achieved in this hospital after implementing PPP. © Iran University of Medical Sciences

Preparation and characterization of magnetic Fe3O4/CdWO4 and Fe3O4/CdWO4/PrVO4 nanoparticles and investigation of their photocatalytic and anticancer properties on PANC1 cells

Fe3O4/CdWO4 and Fe3O4/CdWO4/PrVO4 magnetic nanoparticles were prepared at different molar ratios of PrVO4 to previous layers (Fe3O4/CdWO4) via the co-precipitation method assisted by a sonochemical procedure, in order to investigate the photocatalytic performance of these systems and their cytotoxicity properties. The physico-chemical properties of these magnetic nanoparticles were determined via several experimental methods: X-ray diffraction, energy dispersive X-ray spectroscopy, Fourier transformation infrared spectroscopy and ultraviolet-visible diffuse reflection spectroscopy, using a vibrating sample magnetometer and a scanning electron microscope. The average sizes of these nanoparticles were found to be in the range of 60-100 nm. The photocatalytic efficiency of the prepared nanostructures was measured by methylene blue degradation under visible light (assisted by H2O2). The magnetic nanosystem with a 1:2:1 ratio of three oxide components showed the best performance by the degradation of ca. 70 after 120 min of exposure to visible light irradiation. Afterwards, this sample was used for the photodegradation of methyl orange, methyl violet, fenitrothion, and rhodamine-B pollutants. Finally, the mechanism of the photocatalytic reaction was examined by releasing �OH under UV light in a system including terephthalic acid, as well as O2-, OH, and hole scavengers. Additionally, the cytotoxicity of each synthesized sample was assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay against the human cell line PANC1 (cancer), and its IC50 was approximately 125 mg/L. © 2019 by the authors

Prognostic significance of lung diffusion capacity and spirometric parameters in relation to hemodynamic status in heart transplant candidates

Introduction: Investigations have described a correlation between the severity of heart failure and the severity of pulmonary function abnormalities. In this study, we investigated the association of resting spirometric parameters, lung diffusion for carbon monoxide (DLCO), and the transfer coefficient (KCO) with hemodynamic variables and outcomes in a cohort of heart transplant candidates. Material and methods: Between January 2018 and January 2020, a total of 100 patients with advanced heart failure who were scheduled for right heart catheterization (RHC) as a pre-transplant evaluation measure were enrolled. Spirometry and DLCO were performed in all patients within 24 hours of their RHC. All selected patients were followed for a median (IQR) time of 6 (2�12) months. The end points of interest were heart failure-related mortality and a combined event involving HF-related mortality, heart transplantation (HTX), and need for the placement of a left ventricular assist device (LVAD). Results: Among 846 patients scheduled for RHC, a total of 100 patients (25 female) with a mean (SD) age of 38.5 (12.8) were enrolled. There was a significant correlation between FEV1/FVC and CVP (r = �0.22, p = 0.02), PCWP (r = �0.4, p < 0.001), mPAP (r = �0.45, p < 0.001), and PVR (r = �0.32, p = 0.001). The cardiac output correlated with DLCO (r = 0.3, p = 0.008). Spirometry parameters, DLCO parameters, and hemodynamic parameters did not correlate with the combined event. Among the several variables, only PVR had an independent association with the combined event. Conclusion: Both mechanical and gas diffusion parameters of the lung were not associated with outcomes in the homogeneous group of heart transplant candidates. © 2021 PTChP