Electrical Storms in Brugada Syndrome: Review of Pharmacologic and Ablative Therapeutic Options

Electrical storm occurring in a patient with the Brugada syndrome is an exceptional but malignant and potentially lethal event. Efficient therapeutic solutions should be known and urgently applied because of the inability of usual antiarrhythmic means in preventing multiple recurrences of ventricular arrhythmias. Isoproterenol should be immediately infused while oral quinidine should be further administrated when isoproterenol is not effective. In case of failure of these therapeutic options, ablation of the triggering ventricular ectopies should be attempte

[THE QUR’ĀNIC CONCEPT OF HUMAN BEING: A THEMATIC STUDY] التصور القرآني للإنسان: دراسة موضوعية

The problem statement of this research is that the Qur’ān has widely discussed the concept of human being in a number of verses, thus, there is an immense need for the Qur’ānic concept of human to be identified and highlighted. This research aims to clarify the concept of human being in the light of the Qur’ān. This study is significant because it identifies and uncovers the concept of human being according to the Holy Qur’ān, which is very essential to develop and qualify the human being to undertake the duties he is assigned with. To reach the objectives of the research, both the inductive and the analytical approaches are used. The findings of the research show that the human concepts of the human nature and his essential essence are incorrect and contradictory. However, the Qur’ānic concept of human being is distinct and unique for the fact that it is divine, given by his creator who definitely knows him very well. The human being in the light of the Qur’ān is known where he comes from, and is distinct in his own creation, he is also a creation that is being highly valued and received great appreciation in the Qurʾān, and given a special status in the universe distinguishes him from all other creations. Yet, this honor and special status make him responsible to fulfill the mission Allah S.W.T. entrusted him with. In addition, he is a free and willing being but responsible, he is also a weak being in himself unless he depends on his Creator. Finally, this research recommends that the human being concept should be determined in the light of the Qur’ān, since it is correct, sound and comprehensive, it also emphasizes to develop an integrated approach to build the human being that takes into account the reality, characteristics and needs of that creature as mentioned in the Qur’ān. تكمن مشكلة البحث في أن حديث القرآن الكريم عن الإنسان من حيث ذاته وخصائصه جاء متفرقا فيالآيات الكريمة؛ فلذلك كان جمع تلك الآيات والخلوص بنظرة القرآن الكريم للإنسان على نحو شامل ومتكاملأمرا ضروريا، ويهدف هذا البحث إلى بيان معالم وملامح التصور القرآني للإنسان. هذا البحث مهم لأنهيتناول الإنسان؛ ماهيته وحقيقته وخصائصه في ضوء النظرة القرآنية المتميزة، ومعرفة الإنسان والإلمام بحقيقتهوماهيته يعتبر غاية في الأهمية إذ لا يمكن القيام بعملية بناء الإنسان وعمارته -ثم تأهيله للقيام بمهمتهالوظيفية- على أسس سليمة إلا بمعرفته المعرفة الحقة والتي لا يمكن إيجادها خارج الإطار القرآني، وللوصولإلى أهداف البحث اعتمد الباحث المنهج الاستقرائي لتتبع وجمع الآيات التي تحدثت عن الإنسان وخصائصهوماهيته، مع الرجوع إلى المصادر التفسيرية القديمة والحديثة التي تطرقت إلى هذا الموضوع، وإضافة إلى ذلك،اعتمد الباحث المنهج التحليلي لتحليل النصوص القرآنية لاستنباط نظرة القرآن الكريم للإنسان من حيثماهيته وخصائصه. ومن أهم النتائج التي توصل إليها البحث: أن التصورات البشرية للإنسان تتميز بالقصوروالتناقض بين تصور يحط من قيمة الإنسان وآخر يرفعه إلى مقام الألوهية، وأن الرؤية القرآنية للإنسان متميزةوفريدة من نوعها لأنها من عند الله تعالى خالق هذا الإنسان فهو -وحده- الأعلم به، فالإنسان في التصورالقرآني معلوم الأصل والمصدر، متميز في ذاته وخلقه وتركيبته، وهو مخلوق مكرم نال تقديرا وحفاوة كبيرين فيالخطاب القرآني، وله منزلة خاصة في الكون تميزه عن سائر الموجودات، حيث سخر له جميع ما في الأرضلينتفع به، وهذا التكريم وهذه الحفاوة ليسا لذات الإنسان وإنما للمهمة الشريفة التي أنيطت به، والدور الجللالذي كلف بأدائه وهو خلافة الله في أرضه؛ فهو شُ رِّفَ لأنه كُل فَ. وهو كائن حر وذو إرادة ولكنه مسؤول،كما أنه كائن ضعيف في ذاته ما لم يعتمد على خالقه. ومن أبرز توصيات البحث: ضرورة تحديد التصورللإنسان في ضوء القرآن الكريم لأنه الصحيح والسليم، ليتم -وفق هذا التصور- وضع منهج متكامل لبناءالإنسان يراعي حقيقته وخصائصه وحاجياته

Power fuzzy adaptive control for wind turbine

In recent years, wind energy has become one of the most promising renewable energy sources. The doubly-fed induction generator (DFIG) is currently the most common type of generator used in wind farms. This paper describes an approach for the independent control of the active and reactive power of the variable-speed DFIG. This paper deals with the control of the active and reactive powers in a DFIG designed for a wind system. The simulation model including a 7 KW - DFIG driven by a wind turbine, a PWM inverter and the proposed control strategy are developed and implemented using Matlab Simulink

L’enseignement/apprentissage de la grammaire dans le collège algérien : quelle place pour la démarche inductive ?

Nous voulons mettre en exergue la démarche inductive, préconisée par les spécialistes de l’Education en Algérie pour l’enseignement de la grammaire. Nous nous interrogeons sur le degré d’application de cette démarche en classe de FLE. Nous nous proposons d’analyser les manuels et les documents d’accompagnement de l’enseignement du français et les séances d’observation de classe pour mettre en évidence la pratique enseignante de la grammaire.In the present study, we aim at highlighting the inductive approach advocated by specialists of education in Algeria, for the teaching of grammar. Our main inquiry is about the degree of application of this approach in FFL class. We propose to analyze the textbooks and the accompanying French teaching documents, as well as class observation sessions to highlight the teaching practice of grammar

An Approach to Catheter Ablation of Cavotricuspid Isthmus Dependent Atrial Flutter

Much of our understanding of the mechanisms of macro re-entrant atrial tachycardia comes from study of cavotricuspid isthmus (CTI) dependent atrial flutter. In the majority of cases, the diagnosis can be made from simple analysis of the surface ECG. Endocardial mapping during tachycardia allows confirmation of the macro re-entrant circuit within the right atrium while, at the same time, permitting curative catheter ablation targeting the critical isthmus of tissue located between the tricuspid annulus and the inferior vena cava. The procedure is short, safe and by demonstration of an electrophysiological endpoint - bidirectional conduction block across the CTI - is associated with an excellent outcome following ablation. It is now fair to say that catheter ablation should be considered as a first line therapy for patients with documented CTI-dependent atrial flutter

Microcanonical processing methodology for ECG and intracardial potential: application to atrial fibrillation

Cardiac diseases are the principal cause of human morbidity and mortality in the western world. The electric potential of the heart is a highly complex signal emerging as a result of nontrivial flow conduction, hierarchical structuring and multiple regulation mechanisms. Its proper accurate analysis becomes of crucial importance in order to detect and treat arrhythmias or other abnormal dynamics that could lead to life-threatening conditions. To achieve this, advanced nonlinear processing methods are needed: one example here is the case of recent advances in the Microcanonical Multiscale Formalism. The aim of the present paper is to recapitulate those advances and extend the analyses performed, specially looking at the case of atrial fibrillation. We show that both ECG and intracardial potential signals can be described in a model-free way as a fast dynamics combined with a slow dynamics. Sharp differences in the key parameters of the fast dynamics appear in different regimes of transition between atrial fibrillation and healthy cases. Therefore, this type of analysis could be used for automated early warning, also in the treatment of atrial fibrillation particularly to guide radiofrequency ablation procedures.Comment: Transactions on Mass-Data Analysis of Images and Signals 4, 1 (2012). Accepte

Phantom phenomena and body scheme after limb amputation: A literature review

Phantom phenomena are subject of various, often inconsistent, descriptions, and new concepts and treatment approaches emerge. The aim of the study is to describe contemporary terminology and developments in the field, and to share personal experience. A review of English and French language literature, published prior to 27th February, 2012, extracted from PubMed/MEDLINE, Google.fr, GoogleScholar databases, and by hand searching of selected full text papers and textbooks with correspondence to personal clinical experience was performed. The terminology and classification of phantom phenomena sensations, relations between intensity and character of phantom pain to the etiology and level of amputations, as well as the influence of presence and intensity of pre-operative limb pain and post-operative stump pain on phantom phenomena are described. The benefits of mirror therapy and early introduction of prosthesis and applying functional prosthesis are also presented, with a glance at other conservative and surgical treatment approaches

Detection of focal source and arrhythmogenic substrate from body surface potentials to guide atrial fibrillation ablation

Focal sources (FS) are believed to be important triggers and a perpetuation mechanism for paroxysmal atrial fibrillation (AF). Detecting FS and determining AF sustainability in atrial tissue can help guide ablation targeting. We hypothesized that sustained rotors during FS-driven episodes indicate an arrhythmogenic substrate for sustained AF, and that non-invasive electrical recordings, like electrocardiograms (ECGs) or body surface potential maps (BSPMs), could be used to detect FS and AF sustainability. Computer simulations were performed on five bi-atrial geometries. FS were induced by pacing at cycle lengths of 120–270 ms from 32 atrial sites and four pulmonary veins. Self-sustained reentrant activities were also initiated around the same 32 atrial sites with inexcitable cores of radii of 0, 0.5 and 1 cm. FS fired for two seconds and then AF inducibility was tested by whether activation was sustained for another second. ECGs and BSPMs were simulated. Equivalent atrial sources were extracted using second-order blind source separation, and their cycle length, periodicity and contribution, were used as features for random forest classifiers. Longer rotor duration during FS-driven episodes indicates higher AF inducibility (area under ROC curve = 0.83). Our method had accuracy of 90.6±1.0% and 90.6±0.6% in detecting FS presence, and 93.1±0.6% and 94.2±1.2% in identifying AF sustainability, and 80.0±6.6% and 61.0±5.2% in determining the atrium of the focal site, from BSPMs and ECGs of five atria. The detection of FS presence and AF sustainability were insensitive to vest placement (±9.6%). On pre-operative BSPMs of 52 paroxysmal AF patients, patients classified with initiator-type FS on a single atrium resulted in improved two-to-three-year AF-free likelihoods (p-value < 0.01, logrank tests). Detection of FS and arrhythmogenic substrate can be performed from ECGs and BSPMs, enabling non-invasive mapping towards mechanism-targeted AF treatment, and malignant ectopic beat detection with likely AF progression