Background: Right atrial (RA) size and function are not well described in long-standing persistent AF (LSPAF) patients, nor their value as a predictor for the left atrial (LA) voltage-defined fibrosis. Methods: An evaluation was made as to whether echocardiography determined RA length, planimetered area, volume, emptying fraction, stroke volume, expansion index and calculated derivates among the LSPSAF population predict LA low voltage areas (LVA) acquired with high-density and high-resolution bipolar voltage mapping using the CARTO®3 system. Results: 142 patients aged 63 (58-67) years old, 117 males, were enrolled in our study. LVA were detected in 54% of the patients.Severe global LVA burden was present in 15% of the patients, whereas 30% of the patients presented a disseminated pattern of remodelling. We have shown that (1) the majority of the study population (76%) presented enlarged RA, however RA volumes were larger than LA volumes in the minority of cases (2) RA enlargement had a positive correlation with the presence of mild-to-moderate tricuspid regurgitation, left ventricular hypertrophy, LA enlargement, LA area and volume (3), none of the RA indices were associated with the prediction of absolute LVA or advanced LA fibrotic remodelling, although patients with severe LVA burden presented longer RA length and a larger area than comparing to patients with less advanced remodelling pattern. Conclusions: It was found that RA enlargement and decreased RA function, common in LSPSAF patients, do not translate to the presence of voltage-derived LA fibrotic remodelling

Bioprosthetic valve thrombosis (BPVT) is more common than previously thought and likely underreported. BPVT can be accurately diagnosed with cardiac imaging and treated successfully with anticoagulation, thus preventing re-operation. We hereby report a case of recurrent BPVT in the mitral position successfully treated with anticoagulation along with review of literature.

Background: There is limited information on risk factors for eczema in adults. Recent evidence suggests that air pollution may be associated with increased incidence of eczema in adults. We aimed to assess this possible association. Methods: Ambient air pollution exposures (distance from a major road, nitrogen dioxide [NO2], fine particulate matter with an aerodynamic diameter ≤2.5 µm [PM2.5]) were assessed for the residential address of Tasmanian Longitudinal Health Study participants at ages 43 and 53 years. Eczema incidence (onset after age 43 years), prevalence (at 53 years) and persistence were assessed from surveys, while sensitisation was assessed using skin prick tests. The presence or absence of eczema and sensitisation was classified into four groups: no atopy or eczema, atopy alone, non-atopic eczema, and atopic eczema. Adjusted logistic and multinomial regression models were fitted to estimate associations between ambient air pollution and eczema, and interaction by sex was assessed. Results: Of 3153 participants in both follow ups, 2369 had valid skin prick tests. For males, a 2.3 ppb increase in baseline NO2 was associated with increased risk of prevalent eczema (OR=1.15 [95%CI 0.98-1.36]), both non-atopic (OR=1.39 [1.02-1.90]) and atopic eczema (OR=1.26 [1.00-1.59]). These associations were not seen in females (P for interaction=0.08, <0.01). For both sexes, a 1.6 µg/m3 increase in PM2.5 exposure at follow-up was associated with increased odds of aeroallergen sensitisation (OR=1.15 [1.03-1.30]). Conclusion: Increased exposure to residential ambient air pollutants was associated with an increased risk of eczema, only in males, and aeroallergen sensitisation in both genders.

Acute B-type aortic dissection with bilateral lower limb ischemia is classed as the conditions that require emergency intervention. Herein, a 40-year-old male patient with acute B-type dissection is reported. The true cavity of the descending aorta was severely compressed by the false cavity with left iliac artery stenosis and right iliac artery occlusion. After emergency intervention was carried out using the Castor branching aortic stent, the true lumen was re-opened, the blood flow of both lower extremities was restored and the function of distal limb was preserved, thus extending the application for aortic interventional therapy and making emergency interventional therapy safer.

Sequential atrioventricular activation plays a critical role in the physiology of Fontan circulation. Although bradycardia is usually well tolerated, retroconducted junctional rhythm may acutely increase atrial pressure impairing cardiac output. Echocardiographic evaluation can reveal clues of this hemodynamic condition. The clinical impact of arrhythmic disturbance on the follow up of patients who had undergone total cavo-pulmonary connection is well recognized but the role of transient periods of retroconducted junctional rhythm on the immediate post-operative course is less defined. We describe two cases of acute Fontan circulatory failure due to postoperative retroconducted escaping junctional rhythm despite an adequate heart rate and circadian variation. The patients rapidly improved after atrial pacing, allowing discharge with a minimal dose of diuretic.

In this paper, a hybrid training method for Multilayer Perceptron (MLP) is proposed based on combining Back Propagation (BP) and Genetic Algorithm (GA). The proposed scheme is compared with the Support Vector Machine approach to classify six fault conditions and the normal condition of a centrifugal pump. Two training algorithms were tested and compared. Features were extracted using Wavelet Packet Transform (WPT) with three levels decomposition, and two mother wavelets were used to investigate their effectiveness on feature extraction. Furthermore, GA is also used to optimize the number of hidden layers and neurons of MLP. The results obtained, show improved performance on the feature extraction, GA based hidden layers and neurons selection, training algorithm, and classification performance using the proposed scheme.

We proposed an efficient local differential quadrature method which is based on the radial basis function to the numerical solution of the two-dimensional second-order hyperbolic telegraph equations. The explicit time integration technique is utilized to semi-discretize the model in the time direction whereas the space derivatives of the model is discretized by the proposed local meshless procedure based on multiquadric radial basis function. Numerical experiments on ve test problems are performed with the proposed numerical scheme for rectangular and non-rectangular computational domains. The results obtained show that the proposed scheme solutions are converging extremely faster comparable to different existing protocols.

The main aim of this paper is the use of the rotation minimizing frame for the singularity type classification of timelike sweeping surface in Minkowski 3–Space $\mathbb{E}_{1}^{3}$. Then, we give conditions for a timelike sweeping surface to be developable ruled surfaces. To apply and illustrate the main results, some examples are given.%

In this paper, the time-fractional advection-diffusion equation is solved by a cubic B-spline collocation method. For the fractional derivative we use the concept of the fractional derivative of Capato. Calculating of this numerical scheme is very simple. The presented numerical scheme is unconditional stable and highly accurate. We also obtain some error estimations with L2-norm and L∞-norm.

When grown under cool temperature, winter annuals respond with not only enhanced freezing tolerance but also photosynthetic upregulation. The role of the cold-induced C-repeat-Binding Factor (CBFs) in long-term maintenance of freezing tolerance and photosynthetic upregulation was examined in two Arabidopsis thaliana ecotypes adapted to differing climates (Italy = IT and Sweden = SW) as well as corresponding CBF-disabled mutant lines. Data on photosynthetic, morphological, and freezing-tolerance phenotypes as well as transcriptomic data were collected from plants grown for several weeks under controlled conditions with several combinations of temperature and light levels. Freezing tolerance in these acclimated plants depended strongly on CBFs in both SW and IT. In contrast, photosynthetic upregulation was the same, or modestly reduced, in cbf mutant versus parental lines of SW and IT, respectively. Physiological and transcriptomic data showed a consistent trend for a greater role of CBFs in cool-temperature-grown plants of IT versus SW. These features suggest that IT remained in a state of continuing CBF-related cold-acclimation even after weeks of acclimation, while SW entered a state of completed acclimation in which maintenance of photosynthetic upregulation no longer required CBF activation and maintenance of freezing tolerance was less dependent on CBF than in IT.

A 1 year female child, first in birth order, born term out of nonconsanguineous marriage through normal vaginal delivery and had uneventful postnatal period. She had history of recurrent episodes of tachypnea. On examination patient was hemodynamically stable, afebrile with heart rate of 84 beats/minutes in sinus rhythm, blood pressure of 112/65mm Hg with Spo2 of 99%. On cardiac examination there were normal findings except soft systolic murmur. Echocardiography (echo) revealed a single solid mass arising from papillary muscle extending into left ventricular (LV) posterior wall upto crux of heart measuring 2.7x2.7cms likely of Ventricular Fibroma. Cardiac MRI (CMR) revealed well defined mass lesion of 3.9x3.8 cm arising from posterior wall of left ventricle extending posteriorly with exophytic component showing homogenous delayed enhancement confirming our diagnosis of ventricular fibroma. Her Holter showed intermittent episodes of non-sustained broad complex tachycardia suggestive of Ventricular Tachycardia. She was then discharged on oral Amiodarone and Propanolol and kept on continuous follow up. At 2 years of age she was readmitted with history of palpitation and ECG done showed ventricular tachycardia. She was kept on oral Amiodarone and Propanolol with continuous monitoring. Echo done similar findings but the mass was gradually increasing in size(37x35cms). Holter and ECG showed frequent episodes of wide QRS tachycardia most likely VT,??SVT with aberrancy. Hemodynamics of the child were maintained during the episodic cardiac arrhythmias. CMR was repeated which showed increase in well defined mass measuring 43x42cms arising from mid basal posterior inferior wall of LV extending posteriorly with exophytic component . PET CT scan was done showed non FDG avid nodular lesion in relation with left ventricle suggestive of Fibroma. Her Thyroid profile is being monitored and is within normal range. Sotalol has been introduced in the management of the child and Amiodarone was withdrawn .It demonstrated transient episodes of tachycardia which are non sustained. Child is being kept under regular follow upPrimary cardiac tumors are rare with incidence of 0.03-0.32%.1Cardiac fibroma predominantly affects children and is second most common benign tumor. The most common site is left ventricle(57%) followed by right ventricle(27.5%) and interventricular septum(17%).1Although cardiac fibromas are asymptomatic some may present with serious complications like arrhythmias and intracavitary obstruction. Ventricular tachycardia have been reported in few cases of cardiac fibroma2,3which was also found in our case.Our case was collectively discussed with pediatric cardiothoracic team, radiology and electrophysiology meet. Surgery was deferred keeping in view the extensive involvement of left ventricle which hindered the cleavage plane. Few literatures recommend strategy of postponing surgery and adequate management of ventricular tachycardia for tumors not amenable to resection which would increase the chances of successful surgical outcome later.2REFERENCES:1.Furqan A.Rajput,Faten Limaiem.Cardiac Fibroma.[Updated 2020 Apr 29].In:StatPearls[Internet].Treasure Island(FL):StatPearls Publishing;2020 Jan-.2.Alyssa L .Ritter,Eric J.Granquist,V.Ramesh Iyer,Kosuke Izumi.Cardiac Fibroma with ventricular Tachycardia:An unusual Clinical Presentation of Nevoid Basal Cell Carcinoma Syndrome.Mol Syndromol 2018;9:219-2233.Alice Horovitz,Irene E.van Geldorp,Francis Roubertie,Jean-Benoit Thambo.Large Right Ventricular Fibroma in a 6 month-old infant.Pediatr Cardiol(2012) 33:1458-1460LEGENDSFigure 1: 12 lead ECG showing wide complex regular tachycardiaFigure 2:Two dimensional Echocardiography with apical four chamber view(A) with posterior tilt(B) showing a single solid mass arising from papillary muscle extending into left ventricular (LV) posterior wall upto crux of heart.LA-Left atrium,LV-left ventricleFigure 3: Two dimensional Echocardiography with subcostal long axis view showing a single solid mass arising from papillary muscle extending into left ventricular (LV) wall ,LA-Left Atrium,RA-Right AtriumFigure 4:Contrast Cardiac MRI showing well defined mass lesion arising from posterior wall of left ventricle extending posteriorly with exophytic component showing homogenous delayed enhancement(A),Size of the mass measuring 39x38mm(B)

Objectives: To compare outcomes after the development of early (≤30 days) versus delayed (>30 days) deep sternal wound infection (DSWI) after cardiac surgery. Methods: Between 2005 and 2016, 64 patients were treated surgically for DSWI following cardiac surgery. Thirty-three developed early DSWI, while 31 developed late DSWI. Mean follow up was 34.1 ± 32.3 months. Results: Survival for the entire cohort at 1, 3, and 5 years was 93.9, 85.1, and 80.8%, respectively. DSWI diagnosed early and attempted medical management were strongly associated with overall mortality (hazard ratio (HR), 25.0 and 9.9; 95% confidence intervals (CI), 1.18-528 and 1.28-76.5; p-value 0.04 and 0.04, respectively). Survival was 88.1, 77.0, 70.6 and 100, 94.0 and 94.0% at 1,3, and 5 years in the early and late DSWI groups, respectively (Log-rank = 0.074). Those diagnosed early were more likely to have a positive wound culture (odds ratio (OR), 0.06, 95% CI 0.01-0.69, p=0.024) and diagnosed late were more likely to be female (OR 8.75, 95% CI 2.0-38.4, p=0.004) and require an urgent DSWI procedure (OR 9.25, 95% CI 1.86-45.9, p=0.007). Both early diagnosis of DSWI and initial attempted medial management were strongly associated with mortality (hazard ratio 7.48, 95% CI 1.38-40.4, p=0.019 and hazard ratio 7.76, 95% CI 1.67-35.9, p=0.009, respectively). Conclusions: Early aggressive surgical therapy for deep sternal wound infection after cardiac surgery results in excellent outcomes. Those diagnosed with DSWI early and have failed initial medical management have increased mortality.

We report the case of a 72-year-old man with pulmonary valve infective endocarditis, who complained of general malaise for 10 days. He was afebrile but there was no murmur. However, computed tomography showed a large mobile mass attached to the pulmonary valve, and echocardiography showed the same mass attached to the pulmonary valve but not to other valves. We needed to distinguish between vegetation, thrombus, and tumor. After a positive blood culture result, antibiotic treatment was started, but the mass increased in size since the time of hospitalization. We decided to remove the mass. Resection of the vegetation and pulmonary valve replacement were performed 11 days after hospitalization. After antibiotic treatment, the patient was discharged on postoperative day 30. This is a rare case in which infective endocarditis presented only at the pulmonary valve.

Acoustic Emission (AE) waveforms contain information on microscopic structural features that can be related with damage of coal and rock masses. In this paper the Hilbert-Huang transform (HHT) method is used to obtain detailed structural characteristics of coal and rock masses associated with damage, at different loading stages, from the analyses of the characteristics of AE waveforms. The results show that the HHT method can be used to decompose the target waveform into multiple intrinsic mode function (IMF) components, with the energy mainly concentrated in the c1-c4 IMF components, and where the c1 component has the highest frequency and the largest amount of energy. As the loading continues, the proportion of energy occupied by the low-frequency IMF component shows an increasing trend. In the initial compaction stage, the Hilbert marginal spectrum is mainly concentrated in the low frequencies between 0-40KHz. The plastic deformation stage is associated to energy accumulation in the 0-25KHz and 200-350KHz frequency ranges, while the instability damage stage is mainly concentrated in the 0-25KHz frequency range. At 20KHz, the instability damage reaches its maximum value. There is a relatively clear instantaneous energy peak at each stage, albeit being more distinct at the beginning and at the end of the compaction phase. Since the effective duration of the waveform is short, its resulting energy is small, and so the relatively high value from the instantaneous energy peak, at the time of destruction, is relatively long lasting and is where the waveform reaches its maximum energy value. The Hilbert three-dimensional energy spectrum is generally zero in the region where the real energy is zero. In addition, its energy spectrum is intermittent rather than continuous. It is therefore consistent with the characteristics of the several dynamic ranges mentioned above, and it indicates more clearly the low-frequency energy concentration in the critical stage of instability failure. This study well reflects the response law of geophysical signals in the process of coal-rock instability and failure, providing a basis for monitoring coal-rock dynamic disasters.

In this paper, the authors approximate the solution of time fractional multi- dimensional Burger’s equation using the time-space Chebyshev pseudospectral method. Caputo fractional derivatives formula is used to illustrate the fractional derivatives matrix at CGL points. Using the Chebyshev fractional derivatives matrices the given problem is reduced to a system of nonlinear algebraic equations. These equations can be solved using Newton’s iterative method. Error analysis of the proposed method for the equation is presented. Model examples of time-fractional Burger’s equation are tested for a set of values of $ \nu $, where $ \nu $ represent the fractional order. For the proposed method, highly accurate numerical results are obtained which are compared with the analytical solution to confirm the accuracy and efficiency of the proposed method.

The present study is carried out on the unsteady laminar heat transferable dusty fluid flow past between two parallel Riga plates. The lower plate is kept fixed while the upper plate keeps moving with a constant velocity. A uniform Lorentz forces induced by Riga plates and a constant pressure gradient is applied on the fluid. The governing equations are derived from Navier-Stokes equation, Energy equation. Boundary layer approximations have been employed. The motion of the dust particles is governed by Newton's second law. The non-dimensional equations are solved by using the explicit finite difference method. The effects of necessary parameters on the velocity and temperature distributions as well as the shear stress and Nusselt number of clean fluid particle and dust particles have been discussed in detail.

Melt superheated treatment can affect the solidification structure, but the direct evidence requires strict experiments. The molecular dynamics simulation method can break the limited experimental conditions, and provide advanced prediction for research. In this study, influences of superheated temperature (Ts) on the nucleation undercooling (ΔT) of metallic melts (Ti, Co, Mg, Al, Ni, Fe, Ag) were studied by the molecular dynamics simulation. The results show that the value of ΔT increases with the rise of Ts until the maximal ΔT approaches. In the curve of ΔT vs. Ts, there is an inflexion region where the nucleus cluster was broken. Above this inflexion region, the number of nucleus clusters decreases with the rise of Ts. Based on the simulated results, a model was proposed for describing the relation of ΔT and Ts, with which the maximal undercooling for metals can be predicted.

The paper deals with the analysis of stable thermo-solutal dendritic growth in the presence of intense convection. The n-fold symmetry of crystalline anisotropy as well as the two- and three-dimensional growth geometries are considered. The steady-state analytical solutions are found with allowance for the convective-type heat and mass exchange boundary conditions at the dendritic surface. A linear morphological stability analysis determining the marginal wavenumber is carried out. The new stability criterion is derived from the solvability theory and stability analysis. This selection criterion takes place in the regions of small undercooling. To describe a broader undercooling diapason, the obtained selection criterion, which describes the case of intense convection, is stitched together with the previously known selection criterion for the conductive-type boundary conditions. It is demonstrated that the stitched selection criterion well describes a broad diapason of experimental undercoolings.

The developed model of diffusion-limited and diffusionless solidification of eutectic alloy describes the relation “undercooling (ΔT)–velocity(V)–interlamellar spacing (λ)” for two cases. Namely, if the lamellar velocity V is smaller than the solute diffusion speed in bulk liquid VD, VVD, the solidification is mainly controlled by kinetic and thermal undercoolings. We show an influence of model parameters on the growth kinetics of eutectic solidification. Comparison of the model predictions with experimental data obtained on Fe-B samples processed in melt-glass fluxing is given.

Continuity, in particular sequential continuity, is an important subject of investigation not only in Topology, but also in some other branches of Mathematics. Connor and Grosse-Erdmann remodeled its definition for real functions by replacing {\sf lim} with an arbitrary linear functional $G$ defined on a linear subspace of the vector space of all real sequences. Then, this definition was extended to a topological group $X$ by replacing a linear functional $G$ with an arbitrary additive function defined on a subgroup of the group of all $X$-valued sequences. Also, some new theorems in generalized setting were given and some other theorems that had not been obtained for real functions were presented. In this study, we introduce neutrosophic $G$-continuity and investigate its properties in neutrosophic topological spaces.

Numerous experimental data on rapid solidification of eutectic systems exhibit the formation of metastable solid phases with the initial (nominal) chemical composition. This fact is explained by suppression of eutectic decomposition due to diffusionless (chemically partitionless) solidification beginning at a high but a finite growth velocity of crystals. A model considering the diffusionless growth is developed in the present work to analyze the atomic diffusion ahead of lamellar eutectic couples growing into supercooled liquid. A general solution of the model is presented from which two regimes are followed. The first presents diffusion-limited regime with the existence of eutectic decomposition if the solid-liquid interface velocity is smaller than characteristic diffusion speed in bulk liquid. The second shows suppression of eutectic decomposition under diffusionless transformation from liquid to one-phase solid if the solid-liquid interface velocity overcomes characteristic diffusion speed in bulk liquid.

Purpose:The aim of our study was to examine whether left atrial dispersion and left atrial strain as measured by speckle tracking echocardiography and clinic paramaters are predictors for the development of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy. Methods: A total of 137 patients (70% male, mean age 49.6 ± 14.2 years) with HCM were included in the study. Patients’ clinical, electrocardiographic, 2D classic and speckle tracking echocardiographic (STE) data were collected. AF was searched by 12-lead electrocardiograms or 24-hour Holter recordings during follow-up period. Atrial dispersion was defined as the standard deviation of time to peak strain in 12 left atrial segments Results: During a follow-up period of 5 years 37 patients (16.9%) developed AF. At follow-up, the patients with occurrence of AF were older than in patients without AF. Atrial dispersion was observed to be higher in the AF developing group (61.4 ± 23.2 vs 43.1±15.8, p=<0.001). The multivariate in Cox regression analysis (including atrial dispersion, PALS, age, LA) atrial dispersion (msn) (HR 1.017, 95% CI: 1.001-1.03, p= 0.035) and age were found to be independent predictors of AF occurrence. In the ROC analysis atrial dispersion > 44.7 msn predicted occurrence of AF with 82.4% sensitivity and 64 % specificity. Conclusion: In patients with hypertrophic cardiomyopathy, atrial dispersion and age are predictive of the development of atrial fibrillation. Atrial dispersion measured by the speckle tracking-based method may provide further information in evaluating left atrial functions in patients with hypertrophic cardiomyopathy or other disease states

The modern workplace requires teamwork bridging distances, time-zones and cultures using virtual collaboration platforms. As such teamwork is a key employability skill for our graduates, and yet we rarely explicitly teach team skills or how to navigate and collaborate in a virtual environment. Here we demonstrate that integrating in-person (synchronous) and online (synchronous and asynchronous) learning environments can prove an extremely resilient teaching method that allowed continuity during COVID-19 lockdown, while providing them with these essential skills. Students were given a semester long documentary video team assignment supported by regular compulsory team training sessions and using the Microsoft Teams online collaboration platform. At the end of semester, the 24 students in the class were sent a survey with questions relating to their perspectives of teamwork in general, the team training sessions and online platform and the impact of COVID-19. Of the 12 respondents only 4 reported negative attitudes to teamwork in general and learning and shared workload were the most reported benefits. Implementing explicit (and compulsory) team training sessions throughout semester were valued by the students for reasons ranging from the explicit intention of each task (team establishment and planning, negotiation, reflection of team behaviours, negotiating team member contributions) to the more general appreciation that regular compulsory sessions ensured the teams met frequently. It was particularly positive that every student reported that this team experience was better than their previous team experiences, and this in spite of the COVID-19 lockdown. Included with this manuscript are all the learning materials provided to the students and a few key lessons we learnt along the way.

The desert harvester ant Veromessor pergandei displays geographic variation in colony founding with queens initiating nests singly (haplometrosis) or in groups (pleometrosis). The transition from haplo- to pleometroic founding is associated with lower rainfall. Numerous hypotheses have been proposed to explain the evolution of cooperative founding in this species, but the ultimate explanation remains unanswered. In laboratory experiments, water level was positively associated with survival, condition, and brood production by single queens. Queen survival also was positively influenced by water level and queen number in a two-factor experiment. Water level also was a significant effect for three measures of queen condition, but queen number was not significant for any measure. Foundress queens excavated after two weeks of desiccating conditions were dehydrated compared to alate queens captured from their natal colony, indicating that desiccation can be a source of queen mortality. Long-term monitoring in central Arizona, USA, documented that recruitment only occurred in 4 of 20 years. A discriminant analysis using rainfall as a predictor of recruitment correctly predicted recruitment in 17 of 20 years for total rainfall from January–June (the period for mating flights and establishment) and in 19 of 20 years for early plus late rainfall (January–March and April–June, respectively), often with a posterior probability > 0.90. Moreover, recruitment occurred only in years in which both early and late rainfall exceeded the long-term mean. This result also was supported by the discriminant analysis predicting no recruitment when long-term mean early and late rainfall were included as ungrouped periods. These data suggest that pleometrosis in V. pergandei evolved to enhance colony survival in areas with harsh abiotic (desiccating) conditions, facilitating colonization of habitats in which solitary queens could not establish even in wet years. This favorable-year hypothesis supports enhanced worker production as the primary advantage of pleometrosis.