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Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome

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World Journal of Cardiovascular Surgery 2024年第1期14卷 7-19页

作者： Daniel Manzur-Sandoval Gian Manuel Jiménez-Rodríguez Edgar García-Cruz ramón Espinosa-Soto Erika Yamali ramirez-Marcano Yessenia Máyory Téllez-López José Luis Elizalde-Silva Gustavo Rojas-Velasco Cardiovascular Critical Care Unit Ignacio Ch&#225vez National Institute of Cardiology Mexico City Mexico Adult Congenital Heart Disease Unit Ignacio Ch&#225vez National Institute of Cardiology Mexico City Mexico Cardiology Department Ignacio Ch&#225vez National Institute of Cardiology Mexico City Mexico

Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are an increasingly recognized and growing population and include various groups, such as undiagnosed cases in childhood and palliated and/or corrected cases, which require subsequent care because of residual lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions. In addition, these patients are prone to developing pathologies that are typical of adulthood with a generally increased risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart disease, which makes them candidates for ECMO. These patients represent an additional challenge in this therapy because malformations and the presence of a shunt can generally affect the usual cannulation methods and hemodynamic and oximetry monitoring. Thus, the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method, venopulmonary artery ECMO, which provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in patients with congenital heart diseases.

关键词： Eisenmenger Syndrome Venopulmonary Artery ECMO Refractory Hypoxemia Right Ventricular Dysfunction

An Evolutionary Approach to Improve the Beam Steering Performance over Conventional Approach in CHAA

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Journal of Communications and Information Networks 2023年第2期8卷 164-170页

作者： K Akhitha Gopi ram National Institute of Technology Warangal 506004India

In this work,evolutionary algorithms are applied for the first time to achieve better radiation characteristics over the conventional beamforming algorithm in the concentric hexagonal antenna array(CHAA),which improves the performance of wireless communication.Multiple signal classification(MUSIC)algorithm is employed for direction of arrival(DoA)estimation.The conventional adaptive beam steering algorithm,least mean-square(LMS)algorithm,is used to steer the beam.Further,the proposed approach is employed by novel particle swarm optimization(NPSO)to reduce sidelobe level(SLL)even further.A six-ring CHAA with 126 elements for DoA estimation and beam steering is simulated.The simulation results of the MUSIC,LMS,NPSO,and particle swarm optimization(PSO)algorithms are provided for various DoAs.

关键词： smart antenna hexagonal array PSO MUSIC algorithm LMS algorithm DoA estimation beam steering NPSO

ELLIPTIC RECONSTRUCTION AND A POSTERIORI ERROR ESTIMATES FOR FULLY DISCRETE SEMILINEAR PARABOLIC OPTIMAL CONTROL PROBLEMS

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Journal of Computational Mathematics 2022年第2期40卷 147-176页

作者： ram Manohar Rajen Kumar Sinha Department of Mathematics Indian Institute of Technology GuwahatiGuwahati-781039India

This article studies a posteriori error analysis of fully discrete finite element approximations for semilinear parabolic optimal control problems.Based on elliptic reconstruction approach introduced earlier by Makridakis and Nochetto[25],a residual based a posteriori error estimators for the state,co-state and control variables are derived.The space discretization of the state and co-state variables is done by using the piecewise linear and continuous finite elements,whereas the piecewise constant functions are employed for the control variable.The temporal discretization is based on the backward Euler method.We derive a posteriori error estimates for the state,co-state and control variables in the L^(∞)(0,T;L^(2)(Ω))-norm.Finally,a numerical experiment is performed to illustrate the performance of the derived estimators.

关键词： Semilinear parabolic optimal control problem Finite element method The backward Euler method Elliptic reconstruction A posteriori error estimates

Endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction in Mexico

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World Journal of Surgical Procedures 2024年第3期14卷 15-20页

作者： Massiel Madelin Rosario-Morel Rodrigo Soto-Solis Katia Picazo-Ferrera Miriam Idalia Torres-Ruiz JoséAlberto Estradas-Trujillo Mario Alberto Gallardo-ramírez Gerardo Akram Darwich-del Moral Luis Ariel Waller-González Department of Endoscopy Centro Médico Nacional“20 de Noviembre”ISSSTEMexico City 03229Mexico Department of Gastroenterology HospitalÁngeles PedregalMexico City 10700Mexico Department of Endoscopy Centro Médico ABCMexico City 01120Mexico Department of Endoscopy Hospital General de México“Dr.Eduardo Liceaga”Mexico City 06720Mexico

BACKGROUND Endoscopic ultrasound-guided gastroenterostomy(EUS-GE)has recently emerged as an alternative treatment for gastric outlet obstruction(GOO)in selected patients.AIM To report the initial experience of EUS-GE in patients with GOO.METHODS This study was a retrospective,observational,multicenter study in which the data from 10 patients who underwent EUS-GE due to GOO between September 2021 and May 2023 were collected.We analyzed technical success,clinical success,adverse events,and survival.Technical success was defined as adequate positioning and deployment of the stent.Clinical success was defined as the patient’s ability to tolerate oral intake without vomiting 7 d after the procedure.Postprocedural adverse events were recorded.RESULTS Eleven procedures in 10 patients with GOO were included.The mean age of the patients was 67.5 years(range:56-77 years).Malignant GOO was present in 9 patients.Technical success was achieved in 9/11 procedures(82%).Among them,clinical success was achieved in 9 patients(100%).Adverse events occurred in 1 patient(9%).The median survival was 3 months(n=7;range:1-8 months).CONCLUSION EUS-GE is a feasible therapeutic option in the treatment of GOO.

关键词： Endoscopic ultrasound-guided gastroenterostomy Gastric outlet obstruction Lumen apposing metal stent Interventional endoscopic ultrasound Gastrojejunostomy Duodenal stenting

Laboratory investigation on damping characteristics of homogeneous and stratified soil-ash system

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Journal of Rock Mechanics and Geotechnical Engineering 2023年第10期15卷 2757-2777页

作者： Amit Kumar ram Supriya Mohanty Department of Civil Engineering Indian Institute of Technology(BHU)VaranasiVaranasi221005India

In this study,the damping responses of uniform soil,equi-proportional fly ash,and local soil as a single unit were investigated.The large-strain cyclic triaxial tests were performed for the specimen compacted at the desired density(95%e99%of maximum dry density).The compacted specimens were tested under the loading frequency of 0.3e1 Hz with medium confinement of 70e100 kPa.Also,the unsymmetrical behavior of the hysteresis loop was analyzed using three different damping estimation approaches,i.***.symmetric hysteresis loop(SHL),asymmetric hysteresis loop(ASHL),and the modified American Society for Testing and Materials(ASTM)method.The outcome of the study shows for fly ash,local soil,and layered soil-ash,the ASHL technique has the highest damping value,followed by ASTM and then the SHL approach.The specimens prepared under high density and subjected to high confinement show low damping values.However,the specimens tested at high frequency exhibits high damping behavior.Similarly,the damping value of fly ash determined using the SHL and ASHL methods has a similar profile and reaches a maximum at 1%shear strain value before decreasing.The composite stratified deposit exhibits more dependency on relative compaction,confining pressure,and less on loading frequency.Based on the results,it is highly recommended to use the ASHL approach,especially under large strain conditions irrespective of soil type.The maximum damping ratio of stratified deposits is always in between the damping ratio of local soil and fly ash.The damping ratio of stratified soil and local soil is slightly larger than that of the other soils,although the damping ratio of fly ash is equivalent to that of the sand and clayey soil.These results may be helpful in the accurate determination of the damping properties of the layered soil-ash system that is required in the seismic response analysis.

关键词： Homogeneous soil Stratified soil-ash system Damping behavior Cyclic triaxial test Asymmetric hysteresis loop Model fitting

On the spatio-temporal variation in b-value after 25 April 2015 Gorkha,Nepal earthquake

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Geodesy and Geodynamics 2022年第5期13卷 525-533页

作者： ram Krishna Tiwari Harihar Paudyal Daya Shanker Central Department of Physics Tribhuvan UniversityKirtipurKathmanduNepal Birendra Multiple Campus Tribhuvan UniversityBharatpurChitwanNepal Department of Earthquake Engineering Indian Institute of Technology RoorkeeRoorkeeUttarakhandIndia

In the present study,the spatial-temporal distribution of b-value along the five faults area(the Judi fault,Thaple fault,Kathmandu fault,Motihari-Gauri Shanker fault,and Motihari-Everest fault)was investigated after the Gorkha earthquake(M7.8).The earthquake catalog of 10,500 events was prepared by compiling the published catalogs.The study area is bounded in the central Himalaya from 26.5°to 29°in latitude direction and 84°to 87°in longitude direction.The frequency magnitude distribution shows the variation of the b-value along with fault areas from 0.45 to 0.69,indicating a common characteristic of aftershock sequences.In particular,the Judi fault area,Thaple fault area,and Motihari-Everest fault area are characterized by the low b-values of 0.45±0.02,0.48±0.02,and 0.55±0.04,respectively.These regions could be the source region for future earthquakes.The low b-value observed for fault areas are also consistent with the thrust faulting pattern in the region as indicated by the focal mechanism of mainshock and major aftershocks.The temporal variation of b-value shows inevitable fluctuations during25 April to 12 May 2015.Among the area selected,the Motihari-Everest fault area is in critical strain(mechanically locked)conditions,as indicated by the stepwise energy release pattern.

关键词： Frequency-magnitude distribution Time series analysis Thrust fault Stress Central Himalaya

The potential of legume-derived proteins in the food industry

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Grain & Oil Science and Technology 2022年第4期5卷 167-178页

作者： Neta Goldstein ram Reifen The Institute of Biochemistry and Nutrition The Robert H.Smith Faculty of AgricultureFood and EnvironmentThe Hebrew University of JerusalemRehovot 76100Israel

Legume-derived proteins present an opportunity to replace existing animal-source protein in various applications. Those proteins are abundant, relatively lowcost, sustainable, not highly allergenic, and widely acceptable by consumers. In this paper, it was found that legume-derived protein’s technofunctional properties(e.g. gelation, emulsification and foaming) are being investigated, in order to assess their ability to substitute for animal-derived proteins in food systems and applications. This paper reviewed the functional attributes of legume-derived proteins, their possible applications in food systems, and their potential in the food industry. The techno-functional properties of the proteins vary among different legumes, and while some proteins properties are sufficient for industrial uses, the other may need to be modified. It was concluded that legume-derived proteins could replace some existing animal-derived protein based food systems.

关键词： Legumes Plant protein Food industry Techno-functional properties Fat and protein composition

Macro level performance study of Ahmadabad bus rapid transit system:Janmarg

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Green Energy and Intelligent Transportation 2023年第3期2卷 30-52页

作者： Sanskar Pathak ram Krishna Upadhyay Gati Shakti Vishwavidyalaya VadodaraGujarat390004India

Amidst the rapid urbanization in the country,the importance of urban public transport has been realized by the governments.Public transport is vital to the city's economy and ensures social equity.Bus Rapid Transit System(BRTS)has emerged as an exciting way to decongest the cities,enhancing and increasing mobility and accessi-bility and promoting transit-oriented development.India's longest BRTS,Janmarg,was created with similar ob-jectives.However,the system faces reduced ridership and inhibited growth because of its hidden inefficiencies.This research aims to identify all the factors affecting ridership,accessibility,and inhibiting the system's growth even after having sufficient infrastructure.It also aims to quantitatively determine whether Janmarg could achieve its establishment's objectives on the city transportation system after thirteen years of the successful implementation of the project.The research methodology used in this work combines primary and secondary research.The factors are responsible for preventing Janmarg from achieving its objectives and utilizing its full potential are determined and recommended ways to utilize adversities effectively.Results show that this study endorses reducing ambiguities and a way forward for making a sustainable transportation system.

关键词： Janmarg Ridership Travel mode Passenger behavior

Natural history and management of liver dysfunction in lysosomal storage disorders

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World Journal of Hepatology 2022年第10期14卷 1844-1861页

作者： Moinak Sen Sarma Parijat ram Tripathi Department of Pediatric Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014India Department of Pediatric Gastroenterology Ankura Hospital for Women and ChildrenHyderabad 500072India

Lysosomal storage disorders(LSD)are a rare group of genetic disorders.The major LSDs that cause liver dysfunction are disorders of sphingolipid lipid storage[Gaucher disease(GD)and Niemann-Pick disease]and lysosomal acid lipase deficiency[cholesteryl ester storage disease and Wolman disease(WD)].These diseases can cause significant liver problems ranging from asymptomatic hepatomegaly to cirrhosis and portal hypertension.Abnormal storage cells initiate hepatic fibrosis in sphingolipid disorders.Dyslipidemia causes micronodular cirrhosis in lipid storage disorders.These disorders must be keenly differentiated from other chronic liver diseases and non-alcoholic steatohepatitis that affect children and young adults.GD,Niemann-Pick type C,and WD also cause neonatal cholestasis and infantile liver failure.Genotype and liver phenotype correlation is variable in these conditions.Patients with LSD may survive up to 4-5 decades except for those with neonatal onset disease.The diagnosis of all LSD is based on enzymatic activity,tissue histology,and genetic testing.Enzyme replacement is possible in GD and Niemann-Pick types A and B though there are major limitations in the outcome.Those that progress invariably require liver transplantation with variable outcomes.The prognosis of Niemann-Pick type C and WD is universally poor.Enzyme replacement therapy has a promising role in cholesteryl ester storage disease.This review attempts to outline the natural history of these disorders from a hepatologist’s perspective to increase awareness and facilitate better management of these rare disorders.

关键词： Lysosomal Gaucher Niemann-Pick Wolman Cholesteryl ester Children