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A Quality Improvement Survey to Assess Pain Management in Cardiac Surgery Patients

Open Journal of Anesthesiology 2015年第5期5卷 105-112页

作者： mohammad Hamid Amar Lal Gangwani mohammad irfan akhtar Aga Khan University Karachi Pakistan

Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic pain patients, paediatric patients, emergency surgeries were excluded. A predesigned proforma was prepared according to American Pain Society recommendations and distributed among Cardiac ICU patients after 24 hours of extubation. This proforma was explained to the patients and collected later. The questionnaire was related to pain severity, aggravating and relieving factors, side effects of analgesics, affective experience and satisfaction with pain management. Results: Total 308 patients participated in one year period. 243 (78.9%) were male and 65 (21.1%) were female. Multimodal analgesia was used in most of the patients. Severity of pain was described as mild 70% and moderate 28.6%. Most of the patients complained of sharp pain 100 (37.5%), mainly at the site of incision 129 (41.9%). The main aggravating factor associated with increased pain was deep breathing 118 (39.8%) while pain was minimized by taking pain medications 40.6%. A significant association was found between preoperative counseling about pain options and satisfaction. 96.8% reported satisfaction with pain management. Conclusion: Although overall pain control was reported as adequate and patients were highly satisfied, there were areas which need further improvement. These include strategies to provide preoperative information about postoperative pain management and better training of medical staff to assess and manage pain. Additionally, the concerns and fears of patients about pain treatment need to be addressed.

关键词： Analgesia Cardiac Surgical Procedures Pain Management Questionnaires

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Errors during Paediatric Cardiac Anaesthesia: Reporting and Learning

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Open Journal of Anesthesiology 2013年第9期3卷 408-412页

作者： mohammad Hamid mohammad irfan akhtar Fauzia Nasim Minai Amar Lal Gangwani Department of Anaesthesiology Aga Khan University Karachi Pakistan

Incident reporting is a reliable quality assurance tool, frequently used in anaesthesia to identify errors. It was introduced in anaesthesia by Cooper in 1978 and since then several institutions have adopted this system to find adverse events and near misses. We think that the incident reporting would be more beneficial for prolonged and technically complex procedures like paediatric cardiac surgery. Methods: All paediatric CHD patients scheduled for cardiac surgery were included in this audit. Thoracic and general surgery patients were excluded. Any event in preoperative area, induction room, operating room and during transfer to cardiac ICU was documented in a predesigned proforma by resident/consultant. This proforma included information regarding demographics, the type and severity and responsible factors for the event. Results: 134 patients were included in this two and half years audit. 88 patients were male (65.7%) and 46 (34.3%) were female. The age of the patients ranged from one day to 15 years. Total 105 incidents were noticed in 61 patients. 46 incidents were declared as major events which were potentially serious while 59 events were of minor nature. Cuffed endotracheal tube was used in 73% patients. The majority of events occurred in the pre-bypass period. Most of the incidents were related to cardiovascular system (73%), followed by pharmacological incidents. Human factors (74%) were mainly responsible for the incidents. Conclusion: Incident reporting is a reliable and feasible method of improving quality care in developing countries. It helps in identifying areas which need improvement and helps in developing guidelines to improve safety.

关键词： Paediatric Congenital Heart Surgery Anaesthesia Errors

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Quintessence anisotropic stellar models in quadratic and Born-Infeld modified teleparallel Rastall gravity

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Chinese Physics B 2024年第3期33卷 179-189页

作者： Allah Ditta 夏铁成 irfan Mahmood Asif Mahmood Department of Mathematics Shanghai University and Newtouch Center for Mathematics of Shanghai UniversityShanghai 200444China Centre for High Energy Physics University of the PunjabLahorePakistan College of Engineering Chemical Engineering DepartmentKing Saud University RiyadhSaudi Arabia

This study aims to discuss anisotropic solutions that are spherically symmetric in the quintessence field,which describe compact stellar objects in the modified Rastall teleparallel theory of *** achieve this goal,the Krori and Barua arrangement for spherically symmetric components of the line element is *** explore the field equations by selecting appropriate off-diagonal tetrad ***-Infeld function of torsion f(T)=β√λT+1-1 and power law form h(T)=δTn are *** Born-Infeld gravity was the first modified teleparallel gravity to discuss *** use the linear equation of state pr=ξρto separate the quintessence *** obtaining the field equations,we investigate different physical parameters that demonstrate the stability and physical acceptability of the stellar *** use observational data,such as the mass and radius of the compact star candidates PSRJ 1416-2230,Cen X-3,&4U 1820-30,to ensure the physical plausibility of our findings.

关键词： anisotropic spheres quintessence field modified Rastall teleparallel gravity equation of state(EoS) f(T)gravity

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Isolation and Characterization of Cellulose Nanofiber(CNF)from Kenaf(Hibiscus cannabinus)Bast through the Chemo-Mechanical Process

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Journal of Renewable Materials 2024年第6期12卷 1057-1069页

作者： Rudi Dungani mohammad irfan Bakshi Tsabita Zahra Hanifa Mustika Dewi Firda A.Syamani Melbi Mahardika Widya Fatriasari School of Life Sciences and Technology Institut Teknologi BandungBandung40132Indonesia Research Center for Biomass and Bioproducts National Research and Innovation Agency(BRIN)Cibinong16911Indonesia

The present work emphasizes the isolation of cellulose nanofiber(CNF)from the kenaf(Hibiscus cannabinus)bast through a chemo-mechanical *** order to develop high CNF yield with superior properties of CNF for improving compatibility in varied applications this method is *** fiber purification involved pulping and bleaching treatments,whereas mechanical treatment was performed by grinding and high-pressure *** kraft pulping as a delignification method followed by bleaching has successfully removed almost 99%lignin in the fiber with high pulp yield and delignification *** morphology of the fibers was characterized by scanning electron microscopy,which showed a smooth surface,fiber bundles,gel-shaped nanofiber,and an average size of 94.05 nm with 69%of CNF in 34–100 nm *** chemo-mechanical process exhibited a more crystalline nature in CNF than pulp *** low zeta potential values exhibit the distribution of fibrils and colloidal suspension stability without any further agglomeration.A lower concentration of CNF is less stable exhibiting the product ***,the chemo-mechanical process for the isolation of CNF(Hibiscus cannabinus)from kenaf involves sustainable,low-cost,non-toxic,and cheap alternatives than other traditional methods.

关键词： Kenaf bast fiber kraft delignification and bleaching ultrafine grinder chemo-mechanical properties CNF

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Energy management of buildings with energy storage and solar photovoltaic:A diversity in experience approach for deep reinforcement learning agents

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Energy and AI 2024年第1期15卷 1-14页

作者： akhtar Hussain Petr Musilek Department of Electrical and Computer Engineering University of AlbertaEdmontonT6G 2G2ABCanada Department of Applied Cybernetics University of Hradec Králové50003Hradec KrálovéCzech Republic

Deep reinforcement learning(DRL)is a suitable approach to handle uncertainty in managing the energy consumption of buildings with energy storage ***,DRL agents are trained by randomly selecting samples from a data set,which can result in overexposure to some data categories and under/no exposure to other data ***,the trained model may be biased towards some data groups and underperform(provide suboptimal results)for data groups to which it was less *** address this issue,diversity in experience-based DRL agent training framework is proposed in this *** approach ensures the exposure of agents to all types of *** proposed framework is implemented in two *** the first step,raw data are grouped into different clusters using the K-means clustering *** clustered data is then arranged by stacking the data of one cluster on top of *** the second step,a selection algorithm is proposed to select data from each cluster to train the DRL *** frequency of selection from each cluster is in proportion to the number of data points in that cluster and therefore named the proportional selection *** analyze the performance of the proposed approach and compare the results with the conventional random selection method,two indices are proposed in this study:the flatness index and the divergence *** model is trained using different data sets(1-year,3-year,and 5-year)and also with the inclusion of solar *** simulation results confirmed the superior performance of the proposed approach to flatten the building’s load curve by optimally operating the energy storage system.

关键词： Battery energy storage Building demand management Deep reinforcement learning Diversity in experience Energy management

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A geochemical perspective on the genesis of Cenozoic basic volcanism in northeastern Turkey:an overview of metasomatism and heterogeneity of the sub-continental lithospheric mantle in a post-collisional setting

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Acta Geochimica 2024年第3期43卷 489-506页

作者： Mehmet Arslan irfan Temizel Department of Geological Engineering Karadeniz Technical University61080 TrabzonTurkey

The post-collisional Cenozoic basic volcanic rocks in NE Turkey show temporal variations in whole-rock lithophile element and highly siderophile element(HSE)systematics that are mainly associated with the nature of sub-continental lithospheric mantle(SCLM)sources and parental melt *** far,the traditional whole-rock lithophile geochemical data of these basic volcanic rocks have provided important constraints on the nature of SCLM *** lithophile element and HSE geochemical data of these basic volcanic rocks also reveal the heterogeneity of the SCLM source,which is principally related to variable metasomatism resulting from previous subduction(s)and post-collisional mantle-crust interactions in an extensional *** element geochemical features suggest that the parental magmas have derived from metasomatized spinel-to garnet-bearing SCLM sources for Eocene and Miocene basic volcanic rocks with subduction signatures whereas originated from spinel-to garnet-bearing SCLM sources for Mio-Pliocene and Plio-Quaternary basaltic volcanic rocks without the subduction *** element and HSE geo-chemistry also reveal that Eocene and Miocene basic vol-canic rocks were affected by more pronounced crustal contamination than the basaltic volcanic rocks of Mio-Pliocene and ***,the integrated lithophile element and HSE compositions of these basic volcanic rocks,together with the regional asymmetric lithospheric delamination model,reveal that the compositional variation(especially due to metasomatism)was significant temporally in the heterogeneity of the SCLM sources from which parental magmas formed during the Cenozoic era.

关键词： Basalt Lithospheric mantle Metasomatism Mantle heterogeneity Cenozoic volcanics NE Turkey

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Thermal properties and high-temperature ablation of high-entropy (Ti_(0.25)V_(0.25)Zr_(0.25)Hf_(0.25))B_(2) coating on graphite substrate

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Journal of Advanced Ceramics 2024年第8期13卷 1268-1281页

作者： Ana C.Feltrin Daniel Hedman Farid akhtar Division of Materials Science Lulea University of TechnologyLulea 97187Sweden Center for Multidimensional Carbon Materials(CMCM) Institute for Basic Science(IBS)Ulsan 44919Republic of Korea

An entropy-stabilized multicomponent ultrahigh-temperature ceramic(UHTC)coating,(Ti_(0.25)V_(0.25)Zr_(0.25)Hf_(0.25))B_(2),on a graphite substrate was in-situ sintered by spark plasma sintering(SPs)from constituent transition metal diboride ***(Ti_(0.25)V_(0.25)Zr_(0.25)Hf_(0.25))B_(2) coating had a hardness of 31.2±2.1 GPa and resisted 36.9 GPa of stress before delamination,as observed at the *** temperature-dependent thermal properties of the multicomponent diboride(Ti_(0.25)V_(0.25)Zr_(0.25)Hf_(0.25))B_(2) were obtained by molecular dynamics(MD)simulations driven by a machine learning force field(MLFF)trained on density functional theory(DFT)*** thermal conductivity,density,heat capacity,and coefficient of thermal expansion obtained by the MD simulations were used in time-dependent thermal stress finite element model(FEM)*** low thermal conductivity(<6.52 W·m^(-1)·K^(-1))of the multicomponent diboride coupled with its similar coefficient of thermal expansion to that of graphite indicated that stresses of less than 10 GPa were generated at the interface at high temperatures,and therefore,the coating was mechanically resistant to the thermal stress induced during *** experiments at 220℃ showed that the multicomponent diboride coating was resistant to thermal stresses with no visible cracking or *** ablation mechanisms were mechanical denudation and evaporation of B_(2)O_(5) and light V-Ti oxides,which caused a decrease in the mass and thickness of the coating and resulted in mass and linear ablation rates of-0.51 mg·s^(-1) and -1.38μm·s^(-1),respectively,after 60 *** findings demonstrated the thermal and mechanical stability of multicomponent entropy-stabilized diborides as coatings for carbon materials in engineering components under extreme environments.

关键词： entropy-stabilized diborides ultrahigh temperature ceramics molecular dynamics(MD)simulations density functional theory(DFT) ablation properties

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Assessing Multidimensional Vulnerability of Rural Areas to Flooding:An Index‑Based Approach

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International Journal of Disaster Risk Science 2024年第1期15卷 88-106页

作者： Samavia Rasool irfan Ahmad Rana Hassam Bin Waseem Department of Urban and Regional Planning School of Civil and Environmental Engineering(SCEE)National University of Sciences and Technology(NUST)Islamabad 44000Pakistan

Vulnerability assessment is essential for understanding and launching effective flood risk reduction *** study aimed to examine the vulnerability of flood-prone rural communities in southern Punjab,Pakistan to external *** concept of vulnerability encompasses a range of dimensions,including physical,social,institutional,environmental,economic,and *** a composite index method,indices were developed for each dimension and combined to create a multidimensional measure of vulnerability.A sample of 365 communities was selected using the Yamane sampling technique,and data were collected through a questionnaire containing 65 indicators across all *** statistics and ANOVA tests were used to analyze the *** results show that communities near the Chenab River had higher attitudinal and institutional vulnerability compared to other *** attitudinal vulnerabilities were as sociated with poorly perceived flood risks and low preparedness measures,whereas institutional vulnerabilities were driven by conventional flood protection strategies,lack of institutional trust,and lack of flood risk *** research provides insights into the various components of vulnerability in flood-prone rural communities in Pakistan and demonstrates a useful methodology that can be applied to other disasters at different spatial scales.

关键词： Chenab River Flood hazard Indus River Pakistan-Rural areas:Vulnerability to flooding

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A new class of generalized quasi-variational inequalities with applications to Oseen problems under nonsmooth boundary conditions

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Science China Mathematics 2024年第2期67卷 315-338页

作者： Shengda Zeng akhtar A.Khan Stanislaw Migórski Guangxi Colleges and Universities Key Laboratory of Complex System Optimization and Big Data Processing Yulin Normal UniversityYulin 537000China Faculty of Mathematics and Computer Science Jagiellonian University in Krak´owKrak´ow 30348Poland Center for Applied and Computational Mathematics School of Mathematical SciencesRochester Institute of TechnologyRochesterNY 14623USA College of Sciences Beibu Gulf UniversityQinzhou 535000China

In this paper, we study a generalized quasi-variational inequality (GQVI for short) with twomultivalued operators and two bifunctions in a Banach space setting. A coupling of the Tychonov fixedpoint principle and the Katutani-Ky Fan theorem for multivalued maps is employed to prove a new existencetheorem for the GQVI. We also study a nonlinear optimal control problem driven by the GQVI and givesufficient conditions ensuring the existence of an optimal control. Finally, we illustrate the applicability of thetheoretical results in the study of a complicated Oseen problem for non-Newtonian fluids with a nonmonotone andmultivalued slip boundary condition (i.e., a generalized friction constitutive law), a generalized leak boundarycondition, a unilateral contact condition of Signorini’s type and an implicit obstacle effect, in which themultivalued slip boundary condition is described by the generalized Clarke subgradient, and the leak boundarycondition is formulated by the convex subdifferential operator for a convex superpotential.

关键词： generalized quasi-variational inequality existence theorem optimal control Kakutani-Ky Fan theorem Oseen problem non-Newtonian fluid nonmonotone slip boundary condition

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The Application of Artificial Intelligence in Alzheimer’s Research

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Tsinghua Science and Technology 2024年第1期29卷 13-33页

作者： Qing Zhao Hanrui Xu Jianqiang Li Faheem akhtar Rajput Liyan Qiao Faculty of Information Technology Beijing University of TechnologyBeijing 100124China School of Medicine Tsinghua UniversityBeijing 100084China Department of Computer Science Sukkur IBA UniversitySukkur 65200Pakistan Department of Neurology Tsinghua University Yuquan HospitalBeijing 100040China

Alzheimer's disease(AD)is an irreversible and neurodegenerative disease that slowly impairs memory and neurocognitive function,but the etiology of AD is still *** the explosive growth of electronic health data,the application of artificial inteligence(Al)in the healthcare setting provides excellent potential for exploring etiology and personalized treatment approaches,and improving the disease's diagnostic and prognostic *** paper first briefly introduces Al technologies and applications in medicine,and then presents a comprehensive review of Al in *** simple,it includes etiology discovery based on genetic data,computer-aided diagnosis(CAD),computer-aided prognosis(CAP)of AD using multi-modality data(genetic,neuroimaging and linguistic data),and pharmacological or non-pharmacological approaches for treating ***,some popular publicly available AD datasets are introduced,which are important for advancing Al technologies in AD ***,core research challenges and future research directions are discussed.

关键词： Alzheimer's disease artificial intelligence etiology discovery computer-aided diagnosis computer-aided prognosis treatment

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