Spontaneous Coronary Artery Dissection: A Case Series of 9 Patients With Literature Review.

Spontaneous coronary artery dissection is an increasingly recognized nonatherosclerotic cause of acute coronary syndrome. Reports regarding the prognosis and natural history of this disease are limited. In addition to the diagnostic difficulty, this condition poses a significant therapeutic challenge due to the lack of specific management guidelines. We present here a case series of 9 patients with spontaneous coronary artery dissection. Additionally, this article reviews the incidence, clinical characteristics, risk factors, diagnostic modalities, therapeutic approaches, and patterns of recurrence in patients with spontaneous coronary artery dissection

Analysis of machine learning classifiers for predicting diabetes mellitus in the preliminary stage

Diabetes is the most common disease all over the world and it must be detected early to receive proper treatment, which can prevent the condition from becoming more severe. Automated detection plays an essential role in diabetes early diagnosis. Over the last few decades, many complicated machine learning algorithms and data analysis approaches have been applied for diabetes prediction. To determine the best model for early-stage diabetes prediction, ten different machine learning classifiers have been used in this study. These models were evaluated in terms of accuracy, precision, specificity, recall, F1-score, negative predictive value (NPV), false positive rate (FPR), rate of misclassification, and receiver operating characteristics (ROC) curve. The experimental findings indicated that all of the models performed well. Gradient boosting (GB), with 97.2% accuracy, is observed to show the best performance on the early-stage diabetes risk prediction dataset. Random forest (RF) and Adaboost performed similarly to the GB; however, RF and Adaboost's precision was not as good as the GB precision (GB’s)

Penerapan model pembelajaran Tipe jigsaw berbantu video tutorial untuk meningkatkan hasil belajar siswa

Berdasarkan hasil observasi peneliti pada bulan November 2022 di kelas X SMK Negeri 2 Limboto, menunjukan bahwa pencapaian hasil belajar siswa pada pembelajaran desain grafis masih kurang optimal. dikarenakan kurangnya model pembelajaran yang dilakukan oleh guru serta pembelajaran yang masih berpusat pada guru yang mengakibatkan kurangnya keterlibatan siswa dalam proses pembelajaran. Tujuan yang ingin dicapai dalam penelitian ini adalah untuk mengetahui peningkatan hasil belajar siswa pada materi mengolah grafis dan video. Metode yang digunakan adalah penelitian tindakan kelas (PTK). Penelitian tindakan kelas ini dilaksanakan dalam dua siklus yaitu siklus I dan II, setiap siklusnya teridiri atas 2 kali pertemuan. Yang terdiri dari empat tahap, yaitu perencanaan, pelaksanaan, observasi dan refleksi. Hasil penelitian menunjukan bahwa pada siklus I terjadi peningkatan hasil belajar siswa, dengan persentase hasil belajar siswa yang mencapai ketuntasan minimum yakni 44%. Namun hasil tersebut belum memenuhi capaian dari persentase hasil belajar yang telah di tentukan yaitu 80%, maka penelitian akan dilanjutkan ke siklus II. Pada siklus II terdapat peningkatan persentase terhadapt hasil belajar siswa secara keseluruhan mencapai 100%. Dari hasil penelitian dapat disimpulkan bahwa penerapan model pembelajaran Tipe jigsaw dapat meningkatkan hasil belajar siwa kelas X TKJ SMK Negeri 2 Limboto pada materi mengolah grafis dan video. Kata kunci : hasil belajar;Kooperatif type jigsa

An Approach to Solar Photovoltaic Systems Simulation Utilizing Builder Block: A Case Study of A 100 MW System

This paper offers a new design, simulation, and trying out a strategy for the Photovoltaic (PV) gadget producing 100 MW· The work explores how different irradiance and PV temperature tiers have an effect on the output power· To enhance the PV system, the proposed work utilizes the Maximum Power Point Tracking (MPPT) technique with a DC-DC boost converter and a 3-phase tie inverter· These components can improve output voltage and convert it into AC electricity for integration into the application grid· The Block Builder tool is taken into consideration a key factor of this work, which enables accurate simulation of various environmental conditions inclusive of a wide range of solar radiation and PV temperature· Consequently, the electric power generated underneath varying parameters can be exactly assessed· In this work, 4 cases are simulated to assess the performance of the proposed system.. The simulation results show that the proposed design gives varying output powers based on changes in solar radiation and PV temperature, which demonstrates the adaptability of the system. In Case 4, the simulation results indicate that when increasing the solar radiation, the energy starts to increase up to 85 MW when solar radiation equals 1000 W/m², which occurs at 3 seconds

Iron Permeable Reactive Barrier for Removal of Lead from Contaminated Groundwater

The possibility of using zero-valent iron as permeable reactive barrier in removing lead from a contaminated groundwater was investigated. In the batch tests, the effects of many parameters such as contact time between adsorbate and adsorbent (0-240 min), initial pH of the solution (4-8), sorbent dosage (1-12 g/100 mL), initial metal concentration (50-250 mg/L), and agitation speed (0-250 rpm) were studied. The results proved that the best values of these parameters achieve the maximum removal efficiency of Pb+2 (=97%) were 2 hr, 5, 5 g/100 mL, 50 mg/L and 200 rpm respectively. The sorption data of Pb+2 ions on the zero-valent iron have been performed well by Langmuir isotherm model in compared with Freundlich model under the studied conditions. Finite difference method and computer solutions (COMSOL) multiphysics 3.5a software based on finite element method were used to simulate the one-dimensional equilibrium transport of lead through sand aquifer with and without presence of barrier. The predicted and experimental results proved that the reactive barrier plays a potential role in the restriction of the contaminant plume migration and a reasonable agreement between these results was recognized

INDUSTRY 4.0 ADOPTION FRAMEWORK IN MSMES USING A HYBRID FUZZY AHP-TOPSIS APPROACH

This work presents an outline for adopting industry 4.0 enabling technologies, and appropriate strategies are prioritized to implement them. A hybrid fuzzy Analytic Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) approaches are applied to achieve the objectives. The enabling technologies and strategies were identified based on the literature review and expert’s opinions, a total of 26 enabling technologies and eight strategies were identified. Later fuzzy AHP technique is used to rank the enablers and TOPSIS is applied to order the implementation strategies. From 26 enablers, a total of ten enabling technologies were found to be the most effective. Artificial intelligence (AI), top management commitment and support, virtual reality, and enterprise resource planning (ERP) systems were the top-ranked enablers in the list, whereas edge computing was the least effective enabler. Among the strategies, lean manufacturing, green supply chain and logistics, and integrated and smart manufacturing systems were the top priorities in implementing industry 4.0, while recruiting and managing talents was the least important strategy in the study. The findings from this framework will provide a deep insight to the managers and practitioners of MSMEs to adopt the industry 4.0 technologies in their organizations

Effect of corrugated wall combined with backward-facing step channel on fluid flow and heat transfer

The turbulent fluid flow and heat transfer were numerically studied through backward-facing step combined with various corrugated walls. The governing equation was solved using Finite Volume Method (FVM) and the SIMPLE algorithm was applied to investigate the effect of backward-facing step with corrugated downstream on heat transfer characteristics. A constant heat flux was applied on the downstream wall, while the other walls were considered as adiabatic surfaces. Parameters such as corrugated design, amplitude height (1, 2, 3, 4 and 5 mm) and Reynolds number (Re) in the range of 5000 to 20,000 were used. The performance evaluation criteria (PEC) were estimated to show the heat transfer augmentation. The results indicated that using a corrugated wall with a backward-facing step increased significantly the heat transfer accompanied by a slight increase in the skin friction coefficient simultaneously. The best heat transfer augmentation was observed for the trapezoidal corrugation at 4 mm amplitude height and 20 mm pitch diameter. Combining the corrugated wall with backward-facing step enhanced the Nusselt number (Nu) up to 62% at Re = 5000. The performance evaluation criteria increased with the increase of amplitude height until it reached 4 mm and then decreased steeply

Lift force for cylindrical and elliptical coandă aircraft design

Small aerial vehicles possess advantages in terms of size and accessibility in performing a variety of tasks. Presently, their design and performance is dependent on variations of conventional aerodynamic configurations (fixed- and rotary-wing). A disadvantage for these configurations is the aerodynamic potential between the mainstream airflow and the body surfaces are not fully utilized. To solve this issue, the Coandă effect is proposed whereby a high-velocity jet is blown tangentially over a curved surface to increase circulation and lift. Prior to the costly approach (experimental and numerical), an analytical formulation (via control volume analysis) to predict the aer-odynamic Coandă lift force of the design concept is developed. This is an extended version of the existing mathematical formulations, capturing viscous flow effects. It is also pertinent for circular and elliptical-shaped designs. The results obtained show that the total lift force is dependent on the jet velocity, outflow angle, dimensions of the jet slot, the projected surface area, and the viscous effect. The approach has demonstrated how this modelling technique is effective in calculating the lift force for cylindrical and elliptical Coandă aircraft design

KRAS mutation status is associated with distinct clinical and molecular features in Malaysian stage IV colorectal patients

Aim: The purpose of this study was to estimate the prevalence of KRAS mutations in stage IV colorectal cancer in Malaysians and to investigate the associations of KRAS mutations with clinicopathological characteristics Method: All patients with stage IV colorectal cancer who underwent resection of the primary tumour between January 2017 and December 2021 were included in the single-center retrospective study. KRAS mutation status was determined. A multiple logistic regression model was used to analyse patient characteristics and tumour location Results: 41 patients (51% of whom were men) with an average age of 63 ± 13 years. The most common tumours were left-sided colon cancers (50%). The most common histological subtype was adenocarcinoma (95%). Thirty-two patients (78%) had LN metastasis. Twenty-nine patients (71%) had single-organ metastasis. The lung was the most common metastatic site (66%). KRAS mutation was found in 19 ( 46% ) of patients (63% in codon 12, 15% in codon 13, 15% in codon 61, and 7% in codon 117). KRAS mutation was found to be associated with rectal cancer in multivariable logistic regression analyses (odds ratio [OR] 6.8; confidence interval [CI] 1.41 to 33.2; p = 0.017). Conclusion: In t his study, K RAS mutations were found in 46% of patients with stage IV colorectal cancer. However, according to literature, the right-sided colon has a higher prevalence of mutated KRAS. In our study, the rectum was associated with a high KRAS mutation