Assessment Screening of Chest Pain in Primary Setting: A Review

Chest pain can be caused by a variety of illnesses, ranging from benign and self-limiting to significant or life-threatening. Before a doctor examines more benign reasons, a workup must focus on ruling out significant pathology. The words "dull," "deep," "pressure," and "squeezing" are commonly used to describe visceral discomfort. Visceral pain generally has a diffuse distribution pattern, making it difficult for the patient to pinpoint a precise location. chest discomfort accounts for 1.5 percent of all consultations in primary care. The age group 45 to 64 years has the highest prevalence of chest pain consultations. Patients with suspected Acute coronary syndrome (ACS) should be diagnosed and treated as soon as feasible. While most patients are sent to the hospital, an electrocardiogram (ECG) is the sole examination necessary in primary care. In this review we will be looking at chest pain incident in primary care, and also we’ll be making overview to the etiology and diagnosis of the disease.

Bubble vent localization for marine hydrocarbon seep surveys

Commercial success of marine seep hunting exploration campaigns involves acquisition of high-quality bathymetry and backscatter along with targeted coring of seep sediments. The sharp lateral chemical gradient encompassing seafloor seeps requires accurate identification of seep sites from high-resolution acoustic data. Active seeps featuring plumes of gas bubbles and oil droplets rising into the water column can be imaged in modern multibeam echosounders providing an effective approach to remotely characterizing seafloor seeps. Interpreting the seafloor position of gas plume emissions in multibeam data using existing mapping methodology is hindered by slow processing due to large files sizes, a manual “by eye” qualitative assessment of each sonar ping searching for plume anomalies, skill and fatigue of the geoscientist, and environmental or acquisition artifacts that can mask the precise location of gas emission on the seafloor. These limitations of midwater backscatter mapping create a qualitative dataset with varying inherent positional errors that can lead to missed or incorrect observations about seep-related seafloor features and processes. By vertically integrating midwater multibeam amplitude samples, a two-dimensional midwater backscatter raster can be generated and draped over seafloor morphology, providing a synoptic overview of the spatial distribution of gas plume emission sites for improved interpretation. A multibeam midwater dataset from NOAA Cruise EX1402L2 in the northwestern Gulf of Mexico is reprocessed using a vertical amplitude stacking technique. Midwater backscatter surfaces are compared to digitized plume positions collected during the survey for a comparison into assessing uncertainty in mapping approaches and an assessment of uncertainty. Results show that the accuracy of digitized geopicks over selected plume clusters vary considerably when compared to the midwater backscatter amplitude maps. This mapping technique offers multiple advantages over traditional geopicking from cost-effectiveness, offshore efficiency, repeatability, and higher accuracy, ultimately improving the detectability and sampling of active seafloor seeps through precisely located cores.

A subcellular cookie cutter for spatial genomics in human tissue

Intracellular heterogeneity contributes significantly to cellular physiology and, in a number of debilitating diseases, cellular pathophysiology. This is greatly influenced by distinct organelle populations and to understand the aetiology of disease it is important to have tools able to isolate and differentially analyse organelles from precise location within tissues. Here we report the development of a subcellular biopsy technology that facilitates the isolation of organelles, such as mitochondria, from human tissue. We compared the subcellular biopsy technology to laser capture microdissection (LCM) that is the state of art technique for the isolation of cells from their surrounding tissues. We demonstrate an operational limit of (>20 micron) for LCM and then, for the first time in human tissue, show that subcellular biopsy can be used to isolate mitochondria beyond this limit.

Signature of transition to supershear rupture speed in the coseismic off-fault damage zone

Most earthquake ruptures propagate at speeds below the shear wave velocity within the crust, but in some rare cases, ruptures reach supershear speeds. The physics underlying the transition of natural subshear earthquakes to supershear ones is currently not fully understood. Most observational studies of supershear earthquakes have focused on determining which fault segments sustain fully grown supershear ruptures. Experimentally cross-validated numerical models have identified some of the key ingredients required to trigger a transition to supershear speed. However, the conditions for such a transition in nature are still unclear, including the precise location of this transition. In this work, we provide theoretical and numerical insights to identify the precise location of such a transition in nature. We use fracture mechanics arguments with multiple numerical models to identify the signature of supershear transition in coseismic off-fault damage. We then cross-validate this signature with high-resolution observations of fault zone width and early aftershock distributions. We confirm that the location of the transition from subshear to supershear speed is characterized by a decrease in the width of the coseismic off-fault damage zone. We thus help refine the precise location of such a transition for natural supershear earthquakes.

The Khandaq Shapur: Defense, Irrigation, Boundary, Frontier

Khandaq Shapur has been named one of the great barriers of the ancient world, but very little is known about the monumental-scale linear feature. This interdisciplinary paper brings together archaeologists and historians to present (1) an updated history of the Khandaq Shapur drawing upon a wider range of sources, including Arabic scholarly sources, and (2) a modern map of the Khandaq Shapur produced from a ground truthed remote sensing using historic Corona satellite imagery from the 1960s and imagery available in Google Earth. This new map of the Khandaq Shapur’s ground truthed location is compared to the known locations of Sasanian sites from previous archaeological surveys to contextualise the Khandaq Shapur within the wider archaeological landscape. Together, the landscape archaeology and historical evidence provide a comprehensive picture of this unique feature: shedding light not only on its precise location, but also its nature (what was it?) and how it was used over time.

GNSS-and-GIS based android integration of mobile based virtual guide application ExpLahore for walled city Lahore, Pakistan

The expansion of technology by utilizing Global Navigation Satellite Systems (GNSS) integrated with Geographic Information System (GIS) has made life much easier and handy. Global interactions have given birth to tourism and intra-culture programs. Many foreigners as well as local tourists prefer to explore the sites on their own instead of a guide, this is quite adventurous but can be tedious too and brings along a lot of security risks. This research is based on design and development of an android application considering “Walled City, Lahore, Pakistan”. The application will help tourist geotag their information. This application has been developed with the fact to provide precise position through GNSS, the coordinates have been refined using ArcGIS and QGIS and placed in application using Android Studio and Adobe Illustrator. GIS allowed creating interactive queries, analyzing spatial information and map creation, shape file extraction and 99% precise coordinates than maps we use. In travelling world, geotagging is a great and trending feature that allows user to share their exact position. The application will locate user’s coordinates (Latitude and Longitude), current satellite count, precision, altitude, time and day. The guidance application helps user find the correct possible route to the monuments of walled City, Lahore. Information and precise location of 14 place groups of Lahore city, as well as precise route to them is also a feature of the application.

Ultrasound and Fetal MRI Complementary Contributions to Appropriate Counseling in Small Bowel Obstruction

<b><i>Objective:</i></b> Bowel obstructions beyond the duodenum represent a heterogeneous group of congenital anomalies with a highly variable prognosis, the main issue being postnatal short bowel syndrome (SBS). The objective of our study was to evaluate the contributions of fetal MRI in cases of bowel obstruction. <b><i>Materials and Methods:</i></b> A retrospective analysis of all newborns, for whom both ante-natal ultrasound and fetal MRI were available, referred to our center for suspected bowel obstruction was performed. Examinations were reviewed blinded to the postnatal outcome. Key outcome measures included exact diagnosis and the existence of postoperative SBS. We evaluated the contribution of MRI in determining precise location and etiology of the bowel obstruction, dilatation of the proximal bowel loops, and assessment of the quality of the remaining distal bowel loops. <b><i>Results:</i></b> Twenty-five newborns were included. There were 19 single obstructions and 6 complex forms (4 apple peel syndromes and 2 multiple atresias). MRI correctly identified the affected segment of the small bowel in 59.1% of the cases. MRI identified the mechanism of obstruction in 72% of cases. MRI reliably predicted an abnormal appearance of the bowel distal to the obstruction in 100% of the severe cases (3/3) and in 66.7% of complex forms (4/6). <b><i>Conclusion:</i></b> Our study suggests that fetal MRI, when done in addition to prenatal ultrasound, is contributory in the management of fetuses with suspected bowel obstruction. MRI may be particularly useful in determining the location and origin of the bowel obstruction and in assessing the quality of the bowel distal to the obstruction, which might assist in the prediction of SBS and more detailed prenatal counseling.