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Coronary artery disease (CAD) is reported as one of the most common sources of death all over the world. The presence of stenosis (plaque) in the coronary arteries results in the restriction of blood supply, leading to myocardial infarction. The current study investigates the influence of multi stenosis on hemodynamic properties in a patient-specific left coronary artery.

A three-dimensional model of the patient-specific left coronary artery was reconstructed based on computed tomography (CT) scan images using MIMICS-20 software. The diseased model of the left coronary artery was investigated, having the narrowing of 90% and 70% of area stenosis (AS) at the left anterior descending (LAD) and left circumflex (LCX), respectively.

The results indicate that the upstream region of stenosis experiences very high pressure for 90% AS during the systolic period of the cardiac cycle. The pressure drops maximum as the flow travels into the stenotic zone, and the high flow velocities were observed across the 90% AS. The higher wall shear stresses occur at the stenosis region, and it increases with the increase in the flow rate. It is found that the maximum wall shear stress across 90% AS is at the highest risk for rupture. A recirculation region immediately after the stenosis results in the further development of stenosis.

The current study provides evidence that there is a strong effect of multi-stenosis on the blood flow in the left coronary artery.

This study aims to make full use of the advantages of connected and autonomous vehicles (CAVs) and dedicated CAV lanes to ensure all CAVs can pass intersections without stopping.

The authors developed a signal coordination model for arteries with dedicated CAV lanes by using mixed integer linear programming. CAV non-stop constraints are proposed to adapt to the characteristics of CAVs. As it is a continuous problem, various situations that CAVs arrive at intersections are analyzed. The rules are discovered to simplify the problem by discretization method.

A case study is conducted via SUMO traffic simulation program. The results show that the efficiency of CAVs can be improved significantly both in high-volume scenario and medium-volume scenario with the plan optimized by the model proposed in this paper. At the same time, the progression efficiency of regular vehicles is not affected significantly. It is indicated that full-scale benefits of dedicated CAV lanes can only be achieved with signal coordination plans considering CAV characteristics.

To the best of the authors’ knowledge, this is the first research that develops a signal coordination model for arteries with dedicated CAV lanes.

Purpose – Intravenous leiomyomatosis (IVL) is a very rare subtype of leiomyoma, involving the right obstruction of the heart, and is an unusual cause of outflow tract obstruction. The IVL grows from the vessel’s smooth muscle, protruding into the vessel’s lumen, and can expand to the right atrium and even beyond causing death due to blood flow obstruction into the right atrium and even to pulmonary artery.

Design/Methodology/Approach – We present a 33-year-old Indonesian woman with cardiopulmonary symptoms predominantly, and marked by an intravascular leiomyoma extending from inferior vena cava (IVC) to right chamber atrium, with the chief complaint being easily fatigued since seven months.

Findings – Echocardiography observations found a mass in the right atrium and the IVC that caused dynamics obstructed in tricuspid valve, right atrium and ventricle were dilated, no left ventricular (LV) hypertrophy, normal LV and right ventricular (RV) functions, and no valve abnormality except the tricuspid valve gradient being 21 mmHg with mild regurgitation. Venography resulted in a mobile tumor mass in IVC mouth which partially flew into the right atrium, and partially blocked the IVC mouth. Tumor size was 6.4 cm × 4.8 cm. Abdominal multislice computed tomography resulted in a residual soft tissue mass (leiomyoma) along the IVC extended to the right atrium. The tumor mass size in the IVC and the right atrium was bigger compared to tumor mass on July 2008. The correct diagnosis was established during surgery; therefore a two-stage resection was done.

Originality/Value – Surgical resection is the best treatment for intracardiac extension of intravenous leiomyoma. To remove the ilio-caval portion, iliac venotomy was recommended for the tumor in both stages of the surgeries.

Peduncluar hallucinosis is a rare neurological disorder characterized by visual hallucinations, often described to be vivid and dream-like. While the exact pathophysiology has yet to be elucidated, most cases to date have suggested an etiology stemming from lesions to the thalamus or midbrain. Here presented is a case of a 54-year-old female with peduncular hallucinosis secondary to a pontine cavernoma hemorrhage in the setting of essential hypertension. The patient's vivid visual and auditory hallucinations aligned temporally with the lesion's discovery and resolved after pharmaceutical treatment. This case represents a rare form of peduncular hallucinosis secondary to a pontine cavernoma hemorrhage leading to vasospasm in the arteries feeding the brainstem.

The aim of present study was to integrate vital noncommunicable diseases (coronary artery disease, hypertension, diabetes mellitus and mental health disorders) into Prison-Based Active Health Services Provision (PAHSP).

On Jan 1, 2018, there were 230,000 prisoners in Iran. Timely and systematic detection and diagnosis of chronic health conditions among this population are imperative. The collaboration between healthcare providers in prison and members of the multidisciplinary team of the healthcare community outside prison initiated an active health service provision approach for HIV and tuberculosis (TB). Guidelines for the control of HIV and TB in prison were piloted, and the finalized version was named “Prison-based Active Health Services Provision” (PAHSP), which has been scaled up in 16 of 260 Iranian prisons.

The PAHSP approach emphasizes the importance of early identification of key symptoms and risk factors. This approach provides an opportunity for improved prevention and treatment, enabling prisoners identified at risk or those who have been diagnosed with a target disease to be followed up and receive the appropriate health care.

Initiatives such as screening for chronic health conditions coupled with treatment will reduce the burden of chronic illness among prisoners and the broader community, thereby saving on healthcare costs and lives.

Heart Failure (HF) is one of the leading mortality causes in elderly people. The purpose of this study is to assess readmission rates and reasons in elderly patients with HF.

The authors explored medical records of elderly patients with HF (75 years and more) at Chapidze Emergency Cardiology Center (Georgia) from 2015 to 2019. The authors analyzed the structure of the cardiovascular diseases and readmission rates of hospitalized patients with HF (I50, I50.0 I50.1). A multivariate logistic regression model was used to identify factors, associated with readmission for any reason during 6–9 months after the initial hospitalization for HF.

The major complication of cardiovascular diseases in elderly patients is HF (68.6%). Hospitalization rates due to HF in elderly patients have increased in recent years, which is associated with the population aging process. This trend will be most likely continue. Despite significant improvements in HF treatment, readmission rates are still high. HF is the most commonly revealed cause of readmission (48% of all readmissions). About 6–9 months after the primary hospitalization due to HF, readmission for any reason was 60%. Patients had concomitant diseases, including hypertension (43%), myocardial infarction (14%), diabetes (36%) and stroke (8%), affecting the readmission rate.

HF remains an important problem in public health. During HF-associated hospitalizations, both cardiac and non-cardiac conditions should be addressed, which has the potential for health problems and disease progression. Some readmissions may be prevented by the proper selection of medicines and monitoring.

This scientific article aims to evaluate the efficacy of the drug Doxorubicin for treating hepatocellular carcinoma (HCC) in Egypt. The study analyzes data from patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University. The study includes 40 intermediate-stage HCC patients who underwent treatment with either Doxorubicin-Lipiodol or Doxorubicin-loaded drug-eluting beads-trans-arterial chemoembolization (DEB-TACE).

Patients referred to a multi-disciplinary consultation at the National Cancer Institute, Cairo University with a possible diagnosis of HCC in the intermediate stage were eligible for the study.

The study finds that the plasma peak concentration of Doxorubicin is significantly higher in patients treated with Lipiodol compared to those treated with DEB-TACE. The median plasma peak concentration of patients treated with Lipiodol was significantly higher 424 (202.5–731) than the peak level of patients treated with beads 84.95 (26.6–156.5) with p-value = 0.036. However, there is no significant difference in other pharmacokinetic parameters between the two treatment groups. The research article also investigates the genetic polymorphisms in HCC patients treated with Doxorubicin-Lipiodol and Doxorubicin-loaded DEB-TACE. It identifies a significant association between the ABCB1 gene (C3435T) and the concentration of Doxorubicin in plasma. Patients with the CCand computed tomography (CT) genotypes of ABCB1 have higher concentrations of Doxorubicin compared to those with the TT genotype. Furthermore, the study examines the progression-free survival rates and tumour response in the two treatment groups. It demonstrates that DEB-TACE patients have a higher progression-free survival rate compared to cTACE patients. DEB-TACE also leads to better tumour regression.

The current study helps to increase the understanding of the genetic factors that may contribute to HCC susceptibility in the Egyptian population. However, it is essential to consider that genetic polymorphism is just one aspect of HCC risk, and other factors such as environment, lifestyle and viral infections also play crucial roles. Further research is needed to elucidate the complex interactions between genetic and environmental factors in HCC development among Egyptians.

Successful commercialization is crucial to innovative firms, but further investigation is needed on how diverse stakeholders can contribute to the commercialization of a radical innovation that requires particular market creation support. This paper aims to, therefore, analyze the key stakeholders and their contributive activities in commercialization and market creation, particularly in the case of radical innovations.

This study relies on qualitative research design including interviews with key stakeholders, such as regulators, scientists, experts, licensing partners, core company representatives and extensive secondary data. This single-case study concerns a functional food product, which is a radical innovation requiring the development of a novel product category positioned between the food and medicine categories in global market settings. Since its market launch in 1995, the involvement of multiple stakeholders was needed for its successful commercialization in over 30 countries.

Results uncover the contributions of diverse stakeholders to commercialization and market creation, particularly of radical innovation. Stakeholders performed market creation activities such as regulating the marketing and labeling of food products, conducting safety assessments, revealing and validating the positive health effects of the novelty and raising awareness of healthy living and cardiovascular health. The commercialization activities included distributing the products overseas, applying the ingredient to different food products and making the products available for users.

This single-case study provides an overview of the positive stakeholder activities with contributions to market creation and commercialization of functional food innovations. Although the user perspective was not included in the empirical part of this study because of our focus on B2B actors, users of the innovation can contribute to R&D activities to a great extent.

The developed framework of stakeholders’ contributive activities in radical innovation commercialization and market creation contributes to literature discussing market creation as well as commercialization within the marketing and innovation management research fields. This work also generates practical advice for managers who commercialize (radical) innovations.

The purpose of this paper is to conduct systematic reviews on Indonesian papers, to examine the most recent evidence of the efficacy of the combination of cognitive training and physical exercise, and to make recommendations in order to improve prevention, care and treatment services in elderly patients with mild cognitive impairment (MCI).

The databases of Cochrane, Medline, NIH (US National Library Medicine), ProQuest, EbscoHost, Clinical Key, EMBASE, Medical Librarian (TWE) in Ovid, Science Direct, Scopus, The Lancet Global Health, PubMed, Emerald, Indonesian National Library, Google Scholar, Google Indonesia, and Garuda Portal were systematically searched using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to obtain empirical papers published between June 1976 and January 2018.

Out of the 3,293 articles collected, 10 were included in this analysis. The result of this combined meta-analysis compares the combination therapy group (cognitive therapy and physical exercise) with a control group. It shows that the control group was likely to experience MCI 1.65 times more often than the combination therapy group. According to the result acquired from the synthesized meta-analysis, the control group experienced MCI 1.65 times higher than the combination therapy. The finding is proven to be statistically significant (95% CI= 1.42–1.93).

The research considers only English and Indonesian articles.

It is important to explore the most effective training characteristics in a special combined intervention differentiated by the duration, frequency, intervention, type and combination mode. There is a need for further investigation that focuses on the physiological mechanisms underlying the positive effects, by inserting a more comprehensive neuro-imaging measurement to assess specifically the domain that benefits in terms of cognitive functions and molecular markers. Finally, exploratory studies are definitely required, which will specifically examine maintenance and treatment effects as well as derive theoretical explanations related to the interventions and predictors.

A combination of cognitive training and physical exercise intervention may improve the global health or cognitive functions.

A combination of cognitive training and physical exercise has been found to improve prevention, care and treatment services in elderly patients with MCI. There is an increase in value in comparison to the study of Karssemeijer, which considered five Indonesian articles.

Heart diseases have become one of the most causes of death among Egyptians. With 500 deaths per 100,000 occurring annually in Egypt, it has been noticed that medical data faces a high-dimensional problem that leads to a decrease in the classification accuracy of heart data. So the purpose of this study is to improve the classification accuracy of heart disease data for helping doctors efficiently diagnose heart disease by using a hybrid classification technique.

This paper used a new approach based on the integration between dimensionality reduction techniques as multiple correspondence analysis (MCA) and principal component analysis (PCA) with fuzzy c means (FCM) then with both of multilayer perceptron (MLP) and radial basis function networks (RBFN) which separate patients into different categories based on their diagnosis results in this paper, a comparative study of the performance performed including six structures such as MLP, RBFN, MLP via FCM–MCA, MLP via FCM–PCA, RBFN via FCM–MCA and RBFN via FCM–PCA to reach to the best classifier.

The results show that the MLP via FCM–MCA classifier structure has the highest ratio of classification accuracy and has the best performance superior to other methods; and that Smoking was the most factor causing heart disease.

This paper shows the importance of integrating statistical methods in increasing the classification accuracy of heart disease data.