Background: Coronary artery disease remains the main cause of death despite several preventive programs. Epicardial adipose tissue is a visceral fat depot of the heart located along the large coronary arteries and on the surface of ventricles and apex. Intima media thickness is commonly recognized as the initial stage in the development of atherosclerosis. The development of ultrasound machines, advances in echocardiographic devices and high resolution transducers facilitate comprehensive analysis of epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT).
Aim: To investigate the relationship of echocardiographic epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT) with the severity of coronary artery disease.
Methods: A cross sectional multicenter diagnostic accuracy study carried out at Ibn Al-Nafis Cardiovascular Hospital, Ibn Al- Bitar Cardiology Center and Ghazi Al-Hariri Hospital –Iraqi Center for Cardiology during the period between October 2016 and May 2017 assessing. History regarding demographic data and risk factors was taken. Two dimensional transthoracic echocardiographic measurements were done. EFT was measured from parasternal long axis view perpendicular to the right ventricular free wall. C-IMT was measured according to that recommended by the American society of echocardiography (ASE).
Results: The current study demonstrated that the EFT has a direct and significant correlation with the number of involved vessels (P value ˂ 0.001, r= 0.770). The validity of EFT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.984, cut point > 8mm, sensitivity=92.9%, specificity= 93.3%). There is inverse and significant correlation between ejection fraction (EF) and three vessels disease (P value ˂ 0.001, r= -0.507). Also there is a direct and significant correlation between C-IMT and severity of CAD. ROC analysis for validity of C-IMT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.961, cut point > 1.04mm, sensitivity=92.9%. specificity=86.7%). C-IMT is fair to discriminate between single vessel disease and no vessel involvement (AUC=0.738, cut point ˃ 0.84mm, sensitivity 100%), so if correlated with age, C-IMT above 0.84 can be used as a cut off point for the prediction of CAD. Finally, EFT and C-IMT are more likely to reflect severity of CAD than their ratio.
Conclusions: C-IMT and EFT are simple and reproducible parameters that can be used as a screening tool for the presence and severity of CAD especially before symptoms appearance in high risk patients
The pillars of sustainable development are representing the interface between environmental, economic, and social sustainability. Sustainable development is a method of planning and managing construction projects to reduce the effect of the construction process on the environment so that there is a balance between environmental capabilities and the human needs of present and future generations. Usually, Environmental sustainability is most important and effective in construction projects. The environment suffers from significant negative impacts as a result of the implementation of construction projects; therefore, this study aims to identify the effecting factors on environmentally sustainable development. The methodology of this s
... Show MoreThis research (communicative values of the visual suggestion in TV advertising) presents a precise description for the process of conveying the communicative message through employing the visual suggestion in TV advertisements. This research consists of four chapters. The first chapter includes the research problem which is summarized by the following question: what are the communicative values accomplished in Tv advertisement which produce visual suggestions that raise strangeness and tension in the advertisement?
The research importance lies in benefiting the researchers and scholars in the field of TV advertisement direction and the visual suggestion is one the main ways for building the advertisement. It also benefits the relevan
Zinc oxide thin films were deposited by chemical spray pyrolysis onto glass substrates which are held at a temperature of 673 K. Some structural, electrical, optical and gas sensing properties of films were studied. The resistance of ZnO thin film exhibits a change of magnitude as the ambient gas is cycled from air to oxygen and nitrogen dioxide
This study aims at describing the identity crisis of Diaspora people (Arab -American) in "Laila Halaby's" novel "Once in A promise Land". Halaby tackles the issues of racism, exclusion, and instability of identity that affect the Arab American community after the terrorist event of eleventh of September. She sheds light on the experiences of her significant characters Salwa and Jassim in America, clarifying how this event weakened their social position and turns their presence in America questionable. "Halaby" describes the bitterness of her characters who are induced into a dream of belonging to a land that transcends their original culture and religious values as well as their language. "Halaby" explains the subsistence in America involvi
... Show MoreTrip generation is the first phase in the travel forecasting process. It involves the estimation of the
total number of trips entering or leaving a parcel of land per time period (usually on a daily basis);
as a function of the socioeconomic, locational, and land-use characteristics of the parcel.
The objective of this study is to develop statistical models to predict trips production volumes for a
proper target year. Non-motorized trips are considered in the modeling process. Traditional method
to forecast the trip generation volume according to trip rate, based on family type is proposed in
this study. Families are classified by three characteristics of population social class, income, and
number of vehicle ownersh
An experimental model is used to simulate the loss of soil lateral confinement due to excavation nearby an individual axially loaded pile. The effects of various parameters, such as the horizontal distance of excavation, depth of excavation and pile slenderness ratios are investigated. The experimental analysis results showed the effect of excavation is more remarkable as the horizontal distance of excavation becomes closer to the pile than half pile length. The effect of excavation diminishes gradually as the horizontal distance increases beyond that distance for all the investigated pile slenderness ratios and depths of excavation. The pile head deflection, settlement and bending moments along pile increase with decreasing horizontal d
... Show MoreAir stripping for removal of Trichloroethylene (TCE), Chloroform (CF) and Dichloromethane (DCM) from water were studied in a bubble column (0.073 m inside dia. and 1.08 m height with several sampling ports). The contaminated water was prepared from deionized water and VOCs. The presence of VOCs in feed solution was single, binary or ternary components. They were diluted to the concentrations ranged between 50 mg/l to 250 mg/l. The experiments were carried out in batch experiments which regard the bubble column as stirred tank and only gas was bubbled through stationary liquid. In this case transient measurements of VOC concentration in the liquid phase and the measured concentra
... Show MoreIn this article, a numerical method integrated with statistical data simulation technique is introduced to solve a nonlinear system of ordinary differential equations with multiple random variable coefficients. The utilization of Monte Carlo simulation with central divided difference formula of finite difference (FD) method is repeated n times to simulate values of the variable coefficients as random sampling instead being limited as real values with respect to time. The mean of the n final solutions via this integrated technique, named in short as mean Monte Carlo finite difference (MMCFD) method, represents the final solution of the system. This method is proposed for the first time to calculate the numerical solution obtained fo
... Show MoreMany additives are used to improve the performance of cables in terms of increasing their flame retardancy, thermal stability, thermal conductivity, and other characteristics. Unfortunately, most of these additives contain heavy metals. Therefore, the main objective of this study is to introduce a material representing a new generation of environmentally friendly heavy metal-free stabilizers for cable grade poly(vinyl chloride) that can compete with traditional materials in terms of performance and distinctive properties. This unique additive is Oxydtron, a synthetic silicate or simply nanocement. The tests performed are rheological properties represented by a capillary rheometry analysis, limiting o