Electrocardiography Predictive Value on Coronary Slow Flow Phenomenon

Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.

Dark crescent sign: high-risk calcified coronary plaque detected by electrocardiogram-gated non-contrast computed tomography

Electrocardiogram-gated non-contrast computed tomography can discriminate a dark crescent-shaped calcified plaque characterised as a low-intensity area surrounded by high-intensity signals. Careful attention should be paid to performing a percutaneous coronary intervention for a plaque with the dark crescent sign because of its potential high risk of no-flow phenomenon.

Safety of low-dose dobutamine stress test in coronary slow flow phenomenon

Purpose: To investigate the feasibility and safety of a low-dose dobutamine stress test in coronary slow flow phenomenon (CSFP) patients.Methods: One hundred and forty-two CSFP patients, and forty-four patients without CSFP or significant epicardial coronary stenosis who served as the control group, were retrospectively reviewed. All patients were infused intravenously with dobutamine at an initial infusion rate of 5 μg/kg/min which was then increased at 8-min intervals to 10, 15, and 20 μg/kg/min. Symptoms and echocardiography were monitored simultaneously.Results: Patient tolerance decreased as the doses of dobutamine increased. No termination of the test occurred without dobutamine or at the infusion rate of 5 μg/kg/min. Nonetheless, when the infusion rates were adjusted to 15 and 20 μg/kg/min, the incident of side effects reached up to 30.9 %, and a few patients experienced ST-segment depression in precordial electrocardiographic leads. There were no induced arrhythmias without dobutamine, while the incidence of arrhythmias was highest at the infusion rate of 20 μg/kg/min. Malignant arrhythmias such as ventricular fibrillation and sustained ventricular tachycardia, were not detected. No significant differences were showed in echocardiogram result for left ventricular ejection fraction (LVEF) between CSFP and control group (63.7±7.9 in the CSFP group, versus 64.3±7.2 in the control group; p = 0.63).Conclusion: A low-dose dobutamine stress test is safe and feasible in CSFP patients.

The effect of Reynolds number on near-wall reverse flow in a turbulent duct flow

The influence of the Reynolds number on the statistics of a near-wall reverse flow phenomenon, taking place in a turbulent duct flow, is studied. An increase in the NWRF probability is found in both the core and corner regions of the duct walls for higher Reynolds number. The mechanism of the NWRF formation, described recently by Zaripov et al. [1, 2], is validated for higher Reynolds number flows.

Development of Toddlers’ Smartphone Flow State Scale: Parent Report Form

Toddlers come into contact with smartphones by the time they are 10 months old, and smartphones eventually become a part of the daily lives of toddlers because they are used as parenting tools and are also attractive toys. Routine exposure to these electronic devices may lead to excessive immersion, which can cause smartphone dependence when toddlers grow up. Based on Csikszentmihalyi’s concept of flow, we aimed to develop a new scale to measure the flow phenomenon in toddlers who are exposed to smartphones. We attempted to identify the constituent factors of a toddler’s flow in smartphones through a literature review, observations, and interviews. Initially, 32 questions were screened from the field verification stage and interviews; the final 20 questions were selected by combining technical statistics, exploratory factor analysis, and expert feasibility. We also found five eligible constituent factors, namely, a playfulness-oriented experience, reaction limited by concentration, and intentional pursuit to achieve the goal, assimilate into the virtual world, and acquire desire-fulfilling skills. We then performed a confirmatory factor analysis on our parent-reported toddlers’ smartphone flow state scale. To secure the criterion-related validity, the correlation between our scale and the preexisting smartphone dependence measurement tool for toddlers was evaluated. Cronbach’s α value of the toddlers’ smartphone flow state scale was 0.95 (each factor was verified as 0.79–0.92 and the explanatory power was 72.21%). The test–retest reliability was found to be stable with the intraclass correlation (ICC) coefficient value of 0.78 (p < 0.001). Our research findings suggest that this novel smartphone flow state scale for toddlers could be a valid and reliable tool for measuring how toddlers feel the flow phenomenon while using smartphones. Furthermore, our results could contribute to the development and evaluation of the interventions that prevent side effects from smartphone overflow in toddlers.