Mechanical Support Research Articles

Exploring Afghanistan's Prospective Role in the Shanghai Cooperation Organization

This article analyzes the prospects of Afghanistan's presence in the Shanghai Cooperation Organization. Given the increasing importance of this organization in regional and global dynamics, Afghanistan's effective involvement could play a key role in shaping regional economic, security, and political interactions. This research employs qualitative methods and the Delphi strategy to gather and analyze the views of experts and specialists in international politics, regional security, and economics. Data analysis was conducted using the grounded theory method in NVivo software, and the results, based on the Kendall formula, indicate a consensus among experts regarding the significance and challenges of Afghanistan's participation. The research findings suggest that Afghanistan, due to its geostrategic position, rich natural resources, and potential capacities, can serve as a bridge between Central, South, and West Asian countries, thereby strengthening economic and security cooperation within the framework of the Shanghai Cooperation Organization. However, challenges such as internal instability, economic dependency, and geopolitical pressures from foreign powers pose serious obstacles to Afghanistan's active participation in the organization. According to content analysis, there is a consensus among experts that the Shanghai Cooperation Organization, if it enhances its support mechanisms, can provide a suitable platform for bolstering stability and development in Afghanistan. This endeavor requires multilateral cooperation and sustained support from the key members of the organization. The findings of this research can significantly assist policymakers and decision-makers in formulating effective strategies to enhance Afghanistan's role in this organization.

Microbead Encapsulation for Protection of Electronic Components

Abstract This study investigates the application of microbeads as an innovative encapsulation technique to protect electronic components from harsh mechanical strain. Traditional encapsulation methods using hard epoxy provide substantial mechanical support but create thermal expansion mismatch issues, potentially leading to electronic component failure. We explore the use of finely powdered microbeads to achieve protective structures combining stiffness and energy absorption. The research focuses on key variables, including microbead size, microbead roughness, compaction of microbeads, and circuit board mounting in the encapsulation, all of which influence the encapsulation's effectiveness. Experimental setups and testing protocols were developed to assess the performance of various microbead materials under different impact conditions. Results demonstrate that microbead encapsulation significantly reduces strain on circuit boards, minimizing the risk of damage during mechanical shocks. However, challenges remain, such as optimizing microbead characteristics and modeling their behavior within large-scale circuit board assemblies. Despite these challenges, the findings suggest that microbead encapsulation offers a promising alternative to conventional methods, enhancing the durability and reliability of electronic components in high-stress environments.

The effect of power-based control on the haemodynamics and valve function of the biventricular assist circulation system.

Biventricular assist devices (BiVAD) are capable of providing mechanical support to the left and right ventricles to improve blood supply in heart failure, thereby maintaining patients' lives and improving their quality of life. But there is evidence that the incidence of aortic valve incompetence and other valvular pathologies is related to BiVAD support. Such as constant speed (CS) control may cause the valve to close completely and lose its normal valve function. The valve function is related to the percentage of valve opening which is approximately 30% of the cardiac cycle. This study developed a power-based control model for BiVAD that could regulate motors' speed by altering the power to satisfy objectives of keeping valve function and restoring physiologic perfusion. The effects of the power-based controller on the hemodynamics and valve function were investigated by simulating BiVAD under constant power and variable power controls. Different heart failure and activity levels were also mimicked under variable power control to obtain the BiVAD's critical parameters and the assist ratios. The results show that the power-based control can help the BiVAD to assist a patient with heart failure, and the power settings should comprehensively consider objectives of valve function and physiologic perfusion.

Mai: A Transformer Based Domain Specific Chatbot for Menstrual Health

Traditional health-seeking behaviors, particularly in menstrual health, are deeply rooted in local languages, sociocultural norms, and religious beliefs. These factors significantly influence women in South Asia and other developing regions, often proving detrimental to their physical and psychological health. Recognizing the multifaceted nature of these challenges, this paper investigates the role of generative domain-specific chatbots as a supportive mechanism to enhance menstrual health-seeking behaviors among South Asian women. Specifically, it aims to create and assess Mai, a conversational agent, which utilizes Roman-Urdu and English models to provide accurate information, thereby contributing to the broader effort of empowering women with knowledge and resources. Due to a lack of conversational data in this domain, our research involves creating a dataset from existing English sources and translating it into Roman Urdu, presenting its own set of challenges. These datasets, specifically curated for this research, addressed a wide range of menstrual health topics. Despite being an English monolingual model, DialoGPT’s transformer architecture produced favorable results when fine-tuned on a Roman Urdu dataset. While the Roman Urdu version occasionally faced challenges with contextual understanding, both models achieved promising results. Automatic evaluation metrics indicated strong performance for Mai compared to baseline models. Likewise, user evaluations yielded average ratings of 4.2 and 4.3 (out of 5) for the Roman Urdu and English chatbots, respectively, and more than half of the medical professionals surveyed expressed willingness to recommend the dialogue system. Overall, our findings highlight the transformative potential of domain-specific dialogue systems in health education, with room for improvement in overcoming cultural and linguistic barriers to women’s health information access.

Unique ultrastructural organization of human rod photoreceptors

Rod and cone photoreceptor cells are specialized neurons responsible for transforming the information reaching the eyes in the form of photons into the language of neuronal activity. Rods are the most prevalent photoreceptor type, primarily responsible for light detection under conditions of limited illumination. Here we demonstrate that human rods have a morphological organization unique among all described species, whereby the cell soma extends alongside the light-sensitive outer segment compartment to form a structure we have termed the “accessory inner segment.” These structures have two striking features: they are reinforced by a massive microtubular cytoskeleton and contain electron-dense adhesions that mediate their attachment to outer segments. Given that the spacing of human rod photoreceptors is sparser than in most other species, the accessory inner segment likely provides mechanical support to the closely apposed outer segment. This discovery expands our understanding of the human retina and directs future studies of human photoreceptor function in health and disease.

Design and Preparation of Soluble Polyimide Binder With Random Copolymerized Rigid‐Flexible Segments for Lithium Ion Batteries

ABSTRACTBinders play a critical role in the preparation and operation of electrodes in lithium‐ion batteries (LIBs). Developing new binding materials with high affinity to Li ions and resistance to higher voltages was desirable for the practical applications of LIBs. In this work, soluble polyimide binder (PI) with random copolymerized rigid‐flexible segments were synthesized and evaluated as cathode binder for the typical lithium iron phosphate cathode material in terms of cycling performances, rate capability, and electrochemical impedance. By introducing the polar and soft ether segment into the rigid PI chains, the NMP‐soluble PI precursors were obtained. The rigid‐flexible segments in the PI binders work synergistically during the electrochemical process, in which the rigid segments of aromatic units with strong lithiophilic CO group provided the necessary mechanical support and affinity with electrolytes, while the flexible segments endow the high solubility and buffer effect to the volume change during the charge/discharge process. Moreover, the 3,5‐diaminobenzoic acid (DABA) working as the crosslinking unit was introduced during the synthesis and the addition ratios were optimized. The as‐optimized PI binders exhibited superior rate performances and comparable cycling stability when compared with the commercial PVDF binder, demonstrating the great potential for PI binder in the LIBs systems.

Understanding academic help-seeking among first-generation college students: a phenomenological approach

Seeking academic help is a common practice for students to achieve academic success. Although there are some studies on academic help-seeking, current research has not fully examined this behavior from the perspective of first-generation college students. This study explores how first-generation college students perceive and engage in academic help-seeking, aiming to understand the factors that influence their attitudes and behaviors in seeking academic support. Semi-structured interviews were conducted with 20 participants, guided by the Theory of Planned Behavior. The interviews were recorded and transcribed, then analyzed using Interpretative Phenomenological Analysis. The findings are as follows: (1) Positive perception, (2) Negative perception, (3) Social Expectations and Pressures in Help-Seeking, (4) Motivators for Help-Seeking, and (5) Inhibitors for help-seeking. Most students have a favorable view of seeking help, but many associate it with self-doubt and concerns about peers’ opinions. Subjective norms in help-seeking are shaped by social expectations and pressures, with key influences coming from family, teachers, and peers. Motivation to seek help affects understanding academic needs, problem-solving urgency, and confidence. However, there are inhibiting factors such as emotional barriers, perceived independence, and concerns about help effectiveness. This study provides valuable insights into the complex dynamics of academic help-seeking among first-generation college students. It highlights their positive attitudes and the multifaceted factors influencing their help-seeking behavior. The insights from this study are critical to developing targeted educational approaches and support mechanisms to assist first-generation college students in their academic endeavors more effectively.

Obesity and Different Effect Between Exercise and Diet for Weight Loss

The worldwide increase in obesity has become a significant public health issue, linked to a range of chronic illnesses, including diabetes, heart disease, and some types of cancer. This study investigates the effectiveness of combined dietary and exercise interventions in promoting weight loss, drawing on a systematic literature review and case analysis of recent peer-reviewed research. By examining various dietary approachesincluding low-carbohydrate, Mediterranean, and calorie-restricted dietsalongside different exercise modalities such as aerobic training and high-intensity interval training (HIIT), this research aims to identify the optimal strategies for weight management. Findings indicate that individuals participating in combined interventions experience significantly greater weight loss and improvements in metabolic health compared to those following diet or exercise regimens alone. Moreover, the study emphasizes the importance of personalized interventions that consider individual preferences and psychological factors, suggesting that integrating social support mechanisms and technological tools can enhance adherence and long-term success. The results emphasize the need for comprehensive weight management strategies that address the interplay of dietary and exercise components, psychological support, and social influences to effectively combat obesity and promote overall health.

Exploring cooking fuel choices among Ghanaian women of reproductive age: A socio-economic analysis from a statistical mechanics perspective.

Access to clean and efficient cooking fuel is crucial for promoting good health, safeguarding the environment, and driving economic growth. Despite efforts to promote the adoption of cleaner alternatives, traditional solid fuels such as charcoal and firewood remain prevalent in Ghana. In this study, we utilized a statistical mechanical model as a framework to explore the statistical relationship between socio-economic factors such as educational attainment, wealth status, place of residence, and cooking fuel choices. We analysed data from the Ghana Malaria Indicator Survey (GMIS) conducted in 2019, involving a total of 2,942 women of reproductive age. The findings revealed that 13.77% of participants preferred using LPG fuels for cooking, while 86.23% preferred non-LPG fuels for their cooking needs. The data indicated that among LPG users, 96.54% are educated women of reproductive age, and 3.46% are non-educated women of reproductive age. Among these, 95.31% are non-poor, and 4.69% are poor. Additionally, 21.73% reside in rural areas, while 78.27% live in urban areas. The data also showed that among non-LPG fuel users, 68.70% are educated women of reproductive age, and 31.30% are non-educated women of reproductive age. Among this group, 16.04% are non-poor, and 83.96% are poor. Furthermore, 67.24% reside in rural areas, and 32.76% live in urban areas. Our findings showed that in the absence of social interaction, a woman's wealth status has a relationship to her choice of fuel for cooking. Additionally, women of reproductive age in rural areas with some education demonstrated a significant private incentive (40.12%) to use LPG, implying a positive correlation between education and the use of LPG for cooking. However, when social interactions are considered, factors such as education, wealth status, and place of residence have significant relationships with a woman's decision about fuel choice. The interaction strength among women of reproductive age in urban areas with some education shows a negative estimate (-4.06%), suggesting that there is no significant imitative effect. The study further suggests that urban women of reproductive age who are poor exert a greater influence on their urban counterparts who are not poor when social interaction is incorporated. Women of reproductive age in rural areas with some form of education exert a greater influence on women of reproductive age in rural areas with no form of education. We recommend that the government of Ghana and its stakeholders focus on leveraging the influence of urban poor women and educated rural women through community-led programs and educational campaigns. Financial support mechanisms like microfinance and subsidies, alongside reliable LPG infrastructure, can make access easier for these target groups. Tailored communication strategies, peer-to-peer learning, and collaboration with local institutions are crucial for spreading awareness and encouraging the adoption of LPG.

Experiences of healthcare professionals returning to work post breast cancer diagnosis in China: A descriptive qualitative study

Breast cancer survivors face employment challenges. How to promote BC’s return to work is important for improving their quality of life and promoting recovery. Numerous studies have reported that BC survivors encounter employment challenges due to cognitive limitations, alongside factors. healthcare Professional has a good educational background and a good cognitive level and is also the closest combination of sociocultural tradition and healthcare systems, however, there is a lack of studies on their experience as BC survivors. A descriptive qualitative study was conducted to investigate the experiences of healthcare professionals returning to work following breast cancer diagnosis. 20 doctors and nurses were interviewed face-to-face with a semi-structured interview guide in three municipal hospitals. Four major themes and corresponding sub-themes were extracted from the collected data as follows: (1) Return to Work: Willingness and Conflicts; (2) Cancer Progression Anxiety; (3) Physical and Mental Re-Awareness, including (1) Decreased Physical Ability, (2) Frustration and Diminished Self-Esteem; 4. Reflection and Re-planning, including (1) Past Self-Questioning, (2) Active Life Re-planning, (3) Revitalizing Life’s Value, and (4) Career Changes: Coping and Adapting. This study revealed a positive reintegration into the workforce among participants in China’s healthcare professionals with a notably advanced medical understanding. It implies that, for BC survivors, a combination of rich medical knowledge, a stable work environment, substantial income, and robust support from colleagues and superiors play a positive role in enhancing their adaptability post a breast cancer diagnosis. Additionally, interviewees expressed guilt during sick leave, it was suggested that hospitals implement comprehensive support mechanisms related to leave, acknowledging the imperative need for adequate rest during the treatment period.

Study on Zonal Support Mechanism and the Surrounding Rock Control Technology of Rock Roadway Excavated by TBM in Coal Mine

ABSTRACTTunnel boring machine (TBM) has been increasingly used for excavating rock roadways in coal mines. However, the slower speed of support installation, compared to the cutterhead's fast rock‐breaking capability, limits the overall excavation speed of rock roadways. This study examines the construction of a gas drainage roadway in Shoushan No.1 coal mine using a double‐shield TBM. A mechanical model for TBM excavation was developed, considering the spatial effects of the excavation face. The study identified a zonal support mechanism for the surrounding rock in TBM excavation roadways, it also analyzed the effects of support reaction forces and virtual support forces on the surrounding rock of different zones. A zonal control technology for surrounding rock was proposed and successfully implemented in the field. The results indicate that the strain evolution of the surrounding rock behind the TBM excavation face displays distinct zonal features. Based on this, the study recommends timely support for critical areas of the roadway roof in rapidly deforming zones through localized active primary anchor bolting. In slower deforming zones, secondary active anchor bolting is recommended for the remaining parts of the roadway roof and the side supports. In stable zones, cables anchor bolting support are implemented. A phased control technology system for the zonal management of surrounding rock in TBM excavation roadway was developed, and optimal parameters were determined using numerical simulations. The phased and zonal control technology was successfully applied at Shoushan No. 1 coal mine, achieving a maximum excavation speed of 623 m per month. This study provides valuable insights into the application of rapid excavation technology by TBM under similar conditions.

After Returning to the Rural: The (Un)Sustainable Reintegration of Internal Migrant Workers in China

ABSTRACTThe return of internal migrant workers to rural regions following prolonged periods of employment in cities is an increasingly prominent phenomenon in China. Researchers have examined return migration patterns, but investigating the intricacies of the reintegration process demands more highly sophisticated measurement approaches and warrants deeper empirical investigation. In this study, a comprehensive evaluation framework is designed for assessing reintegration outcomes on three interconnected dimensions: economic re‐engagement, social‐rebonding, and psychological re‐affiliation. By applying this framework to the analysis of data from the 2014 China Labour Force Dynamic Survey, we find that approximately half of returnees meet the defined thresholds for successful reintegration into rural society. There are considerable difficulties associated with economic reintegration, which underscores the need to provide enhanced economic support mechanisms for returning internal migrants. The main socio‐geographical factors contributing to successful reintegration include being in the middle‐to‐late stages of the working age, male gender, living with a spouse, returning with family, having interprovincial migration experience, and extended duration of return. This study enhances the comprehension of the challenges faced by returning migrant workers and provides analytical instruments and perspectives that can be used to deepen the understanding of internal migration issues in China and beyond.

Catalyzing organizational evolution: a scholarly examination of performance improvement plans and their enhancement of employee transition experiences in corporate frameworks

The rapid evolution of technological advancements in today’s corporate world is increasing exponentially, primarily due to the acquisition and retention of exceptionally intellectual and innovation-driven talented individuals. Exemplary employee performance is a key factor contributing to successful businesses and performance evaluations play a pivotal role in assessing whether employees meet, exceed job expectations, or underperform and is conducted on a quarterly or annual basis. Some organizations implement performance-based appraisals and other tangible benefits for preserving talent while others utilize strategic performance development techniques such as skill and role-focused training and development programs. Despite rigorous efforts, corporate employees’ underperformances are not uncommon. To overcome this, organizations deploy a Performance Improvement Plan (PIP) as a strategic risk management measure to ensure that employee performance aligns with organizational expectations and contributes positively to the overall efficacy of the enterprise. However, employees under PIP view the process as demoralizing and career failure indicative rather than a targeted action plan to enhance job performance as superior evaluation is the only construct that defines the outcomes of the PIP process. in recent times. The study aims to broaden the scope of understanding PIP and examine the potential to facilitate positive transitions for employees within corporate environments, rather than leading to terminations. The research explores the anticipated outcomes and actual experiences associated with PIP through comprehensive analysis and pinpoints the key factors contributing to successful employee transitions. The preliminary analysis suggests successful employee PIPs are achieved by adapting to tailored managerial support and continuous feedback mechanisms. The researchers’ study utilizes a survey to collect quantitative data from participants who underwent experienced the Performance Improvement Plan (PIP). The research strives to identify best PIP practices that reinforce performance, and improve employee satisfaction and retention, thus fostering genuine organizational transformation.

Experimental Investigation of the Dynamic Impact Failure of Bolted Rock With Different Anchoring Angles

ABSTRACTBolt support mechanisms represent a key technique to support the surrounding rock in coal mines. In deep rock engineering applications, the bolt‐supported structure of the surrounding rock of a deep roadway under high bearing stress may fail under dynamic loads such as those of blasting vibrations and earthquake motion. In this study, dynamic uniaxial compression tests were conducted on steel bar reinforced rock to investigate the rockbolt performance under dynamic loading. The deformation of the specimen surface and rockbolt was recorded during the test. The strengths and failure modes of the bolted rock samples were investigated. The results show that the bolt and rock deform asynchronously when the bolted specimen is subjected to a dynamic load, and the time of the asynchronous deformation of the specimens with different bolt angles is considerably different. When the stress wave acts along the direction of the bolt, it is more likely to cause the failure of the bolted specimen. Anchorage agents should be employed to realize the synchronous deformation of the bolt and rock mass. The slip and dislocation of the anchorage agent/rock surface and anchorage agent/bolt interface are the key factors influencing the failure of bolted specimens. The influence of a dynamic stress wave on the surrounding rock support structure of a deep roadway can be effectively reduced by improving the antisliding characteristics of the anchoring agent and increasing the bolt density. The research results can provide theoretical guidance and serve as a reference to realize the reinforcement engineering of underground permanent chambers and roadways.

Community Health Workers in Nepal: A Systematic Review of Their Role in Health System Strengthening

Community Health Workers are vital in strengthening Nepal's healthcare system, particularly in underserved rural and remote regions, significantly reducing mortality rates and achieving national health goals. The paper aims to systematically evaluate the literature on CHWs' role in health system strengthening in Nepal, examining their characteristics, impact, motivations, and challenges. A mixed-method systematic review was conducted using PubMed, Research4life, and Google Scholar databases. Eight studies (5 qualitative, 1 quantitative, and 2 mixed methods) were analyzed using the Mixed Method Appraisal Tool 2018 and thematic analysis. Five major themes emerged: (1) Socio-demographic characteristics - CHWs are predominantly female volunteers with varying educational backgrounds; (2) Evolving roles - expanding beyond traditional maternal and child health to include non-communicable diseases; (3) Motivation factors - driven by community service and professional development opportunities; (4) System integration - serving as crucial intermediaries between communities and healthcare facilities; and (5) Implementation challenges - including limited resources, insufficient training, and inadequate incentives. While CHWs are essential to Nepal's healthcare system, particularly in delivering culturally competent primary health services, there is a critical need for sustainable support mechanisms. Enhanced capacity-building initiatives, improved supervision systems, and appropriate incentives are necessary to retain experienced CHWs and maximize their impact. Investment in CHW programmes is crucial for strengthening Nepal's health system and achieving better community health outcomes, especially in rural areas.

Research on policy guidance and risk prevention and control in the digital transformation of sports industry

Background: Digital transformation in the sports industry has become increasingly crucial for sustainable development, yet comprehensive empirical evidence on policy effectiveness and risk management remains limited. Purpose: This study investigates the impact of policy support and risk factors on digital transformation in sports companies, examining heterogeneous effects across different firm characteristics and regional contexts. Methods: Using panel data from 168 sports companies listed on China’s A-shares markets and the New Third Board from 2019 to 2023, this study employs multiple regression analyses, including baseline models, instrumental variables estimation, and robustness tests. The digital transformation level is measured through a composite index incorporating digital infrastructure, capability, and innovation dimensions. Results: The findings reveal that policy support significantly enhances digital transformation levels (coefficient = 0.238, p < 0.01), while financial risks demonstrate the strongest negative impact (−0.162, p < 0.01). Large firms and state-owned enterprises show stronger responses to policy support (0.312 and 0.278, respectively, p < 0.01). Regional development levels significantly moderate the effectiveness of policy implementation. Conclusions: The study provides empirical evidence for the differential effects of policy support and risk factors on digital transformation across various firm characteristics. The findings suggest the need for differentiated policy approaches considering firm size, ownership structure, and regional development levels. Implications: Policy makers should develop targeted support mechanisms addressing specific challenges faced by different types of firms, while considering regional disparities in digital transformation capabilities.

Mechanical analysis of cerclage as a treatment for cervical insufficiency.

The primary treatment for cervical insufficiency is cervical cerclage (mechanical support) with vaginal progesterone (biochemical support). Cerclage is a surgical procedure that mechanically increases the tensile capacity of the cervix. Therefore, it is necessary to analyse the effects of cerclage from a mechanical point of view. To analyse cerclage techniques based on physical principles and mechanical forces. We assumed that the cervix is a thin-walled pressure vessel and applied a uniform vertical distribution model, a linear vertical model, and a non-linear vertical distribution model. According to our model analysis, the higher the position of the thread, the thicker the thread used, and the greater the number of threads, the more effective the confining force on the suture, when performing a cerclage. It is necessary to provide an appropriate cerclage for each patient based on these mechanical characteristics, in addition to considering the risks and benefits and biochemical interactions of the cerclage.

Diagnosis of Protected Agriculture in Imbabura—Ecuador, Period 2016–2023

Protected agriculture in Ecuador began in the 1990s and has expanded due to its comparative advantages over open field production. However, there are no statistics on this sector, which limits decision-making. The aim of this research was to provide a baseline of greenhouse agriculture in Imbabura. Sentinel-2 satellite imagery was used to estimate the spatial distribution of plastic-covered surface area in 2016 and 2023. To minimize biases in estimation, manual verification was also conducted. Based on population data, a structured survey was administered to a probabilistic sample of 234 greenhouses. The results highlight the presence of 1958 greenhouses that cover 527 hectares, with an average of 0.26 hectares. The greenhouses were characterized in terms of their design, construction materials and equipment. The main crop under plastic is tomato, with 76.9%, of which the management characteristics and the productive and economic results obtained in 2023 were identified. The findings could inform the formulation of public policies or specific interventions to strengthen protected agriculture in the region; however, support mechanisms are needed to fully exploit its potential. Among these, producer organization could be a viable strategy to address food security challenges in the context of climate change.

Fathers’ Experiences of Negotiating Co-Parenting Arrangements and Family Court

Background: this study builds on existing research on fathers’ experiences of family breakdown, separation, and post-separation abuse, exploring the systemic challenges they face in negotiating co-parenting arrangements. Methods: using data from a survey of 141 fathers and interviews with 30 participants, we examined the dynamics of post-separation co-parenting, particularly focusing on how fathers perceive and navigate family court systems. The data were analysed using reflexive thematic analysis to identify key themes. Results: the findings highlighted two primary themes: the difficulties that fathers face in establishing equitable co-parenting arrangements and their negative experiences with family courts, including perceptions of gender bias and systemic inefficiency. Conclusions: the results indicate a need for greater support mechanisms post-separation to facilitate healthier co-parenting relationships and minimise reliance on adversarial court processes. Furthermore, the research underscores the importance of addressing gender stereotypes within family law and social services to ensure more just outcomes for fathers and their children.

Triheptanoin use for severe neonatal cardiomyopathy secondary to mitochondrial trifunctional protein deficiency: a first report.

Mitochondrial trifunctional protein deficiency is a long-chain fatty acid disorder that may include manifestations of severe cardiomyopathy and arrhythmias. The pathophysiology for the severe presentation is unclear but is an indicator for worse outcomes. Triheptanoin, a synthetic medium chain triglyceride, has been reported to reverse cardiomyopathy in some individuals, but there is limited literature in severe cases. We describe a neonatal onset of severe disease whose clinical course was not improved despite mechanical support and triheptanoin.