Search results for: blood loss
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5588

Search results for: blood loss

5318 SCNet: A Vehicle Color Classification Network Based on Spatial Cluster Loss and Channel Attention Mechanism

Authors: Fei Gao, Xinyang Dong, Yisu Ge, Shufang Lu, Libo Weng

Abstract:

Vehicle color recognition plays an important role in traffic accident investigation. However, due to the influence of illumination, weather, and noise, vehicle color recognition still faces challenges. In this paper, a vehicle color classification network based on spatial cluster loss and channel attention mechanism (SCNet) is proposed for vehicle color recognition. A channel attention module is applied to extract the features of vehicle color representative regions and reduce the weight of nonrepresentative color regions in the channel. The proposed loss function, called spatial clustering loss (SC-loss), consists of two channel-specific components, such as a concentration component and a diversity component. The concentration component forces all feature channels belonging to the same class to be concentrated through the channel cluster. The diversity components impose additional constraints on the channels through the mean distance coefficient, making them mutually exclusive in spatial dimensions. In the comparison experiments, the proposed method can achieve state-of-the-art performance on the public datasets, VCD, and VeRi, which are 96.1% and 96.2%, respectively. In addition, the ablation experiment further proves that SC-loss can effectively improve the accuracy of vehicle color recognition.

Keywords: feature extraction, convolutional neural networks, intelligent transportation, vehicle color recognition

Procedia PDF Downloads 148
5317 Mixtures of Length-Biased Weibull Distributions for Loss Severity Modelling

Authors: Taehan Bae

Abstract:

In this paper, a class of length-biased Weibull mixtures is presented to model loss severity data. The proposed model generalizes the Erlang mixtures with the common scale parameter, and it shares many important modelling features, such as flexibility to fit various data distribution shapes and weak-denseness in the class of positive continuous distributions, with the Erlang mixtures. We show that the asymptotic tail estimate of the length-biased Weibull mixture is Weibull-type, which makes the model effective to fit loss severity data with heavy-tailed observations. A method of statistical estimation is discussed with applications on real catastrophic loss data sets.

Keywords: Erlang mixture, length-biased distribution, transformed gamma distribution, asymptotic tail estimate, EM algorithm, expectation-maximization algorithm

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5316 Enhancing of Biogas Production from Slaughterhouse and Dairy Farm Waste with Pasteurization

Authors: Mahmoud Hassan Onsa, Saadelnour Abdueljabbar Adam

Abstract:

Wastes from slaughterhouses in most towns in Sudan are often poorly managed and sometimes discharged into adjoining streams due to poor implementation of standards, thus causing environmental and public health hazards and also there is a large amount of manure from dairy farms. This paper presents solution of organic waste from cow dairy farms and slaughterhouse the anaerobic digestion and biogas production. The paper presents the findings of experimental investigation of biogas production with and without pasteurization using cow manure, blood and rumen content were mixed at two proportions, 72.3% manure, 21.7%, rumen content and 6% blood for bio digester1with 62% dry matter at the beginning and without pasteurization and 72.3% manure, 21.7%, rumen content and 6% blood for bio-digester2 with 10% dry matter and pasteurization. The paper analyses the quantitative and qualitative composition of biogas: gas content, the concentration of methane. The highest biogas output 2.9 mL/g dry matter/day (from bio-digester2) together with a high quality biogas of 87.4% methane content which is useful for combustion and energy production and healthy bio-fertilizer but biodigester1 gave 1.68 mL/g dry matter/day with methane content 85% which is useful for combustion, energy production and can be considered as new technology of dryer bio-digesters.

Keywords: anaerobic digestion, bio-digester, blood, cow manure, rumen content

Procedia PDF Downloads 697
5315 Capacity Loss of Urban Arterial Roads under the Influence of Bus Stop

Authors: Sai Chand, Ashish Dhamaniya, Satish Chandra

Abstract:

Curbside bus stops are provided on urban roads when sufficient land is not available to construct bus bays. The present study demonstrates the effect of curbside bus stops on midblock capacity of an urban arterial road. Data were collected on seven sections of 6-lane urban arterial roads in New Delhi. Three sections were selected without any side friction to estimate the base value of capacity. Remaining four sections were with curbside bus stop. Speed and volume data were collected in field and these data were used to estimate the capacity of a section. The average base midblock capacity of a 6–lane divided urban road was found to be 6314 PCU/hr which was further referred as base capacity. Effect of curbside bus stop on midblock capacity of urban road was evaluated by comparing the capacity of a section with curbside bus stop with that of the base capacity. Finally, a mathematical relation has been developed between bus frequency and capacity loss. Also a relation has been suggested between dwell time and capacity loss. The developed relations would be very useful for practising engineers to estimate capacity loss due to bus stop.

Keywords: bus frequency, bus stops, capacity loss, urban arterial

Procedia PDF Downloads 327
5314 Effect of Acute Ingestion of Ice Water on Blood Pressure in Relation to Body Mass Index

Authors: Savitri Siddanagoudra, Shantala Herlekar, Priya Arjunwadekar

Abstract:

Background: The physiological response to water drinking in healthy subjects is an integrated response with an increase in sympathetic vasoconstrictor activity with induced bradycardia. Obesity is a modern pandemic, implicated in the pathogenesis of cardiovascular disease. In autonomic failure patients, water drinking has been shown the increased high blood pressure and bradycardia. Acute effects of ice water ingestion on blood pressure (BP) in relation to body mass index (BMI) is not addressed in literature. Objectives: Objective of this study is to evaluate BP before and after ingestion of cold water in all the three groups. Methods and Material: 60 healthy subjects between the age group of 18-24 yrs were selected and assigned into 3 groups based on BMI. BMI less than and equal to 25 kg/m2 is selected as Normal BMI group ,between 25- 29 kg/m2 as Overweight and BMI more than and equal to 30 kg/m2 as Obese. Procedure: Basal and after ingestion of 250 ml of cold water (7 0C ± 0.5 0C)BP was recorded in all the 3 groups. Results: Basal and after ice water ingestion BP increased statistically in all 3 groups. Conclusion: On acute ingestion of ice water overweight, obese may have more sympathoexcitaion compared to normal subjects.

Keywords: blood pressure, body mass index, ice water, symathoexcitation

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5313 Haemobiogram after Intramuscular Administration of Amoxicillin to Sheep

Authors: Amer Elgerwi, Abdelrazzag El-Magdoub, Abubakr El-Mahmoudy

Abstract:

There are many bacterial infections affecting sheep that necessitates antibiotic intervention. Amoxicillin is among commonly used antibiotics in such case for its broad spectrum of activity. However, the side alterations in blood and organ function that may be associated during or after treatment are questionable. Therefore, the aim of the present study was to assess the possible alterations in blood parameters and organ function bio markers of sheep that may occur following intramuscular injection of amoxicillin. Amoxicillin has been administered intramuscularly to 10 sheep at a dosage regimen of 7 mg/kg of body weight for 5 successive days. Two types of blood samples (with and without anticoagulant) were collected from the jugular vein pre- and post-administration of the drug. Amoxicillin significantly (P < 0.001) increased total leukocyte count and (P < 0.05) absolute eosinophilic count when compared with those of the control samples. Aspartate aminotransferase, alkaline phosphatase and cholesterol were significantly (P < 0.05) higher than the corresponding control values. In addition, amoxicillin significantly (P < 0.05) increased blood urea nitrogen and creatinine but decreased phosphorus level when compared with those of prior-administration samples. These data may indicate that although the side changes caused by amoxicillin are minor in sheep, yet the liver and kidney functions should be monitored during its usage in therapy and it should be used with care for treatment of sheep with renal and/or hepatic impairments.

Keywords: amoxicillin, biogram, haemogram, sheep

Procedia PDF Downloads 435
5312 Evaluation of Vitamin D Levels in Obese and Morbid Obese Children

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Obesity may lead to growing serious health problems throughout the world. Vitamin D appears to play a role in cardiovascular and metabolic health. Vitamin D deficiency may add to derangements in human metabolic systems, particularly those of children. Childhood obesity is associated with an increased risk of chronic and sophisticated diseases. The aim of this study is to investigate associations as well as possible differences related to parameters affected by obesity and their relations with vitamin D status in obese (OB) and morbid obese (MO) children. This study included a total of 78 children. Of them, 41 and 37 were OB and MO, respectively. WHO BMI-for age percentiles were used for the classification of obesity. The values above 99 percentile were defined as MO. Those between 95 and 99 percentiles were included into OB group. Anthropometric measurements were recorded. Basal metabolic rates (BMRs) were measured. Vitamin D status is determined by the measurement of 25-hydroxy cholecalciferol [25- hydroxyvitamin D3, 25(OH)D] using high-performance liquid chromatography. Vitamin D status was evaluated as deficient, insufficient and sufficient. Values < 20.0 ng/ml, values between 20-30 ng/ml and values > 30.0 ng/ml were defined as vitamin D deficient, insufficient and sufficient, respectively. Optimal 25(OH)D level was defined as ≥ 30 ng/ml. SPSSx statistical package program was used for the evaluation of the data. The statistical significance degree was accepted as p < 0.05. Mean ages did not differ between the groups. Significantly increased body mass index (BMI), waist circumference (C) and neck C as well as significantly decreased fasting blood glucose (FBG) and vitamin D values were observed in MO group (p < 0.05). In OB group, 37.5% of the children were vitamin D deficient, and in MO group the corresponding value was 53.6%. No difference between the groups in terms of lipid profile, systolic blood pressure (SBP), diastolic blood pressure (DBP) and insulin values was noted. There was a severe statistical significance between FBG values of the groups (p < 0.001). Important correlations between BMI, waist C, hip C, neck C and both SBP as well as DBP were found in OB group. In MO group, correlations only with SBP were obtained. In a similar manner, in OB group, correlations were detected between SBP-BMR and DBP-BMR. However, in MO children, BMR correlated only with SBP. The associations of vitamin D with anthropometric indices as well as some lipid parameters were defined. In OB group BMI, waist C, hip C and triglycerides (TRG) were negatively correlated with vitamin D concentrations whereas none of them were detected in MO group. Vitamin D deficiency may contribute to the complications associated with childhood obesity. Loss of correlations between obesity indices-DBP, vitamin D-TRG, as well as relatively lower FBG values, observed in MO group point out that the emergence of MetS components starts during obesity state just before the transition to morbid obesity. Aside from its deficiency state, associations of vitamin D with anthropometric measurements, blood pressures and TRG should also be evaluated before the development of morbid obesity.

Keywords: children, morbid obesity, obesity, vitamin D

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5311 Role of Mismatch Repair Protein Expression in Colorectal Cancer: A Study from North India

Authors: Alka Yadav, Mayank Jain, Rajan Saxena, Niraj Kumari, Narendra Krishnani, Ashok Kumar

Abstract:

Purpose: To study the mismatch repair (MMR) protein expression and its clinicopathological correlation in colorectal cancer patients in North India. Methods: A prospective study was conducted on histologically proven 52 (38 males and 14 females) patients with adenocarcinoma of colorectum. MMR protein loss was determined by using immunohistochemistry for MLH1, MSH2, PMS2 and MSH6. Results: 52 patients (38 males and 14 females) underwent resection for colorectal cancer with the median age of 52 years (16-81 years). 35% of the patients (n=18) were younger than 50 years of the age. 3 patients had associated history of malignancy in the family. 29 (56%) patients had right colon cancer, 9 (17%) left colon cancer and 14 (27%) rectal cancer. 2 patients each had synchronous and metachronous cancer. Histology revealed well-differentiated tumour in 16, moderately differentiated in 10 and poorly differentiated tumour in 26 patients. MMR protein loss was seen in 15 (29%) patients. Seven (46%) of these patients were less than 50 years of age. Combined loss of MSH2 and MSH6 was seen most commonly and it was found in 6 patients. 12 (80%) patients with MMR protein loss had tumour located proximal to the splenic flexure compared to 3 (20%) located distal to the splenic flexure. There was no difference in MMR protein loss based on patients' age, gender, degree of tumour differentiation, stage of the disease and tumour histological characteristics. Conclusions: This study revealed that there was less than 30% MMR protein loss in colorectal cancer patients. The loss was most commonly seen in right sided colon cancer than left. A larger study is further required to validate these findings.

Keywords: colorectal cancer, mismatch repair protein, immunohitochemistry, clinicopathological correlation

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5310 Changes in Blood Pressure in a Longitudinal Cohort of Vietnamese Women

Authors: Anh Vo Van Ha, Yun Zhao, Luat Cong Nguyen, Tan Khac Chu, Phung Hoang Nguyen, Minh Ngoc Pham, Colin W. Binns, Andy H. Lee

Abstract:

This study aims to study longitudinal changes in blood pressure (BP) during the 1-year postpartum period and to evaluate the influence of parity, maternal age at delivery, prepregnancy BMI, gestational weight gain, gestational age at delivery and postpartum maternal weight. A prospective longitudinal cohort study of 883 singleton Vietnamese women was conducted in Hanoi, Haiphong, and Ho Chi Minh City, Vietnam during 2015-2017. Women diagnosed with gestational diabetes mellitus at 24-28 weeks of gestation, pre-eclampsia, and hypoglycemia was excluded from analysis. BP was repeatedly measured at discharge, 6 and 12 months postpartum using automatic blood pressure monitors. Linear mixed model with repeated measures was used to describe changes occurring during pregnancy to 1-year postpartum. Parity, self-reported prepregnancy BMI, gestational weight gain, maternal age and gestational age at delivery will be treated as time-invariant variables and measured maternal weight will be treated as a time-varying variable in models. Women with higher measured postpartum weight had higher mean systolic blood pressure (SBP), 0.20 mmHg, 95% CI [0.12, 0.28]. Similarly, women with higher measured postpartum weight had higher mean diastolic blood pressure (DBP), 0.15 mmHg, 95% CI [0.08, 0.23]. These differences were both statistically significant, P < 0.001. There were no differences in SBP and DBP depending on parity, maternal age at delivery, prepregnancy BMI, gestational weight gain and gestational age at delivery. Compared with discharge measurement, SBP was significantly higher in 6 months postpartum, 6.91 mmHg, 95% CI [6.22, 7.59], and 12 months postpartum, 6.39 mmHg, 95% CI [5.64, 7.15]. Similarly, DBP was also significantly higher in 6 and months postpartum than at discharge, 10.46 mmHg 95% CI [9.75, 11.17], and 11.33 mmHg 95% CI [10.54, 12.12]. In conclusion, BP measured repeatedly during the postpartum period (6 and 12 months postpartum) showed a statistically significant increase, compared with after discharge from the hospital. Maternal weight was a significant predictor of postpartum blood pressure over the 1-year postpartum period.

Keywords: blood pressure, maternal weight, postpartum, Vietnam

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5309 Evaluation of Transfusion-Related Acute Lung Injury

Authors: Hossein Barri Ghazani

Abstract:

Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

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5308 Comparison of Serological and Molecular Diagnosis of Cerebral Toxoplasmosis in Blood and Cerebrospinal Fluid in HIV Infected Patients

Authors: Berredjem Hajira, Benlaifa Meriem, Becheker Imene, Bardi Rafika, Djebar Med Reda

Abstract:

Recent acquired or reactivation T.gondii infection is a serious complication in HIV patients. Classical serological diagnosis relies on the detection of anti-Toxoplasma immunoglobulin ; however, serology may be unreliable in HIV immunodeficient patients who fail to produce significant titers of specific antibodies. PCR assays allow a rapid diagnosis of Toxoplasma infection. In this study, we compared the value of the PCR for diagnosing active toxoplasmosis in cerebrospinal fluid and blood samples from HIV patients. Anti-Toxoplasma antibodies IgG and IgM titers were determined by ELISA. In parallel, nested PCR targeting B1 gene and conventional PCR-ELISA targeting P30 gene were used to detect T. gondii DNA in 25 blood samples and 12 cerebrospinal fluid samples from patients in whom toxoplasmic encephalitis was confirmed by clinical investigations. A total of 15 negative controls were used. Serology did not contribute to confirm toxoplasmic infection, as IgG and IgM titers decreased early. Only 8 out 25 blood samples and 5 out 12 cerebrospinal fluid samples PCRs yielded a positive result. 5 patients with confirmed toxoplasmosis had positive PCR results in either blood or cerebrospinal fluid samples. However, conventional nested B1 PCR gave best results than the P30 gene one for the detection of T.gondii DNA in both samples. All samples from control patients were negative. This study demonstrates the unusefulness of the serological tests and the high sensitivity and specificity of PCR in the diagnosis of toxoplasmic encephalitis in HIV patients.

Keywords: cerebrospinal fluid, HIV, Toxoplasmosis, PCR

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5307 Low Nonlinear Effects Index-Guiding Nanostructured Photonic Crystal Fiber

Authors: S. Olyaee, M. Seifouri, A. Nikoosohbat, M. Shams Esfand Abadi

Abstract:

Photonic Crystal Fibers (PCFs) can be used in optical communications as transmission lines. For this reason, the PCFs with low confinement loss, low chromatic dispersion, and low nonlinear effects are highly suitable transmission media. In this paper, we introduce a new design of index-guiding nanostructured photonic crystal fiber (IG-NPCF) with ultra-low chromatic dispersion, low nonlinearity effects, and low confinement loss. Relatively low dispersion is achieved in the wavelength range of 1200 to 1600nm using the proposed design. According to the new structure of nanostructured PCF presented in this study, the chromatic dispersion slope is -30(ps/km.nm) and the confinement loss reaches below 10-7 dB/km. While in the wavelength range mentioned above at the same time an effective area of more than 50.2μm2 is obtained.

Keywords: optical communication systems, nanostructured, index-guiding, dispersion, confinement loss, photonic crystal fiber

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5306 Building Cardiovascular Fitness through Plyometric Training

Authors: Theresa N. Uzor

Abstract:

The word cardiovascular fitness is a topic of much interest to people of Nigeria, especially during this time, some heart diseases run in families. Cardiovascular fitness is the ability of the heart and lungs to supply-rich blood to the working muscle tissues. This type of fitness is a health-related component of physical fitness that is brought about by sustained physical activity such as plyometric training. Plyometric is a form of advanced fitness training that uses fast muscular contractions to improve power and speed in the sports performance by coaches and athletes. Plyometric training involves a rapid stretching of muscle (eccentric phase) immediately followed by a concentric or shortening action of the same muscle and connective tissue. However, the most basic example of true plyometric training is running and can be safe for a wide variety of populations. This paper focused on building cardiovascular health through Plyometric Training. The centre focus of the article is cardiovascular fitness and plyometric training with factors of cardiovascular fitness. Plyometric training at any age provides multiple benefits even beyond weight control and weight loss, decrease the risk of cardiovascular diseases, stroke, high blood pressure, diabetes, and other diseases, among other benefits of plyometric training to cardiovascular fitness. Participation in plyometric training will increase metabolism of an individual, thereby burning more calories even when at rest and reduces weight is also among the benefits of plyometric training. Some guidelines were recommended for planning plyometric training programme to minimise the chance of injury. With plyometric training in Nigeria, fortune can change for good, especially now that there has been an increase in cardiovascular diseases within the society for great savings would be saved.

Keywords: aerobic, cardiovascular, concentric, stretch-shortening cycle, plyometric

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5305 Study of a Cross-Flow Membrane to a Kidney Encapsulation Engineering Structures for Immunosuppression Filter

Authors: Sihyun Chae, Ryoto Arai, Waldo Concepcion, Paula Popescu

Abstract:

The kidneys perform an important role in the human hormones that regulate the blood pressure, produce an active form of vitamin D and control the production of red blood cells. Kidney disease can cause health problems, such as heart disease. Also, increase the chance of having a stroke or heart attack. There are mainly to types of treatments for kidney disease, dialysis, and kidney transplant. For a better quality of life, the kidney transplant is desirable. However, kidney transplant can cause antibody reaction and patients’ body would be attacked by immune system of their own. For solving that issue, patients with transplanted kidney always take immunosuppressive drugs which can hurt kidney as side effects. Patients willing to do a kidney transplant have a waiting time of 3.6 years in average searching to find an appropriate kidney, considering there are almost 96,380 patients waiting for kidney transplant. There is a promising method to solve these issues: bioartificial kidney. Our membrane is specially designed with unique perforations capable to filter the blood cells separating the white blood cells from red blood cells. White blood cells will not pass through the encapsulated kidney preventing the immune system to attack the new organ and eliminating the need of a matching donor. It is possible to construct life-time long encapsulation without needing pumps or a power supply on the cell’s separation method preventing futures surgeries due the Cross-Channel Flow inside the device. This technology allows the possibility to use an animal kidney, prevent cancer cells to spread through the body, arm and leg transplants in the future. This project aims to improve the quality of life of patients with kidney disease.

Keywords: kidney encapsulation, immunosuppression filter, leukocyte filter, leukocyte

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5304 The Effectiveness of Transcranial Electrical Stimulation on Brain Wave Pattern and Blood Pressure in Patients with Generalized Anxiety Disorder

Authors: Mahtab Baghaei, Seyed Mahmoud Tabatabaei

Abstract:

Aim & Background: Electrical stimulation of transcranial direct current is considered one of the treatment methods for mental disorders. The aim of this study was to evaluate the effectiveness of transcranial electrical stimulation on the delta, theta, alpha, beta and systolic and diastolic blood pressure in patients with generalized anxiety disorder. Materials and Methods: The present study was a double-blind intervention with a pre-test and post-test design on people with generalized anxiety disorder in Tabriz in 1400. In this study, 30 patients with generalized anxiety disorder were selected by purposive sampling method based on the criteria specified in DSM-5 and randomly divided into an experimental group (n = 15) and a control group (n = 15). The experimental group received two sessions of 30 minutes of electrical stimulation of transcranial direct current with an intensity of 2 mA in the area of the lateral dorsal prefrontal cortex, and the control group also received artificial stimulation. Results: The results showed that transcranial electrical stimulation reduces delta and theta waves and increases beta and alpha brain waves in the experimental group. On the other hand, this method also showed a significant decrease in systolic and diastolic blood pressure in these patients (p <0.01). Conclusion: The results show that transcranial electrical stimulation has a statistically significant effect on brain waves and blood pressure, and this non-invasive method can be used as one of the treatment methods in people with generalized anxiety disorder.

Keywords: transcranial direct current electrical stimulation, brain waves, systolic blood pressure, diastolic blood pressure

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5303 A Matched Case-Control Study to Asses the Association of Chikunguynya Severity among Blood Groups and Other Determinants in Tesseney, Gash Barka Zone, Eritrea

Authors: Ghirmay Teklemicheal, Samsom Mehari, Sara Tesfay

Abstract:

Objectives: A total of 1074 suspected chikungunya cases were reported in Tesseney Province, Gash Barka region, Eritrea, during an outbreak. This study was aimed to assess the possible association of chikungunya severity among ABO blood groups and other potential determinants. Methods: A sex-matched and age-matched case-control study was conducted during the outbreak. For each case, one control subject had been selected from the mild Chikungunya cases. Along the same line of argument, a second control subject had also been designated through which neighborhood of cases were analyzed, scrutinized, and appeared to the scheme of comparison. Time is always the most sacrosanct element in pursuance of any study. According to the temporal calculation, this study was pursued from October 15, 2018, to November 15, 2018. Coming to the methodological dependability, calculating odds ratios (ORs) and conditional (fixed-effect) logistic regression methods were being applied. As a consequence of this, the data was analyzed and construed on the basis of the aforementioned methodological systems. Results: In this outbreak, 137 severe suspected chikungunya cases and 137 mild chikungunya suspected patients, and 137 controls free of chikungunya from the neighborhood of cases were analyzed. Non-O individuals compared to those with O blood group indicated as significant with a p-value of 0.002. Separate blood group comparison among A and O blood groups reflected as significant with a p-value of 0.002. However, there was no significant difference in the severity of chikungunya among B, AB, and O blood groups with a p-value of 0.113 and 0.708, respectively, and a strong association of chikungunya severity was found with hypertension and diabetes (p-value of < 0.0001); whereas, there was no association between chikungunya severity and asthma with a p-value of 0.695 and also no association with pregnancy (p-value =0.881), ventilator (p-value =0.181), air conditioner (p-value = 0.247), and didn’t use latrine and pit latrine (p-value = 0.318), among individuals using septic and pit latrine (p-value = 0.567) and also among individuals using flush and pit latrine (p-value = 0.194). Conclusions: Non- O blood groups were found to be at risk more than their counterpart O blood group individuals with severe form of chikungunya disease. By the same token, individuals with chronic disease were more prone to severe forms of the disease in comparison with individuals without chronic disease. Prioritization is recommended for patients with chronic diseases and non-O blood group since they are found to be susceptible to severe chikungunya disease. Identification of human cell surface receptor(s) for CHIKV is quite necessary for further understanding of its pathophysiology in humans. Therefore, molecular and functional studies will necessarily be helpful in disclosing the association of blood group antigens and CHIKV infections.

Keywords: Chikungunya, Chikungunya virus, disease outbreaks, case-control studies, Eritrea

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5302 The Efficacy of Pre-Hospital Packed Red Blood Cells in the Treatment of Severe Trauma: A Retrospective, Matched, Cohort Study

Authors: Ryan Adams

Abstract:

Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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5301 The Applications of Four Fingers Theory: The Proof of 66 Acupoints under the Human Elbow and Knee

Authors: Chih-I. Tsai, Yu-Chien. Lin

Abstract:

Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: four fingers theory, meridians circulation, 66 acupoints under human elbow and knee, acupuncture

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5300 Monitoring Memories by Using Brain Imaging

Authors: Deniz Erçelen, Özlem Selcuk Bozkurt

Abstract:

The course of daily human life calls for the need for memories and remembering the time and place for certain events. Recalling memories takes up a substantial amount of time for an individual. Unfortunately, scientists lack the proper technology to fully understand and observe different brain regions that interact to form or retrieve memories. The hippocampus, a complex brain structure located in the temporal lobe, plays a crucial role in memory. The hippocampus forms memories as well as allows the brain to retrieve them by ensuring that neurons fire together. This process is called “neural synchronization.” Sadly, the hippocampus is known to deteriorate often with age. Proteins and hormones, which repair and protect cells in the brain, typically decline as the age of an individual increase. With the deterioration of the hippocampus, an individual becomes more prone to memory loss. Many memory loss starts off as mild but may evolve into serious medical conditions such as dementia and Alzheimer’s disease. In their quest to fully comprehend how memories work, scientists have created many different kinds of technology that are used to examine the brain and neural pathways. For instance, Magnetic Resonance Imaging - or MRI- is used to collect detailed images of an individual's brain anatomy. In order to monitor and analyze brain functions, a different version of this machine called Functional Magnetic Resonance Imaging - or fMRI- is used. The fMRI is a neuroimaging procedure that is conducted when the target brain regions are active. It measures brain activity by detecting changes in blood flow associated with neural activity. Neurons need more oxygen when they are active. The fMRI measures the change in magnetization between blood which is oxygen-rich and oxygen-poor. This way, there is a detectable difference across brain regions, and scientists can monitor them. Electroencephalography - or EEG - is also a significant way to monitor the human brain. The EEG is more versatile and cost-efficient than an fMRI. An EEG measures electrical activity which has been generated by the numerous cortical layers of the brain. EEG allows scientists to be able to record brain processes that occur after external stimuli. EEGs have a very high temporal resolution. This quality makes it possible to measure synchronized neural activity and almost precisely track the contents of short-term memory. Science has come a long way in monitoring memories using these kinds of devices, which have resulted in the inspections of neurons and neural pathways becoming more intense and detailed.

Keywords: brain, EEG, fMRI, hippocampus, memories, neural pathways, neurons

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5299 Radioprotective Effects of Selenium and Vitamin-E against 6Mv X-Rays in Human Volunteers Blood Lymphocytes by Micronuclei Assay

Authors: Vahid Changizi, Aram Rostami, Akbar Mosavi

Abstract:

Purpose of study: Critical macromolecules of cells such as DNA are in exposure to damage of free radicals that induced from interaction of ionizing radiation with biological systems. Selenium and vitamin-E are natural compound that has been shown to be a direct free radical scavenger. The aim of this study was to investigate the in vivo/in vitro radioprotective effect of selenium and vitamin-E separately and synergistically against genotoxicity induced by 6MV x-rays irradiation in cultured blood lymphocytes from 15 human volunteers. Methods: Fifteen volunteers were divided in three groups include A, B and C. These groups were given slenium(800 IU), vitamin-E(100 mg) and selenium(400 IU) + vitamin-E(50 mg), respectively. Peripheral blood samples were collected from each group before(0 hr) and 1, 2 and 3 hr after selenium and vitamin-E administration (separately and synergistically). Then the blood samples were irradiated to 200 cGy of 6 Mv x-rays. After that, lymphocyte samples were cultured with mitogenic stimulation to determine the chromosomal aberrations wih micronucleus assay in cytokinesis-blocked binucleated cells. Results: The lymphocytes in the blood samples collected at 1 hr after ingestion selenium and vitamin-E, exposed in vitro to x-rays exhibited a significant decrease in the incidence of micronuclei, compared with control group at 0 hr. The maximum protection and decrease in frequency of micronuclei(50%) was observed at 1 hr after administration of selenium and vitamin-E synergistically. Conclusion: The data suggest that ingestion of selenium and vitamin-E as a radioprotector substances before exposures may reduce genetic damage caused by x-rays irradiation.

Keywords: x-rays, selenium, vitamin-e, lymphocyte, micronuclei

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5298 Reducing the Incidence of Hyperphosphatemia in Patients Receiving Dialysis

Authors: Tsai Su Hui

Abstract:

Background: Hyperphosphatemia in patients receiving dialysis can cause hyperparathyroidism, which can lead to renal osteodystrophy, cardiovascular disease and mortality. Data showed that 26% of patients receiving dialysis had blood phosphate levels of >6.0 mg/dl at this unit from January to March 2017, higher than the Taiwan Society of Nephrology evaluation criteria of < 20%. After analysis, possible reasons included: 1. Incomprehensive education for nurse and lack of relevant training. 2. Insufficient assistive aids for nursing health education instruction. 3. Patients were unsure which foods are high or low in phosphate. 4. Patients did not have habits of taking medicine with them and how to correctly administer the medication. Purpose: To reduce the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl to less than 20% at this unit. Method: (1) Improve understanding of hyperphosphatemia and food for patients receiving dialysis and their families, (2) Acquire more nursing instruction assistive aids and improve knowledge of hyperphosphatemia for nurse. Results: After implementing the project, the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl decreased from 26.0% to 18.8% at this unit. By implementing the project, the professional skills of nurse improved, blood phosphate levels of patients receiving dialysis were reduced, and the quality of care for patients receiving dialysis at this unit was enhanced.

Keywords: hemodialysis, hyperphosphatemia, incidence, reducing

Procedia PDF Downloads 103
5297 Antidiabetic Evaluation of Pig (Sus scrofa) Bile on Alloxan-Induced BALB/c Mice

Authors: John Lyndon C. Lunnay

Abstract:

This study discerns to evaluate the antidiabetic efficacy of pig bile on alloxan-induced BALB/c mice. The experimental animals were divided and selected using RCBD into 5 groups (n= 4): T1 (negative control), T2 (1ml/kg), T3 (2ml/kg), T4 (3ml/kg) and T5 (Glibenclamide). Hyperglycemia was induced by injecting 1% alloxan monohydrate intraperitoneally. A glucose tolerance test was performed using a 2g/kg glucose solution, and blood glucose levels were measured at different time intervals. 14 days of monitoring was also done to ensure effectivity and efficacy of the different treatments. Bodyweight was also determined. Results show that administration of treatments on test animals significantly reverted the blood glucose levels of mice in 60 minutes and 120 minutes using an oral glucose tolerance test. After 14 days of monitoring, normal blood glucose levels were seen significantly on T2 (1ml/kg), T3 (2ml/kg), T4 (3ml/kg), and T5 (Glibenclamide), which only suggests the efficacy of pig bile on lowering glucose levels on alloxan-induced diabetic mice. Bodyweight analysis shows no significant difference. Duncan’s multiple range test (DMRT) shows comparable efficacy and effectivity between T4 (3ml/kg) and T5 (Glibenclamide) on lowering BGL at different day and time intervals.

Keywords: pig bile, BALB/c mice, blood glucose, Gllibenclamide

Procedia PDF Downloads 116
5296 Association of the Time in Targeted Blood Glucose Range of 3.9–10 Mmol/L with the Mortality of Critically Ill Patients with or without Diabetes

Authors: Guo Yu, Haoming Ma, Peiru Zhou

Abstract:

BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.

Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality

Procedia PDF Downloads 197
5295 Analysis of the IEEE 802.15.4 MAC Parameters to Achive Lower Packet Loss Rates

Authors: Imen Bouazzi

Abstract:

The IEEE-802.15.4 standard utilizes the CSMA-CA mechanism to control nodes access to the shared wireless communication medium. It is becoming the popular choice for various applications of surveillance and control used in wireless sensor network (WSN). The benefit of this standard is evaluated regarding of the packet loss probability who depends on the configuration of IEEE 802.15.4 MAC parameters and the traffic load. Our exigency is to evaluate the effects of various configurable MAC parameters on the performance of beaconless IEEE 802.15.4 networks under different traffic loads, static values of IEEE 802.15.4 MAC parameters (macMinBE, macMaxCSMABackoffs, and macMaxFrame Retries) will be evaluated. To performance analysis, we use ns-2[2] network simulator.

Keywords: WSN, packet loss, CSMA/CA, IEEE-802.15.4

Procedia PDF Downloads 305
5294 Algorithm Development of Individual Lumped Parameter Modelling for Blood Circulatory System: An Optimization Study

Authors: Bao Li, Aike Qiao, Gaoyang Li, Youjun Liu

Abstract:

Background: Lumped parameter model (LPM) is a common numerical model for hemodynamic calculation. LPM uses circuit elements to simulate the human blood circulatory system. Physiological indicators and characteristics can be acquired through the model. However, due to the different physiological indicators of each individual, parameters in LPM should be personalized in order for convincing calculated results, which can reflect the individual physiological information. This study aimed to develop an automatic and effective optimization method to personalize the parameters in LPM of the blood circulatory system, which is of great significance to the numerical simulation of individual hemodynamics. Methods: A closed-loop LPM of the human blood circulatory system that is applicable for most persons were established based on the anatomical structures and physiological parameters. The patient-specific physiological data of 5 volunteers were non-invasively collected as personalized objectives of individual LPM. In this study, the blood pressure and flow rate of heart, brain, and limbs were the main concerns. The collected systolic blood pressure, diastolic blood pressure, cardiac output, and heart rate were set as objective data, and the waveforms of carotid artery flow and ankle pressure were set as objective waveforms. Aiming at the collected data and waveforms, sensitivity analysis of each parameter in LPM was conducted to determine the sensitive parameters that have an obvious influence on the objectives. Simulated annealing was adopted to iteratively optimize the sensitive parameters, and the objective function during optimization was the root mean square error between the collected waveforms and data and simulated waveforms and data. Each parameter in LPM was optimized 500 times. Results: In this study, the sensitive parameters in LPM were optimized according to the collected data of 5 individuals. Results show a slight error between collected and simulated data. The average relative root mean square error of all optimization objectives of 5 samples were 2.21%, 3.59%, 4.75%, 4.24%, and 3.56%, respectively. Conclusions: Slight error demonstrated good effects of optimization. The individual modeling algorithm developed in this study can effectively achieve the individualization of LPM for the blood circulatory system. LPM with individual parameters can output the individual physiological indicators after optimization, which are applicable for the numerical simulation of patient-specific hemodynamics.

Keywords: blood circulatory system, individual physiological indicators, lumped parameter model, optimization algorithm

Procedia PDF Downloads 116
5293 Design for Filter and Transitions to Substrat Integated Waveguide at Ka Band

Authors: Damou Mehdi, Nouri Keltouma, Fahem Mohammed

Abstract:

In this paper, the concept of substrate integrated waveguide (SIW) technology is used to design filter for 30 GHz communication systems. SIW is created in the substrate of RT/Duroid 5880 having relative permittivity ε_r= 2.2 and loss tangent tanφ = 0.0009. Four Via are placed on the century filter the structures of SIW are modeled using and have been optimized in software HFSS (High Frequency Structure Simulator), à transition is designed for a Ka-band transceiver module with a 28.5GHz center frequency, . and then the results are verified using another simulation CST Microwave Studio (Computer Simulation Technology). The return loss are less than -18 dB, and -13 dB respectively. The insertion loss is divided equally -1.2 dB and -1.4 respectively.

Keywords: transition, microstrip, substrat integrated wave guide, filter, via

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5292 Polyphytopharmaca Improving Asthma Control Test Value, Biomarker (Eosinophils and Malondialdehyde): Quasi Experimental Test in Patients with Asthma

Authors: Andri Andri, Susanthy Djajalaksana, Iin Noor Chozin

Abstract:

Background: Despite advances in asthma therapies, a proportion of patients with asthma continue to have difficulty in gaining adequate asthma control. Complex immunological mechanisms and oxidative stress affect this condition, including the role of malondialdehyde (MDA) as a marker of inflammation. This research aimed to determine the effect of polyphytopharmaca administration on the value of asthma control test (ACT), blood eosinophils level and markers of MDA serum inflammation in patients with asthma. Method: Quasi experimental approach was conducted toward 15 stable asthma patients who were not fully controlled in outpatient pulmonary clinic, Public Hospital of Dr. Saiful Anwar Malang. Assessments of ACT values, eosinophil levels, and serum MDA levels were carried out before and after administration of polyphytopharmaca which contained a combination of 100 mg Nigella sativa extract, Kleinhovia hospita 100 mg, Curcuma xanthorrhiza 75 mg, and Ophiocephalus striatus 100 mg, three times daily with two capsules for 12 weeks. The ACT value was determined by the researcher by asking the patient directly, blood eosinophil levels were calculated by analyzing blood type counts, and serum MDA levels were detected by the qPCR method. Result: There was a significant enhancement of ACT value (18.07 ± 2.57 to 22.06 ± 1.83, p = 0.001) (from 60% uncontrolled ACT to 93.3% controlled ACT), a significant decrease in blood eosinophils levels (653.15 ± 276.15 pg/mL to 460.66 ± 202.04 pg/mL, p = 0.038), and decreased serum MDA levels (109.64 ± 53.77 ng / ml to 78.68 ± 64.92 ng/ml, p = 0.156). Conclusion: Administration of polyphytopharmaca can increase ACT value, decrease blood eosinophils levels and reduce MDA serum in stable asthma patients who are not fully controlled.

Keywords: asthma control test, eosinophils levels, malondialdehyde, polyphytopharmaca

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5291 Evaluating Language Loss Effect on Autobiographical Memory by Examining Memory Phenomenology in Bilingual Speakers

Authors: Anastasia Sorokina

Abstract:

Graduate language loss or attrition has been well documented in individuals who migrate and become emersed in a different language environment. This phenomenon of first language (L1) attrition is an example of non-pathological (not due to trauma) and can manifest itself in frequent pauses, search for words, or grammatical errors. While the widely experienced loss of one’s first language might seem harmless, there is convincing evidence from the disciplines of Developmental Psychology, Bilingual Studies, and even Psychotherapy that language plays a crucial role in the memory of self. In fact, we remember, store, and share personal memories with the help of language. Dual-Coding Theory suggests that language memory code deterioration could lead to forgetting. Yet, no one has investigated a possible connection between language loss and memory. The present study aims to address this research gap by examining a corpus of 1,495 memories of Russian-English bilinguals who are on a continuum of L1 (first language) attrition. Since phenomenological properties capture how well a memory is remembered, the following descriptors were selected - vividness, ease of recall, emotional valence, personal significance, and confidence in the event. A series of linear regression statistical analyses were run to examine the possible negative effects of L1 attrition on autobiographical memory. The results revealed that L1 attrition might compromise perceived vividness and confidence in the event, which is indicative of memory deterioration. These findings suggest the importance of heritage language maintenance in immigrant communities who might be forced to assimilate as language loss might negatively affect the memory of self.

Keywords: L1 attrition, autobiographical memory, language loss, memory phenomenology, dual coding

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5290 Study on The Pile Height Loss of Tunisian Handmade Carpets Under Dynamic Loading

Authors: Fatma Abidi, Taoufik Harizi, Slah Msahli, Faouzi Sakli

Abstract:

Nine different Tunisian handmade carpets were used for the investigation. The raw material of the carpet pile yarns was wool. The influence of the different structure parameters (linear density and pile height) on the carpet compression was investigated. Carpets were tested under dynamic loading in order to evaluate and observe the thickness loss and carpet behavior under dynamic loads. To determine the loss of pile height under dynamic loading, the pile height carpets were measured. The test method was treated according to the Tunisian standard NT 12.165 (corresponds to the standard ISO 2094). The pile height measurements are taken and recorded at intervals up to 1000 impacts (measures of this study were made after 50, 100, 200, 500, and 1000 impacts). The loss of pile height is calculated using the variation between the initial height and those measured after the number of reported impacts. The experimental results were statistically evaluated using Design Expert Analysis of Variance (ANOVA) software. As regards the deformation, results showed that both of the structure parameters of the pile yarn and the pile height have an influence. The carpet with the higher pile and the less linear density of pile yarn showed the worst performance. Results of a polynomial regression analysis are highlighted. There is a good correlation between the loss of pile height and the impacts number of dynamic loads. These equations are in good agreement with measured data. Because the prediction is reasonably accurate for all samples, these equations can also be taken into account when calculating the theoretical loss of pile height for the considered carpet samples. Statistical evaluations of the experimen¬tal data showed that the pile material and number of impacts have a significant effect on mean thickness and thickness loss variations.

Keywords: Tunisian handmade carpet, loss of pile height, dynamic loads, performance

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5289 Effects of Raw Bee Propolis and Water or Ethanol Extract of Propolis on Performance, Immune System and Some Blood Parameters on Broiler Bredeers

Authors: Hasan Alp Sahin, Ergin Ozturk

Abstract:

The effects of raw bee propolis (RP) and water (WEP) or ethanol (EEP) extract of propolis on growth performance, selected immune parameters (IgA, IgY and IgM) and some blood parameters such as aspartate aminotransferase, alanine aminotransferase, trygliceride, total protein, albumin, calcium, phosphorus, total antioxidant status and total oxidant status were determined. The study was conducted between 15th and 20th weeks (6 weeks) and used a total of 48 broiler breeder pullets (Ross-308). The broiler breeder in control group was fed diet without propolis whereas the birds in RP, WEP and EEP groups were fed diets with RP, WEP and EEP at the level of 1200, 400 and 400 ppm, respectively. All pullets were fed mash form diet with 15% crude protein and 2800 ME kcal/kg. All propolis forms had not a beneficial effect on any studied parameters compared to control group (P > 0.05). The results of the study indicated that both the level of the active matters supplied from the bee propolis has no enough beneficial effect on performance, some immune and blood parameters on broiler breeders or they did not have such a level that would cause a beneficial effect on these variables.

Keywords: antioxidant, bee product , poultry breeders, growth performance, immune parameters, blood chemistry

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