Search results for: left ventricle assist device (LVAD)

Authors: G. Costa, F. Noto, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

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The ion sources for accelerators devoted to medical applications must provide intense ion beams, with high reproducibility, stability and brightness. AISHa (Advanced Ion Source for Hadron-therapy) is a compact ECRIS whose hybrid magnetic system consists of a permanent Halbach-type hexapole magnet and a set of independently energized superconducting coils. These coils will be enclosed in a compact cryostat with two cryocoolers for LHe-free operation. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadrontherapy center using heavy ions. In the paper, we designed an innovative solution for the plasma containment chamber that allows us to solve our isolation and structural problems. We analyzed the materials chosen for our aim (glass fibers and carbon fibers) and we illustrated the all process (spinning, curing and machining) of the assembly of our chamber. The glass fibers and carbon fibers are used to reinforce polymer matrices and give rise to structural composites and composites by molding.

Keywords: hadron-therapy, carbon fiber, glass fiber, vacuum-bag, ECR, ion source

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Authors: A. Rohit Kumar, B. R. K. Pathak

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Background: Geroanthropology or the anthropology of ageing is a term which can be understood in terms of the anthropology of old age, old age within anthropology, and the anthropology of age. India is known as the land of spirituality and philosophy and is the birthplace of four major religions of the world namely Hinduasim, Buddhisim, Jainisim, and Sikhism. The most dominant religion in India today is Hinduism. About 80% of Indians are Hindus. Hinduism is a religion with a large number of Gods and Goddesses. Religion in India plays an important role at all life stages i.e. at birth, adulthood and particularly during old age. India is the second largest country in the world with 72 million elder persons above 60 years of age in 2001 as compared to china 127 million. The very concept of old age homes in India is new. The elderly people staying away from their homes, from their children or left to them is not considered to be a very happy situation. This paper deals with anthropology of ageing, religion and spirituality among the elderly residing in old age homes and tries to explain that how religion plays a vital role in the health of the elderly during old age. Methods: The data for the present paper was collected through both Qualitative and Quantitative methods. Old age homes located in Jallandher (Punjab) were selected for the present study. Age sixty was considered as a cut off age. Narratives, case studies were collected from 100 respondents residing in old age homes. The dominant religion in Punjab was found to be Sikhism and Hinduism while Jainism and Buddhism were found to be in minority. It was found that as one grows older the religiosity increases. Religiosity and sprituality was found to be directly proportional to ageing. Therefore religiosity and health were found to be connected. Results and Conclusion: Religion was found out to be a coping mechanism during ill health. The elderly living in old age homes were purposely selected for the study as the elderly in old age homes gets medical attention provided only by the old age home authorities. Moreover, the inmates in old age homes were of low socio-economic status couldn’t afford medical attention on their own. It was found that elderly who firmly believed in religion were found to be more satisfied with their health as compare to elderly who does not believe in religion at all. Belief in particular religion, God and godess had an impact on the health of the elderly.

Keywords: ageing, geroanthropology, religion, spirituality

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Authors: Djeddi Khaled, Houssou Hind, Miloudi Abdellatif, Rabah Siham

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In the field of veterinary medicine, there is a growing application of artificial intelligence (AI) for diagnosing bovine mastitis, a prevalent inflammatory disease in dairy cattle. AI technologies, such as automated milking systems, have streamlined the assessment of key metrics crucial for managing cow health during milking and identifying prevalent diseases, including mastitis. These automated milking systems empower farmers to implement automatic mastitis detection by analyzing indicators like milk yield, electrical conductivity, fat, protein, lactose, blood content in the milk, and milk flow rate. Furthermore, reports highlight the integration of somatic cell count (SCC), thermal infrared thermography, and diverse systems utilizing statistical models and machine learning techniques, including artificial neural networks, to enhance the overall efficiency and accuracy of mastitis detection. According to a review of 15 publications, machine learning technology can predict the risk and detect mastitis in cattle with an accuracy ranging from 87.62% to 98.10% and sensitivity and specificity ranging from 84.62% to 99.4% and 81.25% to 98.8%, respectively. Additionally, machine learning algorithms and microarray meta-analysis are utilized to identify mastitis genes in dairy cattle, providing insights into the underlying functional modules of mastitis disease. Moreover, AI applications can assist in developing predictive models that anticipate the likelihood of mastitis outbreaks based on factors such as environmental conditions, herd management practices, and animal health history. This proactive approach supports farmers in implementing preventive measures and optimizing herd health. By harnessing the power of artificial intelligence, the diagnosis of bovine mastitis can be significantly improved, enabling more effective management strategies and ultimately enhancing the health and productivity of dairy cattle. The integration of artificial intelligence presents valuable opportunities for the precise and early detection of mastitis, providing substantial benefits to the dairy industry.

Keywords: artificial insemination, automatic milking system, cattle, machine learning, mastitis

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Authors: Hitakshi Mahendru, Advait Tambe, Simran Chandok, Niharika Sanadhya

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After the Second World War had come to an end, the Founding Fathers of the United Nations recognized a need for a supreme peacekeeping mechanism to act as a mediator between nations and moderate disputes that might blow up, if left unchecked. It has been more than seven decades since the establishment of the International Court of Justice (ICJ). When it was created, there were certain aim and objectives that the ICJ was intended to achieve. However, in today’s world, with change in political dynamics and international relations between countries, the ICJ has not succeeded in achieving several of these objectives. The ICJ is the only body in the international scenario that has the authority to regulate disputes between countries. However, in recent times, with countries like China disregarding the importance of the ICJ, there is no hope for the ICJ to command respect from other nations, thereby sending ICJ on a slow, yet steady path towards redundancy. The authority of the judgements given by the International Court of Justice, which is one of the main pillars of the United Nations, is questionable due to the forthcoming reactions from various countries on public platforms. The ICJ’s principal role within the United Nations framework is to settle peacefully international/bilateral disputes between the states that come under its jurisdiction and in accordance with the principles laid down in international law. By shedding light on the public backlash from the Chinese Government to the recent South China Sea judgement, we see the decreasing relevance of the ICJ in the contemporary world scenario. Philippines and China have wrangled over territory in the South China Sea for centuries but after the recent judgement the tension has reached an all-time high with China threatening to prosecute anybody as trespassers while continuing to militarise the disputed area. This paper will deal with the South China Sea judgement and the manner in which it has been received by the Chinese Government. Also, it will look into the consequences of counter-back. The authors will also look into the Marshall Island matter and propose a model judgement, in accordance with the principles of international law that would be the most suited for the given situation. Also, the authors will propose amendments in the working of the Security Council to ensure that the Marshal Island judgement is passed and accepted by the countries without any contempt.

Keywords: International Court of Justice, international law, Marshall Islands, South China Sea, United Nations Charter

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Authors: G. M. Contessa, L. Lepore, G. Gandolfo, C. Poggi, N. Cherubini, R. Remetti, S. Sandri

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Practical guidelines are provided in this work for the safe use of a portable d-t Thermo Scientific MP-320 neutron generator producing pulsed 14.1 MeV neutron beams. The neutron generator’s emission was tested experimentally and reproduced by MCNPX Monte Carlo code. Simulations were particularly accurate, even generator’s internal components were reproduced on the basis of ad-hoc collected X-ray radiographic images. Measurement campaigns were conducted under different standard experimental conditions using an LB 6411 neutron detector properly calibrated at three different energies, and comparing simulated and experimental data. In order to estimate the dose to the operator vs. the operating conditions and the energy spectrum, the most appropriate value of the conversion factor between neutron fluence and ambient dose equivalent has been identified, taking into account both direct and scattered components. The results of the simulations show that, in real situations, when there is no information about the neutron spectrum at the point where the dose has to be evaluated, it is possible - and in any case conservative - to convert the measured value of the count rate by means of the conversion factor corresponding to 14 MeV energy. This outcome has a general value when using this type of generator, enabling a more accurate design of experimental activities in different setups. The increasingly widespread use of this type of device for industrial and medical applications makes the results of this work of interest in different situations, especially as a support for the definition of appropriate radiation protection procedures and, in general, for risk analysis.

Keywords: instrumentation and monitoring, management of radiological safety, measurement of individual dose, radiation protection of workers

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Authors: Sibani Bisoyi, Ute Zschieschang, Alexander Hoyer, Hagen Klauk

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Abstract— Organic thin-film transistors (TFTs) have great potential to be used for various applications such as flexible displays or sensors. For some of these applications, the TFTs must be able to withstand temperatures in excess of 100 °C, for example to permit the integration with devices or components that require high process temperatures, or to make it possible that the devices can be subjected to the standard sterilization protocols required for biomedical applications. In this work, we have investigated how the thermal stability of low-voltage small-molecule semiconductor dinaphtho[2,3-b:2’,3’-f]thieno[3,2-b]thiophene (DNTT) TFTs is affected by the encapsulation of the TFTs and by the ambient in which the thermal stress is performed. We also studied to which extent the thermal stability of the TFTs depends on the channel length. Some of the TFTs were encapsulated with a layer of vacuum-deposited Teflon, while others were left without encapsulation, and the thermal stress was performed either in nitrogen or in air. We found that the encapsulation with Teflon has virtually no effect on the thermal stability of our TFTs. In contrast, the ambient in which the thermal stress is conducted was found to have a measurable effect, but in a surprising way: When the thermal stress is carried out in nitrogen, the mobility drops to 70% of its initial value at a temperature of 160 °C and to close to zero at 170 °C, whereas when the stress is performed in air, the mobility remains at 75% of its initial value up to a temperature of 160 °C and at 60% up to 180 °C. To understand this behavior, we studied the effect of the thermal stress on the semiconductor thin-film morphology by scanning electron microscopy. While the DNTT films remain continuous and conducting when the heating is carried out in air, the semiconductor morphology undergoes a dramatic change, including the formation of large, thick crystals of DNTT and a complete loss of percolation, when the heating is conducted in nitrogen. We also found that when the TFTs are heated to a temperature of 200 °C in air, all TFTs with a channel length greater than 50 µm are destroyed, while TFTs with a channel length of less than 50 µm survive, whereas when the TFTs are heated to the same temperature (200 °C) in nitrogen, only the TFTs with a channel smaller than 8 µm survive. This result is also linked to the thermally induced changes in the semiconductor morphology.

Keywords: organic thin-film transistors, encapsulation, thermal stability, thin-film morphology

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Authors: Insaf Ajili, Malik Mallem, Jean-Yves Didier

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Human motion recognition has been extensively increased in recent years due to its importance in a wide range of applications, such as human-computer interaction, intelligent surveillance, augmented reality, content-based video compression and retrieval, etc. However, it is still regarded as a challenging task especially in realistic scenarios. It can be seen as a general machine learning problem which requires an effective human motion representation and an efficient learning method. In this work, we introduce a descriptor based on Laban Movement Analysis technique, a formal and universal language for human movement, to capture both quantitative and qualitative aspects of movement. We use Discrete Hidden Markov Model (DHMM) for training and classification motions. We improve the classification algorithm by proposing two DHMMs for each motion class to process the motion sequence in two different directions, forward and backward. Such modification allows avoiding the misclassification that can happen when recognizing similar motions. Two experiments are conducted. In the first one, we evaluate our method on a public dataset, the Microsoft Research Cambridge-12 Kinect gesture data set (MSRC-12) which is a widely used dataset for evaluating action/gesture recognition methods. In the second experiment, we build a dataset composed of 10 gestures(Introduce yourself, waving, Dance, move, turn left, turn right, stop, sit down, increase velocity, decrease velocity) performed by 20 persons. The evaluation of the system includes testing the efficiency of our descriptor vector based on LMA with basic DHMM method and comparing the recognition results of the modified DHMM with the original one. Experiment results demonstrate that our method outperforms most of existing methods that used the MSRC-12 dataset, and a near perfect classification rate in our dataset.

Keywords: human motion recognition, motion representation, Laban Movement Analysis, Discrete Hidden Markov Model

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Authors: Dakeyi Athanase

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The ratification of an international human rights legal instrument provides signatory States with an opportunity to assume a set of obligations and rights for the benefit of their citizens, offering increased possibilities, opportunities, and means to access an improved quality of life – to be, to appear, and to become. Developed nations typically experience cultural, political, social, economic, legal, and regulatory transformations in response to this transition. In a methodologically proactive approach, mechanisms undergo a visible and comprehensible process of qualitative and quantitative change. Conversely, in nations undergoing development, the response to such ratification varies. Some demonstrate positive policy changes, while others remain stagnant or regress. Cameroon falls into the second category, despite efforts, as it legally prohibits 50% of its population with disabilities from acquiring the status of a person with a disability. The overarching goal of this communication is to highlight these deficiencies and their detrimental effects on various aspects of life, fostering awareness among beneficiaries and advocating for more inclusive transformations in the country. Our project employs a popular and participatory methodological approach by involving beneficiaries and their organizations in its preparation. It is also inclusive, representing the diversity of disabilities and engaging natural and legal persons from various backgrounds. Active consultations occur at all levels of the activities. Anticipated outcomes include raising awareness globally among nations, international cooperation organizations, NGOs, and other inclusive development actors. We seek their support for local advocacy efforts to fully implement the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Concurrently, we hope they express solidarity with the victims in Cameroon who have been left behind and recommend legal reforms to align domestic and international legislation with the promotion and protection of disability rights.

Keywords: droit, convention, handicap, discrimination, participation, inclusion

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Authors: Emmanuel U. Unuafe, Oyegoke T. Bukoye, Sandhya Sastry, Yanqing Duan

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Globally, there is increasing interest in project management due to a shortage in infrastructure services supply capability. Hence, it is of utmost importance that organisations understand that choosing a particular project over another is an opportunity cost – tying up the organisations resources. In order to devise constructive ways to bring direction, structure, and oversight to the process of project selection has led to the development of tools and techniques by researchers and practitioners. However, despite the development of various frameworks to assist in the appraisal and selection of government projects, failures are still being recorded with government projects. In developing countries, where frameworks are rarely used, the problems are compounded. To improve the situation, this study will investigate the current practice of construction project selection processes within the Nigeria public sector in order to inform theories of decision making from the perspective of developing nations and project management practice. Unlike other research around construction projects in Nigeria this research concentrate on factors influencing the selection process within the Nigeria public sector, which has received limited study. The authors report the findings of semi-structured interviews of top management in the Nigerian public sector and draw conclusions in terms of decision making extant theory and current practice. Preliminary results from the data analysis show that groups make project selection decisions and this forces sub-optimal decisions due to pressure on time, clashes of interest, lack of standardised framework for selecting projects, lack of accountability and poor leadership. Consequently, because decision maker is usually drawn from different fields, religious beliefs, ethnic group and with different languages. The choice of a project by an individual will be greatly influence by experience, political precedence than by realistic investigation as well as his understanding of the desired outcome of the project, in other words, the individual’s ideology and their level of fairness.

Keywords: factors influencing project selection, public sector construction project selection, projects portfolio selection, strategic decision-making

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Authors: Mandy W. M. Chan, Samantha Y. N. Shek, Chi K. Yeung, Taro Kono, Henry H. L. Chan

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Fractional radiofrequency devices have shown to improve skin texture such as smoothness, rhytides, brightness as well as atrophic acne scars by increasing dermal thickness, dermal collagen content and dermal fibrillin content. The objective of the study is to assess the efficacy and adverse effects of this device on Asian patients with skin textural changes. In this study, 20 Chinese patients (ranging from 21-60 years old) with irregularities of skin texture, rhytides and acne scars were recruited. Patients received six treatments at 2-4 week intervals. Treatment was initiated with maximum energy tolerated and was adjustable during treatment if patients felt excessive discomfort. A total of two passes were delivered at each session. Physician assessment and standardized photographs were taken at baseline, all treatment visits and at one, two, and six month after final treatment. As a result, 17 patients were recruited and completed the study according to the study protocol. One patient withdrew after the first treatment due to reaction to local anesthesia and two patients were lost to follow-up. At six months follow-up, 71% of the patients were satisfied and 24% were very satisfied, while treatment physician reported various degrees of improvement based on the global assessment scale in 60% of the subjects. Anticipated side effects including erythema, edema, pinpoint bleeding, scabs formation and flare of acne were recorded, but there were no serious adverse effects noted. Conclude up, the use of fractional radiofrequency improves skin texture and appears to be safe in Asian patients. No long-term serious adverse effect was noted.

Keywords: Asian, fractional radiogrequency, skin, texture

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Authors: Nurjannatul Naim Kamaruddin, Tengku Sifziuzl Tengku Muhammad, Aina Farahiyah Abdul Manan, Habsah Mohamad

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Atherosclerosis which leads to cardiovascular diseases such as myocardial infarction, unstable angina (ischemic heart pain), sudden cardiac death and stroke is the principal cause of death worldwide. It has been a very critical issue as current common drug treatment, statin therapy has left bad side effects like rhabdomyolysis, atrial fibrillation, liver disease, abdominal and chest pain. Interestingly, the discoveries of proprotein convertase subtilisin-kexin type 9 have paved a new way in the treatment of atherosclerosis. This serine protease is believed to involve in the regulation of LDL- uptake by LDL-receptor. Therefore, this study was conducted to evaluate the potential of Acanthaster plancii fractions to reduce the transcriptional activity of the PCSK9 promoter. In this study, the marine organism which is Acanthaster plancii has been used as the source for marine compounds in inhibiting PCSK9. The cytotoxicity activity of ten fractions from the methanol extracts of Acanthaster plancii was investigated on HepG2 cell lines using MTS assay and dual glo luciferase assay was carried out later to analyses the effects of the samples in reducing the transcriptional activity of the PCSK9 promoter. Both assays used fractions with five different concentrations, 3.13µg/mL, 6.25µg/mL, 12.5µg/mL, 25µg/mL, and 50µg/mL. MTS assay indicated that the fractions are non-cytotoxic towards HepG2 cell lines as their IC50 value is greater than 30µg/mL. Whilst, for the dual glo luciferase assay, among all the fractions, Enhance Fraction 2 (EF2) showed the best potential in reducing the transcriptional activity of the PCSK9 promoter. The results indicated that this EF2 gave the lowest PCSK9 promoter expression at low concentration which is 0.2 fold change at 6.25µg/mL. This finding suggested that further analysis should be done to validate the potential of Acanthaster plancii as the source of anti-atherosclerotic agent.

Keywords: Acanthaster plancii, atherosclerosis, luciferase assay, PCSK9

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Authors: Imam Taufiqurrahman, Anugrah Adiwilaga, Egi Hidayat, Bambang Riyanto Trilaksono

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Autonomous Underwater Vehicle glider is one of the renewal of underwater vehicles. This vehicle is one of the autonomous underwater vehicles that are being developed in Indonesia. Glide ability is obtained by controlling the buoyancy and attitude of the vehicle using the movers within the vehicle. The glider motion mechanism is expected to provide energy resistance from autonomous underwater vehicles so as to increase the cruising range of rides while performing missions. The control system on the vehicle consists of three parts: controlling the attitude of the pitch, the buoyancy engine controller and the yaw controller. The buoyancy and pitch controls on the vehicle are sequentially referring to the finite state machine with pitch angle and depth of diving inputs to obtain a gliding cycle. While the yaw control is done through the rudder for the needs of the guide system. This research is focused on design and implementation of control system of Autonomous Underwater Vehicle glider based on PID anti-windup. The control system is implemented on an ARM TS-7250-V2 device along with a mathematical model of the vehicle in MATLAB using the hardware-in-the-loop simulation (HILS) method. The TS-7250-V2 is chosen because it complies industry standards, has high computing capability, minimal power consumption. The results show that the control system in HILS process can form glide cycle with depth and angle of operation as desired. In the implementation using half control and full control mode, from the experiment can be concluded in full control mode more precision when tracking the reference. While half control mode is considered more efficient in carrying out the mission.

Keywords: control system, PID, underwater glider, marine robotics

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Authors: Rachel Gough

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In 2014, Skellig Michael, an island off Ireland’s western seaboard and UNESCO world heritage site became a major setting in Disney’s Star Wars franchise. The subsequent influx of tourists to the site has proven to be a point of contention nationally. The increased visitor numbers have uplifted certain areas of the local economy, the mainland, but have caused irreparable damage to historic monuments and to endangered bird populations who breed on the island. Recent research carried out by a state body suggests far-reaching and longterm negative impacts on the island’s culture and environment, should the association with the Star Wars franchise persist. In spite of this, the film has been widely endorsed by the Irish government as providing a vital economic boost to historically marginalised rural areas through film tourism. This paper argues quite plainly that what is taking place on Skellig is neocolonialism. Skellig Michael’s unique resources, its aesthetic qualities, its ecosystem, and its cultural currency have been sold by the state to a multinational corporation, who profit from their use. Meanwhile, locals are left to do their best to turn a market trend into sustainable business at the expense of culture ecology and community. This paper intends to be the first dedicated study into the psychogeographic and cultural impact of Skellig Michael’s deterioration as a result of film tourism. It will discuss the projected impact of this incident on Irish culture more broadly and finally will attempt to lay out a roadmap for more collaborative filmmaking and touristic approach, which allows local cultures and ecosystem’s to thrive without drastically inhibiting cultural production. This paper will ultimately find that the consequences of this representation call for a requirement to read tourism as a split concept — namely into what we might loosely call “eco-tourism” and more capital-based “profit-bottom-line tourism.”

Keywords: ecology, film tourism, neocolonialism, sustainability

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Authors: Pankaj Pradhananga

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Inclusive Tourism is a relatively new topic in Nepal. Though the effort of creating accessible and inclusive tourism has already begun, it is still in its infancy. A major concern for Destination Nepal is the lack of awareness and absence of mandatory law in place to encourage Tourism operating sectors for coming up with accessible Tourism products. Given the number economic and social benefits to may be derived from inclusive tourism, it is a critical time for the tourism industry to understand and develop measures towards inclusivity in the gateway to Himalaya. Nepal was struck with a devastating earthquake on April 25th, 2015 which concurrently left more than 4,000 Nepalese with physical disabilities. Nepal has had to rebuild and is continuing to rebuild a lot of infrastructure and the process of rebuilding should be barrier free and use universal design measures. With universal design in place, this would allow access for minority groups such as people with disabilities and the elderly to the historic monuments in Kathmandu valley. Four Seasons Travel ( 4ST) has been a key player in not only creating accessible tourism experiences in Nepal, but also promoting accessible tourism to other tourism operators. Dr. Scott Rains had worked closely with 4ST on accessible tourism. Additionally, it organised an accessible trek which was field tested with a traveler with vision impairment in August 2015. Another accessible trekking experience, in partnership with Washington DC based International Development Institute, was coined as ‘Wounded Heroes Trek to Nepal’, where a group of Veterans that are amputees went trekking in the Annapurna Region. The event made it to the list of UNWTO World Tourism Day celebrations. Such initiatives led by private sector in partnership with various organizations have worked to create a ‘Destination Nepal for all’. However, there is still a lot of work that needs to be done to make Nepal a truly inclusive destination. Partnerships between the private sector and DPOs ( Disabled People’s Organizations) as well as the government are also a sound opportunity for employment creation for people with disabilities. Further, partnerships between the state, tourism service providers and DPOs need to be fostered to create job opportunities for people with disabilities. This can be exemplified through the social Entrepreneurship model with the help of accessible Tourism.

Keywords: accessible tourism, disability, earthquake, inclusion

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Authors: Ira Irawati, Muhammad Rangga Sururi

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The expansion of built-up areas in many cities, particularly, as the consequences of urbanization process, is a common phenomenon in our contemporary world. As happened in many cities in developing world, this horizontal expansion let only a handful size of the area left for green open spaces, creating an extreme unbalance between built-up and green spaces. Combined with the high density and variety of human activities with its transportation modes; a process of urban heat island will occur, resulting in an increase in air temperature. This is one of the indicators of decreasing of the quality of urban microclimate. This paper will explore the effect of several variables of built-up areas and open spaces to the increase of air temperature using multiple linear regression analysis. We selected 11 zones within the radius of 1 km in Inner Bandung city center, and each zones measured within 300 m radius to represent the variety of land use, as well as the composition of buildings and green open spaces. By using a quantitative method which is multiple linear regression analysis, six dependent variables which are a) tree density-x1, b) shade level of tree-x2, c) surface area of buildings’ side which are facing west and east-x3, d) surface area of building side material-x4, e) surface area of pathway material, and f) numbers of motorized vehicles-x6; are calculated to find those influence to the air temperature as an independent variable-y. Finally, the relationship between those variables shows in this equation: y = 30.316 - 3.689 X1 – 6.563 X2 + 0.002 X3 – 2,517E6 X4 + 1.919E-9 X5 + 1.952E-4 X6. It shows that the existence of vegetation has a great impact on lowering temperature. In another way around, built up the area and motorized vehicles would increase the temperature. However, one component of built up area, the surface area of buildings’ sides which are facing west and east, has different result due to the building material is classified in low-middle heat capacity.

Keywords: built-up area, microclimate, vehicles, urban heat island, vegetation

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Authors: Umbreen Javaid

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Pakistan’s experience with nascent, yet to be evolved democratic institutions inherited from the British Empire, has not been a pleasant one when evaluated in terms of good governance, development, and success of anti-corruption mechanisms. The country has remained entangled in a vicious circle of accumulating large budget deficits, dwindling economy, low foreign direct investment, political instability, and rising terrorism. It is thus not surprising that no account of the state aimed at analyzing the six-decade journey since her inception is replete with negative connotations like dysfunctional, failed, fragile or weak state. The limited pool of experience of handling democratic institutions and lack of political will be on the part of country’s political elite to transform the society on democratic footings have left Pakistan as a “limited access order” state. The widespread illiteracy becomes a double edge sword when a largely illiterate electorate elects representatives who mostly come from a semi-educated background with the limited understanding of democratic minutiae and little or no proclivity to resist monetary allures. The prevalence of culture of patronage with widespread poverty coupled with absence of a comprehensive system of investigating, prosecuting and adjudicating cases of corruption encourage the practice that has been eroding the state’s foundations since her inception owing to the unwillingness of the traditional elites who have been strongly resistant towards any attempts aimed at disseminating powers. An analytical study of the historical, political, cultural, economic and administrative hurdles that have been at work in impeding Pakistan’s transition to a democratic, accountable society would be instrumental in understanding the issue of widespread plague of corruption and state’s inefficiency to cope with it effectively. The issue of corruption in Pakistan becomes more important when seen in the context of her vulnerability to terrorism and religious extremism. In this regard, Pakistan needs to learn a lot from developed countries in order to evolve a comprehensive strategy for combating and preventing this pressing issue.

Keywords: Pakistan, corruption, anti-corruption, limited access order

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Authors: Manisha Bal, Amit Verma, B. C. Meikap

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Carbon dioxide (CO₂) is the most abundant waste produced by human activities. It is estimated to be one of the major contributors of greenhouse effect and also considered as a major air pollutant formed by burning of fossil fuels. The main sources of emissions are flue gas from thermal power plants and process industries. It is also a contributor of acid rain. Its exposure through inhalation can lead to health risks. Therefore, control of CO₂ emission in the environment is very necessary. The main focus of this study is on the removal of carbon dioxide from off gases using a self-priming venturi scrubber in submerged conditions using sodium hydroxide as the scrubbing liquid. A self-priming submerged venturi scrubber is an efficient device to remove gaseous pollutants. In submerged condition, venturi scrubber remains submerged in the liquid tank and the liquid enters at the throat section of venturi scrubber due to the pressure difference which includes the hydrostatic pressure of the liquid and static pressure of the gas. The inlet polluted air stream enters through converging section which moves at very high velocity in the throat section and atomizes the liquid droplets. This leads to absorption of CO₂ from the off gases in scrubbing liquid which resulted in removal of CO₂ gas from the off gases. Detailed investigation on the scrubbing of carbon dioxide has been done in this literature. Experiments were conducted at different throat gas velocities, liquid levels in outer cylinder and CO₂ inlet concentrations to study the carbon dioxide removal efficiency. Experimental results give more than 95% removal efficiency of CO₂ in the self priming venturi scrubber which can meet the environmental emission limit of CO₂ to save the human life.

Keywords: carbon dioxide, scrubbing, pollution control, self-priming venturi scrubber

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Authors: George Leventakis, George Kokkinis, Nikos Moustakidis, George Papalexandratos, Ioanna Vasiliadou

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Enhancing the feeling of public safety and crime prevention are tasks customarily assigned to the Police. Police departments have, however, recognized that traditional ways of policing methods are becoming obsolete; Community Policing (CP) philosophy; however, when applied appropriately, leads to seamless collaboration between various stakeholders like the Police, NGOs and the general public and provides the opportunity to identify risks, assist in solving problems of crime, disorder, safety and crucially contribute to improving the quality of life for everyone in a community. Social Media, on the other hand, due to its high level of infiltration in modern life, constitutes a powerful mechanism which offers additional and direct communication channels to reach individuals or communities. These channels can be utilized to improve the citizens’ perception of the Police and to capture individual and community needs, when their feedback is taken into account by Law Enforcement Agencies (LEAs) in a structured and coordinated manner. This paper presents research conducted under INSPEC²T (Inspiring CitizeNS Participation for Enhanced Community PoliCing AcTions), a project funded by the European Commission’s research agenda to bridge the gap between CP as a philosophy and as an organizational strategy, capitalizing on the use of Social Media. The project aims to increase transparency, trust, police accountability, and the role of civil society. It aspires to build strong, trusting relationships between LEAs and the public, supporting two-way, contemporary communication while at the same time respecting anonymity of all affected parties. Results presented herein summarize the outcomes of four online multilingual surveys, focus group interviews, desktop research and interviews with experts in the field of CP practices. The above research activities were conducted in various EU countries aiming to capture requirements of end users from diverse backgrounds (social, cultural, legal and ethical) and determine public expectations regarding CP, community safety and crime prevention.

Keywords: community partnerships, next generation community policing, social media, public safety

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Authors: Yu-Ju Hsieh, Lin-Hung Lin, Wen-Hui Chang

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This study was designed as an interventional research and intended to validate whether the introduction of drinking vinegar every day can reduce and even prevent urinary tract infection in Taiwan home stayed disabilities who using indwelling catheter. The data was collected from the subjects who have received home care case at northern Taiwan, according to the questionnaire and a medical records retroactive methodology, the subjects were informed and consent to drink 15ml of table vinegar in a daily diet, and through routine urine testing and culture study. Home care nurses would assist collecting urine at the point of before and after a meal from total 35 studied subjects per month, and total collected 4 times for testing. The results showed that when the average age of study subjects was 65.46 years and catheter indwelling time was 15 years, drinking table vinegar could inhibit the activity of E. coli O157: H7 and reduce its breeding. Before drinking table vinegar daily, the subjects’ urine pH value was 7.0-8.0, and the average was 7.5, and the urine PH value dropped to 6.5 after drinking table vinegar for a month. There were two purple urine cases whose urine were changed from purple to normal color after two weeks of drinking, and the protein and bacteria values of urine gradually improved. Urine smell unpleasant before attending to this study, and the symptom improved significantly only after 1 week, and the urine smell returned to normal ammonia and became clean after 1 month later. None of these subjects received treatment in a hospital due to urinary tract infection, and there were no signs of bleeding in all cases during this study. The subjects of this study are chronic patients with a long-term bedridden catheterization; drinking cranberry juice is an economic burden for them, and also highly prohibited for diabetes patients. By adapting to use cheaper table vinegar to acidified urine and improve its smell and ease Purple Urine Syndrome, to furthermore, proven urinary tract infection, it can also to reduce the financial burden on families, the cost of social resources and the rate of re-admission.

Keywords: table vinegar, urinary tract infection, disability patients, long-term indwelling catheter

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Authors: Naci Büyükkaracığan, Yıldırım Akyol

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Information technology is called the technology which provides transmission of information elsewhere regardless of time, location, distance. Today, information technology is providing the occurrence of ground breaking changes in all areas of our daily lives. Information can be reached quickly to millions of people with help of information technology. In this Study, effects of information technology on students for educations and their learning preferences were demonstrated with using data obtained from questionnaires administered to students of 2015-2016 academic year at Selcuk University Kadınhanı Faik İçil Vocational School Construction Department. The data was obtained by questionnaire consisting of 30 questions that was prepared by the researchers. SPSS 21.00 package programme was used for statistical analysis of data. Chi-square tests, Mann-Whitney U test, Kruskal-Wallis and Kolmogorov-Smirnov tests were used in the data analysis for Descriptiving statistics. In a study conducted with the participation of 61 students, 93.4% of students' reputation of their own information communication device (computer, smart phone, etc.) That have been shown to be at the same rate and to the internet. These are just a computer of itself, then 45.90% of the students. The main reasons for the students' use of the Internet, social networking sites are 85.24%, 13.11% following the news of the site, as seen. All student assignments in information technology, have stated that they use in the preparation of the project. When students acquire scientific knowledge in the profession regarding their preferred sources evaluated were seen exactly when their preferred internet. Male students showed that daily use of information technology while compared to female students was statistically significantly less. Construction Package program where students are eager to learn about the reputation of 72.13% and 91.80% identified in the well which they agreed that an indispensable element in the professional advancement of information technology.

Keywords: information technologies, computer, construction, internet, learning systems

Procedia PDF Downloads 287

Authors: Zohreh Soleimani, Sally Salome Shahzad, Stamatis Zoras

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As a result of current energy and environmental issues, the human body is known as one of the promising candidate for converting wasted heat to electricity (Seebeck effect). Thermoelectric generator (TEG) is one of the most prevalent means of harvesting body heat and converting that to eco-friendly electrical power. However, the uneven distribution of the body heat and its curvature geometry restrict harvesting adequate amount of energy. To perfectly transform the heat radiated by the body into power, the most direct solution is conforming the thermoelectric generators (TEG) with the arbitrary surface of the body and increase the temperature difference across the thermoelectric legs. Due to this, a computational survey through COMSOL Multiphysics is presented in this paper with the main focus on the impact of integrating a flexible wearable TEG with a corrugated shaped heat sink on the module power output. To eliminate external parameters (temperature, air flow, humidity), the simulations are conducted within indoor thermal level and when the wearer is stationary. The full thermoelectric characterization of the proposed TEG fabricated by a wavy shape heat sink has been computed leading to a maximum power output of 25µW/cm2 at a temperature gradient nearly 13°C. It is noteworthy that for the flexibility of the proposed TEG and heat sink, the applicability and efficiency of the module stay high even on the curved surfaces of the body. As a consequence, the results demonstrate the superiority of such a TEG to the most state of the art counterparts fabricated with no heat sink and offer a new train of thought for the development of self-sustained and unobtrusive wearable power suppliers which generate energy from low grade dissipated heat from the body.

Keywords: device simulation, flexible thermoelectric module, heat sink, human body heat

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Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan

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Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.

Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder

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Authors: Claire Biasco, Thaier Hayajneh

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A smart city is the integration of digital technologies in urban environments to enhance the quality of life. Smart cities capture real-time information from devices, sensors, and network data to analyze and improve city functions such as traffic analysis, public safety, and environmental impacts. Current smart cities face controversy due to their reliance on real-time data tracking and surveillance. Internet of Things (IoT) devices and blockchain technology are converging to reshape smart city infrastructure away from its centralized model. Connecting IoT data to blockchain applications would create a peer-to-peer, decentralized model. Furthermore, blockchain technology powers the ability for IoT device data to shift from the ownership and control of centralized entities to individuals or communities with Decentralized Autonomous Organizations (DAOs). In the context of smart cities, DAOs can govern cyber-physical systems to have a greater influence over how urban services are being provided. This paper will explore how the core components of a smart city now apply to DAOs. We will also analyze different definitions of DAOs to determine their most important aspects in relation to smart cities. Both categorizations will provide a solid foundation to conduct a cybersecurity assessment of DAOs in smart cities. It will identify the benefits and risks of adopting DAOs as they currently operate. The paper will then provide several mitigation methods to combat cybersecurity risks of DAO integrations. Finally, we will give several insights into what challenges will be faced by DAO and blockchain spaces in the coming years before achieving a higher level of maturity.

Keywords: blockchain, IoT, smart city, DAO

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Authors: A. Asaga, N. I. Basuki

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The research area is located in Cisarua, Bogor Regency, West Java, with 12,8 km2 wide. This area belongs to mining region of PT Aneka Tambang Tbk. The purpose of this research is to study geological condition, alteration type and pattern, and type of mineralization. Geomorphology of the research area is at young to mature stage, which can be divided into Ciparigi’s Parasite Volcanic Cone Unit, Ciparigi Caldera Valley Unit, Ciparigi Caldera Rim Hill Unit, and Pongkor Volcanic Hill. Stratigraphy of the research area consist of five units, they are Laharic Breccia (Pliocene), Pyroclastic Breccia, Lapilli Tuff, Flow Tuff, Fall Tuff, and Andesite Lava (Pleistocene). Based on mineral composition, it is interpreted that there is magma composition changing from rhyolite to andesitic. Geological structures in the research area are caused by NE-SW and N-S stress direction; they are Ciparay Right Strike-Slip Fault (Pliocene), Cisarua Right Strike-Slip Fault, G. Singa Left Strike-Slip Fault, and Cinyuncung Right Strike-Slip Fault (Pleistocene). Weak to strong hydrothermal alteration can be found in the research area.They are Chlorite ± Smectite ± Halloysite Zone, Smectite - Illite - Quartz Zone, Smectite - Kaolinite - Illite - Chlorite Zone, and Smectite - Chlorite - Calcite - Quartz Zone. The distribution and assemblage of alteration minerals is controlled by lithology and geological structures in Pleistocene. Mineralization produce ore minerals, those are pyrite, marcasite, chalcopyrite, sphalerite, galena, and chalcocite. There are calcite and quartz veins that show colloform, comb, and crystalline textures. Hydrothermal alteration assemblages, ore minerals, and cavity filling textures suggest that mineralization type in research area is epithermal low sulphidation.

Keywords: Pongkor, hydrothermal alteration, epithermal, geochemistry

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Authors: Thidilweli Denga, Bessie Malila, Lucretia Petersen

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The Coronavirus Disease of 2019 (COVID-19) pandemic should be taken as a wake-up call on the importance of hearing health care considering amongst other things the electronic methods of communication used. The World Health Organization (WHO) estimated that by 2050, there will be more than 2.5 billion people living with hearing loss. These numbers show that more people will need rehabilitation services. Studies have shown that most people living with hearing loss reside in Low-Middle Income Countries (LIMC). Innovative technological solutions such as digital health interventions that can be used to deliver hearing health services to remote areas now exist. Tele-audiology implementation can potentially enable the delivery of hearing loss services to rural and remote areas. This study aimed to establish the concurrent validity of the tele-audiology practice in school-based hearing screening. The study employed a cross-sectional design with a within-group comparison. The portable KUDUwave Audiometer was used to conduct hearing screening from 50 participants (n=50). In phase I of the study, the audiologist conducted on-site hearing screening, while the synchronous remote hearing screening (tele-audiology) using a 5G network was done in phase II. On-site hearing screening results were obtained for the first 25 participants (aged between 5-6 years). The second half started with the synchronous tele-audiology model to avoid order-effect. Repeated sample t-tests compared threshold results obtained in the left and right ears for onsite and remote screening. There was a good correspondence between the two methods with a threshold average within ±5 dB (decibels). The synchronous tele-audiology model has the potential to reduce the audiologists' case overload, while at the same time reaching populations that lack access due to distance, and shortage of hearing professionals in their areas of reach. With reliable and broadband connectivity, tele-audiology delivers the same service quality as the conventional method while reducing the travel costs of audiologists.

Keywords: hearing screening, low-resource communities, portable audiometer, tele-audiology

Procedia PDF Downloads 103

Authors: Henry Lau, Dilupa Nakandala, Li Zhao

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All along the length of the supply chain, fresh food firms face the challenge of managing both product quality, due to the perishable nature of the products, and product cost. This paper develops a method to assist logistics managers upstream in the fresh food supply chain in making cost optimized decisions regarding transportation, with the objective of minimizing the total cost while maintaining the quality of food products above acceptable levels. Considering the case of multiple fresh food products collected from multiple farms being transported to a warehouse or a retailer, this study develops a total cost model that includes various costs incurred during transportation. The practical application of the model is illustrated by using several computational intelligence approaches including Genetic Algorithms (GA), Fuzzy Genetic Algorithms (FGA) as well as an improved Simulated Annealing (SA) procedure applied with a repair mechanism for efficiency benchmarking. We demonstrate the practical viability of these approaches by using a simulation study based on pertinent data and evaluate the simulation outcomes. The application of the proposed total cost model was demonstrated using three approaches of GA, FGA and SA with a repair mechanism. All three approaches are adoptable; however, based on the performance evaluation, it was evident that the FGA is more likely to produce a better performance than the other two approaches of GA and SA. This study provides a pragmatic approach for supporting logistics and supply chain practitioners in fresh food industry in making important decisions on the arrangements and procedures related to the transportation of multiple fresh food products to a warehouse from multiple farms in a cost-effective way without compromising product quality. This study extends the literature on cold supply chain management by investigating cost and quality optimization in a multi-product scenario from farms to a retailer and, minimizing cost by managing the quality above expected quality levels at delivery. The scalability of the proposed generic function enables the application to alternative situations in practice such as different storage environments and transportation conditions.

Keywords: cost optimization, food supply chain, fuzzy sets, genetic algorithms, product quality, transportation

Procedia PDF Downloads 206

Authors: Noor Azlina Mohamed Yunus, Baharom Abd Rahman, Abdul Kadir Othman, Narehan Hassan, Rohana Mat Som, Ibhrahim Zakaria

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Customer satisfaction and customer loyalty are the most important outcomes of marketing in which both elements serve various stages of consumer buying behavior. Excellent service quality has become a major corporate goal as more companies gradually struggle for quality for their products and services. Therefore, the main purpose of this study is to investigate the influence of service quality on customer satisfaction and customer loyalty at one telecommunication company in Malaysia which is Telekom Malaysia. The scope of this research is to evaluate satisfaction on the products or services at TMpoint Bukit Raja, Malaysia. The data are gathered through the distribution of questionnaires to a total of 306 respondents who visited and used the products or services. By using correlation and multiple regression analyses, the result revealed that there was a positive and significant relationship between service quality and customer satisfaction. The most influential factor on customer satisfaction was empathy followed by reliability, assurance and tangibles. However, there was no significant influence between responsiveness and customer satisfaction. The result also showed there was a positive and significant relationship between service quality and customer loyalty. The most influential factor on customer loyalty was assurance followed by reliability and tangibles. TMpoint Bukit Raja is recommended to device excellent strategies to satisfy customers’ needs and to adopt action-oriented approach by focusing on what the customers wanted. It is also recommended that similar study can be carried out in other industries using different methodologies such as longitudinal method, enlarge the sample size and use a qualitative approach.

Keywords: customer satisfaction, customer loyalty, service quality, telecommunication company

Procedia PDF Downloads 440

Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky

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Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.

Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity

Procedia PDF Downloads 195

Authors: Andreina Giustiniani, Massimiliano Oliveri

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Rhythmic activity in different frequencies could subserve distinct functional roles during visual perception and visual mental imagery. In particular, alpha band activity is thought to play a role in active inhibition of both task-irrelevant regions and processing of non-relevant information. In the present blind placebo-controlled study we applied alpha transcranial alternating current stimulation (tACS) in the occipital cortex both during a basic visual perception and a visual working memory task. To understand if the role of alpha is more related to a general inhibition of distractors or to an inhibition of task-irrelevant regions, we added a non visual distraction to both the tasks.Sixteen adult volunteers performed both a simple perception and a working memory task during 10 Hz tACS. The electrodes were placed over the left and right occipital cortex, the current intensity was 1 mA peak-to-baseline. Sham stimulation was chosen as control condition and in order to elicit the skin sensation similar to the real stimulation, electrical stimulation was applied for short periods (30 s) at the beginning of the session and then turned off. The tasks were split in two sets, in one set distracters were included and in the other set, there were no distracters. Motor interference was added by changing the answer key after subjects completed the first set of trials.The results show that alpha tACS improves working memory only when no motor distracters are added, suggesting a role of alpha tACS in inhibiting non-relevant regions rather than in a general inhibition of distractors. Additionally, we found that alpha tACS does not affect accuracy and hit rates during the visual perception task. These results suggest that alpha activity in the occipital cortex plays a different role in perception and working memory and it could optimize performance in tasks in which attention is internally directed, as in this working memory paradigm, but only when there is not motor distraction. Moreover, alpha tACS improves working memory performance by means of inhibition of task-irrelevant regions while it does not affect perception.

Keywords: alpha activity, interference, perception, working memory

Procedia PDF Downloads 238

Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

Procedia PDF Downloads 59