Search results for: disturbance report
2243 Uncommon Presentation of Iscahemic Heart Disease with Sheehan’s Syndrome at Mid-Level Private Hospital of Bangladesh and Its Management- A Case Report
Authors: Nazmul Haque, Syeda Tasnuva Maria
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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland
Procedia PDF Downloads 432242 Bacillus cereus Bacteremia and Multi-Organ Failure With Diffuse Brain Hypoxia During Acute Lymphoblastic Leukemia Induction Therapy. A Case Report
Authors: Roni Rachel Mendelson, Caileigh Pudela
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Bacillus cereus is a toxin-producing, facultatively anaerobic gram-positive bacterium that is widely distributed environmentally. It can quickly multiply at room temperature with an abundantly present preformed toxin. When ingested, this toxin can cause gastrointestinal illness, which is the commonly known manifestation of the disease. Bacillus cereus sepsis is a disease that is mostly concerning in the population of the immunocompromised patients. One of them is acute lymphoblastic leukemia’s patients during induction. Pediatric acute lymphoblastic leukemia is a common pediatric hematologic malignancy. It is characterized by the rapid proliferation of poorly differentiated lymphoid progenitor cells inside the bone marrow. We present here a 21-month-old boy undergoing induction chemotherapy for acute lymphoblastic leukemia who developed bacillus sepsis bacteremia and, as a result, multi organ failure leading to seizures and multiple strokes. Our case report highlights the extensive overall and neurological damage that can be caused because of bacillus cereus bacteremia, which can lead to higher mortality rate and decreased in survivorship in a highly curable disease. It is very subtle and difficult to recognize and appears to be deteriorating extremely fast. There should be a low threshold for work up and empiric coverage for neutropenic patients during acute lymphoblastic leukemia induction therapy.Keywords: acute lymphoblastic leukemia, bacillus cereus, immunocompromised, sepsis
Procedia PDF Downloads 742241 Bifid Ureters: Arising Directly from the Separate Calyces and Renal Pelvis of the Kidney: A Case Report
Authors: Yuri Seu, Hyun Jin Park, Jin Seo Park, Yong-Suk Moon, HongtaeKim, Mi-Sun Hur
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The present case report describes bifid ureters arising directly from the separate calyces and renal pelvis of the kidney. It was a single common ureter leading away from the bladder, which was separated into incompletely duplicated ureters near the level of the anterior superior iliac supine. These two branches then entered the left kidney through their own courses. Each ureter traveled anterior and posterior to the renal vein, respectively. These two ureters formed a Y-shaped pattern. One ureter coursed anterior to the renal vein with shorter length, and it terminated at the renal pelvis that was divided into major calices in approximately lower two thirds of the kidney. The other ureter coursed posterior to the renal vein with longer length, terminating at approximately the upper third of the kidney. The renal calices in the upper third of the kidney were directly connected to the posterior ureter, whereas the other major calices in the lower two thirds of the kidney formed the renal pelvis connecting to the anterior ureter. Thus, convergence of the major calices was separated according to the terminations of two ureters. These anomalous ureters were traced to the calices of the kidney, thereby providing a reference of a rare variation of the ureter. The bifid ureters arising from the separate calyces and renal pelvis should be considered by radiologists when evaluating images and diagnosing possible complications of these anomalies.Keywords: bifid ureters, kidney, major calices, renal pelvis
Procedia PDF Downloads 762240 Assessment of Routine Health Information System (RHIS) Quality Assurance Practices in Tarkwa Sub-Municipal Health Directorate, Ghana
Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei
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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality
Procedia PDF Downloads 702239 Impact of Obesity on Female Fertility
Authors: A. Chennai, M. Yahia, H. Boussenan
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Our study was designed to highlight changes in certain biochemical parameters such as (CH, TG, HDL, TGO, TGP, LDL, and CRP), hormones (FSH, LH, PRL, TSH, and leptin), in women who suffer from over weight and fertile controls as well as the research for potential pathophysiological link between obesity and infertility in this population of women. This practical work has been focused on a population of 24 over weight infertile women, compared to control subjects without any pathology causing disturbance parameters to be studied to determine the contribution of obesity in the etiology of infertility. The assay results revealed a highly significant difference between the two groups in the serum levels of CH, TG, HDL, and TGO TGP (P <0.0001) as well as the rate of LDL (p=0.0017) and CRP (p=0.02). Hormonal profile also shows a significant difference between the two groups (P<0.0001) for LH and leptin but no difference was found for serum TSH. A significant correlation between leptin and FSH, LH, and FSH, age and LH, PRL and age and between HDL and CRP. The present study suggests that obesity is associated with infertility, but no direct pathophysiological link between obesity and infertility has been determined. More in-depth studies are needed to determine the exact mechanism by which overweight leads to female infertility.Keywords: fertility, obesity, hormones, biochemical, pathophysiological
Procedia PDF Downloads 4052238 Restless Leg Syndrome as the Presenting Symptom of Neuroendocrine Tumor
Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana
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Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep
Procedia PDF Downloads 2802237 Rumination in Borderline Personality Disorder: A Meta-Analytic Review
Authors: Mara J. Richman, Zsolt Unoka, Robert Dudas, Zsolt Demetrovics
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Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and effective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while also considering clinical moderator variables such as comorbidity, GAF score, and type of BPD symptom and demographic moderator variables such as age, gender, and education level. Analysis of correlation across rumination domains for the entire sample revealed a medium overall correlation. When assessing types of rumination, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Furthermore, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/ impulsivity, respectively. Demographic variables showed no significance. Clinical implications are considered and further therapeutic interventions are discussed in the context of rumination.Keywords: borderline personality disorder, meta-analysis, rumination, symptoms
Procedia PDF Downloads 1922236 Formalizing a Procedure for Generating Uncertain Resource Availability Assumptions Based on Real Time Logistic Data Capturing with Auto-ID Systems for Reactive Scheduling
Authors: Lars Laußat, Manfred Helmus, Kamil Szczesny, Markus König
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As one result of the project “Reactive Construction Project Scheduling using Real Time Construction Logistic Data and Simulation”, a procedure for using data about uncertain resource availability assumptions in reactive scheduling processes has been developed. Prediction data about resource availability is generated in a formalized way using real-time monitoring data e.g. from auto-ID systems on the construction site and in the supply chains. The paper focuses on the formalization of the procedure for monitoring construction logistic processes, for the detection of disturbance and for generating of new and uncertain scheduling assumptions for the reactive resource constrained simulation procedure that is and will be further described in other papers.Keywords: auto-ID, construction logistic, fuzzy, monitoring, RFID, scheduling
Procedia PDF Downloads 5072235 Smooth Second Order Nonsingular Terminal Sliding Mode Control for a 6 DOF Quadrotor UAV
Authors: V. Tabrizi, A. Vali, R. GHasemi, V. Behnamgol
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In this article, a nonlinear model of an under actuated six degrees of freedom (6 DOF) quadrotor UAV is derived on the basis of the Newton-Euler formula. The derivation comprises determining equations of the motion of the quadrotor in three dimensions and approximating the actuation forces through the modeling of aerodynamic coefficients and electric motor dynamics. The robust nonlinear control strategy includes a smooth second order non-singular terminal sliding mode control which is applied to stabilizing this model. The control method is on the basis of super twisting algorithm for removing the chattering and producing smooth control signal. Also, nonsingular terminal sliding mode idea is used for introducing a nonlinear sliding variable that guarantees the finite time convergence in sliding phase. Simulation results show that the proposed algorithm is robust against uncertainty or disturbance and guarantees a fast and precise control signal.Keywords: quadrotor UAV, nonsingular terminal sliding mode, second order sliding mode t, electronics, control, signal processing
Procedia PDF Downloads 4322234 Access to the Community and Needed Supports among People with Physical Disabilities Receiving Long-Term Services and Supports in the United States
Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia
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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.Keywords: quality-of-life, long-term services and supports, person-centered, community
Procedia PDF Downloads 1022233 Analysis of Criteria for Determining the Location of Hilal Observation in the Tropical Regions: Study of Hilal Observation Location in Bengkulu City
Authors: Badrun Taman
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This study aims to review the use of the Bengkulu Provincial Government Mess as the location of rukyatul hilal because its determination has not been carried out scientifically. There are three things that will be analyzed, namely geographical-astronomical conditions, the suitability of the location with ideal criteria, and the determination of the location of rukyatul hilal in accordance with regional conditions based on the results of the study. The research method used is qualitative with an astronomical geographical approach. The results showed that the factor that strengthened the disturbance from the weather aspect was the western sky horizon in the form of the Indian Ocean sea level. The potential for geographical disturbances on this horizon is high sea waves, relatively high sea breezes, and more seawater vapor due to sea surface temperatures and high air humidity. This study found new criteria for determining the location of the observation crescent. The criteria is the western horizon is not sea level (especially the Indian Ocean).Keywords: criteria, location, Rukyatul Hilal, tropics, Indian ocean
Procedia PDF Downloads 862232 The Efficacy of Clobazam for Landau-Kleffner Syndrome
Authors: Nino Gogatishvili, Davit Kvernadze, Giorgi Japharidze
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Background and aims: Landau Kleffner syndrome (LKS) is a rare disorder with epileptic seizures and acquired aphasia. It usually starts in initially healthy children. The first symptoms are language regression and behavioral disturbances, and the sleep EEG reveals abnormal epileptiform activity. The aim was to discuss the efficacy of Clobazam for Landau Kleffner syndrome. Case report: We report a case of an 11-year-old boy with an uneventful pregnancy and delivery. He began to walk at 11 months and speak with simple phrases at the age of 2,5 years. At the age of 18 months, he had febrile convulsions; at the age of 5 years, the parents noticed language regression, stuttering, and serious behavioral dysfunction, including hyperactivity, temper outbursts. The epileptic seizure was not noticed. MRI was without any abnormality. Neuropsychological testing revealed verbal auditory agnosia. Sleep EEG showed abundant left fronto-temporal spikes, reaching over 85% during non-rapid eye movement sleep (non-REM sleep). Treatment was started with Clobazam. After ten weeks, EEG was improved. Stuttering and behavior also improved. Results: Since the start of Clobazam treatment, stuttering and behavior improved. Now, he is 11 years old, without antiseizure medication. Sleep EEG shows fronto-temporal spikes on the left side, over 10-49 % of non-REM sleep, bioccipital spikes, and slow-wave discharges and spike-waves. Conclusions: This case provides further support for the efficacy of Clobazam in patients with LKS.Keywords: Landau-Kleffner syndrome, antiseizure medication, stuttering, aphasia
Procedia PDF Downloads 612231 Developing Heat-Power Efficiency Criteria for Characterization of Technosphere Structural Elements
Authors: Victoria Y. Garnova, Vladimir G. Merzlikin, Sergey V. Khudyakov, Aleksandr A. Gajour, Andrei P. Garnov
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This paper refers to the analysis of the characteristics of industrial and lifestyle facilities heat- energy objects as a part of the thermal envelope of Earth's surface for inclusion in any database of economic forecasting. The idealized model of the Earth's surface is discussed. This model gives the opportunity to obtain the energy equivalent for each element of terrain and world ocean. Energy efficiency criterion of comfortable human existence is introduced. Dynamics of changes of this criterion offers the possibility to simulate the possible technogenic catastrophes with a spontaneous industrial development of the certain Earth areas. Calculated model with the confirmed forecast of the Gulf Stream freezing in the Polar Regions in 2011 due to the heat-energy balance disturbance for the oceanic subsurface oil polluted layer is given. Two opposing trends of human development under the limited and unlimited amount of heat-energy resources are analyzed.Keywords: Earth's surface, heat-energy consumption, energy criteria, technogenic catastrophes
Procedia PDF Downloads 3132230 Assessment of Gamma Radiation Exposure of Soils Associated with Granitic Rocks in Kapıdağ Peninsula, Turkey
Authors: Buket Canbaz Öztürk, N. Füsun Çam, Günseli Yaprak, Osman Candan
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The external terrestrial radiation exposure is related to the types of rock from which the soils originate. Higher radiation levels are associated with igneous rocks, such as granite, and lower levels with sedimentary rocks. Therefore, this study aims to assess the gamma radiation exposure of soils associated with granitic rocks in Kapıdağ Peninsula, Turkey. In the ongoing study, a comprehensive survey carried out systematically as a part of the environmental monitoring program on radiologic impact of the granitoid areas in Western Anatolia. The activity measurements of the gamma emitters (238U, 232Th and 40K) in the surface soil samples and the granitic rocks carried out by means of NaI(Tl) gamma-ray spectrometry system. To evaluate the radiological hazard of the natural radioactivity, the absorbed dose rate (D), the annual effective dose rate (AED), the radium equivalent activity (Raeq) and the external (Hex) hazard index were calculated according to the UNSCEAR 2000 report. The corresponding absorbed dose rates in air from all natural radionuclides were always much lower than 200 nGy h-1 and did not exceed the typical range of worldwide average values noticed in the UNSCEAR (2000) report. Furthermore, the correlation between soil and granitic rock samples were utilized, and external gamma radiation exposure distribution was mapped in Kapıdağ Peninsula.Keywords: external absorbed dose, granitic rocks, Kapıdağ Peninsula, soil
Procedia PDF Downloads 2302229 Sensor Fault-Tolerant Model Predictive Control for Linear Parameter Varying Systems
Authors: Yushuai Wang, Feng Xu, Junbo Tan, Xueqian Wang, Bin Liang
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In this paper, a sensor fault-tolerant control (FTC) scheme using robust model predictive control (RMPC) and set theoretic fault detection and isolation (FDI) is extended to linear parameter varying (LPV) systems. First, a group of set-valued observers are designed for passive fault detection (FD) and the observer gains are obtained through minimizing the size of invariant set of state estimation-error dynamics. Second, an input set for fault isolation (FI) is designed offline through set theory for actively isolating faults after FD. Third, an RMPC controller based on state estimation for LPV systems is designed to control the system in the presence of disturbance and measurement noise and tolerate faults. Besides, an FTC algorithm is proposed to maintain the plant operate in the corresponding mode when the fault occurs. Finally, a numerical example is used to show the effectiveness of the proposed results.Keywords: fault detection, linear parameter varying, model predictive control, set theory
Procedia PDF Downloads 2392228 Checklist of Odonata of Shasha Forest Reserve, Ife Southern, Osun State, Nigeria
Authors: Ehikhamele Isaac Erhomosele, Ogbogu Sunday Sylvester
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A biodiversity survey was conducted in Shasha Forest Reserve, Ife southern, Osun State, Nigeria between May 2019 to April 2021 with a view to determining the nature of Odonata fauna of the forest. A total number of 1055 individuals of adult dragonflies and damselflies belonging to 8 families (Aeshnidae, Calopterygidae, Chlorocyphidae, Coenagrionidae, Gomphidae, Lestidae, Libellulidae and Platycnemididae) were recorded. Five (5) of these families of which belong to the suborder Zygoptera, and the remaining three (3) to Anisoptera. Libellulidae was the most abundant family while Gomphidae recorded the least representative. No new species of Odonata was recorded. Most of the families reported were previously been documented in the tropical region. Logging activities and human disturbance have been attributed to the nature of Odonata species in the Forest. It is therefore recommended that logging should be restricted to designated areas of the forest and regulated by the Department of Forestry of Osun State Ministry of Agriculture and Natural Resources in conjunction with the Federal Ministry of Environment.Keywords: checklist, Odonata, Shasha, families
Procedia PDF Downloads 1052227 Hypoglycemic Coma in Elderly Patients with Diabetes mellitus
Authors: D. Furuya, H. Ryujin, S. Takahira, Y. Sekine, Y. Oya, K. Sonoda, H. Ogawa, Y. Nomura, R. Maruyama, H. Kim, T. Kudo, A. Nakano, T. Saruta, S. Sugita, M. Nemoto, N. Tanahashi
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Purpose: To study the clinical characteristics of hypoglycemic coma in adult patients with type 1 or type 2 diabetes mellitus (DM). Methods: Participants in this retrospective study comprised 91 patients (54 men, 37 women; mean age ± standard deviation, 71.5 ± 12.6 years; range, 42-97 years) brought to our emergency department by ambulance with disturbance of consciousness in the 7 years from April 2007 to March 2014. Patients with hypoglycemia caused by alcoholic ketoacidosis, nutrition disorder, malignancies and psychological disorder were excluded. Results: Patients with type 1 (8 of 91) or type 2 DM (83 of 91) were analyzed. Mean blood sugar level was 31.6 ± 10.4 in all patients. A sulfonylurea (SU) was more commonly used in elderly (>75 years old; n=44)(70.5%) than in younger patients (36.2%, p < 0.05). Cases showing prolonged unconsciousness (range, 1 hour to 21 days; n=30) included many (p < 0.05) patients with dementia (13.3%; 0.5% without dementia) and fewer (p < 0.05) patients with type 1 DM (0%; 13.1% in type 2 DM). Specialists for DM (n=33) used SU less often (24.2%) than general physicians (69.0%, p < 0.05). Conclusion: In cases of hypoglycemic coma, SU was frequently used in elderly patients with DM.Keywords: hypoglycemic coma, Diabetes mellitus, unconsciousness, elderly patients
Procedia PDF Downloads 4822226 Excision and Reconstruction of a Hypertrophic and Functional Bleb with Bovine Pericardium (Tutopatch®) and Amniotic Membrane: A Case Report
Authors: Blanca Fatela Cantillo, Silvia Iglesias Cerrato, Guadalupe Garrido Ceca
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Purpose: Bleb dysfunction is a late complication following glaucoma filtration surgery. We describe our surgical technique for excision and reconstruction of a hypertrophic bleb complication using bovine pericardium patch graft (Tutopatch®) and amniotic membrane. Material and methods: The case report presents a hypertrophic bleb over the cornea with good intraocular pressure control. The hanging bleb without leak caused dysesthesia and high irregular astigmatism. Bleb reconstruction involved the excision of corneal fibrous material and avascular conjunctiva, preserving the original scleral and tennon. Bovine pericardium patch graft (Tutopatch®) was sited over these with fixed sutures, reinforcing the underlying scleral, and the conjunctiva advanced. The superior epithelium corneal defect was covered using an amniotic membrane. Conclusion: Repair of bleb dysfunction with varied techniques has been reported, including conjunctival advancement, use of scleral patch graft, dural patch graft, or pericardium. Additional use of amniotic membrane promotes epithelialization and exhibits anti-fibrotic and anti-inflammatory features. Reconstruction with bovine pericardium patch graft and amniotic membrane resulted in pain relief, visual rehabilitation, and good aesthetic results, with preservation of bleb function.Keywords: reconstruction, hypertrophic bleb, bovine pericardium, amniotic membrane, dysesthesia of the bleb
Procedia PDF Downloads 712225 Wire Localization Procedures in Non-Palpable Breast Cancers: An Audit Report and Review of Literature
Authors: Waqas Ahmad, Eisha Tahir, Shahper Aqeel, Imran Khalid Niazi, Amjad Iqbal
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Background: Breast conservation surgery applies a number of techniques for accurate localization of lesions. Wire localization remains the method of choice in non-palpable breast cancers post-neoadjuvant chemotherapy. Objective: The aim of our study was to determine the accuracy of wire localization procedures in our department and compare it with internationally set protocols as per the Royal College of Radiologists. Post wire mammography, as well as the margin status of the postoperative specimen, assessed the accuracy of the procedure. Methods: We retrospectively reviewed the data of 225 patients who presented to our department from May 2014 to June 2015 post neoadjuvant chemotherapy with non-palpable cancers. These patients are candidates for wire localized lumpectomies either under ultrasound or stereotactic guidance. Metallic marker was placed in all the patients at the time of biopsy. Post wire mammogram was performed in all the patients and the distance of the wire tip from the marker was calculated. The presence or absence of the metallic clip in the postoperative specimen, as well as the marginal status of the postoperative specimen, was noted. Results: 157 sonographic and 68 stereotactic wire localization procedures were performed. 95% of the wire tips were within 1 cm of the metallic marker. Marginal status was negative in 94% of the patients in histopathological specimen. Conclusion: Our audit report declares more than 95% accuracy of image guided wire localization in successful excision of non-palpable breast lesions.Keywords: breast, cancer, non-palpable, wire localization
Procedia PDF Downloads 3012224 The Study on the Platform Strategy of Taipei City Urban Regeneration Station
Authors: Chao Jen-Chih, Kuo-Wei Hsu
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Many venues and spaces in cities gradually become old and decayed as time goes by and develops. Urban regeneration is the critical strategy to promote local development, but the method of spatial reconstruction which is emphasized in the issue of urban regeneration is questioned for bringing cultural, social and economic impacts on old city areas. The idea of “Urban Regeneration Station (URS)” is proposed for Taipei City Government to introduce the entry and disturbance of communities and related groups with the concept of creative city. This study explored how an URS promotes local development again through the strength of communities and the energy of local residence community, and it established the Platform Strategy for URS. The research results are as follows: URS through the promotion of government agencies, experts, scholars and the third sector, to the selection of different types of units stationed in business, through exhibitions, seminars, and other activities to explore local development issues, vetting each stationed execution efficiency units, and different units stationed by URS establish URS overall network platform strategy.Keywords: urban regeneration, platform strategy, creative city, Taipei city
Procedia PDF Downloads 4512223 The System of Uniform Criteria for the Characterization and Evaluation of Elements of Economic Structure: The Territory, Infrastructure, Processes, Technological Chains, the End Products
Authors: Aleksandr A. Gajour, Vladimir G. Merzlikin, Vladimir I. Veselov
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This paper refers to the analysis of the characteristics of industrial and lifestyle facilities heat- energy objects as a part of the thermal envelope of Earth's surface for inclusion in any database of economic forecasting. The idealized model of the Earth's surface is discussed. This model gives the opportunity to obtain the energy equivalent for each element of terrain and world ocean. Energy efficiency criterion of comfortable human existence is introduced. Dynamics of changes of this criterion offers the possibility to simulate the possible technogenic catastrophes with the spontaneous industrial development of the certain Earth areas. Calculated model with the confirmed forecast of the Gulf Stream freezing in the polar regions in 2011 due to the heat-energy balance disturbance for the oceanic subsurface oil polluted layer is given. Two opposing trends of human development under limited and unlimited amount of heat-energy resources are analyzed.Keywords: Earth's surface, heat-energy consumption, energy criteria, technogenic catastrophes
Procedia PDF Downloads 3972222 Controlled Growth of Charge Transfer Complex Nanowire by Physical Vapor Deposition Method Using Dielectrophoretic Force
Authors: Rabaya Basori, Arup K. Raychaudhuri
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In recent years, a variety of semiconductor nanowires (NWs) has been synthesized and used as basic building blocks for the development of electronic and optoelectronic nanodevices. Dielectrophoresis (DEP) has been widely investigated as a scalable technique to trap and manipulate polarizable objects. This includes biological cells, nanoparticles, DNA molecules, organic or inorganic NWs and proteins using electric field gradients. In this article, we have used DEP force to localize nanowire growth by physical vapor deposition (PVD) method as well as control of NW diameter on field assisted growth of the NWs of CuTCNQ (Cu-tetracyanoquinodimethane); a metal-organic charge transfer complex material which is well known of resistive switching. We report a versatile analysis platform, based on a set of nanogap electrodes, for the controlled growth of nanowire. Non-uniform electric field and dielectrophoretic force is created in between two metal electrodes, patterned by electron beam lithography process. Suspended CuTCNQ nanowires have been grown laterally between two electrodes in the vicinity of electric field and dielectric force by applying external bias. Growth and diameter dependence of the nanowires on external bias has been investigated in the framework of these two forces by COMSOL Multiphysics simulation. This report will help successful in-situ nanodevice fabrication with constrained number of NW and diameter without any post treatment.Keywords: nanowire, dielectrophoretic force, confined growth, controlled diameter, comsol multiphysics simulation
Procedia PDF Downloads 1842221 A Case Report of Aberrant Vascular Anatomy of the Deep Inferior Epigastric Artery Flap
Authors: Karissa Graham, Andrew Campbell-Lloyd
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The deep inferior epigastric artery perforator flap (DIEP) is used to reconstruct large volumes of tissue. The DIEP flap is based on the deep inferior epigastric artery (DIEA) and vein. Accurate knowledge of the anatomy of these vessels allows for efficient dissection of the flap, minimal damage to surrounding tissue, and a well vascularized flap. A 54 year old lady was assessed for bilateral delayed autologous reconstruction with DIEP free flaps. The right DIEA was consistent with the described anatomy. The left DIEA had a vessel branching shortly after leaving the external iliac artery and before entering the muscle. This independent branch entered the muscle and had a long intramuscular course to the largest perforator. The main DIEA vessel demonstrated a type II branching pattern but had perforators that were too small to have a viable DIEP flap. There were no communicating arterial branches between the independent vessel and DIEA, however, there was one venous communication between them. A muscle sparing transverse rectus abdominis muscle flap was raised using the main periumbilical perforator from the independent vessel. Our case report demonstrated an unreported anatomical variant of the DIEA. A few anatomical variants have been described in the literature, including a unilateral absent DIEA and peritoneal-cutaneous perforators that had no connection to the DIEA. Doing a pre-operative CTA helps to identify these rare anatomical variations, which leads to safer, more efficient, and effective operating.Keywords: aberrant anatomy, CT angiography, DIEP anatomy, free flap
Procedia PDF Downloads 1282220 A Comparison of Generation Dependent Brain Targeting Potential of(Poly Propylene Mine) Dendrimers
Authors: Nitin Dwivedi, Jigna Shah
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Aim and objective of study: This article indicates a comparison among various generations of dendrimers, a dendrimer is a bioactive material has repetitively branched molecule and used for delivery of various therapeutic active agents. This debut report compares the effect various generations of PPI dendrimers for brain targeting and management of neurodegenerative disorders potential on single platform. This report involves the study of the various mechanism of synthesis ligand anchored various generations PPI dendrimers deliver the drug directly to the CNS, prove their effectiveness in the management of the various neurodegenerative disease. Material and Methods: The Memantine an anti-Alzheimer drug loaded in different generations (3.0G, 4.0G, and 5.0G) of PPI dendrimers which were synthesized were synthesized. The various studies investigate the effect of PPI dendrimers generation on different characteristic parameters i.e. synthesis procedure, drug loading, release behavior, hemolysis profile at different concentration, MRI study for determine the route drug from olfactory transfer, animal model study in vitro, as well as in vivo performance. The outcomes of the investigation indicate drug delivery benefit as well as superior biocompatibility of 4.0G PPI dendrimer over 3.0G and 5.0G dendrimer, respectively. Results and Conclusion: The above study indicate the superiority of in drug delivery system with maximum drug utilization and minimize the drug dose for neurodegenerative disorder over 5.0G PPI dendrimers. So, 4.0G PPI dendrimers are the safe formulations for the symptomatic treatment of the neurodegenerative disorder. The fifth-generation poly(propyleneimine) (PPI) dendrimers, inherent toxicity due to the presence of many peripheral cationic groups is the major issue that limits their applicability.Keywords: Alzheimer disease, generation, memantine, PPI
Procedia PDF Downloads 6592219 Optimal Design of Multimachine Power System Stabilizers Using Improved Multi-Objective Particle Swarm Optimization Algorithm
Authors: Badr M. Alshammari, T. Guesmi
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In this paper, the concept of a non-dominated sorting multi-objective particle swarm optimization with local search (NSPSO-LS) is presented for the optimal design of multimachine power system stabilizers (PSSs). The controller design is formulated as an optimization problem in order to shift the system electromechanical modes in a pre-specified region in the s-plan. A composite set of objective functions comprising the damping factor and the damping ratio of the undamped and lightly damped electromechanical modes is considered. The performance of the proposed optimization algorithm is verified for the 3-machine 9-bus system. Simulation results based on eigenvalue analysis and nonlinear time-domain simulation show the potential and superiority of the NSPSO-LS algorithm in tuning PSSs over a wide range of loading conditions and large disturbance compared to the classic PSO technique and genetic algorithms.Keywords: multi-objective optimization, particle swarm optimization, power system stabilizer, low frequency oscillations
Procedia PDF Downloads 4252218 Association of Geomagnetic Storms with Coronal Mass Ejections during 1997-2012
Authors: O. P. Tripathi, P. L. Verma
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Coronal Mass Ejections (CMEs) are mostly reached on Earth from 1 to 5 days from the Sun. As a consequence, slow CMEs are accelerated toward the speed of solar wind and fast CMEs are decelerated toward the speed of the solar wind. Coronal mass ejections (CMEs) are bursts of solar material i.e. clouds of plasma and magnetic fields that shoot off the sun’s surface. Other solar events include solar wind streams that come from the coronal holes on the Sun and solar energetic particles that are primarily released by CMEs. We have studied geomagnetic storms (DST ≤ - 80nT) during 1997-2012 with halo and partial halo coronal mass ejections and found that 73.28% CMEs (halo and partial halo coronal mass ejections) are associated with geomagnetic storms. The association rate of halo and partial halo coronal mass ejections are found 67.06% and 32.94% with geomagnetic storms respectively. We have also determined positive co-relation between magnitude of geomagnetic storms and speed of coronal mass ejection with correlation co-efficient 0.23.Keywords: geomagnetic storms, coronal mass ejections (CMEs), disturbance storm time (Dst), interplanetary magnetic field (IMF)
Procedia PDF Downloads 5012217 An Application of Hip Arthroscopy after Acute Injury - A Case Report
Authors: Le Nguyen Binh, Luong Xuan Binh, Le Van Tuan, Tran Binh Duong, Truong Nguyen Khanh Hung, Do Le Hoang Son, Pham Quang Vinh, Hoang Quoc Huy, Nguyen Bach, Nguyen Quoc Khanh Le, Jiunn Horng Kang
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Introduction: Traumatic hip dislocation is an emergency in young adult which can cause avascular necrosis of femoral head or osteoarthritis of hip joint. The reasons for these may be the loose body of bony or chondral fragments, which are difficult to be detected on CT scan or MRI. In those cases, Hip arthroscopy may be the method of choice for diagnosis and treatment of loose bodies in hip joint after traumatic dislocation. Methods: A case report is performed. A 55-year-old male patient was under hip arthroscopy to retrieve the loose body in the right hip joint. Results: The patient’s hip was reduced under anesthesia in the opeation room. Xray and CT scan post-reduction showed that his right hip was wide and a small fragment of femoral head (< 5mm) locking inside the joint. A hip arthroscopy was done to take the fragment out. Post-operation, the patient went under rehabilition. After 6 months, he can walk with full-weight bearing; no further dislocaion was noted, and the Harris score was 84 points. Conclusions: Although acute traumatic injury of hip joint is usually treated with open surgeries, these methods have many drawbacks, such as soft tissue destruction, blood-loss,….Despite its technical requirement, hip arthroscopy is less invasive and effective treatment. Therefore, it may be an alternative treatment for a traumatic hip injury and can be applied frequently in the near future.Keywords: hip dislocation, hip arthroscopy, hip osteoarthritis, acute hip trauma
Procedia PDF Downloads 762216 Disparities in Language Competence and Conflict: The Moderating Role of Cultural Intelligence in Intercultural Interactions
Authors: Catherine Peyrols Wu
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Intercultural interactions are becoming increasingly common in organizations and life. These interactions are often the stage of miscommunication and conflict. In management research, these problems are commonly attributed to cultural differences in values and interactional norms. As a result, the notion that intercultural competence can minimize these challenges is widely accepted. Cultural differences, however, are not the only source of a challenge during intercultural interactions. The need to rely on a lingua franca – or common language between people who have different mother tongues – is another important one. In theory, a lingua franca can improve communication and ease coordination. In practice however, disparities in people’s ability and confidence to communicate in the language can exacerbate tensions and generate inefficiencies. In this study, we draw on power theory to develop a model of disparities in language competence and conflict in a multicultural work context. Specifically, we hypothesized that differences in language competence between interaction partners would be positively related to conflict such that people would report greater conflict with partners who have more dissimilar levels of language competence and lesser conflict with partners with more similar levels of language competence. Furthermore, we proposed that cultural intelligence (CQ) an intercultural competence that denotes an individual’s capability to be effective in intercultural situations, would weaken the relationship between disparities in language competence and conflict such that people would report less conflict with partners who have more dissimilar levels of language competence when the interaction partner has high CQ and more conflict when the partner has low CQ. We tested this model with a sample of 135 undergraduate students working in multicultural teams for 13 weeks. We used a round-robin design to examine conflict in 646 dyads nested within 21 teams. Results of analyses using social relations modeling provided support for our hypotheses. Specifically, we found that in intercultural dyads with large disparities in language competence, partners with the lowest level of language competence would report higher levels of interpersonal conflict. However, this relationship disappeared when the partner with higher language competence was also high in CQ. These findings suggest that communication in a lingua franca can be a source of conflict in intercultural collaboration when partners differ in their level of language competence and that CQ can alleviate these effects during collaboration with partners who have relatively lower levels of language competence. Theoretically, this study underscores the benefits of CQ as a complement to language competence for intercultural effectiveness. Practically, these results further attest to the benefits of investing resources to develop language competence and CQ in employees engaged in multicultural work.Keywords: cultural intelligence, intercultural interactions, language competence, multicultural teamwork
Procedia PDF Downloads 1612215 Control HVAC Parameters by Brain Emotional Learning Based Intelligent Controller (BELBIC)
Authors: Javad Abdi, Azam Famil Khalili
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Modeling emotions have attracted much attention in recent years, both in cognitive psychology and design of artificial systems. However, it is a negative factor in decision-making; emotions have shown to be a strong faculty for making fast satisfying decisions. In this paper, we have adapted a computational model based on the limbic system in the mammalian brain for control engineering applications. Learning in this model based on Temporal Difference (TD) Learning, we applied the proposed controller (termed BELBIC) for a simple model of a submarine. The model was supposed to reach the desired depth underwater. Our results demonstrate excellent control action, disturbance handling, and system parameter robustness for TDBELBIC. The proposal method, regarding the present conditions, the system action in the part and the controlling aims, can control the system in a way that these objectives are attained in the least amount of time and the best way.Keywords: artificial neural networks, temporal difference, brain emotional learning based intelligent controller, heating- ventilating and air conditioning
Procedia PDF Downloads 4272214 A Study of the Atlantoaxial Fracture or Dislocation in Motorcyclists with Helmet Accidents
Authors: Shao-Huang Wu, Ai-Yun Wu, Meng-Chen Wu, Chun-Liang Wu, Kai-Ping Shaw, Hsiao-Ting Chen
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Objective: To analyze the forensic autopsy data of known passengers and compare it with the National database of the autopsy report in 2017, and obtain the special patterned injuries, which can be used as the reference for the reconstruction of hit-and-run motor vehicle accidents. Methods: Analyze the items of the Motor Vehicle Accident Report, including Date of accident, Time occurred, Day, Acc. severity, Acc. Location, Acc. Class, Collision with Vehicle, Motorcyclists Codes, Safety equipment use, etc. Analyzed the items of the Autopsy Report included, including General Description, Clothing and Valuables, External Examination, Head and Neck Trauma, Trunk Trauma, Other Injuries, Internal Examination, Associated Items, Autopsy Determinations, etc. Materials: Case 1. The process of injury formation: the car was chased forward and collided with the scooter. The passenger wearing the helmet fell to the ground. The helmet crashed under the bottom of the sedan, and the bottom of the sedan was raised. Additionally, the sedan was hit on the left by the other sedan behind, resulting in the front sedan turning 180 degrees on the spot. The passenger’s head was rotated, and the cervical spine was fractured. Injuries: 1. Fracture of atlantoaxial joint 2. Fracture of the left clavicle, scapula, and proximal humerus 3. Fracture of the 1-10 left ribs and 2-7 right ribs with lung contusion and hemothorax 4. Fracture of the transverse process of 2-5 lumbar vertebras 5. Comminuted fracture of the right femur 6. Suspected subarachnoid space and subdural hemorrhage 7. Laceration of the spleen. Case 2. The process of injury formation: The motorcyclist wearing the helmet fell to the left by himself, and his chest was crushed by the car going straight. Only his upper body was under the car and the helmet finally fell off. Injuries: 1. Dislocation of atlantoaxial joint 2. Laceration on the left posterior occipital 3. Laceration on the left frontal 4. Laceration on the left side of the chin 5. Strip bruising on the anterior neck 6. Open rib fracture of the right chest wall 7. Comminuted fracture of both 1-12 ribs 8. Fracture of the sternum 9. Rupture of the left lung 10. Rupture of the left and right atria, heart tip and several large vessels 11. The aortic root is nearly transected 12. Severe rupture of the liver. Results: The common features of the two cases were the fracture or dislocation of the atlantoaxial joint and both helmets that were crashed. There were no atlantoaxial fractures or dislocations in 27 pedestrians (without wearing a helmet) versus motor vehicle accidents in 2017 the National database of an autopsy report, but there were two atlantoaxial fracture or dislocation cases in the database, both of which were cases of falling from height. Conclusion: The cervical spine fracture injury of the motorcyclist, who was wearing a helmet, is very likely to be a patterned injury caused by his/her fall and rollover under the sedan. It could provide a reference for forensic peers.Keywords: patterned injuries, atlantoaxial fracture or dislocation, accident reconstruction, motorcycle accident with helmet, forensic autopsy data
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