Search results for: movement variability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2627

Search results for: movement variability

2297 Discovering Event Outliers for Drug as Commercial Products

Authors: Arunas Burinskas, Aurelija Burinskiene

Abstract:

On average, ten percent of drugs - commercial products are not available in pharmacies due to shortage. The shortage event disbalance sales and requires a recovery period, which is too long. Therefore, one of the critical issues that pharmacies do not record potential sales transactions during shortage and recovery periods. The authors suggest estimating outliers during shortage and recovery periods. To shorten the recovery period, the authors suggest using average sales per sales day prediction, which helps to protect the data from being downwards or upwards. Authors use the outlier’s visualization method across different drugs and apply the Grubbs test for significance evaluation. The researched sample is 100 drugs in a one-month time frame. The authors detected that high demand variability products had outliers. Among analyzed drugs, which are commercial products i) High demand variability drugs have a one-week shortage period, and the probability of facing a shortage is equal to 69.23%. ii) Mid demand variability drugs have three days shortage period, and the likelihood to fall into deficit is equal to 34.62%. To avoid shortage events and minimize the recovery period, real data must be set up. Even though there are some outlier detection methods for drug data cleaning, they have not been used for the minimization of recovery period once a shortage has occurred. The authors use Grubbs’ test real-life data cleaning method for outliers’ adjustment. In the paper, the outliers’ adjustment method is applied with a confidence level of 99%. In practice, the Grubbs’ test was used to detect outliers for cancer drugs and reported positive results. The application of the Grubbs’ test is used to detect outliers which exceed boundaries of normal distribution. The result is a probability that indicates the core data of actual sales. The application of the outliers’ test method helps to represent the difference of the mean of the sample and the most extreme data considering the standard deviation. The test detects one outlier at a time with different probabilities from a data set with an assumed normal distribution. Based on approximation data, the authors constructed a framework for scaling potential sales and estimating outliers with Grubbs’ test method. The suggested framework is applicable during the shortage event and recovery periods. The proposed framework has practical value and could be used for the minimization of the recovery period required after the shortage of event occurrence.

Keywords: drugs, Grubbs' test, outlier, shortage event

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2296 Low-Cost Robotic-Assisted Laparoscope

Authors: Ege Can Onal, Enver Ersen, Meltem Elitas

Abstract:

Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.

Keywords: laparoscope, laparoscopy, low-cost, minimally invasive surgery, robotic-assisted surgery

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2295 Gender Differences in Walking Capacity and Cardiovascular Regulation in Patients with Peripheral Arterial Disease

Authors: Gabriel Cucato, Marilia Correia, Wagner Domingues, Aline Palmeira, Paulo Longano, Nelson Wolosker, Raphael Ritti-Dias

Abstract:

Women with peripheral arterial disease (PAD) present lower walking capacity in comparison with men. However, whether cardiovascular regulation is also different between genders is unknown. Thus, the aim of this study was to compare walking capacity and cardiovascular regulation between men and women with PAD. A total of 23 women (66±7 yrs) and 31 men (64±9 yrs) were recruited. Patients performed a 6-minute test and the onset claudication distance and total walking distance were measured. Additionally, cardiovascular regulation was assessed by arterial stiffness (pulse wave velocity and augmentation index) and heart rate variability (frequency domain). Independent T test or Mann-Whitney U test were performed. In comparison with men, women present lower onset claudication distance (108±66m vs. 143±50m; P=0.032) and total walking distance (286±83m vs. 361±91 m, P=0.007). Regarding cardiovascular regulation, there were no differences in heart rate variability SDNN (72±160ms vs. 32±22ms, P=0.587); RMSSD (75±209 vs. 25±22ms, P=0.726); pNN50 (11±17ms vs. 8±14ms, P=0.836) in women and men, respectively. Moreover, there were no difference in augmentation index (39±10% vs. 34±11%, P=0.103); pulse pressure (59±17mmHg vs. 56±19mmHg, P=0.593) and pulse wave velocity (8.6±2.6m\s vs. 9.0±2.7m/s, P=0.580). In conclusion, women have impaired walking capacity compared to men. However, sex differences were not observed on cardiovascular regulation in patients with PAD.

Keywords: exercise, intermittent claudication, cardiovascular load, arterial stiffness

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2294 Association between Noise Levels, Particulate Matter Concentrations and Traffic Intensities in a Near-Highway Urban Area

Authors: Mohammad Javad Afroughi, Vahid Hosseini, Jason S. Olfert

Abstract:

Both traffic-generated particles and noise have been associated with the development of cardiovascular diseases, especially in near-highway environments. Although noise and particulate matters (PM) have different mechanisms of dispersion, sharing the same emission source in urban areas (road traffics) can result in a similar degree of variability in their levels. This study investigated the temporal variation of and correlation between noise levels, PM concentrations and traffic intensities near a major highway in Tehran, Iran. Tehran particulate concentration is highly influenced by road traffic. Additionally, Tehran ultrafine particles (UFP, PM<0.1 µm) are mostly emitted from combustion processes of motor vehicles. This gives a high possibility of a strong association between traffic-related noise and UFP in near-highway environments of this megacity. Hourly average of equivalent continuous sound pressure level (Leq), total number concentration of UFPs, mass concentration of PM2.5 and PM10, as well as traffic count and speed were simultaneously measured over a period of three days in winter. Additionally, meteorological data including temperature, relative humidity, wind speed and direction were collected in a weather station, located 3 km from the monitoring site. Noise levels showed relatively low temporal variability in near-highway environments compared to PM concentrations. Hourly average of Leq ranged from 63.8 to 69.9 dB(A) (mean ~ 68 dB(A)), while hourly concentration of particles varied from 30,800 to 108,800 cm-3 for UFP (mean ~ 64,500 cm-3), 41 to 75 µg m-3 for PM2.5 (mean ~ 53 µg m-3), and 62 to 112 µg m-3 for PM10 (mean ~ 88 µg m-3). The Pearson correlation coefficient revealed strong relationship between noise and UFP (r ~ 0.61) overall. Under downwind conditions, UFP number concentration showed the strongest association with noise level (r ~ 0.63). The coefficient decreased to a lesser degree under upwind conditions (r ~ 0.24) due to the significant role of wind and humidity in UFP dynamics. Furthermore, PM2.5 and PM10 correlated moderately with noise (r ~ 0.52 and 0.44 respectively). In general, traffic counts were more strongly associated with noise and PM compared to traffic speeds. It was concluded that noise level combined with meteorological data can be used as a proxy to estimate PM concentrations (specifically UFP number concentration) in near-highway environments of Tehran. However, it is important to measure joint variability of noise and particles to study their health effects in epidemiological studies.

Keywords: noise, particulate matter, PM10, PM2.5, ultrafine particle

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2293 Exploring Electroactive Polymers for Dynamic Data Physicalization

Authors: Joanna Dauner, Jan Friedrich, Linda Elsner, Kora Kimpel

Abstract:

Active materials such as Electroactive Polymers (EAPs) are promising for the development of novel shape-changing interfaces. This paper explores the potential of EAPs in a multilayer unimorph structure from a design perspective to investigate the visual qualities of the material for dynamic data visualization and data physicalization. We discuss various concepts of how the material can be used for this purpose. Multilayer unimorph EAPs are of particular interest to designers because they can be easily prototyped using everyday materials and tools. By changing the structure and geometry of the EAPs, their movement and behavior can be modified. We present the results of our preliminary user testing, where we evaluated different movement patterns. As a result, we introduce a prototype display built with EAPs for dynamic data physicalization. Finally, we discuss the potentials and drawbacks and identify further open research questions for the design discipline.

Keywords: electroactive polymer, shape-changing interfaces, smart material interfaces, data physicalization

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2292 Sequence Analysis and Structural Implications of Rotavirus Capsid Proteins

Authors: Nishal Parbhoo, John B. Dewar, Samantha Gildenhuys

Abstract:

Rotavirus is the major cause of severe gastroenteritis worldwide in children aged 5 and younger. Death rates are high particularly in developing countries. The mature rotavirus is a non-enveloped triple-layered nucleocapsid containing 11 double-stranded RNA segments. Here a global view on the sequence and structure of the three main capsid proteins, VP7, VP6, and VP2 is taken by generating a consensus sequence for each of these rotavirus proteins, for each species obtained from published data of representative rotavirus genotypes from across the world and across species. The degree of conservation between species was represented on homology models for each of the proteins. VP7 shows the highest level of variation with 14 - 45 amino acids showing conservation of less than 60%. These changes are localized to the outer surface which is exposed to antibodies alluding to a possible mechanism in evading the immune system. The middle layer, VP6 shows lower variability with only 14-32 sites having lower than 70% conservation. The inner structural layer made up of VP2 showed the lowest variability with only 1-16 sites having less than 70% conservation across species. The results correlate with proteins’ multiple structural roles. Although the nucleotide sequences vary due to an error-prone replication and lack of proofreading, the corresponding amino acid sequence of VP2, 6 and 7 remains conserved. Sequence conservation maintained for the virus results in stable protein structures, fit for function. This can be exploited in drug design, molecular studies and biotechnological applications.

Keywords: amino acid sequence conservation, capsid protein, protein structure, vaccine candidate

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2291 Simulation of Stretching and Fragmenting DNA by Microfluidic for Optimizing Microfluidic Devices

Authors: Shuyi Wu, Chuang Li, Quanshui Zheng, Luping Xu

Abstract:

Stretching and snipping DNA molecule by microfluidic has important application value in gene analysis by lab on a chip. Movement, deformation and fragmenting of DNA in microfluidic are typical fluid-solid coupling problems. An efficient and common simulation system for researching the movement, deformation and fragmenting of DNA by microfluidic has not been well developed. In our study, Brownian dynamics-finite element method (BD-FEM) is used to simulate the dynamic process of stretching and fragmenting DNA by contraction flow. The shape and parameters of micro-channels are changed to optimize the stretching and fragmenting properties of DNA. Our results indicate that strain rate, resulting from contraction microchannel, is the main control parameter for stretching and fragmenting DNA. There is good consistency between the simulation data and previous experimental result about the single DNA molecule behavior and averaged fragmenting properties in this study. BD-FEM method is an efficient calculating tool to research stretching and fragmenting behavior of single DNA molecule and optimize microfluidic devices for manipulating, stretching and fragmenting DNA.

Keywords: fragmenting, DNA, microfluidic, optimize.

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2290 An Analysis of the Affect of Climate Change on Humanitarian Law: The Way Forward

Authors: Anjali Kanagali, Astha Sinha

Abstract:

Climate change is the greatest threat being faced by mankind in the 21st century. It no longer is merely an environmental, scientific or economic issue but is a humanitarian issue as well. Paris Agreement put great pressure on the businesses to reduce carbon emissions and mitigate the impact of climate change. However, the already increased climate variability and extreme weather are aggravating emergency humanitarian needs. According to the Intergovernmental Panel on Climate Change (IPCC), if efficient policy changes are not made in time to combat the climate change issues, the situation will deteriorate with an estimated global temperature rise of 4 degrees. The existing international network of Humanitarian system is not adequately structured to handle the projected natural disasters and climate change crisis. The 2030 Agenda which embraces the 17 Sustainable Development Goals (SGDs) discussed the relationship between the climate change and humanitarian assistance. The Humanitarian law aims to protect, amongst other things, ‘internally displaced persons’ which includes people displaced due to natural hazard related disasters engulfing the hazards of climate change. ‘Legal protection’ of displaced people to protect their rights is becoming a pressing need in such times. In this paper, attempts will be made to analyze the causes of the displacement, identify areas where the effect of the climate change is most likely to occur and to examine the character of forced displacement triggering population movement. We shall discuss the pressure on the Humanitarian system and assistance due to climate change issues and the need for vesting powers to the local communities or local government players to deal with the climate changes. We shall also discuss the possibility of setting up a new framework where non-state actors could be set up for climate change impact and its governance.

Keywords: humanitarian assistance to climate change, humanitarian crisis, internally displaced person, legal framework for climate migrants, non-state actors

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2289 Co-Integration Model for Predicting Inflation Movement in Nigeria

Authors: Salako Rotimi, Oshungade Stephen, Ojewoye Opeyemi

Abstract:

The maintenance of price stability is one of the macroeconomic challenges facing Nigeria as a nation. This paper attempts to build a co-integration multivariate time series model for inflation movement in Nigeria using data extracted from the abstract of statistics of the Central Bank of Nigeria (CBN) from 2008 to 2017. The Johansen cointegration test suggests at least one co-integration vector describing the long run relationship between Consumer Price Index (CPI), Food Price Index (FPI) and Non-Food Price Index (NFPI). All three series show increasing pattern, which indicates a sign of non-stationary in each of the series. Furthermore, model predictability was established with root-mean-square-error, mean absolute error, mean average percentage error, and Theil’s unbiased statistics for n-step forecasting. The result depicts that the long run coefficient of a consumer price index (CPI) has a positive long-run relationship with the food price index (FPI) and non-food price index (NFPI).

Keywords: economic, inflation, model, series

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2288 Current Global Education Trends: Issues and Challenges of Physical and Health Education Teaching and Learning in Nigerian Schools

Authors: Bichi Muktar Sani

Abstract:

The philosophy of Physical and Health Education is to develop academic and professional competency which will enable individuals earn a living and render unique services to the society and also provide good basis of knowledge and experience that characterize an educated and fully developed person through physical activities. With the increase of sedentary activities such as watching television, playing videogames, increased computer technology, automation and reduction of high school Physical and Health Education schedules, young people are most likely to become overweight, and less fit. Physical Education is a systematic instruction in sports, training, practice, gymnastics, exercises, and hygiene given as part of a school or college program. Physical and Health Education is the study, practice, and appreciation of the art and science of human movement. Physical and Health Education is course in the curricula that utilizes the learning in the cognitive, affective, and psychomotor domains in a lay or movement exploration setting. The paper made some recommendations on the way forward.

Keywords: issues, challenges, physical education, school

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2287 Spatiotemporal Changes in Drought Sensitivity Captured by Multiple Tree-Ring Parameters of Central European Conifers

Authors: Krešimir Begović, Miloš Rydval, Jan Tumajer, Kristyna Svobodová, Thomas Langbehn, Yumei Jiang, Vojtech Čada, Vaclav Treml, Ryszard Kaczka, Miroslav Svoboda

Abstract:

Environmental changes have increased the frequency and intensity of climatic extremes, particularly hotter droughts, leading to altered tree growth patterns and multi-year lags in tree recovery. The effects of shifting climatic conditions on tree growth are inhomogeneous across species’ natural distribution ranges, with large spatial heterogeneity and inter-population variability, but generally have significant consequences for contemporary forest dynamics and future ecosystem functioning. Despite numerous studies on the impacts of regional drought effects, large uncertainties remain regarding the mechanistic basis of drought legacy effects on wood formation and the ability of individual species to cope with increasingly drier growing conditions and rising year-to-year climatic variability. To unravel the complexity of climate-growth interactions and assess species-specific responses to severe droughts, we combined forward modeling of tree growth (VS-lite model) with correlation analyses against climate (temperature, precipitation, and the SPEI-3 moisture index) and growth responses to extreme drought events from multiple tree-ring parameters (tree-width and blue intensity parameters). We used an extensive dataset with over 1000 tree-ring samples from 23 nature forest reserves across an altitudinal range in Czechia and Slovakia. Our results revealed substantial spatiotemporal variability in growth responses to summer season temperature and moisture availability across species and tree-ring parameters. However, a general trend of increasing spring moisture-growth sensitivity in recent decades was observed in the Scots pine mountain forests and lowland forests of both species. The VS-lite model effectively captured nonstationary climate-growth relationships and accurately estimated high-frequency growth variability, indicating a significant incidence of regional drought events and growth reductions. Notably, growth reductions during extreme drought years and discrete legacy effects identified in individual wood components were most pronounced in the lowland forests. Together with the observed growth declines in recent decades, these findings suggest an increasing vulnerability of Norway spruce and Scots pine in dry lowlands under intensifying climatic constraints.

Keywords: dendroclimatology, Vaganova–Shashkin lite, conifers, central Europe, drought, blue intensity

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2286 Sensitivity Analysis of Principal Stresses in Concrete Slab of Rigid Pavement Made From Recycled Materials

Authors: Aleš Florian, Lenka Ševelová

Abstract:

Complex sensitivity analysis of stresses in a concrete slab of the real type of rigid pavement made from recycled materials is performed. The computational model of the pavement is designed as a spatial (3D) model, is based on a nonlinear variant of the finite element method that respects the structural nonlinearity, enables to model different arrangements of joints, and the entire model can be loaded by the thermal load. Interaction of adjacent slabs in joints and contact of the slab and the subsequent layer are modeled with the help of special contact elements. Four concrete slabs separated by transverse and longitudinal joints and the additional structural layers and soil to the depth of about 3m are modeled. The thickness of individual layers, physical and mechanical properties of materials, characteristics of joints, and the temperature of the upper and lower surface of slabs are supposed to be random variables. The modern simulation technique Updated Latin Hypercube Sampling with 20 simulations is used. For sensitivity analysis the sensitivity coefficient based on the Spearman rank correlation coefficient is utilized. As a result, the estimates of influence of random variability of individual input variables on the random variability of principal stresses s1 and s3 in 53 points on the upper and lower surface of the concrete slabs are obtained.

Keywords: concrete, FEM, pavement, sensitivity, simulation

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2285 Classification of ECG Signal Based on Mixture of Linear and Non-Linear Features

Authors: Mohammad Karimi Moridani, Mohammad Abdi Zadeh, Zahra Shahiazar Mazraeh

Abstract:

In recent years, the use of intelligent systems in biomedical engineering has increased dramatically, especially in the diagnosis of various diseases. Also, due to the relatively simple recording of the electrocardiogram signal (ECG), this signal is a good tool to show the function of the heart and diseases associated with it. The aim of this paper is to design an intelligent system for automatically detecting a normal electrocardiogram signal from abnormal one. Using this diagnostic system, it is possible to identify a person's heart condition in a very short time and with high accuracy. The data used in this article are from the Physionet database, available in 2016 for use by researchers to provide the best method for detecting normal signals from abnormalities. Data is of both genders and the data recording time varies between several seconds to several minutes. All data is also labeled normal or abnormal. Due to the low positional accuracy and ECG signal time limit and the similarity of the signal in some diseases with the normal signal, the heart rate variability (HRV) signal was used. Measuring and analyzing the heart rate variability with time to evaluate the activity of the heart and differentiating different types of heart failure from one another is of interest to the experts. In the preprocessing stage, after noise cancelation by the adaptive Kalman filter and extracting the R wave by the Pan and Tampkinz algorithm, R-R intervals were extracted and the HRV signal was generated. In the process of processing this paper, a new idea was presented that, in addition to using the statistical characteristics of the signal to create a return map and extraction of nonlinear characteristics of the HRV signal due to the nonlinear nature of the signal. Finally, the artificial neural networks widely used in the field of ECG signal processing as well as distinctive features were used to classify the normal signals from abnormal ones. To evaluate the efficiency of proposed classifiers in this paper, the area under curve ROC was used. The results of the simulation in the MATLAB environment showed that the AUC of the MLP and SVM neural network was 0.893 and 0.947, respectively. As well as, the results of the proposed algorithm in this paper indicated that the more use of nonlinear characteristics in normal signal classification of the patient showed better performance. Today, research is aimed at quantitatively analyzing the linear and non-linear or descriptive and random nature of the heart rate variability signal, because it has been shown that the amount of these properties can be used to indicate the health status of the individual's heart. The study of nonlinear behavior and dynamics of the heart's neural control system in the short and long-term provides new information on how the cardiovascular system functions, and has led to the development of research in this field. Given that the ECG signal contains important information and is one of the common tools used by physicians to diagnose heart disease, but due to the limited accuracy of time and the fact that some information about this signal is hidden from the viewpoint of physicians, the design of the intelligent system proposed in this paper can help physicians with greater speed and accuracy in the diagnosis of normal and patient individuals and can be used as a complementary system in the treatment centers.

Keywords: neart rate variability, signal processing, linear and non-linear features, classification methods, ROC Curve

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2284 Understanding the Nexus between Dengue and Climate Variability

Authors: Edilene Mercedes Mauer Machado, Carolina Hadassa Marques Karoly, Amanda Britz, Claudineia Brazil

Abstract:

The El Niño phenomenon, characterized by the anomalous warming of surface waters in the Equatorial Pacific Ocean, can influence weather patterns in various parts of the world, including the occurrence of extreme events such as droughts or heavy rainfall. Studies have suggested a relationship between El Niño and an increase in the incidence of dengue in certain areas. During El Niño periods, there can be changes in climatic conditions, such as increased temperatures and reduced rainfall in certain tropical and subtropical regions. These conditions can favor the reproduction of the Aedes aegypti mosquito, the vector for dengue transmission. Research aims to investigate how climate events like El Niño and La Niña can influence the incidence and transmission of dengue. The results have shown that, on average, there was a significant increase in dengue cases during La Niña years compared to years of climatic neutrality, contradicting the findings of Hopp et al. (2015). The study also highlighted that regions affected by El Niño exhibited greater variability in dengue incidence. However, it is important to emphasize that the effects of El Niño on dengue transmission can vary depending on the region and local factors, such as socioeconomic context and implemented control measures, as described by Johansson et al. (2009). Not all areas affected by El Niño will necessarily experience an increase in dengue incidence, and the interaction between climate and disease transmission is complex.

Keywords: anomalous warming, climatic patterns, dengue incidence, extreme events

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2283 Probability Fuzzy Aggregation Operators in Vehicle Routing Problem

Authors: Anna Sikharulidze, Gia Sirbiladze

Abstract:

For the evaluation of unreliability levels of movement on the closed routes in the vehicle routing problem, the fuzzy operators family is constructed. The interactions between routing factors in extreme conditions on the roads are considered. A multi-criteria decision-making model (MCDM) is constructed. Constructed aggregations are based on the Choquet integral and the associated probability class of a fuzzy measure. Propositions on the correctness of the extension are proved. Connections between the operators and the compositions of dual triangular norms are described. The conjugate connections between the constructed operators are shown. Operators reflect interactions among all the combinations of the factors in the fuzzy MCDM process. Several variants of constructed operators are used in the decision-making problem regarding the assessment of unreliability and possibility levels of movement on closed routes.

Keywords: vehicle routing problem, associated probabilities of a fuzzy measure, choquet integral, fuzzy aggregation operator

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2282 User Authentication Using Graphical Password with Sound Signature

Authors: Devi Srinivas, K. Sindhuja

Abstract:

This paper presents architecture to improve surveillance applications based on the usage of the service oriented paradigm, with smart phones as user terminals, allowing application dynamic composition and increasing the flexibility of the system. According to the result of moving object detection research on video sequences, the movement of the people is tracked using video surveillance. The moving object is identified using the image subtraction method. The background image is subtracted from the foreground image, from that the moving object is derived. So the Background subtraction algorithm and the threshold value is calculated to find the moving image by using background subtraction algorithm the moving frame is identified. Then, by the threshold value the movement of the frame is identified and tracked. Hence, the movement of the object is identified accurately. This paper deals with low-cost intelligent mobile phone-based wireless video surveillance solution using moving object recognition technology. The proposed solution can be useful in various security systems and environmental surveillance. The fundamental rule of moving object detecting is given in the paper, then, a self-adaptive background representation that can update automatically and timely to adapt to the slow and slight changes of normal surroundings is detailed. While the subtraction of the present captured image and the background reaches a certain threshold, a moving object is measured to be in the current view, and the mobile phone will automatically notify the central control unit or the user through SMS (Short Message System). The main advantage of this system is when an unknown image is captured by the system it will alert the user automatically by sending an SMS to user’s mobile.

Keywords: security, graphical password, persuasive cued click points

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2281 Relatively High Heart-Rate Variability Predicts Greater Survival Chances in Patients with Covid-19

Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

Abstract:

Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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2280 Physical Activity, Exercise and Physical Fitness in Different Generation

Authors: Carl J. Caspersen, Kenneth E. Powell, Gregory M. Christenson, Kirupa V. Patel

Abstract:

‘Physical activity’, ‘exercise’, and ‘physical fitness’ are terms that describe different concepts. However, they are often confused with one another, and the terms are sometimes used interchangeably. This paper proposes definitions to distinguish them. Physical activity is defined as any bodily movement produced by skeletal muscles that result in energy expenditure. The energy expenditure can be measured in kilocalories. Physical activity in daily life can be categorized into occupational, sports, Conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. Physical fitness is a set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests. These definitions are offered as an interpretational framework for comparing studies that relate physical activity, exercise, and physical fitness to health. Physical activity is defined as any bodily movement produced by skeletal muscles that require energy expenditure. Physical inactivity has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally. Regular moderate intensity physical activity – such as walking, cycling, or participating in sports – has significant benefits for health. For instance, it can reduce the risk of cardiovascular diseases, diabetes, colon and breast cancer, and depression. Moreover, adequate levels of physical activity will decrease the risk of a hip or vertebral fracture and help control weight. Any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level. In these guidelines, physical activity generally refers to the subset of physical activity that enhances health.

Keywords: physical activity, exercise, physical fitness, sports

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2279 Development of Underactuated Robot Hand Using Cross Section Deformation Spring

Authors: Naoki Saito, Daisuke Kon, Toshiyuki Sato

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This paper describes an underactuated robot hand operated by low-power actuators. It can grasp objects of various shapes using easy operations. This hand is suitable for use as a lightweight prosthetic hand that can grasp various objects using few input channels. To realize operations using a low-power actuator, a cross section deformation spring is proposed. The design procedure of the underactuated robot finger is proposed to realize an adaptive grasping movement. The validity of this mechanism and design procedure are confirmed through an object grasping experiment. Results demonstrate the effectiveness of a cross section deformation spring in reducing the actuator power. Moreover, adaptive grasping movement is realized by an easy operation.

Keywords: robot hand, underactuated mechanism, cross-section deformation spring, prosthetic hand

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2278 A Research on the Improvement of Small and Medium-Sized City in Early-Modern China (1895-1927): Taking Southern Jiangsu as an Example

Authors: Xiaoqiang Fu, Baihao Li

Abstract:

In 1895, the failure of Sino-Japanese prompted the trend of comprehensive and systematic study of western pattern in China. In urban planning and construction, urban reform movement sprang up slowly, which aimed at renovating and reconstructing the traditional cities into modern cities similar to the concessions. During the movement, Chinese traditional city initiated a process of modern urban planning for its modernization. Meanwhile, the traditional planning morphology and system started to disintegrate, on the contrary, western form and technology had become the paradigm. Therefore, the improvement of existing cities had become the prototype of urban planning of early modern China. Currently, researches of the movement mainly concentrate on large cities, concessions, railway hub cities and some special cities resembling those. However, the systematic research about the large number of traditional small and medium-sized cities is still blank, up to now. This paper takes the improvement constructions of small and medium-sized cities in Southern region of Jiangsu Province as the research object. First of all, the criteria of small and medium-sized cities are based on the administrative levels of general office and cities at the county level. Secondly, the suitability of taking the Southern Jiangsu as the research object. The southern area of Jiangsu province called Southern Jiangsu for short, was the most economically developed region in Jiangsu, and also one of the most economically developed and the highest urbanization regions in China. As the most developed agricultural areas in ancient China, Southern Jiangsu formed a large number of traditional small and medium-sized cities. In early modern times, with the help of the Shanghai economic radiation, geographical advantage and powerful economic foundation, Southern Jiangsu became an important birthplace of Chinese national industry. Furthermore, the strong business atmosphere promoted the widespread urban improvement practices, which were incomparable of other regions. Meanwhile, the demonstration of Shanghai, Zhenjiang, Suzhou and other port cities became the improvement pattern of small and medium-sized city in Southern Jiangsu. This paper analyzes the reform movement of the small and medium-sized cities in Southern Jiangsu (1895-1927), including the subjects, objects, laws, technologies and the influence factors of politic and society, etc. At last, this paper reveals the formation mechanism and characteristics of urban improvement movement in early modern China. According to the paper, the improvement of small-medium city was a kind of gestation of the local city planning culture in early modern China,with a fusion of introduction and endophytism.

Keywords: early modern China, improvement of small-medium city, southern region of Jiangsu province, urban planning history of China

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2277 Drivers on Climate in a Neotropical City: Urbanizations and Natural Variability

Authors: Nuria Vargas, Frances Rodriguez

Abstract:

Neotropical medium cities have opportunities to develop in a good manner. Xalapa City (Veracruz capital, Mexico) and its metropolitan region, near to the Gulf of Mexico, has already <1 million inhabitants, a medium city size, but it’s growing rapidly as several cities in Latin America. Inside a landscape where it had been a forest cloud and coffee land, emerges the city with an irregular topography. The rapid grow of the urbanization and the loss of vegetation has result in a change on the climate parameters. Frequently warms spells, floods and landslides had been impacted last 2 decades, also a higher incidence of dengue and diarrhea is mentioned in the region. Therefore, the analysis of hydrometeorological events is crucial to understand the role they play in its problem. The urbanization and others radiative forces has created a modulation that can explain the decadal climate changes on the Xalapa region. The Atlantic Multidecadal Oscillation directly influences the temperature and precipitation of the region, even more than climate change does. The total effect of these drivers can create a significant context that origin more risk. However, the most policies frequently consider only the climate change as a principal factor, but other drivers are important to consider and evaluate for the implementation of actions that improve our ambient and cities, in a context of climate change. Medium-sized cities could create better conditions for future citizens, preventing with urban planning that considers possible risks associated with weather and climate.

Keywords: natural variability, urbanization, atlantic multidecadal oscillation, land use changes

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2276 An Adaptive Decomposition for the Variability Analysis of Observation Time Series in Geophysics

Authors: Olivier Delage, Thierry Portafaix, Hassan Bencherif, Guillaume Guimbretiere

Abstract:

Most observation data sequences in geophysics can be interpreted as resulting from the interaction of several physical processes at several time and space scales. As a consequence, measurements time series in geophysics have often characteristics of non-linearity and non-stationarity and thereby exhibit strong fluctuations at all time-scales and require a time-frequency representation to analyze their variability. Empirical Mode Decomposition (EMD) is a relatively new technic as part of a more general signal processing method called the Hilbert-Huang transform. This analysis method turns out to be particularly suitable for non-linear and non-stationary signals and consists in decomposing a signal in an auto adaptive way into a sum of oscillating components named IMFs (Intrinsic Mode Functions), and thereby acts as a bank of bandpass filters. The advantages of the EMD technic are to be entirely data driven and to provide the principal variability modes of the dynamics represented by the original time series. However, the main limiting factor is the frequency resolution that may give rise to the mode mixing phenomenon where the spectral contents of some IMFs overlap each other. To overcome this problem, J. Gilles proposed an alternative entitled “Empirical Wavelet Transform” (EWT) which consists in building from the segmentation of the original signal Fourier spectrum, a bank of filters. The method used is based on the idea utilized in the construction of both Littlewood-Paley and Meyer’s wavelets. The heart of the method lies in the segmentation of the Fourier spectrum based on the local maxima detection in order to obtain a set of non-overlapping segments. Because linked to the Fourier spectrum, the frequency resolution provided by EWT is higher than that provided by EMD and therefore allows to overcome the mode-mixing problem. On the other hand, if the EWT technique is able to detect the frequencies involved in the original time series fluctuations, EWT does not allow to associate the detected frequencies to a specific mode of variability as in the EMD technic. Because EMD is closer to the observation of physical phenomena than EWT, we propose here a new technic called EAWD (Empirical Adaptive Wavelet Decomposition) based on the coupling of the EMD and EWT technics by using the IMFs density spectral content to optimize the segmentation of the Fourier spectrum required by EWT. In this study, EMD and EWT technics are described, then EAWD technic is presented. Comparison of results obtained respectively by EMD, EWT and EAWD technics on time series of ozone total columns recorded at Reunion island over [1978-2019] period is discussed. This study was carried out as part of the SOLSTYCE project dedicated to the characterization and modeling of the underlying dynamics of time series issued from complex systems in atmospheric sciences

Keywords: adaptive filtering, empirical mode decomposition, empirical wavelet transform, filter banks, mode-mixing, non-linear and non-stationary time series, wavelet

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2275 Multimodal Database of Emotional Speech, Video and Gestures

Authors: Tomasz Sapiński, Dorota Kamińska, Adam Pelikant, Egils Avots, Cagri Ozcinar, Gholamreza Anbarjafari

Abstract:

People express emotions through different modalities. Integration of verbal and non-verbal communication channels creates a system in which the message is easier to understand. Expanding the focus to several expression forms can facilitate research on emotion recognition as well as human-machine interaction. In this article, the authors present a Polish emotional database composed of three modalities: facial expressions, body movement and gestures, and speech. The corpora contains recordings registered in studio conditions, acted out by 16 professional actors (8 male and 8 female). The data is labeled with six basic emotions categories, according to Ekman’s emotion categories. To check the quality of performance, all recordings are evaluated by experts and volunteers. The database is available to academic community and might be useful in the study on audio-visual emotion recognition.

Keywords: body movement, emotion recognition, emotional corpus, facial expressions, gestures, multimodal database, speech

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2274 Pharmacokinetics of First-Line Tuberculosis Drugs in South African Patients from Kwazulu-Natal: Effects of Pharmacogenetic Variation on Rifampicin and Isoniazid Concentrations

Authors: Anushka Naidoo, Veron Ramsuran, Maxwell Chirehwa, Paolo Denti, Kogieleum Naidoo, Helen McIlleron, Nonhlanhla Yende-Zuma, Ravesh Singh, Sinaye Ngcapu, Nesri Padayatachi

Abstract:

Background: Despite efforts to introduce new drugs and shorter drug regimens for drug-susceptible tuberculosis (TB), the standard first-line treatment has not changed in over 50 years. Rifampicin, isoniazid, and pyrazinamide are critical components of the current standard treatment regimens. Some studies suggest that microbiologic failure and acquired drug resistance are primarily driven by low drug concentrations that result from pharmacokinetic (PK) variability independent of adherence to treatment. Wide between-patient pharmacokinetic variability for rifampin, isoniazid, and pyrazinamide has been reported in prior studies. There may be several reasons for this variability. However, genetic variability in genes coding for drug metabolizing and transporter enzymes have been shown to be a contributing factor for variable tuberculosis drug exposures. Objective: We describe the pharmacokinetics of first-line TB drugs rifampicin, isoniazid, and pyrazinamide and assess the effect of genetic variability in relevant selected drug metabolizing and transporter enzymes on pharmacokinetic parameters of isoniazid and rifampicin. Methods: We conducted the randomized-controlled Improving retreatment success TB trial in Durban, South Africa. The drug regimen included rifampicin, isoniazid, and pyrazinamide. Drug concentrations were measured in plasma, and concentration-time data were analysed using nonlinear-mixed-effects models to quantify the effects of relevant covariates and single nucleotide polymorphisms (SNP’s) of drug metabolizing and transporter genes on rifampicin, isoniazid and pyrazinamide exposure. A total of 25 SNP’s: four NAT2 (used to determine acetylator status), four SLCO1B1, three Pregnane X receptor (NR1), six ABCB1 and eight UGT1A, were selected for analysis in this study. Genotypes were determined for each of the SNP’s using a TaqMan® Genotyping OpenArray™. Results: Among fifty-eight patients studied; 41 (70.7%) were male, 97% black African, 42 (72.4%) HIV co-infected and 40 (95%) on efavirenz-based ART. Median weight, fat-free mass (FFM), and age at baseline were 56.9 kg (interquartile range, IQR: 51.1-65.2), 46.8 kg (IQR: 42.5-50.3) and 37 years (IQR: 31-42), respectively. The pharmacokinetics of rifampicin and pyrazinamide was best described using one-compartment models with first-order absorption and elimination, while for isoniazid two-compartment disposition was used. The median (interquartile range: IQR) AUC (h·mg/L) and Cmax (mg/L) for rifampicin, isoniazid, and pyrazinamide were; 25.62 (23.01-28.53) and 4.85 (4.36-5.40), 10.62 (9.20-12.25) and 2.79 (2.61-2.97), 345.74 (312.03-383.10) and 28.06 (25.01-31.52), respectively. Eighteen percent of patients were classified as rapid acetylators, and 34% and 43% as slow and intermediate acetylators, respectively. Rapid and intermediate acetylator status based on NAT 2 genotype resulted in 2.3 and 1.6 times higher isoniazid clearance than slow acetylators. We found no effects of the SLCO1B1 genotypes on rifampicin pharmacokinetics. Conclusion: Plasma concentrations of rifampicin, isoniazid, and pyrazinamide were low overall in our patients. Isoniazid clearance was high overall and as expected higher in rapid and intermediate acetylators resulting in lower drug exposures. In contrast to reports from previous South African or Ugandan studies, we did not find any effects of the SLCO1B1 or other genotypes tested on rifampicin PK. However, our findings are in keeping with more recent studies from Malawi and India emphasizing the need for geographically diverse and adequately powered studies. The clinical relevance of the low tuberculosis drug concentrations warrants further investigation.

Keywords: rifampicin, isoniazid pharmacokinetics, genetics, NAT2, SLCO1B1, tuberculosis

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2273 Soil Penetration Resistance and Water Content Spatial Distribution Following Different Tillage and Crop Rotation in a Chinese Mollisol

Authors: Xuewen Chen, Aizhen Liang, Xiaoping Zhang

Abstract:

To better understand the spatial variability of soil penetration resistance (SPR) and soil water content (SWC) induced by different tillage and crop rotation in a Mollisol of Northeast China, the soil was sampled from the tillage experiment which was established in Dehui County, Jilin Province, Northeast China, in 2001. Effect of no-tillage (NT), moldboard plow (MP) and ridge tillage (RT) under corn-soybean rotation (C-S) and continuous corn (C-C) system on SPR and SWC were compared with horizontal and vertical variations. The results showed that SPR and SWC spatially varied across the ridge. SPR in the rows was higher than inter-rows, especially in topsoil (2.5-15 cm) of NT and RT plots. SPR of MP changed in the trend with the curve-shaped ridge. In contrast to MP, NT, and RT resulted in average increment of 166.3% and 152.3% at a depth of 2.5-17.5 cm in the row positions, respectively. The mean SPR in topsoil in the rows means soil compaction is not the main factor limiting plant growth and crop yield. SPR in the row of RT soil was lower than NT at a depth of 2.5-12.5 cm. The SWC in NT and RT soil was highest in the inter-rows and least in the rows or shoulders, respectively. However, the lateral variation trend of MP was opposite to NT. From the profile view of SWC, MP was greater than NT and RT in 0-20 cm of the rows. SWC in RT soil was higher than NT in the row of 0-20 cm. Crop rotation did not have a marked impact on SPR and SWC. In addition to the tillage practices, the factor which affects SPR greatly was depth but not position. These two factors have significant effects on SWC. These results indicated that the adoption of RT was a more suitable conservation tillage practices than NT in the black soil of Northeast China.

Keywords: row, soil penetration resistance, spatial variability, tillage practice

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2272 Cardio Autonomic Response during Mental Stress in the Wards of Normal and Hypertensive Parents

Authors: Sheila R. Pai, Rekha D. Kini, Amrutha Mary

Abstract:

Objective: To assess and compare the cardiac autonomic activity after mental stress among the wards of normal and hypertensive parents. Methods: The study included 67 subjects, 30 of them had a parental history of hypertension and rest 37 had normotensive parents. Subjects were divided into control group (wards of normotensive parents) and Study group (wards of hypertensive parents). The height, weight were noted, and Body Mass Index (BMI) was also calculated. The mental stress test was carried out. Blood pressure (BP) and electro cardiogram (ECG) was recorded during normal breathing and after mental stress test. Heart rate variability (HRV) analysis was done by time domain method HRV was recorded and analyzed by the time-domain method. Analysis of HRV in the time-domain was done using the software version 1.1 AIIMS, New Delhi. The data obtained was analyzed using student’s t-test followed by Mann-Whitney U-test and P < 0.05 was considered significant. Results: There was no significant difference in systolic blood pressure and diastolic blood pressure (DBP) between study group and control group following mental stress. In the time domain analysis, the mean value of pNN50 and RMSSD of the study group was not significantly different from the control group after the mental stress test. Conclusion: The study thus concluded that there was no significant difference in HRV between study group and control group following mental stress.

Keywords: heart rate variability, time domain analysis, mental stress, hypertensive

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2271 2D and 3D Unsteady Simulation of the Heat Transfer in the Sample during Heat Treatment by Moving Heat Source

Authors: Zdeněk Veselý, Milan Honner, Jiří Mach

Abstract:

The aim of the performed work is to establish the 2D and 3D model of direct unsteady task of sample heat treatment by moving source employing computer model on the basis of finite element method. The complex boundary condition on heat loaded sample surface is the essential feature of the task. Computer model describes heat treatment of the sample during heat source movement over the sample surface. It is started from the 2D task of sample cross section as a basic model. Possibilities of extension from 2D to 3D task are discussed. The effect of the addition of third model dimension on the temperature distribution in the sample is showed. Comparison of various model parameters on the sample temperatures is observed. Influence of heat source motion on the depth of material heat treatment is shown for several velocities of the movement. Presented computer model is prepared for the utilization in laser treatment of machine parts.

Keywords: computer simulation, unsteady model, heat treatment, complex boundary condition, moving heat source

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2270 Human Vibrotactile Discrimination Thresholds for Simultaneous and Sequential Stimuli

Authors: Joanna Maj

Abstract:

Body machine interfaces (BMIs) afford users a non-invasive way coordinate movement. Vibrotactile stimulation has been incorporated into BMIs to allow feedback in real-time and guide movement control to benefit patients with cognitive deficits, such as stroke survivors. To advance research in this area, we examined vibrational discrimination thresholds at four body locations to determine suitable application sites for future multi-channel BMIs using vibration cues to guide movement planning and control. Twelve healthy adults had a pair of small vibrators (tactors) affixed to the skin at each location: forearm, shoulders, torso, and knee. A "standard" stimulus (186 Hz; 750 ms) and "probe" stimuli (11 levels ranging from 100 Hz to 235 Hz; 750 ms) were delivered. Probe and test stimulus pairs could occur sequentially or simultaneously (timing). Participants verbally indicated which stimulus felt more intense. Stimulus order was counterbalanced across tactors and body locations. Probabilities that probe stimuli felt more intense than the standard stimulus were computed and fit with a cumulative Gaussian function; the discrimination threshold was defined as one standard deviation of the underlying distribution. Threshold magnitudes depended on stimulus timing and location. Discrimination thresholds were better for stimuli applied sequentially vs. simultaneously at the torso as well as the knee. Thresholds were small (better) and relatively insensitive to timing differences for vibrations applied at the shoulder. BMI applications requiring multiple channels of simultaneous vibrotactile stimulation should therefore consider the shoulder as a deployment site for a vibrotactile BMI interface.

Keywords: electromyography, electromyogram, neuromuscular disorders, biomedical instrumentation, controls engineering

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2269 The Potential Effect of Climate Changes on Food and Water Associated Infections

Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

Abstract:

Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

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2268 Anatomical Characteristics of Superior Gluteal Artery

Authors: Nawaf Al-Kharashi, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

Abstract:

Superior gluteal artery is one of the largest branches of posterior division of the internal iliac artery. It passes between the lumbosacral and first sacral root to escape from the pelvic cavity through the grater sciatic foramen just above the piriformis. The current study includes 41 cadaver investigates the origin and branch of the superior gluteal artery and clarify the clinical significance. In present study, the superior gluteal artery arises from the posterior division of the internal iliac artery directly in 82.5% whereas it arises indirectly as from the sciatic artery in 15.9%. However, it is congenital absence in 1.6% which is compensated by sciatic artery. The sciatic nerve gains vascular supply from superior gluteal artery in two ways either during its course or giving lateral sacral artery in 27% and lumbar branches in 1.6%. It also supplies the adductors group and iliacus via giving obturator artery in 14.3% and in 1.6% respectively. The superior gluteal artery usually passes between lumbosacral trunk and first sacral root in 82.5% whereas it does not passes the sciatic roots as it arises behind them in 15.9%. With a variability of the superior gluteal artery origin, there is a variability of sciatic nerve roots supply. Further, the superior gluteal artery arising from sciatic artery behind the sciatic roots carries a high risk of intra-pelvic bleeding in case of posterior pelvic fracture. Prolonged ligation of the superior gluteal artery which gives lateral sacral artery may result in sciatic neuropathy. Therefore, surgeons have to be aware of the superior gluteal artery variation in origin, course and branches to reduce the iatrogenic faults.

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery. sciatic neuropathy, sciatic nerve

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