Search results for: idiopathic intracranial hypertension physics of CSF
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 994

Search results for: idiopathic intracranial hypertension physics of CSF

634 Pregnancy Outcome in Women with HIV Infection from a Tertiary Care Centre of India

Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

Abstract:

Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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633 Multimodal Ophthalmologic Evaluation Can Detect Retinal Injuries in Asymptomatic Patients With Primary Antiphospholipid Syndrome

Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

Abstract:

Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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632 Modeling Slow Crack Growth under Thermal and Chemical Effects for Fitness Predictions of High-Density Polyethylene Material

Authors: Luis Marquez, Ge Zhu, Vikas Srivastava

Abstract:

High-density polyethylene (HDPE) is one of the most commonly used thermoplastic polymer materials for water and gas pipelines. Slow crack growth failure is a well-known phenomenon in high-density polyethylene material and causes brittle failure well below the yield point with no obvious sign. The failure of transportation pipelines can cause catastrophic environmental and economic consequences. Using the non-destructive testing method to predict slow crack growth failure behavior is the primary preventative measurement employed by the pipeline industry but is often costly and time-consuming. Phenomenological slow crack growth models are useful to predict the slow crack growth behavior in the polymer material due to their ability to evaluate slow crack growth under different temperature and loading conditions. We developed a quantitative method to assess the slow crack growth behavior in the high-density polyethylene pipeline material under different thermal conditions based on existing physics-based phenomenological models. We are also working on developing an experimental protocol and quantitative model that can address slow crack growth behavior under different chemical exposure conditions to improve the safety, reliability, and resilience of HDPE-based pipeline infrastructure.

Keywords: mechanics of materials, physics-based modeling, civil engineering, fracture mechanics

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631 Moderating Effects of Future Career Interest in Science and Gender on Students' Achievement in Basic Science in Oyo State, Nigeria

Authors: Segun Jacob Ogunkunle

Abstract:

The study examined the moderating effects of future career interest in science and gender on achievement in basic science of students taught in a simulated laboratory and enriched laboratory guide material environments. It adopted the pretest-posttest control group quasi experimental design with a 3x2x2 factorial matrix. A total of 277 (130 males, 147 females; ± 17 years) junior secondary three students randomly selected from six purposively selected secondary schools based on availability of functional computer and physics laboratories participated in the study. Data were collected using achievement test in basic science (r=0.87) and future career interest in science (r=0.99) while analysis of covariance and estimated marginal means were used to test three hypotheses at 0.05 level of significance. The findings of the study show that future career interest in science had significant effect on students’ achievement in basic science whereas gender did not. The interaction effect of future career interest in science and gender on students’ achievement in basic science was not significant. It is therefore recommended that prior knowledge of students’ future career interest in science could be used to improve participation in basic science practical in order to enhance achievement in biology, chemistry, and physics at the post-basic education level in Nigeria.

Keywords: future career interest in science, basic science, simulated laboratory, enriched laboratory guide materials, achievement in science

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630 Pregnancy Outcomes in Women With History of COVID-19 in Alexandria, Egypt

Authors: Nermeen Elbeltagy, Helmy abd Elsatar, Sara Hassan, Mohamed Darwish

Abstract:

Introduction: with the inial appearance in Wuhan, China, in December 2019, the coronavirus disease-related respiratory infection (COVID-19) has rapidly spread among people all over the world. The WHO considered it a pandemic in March 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks have proved that pregnant females as well as their fetuses are exposed to adverse outcomes, including high rates of intensive care unit (ICU) admission and case fatality. Physiological changes occurring during pregnancy such as the increased transverse diameter of the thoracic cage as well as the elevation of the diaphragm can expose the mother to severe infections because of her decreased tolerance for hypoxia. Furthermore, vasodilation and changes in lung capacity can cause mucosal edema and an increase in upper respiratory tract secretions. In addition, the increased susceptibility to infection is enhanced by changes in cellmediated immunity. Aim of the work: to study the effect of COVID-19 on pregnant females admitted to El-Shatby Maternity University Hospital regarding maternal antepartum, intrapartum and postpartum adverse effects on the mothers and their neonates. Method: A retrospective cohort study was done between October 2020 and October 2022. Maternal characteristics and associated health conditions of COVID-19 positive parents were investigated. Also, the severity of their conditions and me of infection (first or second or third trimester)were explored. Cases were diagnosed based on presence of symptoms suggestive of COVID-19, laboratory tests (other than PCR) and radiological findings.all cases were confirmed by positive PCR test results. Results: The most common adverse maternal outcomes were pre-term labor (11.6%) followed by premature rupture of membranes (5.7%), post-partum hemorrhage (5.4%), preeclampsia (5.0%) and placental abrupon (4.3%). One sixth of the neonates of the studied paents were admied to NICUs and 6.5% of them had respiratory distress with no neonatal deaths. The majority of neonates (85.4%) had a birth weight of 2500- 4000g (normal range). Most of the neonates (77.9%) had an APGAR score of equal or more than 7 in 5 minutes. Conclusion: the most common comorbidity that might increase the incidence of COVID-19 before pregnancy were diabetes, cardiac disorders/ chronic hypertension and chronic obstructive lung diseases (non-asthma). During pregnancy, anemia followed by gestational diabetes and pre-eclampsia/gestational hypertension were the most prevalent comorbidity. So, severity of infection can be reduced by good antenatal care.

Keywords: COVID-19, pregnancy outcome, complicated pregnancy., COVID in Egypt

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629 Object-Based Flow Physics for Aerodynamic Modelling in Real-Time Environments

Authors: William J. Crowther, Conor Marsh

Abstract:

Object-based flow simulation allows fast computation of arbitrarily complex aerodynamic models made up of simple objects with limited flow interactions. The proposed approach is universally applicable to objects made from arbitrarily scaled ellipsoid primitives at arbitrary aerodynamic attitude and angular rate. The use of a component-based aerodynamic modelling approach increases efficiency by allowing selective inclusion of different physics models at run-time and allows extensibility through the development of new models. Insight into the numerical stability of the model under first order fixed-time step integration schemes is provided by stability analysis of the drag component. The compute cost of model components and functions is evaluated and compared against numerical benchmarks. Model static outputs are verified against theoretical expectations and dynamic behaviour using falling plate data from the literature. The model is applied to a range of case studies to demonstrate the efficacy of its application in extensibility, ease of use, and low computational cost. Dynamically complex multi-body systems can be implemented in a transparent and efficient manner, and we successfully demonstrate large scenes with hundreds of objects interacting with diverse flow fields.

Keywords: aerodynamics, real-time simulation, low-order model, flight dynamics

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628 Evaluation of Salt Content in Bread and the Amount Intake by Hypertensive Patients in the Algiers Region

Authors: S.lanasri, A.Boudjerrane, R.Belgherbi, O.Hadjoudj

Abstract:

Introduction: Bread is the most popular food in Algeria. The aim of this study was to examine the consumption of salt from bread by hypertensive patients. Materials and methods: sixty breads were collected from different artisans Algiers bakeries, each sample was mixed in harm distilled water until homogeneous and filtered. Analysis of the salt content was carried out according to the Mohr method titration. We calculated the amount of salt in bread consumed by 100 hypertensive patients using a questionnaire about the average amount of bread per day. Results: The salt content values from bread were 3.4g ± 0.37 NaCl / 100g.The average amount of salt consumed per day by patients from only bread was 3.82 g ± 3.8 with a maximum of 17 g per day. Only 38.18% of patients consume bread without salt even then 95% knew that excess salt intake can complicate hypertension. Conclusion: This study showed that bread is a major contributor to salt intake by Algerian hypertensive patients.

Keywords: salt, bread, hypertensive patients, Algiers

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627 Challenges of Management of Acute Pancreatitis in Low Resource Setting

Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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626 Advanced Magnetic Resonance Imaging in Differentiation of Neurocysticercosis and Tuberculoma

Authors: Rajendra N. Ghosh, Paramjeet Singh, Niranjan Khandelwal, Sameer Vyas, Pratibha Singhi, Naveen Sankhyan

Abstract:

Background: Tuberculoma and neurocysticercosis (NCC) are two most common intracranial infections in developing country. They often simulate on neuroimaging and in absence of typical imaging features cause significant diagnostic dilemmas. Differentiation is extremely important to avoid empirical exposure to antitubercular medications or nonspecific treatment causing disease progression. Purpose: Better characterization and differentiation of CNS tuberculoma and NCC by using morphological and multiple advanced functional MRI. Material and Methods: Total fifty untreated patients (20 tuberculoma and 30 NCC) were evaluated by using conventional and advanced sequences like CISS, SWI, DWI, DTI, Magnetization transfer (MT), T2Relaxometry (T2R), Perfusion and Spectroscopy. rCBV,ADC,FA,T2R,MTR values and metabolite ratios were calculated from lesion and normal parenchyma. Diagnosis was confirmed by typical biochemical, histopathological and imaging features. Results: CISS was most useful sequence for scolex detection (90% on CISS vs 73% on routine sequences). SWI showed higher scolex detection ability. Mean values of ADC, FA,T2R from core and rCBV from wall of lesion were significantly different in tuberculoma and NCC (P < 0.05). Mean values of rCBV, ADC, T2R and FA for tuberculoma and NCC were (3.36 vs1.3), (1.09x10⁻³vs 1.4x10⁻³), (0.13 x10⁻³ vs 0.09 x10⁻³) and (88.65 ms vs 272.3 ms) respectively. Tuberculomas showed high lipid peak, more choline and lower creatinine with Ch/Cr ratio > 1. T2R value was most significant parameter for differentiation. Cut off values for each significant parameters have proposed. Conclusion: Quantitative MRI in combination with conventional sequences can better characterize and differentiate similar appearing tuberculoma and NCC and may be incorporated in routine protocol which may avoid brain biopsy and empirical therapy.

Keywords: advanced functional MRI, differentiation, neurcysticercosis, tuberculoma

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625 A Case Report on Diaphragm Disease of Small Bowel Following Usage of Non-Steroidal Anti-Inflammatory Drugs

Authors: Shivani Kuttuva, Bridget Fergie, Andrew Mishreki, Shovkat Mir, Fintan Bergin

Abstract:

Diaphragm disease (DD) of the small bowel is a condition wherein the bowel lumen is divided into a series of short compartments by multiple circumferential membranes of mucosa and submucosa, leading to pinhole lumen and subsequent obstruction. It is a rare condition commonly attributed to non-steroidal anti-inflammatory drugs (NSAIDs) usage. Herein we present a 31-yr-old-female with a history of NSAIDs usage for one year following neurosurgery, who presented with recurrent idiopathic small bowel obstruction, recalcitrant anaemia, and impaction of capsule endoscope on investigating for anaemia. The capsule endoscopy images demonstrated multiple circumferential strictures with ulcers at its tip and villous atrophy in the proximal bowel, suggestive of NSAIDs related damage. However, due to the lack of awareness of the detrimental effects of NSAIDs on bowel mucosa distal to the duodenum, the underlying aetiology of this clinical presentation remained a mystery for a significant duration. The patient had to undergo repeated laparotomies in order to relieve the symptoms of recurring acute small bowel obstruction. Upon examining the resected specimen under microscopy, the histopathological hallmark of expanded, fibrotic, and congested submucosa was picked up, leading to the confirmation of diaphragm disease. Thus, this case report aims to widen the awareness among clinicians and aid surgeons in devising a management plan for young individuals presenting with recurring episodes of obstruction due to Diaphragm disease.

Keywords: capsule endoscopy, diaphragm disease, NSAIDs, recurrent small bowel obstruction

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624 Study of Silent Myocardial Ischemia in Type 2 Diabeic Males: Egyptian Experience

Authors: Ali Kassem, Yhea Kishik, Ali Hassan, Mohamed Abdelwahab

Abstract:

Introduction: Accelerated coronary and peripheral vascular atherosclerosis is one of the most common and chronic complications of diabetes mellitus. A recent aspect of coronary artery disease in this condition is its silent nature. The aim of the work: Detection of the prevalence of silent myocardial ischemia (SMI) in Upper Egypt type 2 diabetic males and to select male diabetic population who should be screened for SMI. Patients and methods: 100 type 2 diabetic male patients with a negative history of angina or anginal equivalent symptoms and 30 healthy control were included. Full medical history and thorough clinical examination were done for all participants. Fasting and post prandial blood glucose level, lipid profile, (HbA1c), microalbuminuria, and C-reactive protein were done for all participants Resting ECG, trans-thoracic echocardiography, treadmill exercise ECG, myocardial perfusion imaging were done for all participants and patients positive for one or more NITs were subjected for coronary angiography. Results Twenty nine patients (29%) were positive for one or more NITs in the patients group compared to only one case (3.3%) in the controls. After coronary angiography, 20 patients were positive for significant coronary artery stenosis in the patients group, while it was refused to be done by the patient in the controls. There were statistical significant difference between the two groups regarding, hypertension, dyslipidemia and obesity, family history of DM and IHD with higher levels of microalbuminuria, C-reactive protein, total lipids in patient group versus controls According to coronary angiography, patients were subdivided into two subgroups, 20 positive for SMI (positive for coronary angiography) and 80 negative for SMI (negative for coronary angiography). No statistical difference regarding family history of DM and type of diabetic therapy was found between the two subgroups. Yet, smoking, hypertension, obesity, dyslipidemia and family history of IHD were significantly higher in diabetics positive versus those negative for SMI. 90% of patients in subgroup positive for SMI had two or more cardiac risk factors while only two patients had one cardiac risk factor (10%). Uncontrolled DM was detected more in patients positive for SMI. Diabetic complications were more prevalent in patients positive for SMI versus those negative for SMI. Most of the patients positive for SMI have DM more than 5 years duration. Resting ECG and resting Echo detected only 6 and 11 cases, respectively, of the 20 positive cases in group positive for SMI compared to treadmill exercise ECG and myocardial perfusion imaging that detected 16 and 18 cases respectively, Conclusion: Type 2 diabetic male patients should be screened for detection of SMI when aged above 50 years old, diabetes duration is more than 5 years, presence of two or more cardiac risk factors and/or patients suffering from one or more of the chronic diabetic complications. CRP, is an important parameter for selection of type 2 diabetic male patients who should be screened for SMI. Non invasive cardiac tests are reliable for screening of SMI in these patients in our locality.

Keywords: C-reactive protein, Silent myocardial ischemia, Stress tests, type 2 DM

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623 Differential Expression of GABA and Its Signaling Components in Ulcerative Colitis and Irritable Bowel Syndrome Pathogenesis

Authors: Surbhi Aggarwal, Jaishree Paul

Abstract:

Background: Role of GABA has been implicated in autoimmune diseases like multiple sclerosis, type1 diabetes and rheumatoid arthritis where they modulate the immune response but role in gut inflammation has not been defined. Ulcerative colitis (UC) and diarrhoeal predominant irritable bowel syndrome (IBS-D) both involve inflammation of gastrointestinal tract. UC is a chronic, relapsing and idiopathic inflammation of gut. IBS is a common functional gastrointestinal disorder characterised by abdominal pain, discomfort and alternating bowel habits. Mild inflammation is known to occur in IBS-D. Aim: Aim of this study was to investigate the role of GABA in UC as well as in IBS-D. Materials and methods: Blood and biopsy samples from UC, IBS-D and controls were collected. ELISA was used for measuring level of GABA in serum of UC, IBS-D and controls. RT-PCR analysis was done to determine GABAergic signal system in colon biopsy of UC, IBS-D and controls. RT-PCR was done to check the expression of proinflammatory cytokines. CurveExpert 1.4, Graphpad prism-6 software were used for data analysis. Statistical analysis was done by unpaired, two-way student`s t-test. All sets of data were represented as mean± SEM. A probability level of p < 0.05 was considered statistically significant. Results and conclusion: Significantly decreased level of GABA and altered GABAergic signal system was detected in UC and IBS-D as compared to controls. Significantly increased expression of proinflammatory cytokines was also determined in UC and IBS-D as compared to controls. Hence we conclude that insufficient level of GABA in UC and IBS-D leads to overproduction of proinflammatory cytokines which further contributes to inflammation. GABA may be used as a promising therapeutic target for treatment of gut inflammation or other inflammatory diseases.

Keywords: diarrheal predominant irritable bowel syndrome, γ-aminobutyric acid (GABA), inflammation, ulcerative colitis

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622 Feedback Matrix Approach for Relativistic Runaway Electron Avalanches Dynamics in Complex Electric Field Structures

Authors: Egor Stadnichuk

Abstract:

Relativistic runaway electron avalanches (RREA) are a widely accepted source of thunderstorm gamma-radiation. In regions with huge electric field strength, RREA can multiply via relativistic feedback. The relativistic feedback is caused both by positron production and by runaway electron bremsstrahlung gamma-rays reversal. In complex multilayer thunderstorm electric field structures, an additional reactor feedback mechanism appears due to gamma-ray exchange between separate strong electric field regions with different electric field directions. The study of this reactor mechanism in conjunction with the relativistic feedback with Monte Carlo simulations or by direct solution of the kinetic Boltzmann equation requires a significant amount of computational time. In this work, a theoretical approach to study feedback mechanisms in RREA physics is developed. It is based on the matrix of feedback operators construction. With the feedback matrix, the problem of the dynamics of avalanches in complex electric structures is reduced to the problem of finding eigenvectors and eigenvalues. A method of matrix elements calculation is proposed. The proposed concept was used to study the dynamics of RREAs in multilayer thunderclouds.

Keywords: terrestrial Gamma-ray flashes, thunderstorm ground enhancement, relativistic runaway electron avalanches, gamma-rays, high-energy atmospheric physics, TGF, TGE, thunderstorm, relativistic feedback, reactor feedback, reactor model

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621 The Morphological and Morphometrical Evaluation of the Bores That Transmit Emissary Veins in Terms of Surgery

Authors: Fikri Turk, Sahika Pinar Akyer, Mevci Ozdemir, Mehmet Bulent Ozdemir, Ilgaz Akdogan

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The complications such as bleeding, thrombosis and air embolism depend on injuries emissary veins is often encountered in surgery. Detailed descriptions of the mastoid foramen, occipital foramen, parietal foramen, posterior condylar canal and foramen vesalius are lacking in the literature. For this reason, the purpose of our study was to explore and represent the morphology and morphometry of these emissary foramina in order to prevent complications and to guide for surgeons. The present study was made on 60 dry human skull in the laboratories of Pamukkale University, Faculty of Medicine Department of Anatomy. After taken photograph of emissary foramens by Canon 650D professional camera, the evaluation and measurement’s these foramens made with Matlab program by computer. The overall prevalence of mastoid foramen was 90.52%, occipital foramen was 72.52%, parietal foramen was 42.85%, posterior condylar canal was 91.25% and foramen vesalius was 78.26%. The mean diameter of the mastoid foramen was 1.81±0.76 mm, occipital foramen was 1.20±0.25 mm, parietal foramen was 1.49±0.46 mm, posterior condylar canal was 2.83±1.33 mm and foramen vesalius was 1.74±0.60 mm. Distances between emissary foramina and fixed bony landmarks were measured. Emissary veins are important in clinic practice and surgical procedures because they act a route of spread of exracranial infection to the intracranial structures and these veins may be a significant bleeding during surgery of the skull and they can be source of thrombosis and air embolism. The detailed anatomical knowledge of these veins and foraminas may help to prevent complications and to guide for surgeons.

Keywords: emissary foramina, mastoid foramen, occipital foramen, parietal foramen, posterior condylar canal, foramen vesalius, morphology, morphometry

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620 A Strategy to Reduce Salt Intake: The Use of a Seasoning Obtained from Wine Pomace

Authors: María Luisa Gonzalez-SanJose, Javier Garcia-Lomillo, Raquel Del Pino, Miriam Ortega-Heras, Maria Dolores Rivero-Perez, Pilar Muñiz-Rodriguez

Abstract:

One of the most preoccupant problems related to the diet of the occidental societies is the high salt intake. In Spain, salt intake is almost twice as recommended by the World Health Organization (WHO). A lot of negative health effects of high sodium intake have been described being the hypertension, cardiovascular and coronary diseases ones of the most important. Due to this fact, government and other institutions are working on the gradual reduction of this consumption. Intake of meat products have been described as the main processed products that bring salt to the diet, followed by snacks and savory crackers. However, fortunately, the food industry has also raised awareness of this problem and is working intensely, and in recent years attempts to reduce the salt content in processed products, and is developing special lines with low sodium content. It is important to consider that processed food are the main source of sodium in occidental countries. One of the possible strategies to reduce the salt content in food is to find substitutes that can emulate their taste properties without adding much sodium or products that mask or substitute salty sensations with other flavors and aromas. In this sense, multiple products have been proposed and used until now. Potassium salts produce similar salty sensations without bring sodium, however their intake should be also limited, by healthy reasons. Furthermore, some potassium salts shows some better notes. Other alternatives are the use of flavor enhancers, spices, aromatic herbs, sea-plant derivate products, etc. The wine pomace is rich in potassium salts, content organic acid and other flavored substances, therefore it could be an interesting raw material to obtain derived products that could be useful as alternative ‘seasonings’. Considering previous comments, the main aim of this study was to evaluate the possible use of a natural seasoning, made from red wine pomace, in two different foods, crackers and burgers. The seasoning was made in the pilot plant of food technology of the University of Burgos, where the studied crackers and patties were also made. Different members of the University, students, docent and administrative personal, taste the products, and a trained panel evaluated salty intensity. The seasoning in addition to potassium contain significant levels of dietary fiber and phenolic compounds, which also makes it interesting as a functional ingredient. Both burgers and crackers made with the seasoning showed better taste that those without salt. Obviously, they showed lower sodium content than normal formulation, and were richer in potassium, antioxidant and fiber. Then, they showed lower values of the relation Na/K. All these facts are correlated with more ‘healthy’ products especially to that people with hypertension and other coronary dysfunctions.

Keywords: healthy foods, low salt, seasoning, wine pomace

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619 Analysis of Basic Science Curriculum as Correlates of Secondary School Students' Achievement in Science Test in Oyo State

Authors: Olubiyi Johnson Ezekiel

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Basic science curriculum is an on-going effort towards developing the potential of manner to produce individuals in a holistic and integrated person, who are intellectually, spiritually, emotionally and physically balanced and harmonious. The main focus of this study is to determine the relationship between students’ achievement in junior school certificate examination (JSCE) and senior school basic science achievement test (SSBSAT) on the basis of all the components of basic science. The study employed the descriptive research of the survey type and utilized junior school certificate examination and senior school basic science achievement test(r = .87) scores as instruments. The data collected were subjected to Pearson product moment correlation, Spearman rank correlation, regression analysis and analysis of variance. The result of the finding revealed that the mean effects of the achievement in all the components of basic science on SSBSAT are significantly different from zero. Based on the results of the findings, it was concluded that the relationship between students’ achievement in JSCE and SSBSAT was weak and to achieve a unit increase in the students’ achievement in the SSBSAT when other subjects are held constant, we have to increase the learning of: -physics by 0.081 units; -chemistry by 0.072 units; -biology by 0.025 units and general knowledge by 0.097 units. It was recommended among others, that general knowledge aspect of basic science should be included in either physics or chemistry aspect of basic science.

Keywords: basic science curriculum, students’ achievement, science test, secondary school students

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618 Iontophoretic Drug Transport: An Non-Invasive Transdermal Approach

Authors: Ashish Jain, Shivam Tayal

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There has been great interest in the field of Iontophoresis since few years due to its great applications in the field of controlled transdermal drug delivery system. It is an technique which is used to enhance the transdermal permeation of ionized high molecular weight molecules across the skin membrane especially Peptides & Proteins by the application of direct current of 1-4 mA for 20-40 minutes whereas chemical must be placed on electrodes with same charge. Iontophoresis enhanced the delivery of drug into the skin via pores like hair follicles, sweat gland ducts etc. rather than through stratum corneum. It has wide applications in the field of experimental, Therapeutic, Diagnostic, Dentistry etc. Medical science is using it to treat Hyperhidrosis (Excessive sweating) in hands and feet and to treat other ailments like hypertension, Migraine etc. Nowadays commercial transdermal iontophoretic patches are available in the market to treat different ailments. Researchers are keen to research in this field due to its vast applications and advantages.

Keywords: iontophoresis, novel drug delivery, transdermal, permeation enhancer

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617 Computationally Efficient Electrochemical-Thermal Li-Ion Cell Model for Battery Management System

Authors: Sangwoo Han, Saeed Khaleghi Rahimian, Ying Liu

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Vehicle electrification is gaining momentum, and many car manufacturers promise to deliver more electric vehicle (EV) models to consumers in the coming years. In controlling the battery pack, the battery management system (BMS) must maintain optimal battery performance while ensuring the safety of a battery pack. Tasks related to battery performance include determining state-of-charge (SOC), state-of-power (SOP), state-of-health (SOH), cell balancing, and battery charging. Safety related functions include making sure cells operate within specified, static and dynamic voltage window and temperature range, derating power, detecting faulty cells, and warning the user if necessary. The BMS often utilizes an RC circuit model to model a Li-ion cell because of its robustness and low computation cost among other benefits. Because an equivalent circuit model such as the RC model is not a physics-based model, it can never be a prognostic model to predict battery state-of-health and avoid any safety risk even before it occurs. A physics-based Li-ion cell model, on the other hand, is more capable at the expense of computation cost. To avoid the high computation cost associated with a full-order model, many researchers have demonstrated the use of a single particle model (SPM) for BMS applications. One drawback associated with the single particle modeling approach is that it forces to use the average current density in the calculation. The SPM would be appropriate for simulating drive cycles where there is insufficient time to develop a significant current distribution within an electrode. However, under a continuous or high-pulse electrical load, the model may fail to predict cell voltage or Li⁺ plating potential. To overcome this issue, a multi-particle reduced-order model is proposed here. The use of multiple particles combined with either linear or nonlinear charge-transfer reaction kinetics enables to capture current density distribution within an electrode under any type of electrical load. To maintain computational complexity like that of an SPM, governing equations are solved sequentially to minimize iterative solving processes. Furthermore, the model is validated against a full-order model implemented in COMSOL Multiphysics.

Keywords: battery management system, physics-based li-ion cell model, reduced-order model, single-particle and multi-particle model

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616 High Accuracy Analytic Approximations for Modified Bessel Functions I₀(x)

Authors: Pablo Martin, Jorge Olivares, Fernando Maass

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A method to obtain analytic approximations for special function of interest in engineering and physics is described here. Each approximate function will be valid for every positive value of the variable and accuracy will be high and increasing with the number of parameters to determine. The general technique will be shown through an application to the modified Bessel function of order zero, I₀(x). The form and the calculation of the parameters are performed with the simultaneous use of the power series and asymptotic expansion. As in Padé method rational functions are used, but now they are combined with other elementary functions as; fractional powers, hyperbolic, trigonometric and exponential functions, and others. The elementary function is determined, considering that the approximate function should be a bridge between the power series and the asymptotic expansion. In the case of the I₀(x) function two analytic approximations have been already determined. The simplest one is (1+x²/4)⁻¹/⁴(1+0.24273x²) cosh(x)/(1+0.43023x²). The parameters of I₀(x) were determined using the leading term of the asymptotic expansion and two coefficients of the power series, and the maximum relative error is 0.05. In a second case, two terms of the asymptotic expansion were used and 4 of the power series and the maximum relative error is 0.001 at x≈9.5. Approximations with much higher accuracy will be also shown. In conclusion a new technique is described to obtain analytic approximations to some functions of interest in sciences, such that they have a high accuracy, they are valid for every positive value of the variable, they can be integrated and differentiated as the usual, functions, and furthermore they can be calculated easily even with a regular pocket calculator.

Keywords: analytic approximations, mathematical-physics applications, quasi-rational functions, special functions

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615 Epilepsy Seizure Prediction by Effective Connectivity Estimation Using Granger Causality and Directed Transfer Function Analysis of Multi-Channel Electroencephalogram

Authors: Mona Hejazi, Ali Motie Nasrabadi

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Epilepsy is a persistent neurological disorder that affects more than 50 million people worldwide. Hence, there is a necessity to introduce an efficient prediction model for making a correct diagnosis of the epileptic seizure and accurate prediction of its type. In this study we consider how the Effective Connectivity (EC) patterns obtained from intracranial Electroencephalographic (EEG) recordings reveal information about the dynamics of the epileptic brain and can be used to predict imminent seizures, as this will enable the patients (and caregivers) to take appropriate precautions. We use this definition because we believe that effective connectivity near seizures begin to change, so we can predict seizures according to this feature. Results are reported on the standard Freiburg EEG dataset which contains data from 21 patients suffering from medically intractable focal epilepsy. Six channels of EEG from each patients are considered and effective connectivity using Directed Transfer Function (DTF) and Granger Causality (GC) methods is estimated. We concentrate on effective connectivity standard deviation over time and feature changes in five brain frequency sub-bands (Alpha, Beta, Theta, Delta, and Gamma) are compared. The performance obtained for the proposed scheme in predicting seizures is: average prediction time is 50 minutes before seizure onset, the maximum sensitivity is approximate ~80% and the false positive rate is 0.33 FP/h. DTF method is more acceptable to predict epileptic seizures and generally we can observe that the greater results are in gamma and beta sub-bands. The research of this paper is significantly helpful for clinical applications, especially for the exploitation of online portable devices.

Keywords: effective connectivity, Granger causality, directed transfer function, epilepsy seizure prediction, EEG

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614 Assessment of Occupational Health and Safety Conditions of Health Care Workers in Barangay Health Centers in a Selected City in Metro Manila

Authors: Deinzel R. Uezono, Vivien Fe F. Fadrilan-Camacho, Bianca Margarita L. Medina, Antonio Domingo R. Reario, Trisha M. Salcedo, Luke Wesley P. Borromeo

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The environment of health care workers is considered one of the most hazardous settings due to the nature of their work. In developing countries especially, the Philippines, this continues to be overlooked in terms of programs and services on occupational health and safety (OHS). One possible reason for this is the existing information gap on OHS which limits data comparability and impairs effective monitoring and assessment of interventions. To address this gap, there is a need to determine the current conditions of Filipino health care workers in their workplace. This descriptive cross-sectional study assessed the occupational health and safety conditions of health care workers in barangay health centers in a selected city in Metro Manila, Philippines by: (1) determining the hazards present in the workplace; (2) determining the most common self-reported medical problems; and (3) describing the elements of an OHS system based on the six building blocks of health system. Assessment was done through walkthrough survey, self-administered questionnaire, and key informant interview. Data analysis was done using Epi Info 7 and NVivo 11. Results revealed different health hazards present in the workplace particularly biological hazards (exposure to sick patients and infectious specimens), physical hazards (inadequate space and/or lighting), chemical hazards (toxic reagents and flammable chemicals), and ergonomic hazards (activities requiring repetitive motion and awkward posture). Additionally, safety hazards (improper capping of syringe and lack of fire safety provisions) were also observed. Meanwhile, the most commonly self-reported chronic diseases among health care workers (N=336) were hypertension (20.24%, n=68) and diabetes (12.50%, n=42). Top commonly self-reported symptoms were colds (66.07%, n=222), coughs (63.10%, n=212), headache (55.65%, n=187), and muscle pain (50.60%, n=170) while other diseases were influenza (16.96%, n=57) and UTI (15.48%, n=52). In terms of the elements of the OHS system, a general policy on occupational health and safety was found to be lacking and in effect, an absence of health and safety committee overseeing the implementing and monitoring of the policy. No separate budget specific for OHS programs and services was also found to be a limitation. As a result, no OHS personnel and trainings/seminar were identified. No established information system for OHS was in place. In conclusion, health and safety hazards were observed to be present across the barangay health centers visited in a selected city in Metro Manila. Medical conditions identified as most commonly self-reported were hypertension and diabetes for chronic diseases; colds, coughs, headache, and muscle pain for medical symptoms; and influenza and UTI for other diseases. As for the elements of the occupational health and safety system, there was a lack in the general components of the six building blocks of the health system.

Keywords: health hazards, occupational health and safety, occupational health and safety system, safety hazards

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613 Computed Tomography Differential Diagnose of Intraventicular Masses in the Emergency Departemen

Authors: Angelis P. Barlampas

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Purpose: A 29 years old woman presented in the emergency department with psychiatric symptoms. The psychiatrist ordered a computed tomography scan as part of a general examination. Material and methods: The CT showed bilateral enlarged choroid plexus structures mimicking papillomata and situated in the trigones of the lateral ventricles. The left choroid plexus was heavily calcified, but the right one has no any obvious calcifications. Results: It is well kown that any brain mass can present with behavioral changes and even psychiatric symptomatology. Papillomata of the ventricular system have been described to cause psychotic episodes. According to literature, choroid plexus papillomas are seldom neuroepithelial intraventricular tumors, which are benign and categorized as WHO grade 1 tumors. They are more common in the pediatric population, but they can occur in the adults, too1. In addition, the distinction between choroid plexus papilloma and carcinoma is very difficult and impossible by imagine alone. It can only be implied with more advanced imaging, such as arterial spin labeling and MRI. The final diagnosis is, of course, after surgical excision. The usual location in adults is the fourth ventricle, but in children, it is the lateral ventricles. Their imaging appearance is that of a solid vascular tumor, which enhances intensely after the intravenous administration of contrast material. One out of fourth tumors presents speckled calcifications1. In our case, there are symmetrically sized masses at the trigones, and there are no calcifications in one of them, whereas the other one is grossly calcified. Also, there is no obvious hydrocephalus or any other evidence of increased intracranial pressure. General conclusions: When there is a new psychiatric patient, someone must undergo any possible examination, and of course, a brain CT study should be done to exclude any rare organic causes that may be responsible for the disease.

Keywords: phycosis, intraventricular masses, CT, brain calcifications

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612 Experimental Activity on the Photovoltaic Effect

Authors: Salomão Manuel Francisco, Manuel António Salgueiro Da Silva, Bento Filipe Barreiras Pinto Cavadas, Teresa Monteiro Seixas

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In bachelor's degrees in Physics Education framework in Angola, and to a certain extent, within the community of Portuguese language countries (CPLP), teaching methodologies rely heavily on theoretical memorization and mathematical demonstrations. This approach often discourages students, particularly the female population, as the reliance on theoretical mathematical demonstrations generates the perception of Physics as an arduous, challenging discipline. To address this challenge and recognize the value of practical application as an evaluative criterion of material truth, we propose a practical activity in Environmental Physics that will be shared with Angolan higher education teachers, who will receive full scaffolding and support from the authors. These teachers, adopting and developing similar activities in a classroom setting, will contribute to the environmental education framework as well. Additionally, this work aligns with different goals of UNESCO's 2030 agenda, namely, specifically, goals 4, 5, 7, 11, 13, and 17. The experimental activity developed in this work is centered around the demonstration of the photovoltaic effect and its application for renewable energy production. The first objective of the activity is to study the variation of electrical power supplied by a photovoltaic system (PV) to an electrical circuit as the angle of light incidence changes. Students can observe that the power supplied to the circuit is greater when light rays fall perpendicularly on the PV. However, as the angle of incidence increases, resulting in a larger area covered by the light rays, the power supplied to the circuit decreases due to lower irradiance. The second objective is to demonstrate that the power output can be maximized by adjusting the circuit load resistance at each irradiance value. In these two parts of the activity, students can analyze experimental data taking into account the irradiance law and the equivalent circuit description of a PV cell. Through detailed data analysis, students are also expected to assess the effects of temperature on PV efficiency degradation and the efficiency enhancement provided by light concentration mechanisms. As a third objective, students can explore how the color of incident light affects the PV output power, considering the quantum nature of light and its interaction with the PV system.

Keywords: experiments, irradiation law, physic teaching, photovoltaic effect

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611 Primary Melanocytic Tumors of the Central Nervous System: A Clinico-Pathological Study of Seven Cases

Authors: Sushila Jaiswal, Awadhesh Kumar Jaiswal

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Background: Primary melanocytic tumors of the central nervous system (CNS) are uncommon lesions and arise from the melanocytes located within the leptomeninges. Aim and objective: The aim of the study was to evaluate the clinical details, histomorphology of the primary melanocytic tumor of CNS. Method: The study was performed by the retrospective review of the case records of the primary melanocytic tumors of CNS diagnosed in our department. The formalin-fixed, paraffin embedded tissue blocks and tissue sections were retrieved and reviewed. Results: Seven cases (6 males, 1 female; age range- 16-40 years; mean age- 27 years) of primary melanocytic tumors of CNS were retrieved over last seven years. The tumor was intracranial (n=5; frontal – 1 case, parietal – 1 case, cerebello-pontine angle- 1 case, occipital -1 case, foramen magnum-1 case) and intra spinal (n=2; cervical – 2 cases). All patients presented with the neurological deficits related to the location of the tumor. Four cases were malignant melanoma; two were melanocytoma of intermediate grade and remaining one was melanocytoma. On histopathology, melanocytoma and melanoma both displayed sheets of well-differentiated melanocytes having round to oval nuclei with finely dispersed chromatin, occasional single eosinophilic nucleoli and a moderate amount of cytoplasm with abundant granular melanin pigment. The absence of mitosis and macronucleoli was noticed in melanocytoma while melanoma showed frequent mitosis and macronucleoli. On immunohistochemistry, both showed diffuse strong HMB45 and S-100 immunopositivity. Conclusion: Primary melanocytic tumors of CNS are rare and predominantly seen in males. It is important to differentiate melanoma from melanocytoma as prognosis of later is good.

Keywords: melanocytoma, melanoma, brain tumor, melanin

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610 Clinical and Radiological Outcome in 300 Patients with Non-Aneurysmal Sah

Authors: Ranjith Menon, Abathar Aladi, Hans-Christean Nahser, Maneesh Bhojak, Sacha Nevin, Paul Eldridge

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Background: Spontaneous subarachnoid haemorrhage (SAH) accounts for approximately 5% of all strokes. Patients with spontaneous SAH (as shown by CT or lumbar puncture) undergo investigations to identify or exclude an underlying structural cause, typically cerebral aneurysm. However in 10 - 20% of cases, no structural cause is found. This includes more than one imaging modality (intracranial MRA, CTA, 4DCTA and/or DSA) and in some spinal MRI. Objective: To determine; 1) If an underlying structural or vascular cause can be identified in non-aneurysmal SAH patients by comparing different imaging modalities at presentation and at follow-up. 2) If MRI spine in patients with non-aneurysmal SAH reveals an underlying SAH cause. 3)The functional outcome at discharge. Results: We performed a retrospective analysis of all non-traumatic SAH patients admitted to the Walton centre from January 2009 to December 2015. There were 1457 patients with non-traumatic SAH admitted to the Walton centre of whom 21.8% (n=300) patients were diagnosed with non-aneurysmal SAH. Males were 65.6% and females were 43.3%. The presenting symptoms were sudden onset headache (93.6%), the focal neurological deficit (12%), loss of consciousness (10.6%) and others (6%). About 285 patients received 2 modalities of imaging (CTA & DSA), 192 received 3 modalities of imaging (CTA, MRA & DSA) and 137 received MRI spine (51/137 whole spine). The modified Rankin Score at discharge were: mRS 0 = 292 (97.33%), mRS 1-2 = 6, mRS 6 = 1 (cardiac arrest in IHD patient) and unknown in 1. Follow-up imaging at 3 to 6 months in 190 (63.3%) patients did not identify an underlying cause. Conclusion: This retrospective analysis concludes that non-aneurysmal SAH has a good functional outcome. A single imaging modality (CTA (4DCTA) or MRA or DSA) was adequate to exclude an underlying cause of SAH and a delayed imaging failed to identify a cause. Routinely performing MRI spine in this group of patients appears not to be necessary according to this evidence.

Keywords: stroke, non-aneurysmal subarachnoid haemorrhage, neuroimaging, modified rankin score

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609 Screening for Diabetes in Patients with Chronic Pancreatitis: The Belfast Trust Experience

Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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608 The Current Ways of Thinking Mild Traumatic Brain Injury and Clinical Practice in a Trauma Hospital: A Pilot Study

Authors: P. Donnelly, G. Mitchell

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Traumatic Brain Injury (TBI) is a major contributor to the global burden of disease; despite its ubiquity, there is significant variation in diagnosis, prognosis, and treatment between clinicians. This study aims to examine the spectrum of approaches that currently exist at a Level 1 Trauma Centre in Australasia by surveying Emergency Physicians and Neurosurgeons on those aspects of mTBI. A pilot survey of 17 clinicians (Neurosurgeons, Emergency Physicians, and others who manage patients with mTBI) at a Level 1 Trauma Centre in Brisbane, Australia, was conducted. The objective of this study was to examine the importance these clinicians place on various elements in their approach to the diagnosis, prognostication, and treatment of mTBI. The data were summarised, and the descriptive statistics reported. Loss of consciousness and post-traumatic amnesia were rated as the most important signs or symptoms in diagnosing mTBI (median importance of 8). MRI was the most important imaging modality in diagnosing mTBI (median importance of 7). ‘Number of the Previous TBIs’ and Intracranial Injury on Imaging’ were rated as the most important elements for prognostication (median importance of 9). Education and reassurance were rated as the most important modality for treating mTBI (median importance of 7). There was a statistically insignificant variation between the specialties as to the importance they place on each of these components. In this Australian tertiary trauma center, there appears to be variation in how clinicians approach mTBI. This study is underpowered to state whether this is between clinicians within a specialty or a trend between specialties. This variation is worthwhile in investigating as a step toward a unified approach to diagnosing, prognosticating, and treating this common pathology.

Keywords: mild traumatic brain injury, adult, clinician, survey

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607 Case Report of Left Atrial Myxoma Diagnosed by Bedside Echocardiography

Authors: Anthony S. Machi, Joseph Minardi

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We present a case report of left atrial myxoma diagnosed by bedside transesophageal (TEE) ultrasound. Left atrial myxoma is the most common benign cardiac tumor and can obstruct blood flow and cause valvular insufficiency. Common symptoms consist of dyspnea, pulmonary edema and other features of left heart failure in addition to thrombus release in the form of tumor fragments. The availability of bedside ultrasound equipment is essential for the quick diagnosis and treatment of various emergency conditions including cardiac neoplasms. A 48-year-old Caucasian female with a four-year history of an untreated renal mass and anemia presented to the ED with two months of sharp, intermittent, bilateral flank pain radiating into the abdomen. She also reported intermittent vomiting and constipation along with generalized body aches, night sweats, and 100-pound weight loss over last year. She had a CT in 2013 showing a 3 cm left renal mass and a second CT in April 2016 showing a 3.8 cm left renal mass along with a past medical history of diverticulosis, chronic bronchitis, dyspnea on exertion, uncontrolled hypertension, and hyperlipidemia. Her maternal family history is positive for breast cancer, hypertension, and Type II Diabetes. Her paternal family history is positive for stroke. She was a current everyday smoker with an 11 pack/year history. Alcohol and drug use were denied. Physical exam was notable for a Grade II/IV systolic murmur at the right upper sternal border, dyspnea on exertion without angina, and a tender left lower quadrant. Her vitals and labs were notable for a blood pressure of 144/96, heart rate of 96 beats per minute, pulse oximetry of 96%, hemoglobin of 7.6 g/dL, hypokalemia, hypochloremia, and multiple other abnormalities. Physicians ordered a CT to evaluate her flank pain which revealed a 7.2 x 8.9 x 10.5 cm mixed cystic/solid mass in the lower pole of the left kidney and a filling defect in the left atrium. Bedside TEE was ordered to follow up on the filling defect. TEE reported an ejection fraction of 60-65% and visualized a mobile 6 x 3 cm mass in the left atrium attached to the interatrial septum extending into the mitral valve. Cardiothoracic Surgery and Urology were consulted and confirmed a diagnosis of left atrial myxoma and clear cell renal cell carcinoma. The patient returned a week later due to worsening nausea and vomiting and underwent emergent nephrectomy, lymph node dissection, and colostomy due to a necrotic colon. Her condition declined over the next four months due to lung and brain metastases, infections, and other complications until she passed away.

Keywords: bedside ultrasound, echocardiography, emergency medicine, left atrial myxoma

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606 Examining the Skills of Establishing Number and Space Relations of Science Students with the 'Integrative Perception Test'

Authors: Ni̇sa Yeni̇kalayci, Türkan Aybi̇ke Akarca

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The ability of correlation the number and space relations, one of the basic scientific process skills, is being used in the transformation of a two-dimensional object into a three-dimensional image or in the expression of symmetry axes of the object. With this research, it is aimed to determine the ability of science students to establish number and space relations. The research was carried out with a total of 90 students studying in the first semester of the Science Education program of a state university located in the Turkey’s Black Sea Region in the fall semester of 2017-2018 academic year. An ‘Integrative Perception Test (IPT)’ was designed by the researchers to collect the data. Within the scope of IPT, the courses and workbooks specific to the field of science were scanned and the ones without symmetrical structure from the visual items belonging to the ‘Physics - Chemistry – Biology’ sub-fields were selected and listed. During the application, it was expected that students would imagine and draw images of the missing half of the visual items that were given incomplete in the first place. The data obtained from the test in which there are 30 images or pictures in total (f Physics = 10, f Chemistry = 10, f Biology = 10) were analyzed descriptively based on the drawings created by the students as ‘complete (2 points), incomplete/wrong (1 point), empty (0 point)’. For the teaching of new concepts in small aged groups, images or pictures showing symmetrical structures and similar applications can also be used.

Keywords: integrative perception, number and space relations, science education, scientific process skills

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605 Real-Time Generative Architecture for Mesh and Texture

Authors: Xi Liu, Fan Yuan

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In the evolving landscape of physics-based machine learning (PBML), particularly within fluid dynamics and its applications in electromechanical engineering, robot vision, and robot learning, achieving precision and alignment with researchers' specific needs presents a formidable challenge. In response, this work proposes a methodology that integrates neural transformation with a modified smoothed particle hydrodynamics model for generating transformed 3D fluid simulations. This approach is useful for nanoscale science, where the unique and complex behaviors of viscoelastic medium demand accurate neurally-transformed simulations for materials understanding and manipulation. In electromechanical engineering, the method enhances the design and functionality of fluid-operated systems, particularly microfluidic devices, contributing to advancements in nanomaterial design, drug delivery systems, and more. The proposed approach also aligns with the principles of PBML, offering advantages such as multi-fluid stylization and consistent particle attribute transfer. This capability is valuable in various fields where the interaction of multiple fluid components is significant. Moreover, the application of neurally-transformed hydrodynamical models extends to manufacturing processes, such as the production of microelectromechanical systems, enhancing efficiency and cost-effectiveness. The system's ability to perform neural transfer on 3D fluid scenes using a deep learning algorithm alongside physical models further adds a layer of flexibility, allowing researchers to tailor simulations to specific needs across scientific and engineering disciplines.

Keywords: physics-based machine learning, robot vision, robot learning, hydrodynamics

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