Search results for: left eye

Authors: Shishir Lamichhane

Abstract:

Nepal neither is a party to any international refugee instruments nor does it have a national legislation to govern the refugee concerns legislated in the international legal instruments. In the absence of both of these, Nepal has adopted a rather ad hoc approach to dealing with refugees. Whereas Nepali state’s ad hocism seems to be paying off well with prominent (and mainstream) refugee populations of Bhutanese and Tibetans, urban refugees like Pakistani Ahmadiyya refugees have been left mostly at the odds. This paper is an attempt to reflect how the ad hoc approach taken by the host country (Nepal) is resulting in the further persecution of the Pakistani Ahmadiyya refugees and is lined up with arguments about how the basic rights of these refugees are being violated in the absence of a proper law. Relevant information regarding urban refugees residing in Kathmandu has been gathered by applying Empirical Research Methodology, while the paper also reviews pertinent literature already available on the case of Ahmadiya community.

Keywords: Pakistan, Ahmadiya community, Nepal, urban refugees

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Authors: Somnath Bhattacharya, Kamal Sharma, Vaibhav Sonkar

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Composite materials emerged in the middle of the 20th century as a promising class of engineering materials providing new prospects for modern technology. Recently, a new class of composite materials known as functionally graded materials (FGMs) has drawn considerable attention of the scientific community. In general, FGMs are defined as composite materials in which the composition or microstructure or both are locally varied so that a certain variation of the local material properties is achieved. This gradual change in composition and microstructure of material is suitable to get gradient of properties and performances. FGMs are synthesized in such a way that they possess continuous spatial variations in volume fractions of their constituents to yield a predetermined composition. These variations lead to the formation of a non-homogeneous macrostructure with continuously varying mechanical and / or thermal properties in one or more than one direction. Lightweight functionally graded composites with high strength to weight and stiffness to weight ratios have been used successfully in aircraft industry and other engineering applications like in electronics industry and in thermal barrier coatings. In the present work, elastic-plastic crack growth problems (using Ramberg-Osgood Model) in an FGM plate under cyclic load has been explored by extended finite element method. Both edge and centre crack problems have been solved by taking additionally holes, inclusions and minor cracks under plane stress conditions. Both soft and hard inclusions have been implemented in the problems. The validity of linear elastic fracture mechanics theory is limited to the brittle materials. A rectangular plate of functionally graded material of length 100 mm and height 200 mm with 100% copper-nickel alloy on left side and 100% ceramic (alumina) on right side is considered in the problem. Exponential gradation in property is imparted in x-direction. A uniform traction of 100 MPa is applied to the top edge of the rectangular domain along y direction. In some problems, domain contains major crack along with minor cracks or / and holes or / and inclusions. Major crack is located the centre of the left edge or the centre of the domain. The discontinuities, such as minor cracks, holes, and inclusions are added either singly or in combination with each other. On the basis of this study, it is found that effect of minor crack in the domain’s failure crack length is minimum whereas soft inclusions have moderate effect and the effect of holes have maximum effect. It is observed that the crack growth is more before the failure in each case when hard inclusions are present in place of soft inclusions.

Keywords: elastic-plastic, fatigue crack, functionally graded materials, extended finite element method (XFEM)

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Authors: Aydin Teymourifar, Gurkan Ozturk

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In this paper, a hybrid Tabu Search (TS) algorithm is suggested for the multi-objective job shop scheduling problems (MO-JSSPs). The algorithm integrates several shifting bottleneck based neighborhood structures with the Giffler & Thompson algorithm, which improve efficiency of the search. Diversification and intensification are provided with local and global left shift algorithms application and also new semi-active, active, and non-delay schedules creation. The suggested algorithm is tested in the MO-JSSPs benchmarks from the literature based on the Pareto optimality concept. Different performances criteria are used for the multi-objective algorithm evaluation. The proposed algorithm is able to find the Pareto solutions of the test problems in shorter time than other algorithm of the literature.

Keywords: tabu search, heuristics, job shop scheduling, multi-objective optimization, Pareto optimality

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Authors: Atef Ibrahim, Hamed Elsimary, Abdullah Aljumah, Fayez Gebali

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This paper presents a novel semi-systolic array architecture for an optimized parallel sequence alignment algorithm. This architecture has the advantage that it can be modified to be reused for multiple pass processing in order to increase the number of processing elements that can be packed into a single FPGA and to increase the number of sequences that can be aligned in parallel in a single FPGA. This resolves the potential problem of many FPGA resources left unused for designs that have large values of short read length. When using the previously published conventional hardware design. FPGA implementation results show that, for large values of short read lengths (M>128), the proposed design has a slightly higher speed up and FPGA utilization over the the conventional one.

Keywords: bioinformatics, genome sequence alignment, re-sequencing applications, systolic array

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Authors: Benchalak Muangmeesri

Abstract:

This research is experiment glaze from use cullet that is broken decayed from the used such as, glass bottle, windshield , etc. For seek raw material compensation that is raw material of the glaze in ceramic. The objective of the research for study the ratio of the glaze that is appropriate for glaze ceramic products and evaluate the experiment glaze on the vitreous china. The experiment has limits in using ceramic process such as, using calculation formula with triaxial, the empirical formula’s of Seger, and formula calculation is the percentage of the compound. for choose formula has will the possibility for glaze on vitreous china. The experiments in 108 triaxial can choose best formula and calculate is be left just 6 a formula for the calculation. The calculation is the percentage of the raw materials. Find that, three formulas in six formula there is percentage amount of the raw material that is cullet has the amount the little more 10 percentages then repeated experiment just three formulas. Overall, this research have three formulas for used its and we get all processes achieved and well done.

Keywords: cullet, glaze, pottery, ceramic

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Authors: Songul Miftakhov

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This study explores political representation and engagement of Eastern and Southeastern Anatolia regions, known to have dense Kurdish population and referred further to as Eastern region, in the Turkish parliament between 1946 and 1980. Traditional local notables had most of the privileges to be represented given their connectedness with political parties. Traditional local notables integrated into right-wing parties considering political and economic aspects. At the same time, they kept control over local political involvement channels. As a result, political representation and presence were monopolized at central, local and civil society levels. One part of Kurdish intellectuals was marginalized from the parliament after addressing issues in Eastern Anatolia and trying to develop solutions apart from the mainstream. Some of them took part in Kurdish oppositional left wing in the 1960s and jounced power of settled notables in 1970s in local administrations or as independent members of the parliament.

Keywords: Kurdish representation, parliament, local nobles, Eastern and Southeastern Anatolia

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Authors: Godwin Dennison, Edwin Cooper, George Theobald, Richard Dalton

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We report an unusual case of giant filiform polyposis in a patient with ulcerative colitis, causing a large stricture in the colon. A 62-year-old man was referred to the Bowel Cancer Screening Programme with a positive Faecal Immunochemical Test (FIT). He was known to have UC for 30 years. A CT scan showed a 9 cm stricture in the transverse colon suspicious of malignancy. A colonoscopy was attempted three times, and biopsies confirmed features of ulcerative colitis. A laparoscopic assisted transverse colectomy (Left hemicolectomy) was performed, and the histology revealed giant filiform polyposis. This should be considered in a UC patient presenting with signs of obstruction mimicking a carcinoma. Whilst it is a benign condition, because of the size of the lesion, it often causes obstruction, and surgery is indicated to relieve symptoms.

Keywords: giant inflammatory polyposis, filiform polyposis, ulcerative colitis, inflammatory bowel disease

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Authors: Nguyen Van Loi, Le Thanh Son, Tran Trung Kien

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The paper deals with the problem of the formation of range profiles (RPs) for an X-band coastal surveillance radar. Two popular methods, the difference operator method, and the window-based method, are reviewed and analyzed via two tests with different datasets. The test results show that although the original window-based method achieves a better performance than the difference operator method, it has three main drawbacks that are the use of 3 or 4 peaks of an RP for creating the windows, the extension of the window size using the power sum of three adjacent cells in the left and the right sides of the windows and the same threshold applied for all types of vessels to finish the formation process of RPs. These drawbacks lead to inaccurate RPs due to the low signal-to-clutter ratio. Therefore, some suggestions are proposed to improve the original window-based method.

Keywords: range profile, difference operator method, window-based method, automatic target recognition

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Authors: Sidra Saleemi, Arsalan Khan, Urooj Baig, Tahir Jamil

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In this research, it was examined that some residual amount of bleaching chemicals left in the liquor, this amount is more in Batch-wise process as compared to continuous process. These chemicals can be recovered and reused for bleaching by adding more quantity of fresh bleaching chemicals and water, this quantity will be required to balance the recipe for fabric. This liquor is recovered and samples were bleached with different modified recipe of liquor for both processes i.e. Batch-wise and continuous process. Every time good results were achieved with negligible variation in the quality parameter between the fabric bleached with fresh liquor and the fabric bleached with Recovered Liquor. Additionally, samples were dyed, and found that dyeing can be done easily on samples bleached with recover liquor.

Keywords: bleaching process, hydrogen peroxide, sodium hydroxide, liquor recovery

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Authors: Eng Lye, Ooi

Abstract:

The Old Man and The Sea is a novella written by Ernest Hemingway that depicts an old fisherman’ journey out into the deep sea in his pursuit to catch a big fish. Through this novella, Hemingway creates a world for his protagonist, Santiago who is portrayed as an old man who has gone eighty-four days without catching a fish, at last hooks an eighteen-foot marlin, the largest he ever known. The old man endures pain and struggles to bring back to shore. Looking through the lens of gerotranscendence, we can see that the old man has his dreams, and goals in life. In his pursuit for happiness, he has fought tirelessly to ward off the shark attacks and finally he won even though only half of his fish is left. Hemingway has portrayed Santiago as an old man as a transcendent self leaping from the dimension of “The Self” to the cosmic dimension with the personal and social relationship dimension in tow. The Old Man and The Sea offers a glimpse of the struggles of an old man, who is old and gaunt but spiritually undefeated in his battle out in the sea. He is surprisingly strong and powerful despite his old age, he respects the sea, the birds. the turtles, the sharks and the fish. He can endure suffering and is focussed on achieving his goals. This is what Hemingway has portrayed Santiago to be a gerotranscendent in the eyes of the gerotranscendental approach in respect of the changes and development as seen in Santiago, the protagonist in this novella.

Keywords: gerotranscendence, gerotranscendenatal, old man, the sea, hemingway

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Authors: Chen Xi, Kuan Sinman, LI Haofeng, Huang Hongming, Zeng Chengyu, Tong Zhiyuan

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Stray animals are on the rise in mainland China's cities. There are legal reasons for this, namely the lack of protection for domestic pets in mainland China, where only wildlife protection laws exist. At a social level, the ease with which families adopt pets and the lack of a social view of animal nature has led to the frequent abandonment and loss of stray animals. If left unmanaged, conflicts between humans and stray animals can also increase. This project provides an inexpensive and widely applicable management tool for urban management by collecting videos and pictures of stray animals captured by surveillance or transmitted by humans and using artificial intelligence technology (mainly using YOLOv5 recognition technology) and recording and managing them in a database.

Keywords: urban planning, urban governance, artificial intelligence, convolutional neural network

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Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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Authors: D. Pogliana, A. Maso, N. Milani, D. Panzin, S. Rivaroli, J. Konin

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This case aims to identify the role of movement quality during the final stage of return to sport (RTS) in a male amateur football player 13 years old after passing the acute phase of the bilateral Osgood-Schlatter disease (OSD). The patient, after a year from passing the acute phase of OSD with the abstention of physical activity, reports bilateral anterior knee pain at the beginning of the football sport activity. Interventions: After the orthopedist check, who recommended physiotherapy sessions for the correction of motor patterns and the isometric reinforcement of the muscles of the quadriceps, the rehabilitation intervention was developed in 7 weeks through 14 sessions of neuro-motor training (NMT) with a frequency of two weekly sessions and six sessions of muscle-strengthening with a frequency of one weekly session. The sessions of NMT were carried out through free body exercises (or with overloads) with visual bio-feedback with the help of two cameras (one with anterior vision and one with lateral vision of the subject) and a big touch screen. The aim of these sessions of NMT was to modify the dysfunctional motor patterns evaluated by the 2D motion analysis test. The test was carried out at the beginning and at the end of the rehabilitation course and included five movements: single-leg squat (SLS), drop jump (DJ), single-leg hop (SLH), lateral shuffle (LS), and change of direction (COD). Each of these movements was evaluated through the video analysis of dynamic valgus knee, pelvic tilt, trunk control, shock absorption, and motor strategy. A free image analysis software (Kinovea) was then used to calculate scores. Results: Baseline assessment of the subject showed a total score of 59% on the right limb and 64% on the left limb (considering an optimal score above 85%) with large deficits in shock absorption capabilities, the presence of dynamic valgus knee, and dysfunctional motor strategies defined “quadriceps dominant.” After six weeks of training, the subject achieved a total score of 80% on the right limb and 86% on the left limb, with significant improvements in shock absorption capabilities, the presence of dynamic knee valgus, and the employment of more hip-oriented motor strategies on both lower limbs. The improvements shown in dynamic knee valgus, greater hip-oriented motor strategies, and improved shock absorption identified through six weeks of the NMT program can help a teenager amateur football player to manage the anterior knee pain during sports activity. In conclusion, NMT was a good choice to help a 13 years old male amateur football player to return to performance without pain after OSD and can also be used with all this type of athletes of the other teams' sports.

Keywords: movement analysis, neuro-motor training, knee pain, movement strategies

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Authors: Hamed Tofangsaz

Abstract:

In the absence of an internationally agreed definition of terrorism, the question which needs to be posed is whether there is a clear and common understanding of what constitutes terrorism, terrorist acts and terrorist groups, the financing of which needs to be stopped. That is, from a criminal law perspective, whether the Terrorist Financing Convention, as the backbone of the counter-terrorist financing regime, clarifies what types of conduct, by who, in what circumstances and when, against whom (targets or victims) and with what intention or motivation should be considered terrorism? It will be explained how and why it has been difficult to reach an agreement on the definition of terrorism. The endeavour of the drafters of the Terrorist Financing Convention and others involved in countering terrorist financing to establish a general definition of terrorism will be examined. The record of attempts to define the elements of terrorism proves that it is hardly possible to reach an agreement on a generic definition of terrorism because the concept of terrorism is elusive and subject to various understandings. Even the definition provided by the Terrorist Financing Convention, is not convincing. With regard to the findings, this paper calls for further research on the legal consequences of the implementation of the terrorist financing-counter measures while the scope of terrorism, terrorist acts and terrorist organizations have been left vague.

Keywords: terrorism, terrorist financing, crime, convention

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Authors: Amira Kaddour, Hedia Teraoui, Khmayes Bougatef

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The main purpose of this paper is to determine the major causes of the underdevelopment of Islamic finance in Tunisia. Indeed, it’s surprising to note that Zitouna bank established in May 2010 is the first Islamic Tunisian bank although 99% of Tunisians are Muslim and Islam is the religion of the State according to the Constitution. So we rely in our paper on the opinions of number of professors of finance and economics as educated people to prove or reject our hypothesis that the underdevelopment of Islamic finance in Tunisia can be explained by the ignorance of its main principles and advantages. Ours findings reveal that this branch of finance is still largely unknown, not only from public but also from professionals. The results obtained surprisingly show that this insignificance of Islamic banking cannot be explained by the fact that Tunisia has been governed since its independence by a secular left-wing party. Indeed, only 3% of respondents believe that legislation and regulation in Tunisia represent an obstacle to the development of Islamic finance. Moreover, respondents are not very optimistic about the future role of Islamic financing.

Keywords: Islamic banking, Islamic insurance (takaful), Islamic law (shariah), usury (riba)

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Authors: Inalegwu Stephany Akipu

Abstract:

Archaeology being the study of mans past using the materials he left behind has been argued to be classified under sciences while some scholars are of the opinion that it does not deserve the status of being referred to as ‘science’. However divergent the opinions of scholars may be on the classification of Archaeology as a science or in the humanities, the discipline has no doubt, greatly aided in shaping the history of man’s past. Through the different stages that the discipline has transgressed, it has encountered some challenges. This paper therefore, attempts to highlight the need for the inclusion of branches of other disciplines when using Archaeology in reconstructing man’s history. The objective of course, is to add to the existing body of knowledge but specifically to expose the incomparable importance of archaeology as a discipline and to place it on such a high scale that it will not be regulated to the background as is done in some Nigerian Universities. The paper attempts a clarification of some conceptual terms and discusses the developmental stages of archaeology. It further describes the present state of the discipline and concludes with the disciplines that need to be imbibed in the use of Archaeology which is an evolving cultural science to obtain the aforementioned interdisciplinary approach.

Keywords: archaeology, cultural, evolution, interdisciplinary, science

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Authors: Odeh Linus

Abstract:

The pace of globalization is increasing continuously in terms of markets for goods and services, investment opportunities across borders amongst others. Enterprises face competition from all fronts. Human resource management is not left out in this transformation crusade as it has obligation to move along with the changing demands of the globalization process. One of the objectives of this paper is to show that effective managers should constantly be aware of the changes taking place in domestic (home country) environment, as well as around the globe (international and foreign environments) on HR issues and developments. By so doing, they can scan their environment on an ongoing basis, and when they detect opportunities and/or threats, they can transform their organization to seize the opportunities and/or combat or neutralize the threats as the case may be. In this presentation, problems, issues and trends in HRM practice in Nigeria in the current period were reviewed. The factors affecting HRM and its practice in a global context and what should be the direction of the profession and its practice in Nigeria constitute the main focus of this paper.

Keywords: human resource, globalization, management, developing countries

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Authors: Anvikshaa Bisen, Krish Makkar

Abstract:

Professionals misdiagnose autism by ticking off symptoms on a checklist without questioning the causes of said symptoms, and without understanding the innate neurophysiology of the autistic brain. A dysfunctional cingulate gyrus (CG) hyperfocuses attention in the left frontal lobe (logical/analytical) with no ability to access the right frontal lobe (emotional/creative), which plays a central role in spontaneity, social behavior, and nonverbal abilities. Autistic people live in a specialized inner space that is entirely intellectual, free from emotional and social distractions. They have no innate biological way of emotionally connecting with other people. Autistic people process their emotions intellectually, a process that can take 24 hours, by which time it is too late to have felt anything. An inactive amygdala makes it impossible for autistic people to experience fear. Because they do not feel emotion, they have no emotional memories. All memories are of events that happened about which they felt no emotion at the time and feel no emotion when talking about it afterward.

Keywords: autism, Asperger, Asd, neuropsychology, neuroscience

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Authors: Chen Xi, LIU Xuebin, Kuan Sinman, LI Haofeng, Huang Hongming, Zeng Chengyu, Lao Xuerui

Abstract:

Stray animals are on the rise in mainland China's cities. There are legal reasons for this, namely the lack of protection for domestic pets in mainland China, where only wildlife protection laws exist. At a social level, the ease with which families adopt pets and the lack of a social view of animal nature have led to the frequent abandonment and loss of stray animals. If left unmanaged, conflicts between humans and stray animals can also increase. This project provides an inexpensive and widely applicable management tool for urban management by collecting videos and pictures of stray animals captured by surveillance or transmitted by humans and using artificial intelligence technology (mainly using Yolov5 recognition technology) and recording and managing them in a database.

Keywords: urban planning, urban governance, artificial intelligence, convolutional neural network, machine vision

Procedia PDF Downloads 65

Authors: Raouf Fareh, Maarouf Saad, Sofiane Khadraoui, Tamer Rabie

Abstract:

This paper presents a tracking control strategy based on Lyapunov approach for nonholonomic wheeled mobile robot. This control strategy consists of two levels. First, a kinematic controller is developed to adjust the right and left wheel velocities. Using this velocity control law, the stability of the tracking error is guaranteed using Lyapunov approach. This kinematic controller cannot be generated directly by the motors. To overcome this problem, the second level of the controllers, dynamic control, is designed. This dynamic control law is developed based on Lyapunov theory in order to track the desired trajectories of the mobile robot. The stability of the tracking error is proved using Lupunov and Barbalat approaches. Simulation results on a nonholonomic wheeled mobile robot are given to demonstrate the feasibility and effectiveness of the presented approach.

Keywords: mobile robot, trajectory tracking, Lyapunov, stability

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Authors: Parthasarathi Pramanik

Abstract:

Paediatric blunt abdominal trauma associated with superficial bruise, hematoma, or laceration and internal organ damage secondary to bicycle handlebar is widely documented in the literature. In this article, we have presented a case of bicycle handlebar inflicted fatal neck laceration in a road accident. The deceased sustained a horizontally placed laceration injury over the front and both sides of the middle third of neck (13 cm x 5-8 cm x 2-3.5 cm).The margins of the wound were irregular and focally abraded. The right corner of the injury was pointed whereas the left one was ended with a skin flap. Multiple graze abrasions, contusions and lacerations were found on different parts of body. Autopsy findings and other circumstantial evidences revealed that the victim died due to exsanguination because of severance of carotid artery and jugular vein of both sides. Analysis of the wound suggests the decease sustained the wound by the revolving bicycle handle bar while he had lost the balance.

Keywords: bicycle handle bar, neck injury, lacerated injury, road acident

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Authors: Lozano Paul

Abstract:

Coupled Membrane Separation Technology (CMST), including Cross Flow Microfiltration (CFM) and Reverse Osmosis (RO), are used to concentrate microalgae biomass or/and to extract and concentrate water-soluble metabolites produced during micro-algae production cycle, as well as water recycling. Micro-algae biomass was produced using different feeding mixtures of ingredients: pure chemical origin compounds and natural/ecological water-extracted components from available local plants. Micro-algae was grown either in conventional plastic bags (100L/unit) or in small-scale innovative bioreactors (75L). Biomass was concentrated as CFM retentate using a P19-60 ceramic membrane (0.2μm pore size), and water-soluble micro-algae metabolites left in the CFM filtrate were concentrated by RO. Large volumes of water (micro-algae culture media) of were recycled by the CMTS for another biomass production cycle.

Keywords: extraction, membrane process, microalgae, natural compound

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Authors: Langhit Kurar, Loren Charles

Abstract:

Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: Yan Jia China

Abstract:

The ruins is a kind of historical intention, which is also the current real existence of developing city. Zen culture of ancient China has a profound esthetic emotion, similarly, the west establish the concept of aesthetics of relic along with the Romanism’s (such as Rousseau etc.) sentiment to historical ruins at the end of 18th century. Nowadays, with the decline of traditional industrial society as well as the rise of post-industrial age, contemporary society must face the ruins and garbage problem which is left by industrial society. Commencing from the perspective of emotion and memory, this paper analyzes the importance for emotional needs as well as their existing status of several projects, such as the Capital Steelworks in Beijing (industrial devastation), the Shibati old section in Chongqing (urban slums) and the Old Hurva Synagogue in Jerusalem (ruins of war). It emphasizes urban design which is started from emotion and the sustainable development of city memory through managing the urban ruins which is criticized by people with the perspective of ecology and art.

Keywords: cultural heritage, urban ruins, ecology, emotion, sustainable urban memory

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Authors: Arthi Ganapathy, Arithra Banerjee, Saroj Kaler

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Abdominal aorta is the sole purveyor of all organs in the abdomen. Anomalies of its main trunk or its branches are to be meticulously observed as it effects the perfusion of an organ. Varying patterns of the testicular artery is one of them. The origin and course of testicular arteries have to be identified carefully during various surgical procedures like renal transplant, intra abdominal surgeries and even in orthopedic surgery like spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of testicular arteries has assumed much more significance. Though the variations of the testicular vein are well documented, the variations of the testicular artery are not so frequent in incidence. We report a case of the bilateral aberrant origin of the testicular artery from polar renal arteries. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to testicular arteries will compromise the function of the gonads.

Keywords: cadaver, gonadal, renal, surgery

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Authors: Tristan R. Fraser, Christopher D. Steadman, Christopher J. Boos

Abstract:

Myopericarditis is an inflammation syndrome characterised by clinical diagnostic criteria for pericarditis, such as chest pain, combined with evidence of myocardial involvement, such as elevation of biomarkers of myocardial damage, e.g., troponins. It can rarely be a complication of therapeutics used for dysregulated immune-mediated diseases such as inflammatory bowel disease (IBD), for example, mesalazine. The infrequency of mesalazine-induced myopericarditis adds to the challenge in its recognition. Rapid diagnosis and the early introduction of treatment are crucial. This case report follows a 24-year-old professional footballer with a past medical history of ulcerative colitis, recently started on mesalazine for disease control. Three weeks after mesalazine was initiated, he was admitted with fever, shortness of breath, and chest pain worse whilst supine and on deep inspiration, as well as elevated venous blood cardiac troponin T level (cTnT, 288ng/L; normal: <13ng/L). Myocarditis was confirmed on initial inpatient cardiac MRI, revealing the presence of florid myocarditis with preserved left ventricular systolic function and an ejection fraction of 67%. This was a longitudinal case study following the progress of a single individual with myopericarditis over four acute hospital admissions over nine weeks, with admissions ranging from two to five days. Parameters examined included clinical signs and symptoms, serum troponin, transthoracic echocardiogram, and cardiac MRI. Serial measurements of cardiac function, including cardiac MRI and transthoracic echocardiogram, showed progressive deterioration of cardiac function whilst mesalazine was continued. Prior to cessation of mesalazine, transthoracic echocardiography revealed a small global pericardial effusion of < 1cm and worsening left ventricular systolic function with an ejection fraction of 45%. After recognition of mesalazine as a potential cause and consequent cessation of the drug, symptoms resolved, with cardiac MRI performed as an outpatient showing resolution of myocardial oedema. The patient plans to make a return to competitive sport. Patients suffering from myopericarditis are advised to refrain from competitive sport for at least six months in order to reduce the risk of cardiac remodelling and sudden cardiac death. Additional considerations must be taken in individuals for whom competitive sport is an essential component of their livelihood, such as professional athletes. Myopericarditis is an uncommon, however potentially serious medical condition with a wide variety of aetiologies, including viral, autoimmune, and drug-related causes. Management is mainly supportive and relies on prompt recognition and removal of the aetiological process. Mesalazine-induced myopericarditis is a rare condition; as such increasing awareness of mesalazine as a precipitant of myopericarditis is vital for optimising the management of these patients.

Keywords: myopericarditis, mesalazine, inflammatory bowel disease, professional athlete

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Authors: Maria Isabel Garcia-Planas, Maria Victoria Garcia-Camba

Abstract:

The use of brain stem auditory evoked potential (BAEP) is a common way to study the auditory function of people, a way to learn the functionality of a part of the brain neuronal groups that intervene in the learning process by studying the behaviour of wave VI. The latest advances in neuroscience have revealed the existence of different brain activity in the learning process that can be highlighted through the use of innocuous, low-cost, and easy-access techniques such as, among others, the BAEP that can help us to detect early possible neurodevelopmental difficulties for their subsequent assessment and cure. To date and to the authors' best knowledge, only the latency data obtained, observing the first to V waves and mainly in the left ear, were taken into account. This work shows that it is essential to take into account both ears; with these latest data, it has been possible had diagnosed more precise some cases than with the previous data had been diagnosed as 'normal' despite showing signs of some alteration that motivated the new consultation to the specialist.

Keywords: ear, neurodevelopment, auditory evoked potentials, intervals of normality, learning disabilities

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Authors: Pawel Kiper, Alfonc Baba, Mahmoud Alhelou, Giorgia Pregnolato, Michela Agostini, Andrea Turolla

Abstract:

Impairment of cervical spine mobility is often related to pain triggered by musculoskeletal disorders or direct traumatic injuries of the spine. To date, these disorders are assessed with goniometers and inclinometers, which are the most popular devices used in clinical settings. Nevertheless, these technologies usually allow measurement of no more than two-dimensional range of motion (ROM) quotes in static conditions. Conversely, the wide use of motion tracking systems able to measure 3 to 6 degrees of freedom dynamically, while performing standard ROM assessment, are limited due to technical complexities in preparing the setup and high costs. Thus, motion tracking systems are primarily used in research. These systems are an integral part of virtual reality (VR) technologies, which can be used for measuring spine mobility. To our knowledge, the accuracy of VR measure has not yet been studied within virtual environments. Thus, the aim of this study was to test the reliability of a protocol for the assessment of sensorimotor function of the cervical spine in a population of healthy subjects and to compare whether using immersive or non-immersive VR for visualization affects the performance. Both VR assessments consisted of the same five exercises and random sequence determined which of the environments (i.e. immersive or non-immersive) was used as first assessment. Subjects were asked to perform head rotation (right and left), flexion, extension and lateral flexion (right and left side bending). Each movement was executed five times. Moreover, the participants were invited to perform head reaching movements i.e. head movements toward 8 targets placed along a circular perimeter each 45°, visualized one-by-one in random order. Finally, head repositioning movement was obtained by head movement toward the same 8 targets as for reaching and following reposition to the start point. Thus, each participant performed 46 tasks during assessment. Main measures were: ROM of rotation, flexion, extension, lateral flexion and complete kinematics of the cervical spine (i.e. number of completed targets, time of execution (seconds), spatial length (cm), angle distance (°), jerk). Thirty-five healthy participants (i.e. 14 males and 21 females, mean age 28.4±6.47) were recruited for the cervical spine assessment with immersive and non-immersive VR environments. Comparison analysis demonstrated that: head right rotation (p=0.027), extension (p=0.047), flexion (p=0.000), time (p=0.001), spatial length (p=0.004), jerk target (p=0.032), trajectory repositioning (p=0.003), and jerk target repositioning (p=0.007) were significantly better in immersive than non-immersive VR. A regression model showed that assessment in immersive VR was influenced by height, trajectory repositioning (p<0.05), and handedness (p<0.05), whereas in non-immersive VR performance was influenced by height, jerk target (p=0.002), head extension, jerk target repositioning (p=0.002), and by age, head flex/ext, trajectory repositioning, and weight (p=0.040). The results of this study showed higher accuracy of cervical spine assessment when executed in immersive VR. The assessment of ROM and kinematics of the cervical spine can be affected by independent and dependent variables in both immersive and non-immersive VR settings.

Keywords: virtual reality, cervical spine, motion analysis, range of motion, measurement validity

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Authors: Raymond C. Hawkins II, Catherine A. Hawkins

Abstract:

The System Contextual Integrated Model (SCIM), developed as a trans-theoretical framework for selecting measures for psychotherapy process and outcome, is reformulated for behavioral health applications. The SCIM “healing cycle” is an allostatic hedonic affective-cognitive right-hemisphere–left-hemisphere coordinated process involving positive alliesthesia that mitigates traumatic pain and generates psychological flexibility. The SCIM “trauma cycle” is an allostatic overload alliesthesia opponent process with long-lasting pathology sequelae. The social ecological context moderates the “healing cycle” and the “trauma cycle.” Repeated evocation of the “healing cycle” in a therapeutic relationship can gradually relieve trauma sequelae. The SCIM is applied to pain, obese binge eating, and substance use disorders.

Keywords: allostasis, alliesthesia, opponent process, behavioral health, assessment

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Authors: Wahab Ali, Oyebade K. Oyedotun, Adnan Khashman

Abstract:

Breast cancer remains a threat to the woman’s world in view of survival rates, it early diagnosis and mortality statistics. So far, research has shown that many survivors of breast cancer cases are in the ones with early diagnosis. Breast cancer is usually categorized into stages which indicates its severity and corresponding survival rates for patients. Investigations show that the farther into the stages before diagnosis the lesser the chance of survival; hence the early diagnosis of breast cancer becomes imperative, and consequently the application of novel technologies to achieving this. Over the year, mammograms have used in the diagnosis of breast cancer, but the inconclusive deductions made from such scans lead to either false negative cases where cancer patients may be left untreated or false positive where unnecessary biopsies are carried out. This paper presents the application of artificial neural networks in the prediction of severity of breast tumour (whether benign or malignant) using mammography reports and other factors that are related to breast cancer.

Keywords: breast cancer, intelligent classification, neural networks, mammography

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