Search results for: left ventricular outflow obstruction

Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

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An estimating equation technique is an alternative method of the widely used maximum likelihood methods, which enables us to ease some complexity due to the complex characteristics of time-varying covariates. In the situations, when both the time-varying covariates and left-truncation are considered in the model, the maximum likelihood estimation procedures become much more burdensome and complex. To ease the complexity, in this study, the modified estimating equations those have been given high attention and considerations in many researchers under semiparametric transformation model was proposed. The purpose of this article was to develop the modified estimating equation under flexible and general class of semiparametric transformation models for left-truncated and right censored survival data with time-varying covariates. Besides the commonly applied Cox proportional hazards model, such kind of problems can be also analyzed with a general class of semiparametric transformation models to estimate the effect of treatment given possibly time-varying covariates on the survival time. The consistency and asymptotic properties of the estimators were intuitively derived via the expectation-maximization (EM) algorithm. The characteristics of the estimators in the finite sample performance for the proposed model were illustrated via simulation studies and Stanford heart transplant real data examples. To sum up the study, the bias for covariates has been adjusted by estimating density function for the truncation time variable. Then the effect of possibly time-varying covariates was evaluated in some special semiparametric transformation models.

Keywords: EM algorithm, estimating equation, semiparametric transformation models, time-to-event outcomes, time varying covariate

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Authors: Mangala Kohli, P. A. Athira, Reeha Mahajan

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The subthalamic nucleus (STN) is a biconvex nucleus situated in the diencephalon. The knowledge of the morphometry of the subthalamic nucleus is essential for accurate targeting of the nucleus during Deep Brain Stimulation. The present study aims to note the morphometry of the subthalamic nucleus in both the cerebral hemispheres which will prove to be of great value to radiologists and neurosurgeons. A cross‐sectional observational study was conducted in the Departments of Anatomy and Forensic Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi on thirty adult cadaveric brain specimens of unclaimed and donated corpses. The specimens were categorized into 3 age groups: 20-35, 35-50 and above 50 years. All samples were collected after following the standard protocol for ethical clearance. The morphometric study of 60 subthalamic nucleus was thus conducted. Transverse section of the brain was made at a plane 4mm ventral to the plane containing mid commissural point. The dimensions of the subthalamic nucleus were measured bilaterally with the aid of digital Vernier caliper and magnifying glass. In the present study, the mean length and width and AC-PC length of the subthalamic nucleus was recorded on the right and left side in Group A, B and C. On comparison of mean of subthalamic nucleus dimensions between the right and left side in Group C, no statistically significant difference was observed. The length and width of subthalamic nucleus measured in the 3 age groups were compared with each other and the p value calculated. There was no statistically significant difference between the dimensions of Group A and B, Group B and C as well as Group A and C. The present study reveals that there is no significant reduction in the size of the nucleus was noted with increasing age. Thus, the values obtained in the present study can be used as a reference for various invasive and non-invasive procedures on subthalamic nucleus.

Keywords: cerebral hemisphere, deep brain stimulation, morphometry, subthalamic nucleus

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Authors: Shinji Sato, M. M. A. Alam, Manabu Takao

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In recent, investigation of an unsteady flow inside the resonance tube have become a strongly motivated research field for their potential application as high-frequency actuators. By generating a shock wave inside the resonance tube, a high temperature and pressure can be achieved inside the tube, and this high temperature can also be used to ignite a jet engine. In the present research, a computational fluid dynamics (CFD) analysis was carried out to investigate the flow inside the resonance tube. The density-based solver of rhoCentralFoam in OpenFOAM was used to numerically simulate the flow. The supersonic jet that was driven by a cylindrical nozzle with a nominal exit diameter of φd = 20.3 mm impinged onto the resonance tube. The jet pressure ratio was varied between 2.6 and 7.8. The gap s between the nozzle exit and tube entrance was changed between 1.5d and 3.0d. The diameter and length of the tube were taken as D = 1.25d and L=3.0D, respectively. As a result, when a supersonic jet has impinged onto the resonance tube, a compression wave was found generating inside the tube and propagating towards the tube end wall. This wave train resulted in a rise in the end wall gas temperature and pressure. While, in an outflow phase, the gas near tube enwall was found cooling back isentropically to its initial temperature. Thus, the compression waves repeated a reciprocating motion in the tube like a piston, and a fluctuation in the end wall pressures and temperatures were observed. A significant change was found in the end wall pressures and temperatures with a change of jet flow conditions. In this study, the highest temperature was confirmed at a jet pressure ratio of 4.2 and a gap of s=2.0d

Keywords: compressible flow, OpenFOAM, oscillations, a resonance tube, shockwave

Procedia PDF Downloads 151

Authors: Ron Dick, P. S. D. V. Prasadarao, Glenn Coltman

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Agenesis of the corpus callosum (ACC) is a failure to develop corpus callosum - the large bundle of fibers of the brain that connects the two cerebral hemispheres. It can occur as a partial or complete absence of the corpus callosum. In the general population, its estimated prevalence rate is 1 in 4000 and a wide range of genetic, infectious, vascular, and toxic causes have been attributed to this heterogeneous condition. The diagnosis of ACC is often achieved by neuroimaging procedures. Though persons with ACC can perform normally on intelligence tests they generally present with a range of neuropsychological and social deficits. The deficit profile is characterized by poor coordination of motor movements, slow reaction time, processing speed and, poor memory. Socially, they present with deficits in communication, language processing, the theory of mind, and interpersonal relationships. The present paper illustrates the role of neuropsychological assessment with implications to psychosocial management in a case of agenesis of the corpus callosum. Method: A 27-year old left handed Caucasian male with a history of ACC was self-referred for a neuropsychological assessment to assist him in his employment options. Parents noted significant difficulties with coordination and balance at an early age of 2-3 years and he was diagnosed with dyspraxia at the age of 14 years. History also indicated visual impairment, hypotonia, poor muscle coordination, and delayed development of motor milestones. MRI scan indicated agenesis of the corpus callosum with ventricular morphology, widely spaced parallel lateral ventricles and mild dilatation of the posterior horns; it also showed colpocephaly—a disproportionate enlargement of the occipital horns of the lateral ventricles which might be affecting his motor abilities and visual defects. The MRI scan ruled out other structural abnormalities or neonatal brain injury. At the time of assessment, the subject presented with such problems as poor coordination, slowed processing speed, poor organizational skills and time management, and difficulty with social cues and facial expressions. A comprehensive neuropsychological assessment was planned and conducted to assist in identifying the current neuropsychological profile to facilitate the formulation of a psychosocial and occupational rehabilitation programme. Results: General intellectual functioning was within the average range and his performance on memory-related tasks was adequate. Significant visuospatial and visuoconstructional deficits were evident across tests; constructional difficulties were seen in tasks such as copying a complex figure, building a tower and manipulating blocks. Poor visual scanning ability and visual motor speed were evident. Socially, the subject reported heightened social anxiety, difficulty in responding to cues in the social environment, and difficulty in developing intimate relationships. Conclusion: Persons with ACC are known to present with specific cognitive deficits and problems in social situations. Findings from the current neuropsychological assessment indicated significant visuospatial difficulties, poor visual scanning and problems in social interactions. His general intellectual functioning was within the average range. Based on the findings from the comprehensive neuropsychological assessment, a structured psychosocial rehabilitation programme was developed and recommended.

Keywords: agenesis, callosum, corpus, neuropsychology, psychosocial, rehabilitation

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Authors: H. H. Goh, K. C. Goh, T. W. Seow, N. S. Said, S. E. P. Ang

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Malaysia is rich with historic buildings, particularly in Penang and Malacca states. Restoration activities are increasingly important as these states are recognized under UNESCO World Heritage Sites. Restoration activities help to maintain the uniqueness and value of a heritage building. However, increasing in restoration activities has resulted in large quantities of waste. To cope with this problem, the 3R concept (reduce, reuse and recycle) is introduced. The 3R concept is one of the waste management hierarchies. This concept is still yet to apply in the building restoration industry compared to the construction industry. Therefore, this study aims to promote the 3R concept in the heritage building restoration industry. This study aims to examine the importance of 3R concept and to identify challenges in applying the 3R concept in the heritage building restoration industry. This study focused on contractors and consultants who are involved in heritage restoration projects in Penang. Literature review and interviews helps to reach the research objective. Data that obtained is analyzed by using content analysis. For the research, application of 3R concept is important to conserve natural resources and reduce pollution problems. However, limited space to organise waste is the obstruction during the implementation of this concept. In conclusion, the 3R concept plays an important role in promoting environmental conservation and helping in reducing the construction waste

Keywords: 3R Concept, heritage building, restoration activities, building science

Procedia PDF Downloads 314

Authors: I. Karagjozova, B. Dejanova, J. Pluncevic, S. Petrovska, V. Antevska, L. Todorovska

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Introduction: Medical checking assessment is important in sports medicine. To follow the health condition in subjects who perform sports, body composition parameters, such as intracellular water, extracellular water, protein and mineral content, muscle and fat mass might be useful. The aim of the study was to show available parameters and to compare them to manual assessment. Material and methods: A number of 20 subjects (14 male and 6 female) at age of 20±2 years were determined in the study, 5 performed recreational sports, while others were professional ones. The mean height was 175±7 cm, the mean weight was 72±9 cm, and the body mass index (BMI) was 23±2 kg/m2. The measured compartments were as following: intracellular water (IW), extracellular water (EW), protein component (PC), mineral component (MC), skeletal muscle mass (SMM) and body fat mass (BFM). Lean balance were examined for right and left arm (LA), trunk (T), right leg (RL) and left leg (LL). The comparison was made between the calculation derived by manual made measurements, using Matejka formula and parameters obtained by body composition analyzer (BCA) - Inbody 720 BCA Biospace. Used parameters for the comparison were muscle mass (SMM), body fat mass (BFM). Results: BCA obtained values were for: IW - 22.6±5L, EW - 13.5±2 L, PC - 9.8±0.9 kg, MC - 3.5±0.3, SMM - 27±3 kg, BFM - 13.8±4 kg. Lean balance showed following values for: RA - 2.45±0.2 kg, LA - 2.37±0.4, T - 20.9±5 kg, RL - 7.43±1 kg, and LL - 7.49 ±1.5 kg. SMM showed statistical difference between manual obtained value, 51±01% to BCA parameter 45.5±3% (p<0.001). Manual obtained values for BFM was lower (17±2%) than BCA obtained one, 19.5±5.9% (p<0.02). Discussion: The obtained results showed appropriate values for the examined age, regarding to all examined parameters which contribute to overview the body compartments, important for sport performing. Due to comparison between the manual and BCA assessment, we may conclude that manual measurements may differ from the certain ones, which is confirmed by statistical significance.

Keywords: athletes, body composition, bio electrical impedance, sports medicine

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Authors: L. C. Prasanna, Antony Sylvan D’Souza, Kumar M. R. Bhat

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Although life as a conjoined twin would seem intolerable, there has recently been an increased interest in this subject because of the increasing number of cases where attempts have been made to separate them surgically. We have reviewed articles on cardiovascular anomalies in conjoined twins and presenting rarest anomaly in dicephalus parapagus fetus having two heads attached to one body from the neck or upper chest downwards, with a pair of limbs and a set of reproductive organs. Both the twins shared a common thoracic cavity with a single sternum. When the thoracic cavity was opened, a common anterior mediastinum was found. On opening the pericardium, two separate, closely apposed hearts were exposed. The two cardia are placed side by side. The left heart was slightly larger than the right and were joined at the atrial levels. Four atrial appendages were present, two for each twin. The atrial complex was a common chamber posterior to the ventricles. A single large tributary which could be taken as inferior vena cava drains into the common atrial chamber. In this case, the heart could not be assigned to either twin and therefore, it is referred to as the shared heart within a common pericardial sac. The right and left descending thoracic aorta have joined with each other just above the diaphragm to form a common descending thoracic aorta which has an opening in the diaphragm to be continued as common abdominal aorta which has a normal branching pattern. Upon an interior dissection, it is observed that the two atria have a wide communication which could be a wide patent foramen ovale and this common atrial cavity has a communication with a remnant of a possible common sinus venosus.

Keywords: atrium, congenital anomaly, conjoined twin, sinus venosus

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Authors: Hannah Nagel, Hayley Lang, Albert Sole Guitart, Natasha Lean, Rachel Allavena, Cleide Sprohnie-Barrera, Alex Young

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Aggressive neoplasia of the hoof is a rare occurrence in horses and has been only sporadically described in the literature. In the few cases reported intra-hoof wall, aggressive neoplasia has been documented radiographically and has been described with variable imaging characteristics. These include a well-defined osteolytic area, a smoothly outlined semi-circular defect, an extensive draining tract beneath the hoof wall, as well as an additional large area of osteolysis or an extensive central lytic region. A 20-year-old Quarterhorse gelding and a 10-year-old Thoroughbred gelding were both presented for chronic reoccurring lameness in the left forelimb and left hindlimb, respectively. Both of the cases displayed radiographic lesions that have been previously described but also displayed osteoproliferative expansile regions of additional bone formation. Changes associated with hoof neoplasia are often non-specific due to the nature and capacity of bone to react to pathological insult, which is either to proliferate or be absorbed. Both cases depict and describe imaging findings seen on radiography, contrast radiography, computed tomography, and magnetic resonance imaging before reaching a histological diagnosis of malignant melanoma and squamous cell carcinoma. Although aggressive hoof wall neoplasia is rare, there are some imaging features which may raise our index of suspicion for an aggressive hoof wall lesion. This case report documents two horses with similar imaging findings who underwent multiple assessments, surgical interventions, and imaging modalities with a final diagnosis of malignant neoplasia.

Keywords: horse, hoof, imaging, radiography, neoplasia

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Authors: Yiyuan David Hu, Alex Lindqwister, Samuel B. Klein, Karen Moodie, Norman A. Paradis

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Introduction: Pseudo-Pulseless Electrical Activity (p-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Patients in pseudo-PEA carry different prognoses than those in true PEA and may require different therapies. End-tidal carbon dioxide (ET-CO2) is a reliable indicator of the return of spontaneous circulation (ROSC) in ventricular fibrillation and true-PEA but has not been studied p-PEA. Hypothesis: ET-CO2 can be used as an independent indicator of ROSC in p-PEA resuscitation. Methods: 30kg female swine (N = 14) under intravenous anesthesia were instrumented with aortic and right atrial micromanometer pressure. ECG and ET-CO2 were measured continuously. p-PEA was induced by ventilation with 6% oxygen in 94% nitrogen and was defined as a systolic Ao less than 40 mmHg. The statistical relationships between ET-CO2 and ROSC are reported. Results: ET-CO2 during resuscitation strongly correlated with ROSC (Figure 1). Mean ET-CO2 during p-PEA was 28.4 ± 8.4, while mean ET-CO2 in ROSC for 100% O2 cohort was 42.2 ± 12.6 (p < 0.0001), mean ET-CO2 in ROSC for 100% O2 + CPR was 33.0 ± 15.4 (p < 0.0001). Analysis of slope was limited to one minute of resuscitation data to capture local linearity; assessment began 10 seconds after resuscitation started to allow the ventilator to mix 100% O2. Pigs who would recover with 100% O2 had a slope of 0.023 ± 0.001, oxygen + CPR had a slope of 0.018 ± 0.002, and oxygen + CPR + epinephrine had a slope of 0.0050 ± 0.0009. Conclusions: During resuscitation from porcine hypoxic p-PEA, a rise in ET-CO2 is indicative of ROSC.

Keywords: ET-CO2, resuscitation, capnography, pseudo-PEA

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Authors: Sarah Ledoux

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This paper analyses the quantitative effects of political content consumption in social media platforms on self-reported ideological preference across the Latin American region. Initially praising the democratic potential of the internet and its social networking websites, digital politics scholars have transitioned their discourse to warning against the undemocratic side-effects it cultivates, such as hate speech, filter bubbles, and ideological polarisation. Holding technology solely responsible for political trends worldwide is an oversimplification of the factors influencing social change. Nonetheless, widespread use of social media in new democracies raises questions on the reproduction of recent trends that have been observed in the US and Western Europe. Through the analysis of ordered logistic regressions on data from the 2018 AmericasBarometer survey, this study examines the extent to which the relationship between the consumption of political content on social media is related to ideological polarisation in Latin America. The findings indicate that there is a close link between consumption of political information on social media, specifically on Facebook and WhatsApp, and ideological positioning on the extremes of the political left- and right-wings. This relation holds when controlling for individual-level demographic and attitudinal factors, as well as country-level effects. These results demonstrate with empirical evidence that viewing political content on social media has a significant positive effect on the likelihood that citizens position themselves on the extreme ends of the left-right ideological spectrum and implies that political polarisation is a phenomenon that accompanies politically driven social media use.

Keywords: Latin America, polarisation, political consumption, political ideology, social media, survey

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Authors: Abhinay Puvvala, Veerendra Kumar Rai

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A bottleneck situation arises when the outflow is lesser than the inflow in a pipe-like setup. A more practical interpretation of bottlenecks emphasizes on the realization of Service Level Objectives (SLOs) at given workloads. Our approach detects two key aspects of bottlenecks – when and where. To identify ‘when’ we continuously poll on certain key metrics such as resource utilization, processing time, request backlog and throughput at a system level. Further, when the slope of the expected sojourn time at a workload is greater than ‘K’ times the slope of expected sojourn time at the previous step of the workload while the workload is being gradually increased in discrete steps, a bottleneck situation arises. ‘K’ defines the threshold condition and is computed based on the system’s service level objectives. The second aspect of our approach is to identify the location of the bottleneck. In multi-tier systems with a complex network of layers, it is a challenging problem to locate bottleneck that affects the overall system performance. We stage the system by varying workload incrementally to draw a correlation between load increase and system performance to the point where Service Level Objectives are violated. During the staging process, multiple metrics are monitored at hardware and application levels. The correlations are drawn between metrics and the overall system performance. These correlations along with the Service Level Objectives are used to arrive at the threshold conditions for each of these metrics. Subsequently, the same method used to identify when a bottleneck occurs is used on metrics data with threshold conditions to locate bottlenecks.

Keywords: bottleneck, workload, service level objectives (SLOs), throughput, system performance

Procedia PDF Downloads 238

Authors: Joo-Hack Lee, Jin-Seung Choi, Dong-Won Kang, Jeong-Woo Seo, Ju-Young Kim, Dae-Hyeok Kim, Seung-Tae Yang, Gye-Rae Tack

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For cycling, the analysis of the pedal force is one of the important factors in the study of exercise ability assessment and overuse injuries. In past studies, a two-axis measurement sensor was used at the sagittal plane to measure the force only in the anterior, posterior, and vertical directions and to analyze the loss of force and the injury on the frontal plane due to the forces in the right and left directions. In this study, which is a basic study on diverse analyses of the pedal force that consider the forces on the sagittal plane and the frontal plane, a three-axis pedal force measurement sensor was developed to measure the anterior-posterior (Fx), medio-lateral (Fz), and vertical (Fy) forces. The sensor was fabricated with a size and shape similar to those of the general flat pedal, and had a 550g weight that allowed smooth pedaling. Its measurement range was ±1000 N for Fx and Fz and ±2000 N for Fy, and its non-linearity, hysteresis, and repeatability were approximately 0.5%. The data were sampled at 1000 Hz using a signal collector. To use the developed sensor, the pedaling efficiency (index of efficiency, IE) and the range of left and right (medio-lateral, ML) forces were measured with two seat heights (low and high). The results of the measurement showed that the IE was higher and the force range in the ML direction was lower with the high position than with the low position. The developed measurement sensor and its application results will be useful in understanding and explaining the complicated pedaling technique, and will enable diverse kinematic analyses of the pedal force on the sagittal plane and the frontal plane.

Keywords: cycling, pedal force, index of effectiveness, measuring

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Authors: Raana Babadi Fathipour

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Nourishment nanotechnology is an range of rising intrigued and opens up a entirety universe of modern conceivable outcomes for the nourishment industry. The essential categories of nanotechnology applications and functionalities right now within the improvement of nourishment bundling incorporate: the enhancement of plastic materials obstructions, the consolidation of dynamic components that can convey utilitarian properties past those of customary dynamic bundling, and the detecting and signaling of significant data. Nano nourishment bundling materials may amplify nourishment life, move forward nourishment security, alarm buyers that nourishment is sullied or ruined, repair tears in bundling, and indeed release preservatives to expand the life of the nourishment within the bundle. Nanotechnology applications within the nourishment industry can be utilized to identify microbes in bundling, or produce stronger flavors and color quality, and security by expanding the obstruction properties. Nanotechnology holds extraordinary guarantee to supply benefits not fair inside nourishment items but too around nourishment items. In reality, nanotechnology presents modern chances for advancement within the nourishment industry at monstrous speed, but instability and wellbeing concerns are moreover developing. EU/WE/global enactment for the direction of nanotechnology in nourishment are scanty. Besides, current enactment shows up unacceptable to nanotechnology specificity.

Keywords: nano technology, nano foods, food packaging, nano participle

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Authors: Letizia Maria Drammis, Maria Antonella Brandimonte

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The idea that people use space representations to think about time and number received support from several lines of research. However, how these representations develop in children and then shape space-time and space-number mappings is still a debated issue. In the present study, 40 children (20 pre-schoolers and 20 elementary-school children) performed 4 main tasks, which required the use of more concrete (non-symbolic) or more abstract (symbolic) space-time and space-number associations. In the non-symbolic conditions, children were required to order pictures of everyday-life events occurring in a specific temporal order (Temporal sequences) and of quantities varying in numerosity (Numerical sequences). In the symbolic conditions, they were asked to perform the typical time-to-position and number-to-position tasks by mapping time-related words and numbers onto lines. Results showed that children performed reliably better in the non-symbolic Time conditions than the symbolic Time conditions, independently of age, whereas only pre-schoolers performed worse in the Number-to-position task (symbolic) as compared to the Numerical sequence (non-symbolic) task. In addition, only older children mapped time-related words onto space following the typical left-right orientation, pre-schoolers’ performance being somewhat mixed. In contrast, mapping numbers onto space showed a clear left-right orientation, independently of age. Overall, these results indicate a cross-domain difference in the way younger and older children process time and number, with time-related tasks being more difficult than number-related tasks only when space-time tasks require symbolic representations.

Keywords: space-time associations, space-number associations, orientation, children

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Authors: Kamyar Moradi

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Background: There is mixed evidence regarding the association between recreational cannabinoid use and memory performance. One of the major reasons for the present controversy is different cannabinoid use-related covariates that influence the cognitive status of an individual. Adjustment of these confounding variables provides accurate insight into the real effects of cannabinoid use on memory status. In this study, we sought to investigate the association between recent recreational cannabinoid use and memory performance while correcting the model for other possible covariates such as demographic characteristics and duration, and amount of cannabinoid use. Methods: Cannabinoid users were assigned to two groups based on the results of THC urine drug screen test (THC+ group: n = 110, THC- group: n = 410). THC urine drug screen test has a high sensitivity and specificity in detecting cannabinoid use in the last 3-4 weeks. The memory domain of NIH Toolbox battery and brain MRI volumetric measures were compared between the groups while adjusting for confounding variables. Results: After Benjamini-Hochberg p-value correction, the performance in all of the measured memory outcomes, including vocabulary comprehension, episodic memory, executive function/cognitive flexibility, processing speed, reading skill, working memory, and fluid cognition, were significantly weaker in THC+ group (p values less than 0.05). Also, volume of gray matter, left supramarginal, right precuneus, right inferior/middle temporal, right hippocampus, left entorhinal, and right pars orbitalis regions were significantly smaller in THC+ group. Conclusions: this study provides evidence regarding the acute effect of recreational cannabis use on memory performance. Further studies are warranted to confirm the results.

Keywords: brain MRI, cannabis, memory, recreational use, THC urine test

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Authors: Nurtati Soewarno, Dian Duhita

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The existence of civilization from the past is recognized by the left objects such as monuments, buildings or even a town. The relics were designed and made well, using the good quality material so it could persist a long period of time. At this moment, those relics are cultural heritage that must be preserved and the authenticity maintained. Indonesia, a country consist of various tribes with many cultural heritages, one of them is the city of Lasem. Lasem city lies in the northern part of Central Java since the Majapahit kingdom era (13th century) poses as a busy harbor city and a trading center. Lasem is one of the residences of Chinese immigrants in Java, seen by the domination of Chinese architectural building styles. The residential was built since the 15th century and the building has the courtyard which is different from other China’s building in another part of Java. This city loses ground since the trade activity experience difficulties during the Japanese colonial era and continues after the Indonesian independence time. Many Chinese people left Lasem city and let the buildings empty not maintained. This paper will present the result of observation to Chinese architectural style buildings in Lasem city which still hold out until this moment. Using typo morphology method, the case study is chosen based on the transformation type. The occurring transformation is parallel with adaptive reuse concept as an effort to revitalize the existence of the buildings. With this concept, it is expected that the buildings could be re functioned and the glory of the foretime Lasem city could be experienced again. Intervention from the local government is expected, issuing regulations, hoping the new building functions won’t ruin the cultural heritage but instead beautifies it.

Keywords: adaptive re-use, brown field area, building transformation, Lasem city

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Authors: M. M. Akhmediev, J. R. Ashrapov, T. M. Akhmediev

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Hydrocephalus frequently occurs with spina bifida, and up to 80% of such patients need to be shunted. Objective: It’s sought to improve the results of the surgical treatment of hydrocephalus in children with spina bifida. Methods: We have analyzed the results of the surgical treatment of 80 patients aged between 1 month and 1,5-year-old with hydrocephalus and myelomeningocele. All patients underwent surgery in the period of 2013-2018. Results: In all patients, spina bifida was associated with hydrocephalus with a predominant extension of the posterior horns of the lateral ventricles in the form of colpocephaly, Chiari malformation type 2. Based on the method “Choose right shunt” the determination of the point of critical deformation of the ventricular system was established, 47 (58.8%) patients for the 1st stage underwent ventriculoperitoneal (VP) shunt surgery with a low-pressure valve, 28 (35.0%) patients with medium pressure and 5 (6.2%) with high-pressure valve. Under or over drainage complications were not observed in the postoperative period. The 2nd stage of surgery for myelomeningocele repair was planned in 1-2 months with the follow-up head ultrasonography and electromyography study. Conclusion: The implantable shunt systems parameters chosen before surgery in the surgical management of hydrocephalus in children with myelomeningocele are important in the causes of under or over drainage states, cerebrospinal fluid leakage from the myelomeningocele sac. Management of hydrocephalus should be performed by considering myelomeningocele affecting craniospinal compliance.

Keywords: hydrocephalus, spina bifida, myelomeningocele, ventriculoperitoneal (VP) shunt

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Authors: Ranitha Guna Selvi D, Ramakrishnan R, Mohideen Abdul Kader

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Purpose: To study the role of Vision centers in managing preventable blindness through refractive error correction in Rural South India. Methods: A retrospective analysis of patients attending 15 Vision centers in Rural South India from a period of January 2021 to December 2021 was done. Medical records of 10,85,81 patients both new and reviewed, 79,562 newly registered patients and 29,019 review patient’s from15 Vision centers were included for data analysis. All the patients registered at the vision center underwent basic eye examination, including visual acuity, IOP measurement, Slit-lamp examination, retinoscopy, Fundus examination etc. Results: A total of 1,08,581 patients were included in the study. Of the total 1,08,581 patients, 79,562 were newly registered patients at Vision center and 29,019 were review patients. Males were 52,201(48.1%) and Females were 56,308(51.9) among them. The mean age of all examined patients was 41.03 ± 20.9 years (Standard deviation) and ranged from 01 – 113 years. Presenting mean visual acuity was 0.31 ± 0.5 in the right eye and 0.31 ± 0.4 in the left eye. Of the 1,08,581 patients 22,770 patients had refractive error in right eye and 22,721 patients had uncorrected refractive error in left eye. Glass prescription was given to 17,178 (15.8%) patients. 8,109 (7.5%) patients were referred to the base hospital for specialty clinic expert opinion or for cataract surgery. Conclusion: Vision center utilizing teleconsultation for comprehensive eye screening unit is a very effective tool in reducing the avoidable visual impairment caused due to uncorrected refractive error. Vision Centre model is believed to be efficient as it facilitates early detection and management of uncorrected refractive errors.

Keywords: refractive error, uncorrected refractive error, vision center, vision technician, teleconsultation

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: Boguslaw Schreyer

Abstract:

During the wheeled robot’s braking process, the extra dynamic vertical forces act on all wheels: left, right, front or rear. Those forces are directed downward on the front wheels while directed upward on the rear wheels. In order to maximize the deceleration, therefore, minimize the braking time and braking distance, we need to calculate a correct torque distribution: the front braking torque should be increased, and rear torque should be decreased. At the same time, we need to provide better transversal stability. In a simple case of all adhesion coefficients being the same under all wheels, the torque distribution may secure the optimal (maximal) control of the robot braking process, securing the minimum braking distance and a minimum braking time. At the same time, the transversal stability is relatively good. At any time, we control the transversal acceleration. In the case of the transversal movement, we stop the braking process and re-apply braking torque after a defined period of time. If we correctly calculate the value of the torques, we may secure the traction coefficient under the front and rear wheels close to its maximum. Also, in order to provide an optimum braking control, we need to calculate the timing of the braking torque application and the timing of its release. The braking torques should be released shortly after the wheels passed a maximum traction coefficient (while a wheels’ slip increases) and applied again after the wheels pass a maximum of traction coefficient (while the slip decreases). The correct braking torque distribution secures the front and rear wheels, passing this maximum at the same time. It guarantees an optimum deceleration control, therefore, minimum braking time. In order to calculate a correct torque distribution, a control unit should receive the input signals of a rear torque value (which changes independently), the robot’s deceleration, and values of the vertical front and rear forces. In order to calculate the timing of torque application and torque release, more signals are needed: speed of the robot: angular speed, and angular deceleration of the wheels. In case of different adhesion coefficients under the left and right wheels, but the same under each pair of wheels- the same under right wheels and the same under left wheels, the Select-Low (SL) and select high (SH) methods are applied. The SL method is suggested if transversal stability is more important than braking efficiency. Often in the case of the robot, more important is braking efficiency; therefore, the SH method is applied with some control of the transversal stability. In the case that all adhesion coefficients are different under all wheels, the front-rear torque distribution is maintained as in all previous cases. However, the timing of the braking torque application and release is controlled by the rear wheels’ lowest adhesion coefficient. The Lagrange equations have been used to describe robot dynamics. Matlab has been used in order to simulate the process of wheeled robot braking, and in conclusion, the braking methods have been selected.

Keywords: wheeled robots, braking, traction coefficient, asymmetric

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Authors: Ho Seong Shin

Abstract:

Introduction: A research in relation to wound healing also showed that platelet-rich plasma (PRP) was effective on normal tissue regeneration. Nonetheless, there is no evidence that when platelet-rich plasma was applied on diabetic wound, it normalize diabetic wound healing process. In this study, we have analyzed matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) expression to know the effect of PRP on diabetic wounds using Reverse transcription-polymerase chain reaction (RT-PCR) of MMP-2, MMP-9 mRNA. Materials and Methods: Platelet-rich plasma (PRP) was prepared from blood of 6 rats. The whole 120-mL was added immediately to an anticoagulant. Citrate phosphonate dextrose(CPD) buffer (0.15 mg CPDmL) in a ratio of 1 mL of CPD buffer to 5 mL of blood. The blood was then centrifuged at 220g for 20minutes. The supernatant was saved to produce fibrin glue. The participate containing PRP was used for second centrifugation at 480g for 20 minutes. The pellet from the second centrifugation was saved and diluted with supernatant until the platelet concentration became 900,000/μL. Twenty male, 4week-old OLETF rats were underwent operation; each rat had two wounds created on left and right sides. The each wound of left side was treated with PRP gel, the wound of right side was treated with physiologic saline gauze. Results: RT-PCR analysis; The levels of MMP-2 mRNA in PRP applied tissues were positively related to postwounding days, whereas MMP-2 mRNA expression in saline-applied tissues remained in 5day after treatment. MMP-9 mRNA was undetectable in saline-applied tissues for either tissue, except 3day after treatment. Following PRP-applied tissues, MMP-9 mRNA expression was detected, with maximal expression being seen at third day. The levels of MMP-9 mRNA in PRP applied tissues were reported high intensity of optical density related to saline applied tissues.

Keywords: diabetes, MMP-2, MMP-9, OLETF, PRP, wound healing MMP-9

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Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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Authors: Junya Kouwa, Shinsuke Matsuno, Chihiro Inoue, Takehiro Himeno, Toshinori Watanabe

Abstract:

Bi-propellant thrusters use impinging jet atomization to atomize liquid fuel and oxidizer. Atomized propellants are mixed and combusted due to auto-ignitions. Therefore, it is important for a prediction of thruster’s performance to simulate the primary atomization phenomenon; especially, the local mixture ratio can be used as indicator of thrust performance, so it is useful to evaluate it from numerical simulations. In this research, we propose a numerical method for considering bi-liquid and the mixture and install it to CIP-LSM which is a two-phase flow simulation solver with level-set and MARS method as an interfacial tracking method and can predict local mixture ratio distribution downstream from an impingement point. A new parameter, beta, which is defined as the volume fraction of one liquid in the mixed liquid within a cell is introduced and the solver calculates the advection of beta, inflow and outflow flux of beta to a cell. By validating this solver, we conducted a simple experiment and the same simulation by using the solver. From the result, the solver can predict the penetrating length of a liquid jet correctly and it is confirmed that the solver can simulate the mixing of liquids. Then we apply this solver to the numerical simulation of impinging jet atomization. From the result, the inclination angle of fan after the impingement in the bi-liquid condition reasonably agrees with the theoretical value. Also, it is seen that the mixture of liquids can be simulated in this result. Furthermore, simulation results clarify that the injecting condition affects the atomization process and local mixture ratio distribution downstream drastically.

Keywords: bi-propellant thrusters, CIP-LSM, free-surface flow simulation, impinging jet atomization

Procedia PDF Downloads 279

Authors: Sohrab Jafarpour, Hamed Farokhi, Mohammad Rahmati, Alireza Gholipour

Abstract:

In the current study, a nonlinear fluid-structure interaction (FSI) biomechanical model of atherosclerosis in the left anterior descending (LAD) coronary artery is developed to perform a detailed sensitivity analysis of the geometrical features of an atheroma plaque. In the development of the numerical model, first, a 3D geometry of the diseased artery is developed based on patient-specific dimensions obtained from the experimental studies. The geometry includes four influential geometric characteristics: stenosis ratio, plaque shoulder-length, fibrous cap thickness, and eccentricity intensity. Then, a suitable strain energy density function (SEDF) is proposed based on the detailed material stability analysis to accurately model the hyperelasticity of the arterial walls. The time-varying inlet velocity and outlet pressure profiles are adopted from experimental measurements to incorporate the pulsatile nature of the blood flow. In addition, a computationally efficient type of structural boundary condition is imposed on the arterial walls. Finally, a non-Newtonian viscosity model is implemented to model the shear-thinning behaviour of the blood flow. According to the results, the structural responses in terms of the maximum principal stress (MPS) are affected more compared to the fluid responses in terms of wall shear stress (WSS) as the geometrical characteristics are varying. The extent of these changes is critical in the vulnerability assessment of an atheroma plaque.

Keywords: atherosclerosis, fluid-Structure interaction modeling, material stability analysis, and nonlinear biomechanics

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Authors: Arina V. Tankanag, Gennady V. Krasnikov, Nikolai K. Chemeris

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The development of respiration-dependent oscillations in the peripheral blood flow may occur by at least two mechanisms. The first mechanism is related to the change of venous pressure due to mechanical activity of lungs. This phenomenon is known as ‘respiratory pump’ and is one of the mechanisms of venous return of blood from the peripheral vessels to the heart. The second mechanism is related to the vasomotor reflexes controlled by the respiratory modulation of the activity of centers of the vegetative nervous system. Early high phase synchronization of respiration-dependent blood flow oscillations of left and right forearm skin in healthy volunteers at rest was shown. The aim of the work was to study the effect of deep controlled breathing on the phase synchronization of skin blood flow oscillations. 29 normotensive non-smoking young women (18-25 years old) of the normal constitution without diagnosed pathologies of skin, cardiovascular and respiratory systems participated in the study. For each of the participants six recording sessions were carried out: first, at the spontaneous breathing rate; and the next five, in the regimes of controlled breathing with fixed breathing depth and different rates of enforced breathing regime. The following rates of controlled breathing regime were used: 0.25, 0.16, 0.10, 0.07 and 0.05 Hz. The breathing depth amounted to 40% of the maximal chest excursion. Blood perfusion was registered by laser flowmeter LAKK-02 (LAZMA, Russia) with two identical channels (wavelength 0.63 µm; emission power, 0.5 mW). The first probe was fastened to the palmar surface of the distal phalanx of left forefinger; the second probe was attached to the external surface of the left forearm near the wrist joint. These skin zones were chosen as zones with different dominant mechanisms of vascular tonus regulation. The degree of phase synchronization of the registered signals was estimated from the value of the wavelet phase coherence. The duration of all recording was 5 min. The sampling frequency of the signals was 16 Hz. The increasing of synchronization of the respiratory-dependent skin blood flow oscillations for all controlled breathing regimes was obtained. Since the formation of respiration-dependent oscillations in the peripheral blood flow is mainly caused by the respiratory modulation of system blood pressure, the observed effects are most likely dependent on the breathing depth. It should be noted that with spontaneous breathing depth does not exceed 15% of the maximal chest excursion, while in the present study the breathing depth was 40%. Therefore it has been suggested that the observed significant increase of the phase synchronization of blood flow oscillations in our conditions is primarily due to an increase of breathing depth. This is due to the enhancement of both potential mechanisms of respiratory oscillation generation: venous pressure and sympathetic modulation of vascular tone.

Keywords: deep controlled breathing, peripheral blood flow oscillations, phase synchronization, wavelet phase coherence

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Authors: Reagan Rodriguez

Abstract:

With a growing divide between political echo chambers in the United States, exacerbated by race and income inequality, it might seem to be unfathomable to draw connections that tie working class in an industrial city and a U.S. territory. Yet, in regions where either the economy has been hit due to dwindling job infrastructure or natural disasters have left indelible marks on an island already once marked by colonial imperialism, a larger social shared identity is at play. Fracking has long been an intergenerational and stable work opportunity for many in the Pittsburg PA, yet the rising severity of global climate change may soon impact the policy and even presidential elections which could result in the reduction of jobs in the industry. Cock-fighting, considered a cultural mainstay within the island of Puerto Rico, has already had legislation banning activity and thus cutting out one of the most lucrative aspects of a severely injured economy. Insecurity, infringement, and isolation while being tied to a working-class bracket with no other opportunities in proximity have left both groups expressing similar frustration and while another larger shared identity politic is giving little other options to develop social mobility. This paper utilizes a thematic analysis and compares convergent and divergent themes on internet forums amongst unionized fracking workers in Pittsburg and cockfighters in Puerto Rico. This research examines how group identity in relation to job and cultural identity is most strong and at which points its most malleable; when intergenerational job identity becomes a part of one’s cultural identity, its override may be strongest when it is perceived as threatened. Final findings and limitations were comprehensively outlined.

Keywords: identity threat, social psychology, group identity, culture and social mobility

Procedia PDF Downloads 151

Authors: Nitesh Kumar, Eoin Twohig, jasparl cheema, Sadiq mawji, Yousif al najjar

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Basal cell carcinoma (BCC) is the commonest cutaneous malignancy affecting humans. Despite this, distant spread is exceptionally rare. Metastatic BCC (mBCC) is estimated to occur in 0.0028 - 0.5%. it aim to illustrate with the aid of histological slides, a case of mBCC occurring in a fit and well 67-year-old. Initial diagnosis of desmoplastic BCC was made in 2006 from a scalp biopsy with the lesion then being excised. Re-excision of local recurrence was undertaken the following year. In 2014 the patient presented with an ipsilateral level 2a mass. Fine Needle Aspiration raised the suspicion of metastatic carcinoma. The patient had excision of two nodes from the left neck alongside pharyngeal tonsillectomy and tongue base biopsies. Histologically, the nodes closely resembled the immunophenotype of the initial scalp lesion. The patient subsequently had a modified radical neck dissection, and residual mBCC was excised from the left Sternocleidomastoid muscle. In 2023 the patient developed haematuria. On further investigation bilateral lung lesions on CT were noted with subsequent biopsy confirming mBCC. Spinal and renal lesions have also been found. Histopathology showed clear resemblance of the lung metastases to both those in the neck and the primary (scalp BCC) – with no squamous differentiation seen. The time span from primary to occurrence of lung metastasis (18 years) affirms the indolent and slow growing nature of BCC.  This case fulfils Lattes and Kessler diagnostic criteria. High risk cases are described as those with advanced local presentation, primary tumour on the Head and Neck and locally recurrent lesions.

Keywords: BCC, metastasis, rare, skin cancer

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Authors: M. A. Fiidow, Ahmad M. Alenezi

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In this work, we study the inner derivations of diassociative algebras in dimension two and three, an algorithmic approach is adopted for the computation of inner derivation, using some results from the derivation of finite dimensional diassociative algebras. Some basic properties of inner derivation of finite dimensional diassociative algebras are also provided.

Keywords: diassociative algebras, inner derivations, derivations, left and right operator

Procedia PDF Downloads 270

Authors: Nur Nadhirah Rusyda Rosnan, Nursuhaili Najwa Masrol, Nurul Fatiha MD Nor, Mohammad Zafrullah Mohammad Salim, Sim Choon Cheak

Abstract:

Accurate inventories of oil palm planted areas are crucial for plantation management as this would impact the overall economy and production of oil. One of the technological advancements in the oil palm industry is semi-automated palm counting, which is replacing conventional manual palm counting via digitizing aerial imagery. Most of the semi-automated palm counting method that has been developed was limited to mature palms due to their ideal canopy size represented by satellite image. Therefore, immature palms were often left out since the size of the canopy is barely visible from satellite images. In this paper, an approach using a morphological filter and high-resolution satellite image is proposed to detect immature palm trees. This approach makes it possible to count the number of immature oil palm trees. The method begins with an erosion filter with an appropriate window size of 3m onto the high-resolution satellite image. The eroded image was further segmented using watershed segmentation to delineate immature palm tree regions. Then, local minimum detection was used because it is hypothesized that immature oil palm trees are located at the local minimum within an oil palm field setting in a grayscale image. The detection points generated from the local minimum are displaced to the center of the immature oil palm region and thinned. Only one detection point is left that represents a tree. The performance of the proposed method was evaluated on three subsets with slopes ranging from 0 to 20° and different planting designs, i.e., straight and terrace. The proposed method was able to achieve up to more than 90% accuracy when compared with the ground truth, with an overall F-measure score of up to 0.91.

Keywords: immature palm count, oil palm, precision agriculture, remote sensing

Procedia PDF Downloads 76

Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

Abstract:

Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

Procedia PDF Downloads 392