Search results for: anterior neck disectomy and fusion

Authors: Rene A. Amadore Jr., Ramar John Bangayan, Therese Eileen L. Natividad

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This is a case of a 59-year-old female who presented with a two-year history of heliotrope rash, Gottron's papules, shawl sign, V-neck sign, and muscle weakness. She was previously managed as a case of systemic lupus erythematosus, who initially responded to unrecalled corticosteroids. She was, however, admitted due to a one-month progressively enlarging sacral mass, which eventually turned out to be an abscess. While the abscess was being treated, her autoimmune condition was worked up, and she was then managed as a case of clinically amyopathic dermatomyositis (CADM) with interstitial lung disease (ILD). She received corticosteroids and underwent the first cycle of cyclophosphamide infusion prior to discharge.

Keywords: clinically amyopathic dermatomyositis, interstitial lung disease, corticosteroids, sacral abscess

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Authors: Donald Zullick, Cihan Varol

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This research paper begins with a look at current work in business continuity as it relates to the cloud and small to medium business (SMB). While cloud services are an emerging paradigm that is quickly making an impact on business, there has been no substantive research applied to SMB. Seeing this lapse, we have taken a fusion of continuity and cloud research with application to the SMB market. It is an initial reflection with base framework guidelines as a starting point for implementation. In this approach, our research ties together existing work and fill the gap with an SMB outlook.

Keywords: business continuity, cloud services, medium size business, risk assessment, small business

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Head and neck cancer (HNC) is a big global health problem in the world. Despite the development of diagnosis and treatment, the overall survival of HNC is still low. The well recognition of the interaction of the host immune system and cancer cells has led to realizing the processes of tumor initiation, progression and metastasis. Many systemic inflammatory responses have been shown to play a crucial role in cancer progression. The pre and post-treatment nutritional and immunological status of HNC patients is a reliable prognostic indicator of tumor outcomes and survivors. Methods: Between July 2020 to June 2022, We have enrolled 60 HNC patients, including 59 males and 1 female, in Chi Mei Medical Center, Liouying, Taiwan. The age distribution was from 37 to 81 years old (y/o), with a mean age of 57.6 y/o. We evaluated the pre-and post-treatment nutritional and immunological status of these HNC patients with body weight, body weight loss, body mass index (BMI), whole blood count including hemoglobin (Hb), lymphocyte, neutrophil and platelet counts, biochemistry including prealbumin, albumin, c-reactive protein (CRP), with the time period of before treatment, post-treatment 3 and 6 months. We calculated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to assess how these biomarkers influence the outcomes of HNC patients. Results: We have carcinoma of the hypopharynx in 21 cases with 35％, carcinoma of the larynx in 9 cases, carcinoma of the tonsil and tongue every 6 cases, carcinoma soft palate and tongue base every 5 cases, carcinoma of buccal mucosa, retromolar trigone and mouth floor every 2 cases, carcinoma of the hard palate and low lip each 1 case. There were stage I 15 cases, stage II 13 cases, stage III 6 cases, stage IVA 10 cases, and stage IVB 16 cases. All patients have received surgery, chemoradiation therapy or combined therapy. We have wound infection in 6 cases, 2 cases of pharyngocutaneous fistula, flap necrosis in 2 cases, and mortality in 6 cases. In the wound infection group, the average BMI is 20.4 kg/m2; the average Hb is 12.9 g/dL, the average albumin is 3.5 g/dL, the average NLR is 6.78, and the average PLR is 243.5. In the PC fistula and flap necrosis group, the average BMI is 21.65 kg/m2; the average Hb is 11.7 g/dL, the average albumin is 3.15 g/dL, average NLR is 13.28, average PLR is 418.84. In the mortality group, the average BMI is 22.3 kg/m2; the average Hb is 13.58 g/dL, the average albumin is 3.77 g/dL, the average NLR is 6.06, and the average PLR is 275.5. Conclusion: HNC is a big challenging public health problem worldwide, especially in the high prevalence of betel nut consumption area Taiwan. Besides the definite risk factors of smoking, drinking and betel nut related, the other biomarkers may play significant prognosticators in the HNC outcomes. We concluded that the average BMI is less than 22 kg/m2, the average Hb is low than 12.0 g/dL, the average albumin is low than 3.3 g/dL, the average NLR is low than 3, and the average PLR is more than 170, the surgical complications and mortality will be increased, and the prognosis is poor in HNC patients.

Keywords: nutritional, immunological, neutrophil-to-lymphocyte ratio, paltelet-to-lymphocyte ratio.

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Authors: Jemal Ebrahim Dessie, Zsolt Lukacs

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The wall of the aerosol can is extruded from the backward extrusion process. Necking is another forming process stage developed on the can shoulder after the backward extrusion process. Due to the thinner thickness of the wall, buckling is the critical challenge for current pure aluminum aerosol can industries. Design and investigation of extrusion with inhomogeneous wall thickness could be the best solution for reducing and optimization of neck retraction numbers. FEM simulation of inhomogeneous wall thickness has been simulated through this investigation. From axisymmetric Deform-2D backward extrusion, an aerosol can with a thickness of 0.4 mm at the top and 0.33 mm at the bottom of the aerosol can have been developed. As the result, it can optimize the number of retractions of the necking process and manufacture defect-free aerosol can shoulder due to the necking process.

Keywords: aerosol can, backward extrusion, Deform-2D, necking

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Authors: Seynabou Toure, Oumar Diop, Kidiyo Kpalma, Amadou S. Maiga

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Color and texture are the two most determinant elements for perception and recognition of the objects in an image. For this reason, color and texture analysis find a large field of application, for example in image classification and segmentation. But, the pioneering work in texture analysis was conducted on grayscale images, thus discarding color information. Many grey-level texture descriptors have been proposed and successfully used in numerous domains for image classification: face recognition, industrial inspections, food science medical imaging among others. Taking into account color in the definition of these descriptors makes it possible to better characterize images. Color texture is thus the subject of recent work, and the analysis of color texture images is increasingly attracting interest in the scientific community. In optical remote sensing systems, sensors measure separately different parts of the electromagnetic spectrum; the visible ones and even those that are invisible to the human eye. The amounts of light reflected by the earth in spectral bands are then transformed into grayscale images. The primary natural colors Red (R) Green (G) and Blue (B) are then used in mixtures of different spectral bands in order to produce RGB images. Thus, good color texture discrimination can be achieved using RGB under controlled illumination conditions. Some previous works investigate the effect of using different color space for color texture classification. However, the selection of the best performing color space in land-sea segmentation is an open question. Its resolution may bring considerable improvements in certain applications like coastline detection, where the detection result is strongly dependent on the performance of the land-sea segmentation. The aim of this paper is to present the results of a study conducted on different color spaces in order to show the best-performing color space for land-sea segmentation. In this sense, an experimental analysis is carried out using five different color spaces (RGB, XYZ, Lab, HSV, YCbCr). For each color space, the Haar wavelet decomposition is used to extract different color texture features. These color texture features are then used for Fusion of Over Segmentation (FOOS) based classification; this allows segmentation of the land part from the sea one. By analyzing the different results of this study, the HSV color space is found as the best classification performance while using color and texture features; which is perfectly coherent with the results presented in the literature.

Keywords: classification, coastline, color, sea-land segmentation

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Authors: Joshua Buli, David Pietrowski, Samuel Britton

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Processing SAR data usually requires constraints in extent in the Fourier domain as well as approximations and interpolations onto a planar surface to form an exploitable image. This results in a potential loss of data requires several interpolative techniques, and restricts visualization to two-dimensional plane imagery. The data can be interpolated into a ground plane projection, with or without terrain as a component, all to better view SAR data in an image domain comparable to what a human would view, to ease interpretation. An alternate but computationally heavy method to make use of more of the data is the basis of this research. Pre-processing of the SAR data is completed first (matched-filtering, motion compensation, etc.), the data is then range compressed, and lastly, the contribution from each pulse is determined for each specific point in space by searching the time history data for the reflectivity values for each pulse summed over the entire collection. This results in a per-3D-point reflectivity using the entire collection domain. New advances in GPU processing have finally allowed this rapid projection of acquired SAR data onto any desired reference surface (called backprojection). Mathematically, the computations are fast and easy to implement, despite limitations in SAR phase history data size and 3D-point cloud size. Backprojection processing algorithms are embarrassingly parallel since each 3D point in the scene has the same reflectivity calculation applied for all pulses, independent of all other 3D points and pulse data under consideration. Therefore, given the simplicity of the single backprojection calculation, the work can be spread across thousands of GPU threads allowing for accurate reflectivity representation of a scene. Furthermore, because reflectivity values are associated with individual three-dimensional points, a plane is no longer the sole permissible mapping base; a digital elevation model or even a cloud of points (collected from any sensor capable of measuring ground topography) can be used as a basis for the backprojection technique. This technique minimizes any interpolations and modifications of the raw data, maintaining maximum data integrity. This innovative processing will allow for SAR data to be rapidly brought into a common reference frame for immediate exploitation and data fusion with other three-dimensional data and representations.

Keywords: backprojection, data fusion, exploitation, three-dimensional, visualization

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Authors: Ziyad S. Haidar

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Background: Saliva plays a major role in maintaining oral and dental health (consequently, general health and well-being). Where it normally bathes the oral cavity and acts as a clearing agent. This becomes more apparent when the amount and quality of salivare significantly reduced due to medications, salivary gland neoplasms, disorders such as Sjögren’s syndrome, and especially ionizing radiation therapy for tumors of the head and neck, the fifth most common malignancy worldwide, during which the salivary glands are included within the radiation field or zone. Clinically, patients affected by salivary gland dysfunction often opt to terminate their radiotherapy course prematurely because they become malnourished and experience a significant decrease in their quality of life. Accordingly, the development of an alternative treatment to restore or regenerate damaged salivary gland tissue is eagerly awaited. Likewise, the formulation of a radioprotection modality and early damage prevention strategy is also highly desirable. Objectives: To assess the pre-clinical radio-protective effect as well as the reparative/regenerative potential of layer-by-layer self-assembled lipid-polymer-based core-shell nanocapsules designed and fine-tuned in this experimental work for the sequential (ordered) release of dual cytokines, following a single local administration (direct injection) into a murine sub-mandibular salivary gland model of irradiation. Methods: The formulated core-shell nanocapsules were characterized by physical-chemical-mechanically pre-/post-loading with the drugs (in solution and powder formats), followed by optimizing the pharmaco-kinetic profile. Then, nanosuspensions were administered directly into the salivary glands, 24hrs pre-irradiation (PBS, un-loaded nanocapsules, and individual and combined vehicle-free cytokines were injected into the control glands for an in-depth comparative analysis). External irradiation at an elevated dose of 18Gy (revised from our previous 15Gy model) was exposed to the head-and-neck region of C57BL/6 mice. Salivary flow rate (un-stimulated) and salivary protein content/excretion were regularly assessed using an enzyme-linked immunosorbent assay (3-month period). Histological and histomorphometric evaluation and apoptosis/proliferation analysis followed by local versus systemic bio-distribution and immuno-histochemical assays were then performed on all harvested major organs (at the distinct experimental end-points). Results: Monodisperse, stable, and cytocompatible nanocapsules capable of maintaining the bioactivity of the encapsulant within the different compartments with the core and shell and with controlled/customizable pharmaco-kinetics, resulted, as is illustrated in the graphical abstract (Figure) below. The experimental animals demonstrated a significant increase in salivary flow rates when compared to the controls. Herein, salivary protein content was comparable to the pre-irradiation (baseline) level. Histomorphometry further confirmed the biocompatibility and localization of the nanocapsules, in vivo, into the site of injection. Acinar cells showed fewer vacuoles and nuclear aberration in the experimental group, while the amount of mucin was higher in controls. Overall, fewer apoptotic activities were detected by a Terminal deoxynucleotidyl Transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay and proliferative rates were similar to the controls, suggesting an interesting reparative and regenerative potential of irradiation-damaged/-dysfunctional salivary glands. The Figure below exemplifies some of these findings. Conclusions: Biocompatible, reproducible, and customizable self-assembling layer-by-layer core-shell delivery system is formulated and presented. Our findings suggest that localized sequential bioactive delivery of dual cytokines (in specific dose and order) can prevent irradiation-induced damage via reducing apoptosis and also has the potential to promote in situ proliferation of salivary gland cells; maxSALIVA is scalable (Good Manufacturing Practice or GMP production for human clinical trials) and patent-pending.

Keywords: saliva, head and neck cancer, nanotechnology, controlled drug delivery, xerostomia, mucositis, biopolymers, innovation

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Authors: F. Tang, S. Boskovich, A. Raheja, Z. Aliyazicioglu, S. Bhandari, N. Tsuchiya

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Calpoly Autonomous Transportation Experience (CATE) is a driverless vehicle that we are developing to provide safe, accessible, and efficient transportation of passengers throughout the Cal Poly Pomona campus for events such as orientation tours. Unlike the other self-driving vehicles that are usually developed to operate with other vehicles and reside only on the road networks, CATE will operate exclusively on walk-paths of the campus (potentially narrow passages) with pedestrians traveling from multiple locations. Safety becomes paramount as CATE operates within the same environment as pedestrians. As driverless vehicles assume greater roles in today’s transportation, this project will contribute to autonomous driving with pedestrian traffic in a highly dynamic environment. The CATE project requires significant interdisciplinary work. Researchers from mechanical engineering, electrical engineering and computer science are working together to attack the problem from different perspectives (hardware, software and system). In this abstract, we describe the software aspects of the project, with a focus on the requirements and the major components. CATE shall provide a GUI interface for the average user to interact with the car and access its available functionalities, such as selecting a destination from any origin on campus. We have developed an interface that provides an aerial view of the campus map, the current car location, routes, and the goal location. Users can interact with CATE through audio or manual inputs. CATE shall plan routes from the origin to the selected destination for the vehicle to travel. We will use an existing aerial map for the campus and convert it to a spatial graph configuration where the vertices represent the landmarks and edges represent paths that the car should follow with some designated behaviors (such as stay on the right side of the lane or follow an edge). Graph search algorithms such as A* will be implemented as the default path planning algorithm. D* Lite will be explored to efficiently recompute the path when there are any changes to the map. CATE shall avoid any static obstacles and walking pedestrians within some safe distance. Unlike traveling along traditional roadways, CATE’s route directly coexists with pedestrians. To ensure the safety of the pedestrians, we will use sensor fusion techniques that combine data from both lidar and stereo vision for obstacle avoidance while also allowing CATE to operate along its intended route. We will also build prediction models for pedestrian traffic patterns. CATE shall improve its location and work under a GPS-denied situation. CATE relies on its GPS to give its current location, which has a precision of a few meters. We have implemented an Unscented Kalman Filter (UKF) that allows the fusion of data from multiple sensors (such as GPS, IMU, odometry) in order to increase the confidence of localization. We also noticed that GPS signals can easily get degraded or blocked on campus due to high-rise buildings or trees. UKF can also help here to generate a better state estimate. In summary, CATE will provide on-campus transportation experience that coexists with dynamic pedestrian traffic. In future work, we will extend it to multi-vehicle scenarios.

Keywords: driverless vehicle, path planning, sensor fusion, state estimate

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Authors: Rachael Collins, George Lafford

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We report a case of a generally fit and a well 54-year-old gentleman who presented with a two-day history of worsening left-sided otorrhea, headache, neck stiffness, vomiting and pyrexia on the background of a seven-week history of OE. His condition progressed dramatically as he developed symptoms consistent with acute complete cervical cord syndrome with radiological evidence of skull base osteomyelitis, parapharyngeal, retropharyngeal and paravertebral abscesses and sigmoid sinus thrombus. Ultimately he made a significant, although not complete, recovery. This case is unique in demonstrating how OE can develop into a potentially life-threatening condition. It emphasizes the importance of early diagnosis and treatment of OE, the recognition of ‘red flag’ symptoms and highlights the importance of a multi-disciplinary team (MDT) approach when managing complex complications of OE.

Keywords: ENT, neurology, otology, MDT

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Authors: Ahmed F. Elaksher, Islam Omar

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In this project, we used MOLA-based DEMs to orthorectify HiRISE optical images. The MOLA data was interpolated using the kriging interpolation technique. Corresponding tie points were then digitized from both datasets. These points were employed in co-registering both datasets using GIS analysis tools. Different transformation models, including the affine and projective transformation models, were used with different sets and distributions of tie points. Additionally, we evaluated the use of the MOLA elevations in co-registering the MOLA and HiRISE datasets. The planimetric RMSEs achieved for each model are reported. Results suggested the use of 3D-2D transformation models.

Keywords: photogrammetry, Mars, MOLA, HiRISE

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Authors: Norica Godja, Andreas Schindel, Luka Payrits, Zsolt Pasztor, Bálint Hegedüs, Petr Homola, Jan Horňas, Jiří Běhal, Roman Ruzek, Martin Holzleitner, Sascha Senck

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In order to reduce fuel consumption and CO₂ emissions in the aviation sector, innovative solutions are being sought to reduce the weight of aircraft, including additive manufacturing (AM). Of particular importance are the excellent mechanical properties that are required for aircraft structures. Ti6Al4V alloys, with their high mechanical properties in relation to weight, can reduce the weight of aircraft structures compared to structures made of steel and aluminium. Currently, conventional processes such as casting and CNC machining are used to obtain the desired structures, resulting in high raw material removal, which in turn leads to higher costs and impacts the environment. Additive manufacturing (AM) offers advantages in terms of weight, lead time, design, and functionality and enables the realisation of alternative geometric shapes with high mechanical properties. However, there are currently technological shortcomings that have led to AM not being approved for structural components with high safety requirements. An assessment of damage tolerance for AM parts is required, and quality control needs to be improved. Pores and other defects cannot be completely avoided at present, but they should be kept to a minimum during manufacture. The mechanical properties of the manufactured parts can be further improved by various treatments. The influence of different treatment methods (heat treatment, CNC milling, electropolishing, chemical polishing) and operating parameters were investigated by scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX), X-ray diffraction (XRD), electron backscatter diffraction (EBSD) and measurements with a focused ion beam (FIB), taking into account surface roughness, possible anomalies in the chemical composition of the surface and possible cracks. The results of the characterisation of the constructed and treated samples are discussed and presented in this paper. These results were generated within the framework of the 3TANIUM project, which is financed by EU with the contract number 101007830.

Keywords: Ti6Al4V alloys, laser powder bed fusion, damage tolerance, heat treatment, electropolishing, potential cracking

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Authors: Anna Jeon, Seung-Ho Han, Je-Hun Lee

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The aim of this study was to determine the location and distribution pattern of neurovascular structures superior and inferior to the clavicle by detailed dissection. Fifteen adult non-embalmed cadavers with a mean age of 71.5 years were studied. For measurements, the most prominent point of the sternal end of the clavicle (SEC) on anterior view and the most prominent point of the acromial end of the clavicle (AEC) were identified before dissection. A line connecting the SEC and AEC was used as a reference line. The surrounding neurovascular structures were investigated. The supraclavicular nerve was densely distributed at 71.73% on the reference line. Branches of the thoracoacromial artery were located at 76.92%. Branches of subclavian vein were evenly distributed at all sections. The subclavian vein and artery and brachial plexus were located from 31.3% to 57.5%. That area needs caution because major neurovascular structures run underneath the clavicle.

Keywords: clavicle, ORIF, neurovascular structure, anatomical study

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Authors: Reinhard Neck, Guido Schäfer

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In this paper, we explore the macroeconomic effects of the European Single Market on Austria by simulating the McKibbin-Sachs Global Model. Global interdependence and the impact of long-run effects on short-run adjustments are taken into account. We study the sensitivity of the results with respect to different assumptions concerning monetary and fiscal policies for the countries and regions of the world economy. The consequences of different assumptions about budgetary policies in Austria are also investigated. The simulation results are contrasted with ex-post evaluations of the actual impact of Austria’s membership in the Single Market. As a result, it can be concluded that the Austrian participation in the European Single Market entails considerable long-run gains for the Austrian economy with nearly no adverse side-effects on any macroeconomic target variable.

Keywords: macroeconomics, European Union, simulation, sensitivity analysis

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Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

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Klebsiella pneumoniae bacteria is a global threat to human health due to an increase in multi-drug resistance among strains. The hypervirulent strains of Klebsiella pneumoniae is a major trouble due to their association with life-threatening infections in a healthy population. One of the major virulence factors of hyper virulent strains of Klebsiella pneumoniae is the T6SS (Type six secretary system) which is majorly involved in microbial antagonism and causes interaction with the host eukaryotic cells during infections. T6SS mediates some of the crucial factors for establishing infection by the bacteria, such as cell adherence, invasion, and subsequent in vivo colonisation. The antibacterial activity and the cell invasion property of the T6SS system is a major requirement for the establishment of K. pneumoniae infections within the gut. The T6SS can be an appropriate target for developing therapeutics. The T6SS consists of an inner tube comprising hexamers of Hcp (Haemolysin -regulated protein) protein, and at the top of this tube sits VgrG (Valine glycine repeat protein G); the tip of the machinery consists of PAAR domain containing proteins which act as a delivery system for bacterial effectors. For this study, immune response to recombinant VgrG protein was generated to establish this protein as a potential immunogen for the development of therapeutic leads. The immunogenicity of the selected protein was determined by predicting the B cell epitopes by the BCEP analysis tool. The gene sequence for multiple domains of VgrG protein (phage_base_V, T6SS_Vgr, DUF2345) was selected and cloned in pMAL vector in E. coli. The construct was subcloned and expressed as a fusion protein of 203 residue protein with mannose binding protein tag (MBP) to enhance solubility and purification of this protein. The purified recombinant VgrG fusion protein was used for mice immunisation. The antiserum showed reactivity with the recombinant VgrG in ELISA and western blot. The immunised mice were challenged with K. pneumoniae bacteria and showed bacterial clearance in immunised mice. The recombinant VgrG protein can further be used for studying downstream signalling of VgrG protein in mice during infection and for therapeutic MAb development to eradicate K. pneumoniae infections.

Keywords: immune response, Klebsiella pneumoniae, multi-drug resistance, recombinant protein expression, T6SS, VgrG

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Authors: Recep Duzsoz, Elif Bilgir, Derya Yildirim, Ozlem Gormez

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Radicular cysts develop in the root apex of tooth that is devitalized. Cysts are pathologic lesions with an epithelial lining encapsulated by connective tissue. Radicular cysts originate from epithelial remnants of the periodontal ligament in the root apex as a result of inflammation. They are most commonly observed in the maxillary anterior region, among men and in the third decade of life. Radiographically, they are seen as ovoid radiolucent lesions surrounded by a thin radioopaque margin. In this case, series was carried out in 15 radicular cysts of the jaws diagnosed in individuals. The cysts were evaluated age, sex, and localization. 12 of the cysts were localized in the maxillae, 3 of them were localised in the mandible. The female/male ratio of the lesions was 1/2. In conclusion, we evaluated age, localization and sex distribution of radicular cysts in this study. The knowledge of the features of the jaw cysts is a basic aspect to achieve diagnosis, complications and proper treatment.

Keywords: radicular cyst, jaws, CBCT, treatment

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Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

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Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

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Authors: Narges Shayesteh Moghaddam

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Tungsten (W), a refractory metal known for its remarkably high melting temperature, offers tremendous potential for use in challenging environments prevalent in sectors such as space exploration, defense, and nuclear industries. Additive manufacturing, especially the Laser Powder-Bed Fusion (LPBF) technique, emerges as a beneficial method for fabricating tungsten parts. This technique enables the production of intricate components while simultaneously reducing production lead times and associated costs. However, the inherent brittleness of tungsten and its tendency to crack under high-temperature conditions pose significant challenges to the manufacturing process. Our research primarily focuses on the process of rolling tungsten parts in a layer-by-layer manner in LPBF and the subsequent changes in microstructure. Our objective is not only to identify the alterations in the microstructure but also to assess their implications on the physical properties and performance of the fabricated tungsten parts. To examine these aspects, we conducted an extensive series of experiments that included the fabrication of tungsten samples through LPBF and subsequent characterization using advanced materials analysis techniques. These investigations allowed us to scrutinize shifts in various microstructural features, including, but not limited to, grain size and grain boundaries occurring during the rolling process. The results of our study provide crucial insights into how specific factors, such as plastic deformation occurring during the rolling process, influence the microstructural characteristics of the fabricated parts. This information is vital as it provides a foundation for understanding how the parameters of the layer-by-layer rolling process affect the final tungsten parts. Our research significantly broadens the current understanding of microstructural evolution in tungsten parts produced via the layer-by-layer rolling process in LPBF. The insights obtained will play a pivotal role in refining and optimizing manufacturing parameters, thus improving the mechanical properties of tungsten parts and, therefore, enhancing their performance. Furthermore, these findings will contribute to the advancement of manufacturing techniques, facilitating the wider application of tungsten parts in various high-demand sectors. Through these advancements, this research represents a significant step towards harnessing the full potential of tungsten in high-temperature and high-stress applications.

Keywords: additive manufacturing, rolling, tungsten, refractory materials

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Authors: Rochelle Daley, Eric Garraway, Catherine Murphy

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Crime is a major problem in Jamaica as well as the high number of unsolved violent crimes. The introduction of forensic entomology in criminal investigations has the potential to decrease the number of unsolved violent crimes through the estimation of PMI (post-mortem interval) or time since death. Though it has great potential, forensic entomology requires data from insects specific to a geographical location to be credibly applied in legal investigations. It is a relatively new area of study in the Caribbean, with multiple pioneer research opportunities. Of critical importance in forensic entomology is the ability to identify the species of interest. Larvae are commonly collected at crime scenes and a means of rapid identification is crucial. Moreover, a low-cost method is critical in countries with limited budget available for crime fighting. Sarcophagids are one of the most important colonisers of a carcass however, they are difficult to distinguish using morphology due to their similarities, however, there is a lack of research on the larvae of this family. This research contributes to that, having identified the larvae of three species from the family Sarcophagidae: Peckia nicasia, Peckia chrysostoma and Blaesoxipha plinthopyga; important agents in flesh decomposition. Adults of Sarcophidae are also difficult to differentiate, often requiring study of the genitalia; the use of larvae in species identification is important in such cases. Adult Sarcophagids were attracted using bottle traps baited with pig liver. These adults larviposited and the larvae were collected and colonises (generation 2 and 3) reared at room temperature for morphological work (n=50). The posterior ends of the larvae from segments 9 or 10 were removed and mounted posterior end upwards to allow study using a light microscope at magnification X200 (posterior cavity and intersegmental spine bands) and X640 (anterior and posterior spiracle). The remaining sections of the larvae were cleared in 10 % KOH and the cephalopharyngeal skeleton dissected out and measured at different points. The cephalopharyngeal skeletons show observable differences in the shapes and sizes of the mouth hooks as well as the length of the ventral cornua. The most notable difference between species is in the general shape of the anal segments and the shape of the posterior spiracles. Intersegmental spine bands of these larvae become less pigmented and visible as the larvae change instars. Spine bands along with anterior spiracle are not recommended as features for species distinction. Larvae can potentially be used to distinguish Sarcophagids to the level of species, with observable differences in the anal segments and the cephalopharyngeal skeletons. However, this method of identification should be tested by comparing these morphological features with other Jamaican Sarcophagids to further support this conclusion.

Keywords: 3rd instar larval morphology, forensic entomology, Jamaica, Sarcophagidae

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Authors: Oday A. Al-Juhaishi, Sa`ad M. Ismail, Hung-Hsun Yen, Christina M. Murray, Helen M. S. Davies

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The functional anatomy of the fascia in the greyhound is still poorly understood, and incompletely described. The basic knowledge of fascia stems mainly from anatomical, histological and ultrastructural analyses. In this study, twelve specimens of hindlimbs from six fresh greyhound cadavers (3 male, 3 female) were used to examine the topographical relationships of the superficial fascia with the skin and underlying tissue. The first incision was made along the dorsal midline from the level of the thoracolumbar junction caudally to the level of the mid sacrum. The second incision was begun at the level of the first incision and extended along the midline of the lateral aspect of the hindlimb distally, to just proximal to the tarsus, and, the skin margins carefully separated to observe connective tissue links between the skin and superficial fascia, attachment points of the fascia and the relationships of the fascia with blood vessels that supply the skin. A digital camera was used to record the anatomical features as they were revealed. The dissections identified fibrous septa connecting the skin with the superficial fascia and deep fascia in specific areas. The presence of the adipose tissue was found to be very rare within the superficial fascia in these specimens. On the extensor aspects of some joints, a fusion between the superficial fascia and deep fascia was observed. This fusion created a subcutaneous bursa in the following areas: a prepatellar bursa of the stifle, a tarsal bursa caudal to the calcaneus bone, and an ischiatic bursa caudal to the ischiatic tuberosity. The evaluation of blood vessels showed that the perforating vessels passed through fibrous septa in a perpendicular direction to supply the skin, with the largest branch noted in the gluteal area. The attachment points between the superficial fascia and skin were mainly found in the region of the flexor aspect of the joints, such as caudal to the stifle joint. The numerous fibrous septa between the superficial fascia and skin that have been identified in some areas, may create support for the blood vessels that penetrate fascia and into the skin, while allowing for movement between the tissue planes. The subcutaneous bursae between the skin and the superficial fascia where it is fused with the deep fascia may be useful to decrease friction between moving areas. The adhesion points may be related to the integrity and loading of the skin. The attachment points fix the skin and appear to divide the hindlimb into anatomical compartments.

Keywords: attachment points, fibrous septa, greyhound, subcutaneous bursa, superficial fascia

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Authors: Sweta Das

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This case report highlights the atypical clinical manifestation of ipsilateral head, neck, shoulder, and eye pain with erythema and edema of right eyelid and conjunctiva, along with typical presentation of right sided Horner’s syndrome in a 37-year-old female, who was correctly diagnosed with Wallenberg syndrome due to collaborative effort from optometry, primary care, emergency, and neurology specialties in medicine. Horner’s syndrome is present in 75% of patients with Wallenberg syndrome. Given that patients with Wallenberg syndrome often first present to the Emergency Department with a vast variety of non-specific symptoms, and a normal MRI, a delayed diagnosis is common. Therefore, a collaborative effort between emergency department, optometry, primary care, and neurology is essential in correctly diagnosing Wallenberg’s syndrome in a timely manner.

Keywords: horner's syndrome, stroke, wallenberg syndrome, lateropulsion of eyes

Procedia PDF Downloads 38

Authors: Tamas Jancso, Andrea Podor, Eva Nagyne Hajnal, Peter Udvardy, Gabor Nagy, Attila Varga, Meng Qingyan

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The paper deals with the conditions and circumstances of integration of remotely sensed data for rural environmental monitoring purposes. The main task is to make decisions during the integration process when we have data sources with different resolution, location, spectral channels, and dimension. In order to have exact knowledge about the integration and data fusion possibilities, it is necessary to know the properties (metadata) that characterize the data. The paper explains the joining of these data sources using their attribute data through a sample project. The resulted product will be used for rural environmental analysis.

Keywords: remote sensing, GIS, metadata, integration, environmental analysis

Procedia PDF Downloads 96

Authors: M. Zare, S. Biau, M. Corq, Y. Roquelaure

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A wide variety of observational methods have been developed to evaluate the ergonomic workloads in manufacturing. However, the precision and accuracy of these methods remain a subject of debate. The aims of this study were to develop biomechanical methods to evaluate ergonomic workloads and to compare them with observational methods. Two observational methods, i.e. SCANIA Ergonomic Standard (SES) and Rapid Upper Limb Assessment (RULA), were used to assess ergonomic workloads at two simulated workstations. They included four tasks such as tightening & loosening, attachment of tubes and strapping as well as other actions. Sensors were also used to measure biomechanical data (Inclinometers, Accelerometers, and Goniometers). Our findings showed that in assessment of some risk factors both RULA & SES were in agreement with the results of biomechanical methods. However, there was disagreement on neck and wrist postures. In conclusion, the biomechanical approach was more precise than observational methods, but some risk factors evaluated with observational methods were not measurable with the biomechanical techniques developed.

Keywords: ergonomic, observational method, biomechanical methods, workload

Procedia PDF Downloads 359

Authors: Khaled A. Abdel-Sater

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There are four areas of the temporal lobe. Primary auditory area (areas 41 and 42); it is for the perception of auditory impulse, auditory association area (area 22, 21, and 20): Areas 21 and 20 are for understanding and interpretation of auditory sensation, recognition of language, and long-term memories. Area 22, also called Wernicke’s area, and a sensory speech centre. It is for interpretation of auditory and visual information, formation of thoughts in the mind, and choice of words to be used. Ideas and thoughts originate in it. The limbic system is a part of cortical and subcortical structure forming a ring around the brainstem. Cortical structures are the orbitofrontal area, subcallosal gyrus, cingulate gyrus, parahippocampal gyrus, and uncus. Subcortical structures are the hypothalamus, hippocampus, amygdala, septum, paraolfactory area, anterior nucleus of the thalamus portions of the basal ganglia. There are several physiological functions of the limbic system, including regulation of behavior, motivation, and emotion.

Keywords: limbic system, motivation, emotions, temporal lobe

Procedia PDF Downloads 176

Authors: Athina Puype, Lorenzo Malerba, Nico De Wispelaere, Roumen Petrov, Jilt Sietsma

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Reduced Activation Ferritic/Martensitic (FM) steels like EUROFER are of interest for first wall application in the future demonstration (DEMO) fusion reactor. Depending on the final design codes for the DEMO reactor, the first wall material will have to function in low-temperature mode or high-temperature mode, i.e. around 250-300°C of above 550°C respectively. However, the use of RAFM steels is limited up to a temperature of about 550°C. For the low-temperature application, the material suffers from irradiation embrittlement, due to a shift of ductile-to-brittle transition temperature (DBTT) towards higher temperatures upon irradiation. The high-temperature response of the material is equally insufficient for long-term use in fusion reactors, due to the instability of the matrix phase and coarsening of the precipitates at prolonged high-temperature exposure. The objective of this study is to investigate the influence of thermal ageing for 1000 hrs and 4000 hrs on microstructural features and mechanical properties of lab-cast EUROFER. Additionally, the ageing behavior of the lab-cast EUROFER is compared with the ageing behavior of standard EUROFER97-2 and T91. The microstructural features were investigated with light optical microscopy (LOM), electron back-scattered diffraction (EBSD) and transmission electron microscopy (TEM). Additionally, hardness measurements, tensile tests at elevated temperatures and Charpy V-notch impact testing of KLST-type MCVN specimens were performed to study the microstructural features and mechanical properties of four different F/M grades, i.e. T91, EUROFER97-2 and two lab-casted EUROFER grades. After ageing for 1000 hrs, the microstructures exhibit similar martensitic block sizes independent on the grain size before ageing. With respect to the initial coarser microstructures, the aged microstructures displayed a dislocation structure which is partially fragmented by polygonization. On the other hand, the initial finer microstructures tend to be more stable up to 1000hrs resulting in similar grain sizes for the four different steels. Increasing the ageing time to 4000 hrs, resulted in an increase of lath thickness and coarsening of M23C6 precipitates leading to a deterioration of tensile properties.

Keywords: ageing experiments, EUROFER, ferritic/martensitic steels, mechanical properties, microstructure, T91

Procedia PDF Downloads 241

Authors: Anna Demian, Levi Howard, L. Ng, Leslie Simon, Mark Dragon, A. Desai, Timothy Devlantes, W. David Freeman

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Introduction: Out-of-hospital cardiac arrest (OHCA) can carry a high mortality. For survivors, the most common complication is hypoxic-ischemic brain injury (HIBI). Rarely, lumbosacral spinal cord and/or other spinal cord artery ischemia can occur due to anatomic variation and variable mean arterial pressure after the return of spontaneous circulation. We present a case of an OHCA survivor who later woke up with bilateral leg weakness with preserved sensation (ASIA grade B, L2 level). Methods: We describe a clinical, radiographic, and laboratory presentation, as well as a National Library of Medicine (NLM) search engine methodology, characterizing incidence/prevalence of this entity is discussed. A 70-year-old male, a longtime smoker, and alcohol user, suddenly collapsed at a bar surrounded by friends. He had complained of chest pain before collapsing. 911 was called. EMS arrived, and the patient was in pulseless electrical activity (PEA), cardiopulmonary resuscitation (CPR) was initiated, and the patient was intubated, and a LUCAS device was applied for continuous, high-quality CPR in the field by EMS. In the ED, central lines were placed, and thrombolysis was administered for a suspected Pulmonary Embolism (PE). It was a prolonged code that lasted 90 minutes. The code continued with the eventual return of spontaneous circulation. The patient was placed on an epinephrine and norepinephrine drip to maintain blood pressure. ECHO was performed and showed a “D-shaped” ventricle worrisome for PE as well as an ejection fraction around 30%. A CT with PE protocol was performed and confirmed bilateral PE. Results: The patient woke up 24 hours later, following commands, and was extubated. He was found paraplegic below L2 with preserved sensation, with hypotonia and areflexia consistent with “spinal shock” or anterior spinal cord syndrome. MRI thoracic and lumbar spine showed a conus medullaris level spinal cord infarction. The patient was given IV steroids upon initial discovery of cord infarct. NLM search using “cardiac arrest” and “spinal cord infarction” revealed 57 results, with only 8 review articles. Risk factors include age, atherosclerotic disease, and intraaortic balloon pump placement. AoA (Artery of Adamkiewicz) anatomic variation along with existing atherosclerotic factors and low perfusion were also known risk factors. Conclusion: Acute paraplegia from anterior spinal cord infarction of the AoA territory after cardiac arrest is rare. Larger prospective, multicenter trials are needed to examine potential interventions of hypothermia, lumbar drains, which are sometimes used in aortic surgery to reduce ischemia and/or other neuroprotectants.

Keywords: cardiac arrest, spinal cord infarction, artery of Adamkiewicz, paraplegia

Procedia PDF Downloads 170

Authors: Huinan Zhang, Wenjie Jiang

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Accurate estimation of tropical cyclone intensity is of great importance for disaster prevention and mitigation. Existing techniques are largely based on satellite imagery data, and research and utilization of the inner thermal core structure characteristics of tropical cyclones still pose challenges. This paper presents a two-stage tropical cyclone intensity estimation network based on the fusion of coarse and fine-grained features from microwave brightness temperature data. The data used in this network are obtained from the thermal core structure of tropical cyclones through the Advanced Technology Microwave Sounder (ATMS) inversion. Firstly, the thermal core information in the pressure direction is comprehensively expressed through the maximal intensity projection (MIP) method, constructing coarse-grained thermal core images that represent the tropical cyclone. These images provide a coarse-grained feature range wind speed estimation result in the first stage. Then, based on this result, fine-grained features are extracted by combining thermal core information from multiple view profiles with a distributed network and fused with coarse-grained features from the first stage to obtain the final two-stage network wind speed estimation. Furthermore, to better capture the long-tail distribution characteristics of tropical cyclones, focal loss is used in the coarse-grained loss function of the first stage, and ordinal regression loss is adopted in the second stage to replace traditional single-value regression. The selection of tropical cyclones spans from 2012 to 2021, distributed in the North Atlantic (NA) regions. The training set includes 2012 to 2017, the validation set includes 2018 to 2019, and the test set includes 2020 to 2021. Based on the Saffir-Simpson Hurricane Wind Scale (SSHS), this paper categorizes tropical cyclone levels into three major categories: pre-hurricane, minor hurricane, and major hurricane, with a classification accuracy rate of 86.18% and an intensity estimation error of 4.01m/s for NA based on this accuracy. The results indicate that thermal core data can effectively represent the level and intensity of tropical cyclones, warranting further exploration of tropical cyclone attributes under this data.

Keywords: Artificial intelligence, deep learning, data mining, remote sensing

Procedia PDF Downloads 35

Authors: Masood Sattari

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Using fuel cell technology to generate electricity for large commercial and industrial sites is a growing segment in the fuel cell industry. The installation of these systems involves design, permitting, procurement of long-lead electrical equipment, and construction involving multiple utilities. The installation of each fuel cell system requires the same amount of coordination as the construction of a new structure requiring a foundation, gas, water, and electricity. Each of these components provide variables that can delay and possibly eliminate a new project. As the manufacturing process and efficiency of fuel cell systems improves, so must the installation methods to prevent a ‘bottle-neck’ in the installation phase of the deployment. Installation methodologies to install the systems vary among companies and this paper will examine the methodologies, describe the benefits and drawbacks for each, and provide guideline for the industry to improve overall installation efficiency.

Keywords: construction, installation, methodology, procurement

Procedia PDF Downloads 170

Authors: Premalatha B. S., Shenoy A. M.

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Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

Procedia PDF Downloads 215

Authors: Karwan Khudhir

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A cross-sectional study was carried out to determine the prevalence of musculoskeletal disorders (MSDs) and psychosocial factors associated with it, among Kurdistan nursing professionals. Simple random sampling was used to select 220 nurses and data were collected by self-administrative questionnaire. Results of the study showed that the overall prevalence of MSDs among Kurdistan nurses was 74% in different body regions and, by body regions, neck pain was reported to be the highest complaint of twelve-month MSDs (48.4%) compared to other body parts. Logistic regression analysis indicated 6 variables that are significantly associated with musculoskeletal disorders: smoking (OR=19.472, 95% CI: 5.396, 70.273), BMI (OR= 5.106, 95% CI: 1.735, 15.025), physical activity (OR=8.639, 95% CI: 3.075, 24.271), psychological demand (OR=6.685, 95% CI: 3.318, 13.468), social support (OR=3.143, 95% CI: 1.202, 4.814) and job satisfaction (OR=2.44, 95% CI: 1.04, 5.63). Prevention strategies and health education which emphasizes on psychosocial risk factors and how to improve working conditions should be introduced.

Keywords: Kurdistan Region, Iraq, musculoskeletal disorders, nurses, psycho-social factors

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Authors: Devieta Romadhon Saendardy

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Introduction: The case of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) in many way. In general, the anterior communicating artery and posterior circulation aneurysms cause Intraventricular Hemorrhage. The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Case: This case report presents a 51-year-old female patient who developed IVH following SAH. The patient's Glasgow Coma Scale score was 14, the patient has a severe headache, and there were right extremity hemipharese neurological deficits. A non-contrast head CT scan revealed a massive intraventricular haemorrhage. In an hour, the patient got her headache and pharese worse. Discussion: Intraventricular hemorrhage is a serious complication of subarachnoid hemorrhage, necessitating prompt recognition and management. This case highlights the importance of a time management, medical management and surgical intervention to optimize outcomes in patients with intraventricular hemorrhage caused by subarachnoid hemorrhage. Placement of a shunt system improves clinical outcome in intraventricular hemorrhage.

Keywords: Intraventricular hemorrhage, subarachnoid hemorrhage, shunt, time

Procedia PDF Downloads 48