Search results for: common bile duct exploration
Commenced in January 2007
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Edition: International
Paper Count: 6880

Search results for: common bile duct exploration

6460 Sources and Potential Ecological Risks of Heavy Metals in the Sediment Samples From Coastal Area in Ondo, Southwest Nigeria

Authors: Ogundele Lasun Tunde, Ayeku Oluwagbemiga Patrick

Abstract:

Heavy metals are released into the sediments in aquatic environment from both natural and anthropogenic sources and they are considered as worldwide issue due to their deleterious ecological risks and food chain disruption. In this study, sediments samples were collected at three major sites (Awoye, Abereke and Ayetoro) along Ondo coastal area using VanVeen grab sampler. The concentrations of As, Cd, Cr, Cu, Fe, Mn, Ni, Pb, V and Zn were determined by employing Atomic Absorption Spectroscopy (AAS). The combined concentrations data were subjected to Positive Matrix Factorization (PMF) receptor approach for source identification and apportionment. The probable risks that might be posed by heavy metals in the sediment were estimated by potential and integrated ecological risks indices. Among the measured heavy metals, Fe had the average concentrations of 20.38 ± 2.86, 23.56 ± 4.16 and 25.32 ± 4.83 lg/g at Abereke, Awoye and Ayetoro sites, respectively. The PMF resulted in identification of four sources of heavy metals in the sediments. The resolved sources and their percentage contributions were oil exploration (39%), industrial waste/sludge (35%), detrital process (18%) and Mn-sources (8%). Oil exploration activities and industrial wastes are the major sources that contribute heavy metals into the coastal sediments. The major pollutants that posed ecological risks to the local aquatic ecosystem are As, Pb, Cr and Cd (40 B Ei ≤ 80) classifying the sites as moderate risk. The integrate risks values of Awoye, Abereke and Ayetoro are 231.2, 234.0 and 236.4, respectively suggesting that the study areas had a moderate ecological risk. The study showed the suitability of PMF receptor model for source identification of heavy metals in the sediments. Also, the intensive anthropogenic activities and natural sources could largely discharge heavy metals into the study area, which may increase the heavy metal contents of the sediments and further contribute to the associated ecological risk, thus affecting the local aquatic ecosystem.

Keywords: positive matrix factorization, sediments, heavy metals, sources, ecological risks

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6459 How Acupuncture Improve Migraine: A Literature Review

Authors: Hsiang-Chun Lai, Hsien-Yin Liao, Yi-Wen Lin

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Migraine is a primary headache disorder which presented as recurrent and moderate to severe headaches and affects nearly fifteen percent of people’s daily life. In East Asia, acupuncture is a common treatment for migraine prevention. Acupuncture can modulate migraine through both peripheral and central mechanism and decrease the allodynia process. Molecular pathway suggests that acupuncture relief migraine by regulating neurotransmitters/neuromodulators. This process was also proven by neural imaging. Acupuncture decrease the headache frequency and intensity compared to routine care. We also review the most common chosen acupoints to treat migraine and its treatment protocol. As a result, we suggested that acupuncture can serve as an option to migraine treatment and prevention. However, more studies are needed to establish the mechanism and therapeutic roles of acupuncture in treating migraine.

Keywords: acupuncture, allodynia, headache, migraine

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6458 Research Progress on the Correlation between Tinnitus and Sleep Behaviors

Authors: Jiajia Peng

Abstract:

Tinnitus is one of the common symptoms of ear diseases and is characterized by an abnormal perception of sound without external stimulation. Tinnitus is agony and seriously affects the life of the general population by approximately 1%. Sleep disturbance is a common problem in patients with tinnitus. Lack of sleep will lead to the accumulation of metabolites in the brain and cannot be cleared in time. These substances enhance sympathetic nerve reactivity in the auditory system, resulting in tinnitus occurrence or aggravation. Then, tinnitus may aggravate sleep disturbance, thus forming a vicious circle. Through a systematic review of the relevant literature, we summarize the research on tinnitus and sleep. Although the results suggest that tinnitus is often accompanied by sleep disturbance, the impact of unfavorable sleep habits on tinnitus is not clear. In particular, the relationships between sleep behaviors and other chronic diseases have been revealed. To reduce the incidence rate of tinnitus, clinicians should pay attention to the relevance between different sleep behaviors and tinnitus.

Keywords: tinnitus, sleep, sleep factor, sleep behavior

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6457 Introduction, Establishment, and Transformation: An Initial Exploration of the Cultural Shifts and Influence of Fa Yi Chong De, Yi-Kuan-Tao in Malaysian Chinese Community

Authors: Lim Pey Huan

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Yi-Kuan-Tao has been developing in Malaysia for nearly 60 years. It was initially introduced from mainland China and later from Taiwan starting from the 1970s. Yi-Kuan-Tao was considered a 'new religion' for the local Chinese community in Malaysia in its early stages, as Chinese immigrants primarily practiced Taoism, Buddhism, Christianity, or Catholicism upon settling in the region. The overseas propagation and development of Yi-Kuan-Tao today primarily occur through Taiwanese temples, which began spreading abroad as early as 1949. Particularly since the 1970s, with the rapid economic growth of Taiwan, various branches of Taiwanese Yi-Kuan-Tao have gained economic strength to propagate abroad, further expanding the influence of Yi-Kuan-Tao overseas. Southeast Asia is the region out from Taiwan where the propagation and development of Yi-Kuan-Tao are fastest and most concentrated. With approximately over 6 million Chinese inhabitants, Malaysia's pursuit of traditional Chinese culture has led to a flourishing interest in Yi-Kuan-Tao, particularly its advocacy of the unity of Confucianism, Buddhism, and Taoism, with an emphasis on promoting Confucian thought. Moreover, Taiwan's rapid economic development since the 1970s has enabled Yi-Kuan-Tao to allocate significant human and financial resources for external propagation efforts. Additionally, Malaysia's government has adopted a relatively tolerant policy towards religion since that time, further fostering the flourishing development of Yi-Kuan-Tao in Malaysia. Furthermore, this thesis aims to strengthen the lineage and continuity of the Yi-Kuan-Tao tradition, particularly the branch of Fa Yi Chong De, through the perspective of Heavenly Mandate (天命). By examining the different origins and ethnic backgrounds, it investigates how the Malaysian Chinese community has experienced different changes through the cultural baptism of religion, thus delving into the religious influence of Yi-Kuan-Tao. Given that the Fa Yi Chong De Academy in Taiwan is currently in an active development and construction phase, academic works related to Yi-Kuan-Tao will lay a more solid academic foundation for the future establishment of the academy.

Keywords: initial exploration, cultural shifts, Yi-Kuan-Tao, Malaysian Chinese community

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6456 University-home Partnerships for Enhancing Students’ Career Adapting Responses: A Moderated-mediation Model

Authors: Yin Ma, Xun Wang, Kelsey Austin

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Purpose – Building upon career construction theory and the conservation of resources theory, we developed a moderated mediation model to examine how the perceived university support impact students’ career adapting responses, namely, crystallization, exploration, decision and preparation, via the mediator career adaptability and moderator perceived parental support. Design/methodology/approach – The multi-stage sampling strategy was employed and survey data were collected. Structural equation modeling was used to perform the analysis. Findings – Perceived university support could directly promote students’ career adaptability, and promote three career adapting responses, namely, exploration, decision and preparation. It could also impact four career adapting responses via mediation effect of career adaptability. Its impact on students’ career adaptability can greatly increase when students’ receive parental related career support. Research limitations/implications – The cross-sectional design limits causal inference. Conducted in China, our findings should be cautiously interpreted in other countries due to cultural differences. Practical implications – University support is vital to students’ career adaptability and supports from parents can enhance this process. University-home collaboration is necessary to promote students’ career adapting responses. For students, seeking and utilizing as much supporting resources as possible is vital for their human resources development. On an organizational level, universities could benefit from our findings by introducing the practices which ask students to rate the career-related courses and encourage them to chat with parents regularly. Originality/ value – Using recently developed scale, current work contributes to the literature by investigating the impact of multiple contextual factors on students’ career adapting response. It also provide the empirical support for the role of human intervention in fostering career adapting responses.

Keywords: career adapability, university and parental support, China studies, sociology of education

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6455 The Sensitization Profile of Children Allergic to IgE-mediated Cow's Milk Proteins

Authors: Gadiri Sabiha

Abstract:

Introduction : IgE-dependent cow's milk protein allergy (APLV) is one of the most common allergies in children and is one of the three most common allergies observed in children under 6 years of age. Its natural evolution is most often towards healing. The objective is to determine the sensitization profile of patients allergic to cow's milk (VL). Material and method :A retrospective study carried out on a pediatric population (age < 12 years) over a period of four years (2018-2021) in the context of a suspected food allergy to cow's milk proteins carried out on 121 children aged between 8 months -12 years The search for specific IgE was carried out by immunodot (EUROLINE Pediatric; EUROIMMUN) test which allows a semi-quantitative determination of specific IgE. Results 36 patients (29.7%) had a cow's milk protein allergy (ALPV) with a slight female predominance (58.33% girls vs 41.66% boys) The main clinical signs were: acute diarrhoea; vomiting; Intense abdominal pain, and cutaneous signs (pruritus/urticaria) with respective frequencies of 72%; 58%; 44% and 19%. The 3 major and specific VL allergens identified were beta-lactoglobulin 59% caseins 51% and alpha-lactalbumin 29.7%, The profile of sensitization to LV varies according to age, in infants before 1 year of anti-casein, IgE are predominant 83.3%, followed by beta-lactoglobulin 66.66% and alpha-lactolbumin 50% Conclusion CMPA is a frequent pathology which ranks among the three most common food allergies in children. This is the first to appear, most often starting in infants under 6 months old.

Keywords: specific Ige, food allergy, cow 's milk, child

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6454 Ant System with Acoustic Communication

Authors: Saad Bougrine, Salma Ouchraa, Belaid Ahiod, Abdelhakim Ameur El Imrani

Abstract:

Ant colony optimization is an ant algorithm framework that took inspiration from foraging behaviour of ant colonies. Indeed, ACO algorithms use a chemical communication, represented by pheromone trails, to build good solutions. However, ants involve different communication channels to interact. Thus, this paper introduces the acoustic communication between ants while they are foraging. This process allows fine and local exploration of search space and permits optimal solution to be improved.

Keywords: acoustic communication, ant colony optimization, local search, traveling salesman problem

Procedia PDF Downloads 581
6453 E4D-MP: Time-Lapse Multiphysics Simulation and Joint Inversion Toolset for Large-Scale Subsurface Imaging

Authors: Zhuanfang Fred Zhang, Tim C. Johnson, Yilin Fang, Chris E. Strickland

Abstract:

A variety of geophysical techniques are available to image the opaque subsurface with little or no contact with the soil. It is common to conduct time-lapse surveys of different types for a given site for improved results of subsurface imaging. Regardless of the chosen survey methods, it is often a challenge to process the massive amount of survey data. The currently available software applications are generally based on the one-dimensional assumption for a desktop personal computer. Hence, they are usually incapable of imaging the three-dimensional (3D) processes/variables in the subsurface of reasonable spatial scales; the maximum amount of data that can be inverted simultaneously is often very small due to the capability limitation of personal computers. Presently, high-performance or integrating software that enables real-time integration of multi-process geophysical methods is needed. E4D-MP enables the integration and inversion of time-lapsed large-scale data surveys from geophysical methods. Using the supercomputing capability and parallel computation algorithm, E4D-MP is capable of processing data across vast spatiotemporal scales and in near real time. The main code and the modules of E4D-MP for inverting individual or combined data sets of time-lapse 3D electrical resistivity, spectral induced polarization, and gravity surveys have been developed and demonstrated for sub-surface imaging. E4D-MP provides capability of imaging the processes (e.g., liquid or gas flow, solute transport, cavity development) and subsurface properties (e.g., rock/soil density, conductivity) critical for successful control of environmental engineering related efforts such as environmental remediation, carbon sequestration, geothermal exploration, and mine land reclamation, among others.

Keywords: gravity survey, high-performance computing, sub-surface monitoring, electrical resistivity tomography

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6452 Low-Complexity Multiplication Using Complement and Signed-Digit Recoding Methods

Authors: Te-Jen Chang, I-Hui Pan, Ping-Sheng Huang, Shan-Jen Cheng

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In this paper, a fast multiplication computing method utilizing the complement representation method and canonical recoding technique is proposed. By performing complements and canonical recoding technique, the number of partial products can be reduced. Based on these techniques, we propose an algorithm that provides an efficient multiplication method. On average, our proposed algorithm is to reduce the number of k-bit additions from (0.25k+logk/k+2.5) to (k/6 +logk/k+2.5), where k is the bit-length of the multiplicand A and multiplier B. We can therefore efficiently speed up the overall performance of the multiplication. Moreover, if we use the new proposes to compute common-multiplicand multiplication, the computational complexity can be reduced from (0.5 k+2 logk/k+5) to (k/3+2 logk/k+5) k-bit additions.

Keywords: algorithm design, complexity analysis, canonical recoding, public key cryptography, common-multiplicand multiplication

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6451 A Retrospective Study: Correlation between Enterococcus Infections and Bone Carcinoma Incidence

Authors: Sonia A. Stoica, Lexi Frankel, Amalia Ardeljan, Selena Rashid, Ali Yasback, Omar Rashid

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Introduction Enterococcus is a vast genus of lactic acid bacteria, gram-positivecocci species. They are common commensal organisms in the intestines of humans: E. faecalis (90–95%) and E. faecium (5–10%). Rare groups of infections can occur with other species, including E. casseliflavus, E. gallinarum, and E. raffinosus. The most common infections caused by Enterococcus include urinary tract infections, biliary tract infections, subacute endocarditis, diverticulitis, meningitis, septicemia, and spontaneous bacterial peritonitis. The treatment for sensitive strains of these bacteria includes ampicillin, penicillin, cephalosporins, or vancomycin, while the treatment for resistant strains includes daptomycin, linezolid, tygecycline, or streptogramine. Enterococcus faecalis CECT7121 is an encouraging nominee for being considered as a probiotic strain. E. faecalis CECT7121 enhances and skews the profile of cytokines to the Th1 phenotype in situations such as vaccination, anti-tumoral immunity, and allergic reactions. It also enhances the secretion of high levels of IL-12, IL-6, TNF alpha, and IL-10. Cytokines have been previously associated with the development of cancer. The intention of this study was to therefore evaluate the correlation between Enterococcus infections and incidence of bone carcinoma. Methods A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th and 10th codes for bone carcinoma diagnosis in a previously Enterococcus infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). Access to the database was granted by Holy Cross Health for academic research. Chi-squared test was used to assess statistical significance. Results A total number of 17,056 patients was obtained in Enterococcus infected group as well as in the control population (matched by Age range and CCI score). Subsequent bone carcinoma development was seen at a rate of 1.07% (184) in the Enterococcal infectious group and 3.42% (584) in the control group, respectively. The difference was statistically significant by p= 2.2x10-¹⁶, Odds Ratio = 0.355 (95% CI 0.311 - 0.404) Treatment for enterococcus infection was analyzed and controlled for in both enterococcus infected and noninfected populations. 78 out of 6,624 (1.17%) patients with a prior enterococcus infection and treated with antibiotics were compared to 202 out of 6,624 (3.04%) patients with no history of enterococcus infection (control) and received antibiotic treatment. Both populations subsequently developed bone carcinoma. Results remained statistically significant (p<2.2x10-), Odds Ratio=0.456 (95% CI 0.396-0.525). Conclusion This study shows a statistically significant correlation between Enterococcus infection and a decreased incidence of bone carcinoma. The immunologic response of the organism to Enterococcus infection may exert a protecting mechanism from developing bone carcinoma. Further exploration is needed to identify the potential mechanism of Enterococcus in reducing bone carcinoma incidence.

Keywords: anti-tumoral immunity, bone carcinoma, enterococcus, immunologic response

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6450 Effect of Low Level Laser Therapy versus Polarized Light Therapy on Oral Mucositis in Cancer Patients Receiving Chemotherapy

Authors: Andrew Anis Fakhrey Mosaad

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The goal of this study is to compare the efficacy of polarised light therapy with low-intensity laser therapy in treating oral mucositis brought on by chemotherapy in cancer patients. Evaluation procedures are the measurement of the WHO oral mucositis scale and the Common toxicity criteria scale. Techniques: Cancer patients (men and women) who had oral mucositis, ulceration, and discomfort and whose ages varied from 30 to 55 years were separated into two groups and received 40 chemotherapy treatments. Twenty patients in Group (A) received low-level laser therapy (LLLT) along with their regular oral mucositis medication treatment, while twenty patients in Group (B) received Bioptron light therapy (BLT) along with their regular oral mucositis medication treatment. Both treatments were applied for 10 minutes each day for 30 days. Conclusion and results: This study showed that the use of both BLT and LLLT on oral mucositis in cancer patients following chemotherapy greatly improved, as seen by the sharp falls in both the WHO oral mucositis scale (OMS) and the common toxicity criteria scale (CTCS). However, low-intensity laser therapy (LLLT) was superior to Bioptron light therapy in terms of benefits (BLT).

Keywords: Bioptron light therapy, low level laser therapy, oral mucositis, WHO oral mucositis scale, common toxicity criteria scale

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6449 Assessment of Reservoir Quality and Heterogeneity in Middle Buntsandstein Sandstones of Southern Netherlands for Deep Geothermal Exploration

Authors: Husnain Yousaf, Rudy Swennen, Hannes Claes, Muhammad Amjad

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In recent years, the Lower Triassic Main Buntsandstein sandstones in the southern Netherlands Basins have become a point of interest for their deep geothermal potential. To identify the most suitable reservoir for geothermal exploration, the diagenesis and factors affecting reservoir quality, such as porosity and permeability, are assessed. This is done by combining point-counted petrographic data with conventional core analysis. The depositional environments play a significant role in determining the distribution of lithofacies, cement, clays, and grain sizes. The position in the basin and proximity to the source areas determine the lateral variability of depositional environments. The stratigraphic distribution of depositional environments is linked to both local topography and climate, where high humidity leads to fluvial deposition and high aridity periods lead to aeolian deposition. The Middle Buntsandstein Sandstones in the southern part of the Netherlands shows high porosity and permeability in most sandstone intervals. There are various controls on reservoir quality in the examined sandstone samples. Grain sizes and total quartz content are the primary factors affecting reservoir quality. Conversely, carbonate and anhydrite cement, clay clasts, and intergranular clay represent a local control and cannot be applied on a regional scale. Similarly, enhanced secondary porosity due to feldspar dissolution is locally restricted and minor. The analysis of textural, mineralogical, and petrophysical data indicates that the aeolian and fluvial sandstones represent a heterogeneous reservoir system. The ephemeral fluvial deposits have an average porosity and permeability of <10% and <1mD, respectively, while the aeolian sandstones exhibit values of >18% and >100mD.

Keywords: reservoir quality, diagenesis, porosity, permeability, depositional environments, Buntsandstein, Netherlands

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6448 Unraveling the Complexities of Competitive Aggressiveness: A Qualitative Exploration in the Oil and Gas Industry

Authors: Salim Al Harthy, Alexandre A. Bachkirov

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This study delves into the complexities of competitive aggressiveness in the oil and gas industry, focusing on the characteristics of the identified competitive actions. The current quantitative research on competitive aggressiveness lacks agreement on the connection between antecedents and outcomes, prompting a qualitative investigation. To address this gap, the research utilizes qualitative interviews with CEOs from Oman's oil and gas service industry to explore the dynamics of competitive aggressiveness. Using Noklenain's typology, the study categorizes and analyzes identified actions, shedding light on the spectrum of competitive behaviors within the industry. Notably, actions predominantly fall under the "Bring about" and "Preserve" elements, with a notable absence in the "Forebear" and "Destroy" categories, possibly linked to the study's focus on service-oriented businesses. The study also explores the detectability of actions, revealing that "Bring about" actions are detectable, while those in "Preserve" and "Suppress" are not. This challenges conventional definitions of competitive aggressiveness, suggesting that not all actions are readily detectable despite being considered competitive. The presence of non-detectable actions introduces complexity to measurement methods reliant on visible empirical data. Moreover, the study contends that companies can adopt an aggressive competitive approach without directly challenging rivals. This challenges traditional views and emphasizes the innovative and entrepreneurial aspects of actions not explicitly aimed at competitors. By not revealing strategic intentions, such actions put rivals at a disadvantage, underscoring the need for a nuanced understanding of competitive aggressiveness. In summary, the lack of consensus in existing literature regarding the relationship between antecedents and outcomes in competitive aggressiveness is addressed. The study reveals a spectrum of detectable and undetectable actions, posing challenges in measurement and emphasizing the need for alternative methods to assess undetectable actions in competitive behavior. This research contributes to a more nuanced understanding of competitive aggressiveness, acknowledging the diverse actions shaping a company's strategic positioning in dynamic business environments.

Keywords: competitive aggressiveness, qualitative exploration, noklenain's typology, oil and gas industry

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6447 Orthopedic Trauma in Newborn Babies

Authors: Joanna Maj, Awais Hussain, Lyndsey Vu, Catherine Roxas

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Background: Bone injuries in babies are common conditions that arise during delivery. Fractures of the clavicle, humerus, femur, and skull are the most common neonatal bone injuries sustained from labor and delivery. During operative deliveries, zealous tractions, ineffective delivery techniques, improper uterine incision, and inadequate relaxation of the uterus can lead to bone fractures in the newborn. Neonatal anatomy is unique. Just as children are not mini-adults, newborns are not mini children. A newborn’s anatomy and physiology are significantly different from a pediatric patient's. In this paper, we describe common orthopedic trauma in newborn babies. We provide a comprehensive overview of the different types of bone injuries in newborns. We hypothesize that the rate of bone fractures sustained at birth is higher in cases of operative deliveries. Methods: Relevant literature was selected by using the PubMed database. Search terms included orthopedic conditions in newborns, neonatal anatomy, and bone fractures in neonates during operative deliveries. Inclusion criteria included age, gender, race, type of bone injury and progression of bone injury. Exclusion criteria were limited in the medical history of cases reviewed and comorbidities. Results: This review finds that a clavicle fracture is the most common type of neonatal orthopedic injury sustained at birth in both operative and non-operative deliveries. We confirm the hypothesis that infants born via operative deliveries have a significantly higher rate of bone fractures than non-cesarean section deliveries. Conclusion: Newborn babies born via operative deliveries have a higher rate of bone fractures of the clavicle, humerus, and femur. A clavicle bone fracture in newborns is most common during emergency operative deliveries in new mothers. We conclude that infants born via an operative delivery sustained more bone injuries than infants born via non-cesarean section deliveries.

Keywords: clavicle fracture, humerus fracture, neonates, newborn orthopedics, orthopedic surgery, pediatrics, orthopedic trauma, orthopedic trauma during delivery, cesarean section, obstetrics, neonatal anatomy, neonatal fractures, operative deliveries, labor and delivery, bone injuries in neonates

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6446 Identifying Common Sports Injuries in Karate and Presenting a Model for Preventing Identified Injuries (A Case Study of East Azerbaijan, Iranian Karatekas)

Authors: Nadia Zahra Karimi Khiavi, Amir Ghiami Rad

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Due to the high likelihood of injuries in karate, karatekas' injuries warrant special treatment. This study explores the prevalence of karate injuries in East Azerbaijan, Iran and provides a model for karatekas to use in the prevention of such injuries. This study employs a descriptive approach. Male and female participants with a brown belt or above in either control or non-control styles in East Azerbaijan province are included in the study's statistical population. A statistical sample size of 100 people was computed using the tools employed (smartpls), and the samples were drawn at random from all clubs in the province with the assistance of the Karate Board in order to give a model for the prevention of karate injuries. Information was gathered by means of a survey that made use of the Standard Questionnaire for Australian Sports Medicine Injury Reports. The information is presented in the form of tables and samples, and descriptive statistics were used to organise and summarise the data. Control and non-control independent t-tests were conducted using SPSS version 20, and structural equation modelling (pls) was utilised for injury prevention modelling at a 0.05 level of significance. The results showed that the most common areas of injury among the control groups were the upper limbs (46.15%), lower limbs (34.61%), trunk (15.38%), and head and neck (3.84%). The most common types of injuries were broken bones (34.61%), sprain or strain (23.13%), bruising and contusions (23.13%), trauma to the face and mouth (11.53%), and damage to the nerves (69.69%). Uncontrolled committees are most likely to sustain injuries to the head and neck (33.33%), trunk (25.92%), upper limbs (22.22%), and lower limbs (18.51%). The most common injuries were to the mouth and face (33.33%), dislocations and fractures (22.22%), aspirin and strain (22.22%), bruises and contusions (18.51%), and nerves (70%), in that order. Among those who practice control kata, injuries to the upper limb account for 45.83%, the lower limb for 41.666%, the trunk for 8.33%, and the head and neck for 4.166%. The most common types of injuries are dislocations and fractures (41.66 per cent), aspirin and strain (29.16 per cent), bruising and bruises (16.66 per cent), and nerves (12.5%). Injuries to the face and mouth were not reported among those practising the control kata. By far, the most common sites of injury for those practising uncontrolled kata were the lower limb (43.74%), upper limb (39.13%), trunk (13.14%), and head and neck (4.34%). The most common types of injuries were dislocations and fractures (34.82%), aspirin and strain (26.08%), bruises and contusions (21.73%), mouth and face (13.14%), and nerves. Teaching the concepts of cooling and warming (0.591) and enhancing the degree of safety in the sports environment (0.413) were shown to play the most essential roles in reducing sports injuries among karate practitioners of controlling and uncontrolled styles, respectively. Use of common sports gear (0.390), Modification of training programme principles (0.341), Formulation of an effective diet plan for athletes (0.284), Evaluation of athletes' physical anatomy, physiology, chemistry, and physics (0.247).

Keywords: sports injuries, karate, prevention, cooling and warming

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6445 Gold-Bearing Alteration Zones in South Eastern Desert of Egypt: Geology and Remote Sensing Analysis

Authors: Mohamed F. Sadek, Safaa M. Hassan, Safwat S. Gabr

Abstract:

Several alteration zones hosting gold mineralization are wide spreading in the South Eastern Desert of Egypt where gold has been mined from many localities since the time of the Pharaohs. The Sukkari is the only mine currently producing gold in the Eastern Desert of Egypt. Therefore, it is necessary to conduct more detailed studies on these locations using modern exploratory methods. The remote sensing plays an important role in lithological mapping and detection of associated hydrothermal mineralization particularly the exploration of gold mineralization. This study is focused on three localities in South Eastern Desert of Egypt, namely Beida, Defiet and Hoteib-Eiqat aiming to detect the gold-bearing hydrothermal alteration zones using the integrated data of remote sensing, field study and mineralogical investigation. Generally, these areas are dominated by Precambrian basement rocks including metamorphic and magmatic assemblages. They comprise ophiolitic serpentinite-talc carbonate, island-arc metavolcanics which were intruded by syn to late orogenic mafic and felsic intrusions mainly gabbro, granodiorite and monzogranite. The processed data of Advanced Spaceborne Thermal Emission and Reflection (ASTER) and Landsat-8 images are used in the present study to map the gold bearing-hydrothermal alteration zones. Band rationing and principal component analysis techniques are used to discriminate the different lithologic units exposed in the studied three areas. Field study and mineralogical investigation have been used to verify the remote sensing data. This study concluded that, the integrated remote sensing data with geological, field and mineralogical investigations are very effective in lithological discrimination, detailed geological mapping and detection of the gold-bearing hydrothermal alteration zones. More detailed exploration for gold mineralization with the help of remote sensing techniques is recommended to evaluate its potentiality in the study areas.

Keywords: pan-african, Egypt, landsat-8; ASTER, gold, alteration zones

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6444 Robotic Mini Gastric Bypass Surgery

Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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6443 Experimental Set-up for the Thermo-Hydric Study of a Wood Chips Bed Crossed by an Air Flow

Authors: Dimitri Bigot, Bruno Malet-Damour, Jérôme Vigneron

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Many studies have been made about using bio-based materials in buildings. The goal is to reduce its environmental footprint by analyzing its life cycle. This can lead to minimize the carbon emissions or energy consumption. A previous work proposed to numerically study the feasibility of using wood chips to regulate relative humidity inside a building. This has shown the capability of a wood chips bed to regulate humidity inside the building, to improve thermal comfort, and so potentially reduce building energy consumption. However, it also shown that some physical parameters of the wood chips must be identified to validate the proposed model and the associated results. This paper presents an experimental setup able to study such a wood chips bed with different solicitations. It consists of a simple duct filled with wood chips and crossed by an air flow with variable temperature and relative humidity. Its main objective is to study the thermal behavior of the wood chips bed by controlling temperature and relative humidity of the air that enters into it and by observing the same parameters at the output. First, the experimental set up is described according to previous results. A focus is made on the particular properties that have to be characterized. Then some case studies are presented in relation to the previous results in order to identify the key physical properties. Finally, the feasibility of the proposed technology is discussed, and some model validation paths are given.

Keywords: wood chips bed, experimental set-up, bio-based material, desiccant, relative humidity, water content, thermal behaviour, air treatment

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6442 On-Screen Disability Delineation and Social Representation: An Evaluation

Authors: Chetna Jaswal, Nishi Srivastava, Ahammedul Kabeer AP, Puja Prasad

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We are a culture of mass media consumers and cinema as its integral part has high visibility and potential influence on public attitude towards disability which maintains no sociocultural boundaries but experiences substantial social marginalization. Given the lack of awareness and direct experience with disability, on-screen or film representations can give powerful and memorable definitions for the public that can contribute to framing the perception and attitude change. Social representation refers to common ways of thinking, conceiving about and evaluating social reality. It is a product of collective cognition, common sense and thought system. This study aims at analyzing the representations and narratives of disability in Indian cinema and Hollywood with the help of a conceptual understanding of social representation and its theoretical framework.

Keywords: disability, social representation, mainstream cinema, diversity

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6441 Production of Single-Chain Antibodies against Common Epitopes of ErbB1 and ErbB2 Using Phage Display Antibody Library

Authors: Gholamreza Hashemitabr, Reza Valadan, Alireza Rafiei, Mohammad Reza Bassami

Abstract:

Breast cancer is the most common malignancy among women worldwide. Cancer cells use a complex multilayer network of epidermal growth factor receptors (EGFRs) signaling pathways to support their survival and growth. The overlapping networks of EGFRs signaling pathways account for the failure of most ErbB-targeted therapies. The aim of this study was to enrich a pool of recombinant antibody fragments against common epitopes of ErbB1 and ErbB2 in order to simultaneous blockade of ErbBs signaling pathways. ErbB1 and ErbB2 were expressed stably in VERO cells. Selection of recombinant antibodies was performed on live cells expressing either of ErbB1 and ErbB2 receptors using subtractive phage display approach. The results of PCR and DNA fingerprinting in the last round of panning showed that most clones contained insert (80% and 85% for ErbB1 and ErbB2 respectively) with an identical restriction pattern. The selected clones showed positive reaction to both ErbB1 and ErbB2 receptors in phage-ELISA test. Furthermore, the resulting soluble antibody fragments recognized common epitopes of both immunoprecipitated ErbB1 and ErbB2 in western blot. Additionally, the antibodies directed against the dimerization domain of ErbB1 demonstrated a significant absorbance in EGF-stimulated VERO/ErbB1 cells than non-stimulated cells (1.91 and 1.09 respectively). Moreover, the results of dimerization inhibition test showed that these antibodies blocked ErbB1 and ErbB2 dimerization on the surface of ErbB1 and ErbB2 expressing VERO cells. Regarding the importance of pan-ErbB approach to cancer therapy, the antibodies developed here might provide novel therapeutics for simultaneous blockade of ErbBs signaling pathways.

Keywords: breast cancer, single-chain antibody, ErbB1, ErbB2, epitope

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6440 Exploring Regularity Results in the Context of Extremely Degenerate Elliptic Equations

Authors: Zahid Ullah, Atlas Khan

Abstract:

This research endeavors to explore the regularity properties associated with a specific class of equations, namely extremely degenerate elliptic equations. These equations hold significance in understanding complex physical systems like porous media flow, with applications spanning various branches of mathematics. The focus is on unraveling and analyzing regularity results to gain insights into the smoothness of solutions for these highly degenerate equations. Elliptic equations, fundamental in expressing and understanding diverse physical phenomena through partial differential equations (PDEs), are particularly adept at modeling steady-state and equilibrium behaviors. However, within the realm of elliptic equations, the subset of extremely degenerate cases presents a level of complexity that challenges traditional analytical methods, necessitating a deeper exploration of mathematical theory. While elliptic equations are celebrated for their versatility in capturing smooth and continuous behaviors across different disciplines, the introduction of degeneracy adds a layer of intricacy. Extremely degenerate elliptic equations are characterized by coefficients approaching singular behavior, posing non-trivial challenges in establishing classical solutions. Still, the exploration of extremely degenerate cases remains uncharted territory, requiring a profound understanding of mathematical structures and their implications. The motivation behind this research lies in addressing gaps in the current understanding of regularity properties within solutions to extremely degenerate elliptic equations. The study of extreme degeneracy is prompted by its prevalence in real-world applications, where physical phenomena often exhibit characteristics defying conventional mathematical modeling. Whether examining porous media flow or highly anisotropic materials, comprehending the regularity of solutions becomes crucial. Through this research, the aim is to contribute not only to the theoretical foundations of mathematics but also to the practical applicability of mathematical models in diverse scientific fields.

Keywords: elliptic equations, extremely degenerate, regularity results, partial differential equations, mathematical modeling, porous media flow

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6439 Technologies of Factory Farming: An Exploration of Ongoing Confrontations with Farm Animal Sanctuaries

Authors: Chetna Khandelwal

Abstract:

This research aims to study the contentions that Farm Animal Sanctuaries pose to human-animal relationships in modernity, which have developed as a result of globalisation of the meat industry and advancements in technology. The sociological history of human-animal relationships in farming is contextualised in order to set a foundation for the follow-up examination of challenges to existing human-(farm)animal relationships by Farm Animal Sanctuaries. The methodology was influenced by relativism, and the method involved three semi-structured small-group interviews, conducted at locations of sanctuaries. The sample was chosen through purposive sampling and varied by location and size of the sanctuary. Data collected were transcribed and qualitatively coded to generate themes. Findings revealed that sanctuary contentions to established human-animal relationships by factory farming could be divided into 4 broad categories – Revealing horrors of factory farming (involving uncovering power relations in agribusiness); transforming relationships with animals (including letting them emotionally heal in accordance with their individual personalities and treating them as partial-pets); educating the public regarding welfare conditions in factory farms as well as animal sentience through practical experience or positive imagery of farm animals, and addressing retaliation made by agribusiness in the form of technologies or discursive strategies. Hence, this research concludes that The human-animal relationship in current times has been characterised by – (ideological and physical) distance from farm animals, commodification due to increased chasing of profits over welfare and exploitation using technological advancements, creating unequal power dynamics that rid animals of any agency. Challenges to this relationship can be influenced by local populations around the sanctuary but not so dependent upon the size of it. This research can benefit from further academic exploration into farm animal sanctuaries and their role in feminist animal rights activism to enrich the ongoing fight against intensive farming.

Keywords: animal rights, factory farming, farm animal sanctuaries, human-animal relationships

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6438 A Critique of The English And Nigerian Marine Insurance Laws on Insurable Interest

Authors: Omotolani Victoria Somoye

Abstract:

The paper examines modern approaches to the insurable interest, which is a fundamental principle of insurance law that affects the enforceability of insurance contracts. The study starts by examining the competing definitions of the nature of the insurable interest doctrine. It finds that while legal interest theory is seen to be sufficient as the test of insurable interest, the paper argues on how this approach deprives the insured of a full indemnity of losses suffered. The problem with the Nigerian and English current legislative framework is that it defines insurable interest as a legally recognized interest of the insured in the subject matter of insurance. However, other countries like Australia, the United States, South Africa, and more recently, Canada, have rejected the English test and trodden their own path along the factual expectancy line. The study justifies the rationale behind the departure of similar common law jurisdictions and argues that the English and Nigerian position, which appears to be too rigid, harsh on the insured, and no longer fit for purpose in the 21st century, should be revised. The paper concludes that the common law doctrine does not represent better interests of certainty, justice, and fairness, as well as not meeting the policy behind the requirement of insurable interest. This paper adopts a doctrinal comparative research methodology to examine complex areas of insurable interest in selected countries and work out some suggestions for reforming the Nigerian and English laws by referring to the approaches of other jurisdictions.

Keywords: Australia, common law, English law, insurable interest, insurance, Nigeria

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6437 A Cross-Sectional Study on Management of Common Mental Disorders Among Patients Living with HIV/AIDS Attending Antiretroviral Treatment (ART) Clinic in Hoima Regional Referral Hospital Uganda

Authors: Agodo Mugenyi Herbert

Abstract:

Background: A high prevalence of both HIV infection and mental disorders exists in Sub-Saharan Africa, however there is little integration of care for mental health disorders among HIV-infected individuals. The study aimed at determining the management of common mental disorders among HIV/AIDS clients attending Antiretroviral clinic in Hoima regional referral hospital. Significancy of the study: The information generated by this study would help mental health advocates, ministry of health, Civil society organizations in HIV programming to advocate for enhanced mental health care for PLWHA. The result will be used in policy development and lobbying for integration of mental health care in HIV/AIDS care. Methods: This study applied a cross sectional design. It involved data collection from clients with HIV/AIDS attending ART clinic in Hoima regional referral hospital at one specific point in time. It aimed at providing data on the entire population under study. Data was collected from Hoima Regional Referral Hospital at the ART clinic. Data analysis was performed using SPSS version 24. Results: 66 HIV/AIDS clients and 10 health workers in the ART clinic who participated fully completed the study. The overall prevalence of at least one form of mental disorder was 83%. Majority of the health care practitioner do not use pharmacological, psychological, and social interventions to manage such disorders. Conclusion: These results are suggestive of a significant proportion of the HIV-infected patients experiencing psychological difficulty for which they do not receive treatment Recommendations: Current care practices applied to patients with HIV/AIDS should be integrated more generally to include treatment services to identify and manage common mental disorders.

Keywords: common mental disorders, mental health, mental illness, and severe mental illness

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6436 An Exploration of The Patterns of Transcendence in Indian and Hopkins’s Aesthetics

Authors: Lima Antony

Abstract:

In G. M. Hopkins’s poetics and aesthetics there is scope for a comparative study with Indian discourses on aesthetics, an area not adequately explored so far. This exploration will enrich the field of comparative study of diverse cultural expressions and their areas of similarity. A comparative study of aesthetic and religious experiences in diverse cultures will open up avenues for the discovery of similarities in self-experiences and their transcendence. Such explorations will reveal similar patterns in aesthetic and religious experiences. The present paper intends to prove this in the theories of Hopkins and Indian aesthetics. From the time of the Vedas Indian sages have believed that aesthetic enjoyment could develop into a spiritual realm. From the Natyasastra of Bharata, Indian aesthetics develops and reaches its culmination in later centuries into a consciousness of union with the mystery of the Ultimate Being, especially in Dhvanaāloka of Anandavardhana and Locana of Abhinavagupta. Dhvanyaloka elaborates the original ideas of rasa (mood or flavor) and dhvani (power of suggestion) in Indian literary theory and aesthetics. Hopkins was successful, like the ancient Indian alankarikas, in creating aesthetically superb patterns at various levels of sound and sense for which he coined the term ‘inscape’. So Hopkins’s aesthetic theory becomes suitable for transcultural comparative study with Indian aesthetics especially the dhvani theories of Anandavardhana and Abhinavagupta. Hopkins’s innovative approach to poetics and his selection of themes are quite suitable for analysis in the light of Indian literary theories. Indian philosophy views the ultimate reality called Brahman, as the 'soul,' or inner essence, of all reality. We see in Hopkins also a search for the essence of things and the chiming of their individuality with the Ultimate Being in multidimensional patterns of sound, sense and ecstatic experience. This search culminates in the realization of a synthesis of the individual self with the Ultimate Being. This is achieved through an act of surrender of the individuality of the self before the Supreme Being. Attempts to reconcile the immanent and transcendent aspects of the Ultimate Being can be traced in the Indian as well as Hopkins’s aesthetics which can contribute to greater understanding and harmony between cultures.

Keywords: Dhvani, Indian aesthetics, transcultural studies, Rasa

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6435 Effect of Particle Aspect Ratio and Shape Factor on Air Flow inside Pulmonary Region

Authors: Pratibha, Jyoti Kori

Abstract:

Particles in industry, harvesting, coal mines, etc. may not necessarily be spherical in shape. In general, it is difficult to find perfectly spherical particle. The prediction of movement and deposition of non spherical particle in distinct airway generation is much more difficult as compared to spherical particles. Moreover, there is extensive inflexibility in deposition between ducts of a particular generation and inside every alveolar duct since particle concentrations can be much bigger than the mean acinar concentration. Consequently, a large number of particles fail to be exhaled during expiration. This study presents a mathematical model for the movement and deposition of those non-spherical particles by using particle aspect ratio and shape factor. We analyse the pulsatile behavior underneath sinusoidal wall oscillation due to periodic breathing condition through a non-Darcian porous medium or inside pulmonary region. Since the fluid is viscous and Newtonian, the generalized Navier-Stokes equation in two-dimensional coordinate system (r, z) is used with boundary-layer theory. Results are obtained for various values of Reynolds number, Womersley number, Forchsheimer number, particle aspect ratio and shape factor. Numerical computation is done by using finite difference scheme for very fine mesh in MATLAB. It is found that the overall air velocity is significantly increased by changes in aerodynamic diameter, aspect ratio, alveoli size, Reynolds number and the pulse rate; while velocity is decreased by increasing Forchheimer number.

Keywords: deposition, interstitial lung diseases, non-Darcian medium, numerical simulation, shape factor

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6434 Analysis of Long-term Results After External Dacryocystorhinostomy Surgery in Patients Suffered from Diabetes Mellitus

Authors: N. Musayeva, N. Rustamova, N. Bagirov, S. Ibadov

Abstract:

Purpose: to analyze the long-term results of external dacryocystorhinostomy (DCR), which remains the preferred primary procedure in the surgical treatment of lacrimal duct obstruction in chronic dacryocystitis. Methodology: long-term results of external DCR (after 3 years) performed on 90 patients (90 eyes) with chronic dacryocystitis from 2018 to 2020 were evaluated. The Azerbaijan National Center of Ophthalmology, named after acad. Zarifa Aliyeva. 15 of the patients were men, 75 – women. The average age was 45±3.2 years. Surgical operations were performed under local anesthesia. All patients suffered from diabetes mellitus for more than 3 years. All patients underwent external DCR and silicone drainage (tube) was implanted. In the postoperative period (after 3 years), lacrimation, purulent discharge, and the condition of the scar at the operation site were assessed. Results: All patients were under observation for more than 18 months. In general, the effectiveness of the surgical operation was 93.34%. Recurrence of disease was observed in 6 patients and in 3 patients (3.33%), the scar at the site of the operation was rough (non-cosmetic). In 3 patients (3.33%) – the surgically formed anastomosis between the lacrimal sac and the nasal bone was obstructed by scar tissue. These patients were reoperated by trans canalicular laser DCR. Conclusion: Despite the long-term (more than a hundred years) use of external DCR, it remains one of the primary techniques in the surgery of chronic dacryocystitis. Due to the high success rate and good long-term results of DCR in the treatment of chronic dacryocystitis in patients suffering from diabetes mellitus, we recommend external DCR for this group of patients.

Keywords: chronic dacryocystitis, diabetes mellitus, external dacryocystorhinostomy, long-term results

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6433 Conductivity-Depth Inversion of Large Loop Transient Electromagnetic Sounding Data over Layered Earth Models

Authors: Ravi Ande, Mousumi Hazari

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One of the common geophysical techniques for mapping subsurface geo-electrical structures, extensive hydro-geological research, and engineering and environmental geophysics applications is the use of time domain electromagnetic (TDEM)/transient electromagnetic (TEM) soundings. A large transmitter loop for energising the ground and a small receiver loop or magnetometer for recording the transient voltage or magnetic field in the air or on the surface of the earth, with the receiver at the center of the loop or at any random point inside or outside the source loop, make up a large loop TEM system. In general, one can acquire data using one of the configurations with a large loop source, namely, with the receiver at the center point of the loop (central loop method), at an arbitrary in-loop point (in-loop method), coincident with the transmitter loop (coincidence-loop method), and at an arbitrary offset loop point (offset-loop method), respectively. Because of the mathematical simplicity associated with the expressions of EM fields, as compared to the in-loop and offset-loop systems, the central loop system (for ground surveys) and coincident loop system (for ground as well as airborne surveys) have been developed and used extensively for the exploration of mineral and geothermal resources, for mapping contaminated groundwater caused by hazardous waste and thickness of permafrost layer. Because a proper analytical expression for the TEM response over the layered earth model for the large loop TEM system does not exist, the forward problem used in this inversion scheme is first formulated in the frequency domain and then it is transformed in the time domain using Fourier cosine or sine transforms. Using the EMLCLLER algorithm, the forward computation is initially carried out in the frequency domain. As a result, the EMLCLLER modified the forward calculation scheme in NLSTCI to compute frequency domain answers before converting them to the time domain using Fourier Cosine and/or Sine transforms.

Keywords: time domain electromagnetic (TDEM), TEM system, geoelectrical sounding structure, Fourier cosine

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6432 Detecting Natural Fractures and Modeling Them to Optimize Field Development Plan in Libyan Deep Sandstone Reservoir (Case Study)

Authors: Tarek Duzan

Abstract:

Fractures are a fundamental property of most reservoirs. Despite their abundance, they remain difficult to detect and quantify. The most effective characterization of fractured reservoirs is accomplished by integrating geological, geophysical, and engineering data. Detection of fractures and defines their relative contribution is crucial in the early stages of exploration and later in the production of any field. Because fractures could completely change our thoughts, efforts, and planning to produce a specific field properly. From the structural point of view, all reservoirs are fractured to some point of extent. North Gialo field is thought to be a naturally fractured reservoir to some extent. Historically, natural fractured reservoirs are more complicated in terms of their exploration and production efforts, and most geologists tend to deny the presence of fractures as an effective variable. Our aim in this paper is to determine the degree of fracturing, and consequently, our evaluation and planning can be done properly and efficiently from day one. The challenging part in this field is that there is no enough data and straightforward well testing that can let us completely comfortable with the idea of fracturing; however, we cannot ignore the fractures completely. Logging images, available well testing, and limited core studies are our tools in this stage to evaluate, model, and predict possible fracture effects in this reservoir. The aims of this study are both fundamental and practical—to improve the prediction and diagnosis of natural-fracture attributes in N. Gialo hydrocarbon reservoirs and accurately simulate their influence on production. Moreover, the production of this field comes from 2-phase plan; a self depletion of oil and then gas injection period for pressure maintenance and increasing ultimate recovery factor. Therefore, well understanding of fracturing network is essential before proceeding with the targeted plan. New analytical methods will lead to more realistic characterization of fractured and faulted reservoir rocks. These methods will produce data that can enhance well test and seismic interpretations, and that can readily be used in reservoir simulators.

Keywords: natural fracture, sandstone reservoir, geological, geophysical, and engineering data

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6431 COVID-19 and Heart Failure Outcomes: Readmission Insights from the 2020 United States National Readmission Database

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

Abstract:

Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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