Search results for: pediatric septic shock

Authors: Rabah Haoui

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Hypersonic flows around spatial vehicles during their reentry phase in planetary atmospheres are characterized by intense aerothermodynamics phenomena. The aim of this work is to analyze high temperature flows around an axisymmetric blunt body taking into account chemical and vibrational non-equilibrium for air mixture species and the no slip condition at the wall. For this purpose, the Navier-Stokes equations system is resolved by the finite volume methodology to determine the flow parameters around the axisymmetric blunt body especially at the stagnation point and in the boundary layer along the wall of the blunt body. The code allows the capture of shock wave before a blunt body placed in hypersonic free stream. The numerical technique uses the Flux Vector Splitting method of Van Leer. CFL coefficient and mesh size level are selected to ensure the numerical convergence.

Keywords: hypersonic flow, viscous flow, chemical kinetic, dissociation, finite volumes, frozen and non-equilibrium flow

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Authors: Karima Megdouli, Bourhan tachtouch

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Ejector refrigeration cycles offer an alternative to conventional systems for producing cold from low-temperature heat. In this article, a thermodynamic model is presented. This model has the advantage of simplifying the calculation algorithm and describes the complex double-throttling mechanism that occurs in the ejector. The model assumption and calculation algorithm are presented first. The impact of each efficiency is evaluated. Validation is performed on several data sets. The ejector model is then used to simulate a RES (refrigeration ejector system), to validate its robustness and suitability for use in predicting thermodynamic cycle performance. A Taguchi and ANOVA optimization is carried out on a RES. TOPSIS analysis was applied to decide the optimum refrigerants with cost, safety, environmental and enviro economic concerns along with thermophysical properties.

Keywords: ejector, velocity distribution, shock circle, Taguchi and ANOVA optimization, TOPSIS analysis

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Authors: Ammara Khan

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Sepsis is characterized by an overwhelming surge of cytokines and oxidative stress to one of many factors, gram-negative bacteria commonly implicated. Despite major expansion and elaboration of sepsis pathophysiology and therapeutic approach; death rate remains very high in septic patients due to multiple organ damages including hepatotoxicity.The present study was aimed to ascertain the adequacy of three different drugs delivered separately and collectively- low dose steroid-dexamethasone (3mg/kg i.p) ,antioxidant-melatonin(10 mg/kg i.p) ,and phosphodiesterases inhibitor - pentoxifylline (75 mg/kg i.p)in endotoxin-induced hepatotoxicity in mice. Endotoxin/lipopolysaccharides induced hepatotoxicity was reproduced in mice by giving lipopolysaccharide of serotype E.Coli intraperitoneally. The preventive role was questioned by giving the experimental agent half an hour prior to LPS injection whereas the therapeutic potential of the experimental agent was searched out via post-LPS delivering. The extent of liver damage was adjudged via serum alanine aminotransferases (ALT) and aspartate aminotransferase (AST) estimation along with a histopathological examination of liver tissue. Dexamethasone is given before (Group 3) and after LPS (group 4) significantly attenuated LPS generated liver injury.Pentoxifylline generated similar results and serum ALT; AST histological alteration abated considerably (p≤ 0.05) both in animals subjected to pentoxifylline pre (Group 5) and post-treatment(Group 6). Melatonin was also prosperous in aversion (Group 7) and curation (Group 8) of LPS invoked hepatotoxicity as evident by lessening of augmented ALT (≤0.01) and AST (≤0.01) along with restoration of pathological changes in liver sections (p≤0.05). Combination therapies with dexamethasone in conjunction with melatonin (Group 9), dexamethasone together with pentoxifylline (Group 10), and pentoxifylline along with melatonin (Group 11) after LPS administration tapered LPS evoked hepatic dysfunction statistically considerably. In conclusion, both melatonin and pentoxifylline set up promising results in endotoxin-induced hepatotoxicity and can be used therapeutic adjuncts to conventional treatment strategies in sepsis-induced liver failure.

Keywords: endotoxin/lipopolysacchride, dexamethasone, hepatotoxicity, melatonin, pentoxifylline

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Authors: T. Bouchabchoub, A. Bendahmane, A. Haouriqui, N. Attou

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This paper presents simulation results of Forex predicting model equations in order to give approximately a prevision of interest rates. First, Hall-Taylor (HT) equations have been used with Taylor rule (TR) to adapt them to European and American Forex Markets. Indeed, initial Taylor Rule equation is conceived for all Forex transactions in every States: It includes only one equation and six parameters. Here, the model has been used with Hall-Taylor equations, initially including twelve equations which have been reduced to only three equations. Analysis has been developed on the following base macroeconomic variables: Real change rate, investment wages, anticipated inflation, realized inflation, real production, interest rates, gap production and potential production. This model has been used to specifically study the impact of an inflation shock on macroeconomic director interest rates.

Keywords: interest rate, Forex, Taylor rule, production, European Central Bank (ECB), Federal Reserve System (FED).

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Authors: Lenka Markovičová, Viera Zatkalíková, Tomasz Garbacz

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The development of composite materials and the related design and manufacturing technologies is one of the most important advances in the history of materials. Composites are multifunctional materials having unprecedented mechanical and physical properties that can be tailored to meet the requirements of a particular application. Some composites also exhibit great resistance to high-temperature corrosion, oxidation, and wear. Polymers are widely used indoors and outdoors, therefore they are exposed to a chemical environment which may include atmospheric oxygen, acidic fumes, acidic rain, moisture heat and thermal shock, ultra-violet light, high energy radiation, etc. Different polymers are affected differently by these factors even though the amorphous polymers are more sensitive. Ageing is also important and it is defined as the process of deterioration of engineering materials resulting from the combined effects of atmospheric radiation, heat, oxygen, water, micro-organisms and other atmospheric factors.

Keywords: composites with glass fibers, mechanical properties, polyamides, UV degradation

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Authors: Shiuh-Jer Huang, Yun-Han Yeh

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A 40 steps manual adjusting shock absorber was refitted with DC motor driving mechanism to construct as a semi-active suspension system for a four-wheel drive electric vehicle. Accelerometer and potentiometer sensors are installed to measure the sprung mass acceleration and suspension system compression or rebound states for control purpose. A fuzzy logic controller was designed to derive appropriate damping target based on vehicle running condition for semi-active suspension system to follow. The damping ratio control of each wheel axis suspension system is executed with a robust fuzzy sliding mode controller (FSMC). Different road surface conditions are chosen to evaluate the control performance of this semi-active suspension system based on wheel axis acceleration signal.

Keywords: semi-active suspension, electric vehicle, fuzzy sliding mode control, accelerometer

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Authors: Gaspar J. Machado, Stéphane Clain, Raphael Loubère

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The goal of the present work is to numerically study steady-state nonlinear hyperbolic equations in the context of the finite volume framework. We will consider the unidimensional Burgers' equation as the reference case for the scalar situation and the unidimensional Euler equations for the vectorial situation. We consider two approaches to solve the nonlinear equations: a time marching algorithm and a direct steady-state approach. We first develop the necessary and sufficient conditions to obtain the existence and unicity of the solution. We treat regular examples and solutions with a steady shock and to provide very-high-order finite volume approximations we implement a method based on the MOOD technology (Multi-dimensional Optimal Order Detection). The main ingredient consists in using an 'a posteriori' limiting strategy to eliminate non physical oscillations deriving from the Gibbs phenomenon while keeping a high accuracy for the smooth part.

Keywords: Euler equations, finite volume, MOOD, steady-state

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Authors: Rugang Tian

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In this study, we generated whole-genome sequence (WGS) data from110 native cattle. Together with whole-genome sequences from world-wide cattle populations, we estimated the genetic diversity and population genetic structure of different cattle populations. Our findings revealed clustering of cattle groups in line with their geographic locations. We identified noticeable genetic diversity between indigenous cattle breeds and commercial populations. Among all studied cattle groups, lower genetic diversity measures were found in commercial populations, however, high genetic diversity were detected in some local cattle, particularly in Rashoki and Mongolian breeds. Our search for potential genomic regions under selection in native cattle revealed several candidate genes related with immune response and cold shock protein on multiple chromosomes such as TRPM8, NMUR1, PRKAA2, SMTNL2 and OXR1 that are involved in energy metabolism and metabolic homeostasis.

Keywords: cattle, whole-genome, population structure, adaptation

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Authors: Georgiana Ciobotaru

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The vocabulary that foreign students assimilate once they start studying the Romanian language must allow them to develop the linguistic competence of oral and written expression, but also the intercultural one, necessary for their integration into the new socio-cultural environment. Therefore, the familiarization courses with Romanian as a foreign language aim at fundamental language acquisitions in order to obtain the expected level of Romanian language. They also relate differently to the new culture and the new language they come in contact with, having a distinct way of expressing themselves. Foreign students want to continue their university and postgraduate studies at specialized faculties in the country; therefore, they need both a general language for their integration into society and for interaction with others, Romanians or students from countries other than their own, but also from a specialized language that facilitates didactic communication and professional development. The complexity of the vocabulary must thus cover the daily communication needs, but also the subsequent evolution of each one. This paper aims to illustrate the most important semantic fields that students must assimilate in order to crystallize a linguistic identity in the new context of their personal and professional development and to help them cope with the culture shock.

Keywords: integration, intercultural, language, linguistic, vocabulary

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Authors: Yawen Xia, Rubi Yang, Jing Zhao

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By using the Reputation Risk Index (RRI) to measure company environmental, social, and governance (ESG) activities, this research studies firms’ ESG comovement with their industry and local peers. This comovement is attenuated during the Covid-19 pandemic. Further analysis shows that corporate governance plays an important role in comovement decrease. We classify companies by region (city, state, region) and industry and calculate the average RRI of companies of the same type. We run separate regressions to test 1) industry comovement; 2) local comovement; 3) Covid-19 pandemic and reputation risk comovement; 4) corporate governance and reputation risk comovement. Our findings are consistent with previous literature that companies follow their industry and local counterparts in engaging in irresponsible activities and reducing ESG engagement. We speculate Covid shock led to a reduction in social activities and information sharing among enterprise managers, and comovement between enterprises, as a result, decreased during the pandemic.

Keywords: ESG, Covid, peer pressure, local comovement, corporate governance

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Authors: Sabiha Sahin

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Introduction: We have planned this study because of the increasing number of corrosive substance poisoning who admitted to the Pediatric Emergency Department. Method: 636 corrosive substance poisoning cases applied to the Osmangazi University PED between 1 January 2015 - 31 December 2017 were retrospectively analyzed. Results: 438 (69%) cases were male.The poisoning rate of groups 0-4 was significantly higher and occurred by accident. A total of 616 cases (96.9%) were poisoned by the oral route, and 20 cases were poisoned by inhalation.462 Patients were admitted to the hospital within an hour (72.8%). Of the 134 patients who had only erosion and redness around the mouth, 24 patients had salivation and dysphagia symptoms besides these. Of the 28 cases of 158 patients with symptoms, eusaphegeal stenosis was detected. on third day examination. Although there was no statistically significant correlation between esophageal stenosis and erosion and redness around the mouth, there was a statistically significant correlation between dysphagia and salivation between esophageal stenosis Conclusion: The increased salivation and the dysphagia are important signs of risk of devoloping esophageal stenosis at first examination corrosive poisoning in children.

Keywords: caustic, corrosive, poisoning, children

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Authors: Warda Fatima, Hasnain Javed

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The emerging trend of Drug resistance in childhood Tuberculosis is increasing worldwide and now becoming a priority challenge for National TB Control Programs of the world. Childhood TB accounts for 10-15% of total TB burden across the globe and same proportion is quantified in case of drug resistant TB. One third population suffering from MDR TB dies annually because of non-diagnosis and unavailability of appropriate treatment. However, true Childhood MDR TB cannot be estimated due to non-confirmation. Diagnosis of Pediatric TB by sputum Smear Microscopy and Culture inoculation are limited due to paucibacillary nature and difficulties in obtaining adequate sputum specimens. Diagnosis becomes more difficult when it comes to HIV infected child. New molecular advancements for early case detection of TB and MDR TB in adults have not been endorsed in children. Multi centered trials are needed to design better diagnostic approaches and efficient and safer treatments for DR TB in high burden countries. The aim of the present study is to sketch out the current situation of the childhood Drug resistant TB especially in the developing world and to highlight the classic and novel methods that are to be implemented in high-burden resource-limited locations.

Keywords: drug resistant TB, childhood, diagnosis, novel methods

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Authors: Nahid H. Hajrah, Jamal S. M. Sabir, Neil Hall

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The jasmonic pathway is ubiquitous in plants and is crucial to plant development. It Is involved in fertility, ripening, and sex determination as well as in response to environmental stresses such as herbivory, pathogen drought or temperature shock. Essentially the jasmonic pathway acts to shut down growth in order to induce defence pathways. These pathways include the production of secondary metabolites which have evolved to defend against herbivores and pathogens but are of increasing interest due to their roll in medicine and biotechnology. Here we describe the transcriptional response of Rhazia stricta (a poisonous shrub widely used in traditional medicine) to jasmonic acid, in order to better characterize the genes involved in secondary metabolite production and its response to stress. We observe coordinated upregulation of flavonoid biosynthesis pathway leading to flavonols, flavones and anthocyanins but no similar coordination of the monoterpene indole alkaloid pathway.

Keywords: medicinal plants, Rhazia stricta, jasmonic acid, transcriptional analysis

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Authors: Azza A. Ali, Asmaa Abdelaty, Mona G. Khalil, Mona M. Kamal, Karema Abu-Elfotuh

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Background: Aluminium (Al) is known as a neurotoxin environmental pollutant that can cause certain diseases as Dementia, Alzheimer's disease, and Parkinsonism. It is widely used in antacid drugs as well as in food additives and toothpaste. Stresses have been linked to cognitive impairment; Social isolation (SI) may exacerbate memory deficits while protein malnutrition (PM) increases oxidative damage in cortex, hippocampus and cerebellum. The risk of cognitive decline may be lower by maintaining social connections. Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea and has antioxidant, anti-inflammatory and anti-atherogenic effects as well as health-promoting effects in CNS. Objective: To study the influence of different stressful conditions as social isolation, electric shock (EC) and inadequate Nutritional condition as PM on neurotoxicity induced by Al in rats as well as to investigate the possible protective effect of EGCG in these stressful and PM conditions. Methods: Rats were divided into two major groups; protected group which was daily treated during three weeks of the experiment by EGCG (10 mg/kg, IP) or non-treated. Protected and non-protected groups included five subgroups as following: One normal control received saline and four Al toxicity groups injected daily for three weeks by ALCl3 (70 mg/kg, IP). One of them served as Al toxicity model, two groups subjected to different stresses either by isolation as mild stressful condition (SI-associated Al toxicity model) or by electric shock as high stressful condition (EC- associated Al toxicity model). The last was maintained on 10% casein diet (PM -associated Al toxicity model). Isolated rats were housed individually in cages covered with black plastic. Biochemical changes in the brain as acetyl cholinesterase (ACHE), Aβ, brain derived neurotrophic factor (BDNF), inflammatory mediators (TNF-α, IL-1β), oxidative parameters (MDA, SOD, TAC) were estimated for all groups. Histopathological changes in different brain regions were also evaluated. Results: Rats exposed to Al for three weeks showed brain neurotoxicity and neuronal degenerations. Both mild (SI) and high (EC) stressful conditions as well as inadequate nutrition (PM) enhanced Al-induced neurotoxicity and brain neuronal degenerations; the enhancement induced by stresses especially in its higher conditions (ES) was more pronounced than that of inadequate nutritional conditions (PM) as indicated by the significant increase in Aβ, ACHE, MDA, TNF-α, IL-1β together with the significant decrease in SOD, TAC, BDNF. On the other hand, EGCG showed more pronounced protection against hazards of Al in both stressful conditions (SI and EC) rather than in PM .The protective effects of EGCG were indicated by the significant decrease in Aβ, ACHE, MDA, TNF-α, IL-1β together with the increase in SOD, TAC, BDNF and confirmed by brain histopathological examinations. Conclusion: Neurotoxicity and brain neuronal degenerations induced by Al were more severe with stresses than with PM. EGCG can protect against Al-induced brain neuronal degenerations in all conditions. Consequently, administration of EGCG together with socialization as well as adequate protein nutrition is advised especially on excessive Al-exposure to avoid the severity of its neuronal toxicity.

Keywords: environmental pollution, aluminum, social isolation, protein malnutrition, neuronal degeneration, epigallocatechin-3-gallate, rats

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Authors: Fawehinmi Olabisi Alaba, O. R. Adeniyi

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Farming households faces lots of disaster which contribute to endemic poverty. Anticipated increases in extreme weather events will exacerbate this. Primary data was administered to farming household using multi-stage random sampling technique. The result of the analysis shows that majority of the respondents (69.9%) are male, have mean household size, years of formal education and age of 5±1.14, 6±3.41, and 51.06±10.43 respectively. The major (48.9%) type of disaster experienced is flooding. Major coping mechanism adopted is sourcing for support from family and friends. Age, education, experience, access to extension agent, and mitigation control method contribute significantly to vulnerability to disaster. The major adaptation method (62.3%) is construction of drainage. The study revealed that the coping mechanisms employed may become less effective as increasingly fragile livelihood systems struggle to withstand disaster shocks. Thus there is need for training of the farmers on measures to adapt to mitigate the shock from disasters.

Keywords: adaptation, disasters, flooding, vulnerability

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Authors: Erkam Arslantas

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Heat pipes one of the thermal control elements are used in communication satellites. A selection of the heat pipes of satellite thermal design will be emphasized how important and effective it is. In this article, manufacturing and performance control tests of heat pipes are reviewed from the current literature. The heat pipe is expected to function efficiently during all missions of the spacecraft from Beginning of Life (BOL) to End of Life (EOL). There are many parameters that are evaluated in manufacturing and performance control tests of the heat pipes which are used in satellites. These parameters are pressure design, leakage, noncondensable gas level (N.C.G), sine vibration, shock and static load capabilities, aging, bending, proof, final test etc. These parameters will be explained separately for the heat pipes in this review article and young researches working on the thermal control system of Geosynchronous Satellites systems can find easily related information in this article.

Keywords: communication satellite, heat pipe, performance test, thermal control

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Authors: Eugene Kogan

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We analytically study the localized running waves in the discrete Josephson transmission lines (JTL), constructed from Josephson junctions (JJ) and capacitors. The quasi-continuum approximation reduces the calculation of the running wave properties to the problem of equilibrium of an elastic rod in the potential field. Making additional approximations, we reduce the problem to the motion of the fictitious Newtonian particle in the potential well. We show that there exist running waves in the form of supersonic kinks and solitons and calculate their velocities and profiles. We show that the nonstationary smooth waves, which are small perturbations on the homogeneous non-zero background, are described by Korteweg-de Vries equation, and those on zero background -by the modified Korteweg-de Vries equation. We also study the effect of dissipation on the running waves in JTL and find that in the presence of the resistors, shunting the JJ and/or in series with the ground capacitors, the only possible stationary running waves are the shock waves, whose profiles are also found.

Keywords: Josephson transmission line, shocks, solitary waves, nonlinear waves

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Authors: Lemu Abebe Geleta

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In this study, it compare the performance of banks and financial services (operational, financial, and market) across four major regions including Asia, Europe, Africa, and North with the extent of sustainability reporting. We examine how the Environment, Social, and Governance score (ESG) and the three pillars such as Return on Assets, Return on Equity, and Tobin's (Q) affect the performance of banks using data collected from 3450 observations across 40 different nations over ten years of (2011-2020). it also consider implications for governance, macroeconomics, and specific bank attributes. The results indicate a negative correlation between ESG and operational performance (ROA), financial performance (ROE), and market performance (TQ). The inclusion of diverse political and economic contexts lends distinctiveness to this paper. the findings hold significant theoretical implications for global scholars and policymakers. The limited correlation between ESG, its pillars, and the performance of banks and financial services underscores managerial shortcomings within these sectors.

Keywords: bank specialization, financial crisis, credit risk, difference-in-differences, herfindahl hirschman index

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Authors: Maryum Nawaz

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Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional study was done. Place and Duration: The study was conducted in Pediatric Ophthalmology, Hayatabad Medical Complex, Peshawar. Materials and Methods: The sample size was 146 keeping 41.45%5 proportion of refractive errors in children with squinting eyes, 95% confidence interval and 8% margin of error under WHO sample size calculations. Non-probability consecutive sampling was done. Result: Mean age was 8.57±2.66 years. Male were 89 (61.0%) and female were 57 (39.0%). Refractive error was present in 56 (38.4%) and was not present in 90 (61.6%) of patients. There was no association of gender, age, parent refractive errors, or early usage of electric equipment with the refractive errors. Conclusion: There is a high prevalence of refractive errors in a patient with strabismus. There is no association of age, gender, parent refractive errors, or early usage of electric equipment in the occurrence of refractive errors. Further studies are recommended for confirmation of these.

Keywords: strabismus, refractive error, myopia, hypermetropia, astigmatism

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Authors: M. Mahdavi, M. Mohseni, R. Rafiei, H. Yari

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Environmental factors can deteriorate the automotive coatings significantly. Such as UV radiations, humidity, hot-cold shock and destructive chemical compounds. Furthermore, some natural materials such as bird droppings and tree gums have the potential to degrade the coatings as well. The present work aims to study the mechanism of degradation for two automotive refinish coating (PU based) systems exposed to two types of biological materials, i.e. Arabic gum and the simulated bird dropping, pancreatin. To reach this goal, effects of these biological materials on surface properties and appearance were studied using different techniques including digital camera, FT-IR spectroscopy, optical microscopy, and gloss measurements. In addition, the thermo-mechanical behavior of coatings was examined by DMTA. It was found that cross-linking had a crucial role on the biological resistance of clear coat. The higher cross-linking enhanced biological resistance.

Keywords: refinish clear coat, pancreatin, Arabic gum, cross-linking, biological degradation

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Authors: Jong Yeop Kim, Sung Young Park, Dae Hee Kim, Han Bum Joe, Ji Young Yoo, Jong Bum Choi, Sook Young Lee

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Emergence agitation (EA) is commonly reported adverse events after sevoflurane anesthesia in pediatric patients. The efficacy of prophylactic remifentanil, one of mu opioid agonist, in preventing EA is controversial. This meta-analysis assessed the effectiveness of remifentanil to decrease the incidence of EA from sevoflurane anesthesia in children. We searched for randomized controlled trials comparing sevoflurane alone anesthesia with sevoflurane and remifentanil anesthesia to prevent EA in the Cochrane Library, Embase, Pubmed, and KoreaMed, and included 6 studies with 361 patients. The number of patients of reporting EA was summarized using risk ratio (RR) with 95% confidence interval (CI), with point estimates and 95CIs derived from a random effects Mantel-Haenszel method. Overall incidence of EA was about 41%. Compared with sevoflurane alone anesthesia, intravenous infusion of remifentanil with sevoflurane significantly reduced the incidence of EA (RR 0.53, 95% CI 0.39-0.73, P < 0.0001), (heterogeneity, I2 = 0, P = 0.42). This meta-analysis suggested that continuous infusion of remifentanil could be effective in decreasing the EA of about 47% after sevoflurane anesthesia. However, considering limitations of the included studies, more randomized controlled studies are required to verify our results.

Keywords: emergence agitation, meta-analysis, remifentanil, pediatrics

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Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

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In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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Authors: Ngoc Quang Nguyen, Daewon Sohn

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Chitosan (CS) is a natural polycationic polysaccharide and pH-sensitive polymer with incomplete deacetylation from claiming chitin. It is also a guaranteeing material in terms of pharmaceutical, chemical, and sustenance industry due to its exceptional structure (reactive –OH and –NH2 groups). In this study, a catechol-functionalized chitosan (CCS, for an eminent level for substitution) was synthesized and propelled by marine mussel cuticles in place on research those intricate connections between Fe³⁺ and catechol under acidic conditions. The ratios of catechol, chitosan and other reagents decide the structure of the hydrogel. The gel formation is then well-maintained by dual cross-linking through electrostatic interactions between Fe³⁺ and CCS and covalent catechol-coupling-based coordinate bonds. The hydrogels showed enhanced cohesiveness and shock-absorbing properties with increasing pH due to coordinate bonds inspired by mussel byssal threads. Thus, the gelation time, rheological properties, UV-vis and ¹H-Nuclear Magnetic Resonance spectroscopy, and the morphologic aspects were elucidated to describe those crosslinking components and the physical properties of the chitosan backbones and hydrogel frameworks.

Keywords: catechol, chitosan, iron ion, gelation, hydrogel

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Authors: Le Fu, Rui Wu, Gang Feng Liu, Jie Zhao

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Normally, impedance control methods are based on a model that connects a spring and damper in parallel. The series connection, namely the Maxwell model, has emerged as a counterpart and draw the attention of robotics researchers. In the theoretical analysis, it turns out that the two pattern are both equivalents to some extent, but notable differences of response characteristics exist, especially in the effect of damping viscosity. However, this novel impedance control design is lack of validation on realistic robot platforms. In this study, stability analysis and experimental evaluation are achieved using a 3-fingered Barrett® robotic hand BH8-282 endowed with tactile sensing, mounted on a torque-controlled lightweight and collaborative robot KUKA® LBR iiwa 14 R820. Object handover and incoming objects catching tasks are executed for validation and analysis. Experimental results show that the series connection pattern has much better performance in natural impact or shock absorption, which indicate promising applications in robots’ safe and physical interaction with humans and objects in various environments.

Keywords: impedance control, Maxwell model, force control, dexterous manipulation

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Authors: Emad M.Abdullat, Hasan A. Ader-Rahman, Rayyan Al Ali, Arwa.A.Hudaib

Abstract:

This retrospective study aims to determine the epidemiological features of such deaths in one of the general teaching hospitals in Jordan with a focus on weaning practices and its relation to sucking as major factors underlying the mechanism of choking in infants and young children. The study utilized a retrospective design to review the records of forensic cases due to foreign body aspiration examined at the forensic department at the Jordan University Hospital. A total of 27 cases of choking in the pediatric age group were retrieved from the reports of the autopsy cases dissected. All cases of children who died due to chocking by foreign bodies were under 11 years old. Choking by food materials constituted (44.4%) of cases under 3 years of age while choking by non-food material were less prevalent under 3 years of age and comprising 18.5% of the cases. Health care personnel and parents need to be aware that introduction of solid food, unlike exclusive breast or formula-milk feeding, can have serious consequences if occurring in inappropriate timing or consistency during early childhood physical and functional development. Parents need to be educated regarding the appropriate timing and process of weaning.

Keywords: chocking, infants, weaning practices, young children

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Authors: Jose A. Alvarez Aldegunde, Adrian Fernandez Sanchez, Matthew D. Menden, Bernardo Vila Rodriguez

Abstract:

Up to five statistical pre-processings have been carried out considering the pollutant records of the stations present in Cartagena de Indias, Colombia, also taking into account the childhood asthma incidence surveys conducted in hospitals in the city by the Health Ministry of Colombia for this study. These pre-processings have consisted of different techniques such as the determination of the quality of data collection, determination of the quality of the registration network, identification and debugging of errors in data collection, completion of missing data and purified data, as well as the improvement of the time scale of records. The characterization of the quality of the data has been conducted by means of density analysis of the pollutant registration stations using ArcGis Software and through mass balance techniques, making it possible to determine inconsistencies in the records relating the registration data between stations following the linear regression. The results obtained in this process have highlighted the positive quality in the pollutant registration process. Consequently, debugging of errors has allowed us to identify certain data as statistically non-significant in the incidence and series of contamination. This data, together with certain missing records in the series recorded by the measuring stations, have been completed by statistical imputation equations. Following the application of these prior processes, the basic series of incidence data for respiratory disease and pollutant records have allowed the characterization of the influence of pollutants on respiratory diseases such as, for example, childhood asthma. This characterization has been carried out using statistical correlation methods, including visual correlation, simple linear regression correlation and spectral analysis with PAST Software which identifies maximum periodicity cycles and minimums under the formula of the Lomb periodgram. In relation to part of the results obtained, up to eleven maximums and minimums considered contemporary between the incidence records and the particles have been identified taking into account the visual comparison. The spectral analyses that have been performed on the incidence and the PM2.5 have returned a series of similar maximum periods in both registers, which are at a maximum during a period of one year and another every 25 days (0.9 and 0.07 years). The bivariate analysis has managed to characterize the variable "Daily Vehicular Flow" in the ninth position of importance of a total of 55 variables. However, the statistical correlation has not obtained a favorable result, having obtained a low value of the R2 coefficient. The series of analyses conducted has demonstrated the importance of the influence of pollutants such as PM2.5 in the development of childhood asthma in Cartagena. The quantification of the influence of the variables has been able to determine that there is a 56% probability of dependence between PM2.5 and childhood respiratory asthma in Cartagena. Considering this justification, the study could be completed through the application of the BenMap Software, throwing a series of spatial results of interpolated values of the pollutant contamination records that exceeded the established legal limits (represented by homogeneous units up to the neighborhood level) and results of the impact on the exacerbation of pediatric asthma. As a final result, an economic estimate (in Colombian Pesos) of the monthly and individual savings derived from the percentage reduction of the influence of pollutants in relation to visits to the Hospital Emergency Room due to asthma exacerbation in pediatric patients has been granted.

Keywords: Asthma Incidence, BenMap, PM2.5, Statistical Analysis

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Authors: Shiuh-Jer Huang, Yun-Han Yeh

Abstract:

A four-wheel drive electric vehicle was built with hub DC motors and FPGA embedded control structure. A 40 steps manual adjusting motorcycle shock absorber was refitted with DC motor driving mechanism to construct as a semi-active suspension system. Accelerometer and potentiometer sensors are installed to measure the sprung mass acceleration and suspension system compression or rebound states for control purpose. An intelligent fuzzy logic controller was proposed to real-time search appropriate damping ratio based on vehicle running condition. Then, a robust fuzzy sliding mode controller (FSMC) is employed to regulate the target damping ratio of each wheel axis semi-active suspension system. Finally, different road surface conditions are chosen to evaluate the control performance of this semi-active suspension and compare with that of passive system based on wheel axis acceleration signal.

Keywords: acceleration, FPGA, Fuzzy sliding mode control, semi-active suspension

Procedia PDF Downloads 420

Authors: Yan Zeng, Li Tao, Liujun Han, Tianye Zhang, Yongan Yu, Kaijun Ma, Long Chen

Abstract:

Mechanical asphyxia is one of the main cause of death; however, death by mechanical asphyxia may be difficult to prove in court, particularly in cases in which corpses exhibit no obvious signs of asphyxia. To identify a credible biomarker of asphyxia, we first examined the expression levels of all the mRNAs in human cardiac tissue specimens subjected to mechanical asphyxia and compared these expression levels with those of the corresponding mRNAs in specimens subjected to craniocerebral injury. A total of 119 differentially expressed mRNAs were selected and the expression levels of these mRNAs were examined in 44 human cardiac tissue specimens subjected to mechanical asphyxia, craniocerebral injury, hemorrhagic shock and other causes of death. We found that DUSP1 and KCNJ2 were up-regulated in tissue specimens of mechanical asphyxia compared with control tissues, with no significant correlation between age, environmental temperature and PMI, indicating that DUSP1 and KCNJ2 may associate with mechanical asphyxia-induced death and can thus serve as useful biomarkers of death by mechanical asphyxia.

Keywords: mechanical asphyxia, biomarkers, DUSP1, KCNJ2, cardiac tissue

Procedia PDF Downloads 295

Authors: Reem Al-Garni

Abstract:

Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

Procedia PDF Downloads 320