Search results for: Finnegan neonatal abstinence syndrome tool

Authors: Mustafa Metin Donma

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Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. One hundred and ninety-four children, aged 06-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight+obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements, as well as blood pressure values were taken. Tense indices were computed. The formula for the first tense index was (SP+DP)/2. The second index was Advanced Donma Tense Index (ADTI). The formula for this index was [(SP+DP)/2] * Height. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and advanced Donma tense index (ADTI), which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: blood pressure, child, height, metabolic syndrome, waist circumference

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Authors: S. Ghorbani, N. I. Polushin

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The machinability of workpieces (AISI 1045 Steel, AA2024 aluminum alloy, A48-class30 gray cast iron) in turning operation has been carried out using different types of cutting tool (conventional, cutting tool with holes in toolholder and cutting tool filled up with composite material) under dry conditions on a turning machine at different stages of spindle speed (630-1000 rpm), feed rate (0.05-0.075 mm/rev), depth of cut (0.05-0.15 mm) and tool overhang (41-65 mm). Experimentation was performed as per Taguchi’s orthogonal array. To evaluate the relative importance of factors affecting surface roughness the single decision tree (SDT), Decision tree forest (DTF) and Group method of data handling (GMDH) were applied.

Keywords: decision tree forest, GMDH, surface roughness, Taguchi method, turning process

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Authors: Ghoul Rachid Brahim

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Introduction: Tuberculous spondylodiscitis is an infection of the spine by Mycobacterium tuberculosis. Tuberculous spondylodiscitis still remains a topical disease in developing countries and continues to pose a public health problem in endemic countries. Materials and methods: Clinical case: This is a 12-year-old child followed in pediatrics for weight loss and progressively worsening low back pain. The neurological examination found an irritative pyramidal syndrome in both lower limbs with a severe lumbar spinal syndrome. The radiological assessment: (Rx of the spine supplemented by CT and MRI) shows L1L2 spondylodiscitis. Treatment: The child is put on anti-tuberculosis treatment, and the spine is restrained with a corset. Control MRI shows a worsening of the dorsal kyphosis with a backward movement of the posterior wall and spinal cord compression. The child is operated on via the posterior approach (the operative procedure consists of an L1 laminectomy and D11 L3 osteosynthesis). Results: Spinal cord décompression and stabilization of the spine. Conclusion: Tuberculous spondylodiscitis in children remains a rare, aggressive, and progressive condition. The prognosis depends on the diagnosis's precocity and the therapeutic management quality.

Keywords: tuberculous spondylodiscitis, mycobacterium tuberculosis, laminectomy, MRI

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Authors: Andreas Latz, Daniela Heinz, Fatima Hashemi, Melek Baygül

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Introduction: Feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), and feline coronavirus (FCoV) are serious infectious diseases affecting cats worldwide. Transmission of these viruses occurs primarily through close contact with infected cats (via saliva, nasal secretions, faeces, etc.). FeLV, FIV, and FCoV infections can occur in combination and are expressed in similar clinical symptoms. Diagnosis can therefore be challenging: Symptoms are variable and often non-specific. Sick cats show very similar clinical symptoms: apathy, anorexia, fever, immunodeficiency syndrome, anemia, etc. Sample volume for small companion animals for diagnostic purposes can be challenging to collect. In addition, multiplex diagnosis of diseases can contribute to an easier, cheaper, and faster workflow in the lab as well as to the better differential diagnosis of diseases. For this reason, we wanted to develop a new diagnostic tool that utilizes less sample volume, reagents, and consumables than multiplesingleplex ELISA assays Methods: The Multiplier from Dynextechonogies (USA) has been used as platform to develop a Multiplex diagnostic tool for the detection of antibodies against FIV and FCoV/FIP and antigens for FeLV. Multiplex diagnostics. The Dynex®Multiplier®is a fully automated chemiluminescence immunoassay analyzer that significantly simplifies laboratory workflow. The Multiplier®ease-of-use reduces pre-analytical steps by combining the power of efficiently multiplexing multiple assays with the simplicity of automated microplate processing. Plastic beads have been coated with antigens for FIV and FCoV/FIP, as well as antibodies for FeLV. Feline blood samples are incubated with the beads. Read out of results is performed via chemiluminescence Results: Bead coating was optimized for each individual antigen or capture antibody and then combined in the multiplex diagnostic tool. HRP: Antibody conjugates for FIV and FCoV antibodies, as well as detection antibodies for FeLV antigen, have been adjusted and mixed. 3 individual prototyple batches of the assay have been produced. We analyzed for each disease 50 well defined positive and negative samples. Results show an excellent diagnostic performance of the simultaneous detection of antibodies or antigens against these feline diseases in a fully automated system. A 100% concordance with singleplex methods like ELISA or IFA can be observed. Intra- and Inter-Assays showed a high precision of the test with CV values below 10% for each individual bead. Accelerated stability testing indicate a shelf life of at least 1 year. Conclusion: The new tool can be used for multiplex diagnostics of the most important feline infectious diseases. Only a very small sample volume is required. Fully automation results in a very convenient and fast method for diagnosing animal diseases.With its large specimen capacity to process over 576 samples per 8-hours shift and provide up to 3,456 results, very high laboratory productivity and reagent savings can be achieved.

Keywords: Multiplex, FIV, FeLV, FCoV, FIP

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Authors: G. Krishna Mohana Rao, P. Ravi Kumar

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Milling is the process of removing unwanted material with suitable tool. Even though the milling process is having wider application, the vibration of machine tool and work piece during the process produces chatter on the products. Various methods of preventing the chatter have been incorporated into machine tool systems. Damper is cut into equal number of parts. Each part is called as finger. Multiple fingers were inserted in the hollow portion of the shank to reduce tool vibrations. In the present work, nonlinear static and dynamic analysis of the damper inserted end milling cutter used to reduce the chatter was done. A comparison is made for the milling cutter with multiple dampers. Surface roughness was determined by machining with multiple finger inserted milling cutters.

Keywords: damping inserts, end milling, vibrations, nonlinear dynamic analysis, number of fingers

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Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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Authors: T. Keiller, E. Hindman, P. Hassmen, K. Radford, L. Lavrencic

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Background: Psychosocial disadvantage is associated with impaired cognitive abilities, with executive functioning (EF) abilities particularly vulnerable. EF abilities strongly predict general daily functioning, educational and career prospects, and health choices. A reliable and valid assessment of EF is important to support appropriate care and intervention strategies. However, evidence-based EF assessment tools for use with Aboriginal Australians are limited. Aim and Method: This research aims to develop and validate a culturally appropriate EF tool for use with indigenous Australians. To this end, Study One aims to review current literature examining the benefits and disadvantages of current EF assessment tools for use with Indigenous Australians. Study Two aims to collate expert opinion on the strengths and weaknesses of various current EF assessment tools for use with Indigenous Australians using Delphi methodology with experienced psychologists (n = 10). The initial two studies will inform the development of a culturally appropriate assessment tool. Study Three aims to evaluate the psychometric properties of the tool with an Indigenous sample living in the New South Wales Mid-North Coast. The study aims to quantify the predictive validity of this tool via comparison to functionality predictors and neuropsychological assessment scores. Study Four aims to collect qualitative data surrounding the feasibility and acceptability of the tool among indigenous Australians and health professionals. Expected Results: Findings from this research are likely to inform cognitive assessment practices and tool selection for health professionals conducting cognitive assessments with Indigenous Australians. Improved assessment of EF will inform appropriate care and intervention strategies for individuals with EF deficits.

Keywords: aboriginal Australians, assessment tool, cognition, executive functioning

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Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

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Authors: Marina G. Galitskaya, Svetlana G. Makarova, Andrey P. Fisenko.

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Children on medication-induced immunosuppression are at high risk of developing severe course infectious diseases. Therefore, preventive vaccination is especially important for these children. However, due to the immunosuppressive effects of treatment for the underlying disease, the effectiveness of vaccination may decrease below the protective level. In a multidisciplinary children's medical center, post-vaccination immunity was studied in 79 children aged 4-17 years. The children were divided into 2 groups: Group 1 (38 children) with kidney pathology (Nephrotic Syndrome) and Group 2 (41 children) with inflammatory bowel diseases (Ulcerative Colitis, Crohn's Disease). Both groups of children were vaccinated according to the national vaccination calendar and received immunosuppressive therapy (prednisolone, methotrexate, cyclosporine, and other drugs) for at least 1 year. Using the enzyme-linked immunosorbent assay method, specific IgG antibodies to vaccine-preventable infections were determined: measles, rubella, mumps, diphtheria, pertussis, tetanus, and hepatitis B. The study showed the percentage of children with positive IgG values for vaccine-preventable infections. The highest percentage of children had protective antibody levels to measles (84.2% in children with nephrotic syndrome and 92.6% in those with inflammatory bowel disease) and rubella (71% and 80.4%, respectively). The lowest percentage of children with protective antibodies was for hepatitis B (5.2% and 29.2% respectively). Antibodies to mumps, diphtheria, pertussis, and tetanus were found not in all children (from 39,4% to 82,9%). The remaining percentage of children did not have detectable IgG antibodies to vaccine-preventable infections. Not all children, despite the previous vaccination, preserved antibodies to vaccine-controlled infections and remained unprotected by specific IgG antibodies. The issue of a booster vaccine dose should be considered in children without contraindications to vaccination. Children receiving long-term immunosuppressive therapy require an individual vaccination approach, including a specific definition of the performed vaccination.

Keywords: immunosuppressive therapy, inflammatory bowel diseases, nephrotic syndrome, post-vaccination immunity, specific antibodies, vaccine-preventable infections.

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Authors: A. Achour L. Chekour, A. Mekroud

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Tribology, the science of lubrication, friction and wear, plays an important role in science "crossroads" initiated by the recent developments in the industry. Its multidisciplinary nature reinforces its scientific interest. It covers all the sciences that deal with the contact between two solids loaded and relative motion. It is thus one of the many intersections more clearly established disciplines such as solid mechanics and the fluids, rheological, thermal, materials science and chemistry. As for his experimental approach, it is based on the physical and processing signals and images. The optimization of operating conditions by cutting tool must contribute significantly to the development and productivity of advanced automation of machining techniques because their implementation requires sufficient knowledge of how the process and in particular the evolution of tool wear. In addition, technological advances have developed the use of very hard materials, refractory difficult machinability, requiring highly resistant materials tools. In this study, we present the behavior wear a machining tool during the roughing operation according to the cutting parameters. The interpretation of the experimental results is based mainly on observations and analyzes of sharp edges e tool using the latest techniques: scanning electron microscopy (SEM) and optical rugosimetry laser beam.

Keywords: friction, wear, tool, cutting

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Authors: Vikrum Malhotra, Manpreet Kaur, Ayesha Ghotto

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Background: Cardiac registries such as ACC Percutaneous Coronary Intervention Registry require high quality data to be abstracted, including data elements such as nuclear cardiology, diagnostic coronary angiography, and PCI. Introduction: The audit tool created is used by data abstractors to provide data audits and assess the accuracy and inter-rater reliability of abstraction performed by the abstractors for a health system. This audit tool solution has been developed across 13 registries, including ACC/NCDR registries, PCI, STS, Get with the Guidelines. Methodology: The data audit tool was used to audit internal registry abstraction for all data elements, including stress test performed, type of stress test, data of stress test, results of stress test, risk/extent of ischemia, diagnostic catheterization detail, and PCI data elements for ACC/NCDR PCI registries. This is being used across 20 hospital systems internally and providing abstraction and audit services for them. Results: The data audit tool had inter-rater reliability and accuracy greater than 95% data accuracy and IRR score for the PCI registry in 50 PCI registry cases in 2021. Conclusion: The tool is being used internally for surgical societies and across hospital systems. The audit tool enables the abstractor to be assessed by an external abstractor and includes all of the data dictionary fields for each registry.

Keywords: abstraction, cardiac registry, cardiovascular registry, registry, data

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Authors: Ashish Ankus Yerunkar, Ravi Terkar

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Study aimed at evaluating the best process environment which could simultaneously satisfy requirements of both quality as well as productivity with special emphasis on reduction of cutting tool flank wear, because reduction in flank wear ensures increase in tool life. The predicted optimal setting ensured minimization of surface roughness. Purpose of this paper is focused on the analysis of optimum cutting conditions to get lowest surface roughness in turning SCM 440 alloy steel by Taguchi method. Design for the experiment was done using Taguchi method and 18 experiments were designed by this process and experiments conducted. The results are analyzed using ANOVA method. Taguchi method has depicted that the depth of cut has significant role to play in producing lower surface roughness followed by feed. The Cutting speed has lesser role on surface roughness from the tests. The vibrations of the machine tool, tool chattering are the other factors which may contribute poor surface roughness to the results and such factors ignored for analyses. The inferences by this method will be useful to other researches for similar type of study and may be vital for further research on tool vibrations, cutting forces etc.

Keywords: surface roughness (ra), machining, dry turning, taguchi method, turning process, anova method, mahr perthometer

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Authors: Emmanuel Kamal Aziz Saba, Sarah Sayed El-Tawab

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The present study was conducted to assess the involvement of ulnar sensory and/or motor nerve fibers in patients with carpal tunnel syndrome (CTS) and whether this affects the accuracy of the median versus ulnar comparative tests. The present study included 145 CTS hands and 71 asymptomatic control hands. Clinical examination was done. The following tests were done: Sensory conduction studies: median, ulnar and dorsal ulnar cutaneous nerves; and median versus ulnar digit (D) four sensory comparative study; and motor conduction studies: median nerve, ulnar nerve and median versus ulnar motor comparative study. It was found that 17 CTS hands (11.7%) had ulnar sensory abnormalities in 17 different patients. The median versus ulnar sensory and motor comparative studies were abnormal among all these 17 CTS hands. There were significant negative correlations between median motor latency and both ulnar sensory amplitudes recording D5 and D4. In conclusion, there is ulnar sensory nerve abnormality among CTS patients. This abnormality affects the amplitude of ulnar sensory nerve action potential. This does not affect the median versus ulnar sensory and motor comparative tests accuracy for use in CTS.

Keywords: median nerve, motor comparative study, sensory comparative study, ulnar nerve

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Authors: Kazi Hossain

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The National Australian Built Environment Rating System (NABERS) is the key industry standard for measuring and benchmarking environmental performance of existing buildings in Australia. Developed and run by the New South Wales government, NABERS measures the operational efficiency of different types of buildings by using a set of tools that provide an easy to understand graphical rating outcome ranged from 0 to 6 stars. This set of tools also include a tool called NABERS IE which enables tenants or building managers to benchmark their buildings indoor environment quality against the national market. Launched in 2009, the number NABERS IE ratings have steadily increased from 10 certified ratings in 2011 to 43 in 2013. However there is a massive uptake of over 50 ratings alone in 2014 making the number of ratings to reach over 100. This paper outlines the methodology used to create this tool, a statistical overview of the tool, and the driving factor that motivates the building owners and managers to use this tool every year to rate their buildings.

Keywords: Acoustic comfort, Indoor air quality, Indoor Environment, NABERS, National Australian Built Environment Rating System, Performance rating, Rating System, Thermal comfort, Ventilation effectiveness, Visual comfort.

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Authors: Zhongzhi Hu, Jie Shen, Jiqiang Wang

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A high precision aeroengine model is needed when developing the engine control system. Compared with other main components, the axial compressor is the most challenging component to simulate. In this paper, a compressor map optimizing tool based on the introduction of a modifiable β function is developed for FWorks (FADEC Works). Three parameters (d density, f fitting coefficient, k₀ slope of the line β=0) are introduced to the β function to make it modifiable. The comparison of the traditional β function and the modifiable β function is carried out for a certain type of compressor. The interpolation errors show that both methods meet the modeling requirements, while the modifiable β function can predict compressor performance more accurately for some areas of the compressor map where the users are interested in.

Keywords: beta function, compressor map, interpolation error, map optimization tool

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Authors: K. Hema Shankari, R. Thirumalaiselvi, N. V. Balasubramanian

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The present paper addresses to the research in the area of regression testing with emphasis on automated tools as well as prioritization of test cases. The uniqueness of regression testing and its cyclic nature is pointed out. The difference in approach between industry, with business model as basis, and academia, with focus on data mining, is highlighted. Test Metrics are discussed as a prelude to our formula for prioritization; a case study is further discussed to illustrate this methodology. An industrial case study is also described in the paper, where the number of test cases is so large that they have to be grouped as Test Suites. In such situations, a genetic algorithm proposed by us can be used to reconfigure these Test Suites in each cycle of regression testing. The comparison is made between a proprietary tool and an open source tool using the above-mentioned metrics. Our approach is clarified through several tables.

Keywords: APFD metric, genetic algorithm, regression testing, RFT tool, test case prioritization, selenium tool

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Authors: Wu Xiaojun, Liu Ruiping, Yu Xingzhan, Wu Qian

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In precision grinding, utilizing the elastic matrix ball has higher processing efficiency and better superficial quality than traditional grinding. The diversity of characteristics which elastic abrasive tool contact with bend surface results in irregular wear abrasion，and abrasive tool machining status get complicated. There is no theoretical interpretation that parameters affect the grinding accuracy.Aiming at corrosion resistance, wear resistance and other characteristics of M 300 material, it is often used as a material on aerospace precision components. The paper carried out grinding and polishing experiments by using material of M 300,to theoretically show the relationship between stress magnitude and grinding efficiency，and predict the optimal combination of grinding parameter for effective grinding, just for the high abrasion resistance features of M 300, analyzing the micro-contact of elastic ball abrasive tool (Whetstone), using mathematical methods deduce the functional relationship between residual peak removal rate and the main parameters which impact the grinding accuracy on the plane case.Thus laying the foundation for the study of elastic abrasive prediction and compensation.

Keywords: flexible abrasive tool, polishing parameters, Hertz theory, removal rate

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Authors: Ali Baker, Russel Krawitz

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This paper describes a rare occurrence where a potentially fatal complication of COVID-19 infection (MIS-A) was misdiagnosed as an acute abdomen. As most patients with this syndrome present with fever and gastrointestinal symptoms, they may inadvertently fall under the care of the surgical unit. However, unusual imaging findings and a poor response to anti-microbial therapy should prompt clinicians to suspect a non-surgical etiology. More than half of MIS-A patients require ICU admission and vasopressor support. Prompt referral to a physician is key, as the cornerstone of treatment is IVIG and corticosteroid therapy. A 32 year old woman presented with right sided abdominal pain and fevers. She had also contracted COVID-19 two months earlier. Abdominal examination revealed generalised right sided tenderness. The patient had raised inflammatory markers, but other blood tests were unremarkable. CT scan revealed extensive lymphadenopathy along the ileocolic chain. The patient proved to be a diagnostic dilemma. She was reviewed by several surgical consultants and discussed with several inpatient teams. Although IV antibiotics were commenced, the right sided abdominal pain, and fevers persisted. Pan-culture returned negative. A mild cholestatic derangement developed. On day 5, the patient underwent preparation for colonoscopy to assess for a potential intraluminal etiology. The following day, the patient developed sinus tachycardia and hypotension that was refractory to fluid resuscitation. That patient was transferred to ICU and required vasopressor support. Repeat CT showed peri-portal edema and a thickened gallbladder wall. On re-examination, the patient was Murphy’s sign positive. Biliary ultrasound was equivocal for cholecystitis. The patient was planned for diagnostic laparoscopy. The following morning, a marked rise in cardiac troponin was discovered, and a follow-up echocardiogram revealed moderate to severe global systolic dysfunction. The impression was post-COVID MIS with myocardial involvement. IVIG and Methylprednisolone infusions were commenced. The patient had a great response. Vasopressor support was weaned, and the patient was discharged from ICU. The patient continued to improve clinically with oral prednisolone, and was discharged on day 17. Although MIS following COVID-19 infection is well-described syndrome in children, only recently has it come to light that it can occur in adults. The exact incidence is unknown, but it is thought to be rare. A recent systematic review found only 221 cases of MIS-A, which could be included for analysis. Symptoms vary, but the most frequent include fever, gastrointestinal, and mucocutaneous. Many patients progress to multi-organ failure and require vasopressor support. 7% succumb to the illness. The pathophysiology of MIS is only partly understood. It shares similarities with Kawasaki disease, macrophage activation syndrome, and cytokine release syndrome. Importantly, by definition, the patient must have an absence of severe respiratory symptoms. It is thought to be due to a dysregulated immune response to the virus. Potential mechanisms include reduced levels of neutralising antibodies and autoreactive antibodies that promote inflammation. Further research into MIS-A is needed. Although rare, this potentially fatal syndrome should be considered in the unwell surgical patient who has recently contracted COVID-19 and poses a diagnostic dilemma.

Keywords: acute-abdomen, MIS, COVID-19, ICU

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Authors: Jung-Ho Moon, Tae Kwon Ha

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In the present study, the effect of Si, Al, Ti, Zr, and Nb addition on the microstructure and hot workability of cast M42 tool steels, basically consisting of 1.0C, 0.2Mn, 3.8Cr, 1.5W, 8.5Co, 9.2Mo, and 1.0V in weight percent has been investigated. Tool steels containing Si of 0.25 and 0.5 wt.%, Al of 0.06 and 0.12 wt.%, Ti of 0.3 wt.%, Zr of 0.3 wt.%, and Nb of 0.3 wt.% were cast into ingots of 140 mm´ 140 mm´ 330 mm by vacuum induction melting. After solution treatment at 1150°C for 1.5 hrs. followed by furnace cooling, hot rolling at 1180 °C was conducted on the ingots. Addition of titanium, zirconium and niobium was found to retard the decomposition of the eutectic carbides and result in the deterioration of hot workability of the tool steels, while addition of aluminium and silicon showed relatively well decomposed carbide structure and resulted in sound hot rolled plates.

Keywords: high speed steels, alloying elements, eutectic carbides, microstructure, hot workability

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Authors: Hamidreza Jahani, Zahra Salehzadeh, Ehsan Amini, Mohsen Tohidifar

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Calvarial Hyperostosis Syndrome (CHS) is a benign bone disease of the skull. It is a non-neoplastic and proliferative bone disease, and the main feature of the disease is progressive and asymmetrical bone involvement. CHS is mostly reported in young male and female bullmastiff dogs and less frequently in other breeds. The etiology of CHS is unknown. This is the first case report of CHS in Iran. A 3-month-old male Persian Mastiff was presented with chief complaints of multiple episodes of seizure, pacing, bizarre behavior, delayed growth, head pressing, and difficulty in opening the mouth. Central blindness and open fontanelles were observed in clinical examination. No abnormality was found in the complete blood count and routine blood biochemical tests. CT scan findings include cortical thickening of frontal and parietal bones and enlargement of the left retropharyngeal lymph node. For treatment, oral clindamycin for two weeks, prednisolone and phenobarbital for one month, respectively, were administrated, and the case showed improvement after a week and recovered after one month.

Keywords: calvarial hyperostosis, Persian Mastiff, frontal bone, seizure

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Authors: Theresa Adderley

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Background: Aside from abstinence, correct and consistent use of latex condoms is the best known effective method to reduce HIV transmission among sexually active heterosexual individuals. When condoms are correctly used, the risk of HIV transmission is reduced by approximately 85%, relative to risk when not protected during sexual intercourse. The literature provides evidence that heterosexual young adults continue to be the group among whom STI rates are highest and the group that engages in more sexual risk-taking behaviors such as inconsistent or no condom usage. This study examines condom attitudes, condom use self-efficacy and their contributions to safer sex behaviors among heterosexual men living in The Bahamas. Methods: Guided by the Theory of Planned Behavior, and a convenience sample of 185 heterosexual males (Mage= 31.95, SD = 11.35), three standardized instruments were used to assess behaviors that may not only place heterosexual males at risk for HIV infection but also their female partners. Results: The results of this study suggest that condom attitudes, and condom use self-efficacy are important in explaining 24% variance in safer sex behaviors among Bahamian men. Income (β= -.15, p < .01; condom attitudes, (β= .36, p < .01), and condom use self-efficacy (β= .1, p < .01) were significantly associated with safer sex behaviors. Conclusion: Rather than focusing only on the use of safer sex behaviors, an effective HIV prevention strategy must consider condom attitudes and condom use self-efficacy as specific variables that may contribute to perpetuating the transmission of HIV.

Keywords: condom attitudes, safer sex behaviors, HIV, condom self-efficacy

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Authors: Yoshio Kurosawa, Takao Yamaguchi

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High frequency automotive interior noise above 500 Hz considerably affects automotive passenger comfort. To reduce this noise, sound insulation material is often laminated on body panels or interior trim panels. For a more effective noise reduction, the sound reduction properties of this laminated structure need to be estimated. We have developed a new calculate tool that can roughly calculate the sound absorption and insulation properties of laminate structure and handy for designers. In this report, the outline of this tool and an analysis example applied to floor mat are introduced.

Keywords: automobile, acoustics, porous material, transfer matrix method

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Authors: Karim Akkouche, Amine Nekmouche, Leyla Bouzid

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This study focuses on the development of a multifunctional Expert System (ES) called post-seismic damage inspection tool (PSDIT), a powerful tool which allows the evaluation, the processing, and the archiving of the collected data stock after earthquakes. PSDIT can be operated by two user types; an ordinary user (ingineer, expert, or architect) for the damage visual inspection and an administrative user for updating the knowledge and / or for adding or removing the ordinary user. The knowledge acquisition is driven by a hierarchical knowledge model, the Information from investigation reports and those acquired through feedback from expert / engineer questionnaires are part.

Keywords: .disaster, damaged structures, damage assessment, expert system

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Authors: Jeonho Moon, Tae Kwon Ha

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In the present study, the effect of Si, Al, Ti, Zr, and Nb addition on the microstructure and hot workability of cast M42 tool steels, basically consisting of 1.0 C, 0.2 Mn, 3.8 Cr, 1.5 W, 8.5 Co, 9.2 Mo, and 1.0 V in weight percent has been investigated. Tool steels containing Si of 0.25 and 0.5 wt.%, Al of 0.06 and 0.12 wt.%, Ti of 0.3 wt.%, Zr of 0.3 wt.%, and Nb of 0.3wt.% were cast into ingots of 140 mm x 140 mm x 330 mm by vacuum induction melting. After solution treatment at 1150 °C for 1.5 hr followed by furnace cooling, hot rolling at 1180 °C was conducted on the ingots. Addition of titanium, zirconium and niobium was found to retard the decomposition of the eutectic carbides and result in the deterioration of hot workability of the tool steels, while addition of aluminum and silicon showed relatively well decomposed carbide structure and resulted in sound hot rolled plates.

Keywords: duplex stainless steel, alloying elements, eutectic carbides, microstructure, hot workability

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Authors: Asinguza P. Allan

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The Advocacy for Better Health aims to equip citizens with enabling environment and systems to effectively advocate for strong action plans to improve health services. This is because the 2020 Government target for Uganda to transform into a middle income country will be achieved if investment is made in keeping the population healthy and productive. Citizen participation as an important foundation for change has been emphasized to gather data through participatory rural appraisal and inform evidence-based advocacy for recruitment and motivation of human resources. Citizens conduct problem ranking during advocacy forums on staffing levels and health worker absenteeism. Citizens prioritised inadequate number of midwives and absenteeism. On triangulation, health worker to population ratio in Uganda remains at 0.25/1,000 which is far below the World Health Organization (WHO) threshold of 2.3/1,000. Working with IntraHealth, the project advocated for recruitment of critical skilled staff (doctors and midwives) and scale up health workers motivation strategy to reduce Uganda’s Neonatal Mortality Rate of 22/1,000 and Maternal Mortality Ratio of 320/100,000. Government has committed to increase staffing to 80% by 2018 (10 districts have passed ordinances and revived use of duty rosters to address health worker absenteeism. On the other hand, the better health advocacy debate has been elevated with need to increase health sector budget allocations from 8% to 10%. The project has learnt that building a body of evidence from citizens enhances the advocacy agenda. Communities will further monitor government commitments to reduce Neonatal Mortality Rate and Maternal Mortality Ratio. The project has learnt that interface meeting between duty bearers and the community allows for immediate feedback and the process is a strong instrument for empowerment. It facilitates monitoring and performance evaluation of services, projects and government administrative units (like district assemblies) by the community members themselves. This, in turn, makes the human resources in health to be accountable, transparent and responsive to communities where they work. This, in turn, promotes human resource performance.

Keywords: advocacy, empowerment, evidence, human resources

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Authors: Munkhtuul G., Bolortsetseg Z., Lutzul M., Sugar N., Nyamdorj D., Nomundari B., Zesemdorj O., Erdenebayar N., Lkhagvasuren T. S., Munkhbayarlakh S., Bayasgalan T. Uurtuya S. H.

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Background: Elevated serum uric acid (SUA) levels are observed in metabolic and cardiovascular conditions as an early predictor of metabolic syndrome (MS). Hyperuricemia, characterised by high uric acid levels in serum, increases the risk of developing MS by 1.6 times. Being overweight and obese significantly contributes to developing MS and cardiovascular disorders. In Mongolia, the prevalence of overweight and obesity is reaching 48.8% among individuals aged 15 to 49 years, indicating a potential surge in the incidence of MS, cardiovascular disorders, diabetes mellitus, and gout.Objective: This study aimed to determine the SUA levels in men diagnosed with MS and investigate the factors influencing these levels.Methods: A total of 119 men aged 30-60, who underwent preventive examinations and resided in Ulaanbaatar city, were included in the study. The criteria established by the International Diabetes Federation (IDF), American Heart Association (AHA), and the National Heart, Lung, and Blood Institute (NHLBI) were employed to define metabolic syndrome. Hyperuricemia was defined as SUA levels ≥7 mg/dL. Dietary intake was evaluated through the 24-hour recall method.Results: The study revealed that the prevalence of MS among the participants was 42.9% (n=51), with hyperuricemia observed in 16.8% (n=20) of the individuals. Among men diagnosed with MS, 21.3% (n=10) exhibited hyperuricemia. The mean SUA levels were as follows: 4.7±0.8 mg/dL in the healthy group, 5.9±1.1 mg/dL in men without MS but presenting central obesity, and 6.2±1.3 mg/dL in men with MS. After adjusting for age and body mass index (BMI), a positive correlation was observed between SUA levels and triglycerides (β=0.93) as well as lipid accumulation product (LAP) (β=0.92) in men with MS. In the central obesity group, SUA levels exhibited a positive correlation with triglycerides (β=0.91), visceral adiposity index (VAI) (β=0.73), LAP (β=0.92), and cardiometabolic index (CMI) (β=0.69). The risk of hyperuricemia increased by 3.29 times with elevated triglycerides and 3.53 times with an increased LAP.Conclusion: The findings indicate that abdominal fat accumulation, as indicated by elevated triglyceride levels and LAP, is associated with increased SUA levels in men with MS. However, no significant relationship was observed between SUA levels and dietary intake.

Keywords: central obesity, obesity, triglycerides, hyperuricemia

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Authors: Claudia Valderrama-Ulloa, Cristian Schmitt, Juan Pablo Marchetti, Viviana Bucarey

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Access to adequate housing is a fundamental human right and a crucial factor for health. Housing should be inclusive, accessible, and able to meet the needs of all its inhabitants at every stage of their lives without hindering their health, autonomy, or independence. This article addresses the importance of designing housing for people with disabilities, which varies depending on individual abilities, preferences, and cultural considerations. Based on the components of the International Classification of Functioning, Disability and Health, wheelchair users, little people (achondroplasia), children with autism spectrum disorder and Down syndrome were characterized, and six domains of activities related to daily life inside homes were defined. The article describes the main barriers homes present for this group of people. It proposes a list of architectural and design aspects to reduce barriers to housing use. The aspects are divided into three main groups: space management, building services, and supporting facilities. The article emphasizes the importance of consulting professionals and users with experience designing for diverse needs to create inclusive, safe, and supportive housing for people with disabilities.

Keywords: achondroplasia, autism spectrum disorder, disability, down syndrome, wheelchair user

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Authors: Darma Putra Sitepu, Dewi Larasati, Yohanes Wolter Hendrik George

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Sepsis is a life-threatening medical emergency frequently observed in intensive care unit (ICU). Surviving Sepsis Campaign in 2018 has recommended the administration of early vasopressor in the first hour of sepsis or septic shock but has not yet included de-resuscitation protocol. De-resuscitation in acute management of septic shock is where patient received active removal of accumulated fluid. It has been proposed by some studies and ongoing clinical trials. Here we present a case with early vasopressor and de-resuscitation. Male, 27 years old presenting to the emergency room with shortness of breath, altered mental status, and widespread blisters on his body and lips started a few hours prior, after receiving non-steroidal anti-inflammatory drug through intravenous injection. Patient was hypotensive, tachycardic, and tachypneic at admission, diagnosed with Steven Johnson Syndrome with Septic Shock. Patient received fluid resuscitation, early vasopressor, and diuresis agent aimed to actively remove fluid after the initial phase of resuscitation. Patient was admitted to ICU and progressively recovering. At day-10, patient was stabilized and was transferred to general ward. Early vasopressor and de-resuscitation are beneficial for the patient.

Keywords: sepsis, shock, de-resuscitation, vasopressor, fluid, case report

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Authors: Niracha Chompurach, Dararat Khampusaen

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EFL students have to be able to synthesize the texts they are reading critically to compose and connect the information. This study focuses on the effects of the application of Infographics as a supplementary tool to improve Thai EFL students’ Academic reading skills. Infographics are graphic visual representations of information, data, and knowledge offering students to work on gathering multiple types of information, such as pictures, texts, graphs, mapping, and charts. The study aims to investigate if the Infographics as a supplementary tool in academic reading lessons can make a difference in students’ reading skills, and the students’ opinions toward the application of infographics as a reading tool. The participants of this study were 3rd year Thai EFL Khon Kaen University students who took English Academic Reading course. This study employed Infographics assignments, Infographics rubric, and Gucus group interview. This study would advantage for both EFL teachers and students as a means to engage the students to handle the larger load of and represents the complex information in visible and comprehensible way.

Keywords: EFL, e-learning, infographics, language education

Procedia PDF Downloads 160

Authors: M. S. Said, J. A. Ghani, C. H. Che Hassan, N. N. Wan, M. A. Selamat, R. Othman

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Metal Matrix Composite (MMCs) have attracted considerable attention as a result of their ability to provide high strength, high modulus, high toughness, high impact properties, improved wear resistance and good corrosion resistance than unreinforced alloy. Aluminium Silicon (Al/Si) alloys Metal Matrix composite (MMC) has been widely used in various industrial sectors such as transportation, domestic equipment, aerospace, military, construction, etc. Aluminium silicon alloy is MMC reinforced with aluminium nitride (AlN) particle and becomes a new generation material for automotive and aerospace applications. The AlN material is one of the advanced materials with light weight, high strength, high hardness and stiffness qualities which have good future prospects. However, the high degree of ceramic particles reinforcement and the irregular nature of the particles along the matrix material that contribute to its low density, is the main problem that leads to the machining difficulties. This paper examines tool wear when milling AlSi/AlN Metal Matrix Composite using a TiB2 coated carbide cutting tool. The volume of the AlN reinforced particle was 10%. The milling process was carried out under dry cutting condition. The TiB2 coated carbide insert parameters used were the cutting speed of (230 m/min, feed rate 0.4mm tooth, DOC 0.5mm, 300 m/min, feed rate 0.8mm/tooth, DOC 0.5mm and 370 m/min, feed rate 0.8, DOC 0.4m). The Sometech SV-35 video microscope system was used for tool wear measurements respectively. The results have revealed that the tool life increases with the cutting speed (370 m/min, feed rate 0.8 mm/tooth and depth of cut 0.4mm) constituted the optimum condition for longer tool life which is 123.2 min. While at medium cutting speed, it is found that the cutting speed of 300m/min, feed rate 0.8 mm/tooth and depth of cut 0.5mm only 119.86 min for tool wear mean while the low cutting speed give 119.66 min. The high cutting speed gives the best parameter for cutting AlSi/AlN MMCs materials. The result will help manufacture to machining the AlSi/AlN MMCs materials.

Keywords: AlSi/AlN Metal Matrix Composite milling process, tool wear, TiB2 coated carbide tool, manufacturing engineering

Procedia PDF Downloads 423