Search results for: anterior segment OCT
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 749

Search results for: anterior segment OCT

269 Millennials' Viewpoints about Sustainable Hotels' Practices in Egypt: Promoting Responsible Consumerism

Authors: Jailan Mohamed El Demerdash

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Millennials are a distinctive and dominant consumer group whose behavior, preferences and purchase decisions are broadly explored but not fully understood yet. Making up the largest market segment in the world, and in Egypt, they have the power to reinvent the hospitality industry and contribute to forming prospective demand for green hotels by showing willingness to adopting their environmental-friendly practices. The current study aims to enhance better understanding of Millennials' perception about sustainable initiatives and to increase the prediction power of their intentions regarding green hotel practices in Egypt. In doing so, the study is exploring the relation among different factors; Millennials' environmental awareness, their acceptance of green practices and their willingness to pay more for them. Millennials' profile, their preferences and environmental decision-making process are brought under light to stimulate actions of hospitality decision-makers and hoteliers. Bearing in mind that responsible consumerism is depending on understanding the different influences on consumption. The study questionnaire was composed of four sections and it was distributed to random Egyptian travelers' blogs and Facebook groups, with approximately 8000 members. Analysis of variance test (ANOVA) was used to examine the study variables. The findings indicated that Millennials' environmental awareness will not be a significant factor in their acceptance of hotel green practices, as well as, their willingness to pay more for them. However, Millennials' acceptance of the level of hotel green practices will have an impact on their willingness to pay more. Millennials were found to have a noticeable level of environmental awareness but lack commitment to tolerating hotel green practices and their associated high prices.

Keywords: millennials, environment, awareness, paying more

Procedia PDF Downloads 121
268 Air Quality Assessment for a Hot-Spot Station by Neural Network Modelling of the near-Traffic Emission-Immission Interaction

Authors: Tim Steinhaus, Christian Beidl

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Urban air quality and climate protection are two major challenges for future mobility systems. Despite the steady reduction of pollutant emissions from vehicles over past decades, local immission load within cities partially still reaches heights, which are considered hazardous to human health. Although traffic-related emissions account for a major part of the overall urban pollution, modeling the exact interaction remains challenging. In this paper, a novel approach for the determination of the emission-immission interaction on the basis of neural network modeling for traffic induced NO2-immission load within a near-traffic hot-spot scenario is presented. In a detailed sensitivity analysis, the significance of relevant influencing variables on the prevailing NO2 concentration is initially analyzed. Based on this, the generation process of the model is described, in which not only environmental influences but also the vehicle fleet composition including its associated segment- and certification-specific real driving emission factors are derived and used as input quantities. The validity of this approach, which has been presented in the past, is re-examined in this paper using updated data on vehicle emissions and recent immission measurement data. Within the framework of a final scenario analysis, the future development of the immission load is forecast for different developments in the vehicle fleet composition. It is shown that immission levels of less than half of today’s yearly average limit values are technically feasible in hot-spot situations.

Keywords: air quality, emission, emission-immission-interaction, immission, NO2, zero impact

Procedia PDF Downloads 103
267 Clinical and Structural Differences in Knee Osteoarthritis with/without Synovial Hypertrophy

Authors: Gi-Young Park, Dong Rak Kwon, Sung Cheol Cho

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Objective: The synovium is known to be involved in many pathological characteristic processes. Also, synovitis is common in advanced osteoarthritis. We aimed to evaluate the clinical, radiographic, and ultrasound findings in patients with knee osteoarthritis and to compare the clinical and imaging findings between knee osteoarthritis with and without synovial hypertrophy confirmed by ultrasound. Methods: One hundred knees (54 left, 46 right) in 95 patients (64 women, 31 men; mean age, 65.9 years; range, 43-85 years) with knee osteoarthritis were recruited. The Visual Analogue Scale (VAS) was used to assess the intensity of knee pain. The severity of knee osteoarthritis was classified according to Kellgren and Lawrence's (K-L) grade on a radiograph. Ultrasound examination was performed by a physiatrist who had 24 years of experience in musculoskeletal ultrasound. Ultrasound findings, including the thickness of joint effusion in the suprapatellar pouch, synovial hypertrophy, infrapatellar tendinosis, meniscal tear or extrusion, and Baker cyst, were measured and detected. The thickness of knee joint effusion was measured at the maximal anterior-posterior diameter of fluid collection in the suprapatellar pouch. Synovial hypertrophy was identified as the soft tissue of variable echogenicity, which is poorly compressible and nondisplaceable by compression of an ultrasound transducer. The knees were divided into two groups according to the presence of synovial hypertrophy. The differences in clinical and imaging findings between the two groups were evaluated by independent t-test and chi-square test. Results: Synovial hypertrophy was detected in 48 knees of 100 knees on ultrasound. There were no significant differences in demographic parameters and VAS score except in sex between the two groups (P<0.05). Medial meniscal extrusion and tear were significantly more frequent in knees with synovial hypertrophy than those in knees without synovial hypertrophy. K-L grade and joint effusion thickness were greater in patients with synovial hypertrophy than those in patients without synovial hypertrophy (P<0.05). Conclusion: Synovial hypertrophy in knee osteoarthritis was associated with greater suprapatellar joint effusion and higher K-L grade and maybe a characteristic ultrasound feature of late knee osteoarthritis. These results suggest that synovial hypertrophy on ultrasound can be regarded as a predictor of rapid progression in patients with knee osteoarthritis.

Keywords: knee osteoarthritis, synovial hypertrophy, ultrasound, K-L grade

Procedia PDF Downloads 53
266 Study of Three-Dimensional Computed Tomography of Frontoethmoidal Cells Using International Frontal Sinus Anatomy Classification

Authors: Prabesh Karki, Shyam Thapa Chettri, Bajarang Prasad Sah, Manoj Bhattarai, Sudeep Mishra

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Introduction: Frontal sinus is frequently described as the most difficult sinus to access surgically due to its proximity to the cribriform plate, orbit, and anterior ethmoid artery. Frontal sinus surgery requires a detailed understanding of the cellular structure and FSDP unique to each patient, making high-resolution CT scans an indispensable tool to assess the difficulty of planned sinus surgery. International Frontal Sinus Anatomy Classification (IFAC) was developed to provide a more precise nomenclature for cells in the frontal recess, classifying cells based on their anatomic origin. Objectives: To assess the proportion of frontal cell variants defined by IFAC, variation with respect to age and gender. Methods: 54 cases were enrolled after a detailed clinical history, thorough general and physical examinations, and CT a report ordered in a film. Assessment and tabulation of the presence of frontal cells according to the IFAC analyzed. The prevalence of each cell type was calculated, and data were entered in MS Excel and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics and frequencies were defined for categorical and numerical variables. Frequency, percentage, the mean and standard deviation were calculated. Result: Among 54 patients, 30 (55.6%) were male and 24 (44.4%) were female. The patient enrolled ranged from 18 to 78 years. Majority33.3% (n=18) were in age group of >50 years.According to IFAC, Agger nasi cells (92.6%) were most common, whereas supraorbital ethmoidal cells were least common 16 (29.6%). Prevalence of other frontoethmoidal cells was SAC- 57.4%, SAFC- 38.9%, SBC- 74.1%, SBFC- 33.3%, FSC- 38.9% of 54 cases. Conclusion: IFAC is an international consensus document that describes an anatomically precise nomenclature for classifying frontoethmoidal cells' anatomy. This study has defined the prevalence, symmetry and reliability of frontoethmoidal cells as established by the IFAC system as in other parts of the world.

Keywords: frontal sinus, frontoethmoidal cells, international frontal sinus anatomy classification

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265 Multidimensional Approach to Analyse the Environmental Impacts of Mobility

Authors: Andras Gyorfi, Andras Torma, Adrienn Buruzs

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Mobility has been evolved to a determining field of science. The continuously developing segment involves a variety of affected issues such as public and economic sectors. Beside the changes in mobility the state of environment had also changed in the last period. Alternative mobility as a separate category and the idea of its widespread appliance is such a new field that needs to be studied deeper. Alternative mobility implies finding new types of propulsion, using innovative kinds of power and energy resources, revolutionizing the approach to vehicular control. Including new resources and excluding others has such a complex effect which cannot be unequivocally confirmed by today’s scientific achievements. Changes in specific parameters will most likely reduce the environmental impacts, however, the production of new substances or even their subtraction of the system will cause probably energy deficit as well. The aim of this research is to elaborate the environmental impact matrix of alternative mobility and cognize the factors that are yet unknown, analyse them, look for alternative solutions and conclude all the above in a coherent system. In order to this, we analyse it with a method called ‘the system of systems (SoS) method’ to model the effects and the dynamics of the system. A part of the research process is to examine its impacts on the environment, and to decide whether the newly developed versions of alternative mobility are affecting the environmental state. As a final result, a complex approach will be used which can supplement the current scientific studies. By using the SoS approach, we create a framework of reference containing elements in which we examine the interactions as well. In such a way, a flexible and modular model can be established which supports the prioritizing of effects and the deeper analysis of the complex system.

Keywords: environment, alternative mobility, complex model, element analysis, multidimensional map

Procedia PDF Downloads 294
264 Fluid Prescribing Post Laparotomies

Authors: Gusa Hall, Barrie Keeler, Achal Khanna

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Introduction: NICE guidelines have highlighted the consequences of IV fluid mismanagement. The main aim of this study was to audit fluid prescribing post laparotomies to identify if fluids were prescribed in accordance to NICE guidelines. Methodology: Retrospective database search of eight specific laparotomy procedures (colectomy right and left, Hartmann’s procedure, small bowel resection, perforated ulcer, abdominal perineal resection, anterior resection, pan proctocolectomy, subtotal colectomy) highlighted 29 laparotomies between April 2019 and May 2019. Two of 29 patients had secondary procedures during the same admission, n=27 (patients). Database case notes were reviewed for date of procedure, length of admission, fluid prescribed and amount, nasal gastric tube output, daily bloods results for electrolytes sodium and potassium and operational losses. Results: n=27 based on 27 identified patients between April 2019 – May 2019, 93% (25/27) received IV fluids, only 19% (5/27) received the correct IV fluids in accordance to NICE guidelines, 93% (25/27) who received IV fluids had the correct electrolytes levels (sodium & potassium), 100% (27/27) patients received blood tests (U&E’s) for correct electrolytes levels. 0% (0/27) no documentation on operational losses. IV fluids matched nasogastric tube output in 100% (3/3) of the number of patients that had a nasogastric tube in situ. Conclusion: A PubMed database literature review on barriers to safer IV prescribing highlighted educational interventions focused on prescriber knowledge rather than how to execute the prescribing task. This audit suggests IV fluids post laparotomies are not being prescribed consistently in accordance to NICE guidelines. Surgical management plans should be clearer on IV fluids and electrolytes requirements for the following 24 hours after the plan has been initiated. In addition, further teaching and training around IV prescribing is needed together with frequent surgical audits on IV fluid prescribing post-surgery to evaluate improvements.

Keywords: audit, IV Fluid prescribing, laparotomy, NICE guidelines

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263 Calculation of the Normalized Difference Vegetation Index and the Spectral Signature of Coffee Crops: Benefits of Image Filtering on Mixed Crops

Authors: Catalina Albornoz, Giacomo Barbieri

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Crop monitoring has shown to reduce vulnerability to spreading plagues and pathologies in crops. Remote sensing with Unmanned Aerial Vehicles (UAVs) has made crop monitoring more precise, cost-efficient and accessible. Nowadays, remote monitoring involves calculating maps of vegetation indices by using different software that takes either Truecolor (RGB) or multispectral images as an input. These maps are then used to segment the crop into management zones. Finally, knowing the spectral signature of a crop (the reflected radiation as a function of wavelength) can be used as an input for decision-making and crop characterization. The calculation of vegetation indices using software such as Pix4D has high precision for monoculture plantations. However, this paper shows that using this software on mixed crops may lead to errors resulting in an incorrect segmentation of the field. Within this work, authors propose to filter all the elements different from the main crop before the calculation of vegetation indices and the spectral signature. A filter based on the Sobel method for border detection is used for filtering a coffee crop. Results show that segmentation into management zones changes with respect to the traditional situation in which a filter is not applied. In particular, it is shown how the values of the spectral signature change in up to 17% per spectral band. Future work will quantify the benefits of filtering through the comparison between in situ measurements and the calculated vegetation indices obtained through remote sensing.

Keywords: coffee, filtering, mixed crop, precision agriculture, remote sensing, spectral signature

Procedia PDF Downloads 366
262 Efficacy of In-Situ Surgical vs. Needle Revision on Late Failed Trabeculectomy Blebs

Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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261 Leveraging Positive Psychology Practices to Elevate the Impact of Check-In, Check-Out (CICO) in Schools

Authors: Kimberli Breen

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Background Check-In, Check-Out is noted as the most widely implemented evidence-based intervention for youth at-promise within schools. Over twenty years of peer-reviewed research demonstrates the powerful effects of this Positive Behavioral Interventions and Supports (PBIS) practice when implemented with fidelity. However, literature to date has not explicitly connected this intervention with Positive Psychology. Aims This session will illustrate the powerful role Positive Psychology and core elements of PERMA play in the worldwide success of this intervention and how more explicitly aligning Positive Behavioral Interventions and Supports (PBIS) practices with Positive Psychology might remove common barriers to current implementation. Method Students receiving the Check-In, Check-Out intervention experience a warm, positive greeting from a caring adult (CICO Coach) before entering their first class of the day. Teachers then provide high frequency positive feedback to the students at the end of each time block, or segment, of the day. An “optimistic close” to the day is then provided by the same CICO Coach at the end of the school day via the “check-out” process, where students assess the day’s accomplishments and goal-set for the next day. Results CICO clearly aligns with the Positive Psychology core elements of PERMA (Positive Emotion, Engagement, Relationships, Meaning and Accomplishments) and could be further strengthened through explicit integration. Conclusion The already powerful impact and reach of the Check-In, Check-Out intervention can be further enhanced and expanded through greater alignment with Positive Psychology elements and practices. Initiating this important alignment with CICO also offers promise for further integration of Positive Psychology and Positive Behavioral Interventions and Supports.

Keywords: positive pscyhology, check-In check-out, schools, alignment

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260 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty: A Retrospective Study at a Tertiary Orthopaedic Centre

Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

Procedia PDF Downloads 91
259 Biosignal Recognition for Personal Identification

Authors: Hadri Hussain, M.Nasir Ibrahim, Chee-Ming Ting, Mariani Idroas, Fuad Numan, Alias Mohd Noor

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A biometric security system has become an important application in client identification and verification system. A conventional biometric system is normally based on unimodal biometric that depends on either behavioural or physiological information for authentication purposes. The behavioural biometric depends on human body biometric signal (such as speech) and biosignal biometric (such as electrocardiogram (ECG) and phonocardiogram or heart sound (HS)). The speech signal is commonly used in a recognition system in biometric, while the ECG and the HS have been used to identify a person’s diseases uniquely related to its cluster. However, the conventional biometric system is liable to spoof attack that will affect the performance of the system. Therefore, a multimodal biometric security system is developed, which is based on biometric signal of ECG, HS, and speech. The biosignal data involved in the biometric system is initially segmented, with each segment Mel Frequency Cepstral Coefficients (MFCC) method is exploited for extracting the feature. The Hidden Markov Model (HMM) is used to model the client and to classify the unknown input with respect to the modal. The recognition system involved training and testing session that is known as client identification (CID). In this project, twenty clients are tested with the developed system. The best overall performance at 44 kHz was 93.92% for ECG and the worst overall performance was ECG at 88.47%. The results were compared to the best overall performance at 44 kHz for (20clients) to increment of clients, which was 90.00% for HS and the worst overall performance falls at ECG at 79.91%. It can be concluded that the difference multimodal biometric has a substantial effect on performance of the biometric system and with the increment of data, even with higher frequency sampling, the performance still decreased slightly as predicted.

Keywords: electrocardiogram, phonocardiogram, hidden markov model, mel frequency cepstral coeffiecients, client identification

Procedia PDF Downloads 258
258 Design of Microwave Building Block by Using Numerical Search Algorithm

Authors: Haifeng Zhou, Tsungyang Liow, Xiaoguang Tu, Eujin Lim, Chao Li, Junfeng Song, Xianshu Luo, Ying Huang, Lianxi Jia, Lianwee Luo, Qing Fang, Mingbin Yu, Guoqiang Lo

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With the development of technology, countries gradually allocated more and more frequency spectrums for civilization and commercial usage, especially those high radio frequency bands indicating high information capacity. The field effect becomes more and more prominent in microwave components as frequency increases, which invalidates the transmission line theory and complicate the design of microwave components. Here a modeling approach based on numerical search algorithm is proposed to design various building blocks for microwave circuits to avoid complicated impedance matching and equivalent electrical circuit approximation. Concretely, a microwave component is discretized to a set of segments along the microwave propagation path. Each of the segment is initialized with random dimensions, which constructs a multiple-dimension parameter space. Then numerical searching algorithms (e.g. Pattern search algorithm) are used to find out the ideal geometrical parameters. The optimal parameter set is achieved by evaluating the fitness of S parameters after a number of iterations. We had adopted this approach in our current projects and designed many microwave components including sharp bends, T-branches, Y-branches, microstrip-to-stripline converters and etc. For example, a stripline 90° bend was designed in 2.54 mm x 2.54 mm space for dual-band operation (Ka band and Ku band) with < 0.18 dB insertion loss and < -55 dB reflection. We expect that this approach can enrich the tool kits for microwave designers.

Keywords: microwave component, microstrip and stripline, bend, power division, the numerical search algorithm.

Procedia PDF Downloads 357
257 The Comparison Study of Human Microbiome in Chronic Rhinosinusitis between Adults and Children

Authors: Il Ho Park, Joong Seob Lee, Sung Hun Kang, Jae-Min Shin, Il Seok Park, Seok Min Hong, Seok Jin Hong

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Introduction: The human microbiota is the aggregate of microorganisms, and the bacterial microbiome of the human digestive tract contributes to both health and disease. In health, bacteria are key components in the development of mucosal barrier function and in innate and adaptive immune responses, and they also work to suppress the establishment of pathogens. In human upper airway, the sinonasal microbiota might play an important role in chronic rhinosinusitis (CRS). The purpose of this study is to investigate the human upper airway microbiome in CRS patients and to compare the sinonasal microbiome of adults with children. Materials and methods: A total of 19 samples from 19 patients (Group1; 9 CRS in children, aged 5 to 14 years versus Group 2; 10 CRS in adults aged 21 to 59 years) were examined. Swabs were collected from the middle meatus and/or anterior ethmoid region under general anesthesia during endoscopic sinus surgery or tonsillectomy. After DNA extraction from swab samples, we analysed bacterial microbiome consortia using 16s rRNA gene sequencing approach (the Illumina MiSeq platform). Results: In this study, relatively abundance of the six bacterial phyla and tremendous genus and species found in substantial amounts in the individual sinus swab samples, include Corynebacterium, Hemophilus, Moraxella, and Streptococcus species. Anaerobes like Fusobacterium and Bacteroides were abundantly present in the children group, Bacteroides and Propionibacterium were present in adults group. In genus, Haemophilus was the most common CRS microbiome in children and Corynebacterium was the most common CRS microbiome in adults. Conclusions: Our results show the diversity of human upper airway microbiome, and the findings will suggest that CRS is a polymicrobial infection. The Corynebacterium and Hemophilus may live as commensals on mucosal surfaces of sinus in the upper respiratory tract. The further study will be needed for analysis of microbiome-human interactions in upper airway and CRS.

Keywords: microbiome, upper airway, chronic rhinosinusitis, adult and children

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256 Interaction between Space Syntax and Agent-Based Approaches for Vehicle Volume Modelling

Authors: Chuan Yang, Jing Bie, Panagiotis Psimoulis, Zhong Wang

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Modelling and understanding vehicle volume distribution over the urban network are essential for urban design and transport planning. The space syntax approach was widely applied as the main conceptual and methodological framework for contemporary vehicle volume models with the help of the statistical method of multiple regression analysis (MRA). However, the MRA model with space syntax variables shows a limitation in vehicle volume predicting in accounting for the crossed effect of the urban configurational characters and socio-economic factors. The aim of this paper is to construct models by interacting with the combined impact of the street network structure and socio-economic factors. In this paper, we present a multilevel linear (ML) and an agent-based (AB) vehicle volume model at an urban scale interacting with space syntax theoretical framework. The ML model allowed random effects of urban configurational characteristics in different urban contexts. And the AB model was developed with the incorporation of transformed space syntax components of the MRA models into the agents’ spatial behaviour. Three models were implemented in the same urban environment. The ML model exhibit superiority over the original MRA model in identifying the relative impacts of the configurational characters and macro-scale socio-economic factors that shape vehicle movement distribution over the city. Compared with the ML model, the suggested AB model represented the ability to estimate vehicle volume in the urban network considering the combined effects of configurational characters and land-use patterns at the street segment level.

Keywords: space syntax, vehicle volume modeling, multilevel model, agent-based model

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255 Ireland to US Food Tourism the Diaspora and the Locale

Authors: Catriona Hilliard

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Food identity is synonymous with many national tourism destinations and perceptions in tourist source markets – stereotypes could include snails in France; beer in Britain and Germany; paella in Spain - and is an accepted element of national identity that can be incorporated into tourism experiences. Irish transatlantic food connections are culturally strong with diaspora subsequent generations in the US displaying an online interest in traditional Irish food, even with a twist. Back ‘home’, the value of the local indigenous experience was a specific element of the way The Gathering 2013 was promoted to the Irish diaspora, developing community interest and input to tourism. Over the past 20 years, Ireland has realized the value of its food industry to tourism. This has included the establishment of food development programmes for the hospitality industry; food festivals as a possible element of the tourist experience; and a programmes of food ambassadors to market Irish produce and to encourage service providers to understand; utilize and incorporate this into their offerings. Irish produce is being now actively marketed as part of the proposed tourism experience, to particular segment markets including transatlantic visitors. In addition, individual providers are becoming aware of the value of the market, and how to gain from it. Also, networks of food providers have developed collaborative structures of promoting their experiences to audiences, displaying a cluster approach of tourism development towards that sector. A power point presentation will look at how Irish produce contributes to tourism marketing and promotion of Ireland to America; how that may have assisted sustainable development of communities here; and hopes to elicit some discussion relating to longer term identification of Irish food, as part of tourism, for the potential benefit of the ‘locale’.

Keywords: Irish, USA, food, tourism

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254 Effect of Retained Posterior Horn of Medial Meniscus on Functional Outcome of ACL Reconstructed Knees

Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

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Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

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253 Numerical Analysis Of Stainless Steel Beam To Column Joints With Bolted Flush End Plates

Authors: Takwiir Tahriim Khan, Tausif Khalid, Mohammad Redwan Ahamed, Md Soebur Rahman

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The mutual connection in joints has a significant impact on the safe and cost-effective design of steel structures. Generally, the end plates are welded at the end of the beam and columns are bolted with the end plates. Thus, the moment will be transferred at the interface, which is a critical segment at the connection. 3-D Finite Element Models (FEM) has been developed using ABAQUS 2017 software to predict the yield capacity of the end plate connections. The parameters used in this study are the depth, width, and thickness of the end plate, dimensions of the bolt, sectional and material properties of beams and columns. The influence width, depth, and thicknesses of the end plate connection on yield capacity were investigated through parametric studies. The results showed that, for increasing plate thickness from 0.3 inch to 0.8 inch by an increment of 0.1 inch the yield capacity increased by 2.85% on average, for decreasing the end plate depth from 13 inch to 11 inch the yield capacity increased by 25.4 %, and for decreasing the end plate width from 6.5 inch to 5.75 inch the yield capacity increased by 35.4%. Variation in yield capacity was also found by changing the beam and column section. Besides, the numerical results showed a good agreement with published experimental literature with an average variation of less than 8.3 % in yield capacity. So the study allows for a more effective combination of beam, column, and end plate dimensions.

Keywords: steel beam-column joints, finite element analysis, yield moment capacity, parametric study, ABAQUS, bolted joints, flush end plates, moment vs rotation curves

Procedia PDF Downloads 83
252 Examining the Relations among Autobiographical Memory Recall Types, Quality of Descriptions, and Emotional Arousal in Psychotherapy for Depression

Authors: Jinny Hong, Jeanne C. Watson

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Three types of autobiographical memory recall -specific, episodic, and generic- were examined in relation to the quality of descriptions and in-session levels of emotional arousal. Correlational analyses and general estimating equation were conducted to test the relationships between 1) quality of descriptions and type of memory, 2) type of memory and emotional arousal, and 3) quality of descriptions and emotional arousal. The data was transcripts drawn from an archival randomized-control study comparing cognitive-behavioral therapy and emotion-focused therapy in a 16-week treatment for depression. Autobiographical memory recall segments were identified and sorted into three categories: specific, episodic, and generic. Quality of descriptions of these segments was then operationalized and measured using the Referential Activity Scale, and each memory segment was rated on four dimensions: concreteness, specificity, clarity, and overall imagery. Clients’ level of emotional arousal for each recall was measured using the Client’s Expression Emotion Scale. Contrary to the predictions, generic memories are associated with higher emotional arousal ratings and descriptive language ratings compared to specific memories. However, a positive relationship emerged between the quality of descriptions and expressed emotional arousal, indicating that the quality of descriptions in which memories are described in sessions is more important than the type of memory recalled in predicting clients’ level of emotional arousal. The results from this study provide a clearer understanding of the role of memory recall types and use of language in activating emotional arousal in psychotherapy sessions in a depressed sample.

Keywords: autobiographical memory recall, emotional arousal, psychotherapy for depression, quality of descriptions, referential activity

Procedia PDF Downloads 142
251 The First Report of Aberrant Corneal Occlusion in Rabbit in Iran

Authors: Bahador Bardshiri, Omid Moradi, Amir Komeilian, Nima Panahifar

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Formation of a conjunctival membrane over the corneal surface is a condition unique to rabbits that has been labeled aberrant corneal occlusion or pseudopterygium. In the summer of 2013, a five years old male Standard Chinchilla rabbit were presented to Karaj Central Veterinary hospital and the owner complained that his rabbit shows degrees of blindness and there were opacities on both eyes of the presented rabbit. Ophthalmic examination of the affected eyes revealed a conjunctival fold stretching over the cornea of both eyes. The fold originated from limbus and it was vascularized and centrally thickened. There were no attachments to the corneal epithelium and the fold could be easily lifted. Surgery was performed under general anesthesia. The conjunctival fold was incised centrifugally up to its attachment at the limbus and the lid margin using small scissors. The central rim of the segment was then replaced to its normal position in the fornix and fixed with mattress sutures (7/0) passing through outside skin. After the surgery, eye drops containing dexamethasone, gentamicin and polymixin were applied twice daily up to 3 weeks. Within the observation period (8 months) no recurrence was noted. "Pseudo" in the term pseudopterygium refers to the fact that the conjunctival membrane is not adhering to the underlying cornea, but growing over it. In rare cases, the membrane may be loosely attached to the cornea, but can be easily separated without causing damage. It can cover only a small part of the cornea with an annular peripheral opacification of the cornea, or cover it almost fully, leading to blindness. Ethiopathogenesis remains unclear and recurrence of the problem is very likely. The surgical technique that used here decreases probability of recurrence of conjunctival fold.

Keywords: rabbit, cornea, aberrant corneal occlusion, pseudopterygium

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250 Changes in Expression of Galanin in the CSMG Neurons Supplying the Prepyloric Area of the Porcine Stomach Induced by Intragastric Infusion of Hydrochloric Acid

Authors: Katarzyna Palus, Jarosław Całka

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Gastrointestinal disorders, especially acid-related diseases, including peptic and duodenal ulcers, gastroesophageal reflux disease, upper GI bleeding or stress-related mucosal disease, are currently serious health issues encountered very frequently in patients worldwide. However, to date, the response of sympathetic neurons to gastric mucosal injury and local inflammation following hyperacidity is unknown. Thus, the present study was designed to determine possible changes in expression of galanin (GAL) in the CSMG neurons supplying the prepyloric area of the porcine stomach in a physiological state and following experimentally-induced hyperacidity by using combined retrograde tracing and double-labelling immunohistochemistry. The choice of the domestic pig as an experimental model in the present study is not accidental and is justified by the high degree of physiological and anatomical similarity to human digestive system functions. In this experiment ten juvenile female pigs of the Large White Polish breed were used. The animals were divided into two groups: control and animals with hydrochloric acid infusion (HCl). The neuronal retrograde marker Fast Blue (FB) was injected into the anterior prepyloric wall of the stomach of all animals. After 23 days, animals of the HCl-group were reintroduced into a state of general anesthesia and intragastrically given 5 ml/kg of body weight of 0.25 M aqueous solution of hydrochloric acid. On the 28th day, all animals were euthanized. The CSMG complexes were then collected and the CSMG cryostat sections were stained immunocytochemically for GAL and TH (tyrosine hydroxylase). Immunohistochemistry revealed that in the control group 8.40 ± 0.53 % out of 200 FB-positive CSMG neurons contained GAL. In HCl group upregulation of the GAL-IR neurons to 22.52 ± 1.18 % were observed. All GAL-IR neurons in both groups showed the simultaneously TH immunoreactivity. Increase in the expression of GAL in FB-positive neurons of the HCL group may suggest its participation in the protective mechanisms of neurons in different pathological processes, such as gastric hyperacidity.

Keywords: coeliac-superior mesenteric ganglion complex, gastric innervation, hyperacidity, immunohistochemistry

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249 Femoropatellar Groove: An Anatomical Study

Authors: Mamatha Hosapatna, Anne D. Souza, Vrinda Hari Ankolekar, Antony Sylvan D. Souza

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Introduction: The lower extremity of the femur is characterized by an anterior groove in which patella is held during motion. This groove separates the two lips of the trochlea (medial and lateral), prolongation of the two condyles. In humans, the lateral trochlear lip is more developed than the medial one, creating an asymmetric groove that is also specific to the human body. Because of femoral obliquity, contraction of quadriceps leads to a lateral dislocation stress on the patella, and the more elevated lateral side of the patellar groove helps the patella stays in its correct place, acting as a wall against lateral dislocation. This specific shape fits an oblique femur. It is known that femoral obliquity is not genetically determined but comes with orthostatism and biped walking. Material and Methodology: To measure the various dimensions of the Femoropatellar groove (FPG) and femoral condyle using digital image analyser. 37 dried adult femora (22 right,15 left) were used for the study. End on images of the lower end of the femur was taken. Various dimensions of the Femoropatellar groove and FP angle were measured using image J software. Results were analyzed statistically. Results: Maximum of the altitude of medial condyle of the right femur is 4.98± 0.35 cm and of the left femur is 5.20±.16 cm. Maximum altitude of lateral condyle is 5.44±0.4 and 5.50±0.14 on the right and left side respectively. Medial length of the groove is 1.30±0.38 cm on the right side and on the left side is 1.88±0.16 cm. The lateral length of the groove on the right side is 1.900±.16 cm and left side is 1.88±0.16 cm. Femoropatellar angle is 136.38◦±2.59 on the right side and on the left side it is 142.38◦±7.0 Angle and dimensions of the femoropatellar groove on the medial and lateral sides were measured. Asymmetry in the patellar groove was observed. The lateral lip was found to be wider and bigger which correlated with the previous studies. An asymmetrical patellar groove with a protruding lateral side associated with an oblique femur is a specific mark of bipedal locomotion. Conclusion: Dimensions of FPG are important in maintaining the stability of patella and also in knee replacement surgeries. The implants used in to replace the patellofemoral compartment consist of a metal groove to fit on the femoral end and a plastic disc that attaches to the undersurface of the patella. The location and configuration of the patellofemoral groove of the distal femur are clinically significant in the mechanics and pathomechanics of the patellofemoral articulation.

Keywords: femoral patellar groove, femoro patellar angle, lateral condyle, medial condyle

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248 Age Estimation and Sex Determination by CT-Scan Analysis of the Hyoid Bone: Application on a Tunisian Population

Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, R. Dhouieb, S. Saadi, M. A. Mesrati, A. Chadly

Abstract:

Introduction: The hyoid bone is considered as one of many bones used to identify a missed person. There is a specificity of each population group in human identifications. Objective: To analyze the relationship between age, sex and metric parameters of hyoid bone in Tunisian population sample, using CT-scan. Materials and Methods: A prospective study was conducted in the Department of Forensic Medicine of FattoumaBourguiba Hospital of Monastir-Tunisia during 4 years. A total of 240 samples of hyoid bone were studied. The age of cases ranged from 18 days to 81 years. The specimens were collected only from the deceased of known age. Once dried, each hyoid bone was scanned using CT scan. For each specimen, 10 measurements were taken using a computer program. The measurements consisted of 6 lengths and 4 widths. A regression analysis was used to estimate the relationship between age, sex, and different measurements. For age estimation, a multiple logistic regression was carried out for samples ≤ 35 years. For sex determination, ROC curve was performed. Discriminant value finally retained was based on the best specificity with the best sensitivity. Results: The correlation between real age and estimated age was good (r²=0.72) for samples aged 35 years or less. The unstandardised canonical function equation was estimated using three variables: maximum length of the right greater cornua, length from the middle of the left joint space to the middle of the right joint space and perpendicular length from the centre point of a line between the distal ends of the right and left greater cornua to the centre point of the anterior view of the body of the hyoid bone. For sex determination, the ROC curve analysis reveals that the area under curve was at 81.8%. Discriminant value was 0.451 with a specificity of 73% and sensibility of 79%. The equation function was estimated based on two variables: maximum length of the greater cornua and maximum length of the hyoid bone. Conclusion: The findings of the current study suggest that metric analysis of the hyoid bone may predict the age ≤ 35 years. Sex estimation seems to be more reliable. Further studies dealing with the fusion of the hyoid bone and the current study could help to achieve more accurate age estimation rates.

Keywords: anthropology, age estimation, CT scan, sex determination, Tunisia

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247 Injection of Bradykinin in Femoral Artery Elicits Cardiorespiratory Reflexes Involving Perivascular Afferents in Rat Models

Authors: Sanjeev K. Singh, Maloy B. Mandal, Revand R.

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The physiology of baroreceptors and chemoreceptors present in large blood vessels of the heart is well known in regulation of cardiorespiratory functions. Since large blood vessels and peripheral blood vessels are of same mesodermal origin, therefore, involvement of the latter in regulation of cardiorespiratory system is expected. Role of perivascular nerves in mediating cardiorespiratory alterations produced after intra-arterial injection of a nociceptive agent (bradykinin) was examined in urethane anesthetized male rats. Respiratory frequency, blood pressure, and heart rate were recorded for 30 min after the retrograde injection of bradykinin/saline in the femoral artery. In addition, paw edema was determined and water content was expressed as percentage of wet weight. Injection of bradykinin produced immediate tachypnoeic, hypotensive and bradycardiac responses of shorter latency (5-8 s) favoring the neural mechanisms involved in it. Injection of equi-volume of saline did not produce any responses and served as time matched control. Paw edema was observed in the ipsilateral hind limb. Pretreatment with diclofenac sodium significantly attenuated the bradykinin-induced responses and also blocked the paw edema. Ipsilateral femoral and sciatic nerve sectioning attenuated bradykinin-induced responses significantly indicating the origin of responses from the local vascular bed. Administration of bradykinin in the segment of an artery produced reflex cardiorespiratory changes by stimulating the perivascular nociceptors involving prostaglandins. This is a novel study exhibiting the role of peripheral blood vessels in regulation of cardiorespiratory system.

Keywords: vasosensory reflex, cardiorespiratory changes, nociceptive agent, bradykinin, VR1 receptors

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246 Low-Cost Parking Lot Mapping and Localization for Home Zone Parking Pilot

Authors: Hongbo Zhang, Xinlu Tang, Jiangwei Li, Chi Yan

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Home zone parking pilot (HPP) is a fast-growing segment in low-speed autonomous driving applications. It requires the car automatically cruise around a parking lot and park itself in a range of up to 100 meters inside a recurrent home/office parking lot, which requires precise parking lot mapping and localization solution. Although Lidar is ideal for SLAM, the car OEMs favor a low-cost fish-eye camera based visual SLAM approach. Recent approaches have employed segmentation models to extract semantic features and improve mapping accuracy, but these AI models are memory unfriendly and computationally expensive, making deploying on embedded ADAS systems difficult. To address this issue, we proposed a new method that utilizes object detection models to extract robust and accurate parking lot features. The proposed method could reduce computational costs while maintaining high accuracy. Once combined with vehicles’ wheel-pulse information, the system could construct maps and locate the vehicle in real-time. This article will discuss in detail (1) the fish-eye based Around View Monitoring (AVM) with transparent chassis images as the inputs, (2) an Object Detection (OD) based feature point extraction algorithm to generate point cloud, (3) a low computational parking lot mapping algorithm and (4) the real-time localization algorithm. At last, we will demonstrate the experiment results with an embedded ADAS system installed on a real car in the underground parking lot.

Keywords: ADAS, home zone parking pilot, object detection, visual SLAM

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245 Variations and Anomalies of the Posterior Cerebral Artery in a South African Population

Authors: Karen Cilliers, Benedict J. Page

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Limited research focuses on the anatomy of the posterior cerebral artery (PCA) and its cortical branches, even though there can be variation in the presence, size, and origin. The PCA branching pattern has not been adequately reported, and the true division point remains unclear. Anomalies of the PCA have been described in the previous literature; however, few examples have been reported. Furthermore, possible differences between right and left, sex, population and age groups may exist. Therefore, the aim of this study was to report on these aspects from a South African population. One hundred and twenty-six hemispheres were obtained consisting of 86 males and 38 females, between the ages of 22 and 84 (average 45 years of age). This comprised of three population groups, namely coloured (n=74), black (n=38), white (n=10) and two unknown cases. The PCA was injected with an isotonic saline and a colored silicone. The external diameter was measured with a digital micrometer, and length was measured with a string and a ruler. Presence and origins of the cortical branches were similar to the literature; however, duplications, triplications, and unusual origins were observed. The diameter and lengths indicated significant differences between the right and left sides, sex, population and age groups. Branching patterns were identified and compared to the prevalence from previous studies. Two fenestrations were observed in the P2A segment. The presence, size, origin, branching pattern and anomalies of the PCA were investigated in this study. The diameter and length can be significantly different, especially between the right and left-hand side. Changes in the diameter and length can be indicative of certain neuropathological conditions and can play a role in aneurysms formation. Adequate knowledge of the normal and abnormal PCA anatomy is crucial for surgery in the vicinity of the PCA. Therefore, future studies should focus on these aspects.

Keywords: branching, cortical branches, fenestration, posterior cerebral artery

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244 Exploring the Spatial Relationship between Built Environment and Ride-hailing Demand: Applying Street-Level Images

Authors: Jingjue Bao, Ye Li, Yujie Qi

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The explosive growth of ride-hailing has reshaped residents' travel behavior and plays a crucial role in urban mobility within the built environment. Contributing to the research of the spatial variation of ride-hailing demand and its relationship to the built environment and socioeconomic factors, this study utilizes multi-source data from Haikou, China, to construct a Multi-scale Geographically Weighted Regression model (MGWR), considering spatial scale heterogeneity. The regression results showed that MGWR model was demonstrated superior interpretability and reliability with an improvement of 3.4% on R2 and from 4853 to 4787 on AIC, compared with Geographically Weighted Regression model (GWR). Furthermore, to precisely identify the surrounding environment of sampling point, DeepLabv3+ model is employed to segment street-level images. Features extracted from these images are incorporated as variables in the regression model, further enhancing its rationality and accuracy by 7.78% improvement on R2 compared with the MGWR model only considered region-level variables. By integrating multi-scale geospatial data and utilizing advanced computer vision techniques, this study provides a comprehensive understanding of the spatial dynamics between ride-hailing demand and the urban built environment. The insights gained from this research are expected to contribute significantly to urban transportation planning and policy making, as well as ride-hailing platforms, facilitating the development of more efficient and effective mobility solutions in modern cities.

Keywords: travel behavior, ride-hailing, spatial relationship, built environment, street-level image

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243 Thermal Performance of an Air Heating Storing System

Authors: Mohammed A. Elhaj, Jamal S. Yassin

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Owing to the lack of synchronization between the solar energy availability and the heat demands in a specific application, the energy storing sub-system is necessary to maintain the continuity of thermal process. The present work is dealing with an active solar heating storing system in which an air solar collector is connected to storing unit where this energy is distributed and provided to the heated space in a controlled manner. The solar collector is a box type absorber where the air flows between a number of vanes attached between the collector absorber and the bottom plate. This design can improve the efficiency due to increasing the heat transfer area exposed to the flowing air, as well as the heat conduction through the metal vanes from the top absorbing surface. The storing unit is a packed bed type where the air is coming from the air collector and circulated through the bed in order to add/remove the energy through the charging / discharging processes, respectively. The major advantage of the packed bed storage is its high degree of thermal stratification. Numerical solution of the packed bed energy storage is considered through dividing the bed into a number of equal segments for the bed particles and solved the energy equation for each segment depending on the neighbor ones. The studied design and performance parameters in the developed simulation model including, particle size, void fraction, etc. The final results showed that the collector efficiency was fluctuated between 55%-61% in winter season (January) under the climatic conditions of Misurata in Libya. Maximum temperature of 52ºC is attained at the top of the bed while the lower one is 25ºC at the end of the charging process of hot air into the bed. This distribution can satisfy the required load for the most house heating in Libya.

Keywords: solar energy, thermal process, performance, collector, packed bed, numerical analysis, simulation

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242 Mathematical Modelling of Blood Flow with Magnetic Nanoparticles as Carrier for Targeted Drug Delivery in a Stenosed Artery

Authors: Sreeparna Majee, G. C. Shit

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A study on targeted drug delivery is carried out in an unsteady flow of blood infused with magnetic NPs (nanoparticles) with an aim to understand the flow pattern and nanoparticle aggregation in a diseased arterial segment having stenosis. The magnetic NPs are supervised by the magnetic field which is significant for therapeutic treatment of arterial diseases, tumor and cancer cells and removing blood clots. Coupled thermal energy have also been analyzed by considering dissipation of energy because of the application of the magnetic field and the viscosity of blood. Simulation technique used to solve the mathematical model is vorticity-stream function formulations in the diseased artery. An elevation in SLP (Specific loss power) is noted in the aortic bloodstream when the agglomeration of nanoparticles is higher. This phenomenon has potential application in the treatment of hyperthermia. The study focuses on the lowering of WSS (Wall Shear Stress) with increasing particle concentration at the downstream of the stenosis which depicts the vigorous flow circulation zone. These low shear stress regions prolong the residing time of the nanoparticles carrying drugs which soaks up the LDL (Low Density Lipoprotein) deposition. Moreover, an increase in NP concentration enhances the Nusselt number which marks the increase of heat transfer from the arterial wall to the surrounding tissues to destroy tumor and cancer cells without affecting the healthy cells. The results have a significant influence in the study of medicine, to treat arterial diseases such as atherosclerosis without the need for surgery which can minimize the expenditures on cardiovascular treatments.

Keywords: magnetic nanoparticles, blood flow, atherosclerosis, hyperthermia

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241 Diagnostic and Prognostic Use of Kinetics of Microrna and Cardiac Biomarker in Acute Myocardial Infarction

Authors: V. Kuzhandai Velu, R. Ramesh

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Background and objectives: Acute myocardial infarction (AMI) is the most common cause of mortality and morbidity. Over the last decade, microRNAs (miRs) have emerged as a potential marker for detecting AMI. The current study evaluates the kinetics and importance of miRs in the differential diagnosis of ST-segment elevated MI (STEMI) and non-STEMI (NSTEMI) and its correlation to conventional biomarkers and to predict the immediate outcome of AMI for arrhythmias and left ventricular (LV) dysfunction. Materials and Method: A total of 100 AMI patients were recruited for the study. Routine cardiac biomarker and miRNA levels were measured during diagnosis and serially at admission, 6, 12, 24, and 72hrs. The baseline biochemical parameters were analyzed. The expression of miRs was compared between STEMI and NSTEMI at different time intervals. Diagnostic utility of miR-1, miR-133, miR-208, and miR-499 levels were analyzed by using RT-PCR and with various diagnostics statistical tools like ROC, odds ratio, and likelihood ratio. Results: The miR-1, miR-133, and miR-499 showed peak concentration at 6 hours, whereas miR-208 showed high significant differences at all time intervals. miR-133 demonstrated the maximum area under the curve at different time intervals in the differential diagnosis of STEMI and NSTEMI which was followed by miR-499 and miR-208. Evaluation of miRs for predicting arrhythmia and LV dysfunction using admission sample demonstrated that miR-1 (OR = 8.64; LR = 1.76) and miR-208 (OR = 26.25; LR = 5.96) showed maximum odds ratio and likelihood respectively. Conclusion: Circulating miRNA showed a highly significant difference between STEMI and NSTEMI in AMI patients. The peak was much earlier than the conventional biomarkers. miR-133, miR-208, and miR-499 can be used in the differential diagnosis of STEMI and NSTEMI, whereas miR-1 and miR-208 could be used in the prediction of arrhythmia and LV dysfunction, respectively.

Keywords: myocardial infarction, cardiac biomarkers, microRNA, arrhythmia, left ventricular dysfunction

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240 Successful Rehabilitation of Recalcitrant Knee Pain Due to Anterior Cruciate Ligament Injury Masked by Extensive Skin Graft: A Case Report

Authors: Geum Yeon Sim, Tyler Pigott, Julio Vasquez

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A 38-year-old obese female with no apparent past medical history presented with left knee pain. Six months ago, she sustained a left knee dislocation in a motor vehicle accident that was managed with a skin graft over the left lower extremity without any reconstructive surgery. She developed persistent pain and stiffness in her left knee that worsened with walking and stair climbing. Examination revealed healed extensive skin graft over the left lower extremity, including the left knee. Palpation showed moderate tenderness along the superior border of the patella, exquisite tenderness over MCL, and mild tenderness on the tibial tuberosity. There was normal sensation, reflexes, and strength in her lower extremities. There was limited active and passive range of motion of her left knee during flexion. There was instability noted upon the valgus stress test of the left knee. Left knee magnetic resonance imaging showed high-grade (grade 2-3) injury of the proximal superficial fibers of the MCL and diffuse thickening and signal abnormality of the cruciate ligaments, as well as edema-like subchondral marrow signal change in the anterolateral aspect of the lateral femoral condyle weight-bearing surface. There was also notable extensive scarring and edema of the skin, subcutaneous soft tissues, and musculature surrounding the knee. The patient was managed with left knee immobilization for five months, which was complicated by limited knee flexion. Physical therapy consisting of quadriceps, hamstrings, gastrocnemius stretching and strengthening, range of motion exercises, scar/soft tissue mobilization, and gait training was given with marked improvement in pain and range of motion. The patient experienced a further reduction in pain as well as an improvement in function with home exercises consisting of continued strengthening and stretching.

Keywords: ligamentous injury, trauma, rehabilitation, knee pain

Procedia PDF Downloads 70