Search results for: adaptive neck supporter
Commenced in January 2007
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Edition: International
Paper Count: 1306

Search results for: adaptive neck supporter

796 Revitalization of the Chinese Residential at Lasem, Indonesia

Authors: Nurtati Soewarno, Dian Duhita

Abstract:

The existence of civilization from the past is recognized by the left objects such as monuments, buildings or even a town. The relics were designed and made well, using the good quality material so it could persist a long period of time. At this moment, those relics are cultural heritage that must be preserved and the authenticity maintained. Indonesia, a country consist of various tribes with many cultural heritages, one of them is the city of Lasem. Lasem city lies in the northern part of Central Java since the Majapahit kingdom era (13th century) poses as a busy harbor city and a trading center. Lasem is one of the residences of Chinese immigrants in Java, seen by the domination of Chinese architectural building styles. The residential was built since the 15th century and the building has the courtyard which is different from other China’s building in another part of Java. This city loses ground since the trade activity experience difficulties during the Japanese colonial era and continues after the Indonesian independence time. Many Chinese people left Lasem city and let the buildings empty not maintained. This paper will present the result of observation to Chinese architectural style buildings in Lasem city which still hold out until this moment. Using typo morphology method, the case study is chosen based on the transformation type. The occurring transformation is parallel with adaptive reuse concept as an effort to revitalize the existence of the buildings. With this concept, it is expected that the buildings could be re functioned and the glory of the foretime Lasem city could be experienced again. Intervention from the local government is expected, issuing regulations, hoping the new building functions won’t ruin the cultural heritage but instead beautifies it.

Keywords: adaptive re-use, brown field area, building transformation, Lasem city

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795 Follicular Thyroid Carcinoma in a Developing Country: A Retrospective Study of 10 Years

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

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

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

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794 Analysis of Factors Affecting the Number of Infant and Maternal Mortality in East Java with Geographically Weighted Bivariate Generalized Poisson Regression Method

Authors: Luh Eka Suryani, Purhadi

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Poisson regression is a non-linear regression model with response variable in the form of count data that follows Poisson distribution. Modeling for a pair of count data that show high correlation can be analyzed by Poisson Bivariate Regression. Data, the number of infant mortality and maternal mortality, are count data that can be analyzed by Poisson Bivariate Regression. The Poisson regression assumption is an equidispersion where the mean and variance values are equal. However, the actual count data has a variance value which can be greater or less than the mean value (overdispersion and underdispersion). Violations of this assumption can be overcome by applying Generalized Poisson Regression. Characteristics of each regency can affect the number of cases occurred. This issue can be overcome by spatial analysis called geographically weighted regression. This study analyzes the number of infant mortality and maternal mortality based on conditions in East Java in 2016 using Geographically Weighted Bivariate Generalized Poisson Regression (GWBGPR) method. Modeling is done with adaptive bisquare Kernel weighting which produces 3 regency groups based on infant mortality rate and 5 regency groups based on maternal mortality rate. Variables that significantly influence the number of infant and maternal mortality are the percentages of pregnant women visit health workers at least 4 times during pregnancy, pregnant women get Fe3 tablets, obstetric complication handled, clean household and healthy behavior, and married women with the first marriage age under 18 years.

Keywords: adaptive bisquare kernel, GWBGPR, infant mortality, maternal mortality, overdispersion

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793 Atypical Clinical Presentation of Wallenberg Syndrome from Acute Right Lateral Medullary Infarct in a-37-year-old Female

Authors: Sweta Das

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

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

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792 Development of a Biomechanical Method for Ergonomic Evaluation: Comparison with Observational Methods

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

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

Keywords: ergonomic, observational method, biomechanical methods, workload

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791 Adaptive Responses of Carum copticum to in vitro Salt Stress

Authors: R. Razavizadeh, F. Adabavazeh, M. Rezaee Chermahini

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Salinity is one of the most widespread agricultural problems in arid and semi-arid areas that limits the plant growth and crop productivity. In this study, the salt stress effects on protein, reducing sugar, proline contents and antioxidant enzymes activities of Carum copticum L. under in vitro conditions were studied. Seeds of C. copticum were cultured in Murashige and Skoog (MS) medium containing 0, 25, 50, 100 and 150 mM NaCl and calli were cultured in MS medium containing 1 μM 2, 4-dichlorophenoxyacetic acid, 4 μM benzyl amino purine and different levels of NaCl (0, 25, 50, 100 and 150 mM). After NaCl treatment for 28 days, the proline and reducing sugar contents of shoots, roots and calli increased significantly in relation to the severity of the salt stress. The highest amount of proline and carbohydrate were observed at 150 and 100 mM NaCl, respectively. The reducing sugar accumulation in shoots was the highest as compared to roots, whereas, proline contents did not show any significant difference in roots and shoots under salt stress. The results showed significant reduction of protein contents in seedlings and calli. Based on these results, proteins extracted from the shoots, roots and calli of C. copticum treated with 150 mM NaCl showed the lowest contents. The positive relationships were observed between activity of antioxidant enzymes and the increase in stress levels. Catalase, ascorbate peroxidase and superoxide dismutase activity increased significantly under salt concentrations in comparison to the control. These results suggest that the accumulation of proline and sugars, and activation of antioxidant enzymes play adaptive roles in the adaptation of seedlings and callus of C. copticum to saline conditions.

Keywords: antioxidant enzymes, Carum copticum, organic solutes, salt stress

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790 Comparison of Fuel Cell Installation Methods at Large Commercial and Industrial Sites

Authors: Masood Sattari

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

Keywords: construction, installation, methodology, procurement

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789 Advanced Mouse Cursor Control and Speech Recognition Module

Authors: Prasad Kalagura, B. Veeresh kumar

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We constructed an interface system that would allow a similarly paralyzed user to interact with a computer with almost full functional capability. A real-time tracking algorithm is implemented based on adaptive skin detection and motion analysis. The clicking of the mouse is activated by the user's eye blinking through a sensor. The keyboard function is implemented by voice recognition kit.

Keywords: embedded ARM7 processor, mouse pointer control, voice recognition

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788 Recent Advancement in Fetal Electrocardiogram Extraction

Authors: Savita, Anurag Sharma, Harsukhpreet Singh

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Fetal Electrocardiogram (fECG) is a widely used technique to assess the fetal well-being and identify any changes that might be with problems during pregnancy and to evaluate the health and conditions of the fetus. Various techniques or methods have been employed to diagnose the fECG from abdominal signal. This paper describes the facile approach for the estimation of the fECG known as Adaptive Comb. Filter (ACF). The ACF can adjust according to the temporal variations in fundamental frequency by itself that used for the estimation of the quasi periodic signal of ECG signal.

Keywords: aECG, ACF, fECG, mECG

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787 Enhancing Power System Resilience: An Adaptive Under-Frequency Load Shedding Scheme Incorporating PV Generation and Fast Charging Stations

Authors: Sami M. Alshareef

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In the rapidly evolving energy landscape, the integration of renewable energy sources and the electrification of transportation are essential steps toward achieving sustainability goals. However, these advancements introduce new challenges, particularly in maintaining frequency stability due to variable photovoltaic (PV) generation and the growing demand for fast charging stations. The variability of photovoltaic (PV) generation due to weather conditions can disrupt the balance between generation and load, resulting in frequency deviations. To ensure the stability of power systems, it is imperative to develop effective under frequency load-shedding schemes. This research proposal presents an adaptive under-frequency load shedding scheme based on the power swing equation, designed explicitly for the IEEE-9 Bus Test System, that includes PV generation and fast charging stations. This research aims to address these challenges by developing an advanced scheme that dynamically disconnects fast charging stations based on power imbalances. The scheme prioritizes the disconnection of stations near affected areas to expedite system frequency stabilization. To achieve these goals, the research project will leverage the power swing equation, a widely recognized model for analyzing system dynamics during under-frequency events. By utilizing this equation, the proposed scheme will adaptively adjust the load-shedding process in real-time to maintain frequency stability and prevent power blackouts. The research findings will support the transition towards sustainable energy systems by ensuring a reliable and uninterrupted electricity supply while enhancing the resilience and stability of power systems during under-frequency events.

Keywords: load shedding, fast charging stations, pv generation, power system resilience

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786 Management of Dysphagia after Supra Glottic Laryngectomy

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

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

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

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785 Psychosocial Factors in Relation to Musculoskeletal Disorders among Nursing Professionals in Kurdistan Region, Iraq

Authors: Karwan Khudhir

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

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

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784 Prevalence and Risk Factors of Musculoskeletal Disorders among School Teachers in Mangalore: A Cross Sectional Study

Authors: Junaid Hamid Bhat

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Background: Musculoskeletal disorders are one of the main causes of occupational illness. Mechanisms and the factors like repetitive work, physical effort and posture, endangering the risk of musculoskeletal disorders would now appear to have been properly identified. Teacher’s exposure to work-related musculoskeletal disorders appears to be insufficiently described in the literature. Little research has investigated the prevalence and risk factors of musculoskeletal disorders in teaching profession. Very few studies are available in this regard and there are no studies evident in India. Purpose: To determine the prevalence of musculoskeletal disorders and to identify and measure the association of such risk factors responsible for developing musculoskeletal disorders among school teachers. Methodology: An observational cross sectional study was carried out. 500 school teachers from primary, middle, high and secondary schools were selected, based on eligibility criteria. A signed consent was obtained and a self-administered, validated questionnaire was used. Descriptive statistics was used to compute the statistical mean and standard deviation, frequency and percentage to estimate the prevalence of musculoskeletal disorders among school teachers. The data analysis was done by using SPSS version 16.0. Results: Results indicated higher pain prevalence (99.6%) among school teachers during the past 12 months. Neck pain (66.1%), low back pain (61.8%) and knee pain (32.0%) were the most prevalent musculoskeletal complaints of the subjects. Prevalence of shoulder pain was also found to be high among school teachers (25.9%). 52.0% subjects reported pain as disabling in nature, causing sleep disturbance (44.8%) and pain was found to be associated with work (87.5%). A significant association was found between musculoskeletal disorders and sick leaves/absenteeism. Conclusion: Work-related musculoskeletal disorders particularly neck pain, low back pain, and knee pain, is highly prevalent and risk factors are responsible for the development of same in school teachers. There is little awareness of musculoskeletal disorders among school teachers, due to work load and prolonged/static postures. Further research should concentrate on specific risk factors like repetitive movements, psychological stress, and ergonomic factors and should be carried out all over the country and the school teachers should be studied carefully over a period of time. Also, an ergonomic investigation is needed to decrease the work-related musculoskeletal disorder problems. Implication: Recall bias and self-reporting can be considered as limitations. Also, cause and effect inferences cannot be ascertained. Based on these results, it is important to disseminate general recommendations for prevention of work-related musculoskeletal disorders with regards to the suitability of furniture, equipment and work tools, environmental conditions, work organization and rest time to school teachers. School teachers in the early stage of their careers should try to adapt the ergonomically favorable position whilst performing their work for a safe and healthy life later. Employers should be educated on practical aspects of prevention to reduce musculoskeletal disorders, since changes in workplace and work organization and physical/recreational activities are required.

Keywords: work related musculoskeletal disorders, school teachers, risk factors funding, medical and health sciences

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783 Understanding and Explaining Urban Resilience and Vulnerability: A Framework for Analyzing the Complex Adaptive Nature of Cities

Authors: Richard Wolfel, Amy Richmond

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Urban resilience and vulnerability are critical concepts in the modern city due to the increased sociocultural, political, economic, demographic, and environmental stressors that influence current urban dynamics. Urban scholars need help explaining urban resilience and vulnerability. First, cities are dominated by people, which is challenging to model, both from an explanatory and a predictive perspective. Second, urban regions are highly recursive in nature, meaning they not only influence human action, but the structures of cities are constantly changing due to human actions. As a result, explanatory frameworks must continuously evolve as humans influence and are influenced by the urban environment in which they operate. Finally, modern cities have populations, sociocultural characteristics, economic flows, and environmental impacts on order of magnitude well beyond the cities of the past. As a result, the frameworks that seek to explain the various functions of a city that influence urban resilience and vulnerability must address the complex adaptive nature of cities and the interaction of many distinct factors that influence resilience and vulnerability in the city. This project develops a taxonomy and framework for organizing and explaining urban vulnerability. The framework is built on a well-established political development model that includes six critical classes of urban dynamics: political presence, political legitimacy, political participation, identity, production, and allocation. In addition, the framework explores how environmental security and technology influence and are influenced by the six elements of political development. The framework aims to identify key tipping points in society that act as influential agents of urban vulnerability in a region. This will help analysts and scholars predict and explain the influence of both physical and human geographical stressors in a dense urban area.

Keywords: urban resilience, vulnerability, sociocultural stressors, political stressors

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782 A Non-linear Damage Model For The Annulus Of the Intervertebral Disc Under Cyclic Loading, Including Recovery

Authors: Shruti Motiwale, Xianlin Zhou, Reuben H. Kraft

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Military and sports personnel are often required to wear heavy helmets for extended periods of time. This leads to excessive cyclic loads on the neck and an increased chance of injury. Computational models offer one approach to understand and predict the time progression of disc degeneration under severe cyclic loading. In this paper, we have applied an analytic non-linear damage evolution model to estimate damage evolution in an intervertebral disc due to cyclic loads over decade-long time periods. We have also proposed a novel strategy for inclusion of recovery in the damage model. Our results show that damage only grows 20% in the initial 75% of the life, growing exponentially in the remaining 25% life. The analysis also shows that it is crucial to include recovery in a damage model.

Keywords: cervical spine, computational biomechanics, damage evolution, intervertebral disc, continuum damage mechanics

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781 Adaptive Certificate-Based Mutual Authentication Protocol for Mobile Grid Infrastructure

Authors: H. Parveen Begam, M. A. Maluk Mohamed

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Mobile Grid Computing is an environment that allows sharing and coordinated use of diverse resources in dynamic, heterogeneous and distributed environment using different types of electronic portable devices. In a grid environment the security issues are like authentication, authorization, message protection and delegation handled by GSI (Grid Security Infrastructure). Proving better security between mobile devices and grid infrastructure is a major issue, because of the open nature of wireless networks, heterogeneous and distributed environments. In a mobile grid environment, the individual computing devices may be resource-limited in isolation, as an aggregated sum, they have the potential to play a vital role within the mobile grid environment. Some adaptive methodology or solution is needed to solve the issues like authentication of a base station, security of information flowing between a mobile user and a base station, prevention of attacks within a base station, hand-over of authentication information, communication cost of establishing a session key between mobile user and base station, computing complexity of achieving authenticity and security. The sharing of resources of the devices can be achieved only through the trusted relationships between the mobile hosts (MHs). Before accessing the grid service, the mobile devices should be proven authentic. This paper proposes the dynamic certificate based mutual authentication protocol between two mobile hosts in a mobile grid environment. The certificate generation process is done by CA (Certificate Authority) for all the authenticated MHs. Security (because of validity period of the certificate) and dynamicity (transmission time) can be achieved through the secure service certificates. Authentication protocol is built on communication services to provide cryptographically secured mechanisms for verifying the identity of users and resources.

Keywords: mobile grid computing, certificate authority (CA), SSL/TLS protocol, secured service certificates

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780 A Rare Case of Acquired Benign Tracheoesophageal Fistula: Case Report and Literature Review

Authors: Sarah Bouayyad, Ajay Nigam, Meera Beena

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Acquired benign tracheoesophageal fistula is a rare medical condition that usually results from trauma, foreign bodies, or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who had had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which had led to the formation of a tracheoesophageal fistula. Due to the patient’s obsessive habit, we couldn’t manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar etiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

Keywords: tracheoesophageal fistula, speech valve, endoscopic insertion of salivary bypass tube, head and neck malignancies

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779 Differentiated Thyroid Cancer Presenting with Solitary Bony Metastases to the Frontal Bone of the Skull

Authors: Christy M. Moen, Richard B. Townsley

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Introduction: Metastasis to the frontal bone in thyroid cancer is extremely rare. A literature review found only six cases of thyroid cancer that metastasised to the frontal bone, with two of those involving further bone sites. Case Report: The patient was originally referred to the Oral and Maxillofacial Surgery team with an isolated mass on her forehead. Biopsies were performed, which showed this was likely a metastatic deposit from thyroid cancer. CT-PET scan showed this was an isolated lesion. The patient had a total thyroidectomy, and the forehead lesion was managed with radiotherapy. On interval scanning, the patient’s bony lesion had increased in size and had new lung nodules, which likely represented further metastasis. Conclusion: Isolated bony metastases to the frontal bone are rare. An important clinical principle to remember is that a bony metastasis from an unknown primary is more likely than primary bone cancer.

Keywords: cancer, thyroid, head and neck, surgery

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778 Implications of Optimisation Algorithm on the Forecast Performance of Artificial Neural Network for Streamflow Modelling

Authors: Martins Y. Otache, John J. Musa, Abayomi I. Kuti, Mustapha Mohammed

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The performance of an artificial neural network (ANN) is contingent on a host of factors, for instance, the network optimisation scheme. In view of this, the study examined the general implications of the ANN training optimisation algorithm on its forecast performance. To this end, the Bayesian regularisation (Br), Levenberg-Marquardt (LM), and the adaptive learning gradient descent: GDM (with momentum) algorithms were employed under different ANN structural configurations: (1) single-hidden layer, and (2) double-hidden layer feedforward back propagation network. Results obtained revealed generally that the gradient descent with momentum (GDM) optimisation algorithm, with its adaptive learning capability, used a relatively shorter time in both training and validation phases as compared to the Levenberg- Marquardt (LM) and Bayesian Regularisation (Br) algorithms though learning may not be consummated; i.e., in all instances considering also the prediction of extreme flow conditions for 1-day and 5-day ahead, respectively especially using the ANN model. In specific statistical terms on the average, model performance efficiency using the coefficient of efficiency (CE) statistic were Br: 98%, 94%; LM: 98 %, 95 %, and GDM: 96 %, 96% respectively for training and validation phases. However, on the basis of relative error distribution statistics (MAE, MAPE, and MSRE), GDM performed better than the others overall. Based on the findings, it is imperative to state that the adoption of ANN for real-time forecasting should employ training algorithms that do not have computational overhead like the case of LM that requires the computation of the Hessian matrix, protracted time, and sensitivity to initial conditions; to this end, Br and other forms of the gradient descent with momentum should be adopted considering overall time expenditure and quality of the forecast as well as mitigation of network overfitting. On the whole, it is recommended that evaluation should consider implications of (i) data quality and quantity and (ii) transfer functions on the overall network forecast performance.

Keywords: streamflow, neural network, optimisation, algorithm

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777 Item-Trait Pattern Recognition of Replenished Items in Multidimensional Computerized Adaptive Testing

Authors: Jianan Sun, Ziwen Ye

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Multidimensional computerized adaptive testing (MCAT) is a popular research topic in psychometrics. It is important for practitioners to clearly know the item-trait patterns of administered items when a test like MCAT is operated. Item-trait pattern recognition refers to detecting which latent traits in a psychological test are measured by each of the specified items. If the item-trait patterns of the replenished items in MCAT item pool are well detected, the interpretability of the items can be improved, which can further promote the abilities of the examinees who attending the MCAT to be accurately estimated. This research explores to solve the item-trait pattern recognition problem of the replenished items in MCAT item pool from the perspective of statistical variable selection. The popular multidimensional item response theory model, multidimensional two-parameter logistic model, is assumed to fit the response data of MCAT. The proposed method uses the least absolute shrinkage and selection operator (LASSO) to detect item-trait patterns of replenished items based on the essential information of item responses and ability estimates of examinees collected from a designed MCAT procedure. Several advantages of the proposed method are outlined. First, the proposed method does not strictly depend on the relative order between the replenished items and the selected operational items, so it allows the replenished items to be mixed into the operational items in reasonable order such as considering content constraints or other test requirements. Second, the LASSO used in this research improves the interpretability of the multidimensional replenished items in MCAT. Third, the proposed method can exert the advantage of shrinkage method idea for variable selection, so it can help to check item quality and key dimension features of replenished items and saves more costs of time and labors in response data collection than traditional factor analysis method. Moreover, the proposed method makes sure the dimensions of replenished items are recognized to be consistent with the dimensions of operational items in MCAT item pool. Simulation studies are conducted to investigate the performance of the proposed method under different conditions for varying dimensionality of item pool, latent trait correlation, item discrimination, test lengths and item selection criteria in MCAT. Results show that the proposed method can accurately detect the item-trait patterns of the replenished items in the two-dimensional and the three-dimensional item pool. Selecting enough operational items from the item pool consisting of high discriminating items by Bayesian A-optimality in MCAT can improve the recognition accuracy of item-trait patterns of replenished items for the proposed method. The pattern recognition accuracy for the conditions with correlated traits is better than those with independent traits especially for the item pool consisting of comparatively low discriminating items. To sum up, the proposed data-driven method based on the LASSO can accurately and efficiently detect the item-trait patterns of replenished items in MCAT.

Keywords: item-trait pattern recognition, least absolute shrinkage and selection operator, multidimensional computerized adaptive testing, variable selection

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776 Flat-Top Apodization of Laser Beams by Means of Acousto-Optics

Authors: Sergey I. Chizhikov, Vladimir Y. Molchanov, Konstantin B. Yushkov

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We demonstrate a method for adaptive spatial shaping of laser beams by means of acousto-optic Bragg diffraction. Transformation of the angular spectrum during Bragg diffraction is used to convert Gaussian intensity distribution into a flat-top one. Theoretical model is supported by the experiment.

Keywords: acousto-optics, flat top, beam shaping, Bragg diffraction

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775 Pilomatrixoma of the Left Infra-Orbital Region in a 9 Year Old

Authors: Zainab Shaikh, Yusuf Miyanji

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Pilomatrixoma is a benign neoplasm of the hair follicle matrix that is not commonly diagnosed in general practice. This is a case report of a 9-year-old boy who presented with a one-year history of a 19mm x 11 mm swelling in the left infra-orbital region. This was previously undiagnosed in Spain, where the patient resided at the time of initial presentation, due to the language barrier the patient’s family encountered. An ultrasound and magnetic resonance imaging gave useful information regarding surrounding structures for complete tumor excision and indicated that the risk of facial nerve palsy is low. The lesion was surgically excised and a definitive diagnosis was made after histopathology. Pilomatrixoma, although not rare in its occurrence, is rarely this large at the time of excision due to early presentation. This case highlights the importance of including pilomatrixoma in the differential diagnosis of dermal and subcutaneous lesions in the head and neck region, as it is often misdiagnosed due to the lack of awareness of its clinical presentation.

Keywords: pilomatrixoma, swelling, infra-orbital, facial swelling

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774 Termination of the Brachial Artery in the Arm and Its Clinical Significance

Authors: Ramya Rathan, Miral N. F. Salama

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The variations in the arteries have been drawing attention of anatomists for a long time because of their clinical significance. The brachial artery is the principal artery of the arm which is the continuation of the axillary artery from the lower border of the Teres Major. It terminates into the radial and ulnar arteries below the elbow joint at the neck radius. The present study aims at exploring the clinical significance of the high termination of the brachial artery. During the routine cadaveric dissection of the arm, for the undergraduate students of medicine at our university, we observed a high bifurcation of the radial and the ulnar artery at the midshaft of the humerus. The median nerve was seen passing between these two junctions. Further, the course and the relations of this artery were studied. The accurate knowledge regarding these kinds of variation in the blood vessels is mandatory for planning of designing. General physicians, surgeons and radiologists should keep in mind the variations in the branching pattern of the arteries in their daily medical, diagnostic and therapeutic procedures to avoid complications in diagnostic and surgical procedures.

Keywords: brachial artery, high termination, radial artery, ulnar artery

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773 Exploring Perceptions of Local Stakeholders in Climate Change Adaptation in Central and Western Terai, Nepal

Authors: Shree Kumar Maharjan

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Climate change has varied impacts on diverse livelihood sectors, which is more prominent at the community level. The stakeholders and local institutions have been supporting the communities either by building adaptive capacities and resilience or minimizing the impacts of different adaptation interventions. Some of these interventions are effective, whereas others need further dynamisms and exertions considering the complexity of the risks and vulnerabilities. Hence, consolidated efforts of concerned stakeholders are required to minimize and adapt the present and future impacts. This study digs out and analyses the perceptions of local stakeholders in climate change adaptation in Madi and Deukhuri valleys of Nepal through a questionnaire survey. The study has categorized the local stakeholders into 5 groups in the study sites – Farmers groups and cooperatives, Government, I/NGOs, Development banks and education and other organizations. The local stakeholders revealed flood, drought, cold wave and riverbank erosion as the major climatic risks and hazards found in the sites eventually impacting on the loss of agricultural production, loss of agricultural land and properties, loss of livestock, the emergence of diseases and pest. The stakeholders believed that most of the farmers dealing with these impacts based on their traditional knowledge and practices, followed by with the support of NGOs and with the help of neighbors and community. The major supports of the stakeholders to deal with these impacts were on training and awareness, risk analysis and minimization, livelihood improvement, financial support, coordination and networking and facilitation in policy formulation. The stakeholders emphasized primarily on capacity building, appropriate technologies, community-based planning and monitoring, prioritization to the poor and the marginalized and establishment of community fund respectively for building adaptive capacities.

Keywords: climate change adaptation, local stakeholders, Madi, Deukhuri, Nepal

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772 Laboratory Indices in Late Childhood Obesity: The Importance of DONMA Indices

Authors: Orkide Donma, Mustafa M. Donma, Muhammet Demirkol, Murat Aydin, Tuba Gokkus, Burcin Nalbantoglu, Aysin Nalbantoglu, Birol Topcu

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Obesity in childhood establishes a ground for adulthood obesity. Especially morbid obesity is an important problem for the children because of the associated diseases such as diabetes mellitus, cancer and cardiovascular diseases. In this study, body mass index (BMI), body fat ratios, anthropometric measurements and ratios were evaluated together with different laboratory indices upon evaluation of obesity in morbidly obese (MO) children. Children with nutritional problems participated in the study. Written informed consent was obtained from the parents. Study protocol was approved by the Ethics Committee. Sixty-two MO girls aged 129.5±35.8 months and 75 MO boys aged 120.1±26.6 months were included into the scope of the study. WHO-BMI percentiles for age-and-sex were used to assess the children with those higher than 99th as morbid obesity. Anthropometric measurements of the children were recorded after their physical examination. Bio-electrical impedance analysis was performed to measure fat distribution. Anthropometric ratios, body fat ratios, Index-I and Index-II as well as insulin sensitivity indices (ISIs) were calculated. Girls as well as boys were binary grouped according to homeostasis model assessment-insulin resistance (HOMA-IR) index of <2.5 and >2.5, fasting glucose to insulin ratio (FGIR) of <6 and >6 and quantitative insulin sensitivity check index (QUICKI) of <0.33 and >0.33 as the frequently used cut-off points. They were evaluated based upon their BMIs, arms, legs, trunk, whole body fat percentages, body fat ratios such as fat mass index (FMI), trunk-to-appendicular fat ratio (TAFR), whole body fat ratio (WBFR), anthropometric measures and ratios [waist-to-hip, head-to-neck, thigh-to-arm, thigh-to-ankle, height/2-to-waist, height/2-to-hip circumference (C)]. SPSS/PASW 18 program was used for statistical analyses. p≤0.05 was accepted as statistically significance level. All of the fat percentages showed differences between below and above the specified cut-off points in girls when evaluated with HOMA-IR and QUICKI. Differences were observed only in arms fat percent for HOMA-IR and legs fat percent for QUICKI in boys (p≤ 0.05). FGIR was unable to detect any differences for the fat percentages of boys. Head-to-neck C was the only anthropometric ratio recommended to be used for all ISIs (p≤0.001 for both girls and boys in HOMA-IR, p≤0.001 for girls and p≤0.05 for boys in FGIR and QUICKI). Indices which are recommended for use in both genders were Index-I, Index-II, HOMA/BMI and log HOMA (p≤0.001). FMI was also a valuable index when evaluated with HOMA-IR and QUICKI (p≤0.001). The important point was the detection of the severe significance for HOMA/BMI and log HOMA while they were evaluated also with the other indices, FGIR and QUICKI (p≤0.001). These parameters along with Index-I were unique at this level of significance for all children. In conclusion, well-accepted ratios or indices may not be valid for the evaluation of both genders. This study has emphasized the limiting properties for boys. This is particularly important for the selection process of some ratios and/or indices during the clinical studies. Gender difference should be taken into consideration for the evaluation of the ratios or indices, which will be recommended to be used particularly within the scope of obesity studies.

Keywords: anthropometry, childhood obesity, gender, insulin sensitivity index

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771 Site Selection in Adaptive Reuse Architecture for Social Housing in Johannesburg, South Africa

Authors: Setapo Moloi, Jun-Ichiro Giorgos Tsutsumi

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South Africa’s need for the provision of housing within its major city centres, specifically Gauteng Province (GP), is a major concern. Initiatives for converting misused/ unused buildings to suitable housing for residents who work in the city as well as prospective citizens are currently underway, one aspect that is needed currently, is the re-possession of these buildings repurposing, into housing communities for quality low cost mixed density housing and for this process to have minimal strain on existing infrastructure like energy, emission reduction etc. Unfortunately, there are instances in Johannesburg, the country’s economic capital, with 2017 estimates claiming that 700 buildings lay unused or misused due to issues that will be discussed in this paper, these then become hubs for illegal activity and are an unacceptable form of shelter. It can be argued that the provision of inner-city social housing is lacking, but not due to the unavailability of funding or usable land and buildings, but that these assets are not being used appropriately nor to their full potential. Currently the GP government has mandated the re-purposing of all buildings that meet their criteria (structural stability, feasibility, adaptability, etc.) with the intention of inviting interested parties to propose conversions of the buildings into densified social housing. Going forward, the proposed focus is creation of social housing communities within existing buildings which may be retrofitted with sustainable technologies, green design strategies and principles, aiming for the finished buildings to achieve ‘Net-Zero/Positive’ status. A Net-Zero building, according to The Green Building Council of South Africa (GBCSA) is a building which manages to produce resources it needs to function, and reduces wastage, emissions and demand of these resources during its lifespan. The categories which GBCSA includes are carbon, water, waste and ecology, this may include material selection, construction methods, etc.

Keywords: adaptive reuse, conversion, net-zero, social housing, sustainable communities

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770 Building Tutor and Tutee Pedagogical Agents to Enhance Learning in Adaptive Educational Games

Authors: Ogar Ofut Tumenayu, Olga Shabalina

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This paper describes the application of two types of pedagogical agents’ technology with different functions in an adaptive educational game with the sole aim of improving learning and enhancing interactivities in Digital Educational Games (DEG). This idea could promote the elimination of some problems of DEG, like isolation in game-based learning, by introducing a tutor and tutee pedagogical agents. We present an analysis of a learning companion interacting in a peer tutoring environment as a step toward improving social interactions in the educational game environment. We show that tutor and tutee agents use different interventions and interactive approaches: the tutor agent is engaged in tracking the learner’s activities and inferring the learning state, while the tutee agent initiates interactions with the learner at the appropriate times and in appropriate manners. In order to provide motivation to prevent mistakes and clarity a game task, the tutor agent uses the help dialog tool to provide assistance, while the tutee agent provides collaboration assistance by using the hind tool. We presented our idea on a prototype game called “Pyramid Programming Game,” a 2D game that was developed using Libgdx. The game's Pyramid component symbolizes a programming task that is presented to the player in the form of a puzzle. During gameplay, the Agents can instruct, direct, inspire, and communicate emotions. They can also rapidly alter the instructional pattern in response to the learner's performance and knowledge. The pyramid must be effectively destroyed in order to win the game. The game also teaches and illustrates the advantages of utilizing educational agents such as TrA and TeA to assist and motivate students. Our findings support the idea that the functionality of a pedagogical agent should be dualized into an instructional and learner’s companion agent in order to enhance interactivity in a game-based environment.

Keywords: tutor agent, tutee agent, learner’s companion interaction, agent collaboration

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769 A Smart Electric Power Wheelchair Controlled by Head Motion

Authors: Dechrit Maneetham

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The aim of this paper was to design a smart electric power wheelchair (SEPW) with a novel control system for quadriplegics with head and neck mobility. Head movement has been used as a control interface for people with motor impairments in a range of applications. Acquiring measurements from the module is simplified through a synchronous a motor. Axis measures the two directions namely X ,Y and Z. The model of a DC motor is considered as a speed control by selection of a PID parameters using genetic algorithm. An experimental set-up constructed, which consists of micro controller Arduino ATmega32u4 as controllers, a DC motor driven SEPW and feedback elements. And this paper is tuning methods of parameter for a pulse width modulation (PWM) control system. A speed controller has been designed successfully for closed loop of the DC motor so that the motor runs very closed to the reference speed and angle. SEPW controller can be used to ensure the person’s head is attending the direction of travel asserted by a conventional, direction and speed control.

Keywords: wheelchair, quadriplegia, rehabilitation, medical devices, speed control

Procedia PDF Downloads 381
768 The Location-Routing Problem with Pickup Facilities and Heterogeneous Demand: Formulation and Heuristics Approach

Authors: Mao Zhaofang, Xu Yida, Fang Kan, Fu Enyuan, Zhao Zhao

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Nowadays, last-mile distribution plays an increasingly important role in the whole industrial chain delivery link and accounts for a large proportion of the whole distribution process cost. Promoting the upgrading of logistics networks and improving the layout of final distribution points has become one of the trends in the development of modern logistics. Due to the discrete and heterogeneous needs and spatial distribution of customer demand, which will lead to a higher delivery failure rate and lower vehicle utilization, last-mile delivery has become a time-consuming and uncertain process. As a result, courier companies have introduced a range of innovative parcel storage facilities, including pick-up points and lockers. The introduction of pick-up points and lockers has not only improved the users’ experience but has also helped logistics and courier companies achieve large-scale economy. Against the backdrop of the COVID-19 of the previous period, contactless delivery has become a new hotspot, which has also created new opportunities for the development of collection services. Therefore, a key issue for logistics companies is how to design/redesign their last-mile distribution network systems to create integrated logistics and distribution networks that consider pick-up points and lockers. This paper focuses on the introduction of self-pickup facilities in new logistics and distribution scenarios and the heterogeneous demands of customers. In this paper, we consider two types of demand, including ordinary products and refrigerated products, as well as corresponding transportation vehicles. We consider the constraints associated with self-pickup points and lockers and then address the location-routing problem with self-pickup facilities and heterogeneous demands (LRP-PFHD). To solve this challenging problem, we propose a mixed integer linear programming (MILP) model that aims to minimize the total cost, which includes the facility opening cost, the variable transport cost, and the fixed transport cost. Due to the NP-hardness of the problem, we propose a hybrid adaptive large-neighbourhood search algorithm to solve LRP-PFHD. We evaluate the effectiveness and efficiency of the proposed algorithm by using instances generated based on benchmark instances. The results demonstrate that the hybrid adaptive large neighbourhood search algorithm is more efficient than MILP solvers such as Gurobi for LRP-PFHD, especially for large-scale instances. In addition, we made a comprehensive analysis of some important parameters (e.g., facility opening cost and transportation cost) to explore their impacts on the results and suggested helpful managerial insights for courier companies.

Keywords: city logistics, last-mile delivery, location-routing, adaptive large neighborhood search

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767 Adaptive Response of Plants to Environmental Stress: Natural Oil Seepage; The Living Laboratory in Tramutola, Basilicata Region

Authors: Maria Francesca Scannone, Martina Bochicchio

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One of the major environmental problems today is hydrocarbon contamination. The promising sustainable technologies for the treatment of these contaminated sites involves the use of biological organisms. In Agri Valley (Basilicata Region) there is a living laboratory (natural oil seeps) where the selective pressure has enriched the environmental matrices with microorganisms, fungi and plant species able to use the hydrocarbons as a source of metabolic energy, to degrade or tolerate hydrocarbons. Observers visiting this area are fascinated by its unspoiled nature, and the condition of the ecosystem does not appear to has been damaged. The amazing resiliency observed in Tramutola site is of key importance to try to bring green remediation technologies, but no research has been done to identify high-performing native species. The aim of this research was to study how natural processes affect the fate of released oil or how individual species or communities of plants and animals are capable of dealing with the burden of otherwise toxic chemicals. The survey of vegetation was carried out, more than 60 species have been identified and divided into tree, shrub and herb layer. Plant data sheets have been completed only for the species that showed the most appropriate properties for phytoremediation. In general, members of the Salicales, Cyperales, Poales, Fagales, Cornales, Equisetales orders were the most commonly identified orders. They are pioneer plants with high adaptive capacity and vegetative propagation. The literature review has highlighted the existence of rhizosphere effect and a green liver model on selected plants. The study provides significant information on the environmental stress adaptation processes of many indigenous plants that are living and growing on a natural leak of crude oil and gas that migrates up through subsurface.

Keywords: green liver, hydrocarbon degradation, oil seeps, phytoremediation

Procedia PDF Downloads 153