Search results for: rare stroke

Authors: Chetneti Srisa-an

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In Knowledge and Data Engineering field, relational database is the best repository to store data in a real world. It has been using around the world more than eight decades. Normalization is the most important process for the analysis and design of relational databases. It aims at creating a set of relational tables with minimum data redundancy that preserve consistency and facilitate correct insertion, deletion, and modification. Normalization is a major task in the design of relational databases. Despite its importance, very few algorithms have been developed to be used in the design of commercial automatic normalization tools. It is also rare technique to do it automatically rather manually. Moreover, for a large and complex database as of now, it make even harder to do it manually. This paper presents a new complete automated relational database normalization method. It produces the directed graph and spanning tree, first. It then proceeds with generating the 2NF, 3NF and also BCNF normal forms. The benefit of this new algorithm is that it can cope with a large set of complex function dependencies.

Keywords: relational database, functional dependency, automatic normalization, primary key, spanning tree

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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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Authors: Zhixiang Li, Shuguang Yao, Wen Ma

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Coupler rubber buffer has been widely applied on the high-speed trains and the main function of the rubber buffer is dissipating the impact energy between vehicles. The rubber buffer consists of two groups of rubbers, which are both pre-compressed and then installed into the frame body. This paper focuses on the energy absorption characteristics of the rubber buffers particularly. Firstly, the quasi-static compression tests were carried out for 1 and 3 pairs of rubber sheets and some energy absorption responses relationship, i.e. Eabn = n×Eab1, Edissn = n×Ediss1, and Ean = Ea1, were obtained. Next, a series of quasi-static tests were performed for 1 pair of rubber sheet to investigate the energy absorption performance with different compression ratio of the rubber buffers. Then the impact tests with five impact velocities were conducted and the coupler knuckle was destroyed when the impact velocity was 10.807 km/h. The impact tests results showed that with the increase of impact velocity, the Eab, Ediss and Ea of rear buffer increased a lot, but the three responses of front buffer had not much increase. Finally, the results of impact tests and quasi-static tests were contrastively analysed and the results showed that with the increase of the stroke, the values of Eab, Ediss, and Ea were all increase. However, the increasing rates of impact tests were all larger than that of quasi-static tests. The maximum value of Ea was 68.76% in impact tests, it was a relatively high value for vehicle coupler buffer. The energy capacity of the rear buffer was determined for dynamic loading, it was 22.98 kJ.

Keywords: rubber buffer, coupler, energy absorption, impact tests

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Authors: Majid Shahbazi

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Subclavian artery stenosis (SAS) is a common vascular disease that can cause a range of symptoms, from arm fatigue and weakness to ischemic stroke. Revascularization procedures, such as percutaneous transluminal angioplasty and stenting, are widely used to treat SAS and improve blood flow to the affected arm. However, the optimal management of patients with SAS is still unclear, and further research is needed to evaluate the safety and efficacy of different treatment options. This study aims to investigate the characteristics of patients with SAS who underwent revascularization procedures in Latvia (Specifically RAKUS). The research part of this paper aims to describe and analyze the demographics, comorbidities, diagnostic methods, types of revascularization procedures, and antiaggregant therapy used. The goal of this study is to provide insights into the current clinical practice in Latvia and help future treatment decision-makers. To achieve this aim, a retrospective study of 76 patients with SAS who underwent revascularization procedures was performed. After statistical analysis of the data, the study provided insights into the characteristics and management of patients with SAS in Latvia, highlighting the most observed comorbidities in these patients, the preferred diagnostic methods, and the most performed procedures. These findings can inform clinical decision-making and may have implications for the management of patients with subclavian artery stenosis in Latvia.

Keywords: subclavian artery stenosis, revascularization, characteristics of patients, comorbidities, retrospective analysis

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Authors: Umut Çınar

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The fact that ozone gas has color bleaching properties has made the use of ozone gas widespread in the textile sector as well as in many other sectors. Ozone gas, which is a strong oxidative agent on the fabric, causes the paint on the fabric to wear off and lighten its color with an aged appearance. Within the scope of this thesis, parameters affecting the bleaching properties of ozone gas on reactive dyed knitted fabric, which is rare in the literature, were investigated. Ozone concentration, time, and pH values were analyzed with the Box Behnken experimental design method, and optimum conditions were determined. After the experiments, wear and opacity values were measured with the help of a spectrophotometer. With the help of the Design Expert program, the graphics related to the data were prepared and interpreted with Box Behnken and ANOVA. These experiments on reactive dyed knitted fabric were tested on these parameters, and the spectrophotometric values of the fabric and optimum parameters in abrasion and opacity were revealed.

Keywords: ozone, reactive dye, bleaching, textile, garment wash, sustainability, washing, Box–Behnken, experimental design

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Authors: Mina Beheshti, Vida Shams, Mojtaba Esfandiari, Farzaneh Abdollahi, Abdolreza Ohadi

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Most of the people who survive a stroke need rehabilitation tools to regain their mobility. The core function of these devices is a brake actuator. The goal of this study is to design and control a magnetorheological brake which can be used as a rehabilitation tool. In fact, the fluid used in this brake is called magnetorheological fluid or MR that properties can change by variation of the magnetic field. The braking properties can be set as control by using this feature of the fluid. In this research, different MR brake designs are first introduced in each design, and the dimensions of the brake have been determined based on the required torque for foot movement. To calculate the brake dimensions, it is assumed that the shear stress distribution in the fluid is uniform and the fluid is in its saturated state. After designing the rehabilitation brake, the mathematical model of the healthy movement of a healthy person is extracted. Due to the nonlinear nature of the system and its variability, various adaptive controllers, neural networks, and robust have been implemented to estimate the parameters and control the system. After calculating torque and control current, the best type of controller in terms of error and control current has been selected. Finally, this controller is implemented on the experimental data of the patient's movements, and the control current is calculated to achieve the desired torque and motion.

Keywords: rehabilitation, magnetorheological fluid, knee, brake, adaptive control, robust control, neural network control, torque control

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Authors: Augustas Vaitkevicius, Mikhail Korjik, Eugene Tretyak, Ekaterina Trusova, Gintautas Tamulaitis

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Silicate materials are widely used as luminescent materials in amorphous and crystalline phase. Lithium silicate glass is popular for making neutron sensitive scintillation glasses. Cerium-doped single crystalline silicates of rare earth elements and yttrium have been demonstrated to be good scintillation materials. Due to their high thermal and photo-stability, silicate glass ceramics are supposed to be suitable materials for producing light converters for high power white light emitting diodes. In this report, the influence of glass composition and crystallization on photoluminescence (PL) of different silicate glasses was studied. Barium (BaO-2SiO₂) and lithium (Li₂O-2SiO₂) glasses were under study. Cerium, dysprosium, erbium and europium ions as well as their combinations were used for doping. The influence of crystallization was studied after transforming the doped glasses into glass ceramics by heat treatment in the temperature range of 550-850 degrees Celsius for 1 hour. The study was carried out by comparing the photoluminescence (PL) spectra, spatial distributions of PL parameters and quantum efficiency in the samples under study. The PL spectra and spatial distributions of their parameters were obtained by using confocal PL microscopy. A WITec Alpha300 S confocal microscope coupled with an air cooled CCD camera was used. A CW laser diode emitting at 405 nm was exploited for excitation. The spatial resolution was in sub-micrometer domain in plane and ~1 micrometer perpendicularly to the sample surface. An integrating sphere with a xenon lamp coupled with a monochromator was used to measure the external quantum efficiency. All measurements were performed at room temperature. Chromatic properties of the light emission from the glasses and glass ceramics have been evaluated. We observed that the quantum efficiency of the glass ceramics is higher than that of the corresponding glass. The investigation of spatial distributions of PL parameters revealed that heat treatment of the glasses leads to a decrease in sample homogeneity. In the case of BaO-2SiO₂: Eu, 10 micrometer long needle-like objects are formed, when transforming the glass into glass ceramics. The comparison of PL spectra from within and outside the needle-like structure reveals that the ratio between intensities of PL bands associated with Eu²⁺ and Eu³⁺ ions is larger in the bright needle-like structures. This indicates a higher degree of crystallinity in the needle-like objects. We observed that the spectral positions of the PL bands are the same in the background and the needle-like areas, indicating that heat treatment imposes no significant change to the valence state of the europium ions. The evaluation of chromatic properties confirms applicability of the glasses under study for fabrication of white light sources with high thermal stability. The ability to combine barium and lithium glass matrixes and doping by Eu, Ce, Dy, and Tb enables optimization of chromatic properties.

Keywords: glass ceramics, luminescence, phosphor, silicate

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Authors: Emna Abid, Linda Chebbi, Yosra Mabrouk, Amel Labidi, Lamia Mansour

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Werner syndrome (WS) is a rare genetic disorder inherited in an autosomal recessive pattern characterized by accelerated aging. While extensive research has been conducted on its systemic manifestations, the specific dental implications of WS remain poorly understood. The medical history and the oral health status of two patients diagnosed with WS were detailed. Our findings revealed a high prevalence of dental problems in both patients, including periodontitis, xerostomia, and temporomandibular joint disorders. This article aims to investigate the dental challenges faced by individuals with WS as well as the prosthetic options envisaged through two clinical cases contributing to a deeper understanding of the dental implications of WS and to choose the appropriate prosthetic solution in this population. Future research should focus on larger scale studies and clinical trials to validate these proposed strategies.

Keywords: adult progeria, clinical symptoms, oral manifestations, dental care, prosthetic management

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Authors: Joshua Chew, Vesa Cheng, David Thomson

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Background: Hereditary angioedema (HAE) or C1 esterase deficiency is a relatively rare entity that has a potential for significant anesthetic complications. Methods: A literature review was performed of published cases of surgery in patients with HAE. Results were limited to English language only and cases were examined for management strategies and successful prevention of acute attacks. Results: The literature revealed the successful use of C1 esterase inhibitors as the most common agent in surgical prophylaxis therapy. Other therapeutic targets described included kallikrein inhibitors and bradykinin B2 receptor antagonists. Conclusions: Therapeutic targets that exist for the management of acute attacks in HAE have been successfully employed in the setting of surgery. The data is currently limited and could not be used as a firm evidence base, but the limited outcomes seen are positive and reassuring for the prospective anesthetic management of this potentially fatal condition.

Keywords: anesthesia, C1 esterase deficiency, hereditary angioedema, surgical prophylaxis

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Authors: Seyed Mahdi Rafiaei

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In this investigation, red emitting Eu³⁺ doped YVO₄ nano-phosphors have been synthesized via the facile combustion method using isobutyl nitrite and urea fuels, individually. Field-emission scanning electron microscope (FE-SEM) images, high resolution transmission electron microscope (TEM) images and X-ray diffraction (XRD) spectra reveal that the mentioned fuels can be used successfully to synthesis YVO₄: Eu³⁺ nano-particles. Interestingly, the fuels have a large effect on the size and morphology of nano-phosphors as well as luminescence properties. Noteworthy the use of isobutyl nitrite provides an average particle size of 65 nm, while the employment of urea, results in the formation of larger particles and also provides higher photoluminescence emission intensity. The improved luminescence performance is attributed to the condition of chemical reaction via the combustion synthesis and the size of synthesized phosphors.

Keywords: phosphors, combustion, fuels, luminescence, nanostructure

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Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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Coronary artery dissection leading to acute myocardial infarction after blunt chest trauma is extremely rare. A 67-year-old woman suffered blunt chest trauma following a traffic accident. The electrocardiogram revealed acute posterior ST-segment elevation and myocardial infarction and coronary angiography demonstrated acute right coronary artery dissection. Following the death of the victim an autopsy was performed after cardiopulmonary support had been carried out. In this case report, we describe the case of a woman with blunt chest trauma, who developed an acute myocardial infarction secondary to right coronary artery dissection. Although there was additional the blunt chest trauma due to chest compression, we confirmed the injury at autopsy and by histological findings.

Keywords: blunt chest trauma, right coronary artery dissection, coronary angiography, autopsy, histological examination

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Authors: Till Fehlauer, Blanche Collin, Bernard Angeletti, Andrea Somogyi, Claire Lallemand, Perrine Chaurand, Cédric Dentant, Clement Levard, Jerome Rose

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Over the last decades, yttrium (Y) has gained importance in high-tech applications. It is an essential part of alloys and compounds used for lasers, displays, or cell phones, for example. Due to its chemical similarities with the lanthanides, Y is often considered a rare earth element (REE). Despite their increased usage, the environmental behavior of REEs remains poorly understood. Especially regarding their interactions with plants, many uncertainties exist. On the one hand, Y is known to have a negative effect on root development and germination, but on the other hand, it appears to promote plant growth at low concentrations. In order to understand these phenomena, a precise knowledge is necessary about how Y is absorbed by the plant and how it is handled once inside the organism. Contradictory studies exist, stating that due to a similar ionic radius, Y and the other REEs might be absorbed through Ca²⁺-channels, while others suspect that Y has a shared pathway with Al³⁺. In this study, laser ablation coupled ICP-MS, and synchrotron-based micro-X-ray fluorescence (µXRF, beamline Nanoscopium, SOLEIL, France) have been used in order to localize Y within the plant tissue and identify associated elements. The plant used in this study is Saxifraga paniculata, a rugged alpine plant that has shown an affinity for Y in previous studies (in prep.). Furthermore, Saxifraga paniculata performs guttation, which means that it possesses phloem sap secreting openings on the leaf surface that serve to regulate root pressure. These so-called hydathodes could provide special insights in elemental transport in plants. The plants have been grown on Y doped soil (500mg/kg DW) for four months. The results showed that Y was mainly concentrated in the roots of Saxifraga paniculata (260 ± 85mg/kg), and only a small amount was translocated to the leaves (10 ± 7.8mg/kg). µXRF analysis indicated that within the root transects, the majority of Y remained in the epidermis and hardly penetrated the stele. Laser ablation coupled ICP-MS confirmed this finding and showed a positive correlation in the roots between Y, Fe, Al, and to a lesser extent Ca. In the stem transect, Y was mainly detected in a hotspot of approximately 40µm in diameter situated in the endodermis area. Within the stem and especially in the hotspot, Y was highly colocalized with Al and Fe. Similar-sized Y hotspots have been detected in/on the leaves. All of them were strongly colocalized with Al and Fe, except for those situated within the hydathodes, which showed no colocalization with any of the measured elements. Accordingly, a relation between Y and Ca during root uptake remains possible, whereas a correlation to Fe and Al appears to be dominant in the aerial parts, suggesting common storage compartments, the formation of complexes, or a shared pathway during translocation.

Keywords: laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS), Phytoaccumulation, Rare earth elements, Saxifraga paniculata, Synchrotron-based micro-X-ray fluorescence, Yttrium

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Authors: Kamal Chafiq, Youssef Hadzine, Adel Elmekkaoui, Othmane Benlenda, Houssam Rajad, Soukaina Wakrim, Hicham Nassik

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Guillain-Barré syndrome/Miller Fishe syndrome (GBS/MFS) overlap syndrome is an extremely rare variant of Guillain-Barré syndrome (GBS) in which Miller Fisher syndrome (MFS) coexists with other characteristics of GBS, such as limb weakness, paresthesia, and facial paralysis. We report the clinical case of a 12-year-old patient, with no pathological history, who acutely presents with ophthalmoplegia, areflexia, facial diplegia, and swallowing and phonation disorders, followed by progressive, descending, and symmetrical paresis affecting first the upper limbs and then the lower limbs. An albuminocytological dissociation was found in the cerebrospinal fluid study. Magnetic resonance imaging of the spinal cord showed enhancement and thickening of the cauda equina roots. The patient was treated with immunoglobulins with a favorable clinical outcome.

Keywords: Guillain-Barré syndrome, Miller Fisher syndrome, overlap syndrome, anti-GQ1b antibodies

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Authors: Alla Ovsyannikova, Oksana Rymar, Elena Shakhtshneider, Mikhail Voevoda

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In Siberia endocrinologists increasingly noted young patients with the course of diabetes mellitus differing from 1 and 2 types. Therefore we did a molecular genetic study for this group of patients to verify the monogenic forms of diabetes mellitus in them and researched the characteristics of this pathology. When confirming the monogenic form of diabetes, we performed a correction therapy for many patients (transfer from insulin to tablets), prevented specific complications, examined relatives and diagnosed their diabetes at the preclinical stage, revealed phenotypic characteristics of the pathology which led to the high significance of this work. Materials and Methods: We observed 5 patients (4 families). We diagnosed MODY (Maturity Onset Diabetes of the Young) during the molecular genetic testing (direct automatic sequencing). All patients had a full clinical examination, blood samples for biochemical research, determination of C-peptide and TSH, antibodies to b-cells, microalbuminuria, abdominal ultrasound, heart and thyroid ultrasound, examination of ophthalmologist. Results: We diagnosed 3 rare types of MODY: two women had MODY8, one man – MODY6 and man and his mother - MODY12. Patients with types 8 and 12 had clinical features. Age of onset hyperglycemia ranged from 26 to 34 years. In a patient with MODY6 fasting hyperglycemia was detected during a routine examination. Clinical symptoms, complications were not diagnosed. The patient observes a diet. In the first patient MODY8 was detected during first pregnancy, she had itchy skin and mostly postprandial hyperglycemia. Upon examination we determined glycated hemoglobin 7.5%, retinopathy, non-proliferative stage, peripheral neuropathy. She uses a basic bolus insulin therapy. The second patient with MODY8 also had clinical manifestations of hyperglycemia (pruritus, thirst), postprandial hyperglycemia and diabetic nephropathy, a stage of microalbuminuria. The patient was diagnosed autoimmune thyroiditis. She used inhibitors of DPP-4. The patient with MODY12 had an aggressive course. In the detection of hyperglycemia he had complaints of visual impairment, intense headaches, leg cramps. The patient had a history of childhood convulsive seizures of non-epileptic genesis, without organic pathology, which themselves were stopped at the age of 12 years. When we diagnosed diabetes a patient was 28 years, he had hypertriglyceridemia, atherosclerotic plaque in the carotid artery, proliferative retinopathy (lacerocoagulation). Diabetes and early myocardial infarction were observed in three cases in family. We prescribe therapy with sulfonylureas and SGLT-2 inhibitors with a positive effect. At the patient's mother diabetes began at a later age (30 years) and a less aggressive course was observed. She also has hypertriglyceridemia and uses oral hypoglycemic drugs. Conclusions: 1) When young patients with hyperglycemia have extrapancreatic pathologies and diabetic complications with a short duration of diabetes we can assume they have one of type of MODY diabetes. 2) In patients with monogenic forms of diabetes mellitus, the clinical manifestations of hyperglycemia in each succeeding generation are revealed at an earlier age. Research had increased our knowledge of the monogenic forms of diabetes. The reported study was supported by RSCF, research project No. 14-15-00496-P.

Keywords: diabetes mellitus, MODY diabetes, monogenic forms, young patients

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Authors: Ghada Esheba, Fatimah Alturkistani, Arwa Obaid, Ahdab Bashehab, Moayad Alturkistani

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Introduction: Craniopharyngiomas (CPs) are rare epithelial tumors located mainly in the sellar/parasellar region. CPs have been classified histopathologically, genetically, clinically and prognostically into two distinctive subtypes: adamantinomatous and papillary variants. Aim: To examine the pattern of expression of both the β-catenin and epidermal growth factor receptor (EGFR) in surgically resected samples of adamantinomatous CP, and to asses for the possibility of using anti-EGFR in the management of ACP patients. Materials and methods: β-catenin and EGFR immunostaining was performed on paraffin-embedded tissue sections of 18 ACP cases. Result: 17 out of 18 cases (94%) of ACP exhibited strong nuclear/cytoplasmic expression of β-catenin, 15 (83%) of APC cases were positive for EGFR. Conclusion: Nuclear accumulation of β-catenin is a diagnostic hallmark of ACP. EGFR positivity in most cases of ACP could qualify the use of anti-EGFR therapy. 

Keywords: craniopharyngioma, adamantinomatous, papillary, epidermal growth factor receptor, B-catenin

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Authors: Wajid Mumtaz, Aamir Saeed Malik, Syed Saad Azhar Ali, Mohd Azhar Mohd Yasin

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In this paper, a technique based on electroencephalogram (EEG) analysis is presented, aiming for diagnosing major depressive disorder (MDD) among a potential population of MDD patients and healthy controls. EEG is recognized as a clinical modality during applications such as seizure diagnosis, index for anesthesia, detection of brain death or stroke. However, its usability for psychiatric illnesses such as MDD is less studied. Therefore, in this study, for the sake of diagnosis, 2 groups of study participants were recruited, 1) MDD patients, 2) healthy people as controls. EEG data acquired from both groups were analyzed involving inter-hemispheric asymmetry and composite permutation entropy index (CPEI). To automate the process, derived quantities from EEG were utilized as inputs to classifier such as logistic regression (LR) and support vector machine (SVM). The learning of these classification models was tested with a test dataset. Their learning efficiency is provided as accuracy of classifying MDD patients from controls, their sensitivities and specificities were reported, accordingly (LR =81.7 % and SVM =81.5 %). Based on the results, it is concluded that the derived measures are indicators for diagnosing MDD from a potential population of normal controls. In addition, the results motivate further exploring other measures for the same purpose.

Keywords: major depressive disorder, diagnosis based on EEG, EEG derived features, CPEI, inter-hemispheric asymmetry

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Authors: Jaspal Rana

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Oxidative stress has been identified as an underlying cause of ischemia-reperfusion (IR) related cognitive dysfunction and brain damage. Therefore, antioxidant based therapies to treat IR injury are being investigated. Allium cepa L. (onion) is used as culinary medicine and is documented to have marked antioxidant effects. Hence, the present study was designed to evaluate the effect of A. cepa outer scale extract (ACE) against IR induced cognition and biochemical deficit in mice. ACE was prepared by maceration with 70% methanol and fractionated into ethylacetate and aqueous fractions. Bilateral common carotid artery occlusion for 10 min followed by 24 h reperfusion was used to induce cerebral IR injury. Following IR injury, ACE (100 and 200 mg/kg) was administered orally to animals for 7 days once daily. Behavioral outcomes (memory and sensorimotor functions) were evaluated using Morris water maze and neurological severity score. Cerebral infarct size, brain thiobarbituric acid reactive species, reduced glutathione, and superoxide dismutase activity was also determined. Treatment with ACE significantly ameliorated IR mediated deterioration of memory and sensorimotor functions and rise in brain oxidative stress in animals. The results of the present investigation revealed that ACE improved functional outcomes after cerebral IR injury which may be attributed to its antioxidant properties.

Keywords: ischemia-reperfusion, neuroprotective, stroke, antioxidant

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Authors: Yusuf Ziya Halefoğlu

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Phosphorescence, classically, excitation effects (radiation, electron beam, electric field, temperature, etc.) is the name given after the elimination of materials that glow in the visible region. This event continues to glow after the elimination of the effect of excitation is called phosphorescence. In this study were synthesized by the method of the combustion lanthanide doped alkaline earth aluminates. High temperature and long reaction time required and the sol-gel method of combustion according to the methods of solid state synthesis temperature lower than the short reaction time, a small particle size, convenience, and is superior in terms of being secured. Their microstructures and its effect on the photoluminescence properties were studied. Phosphorescence is derived in the dark when produced materials are held in sunlight or under ultraviolet light typically at 365-520 nm wavelength range. In this study, the optimal ratio of rare earth elements, in terms of brightness and glow duration was examined by SEM, XRD and photoluminescence analysis.

Keywords: persistence luminescence, phosphorescence, trap depth, combustion method

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Authors: Perminderjit Singh, Randeep Singh

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The performance, emission and combustion characteristics of a single cylinder four stroke variable compression ratio multifuel engine when fueled with different blends of rice bran oil methyl ester and ethanol are investigated and compared with the results of standard diesel. Biodiesel produced from rice bran oil by transesterification process has been used in this study. The experiment has been conducted at a fixed engine speed of 1500 rpm, 50% load and at compression ratios of 16.5:1, 17:1, 17.5:1 and 18:1. The impact of compression ratio on fuel consumption, brake thermal efficiency and exhaust gas emissions has been investigated and presented. Optimum compression ratio which gives the best performance has been identified. The results indicate longer ignition delay, the maximum rate of pressure rise, lower heat release rate and higher mass fraction burnt at higher compression ratio for waste cooking oil methyl ester when compared to that of diesel. The brake thermal efficiency at 50% load for rice bran oil methyl ester blends and diesel has been calculated and the blend B40 is found to give maximum thermal efficiency. The blends when used as fuel results in the reduction of carbon monoxide, hydrocarbon and increase in nitrogen oxides emissions.

Keywords: biodiesel, rice bran oil, transesterification, ethanol, compression ratio

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Authors: David J. Thomson, Joshua C. J. Chew

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Background: Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) is a rare complication of lithium toxicity that typically causes irreversible cerebellar dysfunction. These patients may require hemodialysis and extensive supports in the intensive care. Methods: A review was performed on the available literature of SILENT with a focus on current pathophysiological hypotheses and advances in treatment. Articles were restricted to the English language. Results: Although the exact mechanism is unclear, CNS demyelination, especially in the cerebellum, was seen on the brain biopsies of a proportion of patients. There is no definitive management of SILENT but instead current management is focused on primary and tertiary prevention – detection of those at risk, and rehabilitation post onset of neurological deficits. Conclusions: This review draws conclusions from a limited amount of available literature, most of which are isolated case reports. Greater awareness of SILENT and further investigation into the risk factors and pathogenesis are required so this serious and irreversible syndrome may be avoided.

Keywords: lithium toxicity, pathogenesis, SILENT, syndrome of irreversible lithium-effectuated neurotoxicity

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Authors: Sky Chou, Joseph C. Chen

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This paper focuses on using six sigma methodologies to reach the desired shrinkage of a manufactured high-density polyurethane (HDPE) part produced by the injection molding machine. It presents a case study where the correct shrinkage is required to reduce or eliminate defects and to improve the process capability index Cp and Cpk for an injection molding process. To improve this process and keep the product within specifications, the six sigma methodology, design, measure, analyze, improve, and control (DMAIC) approach, was implemented in this study. The six sigma approach was paired with the Taguchi methodology to identify the optimized processing parameters that keep the shrinkage rate within the specifications by our customer. An L9 orthogonal array was applied in the Taguchi experimental design, with four controllable factors and one non-controllable/noise factor. The four controllable factors identified consist of the cooling time, melt temperature, holding time, and metering stroke. The noise factor is the difference between material brand 1 and material brand 2. After the confirmation run was completed, measurements verify that the new parameter settings are optimal. With the new settings, the process capability index has improved dramatically. The purpose of this study is to show that the six sigma and Taguchi methodology can be efficiently used to determine important factors that will improve the process capability index of the injection molding process.

Keywords: injection molding, shrinkage, six sigma, Taguchi parameter design

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Authors: Jui-Chien Hsieh

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Background:12-lead electrocardiography(ECG) is one of frequently-used tools to detect atrial fibrillation (AF), which might degenerate into life-threaten stroke, in clinical Practice. Based on this study, the AF detection by the clinically-used 12-lead ECG device has only 0.73~0.77 positive predictive value (ppv). Objective: It is on great demand to develop a new algorithm to improve the precision of AF detection using 12-lead ECG. Due to the progress on artificial intelligence (AI), we develop an ECG deep model that has the ability to recognize AF patterns and reduce false-positive errors. Methods: In this study, (1) 570-sample 12-lead ECG reports whose computer interpretation by the ECG device was AF were collected as the training dataset. The ECG reports were interpreted by 2 senior cardiologists, and confirmed that the precision of AF detection by the ECG device is 0.73.; (2) 88 12-lead ECG reports whose computer interpretation generated by the ECG device was AF were used as test dataset. Cardiologist confirmed that 68 cases of 88 reports were AF, and others were not AF. The precision of AF detection by ECG device is about 0.77; (3) A parallel 4-layer 1 dimensional convolutional neural network (CNN) was developed to identify AF based on limb-lead ECGs and chest-lead ECGs. Results: The results indicated that this model has better performance on AF detection than traditional computer interpretation of the ECG device in 88 test samples with 0.94 ppv, 0.98 sensitivity, 0.80 specificity. Conclusions: As compared to the clinical ECG device, this AI ECG model promotes the precision of AF detection from 0.77 to 0.94, and can generate impacts on clinical applications.

Keywords: 12-lead ECG, atrial fibrillation, deep learning, convolutional neural network

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Authors: Mile Vuković, Lana Jerkić Rajić

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Introduction: Broca's aphasia is a non-fluent type of aphasic syndrome, which is primarily manifested by impairment of language production. In connected speech, patients with this type of aphasia produce short sentences in which they often omit function words and morphemes or choose inadequate forms. Aim: This research was conducted to examine the morphosyntactic abilities of people with Broca's aphasia, comparing them with neurologically healthy subjects without a language disorder. Method: The sample included 15 patients with Broca's post-stroke aphasia, who had the relatively intact ability of auditory comprehension. The diagnosis of aphasia was based on the Boston Diagnostic Aphasia Examination. The control group comprised 16 neurologically healthy subjects without data on the presence of disorders in speech and language development. The patients' mother tongue was Serbian. The new Serbian Morphosyntactic Abilities Test (SMAT) was used. Descriptive (frequency, percentage, mean, SD, min, max) and inferential (Mann-Whitney U-test) statistics were used in data processing. Results: We noticed statistically significant differences between people with Broca's aphasia and neurotypical subjects on the SMAT (U = 1.500, z = -4.982, p = 0.000). The results showed that people with Broca's aphasia had achieved low scores on the SMAT, regardless of age (ρ = -0.045, p = 0.873) and time post onset (ρ = 0.330, p = 0.229). Conclusion: Preliminary results show that the SMAT has the potential to detect morphosyntactic deficits in Serbian speakers with Broca's aphasia.

Keywords: Broca’s aphasia, morphosyntactic abilities, agrammatism, Serbian language

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Authors: Viyango Pandian, Kumaresh Athiyappan

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Pelvic congestion Syndrome (PCS) is usually seen in multiparous women who give history of chronic dull-aching pelvic pain. We report a case of a 17 year old unmarried female, who presented with acute onset of chronic dull-aching abdominal pain in the left iliac fossa, which particularly increased during menstruation and was finally diagnosed to be pelvic congestion syndrome. On ultrasonography, multiple tortuous and dilated veins were observed in the left adnexa. Both ovaries appeared normal in size, volume and echotexture. Computed tomography (CT) angiography was performed to precisely delineate the venous pathway and to assess any associated abnormality; which showed a dilated and tortuous left ovarian vein with an anomalous course around the left kidney and draining into the left renal vein. Clinical parameters and hormonal levels were within normal limits. This is a rare case of anomalous course of left ovarian vein associated with pelvic congestion syndrome.

Keywords: anomalous course of ovarian vein, computed tomography, pelvic congestion syndrome, ultrasonography

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Authors: Karthikeyan M., Paul M. J.

Abstract:

This case report discusses a 54-year-old woman from Salem, Tamilnadu, who presented with a rare case of papillary thyroid carcinoma (PTC), manifesting as a hypervascular mass in the left carotid sheath. The patient had a two-and-a-half-month history of non-progressive neck swelling, with symptoms including dysphagia and a choking sensation. Clinical examination and investigations such as FNAC and CECT revealed a large vascular mass in the left neck region, initially perplexing the diagnosis. The patient underwent total thyroidectomy and excision of the left carotid sheath mass. Histopathology confirmed PTC. Postoperatively, the patient received Iodine-131 ablation and showed good recovery with no recurrence. This case highlights the diagnostic challenge and atypical presentation of PTC as a vascular neck mass, emphasizing the importance of a comprehensive approach in evaluating thyroid and neck lesions.

Keywords: lateral neck vascular mass, lateral aberrant thyroid, thyroid vascular swelling, smooth post op recovery

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Authors: Jelena Bašić, Višnjica Vučetić, Mislav Anić, Tomislav Bašić

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Lack of precipitation combined with high temperatures causes great damage to the agriculture and economy in Croatia. Therefore, it is important to understand water circulation and balance. We decided to gain a better insight into the spatial distribution of water balance components (WBC) and their long-term changes in Croatia. WBC are precipitation (P), potential evapotranspiration (PET), actual evapotranspiration (ET), soil moisture content (S), runoff (RO), recharge (R), and soil moisture loss (L). Since measurements of the mentioned components in Croatia are very rare, the Palmer model has been applied to estimate them. We refined method by setting into the account the corrective factor to include influence effects of the wind as well as a maximum soil capacity for specific soil types. We will present one hundred years’ time series of PET and ET showing the trends at few meteorological stations and a comparison of components of two climatological periods. The meteorological data from 109 stations have been used for the spatial distribution map of the WBC of Croatia.

Keywords: croatia, long-term trends, the palmer method, water balance components

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Authors: Kuan Lun Pan, Moo Been Chang

Abstract:

Volatile organic compounds (VOCs) are one of major air contaminants, and they can react with nitrogen oxides (NOx) in atmosphere to form ozone (O3) and peroxyacetyl nitrate (PAN) with solar irradiation, leading to environmental hazards. In addition, some VOCs are toxic at low concentration levels and cause adverse effects on human health. How to effectively reduce VOCs emission has become an important issue. Thermal catalysis is regarded as an effective way for VOCs removal because it provides oxidation route to successfully convert VOCs into carbon dioxide (CO2) and water (H2O(g)). Single perovskite-type catalysts are promising for VOC removal, and they are of good potential to replace noble metals due to good activity and high thermal stability. Single perovskites can be generally described as ABO3 or A2BO4, where A-site is often a rare earth element or an alkaline. Typically, the B-site is transition metal cation (Fe, Cu, Ni, Co, or Mn). Catalytic properties of perovskites mainly rely on nature, oxidation states and arrangement of B-site cation. Interestingly, single perovskites could be further synthesized to form double perovskite-type catalysts which can simply be represented by A2B’B”O6. Likewise, A-site stands for an alkaline metal or rare earth element, and the B′ and B′′ are transition metals. Double perovskites possess unique surface properties. In structure, three-dimensional of B-site with ordered arrangement of B’O6 and B”O6 is presented alternately, and they corner-share octahedral along three directions of the crystal lattice, while cations of A-site position between the void of octahedral. It has attracted considerable attention due to specific arrangement of alternating B-site structure. Therefore, double perovskites may have more variations than single perovskites, and this greater variation may promote catalytic performance. It is expected that activity of double perovskites is higher than that of single perovskites toward VOC removal. In this study, double perovskite-type catalyst (La2CoMnO6) is prepared and evaluated for VOC removal. Also, single perovskites including LaCoO3 and LaMnO3 are tested for the comparison purpose. Toluene (C7H8) is one of the important VOCs which are commonly applied in chemical processes. In addition to its wide application, C7H8 has high toxicity at a low concentration. Therefore, C7H8 is selected as the target compound in this study. Experimental results indicate that double perovskite (La2CoMnO6) has better activity if compared with single perovskites. Especially, C7H8 can be completely oxidized to CO2 at 300oC as La2CoMnO6 is applied. Characterization of catalysts indicates that double perovskite has unique surface properties and is of higher amounts of lattice oxygen, leading to higher activity. For durability test, La2CoMnO6 maintains high C7H8 removal efficiency of 100% at 300oC and 30,000 h-1, and it also shows good resistance to CO2 (5%) and H2O(g) (5%) of gas streams tested. For various VOCs including isopropyl alcohol (C3H8O), ethanal (C2H4O), and ethylene (C2H4) tested, as high as 100% efficiency could be achieved with double perovskite-type catalyst operated at 300℃, indicating that double perovskites are promising catalysts for VOCs removal, and possible mechanisms will be elucidated in this paper.

Keywords: volatile organic compounds, Toluene (C7H8), double perovskite-type catalyst, catalysis

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Authors: Armaghan Moravej Aleali, Seyed Mahmoud Latifi, Homeira Rashidi

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Objective: High blood pressure in a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. The aim of this present was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. Material & Methods: This descriptive-analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran). A questionnaire include: height, weight, and body mass index, systolic and diastolic blood pressures filled for each participant. Blood pressure was measured twice for each person. For the diagnosis of hypertension, the fourth report of the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Health Institute of United States was used. Results: The subject participants of the study were 1707children and adolescents including 922 boys (54%) and 785 girls 46%). The prevalence of high blood pressure was 1.7% (boys 2.5% girls 0.8%). The prevalence of pre-hypertension was 9 % (7.6% in boys, 10.6% in girls). The mean systolic and diastolic blood pressures increased with increasing body mass index. Conclusion: In this study, the prevalence of high blood pressure was found to be lower than other studies in our country. The prevalence of the high blood pressure in boys was significantly higher than girls. This study, like other studies, showed a high correlation between being overweight and an increase in systolic and diastolic blood pressure.

Keywords: hypertension, pre-hypertension, childhood, adolescence

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Authors: Simon B. N. Thompson

Abstract:

Cortisol is important to our immune system, regulates our stress response, and is a factor in maintaining brain temperature. Saliva cortisol is a practical and useful non-invasive measurement that signifies the presence of the important hormone. Electrical activity in the jaw muscles typically rises when the muscles are moved during yawning and the electrical level is found to be correlated with the cortisol level. In two studies using identical paradigms, a total of 108 healthy subjects were exposed to yawning-provoking stimuli so that their cortisol levels and electrical nerve impulses from their jaw muscles was recorded. Electrical activity is highly correlated with cortisol levels in healthy people. The Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details were collected and exclusion criteria applied for voluntary recruitment: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners as compared with the non-yawners between rest and post-stimuli. Significant evidence supports the Thompson Cortisol Hypothesis that suggests rises in cortisol levels are associated with yawning. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, diagnosis, neurological disease, thompson cortisol hypothesis, yawning

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Authors: Michael Brave, Mark Kroll, Steven Karch, Charles Wetli, Michael Graham, Sebastian Kunz, Dorin Panescu

Abstract:

Background: Conducted electrical weapons (CEW) are now used in 107 countries and are a common law enforcement less-lethal force practice in the United Kingdom (UK), United States of America (USA), Canada, Australia, New Zealand, and others. Use of these devices is rarely temporally associated with the occurrence of sudden arrest-related deaths (ARD). Because such deaths are uncommon, few Medical Examiners (MEs) ever encounter one, and even fewer offices have established comprehensive investigative protocols. Without sufficient scientific data, the role, if any, played by a CEW in a given case is largely supplanted by conjecture often defaulting to a CEW-induced fatal cardiac arrhythmia. In addition to the difficulty in investigating individual deaths, the lack of information also detrimentally affects being able to define and evaluate the ARD cohort generally. More comprehensive, better information leads to better interpretation in individual cases and also to better research. The purpose of this presentation is to provide MEs with a comprehensive evidence-based checklist to assist in the assessment of CEW-ARD cases. Methods: PUBMED and Sociology/Criminology data bases were queried to find all medical, scientific, electrical, modeling, engineering, and sociology/criminology peer-reviewed literature for mentions of CEW or synonymous terms. Each paper was then individually reviewed to identify those that discussed possible bioelectrical mechanisms relating CEW to ARD. A Naranjo-type pharmacovigilance algorithm was also employed, when relevant, to identify and quantify possible direct CEW electrical myocardial stimulation. Additionally, CEW operational manuals and training materials were reviewed to allow incorporation of CEW-specific technical parameters. Results: Total relevant PUBMED citations of CEWs were less than 250, and reports of death extremely rare. Much relevant information was available from Sociology/Criminology data bases. Once the relevant published papers were identified, and reviewed, we compiled an annotated checklist of data that we consider critical to a thorough CEW-involved ARD investigation. Conclusion: We have developed an evidenced-based checklist that can be used by MEs and their staffs to assist them in identifying, collecting, documenting, maintaining, and objectively analyzing the role, if any, played by a CEW in any specific case of sudden death temporally associated with the use of a CEW. Even in cases where the collected information is deemed by the ME as insufficient for formulating an opinion or diagnosis to a reasonable degree of medical certainty, information collected as per the checklist will often be adequate for other stakeholders to use as a basis for informed decisions. Having reviewed the appropriate materials in a significant number of cases careful examination of the heart and brain is likely adequate. Channelopathy testing should be considered in some cases, however it may be considered cost prohibitive (aprox $3000). Law enforcement agencies may want to consider establishing a reserve fund to help manage such rare cases. The expense may stay the enormous costs associated with incident-precipitated litigation.

Keywords: ARD, CEW, police, TASER

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