Search results for: planning and organizing of the investigation

Authors: Geovanna dos Santos Romeiro, Polintia Rayza Brito da Silva, Luis Henrique Moura, Izadora Moreira Do Amaral, Marília Vitória Pinto Milhomem

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Introduction: The nose is one of the most likely sites for the appearance of malignancy on the face. This can be associated with its unique position of exposure to environmental damage, lack of photoprotection and because it is an area susceptible to greater sun exposure. It is already known that the most common type of nasal tumor is basal cell carcinoma. Squamous cell carcinoma is less common but considerably more aggressive, with a tendency to grow rapidly and metastasize. Nasal skin cancer can have a good prognosis, regardless of the type of treatment chosen, i.e., surgery, radiotherapy or electrodissection. However, tumors that are not diagnosed and treated quickly can be harmful and have a greater chance of metastasizing. When curative surgery is performed, therapies and reconstructive surgical procedures are usually required. Objective: The objective is to review the literature on nasal skin tumors and their types and specific locations. Forty-four articles published in Pubmed related to the location of skin cancer in the specific nasal areas region were analyzed. Twelve were excluded for being prior to the year 2000, three with inconclusive results, and one with unbiased conclusions. Results and Conclusion: Regarding the prevalence of types of nasal tumors, basal cell carcinoma comprises the majority, occurring predominantly in the ala, tip and root; squamous cell carcinoma, on the other hand, is more common in the lateral borders and columella. Even so, 2 articles report that the prevalence of metastasis has a higher incidence in squamous cell carcinomas. All of this points to the importance of early location, including regions that are often overlooked in the examination if the patient is wearing glasses. This topic needs further investigation for a greater correlation between anatomy and clinical-surgical implications.

Keywords: skin cancer, melanoma, non-melanoma, surgery

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Authors: Zahra Fotovatnia, Jeffery A. Jones, Alexandra Gottardo

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Speech communication often occurs in environments where noise conceals part of a message. Listeners should compensate for the lack of auditory information by picking up distinct acoustic cues and using semantic and sentential context to recreate the speaker’s intended message. This situation seems to be more challenging in a nonnative than native language. On the other hand, early bilinguals are expected to show an advantage over the late bilingual and monolingual speakers of a language due to their better executive functioning components. In this study, English monolingual speakers were compared with early and late nonnative speakers of English to understand speech in noise processing (SIN) and the underlying neurobiological features of this phenomenon. Auditory mismatch negativities (MMNs) were recorded using a double-oddball paradigm in response to a minimal pair that differed in their middle vowel (beat/bit) at Wilfrid Laurier University in Ontario, Canada. The results did not show any significant structural and electroneural differences across groups. However, vocabulary knowledge correlated positively with performance on tests that measured SIN processing in participants who learned English after age 6. Moreover, their performance on the test negatively correlated with the integral area amplitudes in the left superior temporal gyrus (STG). In addition, the STG was engaged before the inferior frontal gyrus (IFG) in noise-free and low-noise test conditions in all groups. We infer that the pre-attentive processing of words engages temporal lobes earlier than the fronto-central areas and that vocabulary knowledge helps the nonnative perception of degraded speech.

Keywords: degraded speech perception, event-related brain potentials, mismatch negativities, brain regions

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Authors: Ishan Tank, Ashmita Rupal, Sanjay Kumar Sharma

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Concrete, a widely used building material, has cement as its main constituent. An excessive amount of emissions are released into the atmosphere during the manufacture of cement, which is detrimental to the environment. To minimize this problem, innovative materials like geopolymer mortar (GPM) seem to be a better alternative. By using fly ash-based geopolymer instead of standard cement mortar as a binding ingredient, this concept has been successfully applied to the building sector. The advancement of this technology significantly reduces greenhouse gas emissions and helps in source reduction, thereby minimizing pollution of the environment. In order to produce mortar and use this geopolymer mortar in the development of building materials, the current investigation is properly introducing this geopolymeric material, namely fly ash, as a binder in place of standard cement. In the domain of the building material industry, fly ash based geopolymer is a new and optimistic replacement for traditional binding materials because it is both environmentally sustainable and has good durability. The setting behaviour and strength characteristics of fly ash, when mixed with alkaline activator solution with varied concentration of sodium hydroxide solution, alkaline liquids mix ratio, and curing temperature, must be investigated, though, in order to determine its suitability and application in comparison with the traditional binding material, by activating the raw materials, which include various elements of silica and alumina, finer material known as geopolymer mortar is created. The concentration of the activator solution has an impact on the compressive strength of the geopolymer concrete formed. An experimental examination of compressive strength after 7, 14, and 28 days of fly ash-based geopolymer concrete is presented in this paper. Furthermore, the process of geopolymerization largely relies on the curing temperature. So, the setting time of Geopolymer mortar due to different curing temperatures has been studied and discussed in this paper.

Keywords: geopolymer mortar, setting time, flyash, compressive strength, binder material

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Authors: Rajlakshmi Banerjee, Sujoy Banerjee

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The prevalence of malnutrition, as the most common cause of morbidity and mortality increases with old age, especially in developing countries like India, because of many factors out of which dentate status is one. It affects diet, nutritional status and general health due to reduced chewing ability and poor food choices. Aim and Objective: This study aimed to evaluate the effect of nutritional status, dietary intake on the Oral Health-related Quality of life (OHRQoL) of elderly edentulous complete denture wearing patients and to know whether they are at a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counselling during Prosthodontic rehabilitation of elderly edentulous patients. Materials and method: A cross-sectional study was conducted among 200 elderly denture wearing patients above 60 yrs of age from Nagpur, Maharashtra. The majority of study subjects (60%) were between the age group 60 and 75 years. Mini-Nutritional Assessment (MNA) Questionnaire was used to assess nutritional status and General Oral Health Assessment Index (GOHAI) questionnaire was used to determine the Oral health related Quality of life of these patients.Descriptive statistics was used to analyze data using SPSS version 21. Results: Among the assessed subjects, nearly 80% of them had total scores of GOHAI between 12 and 57 which require ‘needed dental care.’ As per MNA, 10.5% had adequate nutrition, 70 % were at risk of malnutrition, and remaining 19.5 % of subjects were malnourished. There was a significant correlation between GOHAI and MNA scores. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL.Conclusion: The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly and therefore severely affecting the quality of life. Dietary analysis and counselling should be strictly incorporated into geriatric treatment planning during Prosthetic rehabilitation.

Keywords: general oral health assessment index, General Oral Health Assessment Index (GOHAI), nutritional assessment, mini-nutritional assessment, Mini-Nutritional Assessment (MNA), quality of life

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Authors: Taju Abdela Mohammed

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Introduction: There has been a rise in awareness of violence against young women and girls, particularly when it occurs in educational environments. Gender-based violence in schools is a significant barrier. Therefore, it would be a threat to the achievement of the sustainable development goals, strive for gender equality in all our programs, right from the planning stages, to make sure we are as equitable as possible. Research on the causes, attitudes, and perceptions of gender-based violence was scant. Furthermore, there aren't many studies done on female students attending private colleges. Thus, the purpose of this study is to evaluate the frequency of gender-based violence and related variables among female students attending private colleges in Harar City, Ethiopia. Methodology: A facility-based mixed method concurrent triangulation study design was conducted among 500 randomly selected Private college female students in Harar City. Self-administered questionnaire and an in-depth interview were used to collect the data. The collected data were cleaned and analyzed using a statistical package for social science. Descriptive statistics were conducted and the results were reported using frequency, and percentile. Bivariate logistic regression was performed to identify associated factors. Adjusted odds ratios with 95% confidence intervals and p values < 0.05 were used to explain statistically significant associations. Thematic analysis was used to manually translate, transcribe, and analyze qualitative data. Result: The study showed the prevalence of gender-based violence was 338 (67.6%) (CI 0.432–0.721) Private college female students in Harar city Administration. Age less than 20 years and 20–24 years, [AOR = 0.21, 95% CI (0.03–0.81)] and [AOR = 0.12, 95% CI (0.03–0.51)], tight family control, [AOR = 5.12, 95% CI (1.43–6.9)], Witnessed father abuse mother at childhood; [AOR = 4.04, 95% CI (1.36–12.1)], had drunkenness female or boyfriend; [AOR = 2.12, 95% CI (1.60–14.05)] had significant association with gender-based violence. Conclusion: Our study shows the prevalence of gender-based violence among Private college female students is significant. This is due to the fact that gender-based violence, such as school dropout, unintended pregnancy, abortion, STDs, and psychological disorders, is abandoning young girls' lives and lowering their productivity.

Keywords: female students, gender-violence, harar, Ethiopia

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Authors: Mikael M. Johansson, Peter Stenvall, Leif Karlsson, Joel Andersson

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Sandvik Sanicro 25, UNS S31035, is an advanced high temperature austenitic stainless steel that potentially can be used in super-heaters and reheaters in the next generation of advanced ultra-super critical power plants. The material possesses both high creep strength and good corrosion resistance at temperatures up to 700°C. Its high temperature properties are positioned between other commercially available high temperature austenitic stainless steels and nickel-based alloys. It is, however, well known that an austenitic solidification mode combined with a fully austenitic microstructure exacerbate susceptibility towards hot cracking. The problem increases even more for thick walled material in multipass welding and could compromise the integrity of the welded component. Varestraint weldability testing is commonly used to evaluate susceptibility towards hot cracking of materials. In this paper, Varestraint test results are evaluated for base material of both UNS S31035 steel and are compared to those of the well-known and well-characterized UNS S31008 grade. The more creep resistant alloy, UNS S31035, is metallurgically more complicated than the UNS S31008 grade and has additions of several alloying elements to improve its high temperature properties. It benefits from both solid solution hardening as well as precipitation hardening. This investigation therefore attempts, based on the Varestraint weldability test, to understand if there are any differences in cracking mechanisms between these two grades due to the additional alloying elements used in UNS S31035. Results from Varestraint testing and crack type investigations will be presented and discussed in some detail. It is shown that hot cracking susceptibility of the UNS S31035 steel is only slightly higher than that of UNS S31008 despite the more complicated metallurgy. Weldability of the two alloys is therefore judged to be comparable making the newer alloy well suited also for critical applications.

Keywords: austenitic stainless steel, hot cracking susceptibility, UNS S31035, UNS S31008, varestraint weldability testing

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Authors: Ganesh R. Bhand, N. B. Chaure

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Cadmium selenide (CdSe) quantum dots (QDs) were prepared by solvothermal route. Subsequently a inorganic QDs-organic semiconductor (copper phthalocyanine) nanocomposite (i.e CuPc:CdSe nanocomposites) were produced by different concentration of QDs varied in CuPc. The nanocomposite thin films have been prepared by means of spin coating technique. The optical, structural and morphological properties of nanocomposite films have been investigated. The transmission electron microscopy (TEM) confirmed the formation of QDs having average size of  4 nm. The X-ray diffraction pattern exhibits cubic crystal structure of CdSe with reflection to (111), (220) and (311) at 25.4ᵒ, 42.2ᵒ and 49.6ᵒ respectively. The additional peak observed at lower angle at 6.9ᵒ in nanocomposite thin films are associated to CuPc. The field emission scanning electron microscopy (FESEM) observed that surface morphology varied in increasing concentration of CdSe QDs. The obtained nanocomposite show significant improvement in the thermal stability as compared to the pure CuPc indicated by thermo-gravimetric analysis (TGA) in thermograph. The effect in the Raman spectra of composites samples gives a confirm evidence of homogenous dispersion of CdSe in the CuPc matrix and their strong interaction between them to promotes charge transfer property. The success of reaction between composite was confirmed by Fourier transform infrared spectroscopy (FTIR). The photo physical properties were studied using UV - visible spectroscopy. The enhancement of the optical absorption in visible region for nanocomposite layer was observed with increasing the concentration of CdSe in CuPc. This composite may obtain the maximized interface between QDs and polymer for efficient charge separation and enhance the charge transport. Such nanocomposite films for potential application in fabrication of hybrid solar cell with improved power conversion efficiency.

Keywords: CdSe QDs, cupper phthalocyanine, FTIR, optical absorption

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Authors: Mukhtar Raban

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Nelson Mandela University subscribes to a humanizing pedagogy (HP), as housed under broader critical pedagogy, that underpins and informs learning and teaching activities at the institution. The investigation sought to explore the implications of humanizing and critical pedagogical considerations for a technology-enhanced language learning (TELL) environment in a university course. The paper inquires into the design of a learning resource in an online learning environment of an English communication module, that applied HP principles. With an objective of creating agentive spaces for foregrounding identity, student voice, critical self-reflection, and recognition of others’ humanity; a flexible and open 'My Presence' feature was added to the TELL environment that allowed students and lecturers to share elements of their backgrounds in a ‘mutually vulnerable’ manner as a way of establishing digital identity and a more ‘human’ presence in the online language learning encounter, serving as a catalyst for the recognition of the ‘other’. Following a qualitative research design, the study adopted an auto-ethnographic approach, complementing the critical inquiry nature embedded into the activity’s practices. The study’s findings provide critical reflections and deductions on the possibilities of leveraging digital human expression within a humanizing pedagogical framework to advance the realization of HP-adoption in language learning and teaching encounters. It was found that the consideration of humanizing pedagogical principles in the design of online learning was more effective when the critical outcomes were explicated to students and lecturers prior to the completion of the activities. The integration of humanizing pedagogy also led to a contextual advancement of ‘affective’ language learning. Upon critical reflection and analysis, student identity and agency can flourish in a technology-enhanced learning environment when humanizing, and critical pedagogy influences the learning design.

Keywords: critical reflection, humanizing pedagogy, student identity, technology-enhanced language learning

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Authors: Syahrir Andi Mangga, Ipranta

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The geological, paleomagnetic, geochemical and geophysical Investigation in The Sumatra Region has yielded some new data, has stimulated a reassessment of stratigraphy, structure, tectonic evolution and which can show a Sumatra geodynamic model. Sumatra island has in the margin of southwest part of the Eurasia plate in the Sundaland cratonic block and occurred as the amalgamation of allochtonous microplates, continental fragments, Island arc and accrctionary by foreland complex which assembled prior to Tertiary. The allochtonous rocks (terranes), can be divided into 4 (four) Terranes with Paleozoic to Mesosoic in age, had different origin, lithology and are separated by a Suture as main fault with trending NW-SE. The terranes are: the Tigapuluh-Bohorok (East Sumatra block / Sibumasu block), Permo-Carboniferous in age and is characterized by the rock types formed in glacio-marine and was intruded by Late Triassic to Early Jurrasic granitics, occupied in the Eastern part of Sumatra, the paleomagnetic data shown 41° South. Tanjung Karang - Gunung Kasih Terrane, is composed of higher metamorphic rocks and supposed to be pre-Carboniferous in age, covered by Mesozoic sedimentary rocks and were intruded by granitic-dioritic rocks, occupied in the Southern part of Sumatra, the paleomagnetic data shown 19° North. The Kuantan-Duabelas Mountain (West Sumatra block) is occupied by metamorphic, sedimentary and volcanic rocks of Paleozoic - Mesozoic (Carboniferous - Triassic) in age, contains a Cathaysion fauna and flora and are intruded by the Mesozoic granitoid rocks. The terrane occurred in the western part of Sumatra. Meanwhile, the Gumai-Garba (Waloya Terrane) which is occupied by the tectonite/melange, metasediment, carbonate and volcanic rocks of Mesozoic (Jurassic - Cretaceous) in age, are intruted by the Late Cretaceous granitoid rocks, the paleomagnetic data shown 30° - 31° South.

Keywords: tectonostratigraphy, amalgamation, allochtonous, terranes, sumatra

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Authors: Norbert Simon, Rodeano Roslee, Abdul Ghani Rafek, Goh Thian Lai, Azimah Hussein, Lee Khai Ern

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The 54 km stretch of Ranau-Tambunan (RTM) road in Sabah is subjected to slope failures almost every year. This study is focusing on identifying section of roads that are susceptible to failure based on temporal landslide density and lineament density analyses. In addition to the analyses, the rock slopes in several sections of the road were assessed using the geological strength index (GSI) technique. The analysis involved 148 landslides that were obtained in 1978, 1994, 2009 and 2011. The landslides were digitized as points and the point density was calculated based on every 1km2 of the road. The lineaments of the area was interpreted from Landsat 7 15m panchromatic band. The lineament density was later calculated based on every 1km2 of the area using similar technique with the slope failure density calculation. The landslide and lineament densities were classified into three different classes that indicate the level of susceptibility (low, moderate, high). Subsequently, the two density maps were overlap to produce the final susceptibility map. The combination of both high susceptibility classes from these maps signifies the high potential of slope failure in those locations in the future. The final susceptibility map indicates that there are 22 sections of the road that are highly susceptible. Seven rock slopes were assessed along the RTM road using the GSI technique. It was found from the assessment that rock slopes along this road are highly fractured, weathered and can be classified into fair to poor categories. The poor condition of the rock slope can be attributed to the high lineament density that presence in the study area. Six of the rock slopes are located in the high susceptibility zones. A detailed investigation on the 22 high susceptibility sections of the RTM road should be conducted due to their higher susceptibility to failure, in order to prevent untoward incident to road users in the future.

Keywords: GSI, landslide, landslide density, landslide susceptibility, lineament density

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Authors: Guadalupe Stefanny Aguilar-Moreno, Miguel Angel Aguilar-Mendez, Teodoro Espinosa-Solares

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In the agricultural sector, one of the main emitters of greenhouse gases is manure management, which has been increased considerably in recent years. Biogas is an energy source that can be produced from different organic materials through anaerobic digestion (AD); however, production efficiency is still low. Several techniques have been studied to increase its performance, such as co-digestion, the variation of digestion conditions, and nanomaterials used. Therefore, the aim of this investigation was to evaluate the effect of magnetite nanoparticles (NPs) concentration, synthesized by co-precipitation, on the biogas and methane production in AD using chicken litter as a substrate. Synthesis of NPs was performed according to the co-precipitation method, for which a fractional factorial experimental design 25⁻² with two replications was used. The study factors were concentrations (precursors and passivating), time of sonication and dissolution temperatures, and the response variables were size, hydrodynamic diameter (HD) and zeta potential. Subsequently, the treatment that presented the smallest NPs was chosen for their use on AD. The AD was established in serological bottles with a working volume of 250 mL, incubated at 36 ± 1 °C for 80 days. The treatments consisted of the addition of different concentrations of NPs in the microcosms: chicken litter only (control), 20 mg∙L⁻¹ of NPs + chicken litter, 40 mg∙L⁻¹ of NPs + chicken litter and 60 mg∙L⁻¹ of NPs + chicken litter, all by triplicate. Methane and biogas production were evaluated daily. The smallest HD (49.5 nm) and the most stable NPs (21.22 mV) were obtained with the highest passivating concentration and the lower precursors dissolution temperature, which were the only factors that had a significant effect on the HD. In the transmission electron microscopy performed to these NPs, an average size of 4.2 ± 0.73 nm was observed. The highest biogas and methane production was obtained with the treatment that had 20 mg∙L⁻¹ of NPs, being 29.5 and 73.9%, respectively, higher than the control, while the treatment with the highest concentration of NPs was not statistically different from the control. From the above, it can be concluded that the magnetite NPs promote the biogas and methane production in AD; however, high concentrations may cause inhibitory effects among methanogenic microorganisms.

Keywords: agricultural sector, anaerobic digestion, nanotechnology, waste management

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Authors: Guo Rui, Cao Xinhu

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In recent decades, the world has endured severe challenges in light of climate change, epidemics, geopolitics, terrorism, economic uncertainties, as well as regional conflicts and rivalries. The appropriate use of critical infrastructures (Cis) is confronted. Ports, as typical Cis cover more than 80% of the global freight movement. Within this context, even the minimal disruption of port operations could cause malfunction of the holistic supply chain network and substantial economic losses. Hence, it is crucial to evaluate port performance from the perspective of resilience. Research on resilience and risk/safety management has been increasing, however, it needs more attention, as it could prevent potential socio-economic losses and inspire decision-makers to make resilience-based decisions to answer the challenges, such as COVID-19. To facilitate better moves from decision-makers, ports need to identify proper factors influencing port resilience. Inappropriately influenced factor selection could have a cascading effect on undesirable port performances. Thus, a systematic evaluation of factors is essential to stimulate the improvement process of port resilience investigation. This study zooms into container ports considering their critical role in international trade and global supply chains. 440 articles are selected after relevance ranking, and consequently, 62 articles are scrutinized after the title and abstract screening. Forty-one articles are included for bibliographic analysis in the end. It is found that there is no standardized index system to measure port resilience. And most studies evaluate port resilience merely in the recovery phase. Only two articles cover absorption, adaption and recovery state. However, no literature involves the prevention state. Hence, a uniform resilience index system is expected with a clear resilience definition. And port safety and security should also be considered while evaluating port resilience.

Keywords: port resilience, port safety and security, literature review, index system, port performance

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Authors: Dylan Santos De Pinho, Arnaud Gay De Combes, Matthieu Steuhlet, Claude Jeannerat, Nabil Ouerhani

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The Industry 4.0 initiative has been launched to address huge challenges related to ever-smaller batch sizes. The end-user need for highly customized products requires highly adaptive production systems in order to keep the same efficiency of shop floors. Most of the classical Software solutions that operate the manufacturing processes in a shop floor are based on rigid Manufacturing Execution Systems (MES), which are not capable to adapt the production order on the fly depending on changing demands and or conditions. In this paper, we present a highly modular and flexible solution to orchestrate a set of production systems composed of a micro-milling machine-tool, a polishing station, a cleaning station, a part inspection station, and a rough material store. The different stations are installed according to a novel matrix configuration of a 3x3 vertical shelf. The different cells of the shelf are connected through horizontal and vertical rails on which a set of shuttles circulate to transport the machined parts from a station to another. Our software solution for orchestrating the tasks of each station is based on a Multi-Agent System. Each station and each shuttle is operated by an autonomous agent. All agents communicate with a central agent that holds all the information about the manufacturing order. The core innovation of this paper lies in the path planning of the different shuttles with two major objectives: 1) reduce the waiting time of stations and thus reduce the cycle time of the entire part, and 2) reduce the disturbances like vibration generated by the shuttles, which highly impacts the manufacturing process and thus the quality of the final part. Simulation results show that the cycle time of the parts is reduced by up to 50% compared with MES operated linear production lines while the disturbance is systematically avoided for the critical stations like the milling machine-tool.

Keywords: multi-agent systems, micro-manufacturing, flexible manufacturing, transfer systems

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Authors: Sarra Kitanou

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Water recycling and reuse is an effective measure to solve the water stress problem. The sustainable use of water resource has become a national development strategy in Morocco. A key aspect of improving overall sustainability is the potential for direct wastewater effluent reuse. However, the hybrid technology membrane bioreactors (MBR) have been identified as an attractive option for producing high quality and nutrient-rich effluents for wastewater treatment. It is based on complex interactions between biological processes, filtration process and rheological properties of the liquid to be treated. Currently, with the evolution of wastewater treatment projects in Morocco, the MBR technology can be used as a technology treating different types of wastewaters and to produce effluent with suitable quality for reuse. However, the energetic consumption of this process is a great concern, which can limit the development and implementation of this technology. In this investigation, the electric energy consumption of an ultrafiltration membrane bioreactor process in domestic wastewater treatment is evaluated and compared to some MBR installations based on literature review. Energy requirements of the MBR are linked to operational parameters and reactor performance. The analysis of energy consumption shows that the biological aeration and membrane filtration are more energy consuming than the other components listed as feed and recirculation pumps. Biological aeration needs 53% of the overall energetic consumption and the specific energy consumption for membrane filtration is about 25%. However, aeration is a major energy consumer, often exceeding 50% share of total energy consumption. The optimal results obtained on the MBR process (pressure p = 1.15 bar), hydraulic retention time (15 h) showed removal efficiencies up to 90% in terms of organic compounds removal, 100% in terms of suspended solids presence and up to 80% reduction of total nitrogen and total phosphorus. The effluent from this MBR system could be considered as qualified for irrigation reuse, showing its potential application in the future.

Keywords: hybrid process, membrane bioreactor, wastewater treatment, reuse

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Authors: Prama Mukhopadhyay, Rishika Mukhopadhyay

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The twentieth century has seen the world getting divided into three distinct blocks, created by the proponents of the mainstream developmental discourse. India, which has now gained the label of being a ‘developing nation’, stands in between these three groups, as it constantly tries to ‘catch up’ and emulate the developmental standards of the ‘west’. In this endeavour, we find our country trying really hard to blindly replicate the health care infrastructures of the ‘first worlds’, without realizing the needs of evaluating the ground reality. In such a situation, the sudden outbreak of child death in the district of Malda, WB, poses an obvious questions towards the kind of development that our country has been engaging in, ever since its Post Colonial inception. Through this paper we thus try to understand the harsh veracity of the health care facility that exists in rural Bengal, and thereby challenge the conventional notion of ‘health-care’ as is normally discussed in the mainstream developmental discourse. Grounding our research work on detailed ethnography and through the help of questionnaire, interviews and focus group discussions with the local government officials(BDOs), health workers (ICDS, ASHA workers, ANHM and BMOHs) and members of families with experiences of child deaths, we have tried to find out the real and humane factors behind the sudden rise of reported infant deaths in the district, issues which are normally neglected and left out while discussing and evaluating IMR in the mainstream studies on health care and planning in our nation. Therefore the main aim of this paper is to try and look at child death from a ‘wider perspective’, where it is seen from an eye not bounded by the common registers of caste, class and religion. This paper, would thus be an eye opener in some sense, bringing in stories from the rural belt of the country; where the people are regularly torn between the binaries of the developing and shining modernity of ‘India’ which now gets ready to run the last lap and gain the status of becoming a ‘developed nation’ by 2020, and the staggering, dark traditional ‘ Bharat, which lags behind.

Keywords: child mortality, development discourse, health care, tradition and modernity

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Authors: Jonnalagadda Naveen, M. P. S. Tomar, Putluru Satish, Palanisamy Dharani

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Present investigation was carried out on a single specimen of the heart of yellow-bellied sea snake, which accidentally came to the seashore with the fisherman’s net. After the death, these specimens was preserved in 10% neutral buffered formalin and observe for its morphology. The literature cited revealed that meager information was available on the anatomy of the heart of this species of snake thus present study was planned on the gross anatomy of the heart of yellow-bellied sea snake. The heart of yellow-bellied sea snake was located between 28-35th rib in an oblique direction in the pericardial sac. It was three chambered with the complete division of atria but the ventricular cavity was incompletely divided. The apex did not show any gubernaculum cordis. The sinus venosus was the common cavity for confluence of anterior and posterior vana cava and the jugular vein was opened with anterior vena cava. The opening of posterior vena cava was slit-like and it was guarded by membranous valves whereas no valve could be observed at the opening of anterior vana cava and the jugular vein. Both the caval veins ran along the right border of the heart. Pulmonary vein was single which later divided into two branches. The length-width index for the atria was 1.33 whereas it was 1.67 for the ventricle. The atrioventricular canal was situated slightly towards the left of the midline of the heart and was divided into a right cavum pulmonale and left cavum arteriosum of which the right one was slightly larger and longer than the left. The cavum venosum was present in between the cavum pulmonale and the cavum arteriosum. The Ventricle was elongated triangle muscular compartment with ventrally located apex. Internally the cavity of ventricle was divided into two partial chambers dorsally by a muscular ridge and ventrally by an incomplete inter ventricular septum.

Keywords: aorta, atrium, heart, sea snake, sinus venosus, ventricle

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Authors: Caroline Rocco, Feyza Karasu, Céline Croutxé-Barghorn, Xavier Allonas, Maxime Lecompère, Gérard Riess, Yujing Zhang, Catarina Esteves, Leendert van der Ven, Rolf van Benthem Gijsbertus de With

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Acrylates are widely used in UV-curing technology. Their high reactivity can, however, limit their conversion due to early vitrification. In addition, the free radical photopolymerization is known to be sensitive to oxygen inhibition leading to tacky surfaces. Although epoxides can lead to full polymerization, they are sensitive to humidity and exhibit low polymerization rate. To overcome the intrinsic limitations of both classes of monomers, Interpenetrating Polymer Networks (IPNs) can be synthesized. They consist of at least two cross linked polymers which are permanently entangled. They can be achieved under thermal and/or light induced polymerization in one or two steps approach. IPNs can display homogeneous to heterogeneous morphologies with various degrees of phase separation strongly linked to the monomer miscibility and also synthesis parameters. In this presentation, we synthesize UV-cured methacrylate - epoxide based IPNs with different chemical compositions in order to get a better understanding of their formation and phase separation. Miscibility before and during the photopolymerization, reaction kinetics, as well as mechanical properties and morphology have been investigated. The key parameters controlling the morphology and the phase separation, namely monomer miscibility and synthesis parameters have been identified. By monitoring the stiffness changes on the film surface, atomic force acoustic microscopy (AFAM) gave, in conjunction with polymerization kinetic profiles and thermomechanical properties, explanations and corroborated the miscibility predictions. When varying the methacrylate / epoxide ratio, it was possible to move from a miscible and highly-interpenetrated IPN to a totally immiscible and phase-separated one.

Keywords: investigation of properties and morphology, kinetics, phase separation, UV-cured IPNs

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Authors: Elizaveta Petelina, Anton Sizo

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Environmental remediation projects deal with a wide spectrum of data, including data collected during site assessment, execution of remediation activities, and environmental monitoring. Therefore, an appropriate data management is required as a key factor for well-grounded decision making. The Environmental Data Management System (EDMS) was developed to address all necessary data management aspects, including efficient data handling and data interoperability, access to historical and current data, spatial and temporal analysis, 2D and 3D data visualization, mapping, and data sharing. The system focuses on support of well-grounded decision making in relation to required mitigation measures and assessment of remediation success. The EDMS is a combination of enterprise and desktop level data management and Geographic Information System (GIS) tools assembled to assist to environmental remediation, project planning, and evaluation, and environmental monitoring of mine sites. EDMS consists of seven main components: a Geodatabase that contains spatial database to store and query spatially distributed data; a GIS and Web GIS component that combines desktop and server-based GIS solutions; a Field Data Collection component that contains tools for field work; a Quality Assurance (QA)/Quality Control (QC) component that combines operational procedures for QA and measures for QC; Data Import and Export component that includes tools and templates to support project data flow; a Lab Data component that provides connection between EDMS and laboratory information management systems; and a Reporting component that includes server-based services for real-time report generation. The EDMS has been successfully implemented for the Project CLEANS (Clean-up of Abandoned Northern Mines). Project CLEANS is a multi-year, multimillion-dollar project aimed at assessing and reclaiming 37 uranium mine sites in northern Saskatchewan, Canada. The EDMS has effectively facilitated integrated decision-making for CLEANS project managers and transparency amongst stakeholders.

Keywords: data management, environmental remediation, geographic information system, GIS, decision making

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Authors: Tesfaye Walle Mekonnen

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Maize is one of the most important staple food crops for most low-income households in the Sub-Saharan (SSA). Combined heat and drought stress is the major production threats that reduce the yield potential of biofortified maize and restrain various macro and micronutrient deficiencies highly prevalent in low-income people who rely solely on maize-based diets, SSA. This problem can be alleviated by crossing the biofortified inbred lines with different nutritional attributes, Fe, Zn, Protein, and Provitamin A, and developing agronomically superior and stable multi-nutrient maize of various genetic backgrounds. This aimed to understand the correlation between biofortified inbred lines per se and hybrid performance under combined heat and drought stress conditions (CSC). The experiment was conducted at CIMMYT, Zimbabwe, using α-lattice design with three replications. The hybrid effect was highly significant for zein fractions (α-, β-, γ- and δ-zein) zinc, (Zn), and iron (Fe) provitamin A, phytic acid, and grain yield. Under CSC, Fe, Zn concentration, provitamin A in grain and grain yield of hybrids were significantly decreased, however, the zein fraction content and phytic acid content increases in grain were increased under CSC. The phenotypic correlation between grain yield with Zn, Fe concentration, and Provitamin A in grain was strongly positive and higher under CSC than in well-watered conditions. The present investigation confirmed that under CSC, Fe, and Zn-enhanced hybrids could be forecasted to a certain scope based on the performance of and scientifically selected for desirable grain yield and related traits with CSC tolerance during hybrid development programs. In conclusion, the development of high-yielding and micronutrient-dense maize variety is possible under CSC, which could reduce the highly prevalent micronutrient in SSA.

Keywords: drought, Fe, heat, maize, protein, zein fractions, Zn

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Authors: Bhaumik Patel, Amit Gotecha

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Commercial centres of different hierarchy and sizes play a vital role in the growth and development of the city. Economic uncertainty and demand for space leads to more urban sprawl and emerging more commercial spaces. The study was focused on the understanding of various indicators affecting the commercial development that can help to solve many issues related to commercial urban development and can guide for future employment growth centre development, Accessibility, Infrastructure, Planning and development regulations and Market forces. The aim of the study was to review characteristics and identifying employment density of Commercial Employment Sub-centres by achieving objectives Understanding various employment sub-centres, Identifying characteristics and deriving behaviour of employment densities and Evaluating and comparing employment sub-centres for the Ahmedabad city. Commercial employment sub-centres one in old city (Kalupur), second in highly developed commercial (C.G.road-Ashram road) and third in the latest developing commercial area (Prahladnagar) were identified by distance from city centre, Land use diversity, Access to Major roads and Public transport, Population density in proximity, Complimentary land uses in proximity and Land price. Commercial activities were categorised into retail, wholesale and service sector and sub categorised into various activities. From the study, Time period of establishment of the unit is a critical parameter for commercial activity, building height, and land-use diversity. Employment diversity is also one parameter for the commercial centre. The old city has retail, wholesale and trading and higher commercial density concerning units and employment both. Prahladnagar area functioned as commercial due to market pressure and developed as more units rather than a requirement. Employment density is higher in the centre of the city, as far as distance increases from city centre employment density and unit density decreases. Characters of influencing employment density and unit density are distance from city centre, development type, establishment time period, building density, unit density, public transport accessibility and road connectivity.

Keywords: commercial employment sub-centres, employment density, employment diversity, unit density

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Authors: Vidhi Chandra, Arshpreet Singh Grewal

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A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

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Authors: Emineh Tsegahun Gedif

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Zinc oxide nanoparticles (ZnO NPs) have garnered significant attention due to their diverse applications encompassing catalytic, optical, photonic, and antibacterial properties. In this study, we successfully synthesized zinc oxide nanoparticles using a rapid, environmentally benign, and cost-effective method. Neem (Azadirachta indica) leaf extract served as the reducing agent for Zn (NO₃)₂.6H2O solution under optimized conditions (pH = 9). Qualitative screening techniques and FT-IR Spectroscopy confirmed the presence of active biomolecules such as flavonoids, phenolic groups, alkaloids, terpenoids, and tannins within the Neem leaf extract, both before and after reduction. The formation of ZnO NPs was visually evident through a distinct color change from colorless to light yellow. The biosynthesized nanoparticles underwent comprehensive characterization through UV-visible, FT-IR, and XRD spectroscopies. The reduction process proved to be straightforward and user-friendly, with UV-visible spectroscopy demonstrating a surface plasmon resonance (SPR) at 321 nm, unequivocally confirming the ZnO NP formation. X-ray diffraction analysis elucidated the crystal structure, revealing an average particle size of approximately 20 nm using Scherrer's equation based on the line width of the plane. Furthermore, the synthesized zinc oxide nanoparticles were evaluated for their antimicrobial properties against both Gram-positive and Gram-negative bacteria. The results showcased significant inhibitory activity, with the highest zone of inhibition observed against Escherichia coli (15 mm) and comparatively lower activity against Staphylococcus aureus. This research underscores the potential of Neem leaf extract-mediated synthesis of ZnO NPs as an eco-friendly and effective approach for various applications, including antibacterial agents.

Keywords: zinc oxide nanoparticles (ZnO NPs), bioreducing agent, green synthesis, antibacterial activity

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Authors: Djebbar Atmani, Dina Kilani, Tristan Richard

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Medicinal plants are an important source for the discovery of potential new substances for use in medicine and food. Pistacia lentiscus, Fraxinus angustifolia and Clematis flammula, plants growing in the Mediterranean basin, are widely used in traditional medicine. Therefore, the present study was designed to investigate their antioxidant, anti-inflammatory, antidiabetic, anti-mutagenic/genotoxic and neuroprotective potential and identification of active compounds using appropriate methodology. Plant extracts and fractions exhibited high scavenging capacity against known radicals, enhanced superoxide dismutase and catalase activitiesand restored blood glucose levels, in vivo, to normal values, in agreement with the in vitro enzymatic inhibition data, through inhibition of amylase and glucosidase activities. Administration of Pistacia lentiscus extracts significantly decreased carrageenan-induced mice paw oedema and reduced effectively IL-1β levels in cell culture, whereas Fraxinus angustifolia extracts showed good healing capacity against wounds when applied topically on rabbits. Pistacia lentiscus and Fraxinus angustifolia extracts showed good neuro-protection and restored cognitive functions in mice, while Clematis flammula extracts showed potent anti-ulcerogenic activity associated to a promising anti-mutagenic/genotoxic activity. HPLC-MS and NMR analyses allowed the identification and structural elucidation of several known and new anthocyanins, flavonols and flavanols. Therefore, Pistacia lentiscus, Fraxinus angustifolia and Clematis flammulacould be used in palliative treatments against inflammatory conditions and diabetes complications, as well as against deterioration of cognitive functions.

Keywords: pistacia lentiscus, clematis flammula, fraxinus angustifolia, phenolic compounds, biological activity

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Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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Authors: Meng-Li Lin, Shang-Hsuan Chiu

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Taiwan is a country of diverse ethnic groups, the historical background of each ethnic group is different, and the conflict between them influence on each other, result in Taiwan's multi-culture. The Changhua County in Taiwan is the largest county of Hoklo-Hakka. Hakka people get along with Hoklo people for a long time. There are integration and conflict during that time and makes Hakka people gradually assimilated Hoklo-Hakka people. Today in Changhua Plain area, many Hoklo-Hakka people do not speak Hakka language. Therefore, it has been difficult to find information of Hakka from the Hakka language in the group of Hoklo-Hakka. But in the living space or culture to find relevant historical traces of life could be confirmed in Hakka Culture. In this paper, through the investigation of descent, life field, religion, language and other investigations of the Dacun, Changhua County residents to carry out the analysis of the process of assimilating Hoklo in living cultural landscape. First is through the local literature, the elderly and other oral history stories, to investigate the changes in Dacun field historical. Second, the comparison of collected traditional Hakka culture and the living cultural landscape of Hoklo-Haka are done to explore the differences between the living cultural landscape and the traditional Hakka culture. After analysis Hoklo-Hakka living cultural landscape, the significant differences, we proposed preservation strategy to provide recommendations to save the cultural life of Hoklo-Hakka landscape in future. Changhua Dacun traditional Hakka landscape is disappearing, in this study, we explore and investigate the data of Changhua Dacun Hoklo-Hakka living cultural landscape to analyze and to provide strategic advice to save. Here we have three study purposes. 1. Discuss the Hoklo-Hakka living cultural landscape of Changhua Dacun. 2. Investigate and record the Hoklo-Hakka living cultural landscape. 3. Propose a reserve strategy of the Hoklo-Hakka living cultural landscape in future.

Keywords: Hoklo-Hakka, Dacun, save policy, life Culture

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Authors: W. C. Lucas, S. Titus, M. E. M. Young

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Gymnastics is the umbrella term that represents seven different and unique disciplines of gymnastics. Men and women of all ages and abilities practice this sport, and participation in gymnastics can develop both gross and fine motor skills, strength, flexibility, coordination and balance. There are various social factors, such as a family’s socioeconomic status or accessibility to sports facilities that may play a role in affecting levels of participation. The aim of this study is to investigate the social factors that have an influence on gymnastics participation in the Western Cape. To this end, a qualitative approach is adopted to collect data. This study also adopts the ecological systems theory as the theoretical framework, and is used to analyze and interpret current social factors that directly or indirectly influence participation in gymnastics. The study’s objectives were to ascertain which social factors hinder participation, and which social factors promote participation, thus, coaches, parents and gymnasts participated in focus group discussions. Key informant interviews took place with experts in the field of gymnastics in the Western Cape. A thematic analysis was conducted on transcriptions from the focus group discussions and key informant interviews. Social factors investigated in this study occurred in the chronosystem, macrosystem, exosystem, mesosystem, and microsystem, and had both a direct and indirect influence on the gymnast’s continued participation. These systems are defined as the environment of the individual, in which they grow and develop. The research findings of this paper are used to draw conclusions and make specific recommendations for practice and further research. The information gathered in this study can assist all stakeholders within the field of gymnastics, such as parents, judges, coaches, gymnasts, and the supporting community which surround the participating gymnast.

Keywords: developing child, ecological systems theory, facilities, federation, gymnastics, influence, participation, social factors, socioeconomic status, sport

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Authors: Kayode Ilesanmi Ebenezer Bowale, Dominic Azuh, Busayo Aderounmu, Alfred Ilesanmi

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There has been a debate among scholars and policymakers about the effects of oil exploration and production on industrial development. In Nigeria, there were many reforms resulting in an increase in crude oil production in the recent past. There is a controversy on the importance of oil production in the development of the manufacturing sector in Nigeria. Some scholars claim that oil has been a blessing to the development of the manufacturing sector, while others regard it as a curse. The objective of the study is to determine if empirical analysis supports the presence of Dutch Disease and de-industrialisation in the Nigerian manufacturing sector between 2019- 2022. The study employed data that were sourced from World Development Indicators, Nigeria Bureau of Statistics, and the Central Bank of Nigeria Statistical Bulletin on manufactured exports, manufacturing employment, agricultural employment, and service employment in line with the theory of Dutch Disease using the unit root test to establish their level of stationarity, Engel and Granger cointegration test to check their long-run relationship. Autoregressive. Distributed Lagged bound test was also used. The Vector Error Correction Model will be carried out to determine the speed of adjustment of the manufacturing export and resource movement effect. The results showed that the Nigerian manufacturing industry suffered from both direct and indirect de-industrialisation over the period. The findings also revealed that there was resource movement as labour moved away from the manufacturing sector to both the oil sector and the services sector. The study concluded that there was the presence of Dutch Disease in the manufacturing industry, and the problem of de-industrialisation led to the crowding out of manufacturing output. The study recommends that efforts should be made to diversify the Nigerian economy. Furthermore, a conducive business environment should be provided to encourage more involvement of the private sector in the agriculture and manufacturing sectors of the economy.

Keywords: Dutch disease, resource movement, manufacturing sector performance, Nigeria

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Authors: Yu-Ching Liu

Abstract:

Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.

Keywords: family caregiver, Long-term care, work-life balance, decision-making

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Authors: Seyedeh Mozhgan Seyed Talebi, Chih -Hao Lee

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With an abrupt rise in the power conservation efficiency (PCE) of perovskite solar cells (PSCs) within a short span of time, the toxicity of lead was raised as a major hurdle in the path toward their commercialization. In the present research, a systematic investigation of the electrical and optical characteristics of the all-inorganic CsSnI₃ perovskite absorber layer was performed with the Vienna Ab Initio Simulation Package (VASP) using the projector-augmented wave method. The presence of inorganic halide perovskite offers the advantages of enhancing the degradation resistance of the device, reducing the cost of cells, and minimizing the recombination of generated carriers. The simulated standard device using a 1D simulator like solar cell capacitance simulator (SCAPS) version 3308 involves FTO/n-TiO₂/CsSnI₃ Perovskite absorber/Spiro OmeTAD HTL/Au contact layer. The variation in the device design key parameters such as the thickness and defect density of perovskite absorber, hole transport layer and electron transport layer and interfacial defects are examined with their impact on the photovoltaic characteristic parameters. The effect of an increase in operating temperature from 300 K to 400 K on the performance of CsSnI3-based perovskite devices is also investigated. The optimized standard device at room temperature shows the highest PCE of 25.18 % with FF of 75.71 %, Voc of 0.96 V, and Jsc of 34.67 mA/cm². The outcomes and interpretation of different inorganic Cu-based HTLs presence, such as CuSCN, Cu₂O, CuO, CuI, SrCu₂O₂, and CuSbS₂, here represent a critical avenue for the possibility of fabricating high PCE perovskite devices made of stable, low-cost, efficient, safe, and eco-friendly all-inorganic materials like CsSnI₃ perovskite light absorber.

Keywords: CsSnI₃, hole transporting layer (HTL), lead-free perovskite solar cell, SCAPS-1D software

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Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran

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This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.

Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure

Procedia PDF Downloads 80