Search results for: airy stress function

Authors: Lorenzo Buti

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This paper investigates the nature of democratic action through a critical reading of Claude Lefort’s notion of the democratic ‘regime’. Lefort provides one of the most innovative accounts of the essential features of a democratic regime. According to him, democracy is a political regime that acknowledges the indeterminacy of a society and stages it as a contestation between competing political actors. As such, democracy provides the symbolic markers of society’s openness towards the future. However, despite their democratic features, the recent decades in late capitalist societies attest to a sense of the future becoming fixed and predetermined. This suggests that Lefort’s conception of democracy harbours a misunderstanding of the character and experience of democratic action. This paper examines this underlying tension in Lefort’s work. It claims that Lefort underestimates how a democratic regime, next to its symbolic function, also takes a materially constituted form with its particular dynamics of power relations. Lefort’s systematic dismissal of this material dimension for democratic action can lead to the contemporary paradoxical situation where democracy’s symbolic markers are upheld (free elections, public debate, dynamic between government and opposition in parliament,…) but the room for political decision-making is constrained due to a myriad of material constraints (e.g., market pressures, institutional inertias). The paper draws out the implications for the notion of democratic action. Contra Lefort, it argues that democratic action necessarily targets the material conditions that impede the capacity for decision-making on the basis of equality and liberty. This analysis shapes our understanding of democratic action in two ways. First, democratic action takes an asymmetrical, insurgent form, as a contestation of material power relations from below. Second, it reveals an ambivalent position vis-à-vis the political regime: democratic action is symbolically made possible by the democratic dispositive, but it contests the constituted form that the democratic regime takes.

Keywords: Claude Lefort, democratic action, material constitution, political regime

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Authors: Deepshikha Shukla, C. H. Solanki, Mayank Desai

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In the last few years, it has been observed that earthquake is proving a threat to the scientist across the world. With a large number of earthquakes occurring in day to day life, the threat to life and property has increased manifolds which call for an urgent attention of all the researchers globally to carry out the research in the field of Earthquake Engineering. Any hazard related to the earthquake and seismicity is considered to be seismic hazards. The common forms of seismic hazards are Ground Shaking, Structure Damage, Structural Hazards, Liquefaction, Landslides, Tsunami to name a few. Among all the natural hazards, the most devastating and damaging is the earthquake as all other hazards are triggered only after the occurrence of an earthquake. In order to quantify and estimate the seismicity and seismic hazards, many methods and approaches have been proposed in the past few years. Such approaches are Mathematical, Conventional and Computational. Convex Set Theory, Empirical Green’s Function are some of the Mathematical Approaches whereas the Deterministic and Probabilistic Approaches are the Conventional Approach for the estimation of the seismic Hazards. Ground response and Ground Shaking of a particular area or region plays an important role in the damage caused due to the earthquake. In this paper, seismic study using Deterministic Approach and 1 D Ground Response Analysis has been carried out for Madhya Pradesh Tourism Office in Indore Region in Madhya Pradesh in Central India. Indore lies in the seismic zone III (IS: 1893, 2002) in the Seismic Zoning map of India. There are various faults and lineament in this area and Narmada Some Fault and Gavilgadh fault are the active sources of earthquake in the study area. Deepsoil v6.1.7 has been used to perform the 1 D Linear Ground Response Analysis for the study area. The Peak Ground Acceleration (PGA) of the city ranges from 0.1g to 0.56g.

Keywords: seismicity, seismic hazards, deterministic, probabilistic methods, ground response analysis

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Authors: Titanilla Komenda

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Human-machine-collaboration defines a direct interaction between humans and machines to fulfil specific tasks. Those so-called collaborative machines are used without fencing and interact with humans in predefined workspaces. Even though, human-machine-collaboration enables a flexible adaption to variable degrees of freedom, industrial applications are rarely found. The reasons for this are not technical progress but rather limitations in planning processes ensuring safety for operators. Until now, humans and machines were mainly considered separately in the planning process, focusing on ergonomics and system performance respectively. Within human-machine-collaboration, those aspects must not be seen in isolation from each other but rather need to be analysed in interaction. Furthermore, a simulation model is needed that can validate the system performance and ensure the safety for the operator at any given time. Following on from this, a holistic simulation model is presented, enabling a simulative representation of collaborative tasks – including both, humans and machines. The presented model does not only include a geometry and a motion model of interacting humans and machines but also a numerical behaviour model of humans as well as a Boole’s probabilistic sensor model. With this, error scenarios can be simulated by validating system behaviour in unplanned situations. As these models can be defined on the basis of Failure Mode and Effects Analysis as well as probabilities of errors, the implementation in a collaborative model is discussed and evaluated regarding limitations and simulation times. The functionality of the model is shown on industrial applications by comparing simulation results with video data. The analysis shows the impact of considering human factors in the planning process in contrast to only meeting system performance. In this sense, an optimisation function is presented that meets the trade-off between human and machine factors and aids in a successful and safe realisation of collaborative scenarios.

Keywords: human-machine-system, human-robot-collaboration, safety, simulation

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Authors: Athicha Cherdpunt, Patompong Satapornpong

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The medical cannabis is made up of components also known as cannabinoids, which consists of two ingredients which are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Interestingly, the Cannabinoid can be used for many treatments such as chemotherapy, including nausea and vomiting, cachexia, anorexia nervosa, spinal cord injury and disease, epilepsy, pain, and many others. However, the adverse drug reactions (ADRs) of THC can cause sedation, anxiety, dizziness, appetite stimulation and impairments in driving and cognitive function. Furthermore, genetic polymorphisms of CYP2C9, CYP2C19 and CYP3A4 influenced the THC metabolism and might be a cause of ADRs. Particularly, CYP2C19*17 allele increases gene transcription and therefore results in ultra-rapid metabolizer phenotype (UM). The aim of this study, is to investigate the frequency of CYP2C19*17 alleles in Thai patients who have been treated with medical cannabis. We prospectively enrolled 60 Thai patients who were treated with medical cannabis and clinical data from College of Pharmacy, Rangsit University. DNA of each patient was isolated from EDTA blood, using the Genomic DNA Mini Kit. CYP2C19*17 genotyping was conducted using the real time-PCR ViiA7 (ABI, Foster City, CA, USA). 30 patients with medical cannabis-induced ADRs group, 20 (67%) were female, and 10 (33%) were male, with an age range of 30-69 years. On the other hand, 30 patients without medical cannabis-induced ADRs (control group) consist of 17 (57%) female and 13 (43%) male. The most ADRs for medical cannabis treatment in the case group were dry mouth and dry throat (77%), tachycardia (70%), nausea (30%) and arrhythmia(10%). Accordingly, the case group carried CYP2C19*1/*1 (normal metabolizer) approximately 93%, while 7% patients carrying CYP2C19*1/*17 (ultra rapid metabolizers) exhibited in this group. Meanwhile, we found 90% of CYP2C19*1/*1 and 10% of CYP2C19*1/*17 in control group. In this study, we identified the frequency of CYP2C19*17 allele in Thai population which will support the pharmacogenetics biomarkers for screening and avoid ADRs of medical cannabis treatment.

Keywords: CYP2C19, allele frequency, ultra rapid metabolizer, medical cannabis

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Authors: Emad A. S. Abu-Ayyash

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Cohesive devices, the linguistic tools that are usually employed to hold the different parts of the text together, have been the focus of a significant number of discourse analysis studies. These linguistic tools have grabbed the attention of researchers since the inception of the first and most comprehensive model of cohesion in 1976. However, it was noticed that some cohesive devices (e.g., endophoric reference, conjunctions, ellipsis, substitution, and lexical ties) – being thought of as more popular than others (e.g., exophoric reference) – were over-researched. The present paper explores the usage of two cohesive devices that have been evidently almost absent from discourse analysis studies. These cohesive devices are exophoric and homophoric references, the linguistic items that can be interpreted in terms of the physical and cultural contexts of discourse. The significance of the current paper, therefore, stems from the fact that it attempts to fill a gap in the research conducted so far on cohesive devices. This study provides an explanation of the concepts of the cohesive devices that have been employed in a plethora of research on cohesion and elucidates the relevant context-related concepts. The paper also identifies the gap in cohesive devices research. Exophora and homophora, the least visited cohesive devices in previous studies, were qualitatively and quantitatively explored in six opinion articles, four produced by eight postgraduate English as a Foreign Language (EFL) students in a university in the United Arab Emirates and two by professional NS writers in the Independent and the Guardian. The six pieces were about the United Kingdom Independent Party (UKIP) leader’s call to ban the burqa in the UK and were analysed vis-a-vis the employment and function of homophora and exophora. The study found that both EFL students and native speakers employed exophora and homophora considerably in their writing to serve a variety of functions, including building assumptions, supporting main ideas, and involving the readers among others.

Keywords: cohesive devices, context, culture, exophoric reference, homophoric reference

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Authors: Citlali Aguilera Lira, David Lynch Steinicke, Andrea León García

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One of the challenges that higher education faces is to find how to approach the sustainability in an inclusive way to the student within all the different academic areas, how to move the sustainable development from the abstract field to the operational field. This research comes from the ecoliteracy and the pedagogical praxis as tools for rebuilding the teaching processes inside of universities. The purpose is to determine and describe which are the factors involved in the process of learning particularly in the Greenhouse-School Siembra UV. In the Greenhouse-School Siembra UV, of the University of Veracruz, are cultivated vegetables, medicinal plants and small cornfields under the usage of eco-technologies such as hydroponics, Wickingbed and Hugelkultur, which main purpose is the saving of space, labor and natural resources, as well as function as agricultural production alternatives in the urban and periurban zones. The sample was formed with students from different academic areas and who are actively involved in the greenhouse, as well as institutes from the University of Veracruz and governmental and non-governmental departments. This project comes from a pedagogic praxis approach, from filling the needs that the different professional profiles of the university students have. All this with the purpose of generate a pragmatic dialogue with the sustainability. It also comes from the necessity to understand the factors that intervene in the students’ praxis. In this manner is how the students are the fundamental unit in the sphere of sustainability. As a result, it is observed that those University of Veracruz students who are involved in the Greenhouse-school, Siembra UV, have enriched in different levels the sense of urban and periurban agriculture because of the diverse academic approaches they have and the interaction between them. It is concluded that the eco-technologies act as fundamental tools for ecoliteracy in society, where it is strengthen the nutritional and food security from a sustainable development approach.

Keywords: farming eco-technologies, food security, multidisciplinary, pedagogical praxis

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Authors: Abdullah Alassiri

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Prompted by the widespread saturation of Facebook usage in Saudi Arabia, among university students to socialize with online members, this study investigated the usage, self-presentation, psychological and sociological consequences of the Facebook social networking site among undergraduate students in Saudi Arabia. The problem statement of this study was addressed by answering the following questions: 1) What motivation do undergraduate students have for joining Facebook? 2) How do undergraduate students consume Facebook? 3) In what condition do undergraduate students need Facebook? 4) How do undergraduate students manage their self-presentation via Facebook? 5) What are the experiences obtained by the undergraduate students from Facebook psychologically? 6) What are the experiences obtained by the undergraduate students from Facebook sociologically? 7) How have Facebook activities affected the lifestyle of the undergraduate students?. These questions were answered by analyzing in-depth interview data collected from twenty male undergraduate students between the ages of 18 and 24 years selected from King Saud University (KSU) and King Khalid University (KKU) Saudi Arabia. Using thematic analysis, informants data were coded ‘R1 to R20’, validated and was transcribed to minimize error from translating into the study items from Arabic back to the English Language. Using purposive sampling method, informant perspective within the research context were explored. Data collection was confined to students’ motivations for engaging in online activities, self-presentation, psychological and sociological consequences to their everyday life was investigated based on the theoretical and philosophical perspective underpinnings media and gratification paradigm and social influence theory. The findings contributed to the development of important study themes that supported the development of a new research framework. Based on the analysis, all the study questions were answered. The findings of this study showed that the students use Facebook for the purpose of interacting with others, getting information and as knowledge sources. In terms of self-presentation, this study revealed that the students portray themselves in the real and not fake image while socializing with others. Psychological and sociological consequences from the usage of Facebook are recorded ranging from cheerful to stress and from loneliness to having many friends. As a conclusion, this study conclusively drew that Facebook is a very persuasive medium of communication among the University students in Saudi Arabia that bridges across socio-cultural boundaries and unite students to interact as a community.

Keywords: Saudi Arabia, Facebook, undergraduate students, social network

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Ozan Yavuz Baytemir, Ender Cigeroglu, Gokhan Osman Ozgen

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Vibration is an important issue in the design of various components of aerospace, marine and vehicular applications. In order not to lose the components’ function and operational performance, vibration isolation design involving the optimum isolator properties selection and isolator positioning processes appear to be a critical study. Knowing the growing need for the vibration isolation system design, this paper aims to present two types of software capable of implementing modal analysis, response analysis for both random and harmonic types of excitations, static deflection analysis, Monte Carlo simulations in addition to study of parameter and location optimization for different types of isolation problem scenarios. Investigating the literature, there is no such study developing a software-based tool that is capable of implementing all those analysis, simulation and optimization studies in one platform simultaneously. In this paper, the theoretical system model is generated for a 6-DOF rigid body. The vibration isolation system of any mechanical structure is able to be optimized using hybrid method involving both global search and gradient-based methods. Defining the optimization design variables, different types of optimization scenarios are listed in detail. Being aware of the need for a user friendly vibration isolation problem solver, two types of graphical user interfaces (GUIs) are prepared and verified using a commercial finite element analysis program, Ansys Workbench 14.0. Using the analysis and optimization capabilities of those GUIs, a real application used in an air-platform is also presented as a case study at the end of the paper.

Keywords: hybrid optimization, Monte Carlo simulation, multi-degree-of-freedom system, parameter optimization, location optimization, passive vibration isolation analysis

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Authors: Garima Singh, Kunal Malhotra

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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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Authors: Mostafa Mjahed

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This paper concerns the control of a nonlinear system using two different methods, reference model and genetic algorithm. The quadcopter is a nonlinear unstable system, which is a part of aerial robots. It is constituted by four rotors placed at the end of a cross. The center of this cross is occupied by the control circuit. Its motions are governed by six degrees of freedom: three rotations around 3 axes (roll, pitch and yaw) and the three spatial translations. The control of such system is complex, because of nonlinearity of its dynamic representation and the number of parameters, which it involves. Numerous studies have been developed to model and stabilize such systems. The classical PID and LQ correction methods are widely used. If the latter represent the advantage to be simple because they are linear, they reveal the drawback to require the presence of a linear model to synthesize. It also implies the complexity of the established laws of command because the latter must be widened on all the domain of flight of these quadcopter. Note that, if the classical design methods are widely used to control aeronautical systems, the Artificial Intelligence methods as genetic algorithms technique receives little attention. In this paper, we suggest comparing two PID design methods. Firstly, the parameters of the PID are calculated according to the reference model. In a second phase, these parameters are established using genetic algorithms. By reference model, we mean that the corrected system behaves according to a reference system, imposed by some specifications: settling time, zero overshoot etc. Inspired from the natural evolution of Darwin's theory advocating the survival of the best, John Holland developed this evolutionary algorithm. Genetic algorithm (GA) possesses three basic operators: selection, crossover and mutation. We start iterations with an initial population. Each member of this population is evaluated through a fitness function. Our purpose is to correct the behavior of the quadcopter around three axes (roll, pitch and yaw) with 3 PD controllers. For the altitude, we adopt a PID controller.

Keywords: quadcopter, genetic algorithm, PID, fitness, model, control, nonlinear system

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Authors: Magdalena B. Kaziuk, Waldemar Kosiba

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Background: In the XXI century we have to deal with the epidemic of obesity which is important risk factor for the cardiovascular and kidney diseases. Lipo proteins are directly involved in the atherosclerotic process. Non-high-density lipo protein (non-HDL) began following widespread recognition of its superiority over LDL as a measurement of vascular event risk. Non-HDL includes residual risk which persists in patients after achieved recommended level of LDL. Materials and Methods: The study covered 111 patients (52 females, 59 males, age 51,91±14 years), hospitalized on the intern department. Body composition was assessed using the bioimpendance method and anthropometric measurements. Physical activity data were collected during the interview. The nutritional status and the obesity type were determined with the Waist to Height Ratio and the Waist to Hip Ratio. A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using MDRD formula. Non-HDL was calculated as a difference between concentration of the Total and HDL cholesterol. Results: 10% of patients were found to be underweight; 23.9 % had correct body weight; 15,08 % had overweight, while the remaining group had obesity: 51,02 %. People with the android shape have higher non-HDL cholesterol versus with the gynoid shape (p=0.003). The higher was non-HDL, the lower eGFR had studied subjects (p < 0.001). Significant correlation was found between high non-HDL and incorrect dietary habits in patients avoiding eating vegetables, fruits and having low physical activity (p < 0.005). Conclusions: Android type of figure raises the residual risk of the heart disease associated with higher levels of non-HDL. Increasing physical activity in these patients reduces the level of non-HDL. Non-HDL seems to be the best predictor among all cholesterol measures for the cardiovascular events and worsening eGFR.

Keywords: obesity, non-HDL cholesterol, glomerular filtration rate, lifestyle

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Authors: А. I. Dovgyalo, S. O. Nekrasova, D. V. Sarmin, A. A. Shimanov, D. A. Uglanov

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Usually liquefied natural gas (LNG) gasification is performed due to atmospheric heat. In order to produce a liquefied gas a sufficient amount of energy is to be consumed (about 1 kW∙h for 1 kg of LNG). This study offers a number of solutions, allowing using a cold energy of LNG. In this paper it is evaluated the application turbines installed behind the evaporator in LNG complex due to its work additional energy can be obtained and then converted into electricity. At the LNG consumption of G=1000kg/h the expansion work capacity of about 10 kW can be reached. Herewith-open Rankine cycle is realized, where a low capacity cryo-pump (about 500W) performs its normal function, providing the cycle pressure. Additionally discussed an application of Stirling engine within the LNG complex also gives a possibility to realize cold energy. Considering the fact, that efficiency coefficient of Stirling engine reaches 50 %, LNG consumption of G=1000 kg/h may result in getting a capacity of about 142 kW of such a thermal machine. The capacity of the pump, required to compensate pressure losses when LNG passes through the hydraulic channel, will make 500 W. Apart from the above-mentioned converters, it can be proposed to use thermoelectric generating packages (TGP), which are widely used now. At present, the modern thermoelectric generator line provides availability of electric capacity with coefficient of efficiency up to 15%. In the proposed complex, it is suggested to install the thermoelectric generator on the evaporator surface is such a way, that the cold end is contacted with the evaporator’s surface, and the hot one – with the atmosphere. At the LNG consumption of G=1000 kgг/h and specified coefficient of efficiency the capacity of the heat flow Qh will make about 32 kW. The derivable net electric power will be P=4,2 kW, and the number of packages will amount to about 104 pieces. The carried out calculations demonstrate the research perceptiveness in this field of propulsion plant development, as well as allow realizing the energy saving potential with the use of liquefied natural gas and other cryogenics technologies.

Keywords: cold energy, gasification, liquefied natural gas, electricity

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Authors: Firas Daghistani, Hossam Abuel Naga

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Waste tyres is a global problem that has a negative effect on the environment, where there are approximately one billion waste tyres discarded worldwide yearly. Waste tyres are discarded in stockpiles, where they provide harm to the environment in many ways. Finding applications to these materials can help in reducing this global problem. One of these applications is recycling these waste materials and using them in geotechnical engineering. Recycled waste tyre particulates can be mixed with sand to form a lightweight material with varying shear strength characteristics. Contradicting results were found in the literature on the inclusion of particulate rubber to sand, where some experiments found that the inclusion of particulate rubber can increase the shear strength of the mixture, while other experiments stated that the addition of particulate rubber decreases the shear strength of the mixture. This research further investigates the inclusion of particulate rubber to sand and whether it can increase or decrease the shear strength characteristics of the mixture. For the experiment, a series of direct shear tests were performed on a poorly graded sand with a mean particle size of 0.32 mm mixed with recycled poorly graded particulate rubber with a mean particle size of 0.51 mm. The shear tests were performedon four normal stresses 30, 55, 105, 200 kPa at a shear rate of 1 mm/minute. Different percentages ofparticulate rubber content were used in the mixture i.e., 10%, 20%, 30% and 50% of sand dry weight at three density states, namely loose, slight dense, and dense state. The size ratio of the mixture,which is the mean particle size of the particulate rubber divided by the mean particle size of the sand, was 1.59. The results identified multiple parameters that can influence the shear strength of the mixture. The parameters were: normal stress, particulate rubber content, mixture gradation, mixture size ratio, and the mixture’s density. The inclusion of particulate rubber tosand showed a decrease to the internal friction angle and an increase to the apparent cohesion. Overall, the inclusion of particulate rubber did not have a significant influenceon the shear strength of the mixture. For all the dense states at the low normal stresses 33 and 55 kPa, the inclusion of particulate rubber showed aslight increase in the shear strength where the peak was at 20% rubber content of the sand’s dry weight. On the other hand, at the high normal stresses 105, and 200 kPa, there was a slight decrease in the shear strength.

Keywords: shear strength, direct shear, sand-rubber mixture, waste material, granular material

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Authors: Tanja Ecken, Laura Fricke, Anika Steger, Maren M. Michaelsen, Tobias Esch

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Studies and applied experiences evidence severe and traumatic accidents to not only require physical rehabilitation and recovery but also to necessitate a psychological adaption and reorganization to the changed living conditions. Neurobiological models underpinning the experience of happiness and satisfaction postulate life shocks to potentially enhance the experience of happiness and life satisfaction, i.e., posttraumatic growth (PTG). This present study aims to provide an in-depth understanding of the underlying psychological processes of PTG and to outline its consequences on subjective happiness and life satisfaction. To explore the aforementioned, Esch’s (2022) ABC Model was used as guidance for the development of a questionnaire assessing changes in happiness and life satisfaction and for a schematic model postulating the development of PTG in the context of paraplegia. Two-stage qualitative interview procedures explored participants’ experiences of paraplegia. Specifically, narrative, semi-structured interviews (N=28) focused on the time before and after the accident, the availability of supportive resources, and potential changes in the perception of happiness and life satisfaction. Qualitative analysis (Grounded Theory) indicated an initial phase of reorganization was followed by a gradual psychological adaption to novel, albeit reduced, opportunities in life. Participants reportedly experienced a ‘compelled’ slowing down and elements of mindfulness, subsequently instilling a sense of gratitude and joy in relation to life’s presumed trivialities. Despite physical limitations and difficulties, participants reported an enhanced ability to relate to oneself and others and a reduction of perceived every day nuisances. Concluding, PTG can be experienced in response to severe, traumatic life events and has the potential to enrich the lives of affected persons in numerous, unexpected and yet challenging ways. PTG appears to be spectrum comprised of an interplay of internal and external resources underpinned by neurobiological processes. Participants experienced PTG irrelevant of age, gender, marital status, income or level of education.

Keywords: inhibition theory, posttraumatic growth, trauma, stress, life satisfaction, subjective happiness, traumatic life events, paraplegia

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Authors: Rana Sameeh

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The city is the greatest symbol of human civilization and has been built for safety and comfort. However, uncontrolled urban growth caused some anonymous and unsightly images of the cities such as unused or abandoned spaces. When social interaction is missed in a public space it means the public space is lost since public spaces reflect the social life and interaction of people. Accordingly; this space became one of the most meaningless parts of the cities and has broken the continuity of the urban fabric. Lost urban spaces are the leftover unstructured landscape within the urban fabric. They are generally the unrecognized urban areas that are in need of redesign, since they have a great value that can add to their surrounding urban context. The research significance lies within the importance of urban open spaces, their value and their impact on the urban fabric. The research also addresses the reuse and reclamation of lost urban spaces in order to increase the percentage of green areas along the urban fabric, provide urban open spaces, develop a sustainable approach towards urban landscape and enhance the quality of the public open space and user experience. In addition, the reuse of lost space will give it the identity and function it lacks while also providing places for presence, spending time and observing. Creating continuity in a broken urban fabric represents an exploratory process in the relationship between infrastructure and the urban fabric and seeks to establish an architectural solution to leftover space within the city. In doing so, the research establishes a framework (criteria) for adaptive reuse of lost urban space throughout inductive and deductive methodology, analytical methodology; by analyzing some relevant examples and similar cases of lost spaces and finally through field methodology; by applying the achieved criteria on a case study in Alexandria and carrying on SWOT analysis and evaluation of the potentials of this case study.

Keywords: adaptive reuse, lost urban space, quality of public open space, urban fabric

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Authors: Chondrogianni Dimitra, Yorgos J. Stephanedes

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The impact of the economic crisis, coupled with the aging of the city's old core, is reflected in central Athens. Public and private users, residents, employees, visitors desire the quality upgrading of abandoned buildings and public spaces through environmental upgrading and sustainable mobility, and promotion of the international metropolitan character of the city. In the study, a strategy for reshaping the character and function of the historic Athenian triangle is proposed, aiming at its economic, environmental, and social sustainable development through feasible, meaningful, and non-landscaping solutions of low cost and high positive impact. Sustainable mobility is the main principle in re-planning the study area and transforming it into a “Low Pollution and Limited Vehicle Traffic Zone” is the main strategy. Τhe proposed measures include the development of pedestrian mobility networks by expanding the pedestrian roads and limited-traffic routes, of bicycle networks based on the approved Metropolitan Bicycle Route of Athens, of public transportation networks with new lines of electric mini-buses, and of new regulations for vehicle mobility in the historic triangle. In addition, complementary actions are proposed regarding the provision of Wi-Fi on fixed track media, development of applications that facilitate combined travel and provide real-time data, integration of micromobility (roller skates, Segway, Hoverboard), and its enhancement as a flexible means of personal mobility, and development of car-sharing, ride-sharing and dynamic carpooling initiatives.

Keywords: regeneration plans, sustainable mobility, environmental upgrading, athens historical triangle

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Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

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Therapeutic approaches used previously relied on disease-modifying antirheumatic drugs (DMARDs) that had only partial clinical benefit and were associated with significant toxicity. Spironolactone, an oral aldosterone antagonist, suppresses inflammatory mediators. Clinical efficacy of spironolactone compared with placebo in patients with active psoriatic arthritis despite treatment with prior traditional DMARDs. In the 24-week, placebo-controlled study patients (n=31) were randomized to placebo and spironolactone (2 m/kg/day). Patients on background concurrent DMARDs continued stable doses (methotrexate, leflunomide, and/or sulfasalazine). Primary outcome measures were the assessment of disease activity measures i.e. 28-joint disease activity score (DAS28) and diseases activity in psoriatic arthritis (DAPSA) at week 24. The key secondary endpoint was change from baseline in Health Assessment Questionnaire–Disability Index (HAQ-DI) at week 24. Additional efficacy outcome measures at week 24 included improvements in the markers of inflammation (ESR and CRP) and pro-inflammatory cytokines TNF-α, IL-6 and IL-1. At week 24, spironolactone significantly reduced disease activity measure DAS-28 (p<0.001) and DAPSA (p=0.001) compared with placebo. Significant improvements in key secondary measures HAQ-DI (disability index) were evident with spironolactone (p=0.02) versus placebo. After week 24, there was significant reduction in pro-inflammatory cytokines level TNF-α, IL-6 (p<0.01) as compared with placebo group. However, there was no significant improvement in IL-1 in both treatment and placebo groups. There were minor side effects which did not mandate stopping of spironolactone. No change in any biochemical profile was noted after spironolactone treatment. Spironolactone was effective in the treatment of PsA, improving disease activity, physical function and suppressing the level of pro-inflammatory cytokines. Spironolactone demonstrated an acceptable safety profile and was well tolerated.

Keywords: spironolactone, inflammation, inflammatory cytokine, psoriatic arthritis

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Authors: D. Kuvshinov, A. Siswanto, J. Lozano-Parada, W. Zimmerman

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Ozone is well known as a powerful fast reaction rate oxidant. The ozone based processes produce no by-product left as a non-reacted ozone returns back to the original oxygen molecule. Therefore an application of ozone is widely accepted as one of the main directions for a sustainable and clean technologies development. There are number of technologies require ozone to be delivered to specific points of a production network or reactors construction. Due to space constrains, high reactivity and short life time of ozone the use of ozone generators even of a bench top scale is practically limited. This requires development of mini/micro scale ozone generator which can be directly incorporated into production units. Our report presents a feasibility study of a new micro scale rector for ozone generation (MROG). Data on MROG calibration and indigo decomposition at different operation conditions are presented. At selected operation conditions with residence time of 0.25 s the process of ozone generation is not limited by reaction rate and the amount of ozone produced is a function of power applied. It was shown that the MROG is capable to produce ozone at voltage level starting from 3.5kV with ozone concentration of 5.28E-6 (mol/L) at 5kV. This is in line with data presented on numerical investigation for a MROG. It was shown that in compare to a conventional ozone generator, MROG has lower power consumption at low voltages and atmospheric pressure. The MROG construction makes it applicable for emerged and dry systems. With a robust compact design MROG can be used as incorporated unit for production lines of high complexity.

Keywords: dielectric barrier discharge (DBD), micro reactor, ozone, plasma

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Authors: Janet Modu, Jean-Francois Georgin, Laurent Briancon, Eric Antoinet

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The current practice during the repowering phase of wind turbines is deconstruction of existing foundations and construction of new foundations to accept larger wind loads or once the foundations have reached the end of their service lives. The ongoing research project FUI25 FEDRE (Fondations d’Eoliennes Durables et REpowering) therefore serves to propose scalable wind turbine foundation designs to allow reuse of the existing foundations. To undertake this research, numerical models and laboratory-scale models are currently being utilized and implemented in the GEOMAS laboratory at INSA Lyon following instrumentation of a reference wind turbine situated in the Northern part of France. Sensors placed within both the foundation and the underlying soil monitor the evolution of stresses from the foundation’s early age to stresses during service. The results from the instrumentation form the basis of validation for both the laboratory and numerical works conducted throughout the project duration. The study currently focuses on the effect of coupled mechanisms (Thermal-Hydro-Mechanical-Chemical) that induce stress during the early age of the reinforced concrete foundation, and scale factor considerations in the replication of the reference wind turbine foundation at laboratory-scale. Using THMC 3D models on COMSOL Multi-physics software, the numerical analysis performed on both the laboratory-scale and the full-scale foundations simulate the thermal deformation, hydration, shrinkage (desiccation and autogenous) and creep so as to predict the initial damage caused by internal processes during concrete setting and hardening. Results show a prominent effect of early age properties on the damage potential in full-scale wind turbine foundations. However, a prediction of the damage potential at laboratory scale shows significant differences in early age stresses in comparison to the full-scale model depending on the spatial position in the foundation. In addition to the well-known size effect phenomenon, these differences may contribute to inaccuracies encountered when predicting ultimate deformations of the on-site foundation using laboratory scale models.

Keywords: cement hydration, early age behavior, reinforced concrete, shrinkage, THMC 3D models, wind turbines

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Authors: Bernardo C. P. Albuquerque, Darym J. F. Campos

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Increasing our ability to solve complex engineering problems is directly related to the processing capacity of computers. By means of such equipments, one is able to fast and accurately run numerical algorithms. Besides the increasing interest in numerical simulations, probabilistic approaches are also of great importance. This way, statistical tools have shown their relevance to the modelling of practical engineering problems. In general, statistical approaches to such problems consider that the random variables involved follow a normal distribution. This assumption tends to provide incorrect results when skew data is present since normal distributions are symmetric about their means. Thus, in order to visualize and quantify this aspect, 9 statistical distributions (symmetric and skew) have been considered to model a hypothetical slope stability problem. The data modeled is the friction angle of a superficial soil in Brasilia, Brazil. Despite the apparent universality, the normal distribution did not qualify as the best fit. In the present effort, data obtained in consolidated-drained triaxial tests and saturated direct shear tests have been modeled and used to analytically derive the probability density function (PDF) of the safety factor of a hypothetical slope based on Mohr-Coulomb rupture criterion. Therefore, based on this analysis, it is possible to explicitly derive the failure probability considering the friction angle as a random variable. Furthermore, it is possible to compare the stability analysis when the friction angle is modelled as a Dagum distribution (distribution that presented the best fit to the histogram) and as a Normal distribution. This comparison leads to relevant differences when analyzed in light of the risk management.

Keywords: statistical slope stability analysis, skew distributions, probability of failure, functions of random variables

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Authors: Mark Herman Sumagang Potoy

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State of the City Address (SOCA) is a speech, modelled after the State of the Nation Address, given not as mandated by law but usually a matter of practice or tradition delivered before the chief executive’s constituents. Through this, the general public is made to know the performance of the local government unit and its agenda for the coming year. Therefore, it is imperative for SOCAs to clearly convey its message and carry out the myriad function of enlightening its readers which could be achieved through the proper use of reference. Anaphora and cataphora are the two major types of reference; the former refer back to something that has already been mentioned while the latter points forward to something which is yet to be said. This paper seeks to identify the types of reference employed on the SOCAs from 2014 to 2016 of Hon. Rosalina Garcia Jalosjos, Mayor of Dapitan City and look into how the references contribute to the clarity of the message of the text. The qualitative method of research is used in this study through an in-depth analysis of the corpus. As soon as the copies of the SOCAs are secured from the Office of the City Mayor, they are then analyzed using documentary technique categorizing the types of reference as to anaphora and cataphora, counting each of these types and describing the implications of the dominant types used in the addresses. After a thorough analysis, it is found out that the two reference types namely, anaphora and cataphora are both employed on the three SOCAs, the former being used more frequently than the latter accounting to 80% and 20% of actual usage, respectively. Moreover, the use of anaphors and cataphora on the three addresses helps in conveying the message clearly because they primarily become aids to avoid the repetition of the same element in the text especially when there wasn’t a need to emphasize a point. Finally, it is recommended that writers of State of the City Addresses should have a vast knowledge on how reference should be used and the functions they take in the text since this is a vital tool to clearly transmit a message. Moreover, English teachers should explicitly teach the proper usage of anaphora and cataphora, as instruments to develop cohesion in written discourse, to enable students to write not only with sense but also with fluidity in tying utterances together.

Keywords: anaphora, cataphora, reference, State of the City Address

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Authors: Ruphi Naz, Altaf Ahmad, Mohammad Anis

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Sialic acid (5-Acetylneuraminic acid, Neu5Ac) is a common sugar found as a terminal residue on glycoconjugates in many animals. Humans brain and the central nervous system contain the highest concentration of sialic acid (as N-acetylneuraminic acid) where these acids play an important role in neural transmission and ganglioside structure in synaptogenesis. Due to its important biological function, sialic acid is attracting increasing attention. To understand metabolic networks, fluxes and regulation, it is essential to be able to determine the cellular and subcellular levels of metabolites. Genetically-encoded fluorescence resonance energy transfer (FRET) sensors represent a promising technology for measuring metabolite levels and corresponding rate changes in live cells. Taking this, we developed a genetically encoded FRET (fluorescence resonance energy transfer) based nanosensor to analyse the sialic acid level in living cells. Sialic acid periplasmic binding protein (sia P) from Haemophilus influenzae was taken and ligated between the FRET pair, the cyan fluorescent protein (eCFP) and Venus. The chimeric sensor protein was expressed in E. coli BL21 (DE3) and purified by affinity chromatography. Conformational changes in the binding protein clearly confirmed the changes in FRET efficiency. So any change in the concentration of sialic acid is associated with the change in FRET ratio. This sensor is very specific to sialic acid and found stable with the different range of pH. This nanosensor successfully reported the intracellular level of sialic acid in bacterial cell. The data suggest that the nanosensors may be a versatile tool for studying the in vivo dynamics of sialic acid level non-invasively in living cells

Keywords: nanosensor, FRET, Haemophilus influenzae, metabolic networks

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Authors: Hadjer Sadoune, Liza Lamini, Scherazade Krim, Amel Djouadi, Rachida Rihani

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Deep neural networks are highly regarded for their accuracy in predicting intricate fermentation processes. Their ability to learn from a large amount of datasets through artificial intelligence makes them particularly effective models. The primary obstacle in improving the performance of these models is to carefully choose the suitable hyperparameters, including the neural network architecture (number of hidden layers and hidden units), activation function, optimizer, learning rate, and other relevant factors. This study predicts biogas production from real wastewater treatment plant data using a sophisticated approach: hybrid Bayesian optimization with a tree-structured Parzen estimator (BO-TPE) for an optimised deep neural network (DNN) model. The plant utilizes an Upflow Anaerobic Sludge Blanket (UASB) digester that treats industrial wastewater from soft drinks and breweries. The digester has a working volume of 1574 m3 and a total volume of 1914 m3. Its internal diameter and height were 19 and 7.14 m, respectively. The data preprocessing was conducted with meticulous attention to preserving data quality while avoiding data reduction. Three normalization techniques were applied to the pre-processed data (MinMaxScaler, RobustScaler and StandardScaler) and compared with the Non-Normalized data. The RobustScaler approach has strong predictive ability for estimating the volume of biogas produced. The highest predicted biogas volume was 2236.105 Nm³/d, with coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE) values of 0.712, 164.610, and 223.429, respectively.

Keywords: anaerobic digestion, biogas production, deep neural network, hybrid bo-tpe, hyperparameters tuning

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Authors: Niroshan K. Walgama Wellalage, Tieling Zhang, Richard Dwight

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State-based Markov deterioration models (SMDM) sometimes fail to find accurate transition probability matrix (TPM) values, and hence lead to invalid future condition prediction or incorrect average deterioration rates mainly due to drawbacks of existing nonlinear optimization-based algorithms and/or subjective function types used for regression analysis. Furthermore, a set of separate functions for each condition state with age cannot be directly derived by using Markov model for a given bridge element group, which however is of interest to industrial partners. This paper presents a new approach for generating Homogeneous SMDM model output, namely, the Modified Weibull approach, which consists of a set of appropriate functions to describe the percentage condition prediction of bridge elements in each state. These functions are combined with Bayesian approach and Metropolis Hasting Algorithm (MHA) based Markov Chain Monte Carlo (MCMC) simulation technique for quantifying the uncertainty in model parameter estimates. In this study, factors contributing to rail bridge deterioration were identified. The inspection data for 1,000 Australian railway bridges over 15 years were reviewed and filtered accordingly based on the real operational experience. Network level deterioration model for a typical bridge element group was developed using the proposed Modified Weibull approach. The condition state predictions obtained from this method were validated using statistical hypothesis tests with a test data set. Results show that the proposed model is able to not only predict the conditions in network-level accurately but also capture the model uncertainties with given confidence interval.

Keywords: bridge deterioration modelling, modified weibull approach, MCMC, metropolis-hasting algorithm, bayesian approach, Markov deterioration models

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Authors: Chiara Magliacane

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This project aims to analyse the relationship between the post-conflict Northern Irish environment and youth trauma in deprived areas. Using an anthropological perspective and methodology, the study investigates the possible contribution that a socio-cultural perspective can give to the current research on the field, with a special focus on the role of transgenerational trauma. The recognition of the role that socio-economic determinants have on health is usually a challenge for social researchers. In post-conflict Northern Ireland, the overall lack of research about connections between the social context and youth trauma opens the way to the present project. Anthropological studies on social implications of mental disorders have achieved impressive results in many societies; they show how conditions of sufferance and poverty are not intrinsically given, but are the products of historical processes and events. The continuum of violence and the politics of victimhood sustains a culture of silence and fear in deprived areas; this implies the need of investigating the structural and symbolic violence that lies behind the diffusion of mental suffering. The project refers to these concepts from Medical Anthropology and looks at connections between trauma and social, political and economic structures. Accordingly, the study considers factors such as poverty, unemployment, social inequality and gender and class perspectives. At the same time, the project problematises categories such as youth and trauma. 'Trauma' is currently debated within the social sciences since the 'invention' of the Post-Traumatic Stress Disorder (PTSD) in 1980. Current critics made to its clinical conception show how trauma has been mainly analysed as a memory of the past. On the contrary, medical anthropological research focuses on wider perspectives on society and its structures; this is a new and original approach to the study of youth trauma considering that, to author’s best knowledge, there is no research of this kind regarding Northern Ireland. Methods: Qualitative interviews, participant observation. Expected Impact: Local Northern Ireland organizations, i.e. specific charities that provide mental health support. Ongoing and present connections will ensure they will hear about this research.

Keywords: health and social inequalities, Northern Ireland, structural violence, youth

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Authors: Yubo Bi, Xiao Chen, Shouxiang Lu

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A kind of gas-fueled burner, named Burning Rate Emulator, was proposed for the purpose of the emulation of condensed fuel recently. The gaseous fuel can be pure combustible fuel gas or blends of gaseous fuel or inert gas. However, this concept was recently proposed without detailed study on the combustion characteristic of fuel blends. In this study, two kinds of common gaseous fuels were selected, propane and acetylene, to provide the combustion heat as well as a large amount of smoke, which widely exists in liquid and solid fuel burning process. A set of experiments were carried out using a gas-fueled burner with a diameter of 8 cm. The total volume flow rate of propane and acetylene was kept at 3 liters per minute. The volume fraction of propane varied from 0% to 100% at interval of 10%. It is found that the flame height increases with propane volume fraction, which may be caused by the increase of heat release rate, as the energy density of propane is larger than that of acetylene. The dimensionless flame height is correlated against dimensionless heat release rate, which shows a power function relationship. The radiation fraction of the flame does not show a monotonic relationship with propane volume fraction. With the increase of propane volume fraction from 0% to 100%, the value of radiation fraction increases first and reach a maximum value around 0.46 at a propane volume fraction of 10%, and then decreases continuously to a value of 0.25 at the propane volume fraction of 100%. The flame radiation is related to the soot in the flame. The trend of the radiation fraction reflects that there may be a synergistic effect of soot formation between propane and acetylene which can be guessed from the significantly high radiation fraction at a propane volume fraction of 10%. This work provides data for combustion of gaseous fuel blends pool fire and also give reference on the design of Burning Rate Emulator.

Keywords: Burning Rate Emulator, fuel blends pool fire, flame height, radiation fraction

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Authors: Dean J. Hill

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This paper undertakes the task of conducting an in-depth textual analysis of the cli-fi genre. It examines how writing in the genre contributes to expressing and facilitating the articulation of environmental consciousness through the form of narrative. The paper begins by situating cli-fi within the literary continuum of ecological narratives and identifying the unique textual characteristics and thematic preoccupations of this area. The paper unfolds how cli-fi transforms the esoteric nature of climate science into credible narrative forms by drawing on language use, metaphorical constructs, and narrative framing. It also involves how descriptive and figurative language in the description of nature and disaster makes climate change so vivid and emotionally resonant. The work also points out the dialogic nature of cli-fi, whereby the characters and the narrators experience inner disputes in the novel regarding the ethical dilemma of environmental destruction, thus demanding the readers challenge and re-evaluate their standpoints on sustainability and ecological responsibilities. The paper proceeds with analysing the feature of narrative voice and its role in eliciting empathy, as well as reader involvement with the ecological material. In looking at how different narratorial perspectives contribute to the emotional and cognitive reaction of the reader to text, this study demonstrates the profound power of perspective in developing intimacy with the dominating concerns. Finally, the emotional arc of cli-fi narratives, running its course over themes of loss, hope, and resilience, is analysed in relation to how these elements function to marshal public feeling and discourse into action around climate change. Therefore, we can say that the complexity of the text in the cli-fi not only shows the hard edge of the reality of climate change but also influences public perception and behaviour toward a more sustainable future.

Keywords: cli-fi genre, ecological narratives, emotional arc, narrative voice, public perception

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Authors: Najla Alhkalaf

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The focus of this study is answering the following question: How do e-government services in Bahrain support the productivity of SMEs? This study examines the current E-government function in enhancing SME productivity in Bahrain through analysing the efficiency of e- government by viewing its facilitators and barriers from the perspective of different stakeholders. The study aims to identify and develop best practice guidelines with the end-goal of creating a standardised channel of communication between e-government and SMEs that fulfil the requirement of SME owners, and thus achieve the prime objective of e-government. E-government services for SMEs have been offered in Bahrain since 2005. However, the current services lack the required mechanism for SMEs to fully take advantage of these services because of lagging communication between service provider and end-user. E-government employees believe that a lack of awareness and trust are the main stumbling block, whereas the SME owners believe that there is a lack of sufficiency in the content and efficiency provided through e- services. A questionnaire has been created based on a pilot study that highlighted the main indicators of e-government efficiency and SMEs productivity as well as previous studies conducted on this subject. This allowed for quantitative data to be extracted. Also interviews were conducted with SME owners and government employees from both case studies, which formed the qualitative data for this study. The findings portray that both the service provider and service receiver largely agree on the existence of most of the technical and administrative barriers. However, the data reflects a level of dissatisfaction from the SME side, which contradicts with the perceived level of satisfaction from the government employees. Therefore, the data supports the argument that assures the existence of a communication gap between stakeholders. To this effect, this research would help build channels of communication between stakeholders, and then induces a plan unlocking the potential of e-government application. The conclusions of this study will help devise an optimised E-government strategy for Bahrain.

Keywords: e-government, SME, e-services, G2B, government employees' perspective, entrepreneurs' perspective, enterprise

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Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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