Search results for: anterior gleno-humeral instability

Authors: F. Mohammadsadeghi

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Relevance of research: Axial compressors are used in both aircraft engine construction and ground-based gas turbine engines. The compressor is considered to be one of the main gas turbine engine units, which define absolute and relative indicators of engine in general. Failure of compressor often leads to drastic consequences. Therefore, safe (stable) operation must be maintained when using axial compressor. Currently, we can observe a tendency of increase of power unit, productivity, circumferential velocity and compression ratio of axial compressors in gas turbine engines of aircraft and ground-based application whereas metal consumption of their structure tends to fall. This causes the increase of dynamic loads as well as danger of damage of high load compressor or engine structure elements in general due to transient processes. In operating practices of aeronautical engineering and ground units with gas turbine drive the operational stability failure of gas turbine engines is one of relatively often failure causes what can lead to emergency situations. Surge occurrence is considered to be an absolute buckling failure. This is one of the most dangerous and often occurring types of instability. However detailed were the researches of this phenomenon the development of measures for surge before-the-fact prevention is still relevant. This is why the research of transient processes for axial compressors is necessary in order to provide efficient, stable and secure operation. The paper addresses the problem of automatic control system improvement by integrating the anti-surge algorithms for axial compressor of aircraft gas turbine engine. Paper considers dynamic exhaustion of gas dynamic stability of compressor stage, results of numerical simulation of airflow flowing through the airfoil at design and stalling modes, experimental researches to form the criteria that identify the compressor state at pre-surge mode detection. Authors formulated basic ways for developing surge preventing systems, i.e. forming the algorithms that allow detecting the surge origination and the systems that implement the proposed algorithms.

Keywords: axial compressor, rotation stall, Surg, unstable operation of gas turbine engine

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Authors: Layal Mansour

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The aim of this paper is to identify whether oil price volatility or geopolitical risks can predict future financial stress periods or economic recessions in Kuwait. We construct the first Financial Stress Index for Kuwait (FSIK) that includes informative vulnerable indicators of the main financial sectors: the banking sector, the equities market, and the foreign exchange market. The study covers the period from 2000 to 2020, so it includes the two recent most devastating world economic crises with oil price fluctuation: the Covid-19 pandemic crisis and Ukraine-Russia War. All data are taken by the central bank of Kuwait, the World Bank, IMF, DataStream, and from Federal Reserve System St Louis. The variables are computed as the percentage growth rate, then standardized and aggregated into one index using the variance equal weights method, the most frequently used in the literature. The graphical FSIK analysis provides detailed information (by dates) to policymakers on how internal financial stability depends on internal policy and events such as government elections or resignation. It also shows how monetary authorities or internal policymakers’ decisions to relieve personal loans or increase/decrease the public budget trigger internal financial instability. The empirical analysis under vector autoregression (VAR) models shows the dynamic causal relationship between the oil price fluctuation and the Kuwaiti economy, which relies heavily on the oil price. Similarly, using vector autoregression (VAR) models to assess the impact of the global geopolitical risks on Kuwaiti financial stability, results reveal whether Kuwait is confronted with or sheltered from geopolitical risks. The Financial Stress Index serves as a guide for macroprudential regulators in order to understand the weakness of the overall Kuwaiti financial market and economy regardless of the Kuwaiti dinar strength and exchange rate stability. It helps policymakers predict future stress periods and, thus, address alternative cushions to confront future possible financial threats.

Keywords: Kuwait, financial stress index, causality test, VAR, oil price, geopolitical risks

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Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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Authors: Mia Bahar, Özlem Bozkurt

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Obsessive-compulsive disorder (OCD) is a typical, persistent, and long-lasting mental health condition in which a person experiences uncontrollable, recurrent thoughts (or "obsessions") and/or activities (or "compulsions") that they feel compelled to engage in repeatedly. Obsessive-compulsive disorder is both underdiagnosed and undertreated. It frequently manifests in a variety of medical settings and is persistent, expensive, and burdensome. Obsessive-compulsive neurosis was long believed to be a condition that offered valuable insight into the inner workings of the unconscious mind. Obsessive-compulsive disorder is now recognized as a prime example of a neuropsychiatric condition susceptible to particular pharmacotherapeutic and psychotherapy therapies and mediated by pathology in particular neural circuits. An obsessive-compulsive disorder which is called OCD, usually has two components, one cognitive and the other behavioral, although either can occur alone. Obsessions are often repetitive and intrusive thoughts that invade consciousness. These obsessions are incredibly hard to control or dismiss. People who have OCD often engage in rituals to reduce anxiety associated with intrusive thoughts. Once the ritual is formed, the person may feel extreme relief and be free from anxiety until the thoughts of contamination intrude once again. These thoughts are strengthened through a manifestation of negative reinforcement because they allow the person to avoid anxiety and obscurity. These thoughts are described as autogenous, meaning they most likely come from nowhere. These unwelcome thoughts are related to actions which we can describe as Thought Action Fusion. The thought becomes equated with an action, such as if they refuse to perform the ritual, something bad might happen, and so people perform the ritual to escape the intrusive thought. In almost all cases of OCD, the person's life gets extremely disturbed by compulsions and obsessions. Studies show OCD is an estimated 1.1% prevalence, making it a challenging issue with high co-morbidities with other issues like depressive episodes, panic disorders, and specific phobias. The first to reveal brain anomalies in OCD were numerous CT investigations, although the results were inconsistent. A few studies have focused on the orbitofrontal cortex (OFC), anterior cingulate gyrus (AC), and thalamus, structures also implicated in the pathophysiology of OCD by functional neuroimaging studies, but few have found consistent results. However, some studies have found abnormalities in the basal ganglion. There have also been some discussions that OCD might be genetic. OCD has been linked to families in studies of family aggregation, and findings from twin studies show that this relationship is somewhat influenced by genetic variables. Some Research has shown that OCD is a heritable, polygenic condition that can result from de novo harmful mutations as well as common and unusual variants. Numerous studies have also presented solid evidence in favor of a significant additive genetic component to OCD risk, with distinct OCD symptom dimensions showing both common and individual genetic risks.

Keywords: compulsions, obsessions, neuropsychiatric, genetic

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Authors: Abdel Rahman Khider Hassan

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This paper describes a multi-criteria geospatial model for prediction of landslide hazard zonation (LHZ) for Lake Naivasha catchment (Kenya), based on spatial analysis of integrated datasets of location intrinsic parameters (slope stability factors) and external landslides triggering factors (natural and man-made factors). The intrinsic dataset included: lithology, geometry of slope (slope inclination, aspect, elevation, and curvature) and land use/land cover. The landslides triggering factors included: rainfall as the climatic factor, in addition to the destructive effects reflected by proximity of roads and drainage network to areas that are susceptible to landslides. No published study on landslides has been obtained for this area. Thus, digital datasets of the above spatial parameters were conveniently acquired, stored, manipulated and analyzed in a Geographical Information System (GIS) using a multi-criteria grid overlay technique (in ArcGIS 10.2.2 environment). Deduction of landslide hazard zonation is done by applying weights based on relative contribution of each parameter to the slope instability, and finally, the weighted parameters grids were overlaid together to generate a map of the potential landslide hazard zonation (LHZ) for the lake catchment. From the total surface of 3200 km² of the lake catchment, most of the region (78.7 %; 2518.4 km²) is susceptible to moderate landslide hazards, whilst about 13% (416 km²) is occurring under high hazards. Only 1.0% (32 km²) of the catchment is displaying very high landslide hazards, and the remaining area (7.3 %; 233.6 km²) displays low probability of landslide hazards. This result confirms the importance of steep slope angles, lithology, vegetation land cover and slope orientation (aspect) as the major determining factors of slope failures. The information provided by the produced map of landslide hazard zonation (LHZ) could lay the basis for decision making as well as mitigation and applications in avoiding potential losses caused by landslides in the Lake Naivasha catchment in the Kenya Highlands.

Keywords: decision making, geospatial, landslide, multi-criteria, Naivasha

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Authors: Mylena McCoggle, Shyra Wilson, Andrea Rivera, Rocio Alba-Flores

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This work introduces the use of EMGs (electromyography) from muscle sensors to develop an Artificial Neural Network (ANN) for pattern recognition to control a small unmanned aerial vehicle. The objective of this endeavor exhibits interfacing drone applications beyond manual control directly. MyoWare Muscle sensor contains three EMG electrodes (dual and single type) used to collect signals from the posterior (extensor) and anterior (flexor) forearm and the bicep. Collection of raw voltages from each sensor were connected to an Arduino Uno and a data processing algorithm was developed with the purpose of interpreting the voltage signals given when performing flexing, resting, and motion of the arm. Each sensor collected eight values over a two-second period for the duration of one minute, per assessment. During each two-second interval, the movements were alternating between a resting reference class and an active motion class, resulting in controlling the motion of the drone with left and right movements. This paper further investigated adding up to three sensors to differentiate between hand gestures to control the principal motions of the drone (left, right, up, and land). The hand gestures chosen to execute these movements were: a resting position, a thumbs up, a hand swipe right motion, and a flexing position. The MATLAB software was utilized to collect, process, and analyze the signals from the sensors. The protocol (machine learning tool) was used to classify the hand gestures. To generate the input vector to the ANN, the mean, root means squared, and standard deviation was processed for every two-second interval of the hand gestures. The neuromuscular information was then trained using an artificial neural network with one hidden layer of 10 neurons to categorize the four targets, one for each hand gesture. Once the machine learning training was completed, the resulting network interpreted the processed inputs and returned the probabilities of each class. Based on the resultant probability of the application process, once an output was greater or equal to 80% of matching a specific target class, the drone would perform the motion expected. Afterward, each movement was sent from the computer to the drone through a Wi-Fi network connection. These procedures have been successfully tested and integrated into trial flights, where the drone has responded successfully in real-time to predefined command inputs with the machine learning algorithm through the MyoWare sensor interface. The full paper will describe in detail the database of the hand gestures, the details of the ANN architecture, and confusion matrices results.

Keywords: artificial neural network, biosensors, electromyography, machine learning, MyoWare muscle sensors, Arduino

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Authors: Fawad Hussain, Saleh Abdullah Saleh, Mohammad Basir B Saud, Mohd Azwardi Md. Isa

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It is very important for a developing nation to develop their infrastursture on the prime priority because their infrastursture particularly their roads and transporation functions as a blood in the system. Almost 1.1 billion populations share the travel and transportation industry in India. On the other hand, the Pakistan transportation industry is also extensive and elevating about 170 million users of transportation. Indian and Pakistani specifically within bus industry have good interconnectivity within and between the urban and rural areas as well as connectivity between the two countries, which is dramatically helping the economic alleviation of both countries. Due to high economic instability, unemployment and poverty rate are among the reasons why both the governments are very committed and seriously taken further action to help boost their economy. They believe that any form of transportation development would play a vital role in the development of land, infrastructure which could indirectly support many other industries’ development, such as tourism, freighting and shipping businesses, just to mention a few. However, it seems that their previous transportation planning in the due course has failed to meet the fast growing demand. As with the spin of time, both the countries are looking forward for a reasonable, safe and economical long term solutions, which is from time to time keep appreciating and reacting according to other key economic drivers. Content analysis method and case study approach is used in this paper and secondary data from the bureau of statistic is used for case analysis. The paper centered on the mobility concerns of the lower and middle income people in India and Pakistan. The paper is aimed to highlight the weaknesses, opportunities and limitations resulting from low priority industry for government, which is making the either country's public suffer. The paper has concluded that the main issue is identified as the slow, inappropriate and unfavorable decisions which are not in favor of long term country’s economic development and public welfare as well as interest. The paper also recommends to future market sense public and private transportation, which has failed to meet the public expectations.

Keywords: bus transportation industries, transportation demand, government parallel initiatives, road and traffic congestions

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Authors: Eman Ismail, Adnan Masri

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Energy dissipation in ductile moment frames occurs mainly through plastic hinge rotations in its members (beams and columns). Generally, plastic hinge locations are pre-determined and limited to the beam ends, where columns are designed to remain elastic in order to avoid premature instability (aka story mechanisms) with the exception of column bases, where a base is 'fixed' in order to provide higher stiffness and stability and to form a plastic hinge. Plastic hinging at steel column bases in ductile moment frames using conventional base connection details is accompanied by several complications (thicker and heavily stiffened connections, larger embedment depths, thicker foundation to accommodate anchor rod embedment, etc.). An encased composite base connection is proposed where a segment of the column beginning at the base up to a certain point along its height is encased in reinforced concrete with headed shear studs welded to the column flanges used to connect the column to the concrete encasement. When the connection is flexurally loaded, stresses are transferred to a reinforced concrete encasement through the headed shear studs, and thereby transferred to the foundation by reinforced concrete mechanics, and axial column forces are transferred through the base-plate assembly. Horizontal base reactions are expected to be transferred by the direct bearing of the outer and inner faces of the flanges; however, investigation of this mechanism is not within the scope of this research. The inelastic and cyclic behavior of the connection will be investigated where it will be subjected to reversed cyclic loading, and rotational ductility will be observed in cases of yielding mechanisms where yielding occurs as flexural yielding in the beam-column, shear yielding in headed studs, and flexural yielding of the reinforced concrete encasement. The findings of this research show that the connection is capable of achieving satisfactory levels of ductility in certain conditions given proper detailing and proportioning of elements.

Keywords: seismic design, plastic mechanisms steel structure, moment frame, composite construction

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Authors: Moujib Bahri, Rahim Kallel, Ouafa Sakka

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Corruption is a phenomenon that increases uncertainty and risk of SMEs as it undermines the quality of the business environment and the easy access to public services. Our research builds on existing research on corruption's effects on economic growth at the firm level. Several papers have analyzed the effect of firms’ payments of bribes on their performance; however, only limited research has investigated the link between corruption, innovation, and exports. Drawing on principal-agent theory, we explore how corruption weakens the institutional context and makes the business environment unsound and not conducive to innovation and exports. This study employs data from The Enterprise Surveys conducted in Tunisia between March 2013 and July 2014 by the World Bank, the European Bank for Reconstruction and Development (EBRD) and the European Investment Bank (EIB). The main objective of this survey was to gain a better understanding of Tunisian firms’ perception of the environment in which they operate. Since 2011, the country's political situation has become fragile and unstable, and public services are perceived as inefficient and corrupt. We test our hypotheses on a sample of 537 Tunisian manufacturing SMEs using structural equation modeling and path analysis. We find that political instability leads to higher level of corruption, and that excessive business licensing regulations create a fertile ground for bribery. Our findings do not support the greasing hypothesis suggesting that corruption can reduce the negative effect of bureaucratic delays and the hard access of companies to public services related to innovation and exports. Instead, our results support the sanding hypothesis according to which corruption hinders innovation activities and exports. Furthermore, corruption is found to, negatively and significantly, impact firms’ ownership of quality certificates. Our results suggest that, in an environment with a high level of corruption, governments and policymakers interested in assisting SMEs with their innovation and export activities should have a better control on corruption to allow them developing those activities without being forced to bribe government officers.

Keywords: corruption, innovation, exports, SMEs

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Authors: Azariah Sosa, Carlos Renedo Sanchez

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The development of a new motorway north of Auckland (New Zealand) includes steep rock cuts, from 63 up to 85 degrees, in an interbedded sandstone and siltstone rock mass of the geological unit Waitemata Group (Pakiri Formation), which shows sub-horizontal bedding planes, various sub-vertical joint sets, and a diverse weathering profile. In this kind of rock mass -that can be classified as a weak rock- the definition of the stable maximum geometry is not only governed by discontinuities and defects evident in the rock but is important to also consider the global stability of the rock slope, including (in the analysis) the rock mass characterisation, influence of the groundwater, the geological evolution, and the weathering processes. Depending on the weakness of the rock and the processes suffered, the global stability could, in fact, be a more restricting element than the potential instability of individual blocks through discontinuities. This paper discusses those elements that govern the stability of the rock slopes constructed in a rock formation with favourable bedding and distribution of discontinuities (horizontal and vertical) but with a weak behaviour in terms of global rock mass characterisation. In this context, classifications as Q-Slope and slope stability assessment methodology (SSAM) have been demonstrated as important tools which complement the assessment of the global stability together with the analytical tools related to the wedge-type failures and limit equilibrium methods. The paper focuses on the applicability of these two new empirical classifications to evaluate the slope stability in 18 already excavated rock slopes in the Pakiri formation through comparison between the predicted and observed stability issues and by reviewing the outcome of analytical methods (Rocscience slope stability software suite) compared against the expected stability determined from these rock classifications. This exercise will help validate such findings and correlations arising from the two empirical methods in order to adjust the methods to the nature of this specific kind of rock mass and provide a better understanding of the long-term stability of the slopes studied.

Keywords: Pakiri formation, Q-slope, rock slope stability, SSAM, weak rock

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Authors: Kseniya Gladun

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Tactile stimulation of a dorsal side of the wrist can have a strong impact on our attitude toward physical objects such as pleasant and unpleasant impact. This study explored different aspects of tactile perception to investigate atypical touch sensitivity in children with autism spectrum disorder (ASD). This study included 40 children with ASD and 40 healthy children aged 5 to 9 years. We recorded rsEEG (sampling rate of 250 Hz) during 20 min using EEG amplifier “Encephalan” (Medicom MTD, Taganrog, Russian Federation) with 19 AgCl electrodes placed according to the International 10–20 System. The electrodes placed on the left, and right mastoids served as joint references under unipolar montage. The registration of EEG v19 assignments was carried out: frontal (Fp1-Fp2; F3-F4), temporal anterior (T3-T4), temporal posterior (T5-T6), parietal (P3-P4), occipital (O1-O2). Subjects were passively touched by 4 types of tactile stimuli on the left wrist. Our stimuli were presented with a velocity of about 3–5 cm per sec. The stimuli materials and procedure were chosen for being the most "pleasant," "rough," "prickly" and "recognizable". Type of tactile stimulation: Soft cosmetic brush - "pleasant" , Rough shoe brush - "rough", Wartenberg pin wheel roller - "prickly", and the cognitive tactile stimulation included letters by finger (most of the patient’s name ) "recognizable". To designate the moments of the stimuli onset-offset, we marked the moment when the moment of the touch began and ended; the stimulation was manual, and synchronization was not precise enough for event-related measures. EEG epochs were cleaned from eye movements by ICA-based algorithm in EEGLAB plugin for MatLab 7.11.0 (Mathwork Inc.). Muscle artifacts were cut out by manual data inspection. The response to tactile stimuli was significantly different in the group of children with ASD and healthy children, which was also depended on type of tactile stimuli and the severity of ASD. Amplitude of Alpha rhythm increased in parietal region to response for only pleasant stimulus, for another type of stimulus ("rough," "thorny", "recognizable") distinction of amplitude was not observed. Correlation dimension D2 was higher in healthy children compared to children with ASD (main effect ANOVA). In ASD group D2 was lower for pleasant and unpleasant compared to the background in the right parietal area. Hilbert transform changes in the frequency of the theta rhythm found only for a rough tactile stimulation compared with healthy participants only in the right parietal area. Children with autism spectrum disorders and healthy children were responded to tactile stimulation differently with specific frequency distribution alpha and theta band in the right parietal area. Thus, our data supports the hypothesis that rsEEG may serve as a sensitive index of altered neural activity caused by ASD. Children with autism have difficulty in distinguishing the emotional stimuli ("pleasant," "rough," "prickly" and "recognizable").

Keywords: autism, tactile stimulation, Hilbert transform, pediatric electroencephalography

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Adriana Garcia-Gurrola, Carlos Adrian Peña Natividad, Ana Laura Martinez Martinez, Alberto Abraham Escobar Puentes, Estefania Ochoa Ruiz, Aracely Serrano Medina, Abraham Wall Medrano, Simon Yobanny Reyes Lopez

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Type 2 diabetes mellitus (T2DM) is a metabolic disease characterized by elevated blood glucose levels. Quercetin is a natural flavonoid with a hypoglycemic effect, but reported data are inconsistent due mainly to the structural instability and low solubility of quercetin. Nanoencapsulation is a distinct strategy to overcome the intrinsic limitations of quercetin. Therefore, this work aims to develop a quercetin nano-formulation based on biopolymeric starch nanoparticles to enhance the release and hypoglycemic effect of quercetin in T2DM induced mice model. Starch-quercetin nanoparticles were synthesized using high-intensity ultrasonication, and structural and colloidal properties were determined by FTIR and DLS. For in vivo studies, CD1 male mice (n=25) were divided into five groups (n=5). T2DM was induced using a high-fat and high-sugar diet for 32 weeks and streptozotocin injection. Group 1 consisted of healthy mice fed with a normal diet and water ad libitum; Group 2 were diabetic mice treated with saline solution; Group 3 were diabetic mice treated with glibenclamide; Group 4 were diabetic mice treated with empty nanoparticles; and Group 5 was diabetic mice treated with quercetin nanoparticles. Quercetin nanoparticles had a hydrodynamic size of 232 ± 88.45 nm, a PDI of 0.310 ± 0.04 and a zeta potential of -4 ± 0.85 mV. The encapsulation efficiency of nanoparticles was 58 ± 3.33 %. No significant differences (p = > 0.05) were observed in biochemical parameters (lipids, insulin, and peptide C). Groups 3 and 5 showed a similar hypoglycemic effect, but quercetin nanoparticles showed a longer-lasting effect. Histopathological studies reveal that T2DM mice groups showed degenerated and fatty liver tissue; however, a treated group with quercetin nanoparticles showed liver tissue like that of the healthy mice group. These results demonstrate that quercetin nano-formulations based on starch nanoparticles are effective alternatives with hypoglycemic effects.

Keywords: quercetin, diabetes mellitus tipo 2, in vivo study, nanoparticles

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Authors: Vijaya Kumar, Vidayasagar Pagilla, Abraham Joshua, Rakshith Kedambadi, Prasanna Mithra

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Background: Post stroke rehabilitation are aimed to accelerate for optimal sensorimotor recovery, functional gain and to reduce long-term dependency. Intensive physical therapy interventions can enhance this recovery as experience-dependent neural plastic changes either directly act at cortical neural networks or at distal peripheral level (muscular components). Neuromuscular Electrical Stimulation (NMES), a traditional bottom-up approach, mirror therapy (MT), a relatively new top down approach have found to be an effective adjuvant treatment methods for lower extremity motor and functional recovery in stroke rehabilitation. However there is a scarcity of evidence to compare their therapeutic gain in stroke recovery.Aim: To compare the efficacy of neuromuscular electrical stimulation (NMES) and mirror therapy (MT) in very early phase of post stroke rehabilitation addressed to lower extremity motor recovery and balance. Design: observer blinded Randomized Clinical Trial. Setting: Neurorehabilitation Unit, Department of Physical Therapy, Tertiary Care Hospitals. Subjects: 32 acute stroke subjects with first episode of unilateral stroke with hemiparesis, referred for rehabilitation (onset < 3 weeks), Brunnstorm lower extremity recovery stages ≥3 and MMSE score more than 24 were randomized into two group [Group A-NMES and Group B-MT]. Interventions: Both the groups received eclectic approach to remediate lower extremity recovery which includes treatment components of Roods, Bobath and Motor learning approaches for 30 minutes a day for 6 days. Following which Group A (N=16) received 30 minutes of surface NMES training for six major paretic muscle groups (gluteus maximus and medius,quadriceps, hamstrings, tibialis anterior and gastrocnemius). Group B (N=16) was administered with 30 minutes of mirror therapy sessions to facilitate lower extremity motor recovery. Outcome measures: Lower extremity motor recovery, balance and activities of daily life (ADLs) were measured by Fugyl Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), Barthel Index (BI) before and after intervention. Results: Pre Post analysis of either group across the time revealed statistically significant improvement (p < 0.001) for all the outcome variables for the either group. All parameters of NMES had greater change scores compared to MT group as follows: FMA-LE (25.12±3.01 vs. 23.31±2.38), BBS (35.12±4.61 vs. 34.68±5.42) and BI (40.00±10.32 vs. 37.18±7.73). Between the groups comparison of pre post values showed no significance with FMA-LE (p=0.09), BBS (p=0.80) and BI (p=0.39) respectively. Conclusion: Though either groups had significant improvement (pre to post intervention), none of them were superior to other in lower extremity motor recovery and balance among acute stroke subjects. We conclude that eclectic approach is an effective treatment irrespective of NMES or MT as an adjunct.

Keywords: balance, motor recovery, mirror therapy, neuromuscular electrical stimulation, stroke

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Authors: Mark Wenyi Lai

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The very lethal weapon of nuclear warhead had threatened the survival of the world for half of the 20th century. When most of the countries have already denounced and stopped the development, one country is eager to produce and use them. Since 2006, Pyongyang has launched six times of nuclear tests. The most recent one in September 2017 signaled North Korea’s military capability to project the mass destruction through ICBM (Intercontinental Ballistic Missile) over Seoul, Tokyo, Guam, Hawaii, Alaska or probably the West Coast of the United States with the explosive energy ten times of the atom bombing of Hiroshima in 1945. This research paper adopted time-series content analysis focusing on the related countries responses to North Korea’s tests in 2006, 2009, 2013, and 2016. The preliminary hypotheses are first, North Korea determined to protect the regime by having triad nuclear capability. Negotiations are mere means to this end. Second, South Korea is paralyzed by its ineffective domestic politics and unable to develop its independent strategy toward the North. Third, Japan was using the external threat to campaign for its rearmament plan and brought instability in foreign relations. Fourth, China found herself in the strange position of defending the loyal buffer state meanwhile witnessing the fourth and dangerous neighboring country gaining the card into nuclear club. Fifth, the United States had admitted that North Korea’s going nuclear is unstoppable. Therefore, to keep the regional stability in the East Asia, the US relied on the new balance of power formed by everyone versus Pyongyang. But, countries in East Asia actually have problems getting along with each other. Sixth, Russia distanced herself from the North Kore row but benefitted by advancing its strategic importance in the Far East. Tracing back the history of nuclear states, this research paper concluded that North Korea will head on becoming a more confident country. The regional stability will restore once related countries deal with the new fact and treat Pyongyang regime with a new strategy. The gradual opening and economic reform are on the way for the North Korea in the near future.

Keywords: nuclear test, North Korea, six party talk, US foreign policy

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Authors: Ann Ukachi Madukwe, Juliana Chinwendu Njoku

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Marital conflict, conceptualized in this study as the ongoing lack of peace and satisfaction in a marital union which threatens marital stability, has become quite prevalent in modern Igbo communities. The frequent incidences of spousal battery, spousal sexual abuse, domestic violence, long term separation and in some cases outright divorce are worrisome indicators of the endemic challenge marital conflict poses in most Igbo communities. This study examined marital expectations, marital infidelity (self and spouse), and neuroticism as predictors of marital conflict. Marital expectation was described as a married person’s appraisal of how well their pre-marital desires were being met by their spouses and within the marriage relationship. It assessed different aspects of personal and interpersonal positive outcomes in a marital union. Marital infidelity referred to the likelihood that married individuals or their spouses could have indulged in intimate activities like passionate kisses and romantic dates with someone other than their spouses. Participants reported on themselves as well as their spouses. The last predictor variable neuroticism was measured as a personality trait that addresses issues of emotional instability especially as it relates to a person’s interactions. Neurotic persons were considered to have high emotional reactivity; they would have strong emotional response to issues that emotionally stable persons might overlook. Participants comprised of Igbo male and female spouses selected from Imo state using randomized cluster sampling method. The study utilized the cross sectional survey design and Stepwise linear multiple regression for data analyses. Findings showed that though marital infidelity by spouse was generally below average and spouses marital expectations were being fulfilled; marital expectations followed by marital infidelity – spouse proved to be significant predictors of marital conflict. Marital conflict reduced as marital expectations got fulfilled and increased as the level of likelihood of marital infidelity by the spouse increased. Spouses in this study also reported an increased level of neuroticism, with males being more neurotic than females. Neuroticism was found to be the least significant predictor of marital conflict compared to marital expectations and marital infidelity – spouse. Finally, the article made recommendations to spouses and marital counsellors regarding especially the need to manage the neurotic tendencies of Igbo spouses.

Keywords: Igbo spouses, marital conflict, marital expectations, Nigeria

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Authors: Nirav Jadav, M. G.Vanza

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Black cotton soils mainly exhibit the property of swelling/shrinkage when they react to moisture variations. This property causes development of cracks in the structures resting on these soils, which poses instability to the structures. Soil stabilization is a technique to enhance the geotechnical characteristics of Black cotton soils by changing their properties. Due to rapid growth in construction industry, a lot of waste material is being generated every day, which poses the problem of its disposal. If the waste material can be utilized for soil stabilization, it will mitigate the problems of its disposal. The tests results evaluate that the strength of the Black cotton soils increased by the use of C&D waste material. This study determines various Index and engineering properties of soil and compare for different proportions of soil and C&D Waste. For finding properties of soil and C&D Waste, various test is carried out like sieve analysis, hydrometer test, specific gravity test, Atterberg’s limit test, Standard proctor test and soil Triaxial unconsolidated undrained test. It also takes into account the characteristics alteration due to addition of C&D Waste in active and passive pressure. This study presents the efficacy for use of C&D Waste as a stabilizing material to be mixed with backfill soil in retaining walls. Standard proctor test was conducted at proportions S1W0 (soil = 100%, Waste = 0%), S7W1 (soil = 87.5%, waste = 12.5%), S3W1, S5W3 and S1W1. From these, S5W3 showed optimum results, so this proportion was considered for Soil Triaxial UU-Test. Also, S1W0 was considered too. When 37.5% of soil is replaced by C&D Waste, the Optimum moisture content (OMC) decrease by 11.48%, further, increase C&D Waste in soil OMC remains constant, and maximum dry density (MDD) were observed to be increased by 9.27%, further increased C&D Waste in soil MDD reduces. Carried out strength test, which shows cohesion decreased by 162% and the internal friction angle increased by 49.4% with compare to virgin soil. The study focuses on the potential use of C&D Waste as a stabilizing material in the retaining wall backfill. The active earth pressure decreases, and the passive earth pressure increases in the S5W3 mixture compared to the S1W0 mixture at the same depth.

Keywords: black cotton soil, construction demolition waste, compaction test, strength test

Procedia PDF Downloads 82

Authors: Sameh Shahin, Nannang Arrys

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Optimizing pit slope stability and reducing strip ratio of a mining operation are two key tasks in geotechnical engineering. With a growing demand for minerals and an increasing cost associated with extraction, companies are constantly re-evaluating the viability of mineral deposits and challenging their geological understanding. Within Rio Tinto Iron Ore, the Structural Geology (SG) team investigate and collect critical data, such as point based orientations, mapping and geological inferences from adjacent pits to re-model deposits where previous interpretations have failed to account for structurally controlled slope failures. Utilizing innovative data collection methods and data-driven investigation, SG aims to address the root causes of slope instability. Committing to a resource grid drill campaign as the primary source of data collection will often bias data collection to a specific orientation and significantly reduce the capability to identify and qualify complexity. Consequently, these limitations make it difficult to construct a realistic and coherent structural model that identifies adverse structural domains. Without the consideration of complexity and the capability of capturing these structural domains, mining operations run the risk of inadequately designed slopes that may fail and potentially harm people. Regional structural trends have been considered in conjunction with surface and in-pit mapping data to model multi-batter fold structures that were absent from previous iterations of the structural model. The risk is evident in newly identified dip-slope and rock-mass controlled sectors of the geotechnical design rather than a ubiquitous dip-slope sector across the pit. The reward is two-fold: 1) providing sectors of rock-mass controlled design in previously interpreted structurally controlled domains and 2) the opportunity to optimize the slope angle for mineral recovery and reduced strip ratio. Furthermore, a resulting high confidence model with structures and geometries that can account for historic slope instabilities in structurally controlled domains where design assumptions failed.

Keywords: structural geology, geotechnical design, optimization, slope stability, risk mitigation

Procedia PDF Downloads 46

Authors: Heba A. Hazzah, Ragwa M. Farid, Maha M. A. Nasra, Mennatallah Zakria, Magda A. El Massik, Ossama Y. Abdallah

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Introduction: Curcumin (Cur) is a polyphenol derived from the herbal remedy and dietary spice turmeric. It possesses diverse anti-inflammatory and anti-cancer properties following oral or topical administration. The buccal delivery of curcumin can be useful for both systemic and local disease treatments such as gingivitis, periodontal diseases, oral carcinomas, and precancerous oral lesions. Despite of its high activity, it suffers a limited application due to its low oral bioavailability, poor aqueous solubility, and instability. Aim: Preparation and characterization of curcumin solid lipid nanoparticles with a high loading capacity into a mucoadhesive gel for buccal application. Methodology: Curcumin was formulated as nanoparticles using different lipids, namely Gelucire 39/01, Gelucire 50/13, Precirol, Compritol, and Polaxomer 407 as a surfactant. The SLN were dispersed in a mucoadhesive gel matrix to be applied to the buccal mucosa. All formulations were evaluated for their content, entrapment efficiency, particle size, in vitro drug dialysis, ex vivo mucoadhesion test, and ex vivo permeation study using chicken buccal mucosa. Clinical evaluation was conducted on 15 cases suffering oral erythroplakia and erosive lichen planus. Results: The results showed high entrapment efficiency reaching almost 90 % using Gelucire 50, the loaded gel with Cur-SLN showed good adhesion property and 25 minutes in vivo residence time. In addition to stability enhancement for the Cur powder. All formulae did not show any drug permeated however, a significant amount of Cur was retained within the mucosal tissue. Pain and lesion sizes were significantly reduced upon topical treatment. Complete healing was observed after 6 weeks of treatment. Conclusion: These results open a room for the pharmaceutical technology to optimize the use of this golden magical powder to get the best out of it. In addition, the lack of local anti-inflammatory compounds with reduced side effects intensifies the importance of studying natural products for this purpose.

Keywords: curcumin, erythroplakia, mucoadhesive, pain, solid lipid nanoparticles

Procedia PDF Downloads 451

Authors: Tomohiko Utsuki, Kyoka Sato

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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.

Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control

Procedia PDF Downloads 156

Authors: Mohamad Shamsuri Juhari

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Fathers who positively involve themselves in their children’s lives will have had a constructive influence on the latter’s social, behavioural, and psychological development. This paper will share the preliminary findings of an ongoing research project which investigates Singaporean fathers from the nation’s minority Malay-Muslim community who commit the reverse, that is, it intends to study the reasons behind these fathers’ non-involvement during the period of their children’s developing years be it through absence, disinterest or ignorance. For instance, children from homes with absentee fathers are more likely to develop deficiencies in attitude and conduct. A father’s negative show of parental skills can also cause setbacks in the child’s education, economic instability in the latter’s future family life, as well as the likelihood of an ensuing intergenerational transmission of criminal behaviour. In the context of the minority Singaporean Malay-Muslim community, the need to investigate the challenges faced by fathers from the ethnic group in carrying out their parental roles arose due to the perceptible rise in statistics reflecting delinquency among its youths. This has resulted in other associated issues such as teenage pregnancies (and the subsequent cyclical patterns of divorce and single motherhood), over-representation in the data for drug offences, and under-representation in statistics reflecting academic achievement. While other factors are known to be involved, these negative outcomes have also been attributed to the lack of fatherly guidance in the affected Malay families. This still-ongoing research project is being carried out in two phases: The first by means of secondary research as well as exploratory data collection via roundtable and focus group discussions with fathers from diverse socio-economic backgrounds. This sets the way for the second phase in which a survey will be undertaken, followed by a series of in-depth face-to-face interviews. The research findings will then be translated into intervention initiatives to overcome the identified challenges. Based on the results collated from Phase 1 of the research, this paper will share a ‘first look’ on the challenges to effective parenting faced by Malay-Muslim fathers in Singapore specifically those relating to the socio-cultural domains of attitude, knowledge, and practice.

Keywords: Malay fathers, socio-cultural domains, attitude, knowledge, practice

Procedia PDF Downloads 196

Authors: Cherrie Mae S. Sia, Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Background: Parkinson’s disease (PD) is a chronic progressive, neurodegenerative disorder known for its motor symptoms such as bradykinesia, resting tremor, muscle rigidity, and postural instability. Patients with PD also experience non-motor symptoms (NMS) such as depression, fatigue, and sleep disturbances that are most of the time unrecognized by clinicians. This may be due to the lack of spontaneous reports from the patients or partly because of the lack of systematic questioning from the healthcare professional. There is limited data with regards to these NMS especially that of Filipino patients with PD. Objectives: This study aims to determine the non-motor symptoms of Filipino patients with Parkinson’s disease. Materials and Methods: This is a prospective, cohort study involving thirty-four patients of Filipino-descent diagnosed with PD in three out-patient clinics in Cebu City from April to September 2014. Each patient was interviewed using the Non-Motor Symptom Scale (NMSS). A Cebuano version of the NMSS was also provided for the non-English speaking patients. Interview time was approximately ten to fifteen minutes for each respondent. Results: Of the thirty-four patients with Parkinson’s disease, majority was noted to be males (N=19) and the disease was noted to be more prevalent in patients with a mean age of 62 (SD±9) years old. Hypertension (59%) and diabetes mellitus (29%) were the common co-morbidities in the study population. All patients presented more than one NMS, with insomnia (41.2%), poor memory (23.5%) and depression (14.7%) being the first non-motor symptoms to occur. Symptoms involving mood/cognition (mean=2.21), and attention/memory (mean=2.05) were noted to be the most frequent and of moderate severity. Based on the NMSS, the symptoms that were noted to be mild and often to occur were those that involved the mood/cognition (score=3.84), attention/memory (score=3.50), and sleep/fatigue (score=3.00) domains. Levodopa-Carbidopa, Ropinirole, and Pramipexole were the most frequently used medications in the study population. Conclusion: Non-motor symptoms (NMS) are common in patients with Parkinson’s disease (PD). They appear at the time of diagnosis of PD or even before the motor symptoms manifest. The earliest non-motor symptoms to occur are insomnia, poor memory, and depression. Those pertaining to mood/cognition and attention/memory are the most frequent NMS and they are of moderate severity. Identifying these NMS by doing a questionnaire-guided interview such as the Non-Motor Symptom Scale (NMSS) before they can become more severe and affect the patient’s quality of life is a must for every clinician caring for a PD patient. Early treatment and control of these NMS can then be given, hence, improving the patient’s outcome and prognosis.

Keywords: non motor symptoms, Parkinson's Disease, insomnia, depression

Procedia PDF Downloads 448

Authors: Beverly Wang

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Background: Rosai-Dorfman disease (RDD), aka sinus histiocytosis with massive lymphadenopathy, is a rare, idiopathic histiocytic proliferative disorder. Although RDD can be seen involving the head and neck lymph nodes, rarely it can affect other extranodal sites. It present 3 unique cases of RDD affecting the nasal cavity, paranasal sinuses, and ear canal. The initial clinical presentation on two cases mimicked a malignant neoplasm. The 3rd case of RDD co-existed with a cholesteatoma of the ear canal. The clinical presentation, histology and immunohistochemical stains, and radiographic findings are discussed. Design: An overview of 3 cases of RDD affected sinonasal cavity and ear canal from UCI Medical Center was conducted. Case 1: A 61 year old male complaining of breathing difficulty presented with bilateral polypoid sinonasal masses and severe nasal obstruction. The masses elevated the nasal floor, and involved the anterior nasal septum to lateral wall. It was endoscopically excised. At intraoperative consultation, frozen section reported a pleomorphic spindle cell neoplasm with scattered large atypical spindle cells, resembling a high grade sarcoma. Case 2: A 46 year old male presented with recurrent bilateral maxillary chronic sinusitis with mass formation, clinically suspicious for malignant lymphoma. Excisional tissue sample showed large irregular spindled histiocytes with abundant granular and vacuolated cytoplasm. Case 3: A 36 year old female with a history of asthma initially presented with left-sided chronic otalgia, occasional nausea, vertigo, and fluctuating pain exacerbated by head movement and temperature changes. CT scan revealed an external auditory canal mass extending to the middle ear, coexisting with a small cholesteatoma. Results: The morphology of all cases revealed large atypical spindled histiocytes resembling fibrohistiocytic or myofibroblastic proliferative neoplasms. Scattered emperipolesis was seen. All 3 cases were confirmed as extranodal sinus RDD, confirmed by immunohistochemistry. The large atypical cells were positive for S100, CD68, and CD163. No evidence for malignancy was identified. Case 3 showed concurrent RDD co-existing with a cholesteatoma. Conclusion: Due to its rarity and variable clinical presentations, the diagnosis of RDD is seldom clinically considered. Extranodal sinus RDD morphologically can be pitfall as mimicker of spindly neoplasm, especially at intraoperative consultation. It can create diagnostic and therapeutic challenges. Correlation of radiological findings with histologic features will help to reach the diagnosis.

Keywords: head and neck, extranodal, rosai-dorfman disease, mimicker, immunohistochemistry

Procedia PDF Downloads 79

Authors: Zeineb Baatout, Safa Teka, Nejmeddine Jaballah, Nawfel Sakly, Xiaonan Sun, Mustapha Majdoub

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Currently, the economic interests linked to the development of bio-based materials make biomass one of the most interesting areas for science development. We are interested in the β-cyclodextrin (β-CD), one of the popular bio-sourced macromolecule, produced from the starch via enzymatic conversion. It is a cyclic oligosaccharide formed by the association of seven glucose units. It presents a rigid conical and amphiphilic structure with hydrophilic exterior, allowing it to be water-soluble. It has also a hydrophobic interior enabling the formation of inclusion complexes, which support its application for the elaboration of electrochemical and optical sensors. Nevertheless, the solubility of β-CD in water makes its use as sensitive layer limit and difficult due to their instability in aqueous media. To overcome this limitation, we chose to precede by modification of the hydroxyl groups to obtain hydrophobic derivatives which lead to water-stable sensing layers. Hence, a series of benzylated β-CDs were synthesized in basic aqueous media in one pot. This work reports the synthesis of a new family of substituted amphiphilic β-CDs using a green methodology. The obtained β-CDs showed different degree of substitution (DS) between 0.85 and 2.03. These organic macromolecular materials were soluble in common organic volatile solvents, and their structures were investigated by NMR, FT-IR and MALDI-TOF spectroscopies. Thermal analysis showed a correlation between the thermal properties of these derivatives and the benzylation degree. The surface properties of the thin films based on the benzylated β-CDs were characterized by contact angle measurements and atomic force microscopy (AFM). These organic materials were investigated as sensitive layers, deposited on quartz crystal microbalance (QCM) gravimetric transducer, for humidity sensor at room temperature. The results showed that the performances of the prepared sensors are greatly influenced by the benzylation degree of β-CD. The partially modified β-CD (DS=1) shows linear response with best sensitivity, good reproducibility, low hysteresis, fast response time (15s) and recovery time (17s) at higher relative humidity levels (RH) between 11% and 98% in room temperature.

Keywords: β-cyclodextrin, green synthesis, humidity sensor, quartz crystal microbalance

Procedia PDF Downloads 271

Authors: Shang Yee Chong

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Perioperative pain is a complex mechanism activated by various nociceptive, neuropathic, and inflammatory pathways. Opioids have long been a mainstay for analgesia in this period, even as we are continuously moving towards a multimodal model to improve pain control while minimising side effects. Dexmedetomidine, a potent alpha-2 agonist, is a useful sedative and hypnotic agent. Its use in the intensive care unit has been well described, and it is increasingly an adjunct intraoperatively for its opioid sparing effects and to decrease pain scores. We describe a case of a general surgical patient in whom minimal opioids was required with dexmedetomidine use. The patient was a 61-year-old Indian gentleman with a history of hyperlipidaemia and type 2 diabetes mellitus, presenting with rectal adenocarcinoma detected on colonoscopy. He was scheduled for a robotic ultra-low anterior resection. The patient was induced with intravenous fentanyl 75mcg, propofol 160mg and atracurium 40mg. He was intubated conventionally and mechanically ventilated. Anaesthesia was maintained with inhalational desflurane and anaesthetic depth was measured with the Masimo EEG Sedline brain function monitor. An initial intravenous dexmedetomidine dose (bolus) of 1ug/kg for 10 minutes was given prior to anaesthetic induction and thereafter, an infusion of 0.2-0.4ug/kg/hr to the end of surgery. In addition, a bolus dose of intravenous lignocaine 1.5mg/kg followed by an infusion at 1mg/kg/hr throughout the surgery was administered. A total of 10mmol of magnesium sulphate and intravenous paracetamol 1000mg were also given for analgesia. There were no significant episodes of bradycardia or hypotension. A total of intravenous phenylephrine 650mcg was given throughout to maintain the patient’s mean arterial pressure within 10-15mmHg of baseline. The surgical time lasted for 5 hours and 40minutes. Postoperatively the patient was reversed and extubated successfully. He was alert and comfortable and pain scores were minimal in the immediate post op period in the postoperative recovery unit. Time to first analgesia was 4 hours postoperatively – with paracetamol 1g administered. This was given at 6 hourly intervals strictly for 5 days post surgery, along with celecoxib 200mg BD as prescribed by the surgeon regardless of pain scores. Oral oxycodone was prescribed as a rescue analgesic for pain scores > 3/10, but the patient did not require any dose. Neither was there nausea or vomiting. The patient was discharged on postoperative day 5. This case has reinforced the use of dexmedetomidine as an adjunct in general surgery cases, highlighting its excellent opioid-sparing effects. In the entire patient’s hospital stay, the only dose of opioid he received was 75mcg of fentanyl at the time of anaesthetic induction. The patient suffered no opioid adverse effects such as nausea, vomiting or postoperative ileus, and pain scores varied from 0-2/10. However, intravenous lignocaine infusion was also used in this instance, which would have helped improve pain scores. Paracetamol, lignocaine, and dexmedetomidine is thus an effective, opioid-sparing combination of multi-modal analgesia for major abdominal surgery cases.

Keywords: analgesia, dexmedetomidine, general surgery, opioid sparing

Procedia PDF Downloads 135

Authors: Francisco J. García-de-Quirós, Gianmarco Radice

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When considering small robots working in a cooperative community for Moon surface exploration, navigation and inter-nodes communication aspects become a critical issue for the mission success. For this approach to succeed, it is necessary however to deploy the required infrastructure for the robotic community to achieve efficient self-localization as well as relative positioning and communications between nodes. In this paper, an exploration mission concept in which two cooperative robotic systems co-exist is presented. This paradigm hinges on a community of reference agents that provide support in terms of communication and navigation to a second agent community tasked with exploration goals. The work focuses on the role of the agent community in charge of the overall support and, more specifically, will focus on the positioning and navigation methods implemented in RF microwave bands, which are combined with the communication services. An analysis of the different methods for range and position calculation are presented, as well as the main limiting factors for precision and resolution, such as phase and frequency noise in RF reference carriers and drift mechanisms such as thermal drift and random walk. The effects of carrier frequency instability due to phase noise are categorized in different contributing bands, and the impact of these spectrum regions are considered both in terms of the absolute position and the relative speed. A mission scenario is finally proposed, and key metrics in terms of mass and power consumption for the required payload hardware are also assessed. For this purpose, an application case involving an RF communication network in UHF Band is described, in coexistence with a communications network used for the single agents to communicate within the both the exploring agents as well as the community and with the mission support agents. The proposed approach implements a substantial improvement in planetary navigation since it provides self-localization capabilities for robotic agents characterized by very low mass, volume and power budgets, thus enabling precise navigation capabilities to agents of reduced dimensions. Furthermore, a common and shared localization radiofrequency infrastructure enables new interaction mechanisms such as spatial arrangement of agents over the area of interest for distributed sensing.

Keywords: cooperative robotics, localization, robot navigation, surface exploration

Procedia PDF Downloads 294

Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

Abstract:

The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

Procedia PDF Downloads 119

Authors: Shubham Kumar, Chaitanya Goswami, Sudipto Sarkar

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Pseudoplastic (n < 1, n being the power index) fluid flow can be found in food, pharmaceutical and process industries and has very complex flow nature. To our knowledge, inadequate research work has been done in this kind of flow even at very low Reynolds numbers. Here, in the present computation, we have considered unsteady laminar flow over a square cylinder in pseudoplastic flow environment. For Newtonian fluid flow, this laminar vortex shedding range lies between Re = 47-180. In this problem, we consider Re = 100 (Re = U∞ a/ ν, U∞ is the free stream velocity of the flow, a is the side of the cylinder and ν is the kinematic viscosity of the fluid). The pseudoplastic fluid range has been chosen from close to the Newtonian fluid (n = 0.8) to very high pseudoplasticity (n = 0.1). The flow domain is constituted using Gambit 2.2.30 and this software is also used to generate mesh and to impose the boundary conditions. For all places, the domain size is considered as 36a × 16a with 280 ×192 grid point in the streamwise and flow normal directions respectively. The domain and the grid points are selected after a thorough grid independent study at n = 1.0. Fine and equal grid spacing is used close to the square cylinder to capture the upper and lower shear layers shed from the cylinder. Away from the cylinder the grid is unequal in size and stretched out in all direction. Velocity inlet (u = U∞), pressure outlet (Neumann condition), symmetry (free-slip boundary condition du/dy = 0, v = 0) at upper and lower domain boundary conditions are used for this simulation. Wall boundary (u = v = 0) is considered on the square cylinder surface. Fully conservative 2-D unsteady Navier-Stokes equations are discretized and then solved by Ansys Fluent 14.5 to understand the flow nature. SIMPLE algorithm written in finite volume method is selected for this purpose which is the default solver in scripted in Fluent. The result obtained for Newtonian fluid flow agrees well with previous work supporting Fluent’s usefulness in academic research. A minute analysis of instantaneous and time averaged flow field is obtained both for Newtonian and pseudoplastic fluid flow. It has been observed that drag coefficient increases continuously with the reduced value of n. Also, the vortex shedding phenomenon changes at n = 0.4 due to flow instability. These are some of the remarkable findings for laminar periodic vortex shedding regime in pseudoplastic flow environment.

Keywords: Ansys Fluent, CFD, periodic vortex shedding, pseudoplastic fluid flow

Procedia PDF Downloads 204

Authors: S. D. Zalepugin, A. E. Murzich, D. G. Satskevich, A. B. Palivanov

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Introduction. The incidence of spinal injuries in patients under 18 years of age has increased significantly in recent years, which represents a significant economic, social and medical problem. The most common method of surgical stabilization of spinal fractures in pediatric patients is transpedicular posterior spinal fusion, which is widely used by spinal neurosurgeons in adult patients. Purpose of the study: This study evaluates the results of treatment of thoracolumbar spine lesions in children using the transpedicular screw fixation method. Materials and methods. From 2019 to 2024, 35 children with injuries to the thoracic and lumbar spine underwent surgical treatment using the transpedicular screw fixation method. Among the injured, girls prevailed (21 cases, 60%). The age of the victims ranged from 9 to 17 years. The main causes of damage were: catatrauma (19 cases), road accident (5 cases), sports injury (6 cases), and other reasons - 5 cases. In 5 cases, suicidal attempts occurred. Co-injury was observed in most cases (20 patients, or 57%), which is natural for high-energy injury. Vertebral-spinal injury with neurological disorders was observed in 13 patients, the disorders ranged from mild inferior (4 children) to moderate/severe paraparesis (5 patients) and inferior paraplegia (4 children). 6 children had pelvic organ dysfunction in the form of urinary and fecal retention or incontinence. All thirty-five patients, within a period of 1 to 57 days after the injury, underwent several surgical interventions from the posterior surgical access using a screw fixation method (posterior decompression + spinal fusion). In 12 cases, it was necessary to perform the second stage of surgical treatment - anterior decompression of the spinal cord or its roots. Verticalization of patients was carried out within 1 to 5 days after surgery. Results. In all patients, the nearest, up to 1 year, results were evaluated. In children operated in 2019-2021, the results were studied in terms of 3 to 5 years. The procedures used, clinical results and the quality of the fixative installation were assessed. All patients managed to achieve positive results. The use of internal fixation made it possible to carry out early verticalization of children, eliminate pain syndrome and achieve a regression of neurological disorders in most patients (especially in cases when the operation was performed early after injury - from 1 to 3 days). Within the first month, the ability to self-care was fully restored. Bone fusion was observed within 6-12 months after surgery. There were no complications after surgery. The analysis of postoperative radiographs, CT and MRI images revealed the correct standing of the screws in all cases. Conclusion. The posterior spinal fusion using the new method of screw fixation in pediatric patients allows to achieve durable stabilization of damage, begins early rehabilitation of patients and reduces the duration of hospital treatment by 2-3 times. Thus, we recommend the use of a transpedicular fixator in children as a reliable, technically feasible method for restoring spinal stability with a low risk of intra- and postoperative complications.

Keywords: pediatric patients, spinal injuries, transpedicular stabilization, operative treatment

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Authors: Newton Muhury, Armando A. Apan, Tek Maraseni

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This study modelled the relationships between vegetation response and available water below the soil surface using the Terra’s Moderate Resolution Imaging Spectroradiometer (MODIS) generated Normalised Difference Vegetation Index (NDVI) and soil water content (SWC) data. The Soil & Water Assessment Tool (SWAT) interface known as ArcSWAT was used in ArcGIS for the groundwater analysis. The SWAT model was calibrated and validated in SWAT-CUP software using 10 years (2001-2010) of monthly streamflow data. The average Nash-Sutcliffe Efficiency during the calibration and validation was 0.54 and 0.51, respectively, indicating that the model performances were good. Twenty years (2001-2020) of monthly MODIS NDVI data for three different types of vegetation (forest, shrub, and grass) and soil water content for 43 sub-basins were analysed using the WEKA, machine learning tool with a selection of two supervised machine learning algorithms, i.e., support vector machine (SVM) and random forest (RF). The modelling results show that different types of vegetation response and soil water content vary in the dry and wet season. For example, the model generated high positive relationships (r=0.76, 0.73, and 0.81) between the measured and predicted NDVI values of all vegetation in the study area against the groundwater flow (GW), soil water content (SWC), and the combination of these two variables, respectively, during the dry season. However, these relationships were reduced by 36.8% (r=0.48) and 13.6% (r=0.63) against GW and SWC, respectively, in the wet season. On the other hand, the model predicted a moderate positive relationship (r=0.63) between shrub vegetation type and soil water content during the dry season, which was reduced by 31.7% (r=0.43) during the wet season. Our models also predicted that vegetation in the top location (upper part) of the sub-basin is highly responsive to GW and SWC (r=0.78, and 0.70) during the dry season. The results of this study indicate the study region is suitable for seasonal crop production in dry season. Moreover, the results predicted that the growth of vegetation in the top-point location is highly dependent on groundwater flow in both dry and wet seasons, and any instability or long-term drought can negatively affect these floodplain vegetation communities. This study has enriched our knowledge of vegetation responses to groundwater in each season, which will facilitate better floodplain vegetation management.

Keywords: ArcSWAT, machine learning, floodplain vegetation, MODIS NDVI, groundwater

Procedia PDF Downloads 119