Search results for: multiple sills emplacement
Commenced in January 2007
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Edition: International
Paper Count: 4754

Search results for: multiple sills emplacement

4034 Easy Way of Optimal Process-Storage Network Design

Authors: Gyeongbeom Yi

Abstract:

The purpose of this study is to introduce the analytic solution for determining the optimal capacity (lot-size) of a multiproduct, multistage production and inventory system to meet the finished product demand. Reasonable decision-making about the capacity of processes and storage units is an important subject for industry. The industrial solution for this subject is to use the classical economic lot sizing method, EOQ/EPQ (Economic Order Quantity/Economic Production Quantity) model, incorporated with practical experience. However, the unrealistic material flow assumption of the EOQ/EPQ model is not suitable for chemical plant design with highly interlinked processes and storage units. This study overcomes the limitation of the classical lot sizing method developed on the basis of the single product and single stage assumption. The superstructure of the plant considered consists of a network of serially and/or parallelly interlinked processes and storage units. The processes involve chemical reactions with multiple feedstock materials and multiple products as well as mixing, splitting or transportation of materials. The objective function for optimization is minimizing the total cost composed of setup and inventory holding costs as well as the capital costs of constructing processes and storage units. A novel production and inventory analysis method, PSW (Periodic Square Wave) model, is applied. The advantage of the PSW model comes from the fact that the model provides a set of simple analytic solutions in spite of a realistic description of the material flow between processes and storage units. The resulting simple analytic solution can greatly enhance the proper and quick investment decision for plant design and operation problem confronted in diverse economic situations.

Keywords: analytic solution, optimal design, process-storage network

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4033 Anti-Parasite Targeting with Amino Acid-Capped Nanoparticles Modulates Multiple Cellular Processes in Host

Authors: Oluyomi Stephen Adeyemi, Kentaro Kato

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Toxoplasma gondii is the etiological agent of toxoplasmosis, a common parasitic disease capable of infecting a range of hosts, including nearly one-third of the human population. Current treatment options for toxoplasmosis patients are limited. In consequence, toxoplasmosis represents a large global burden that is further enhanced by the shortcomings of the current therapeutic options. These factors underscore the need for better anti-T. gondii agents and/or new treatment approach. In the present study, we sought to find out whether preparing and capping nanoparticles (NPs) in amino acids, would enhance specificity toward the parasite versus the host cell. The selection of amino acids was premised on the fact that T. gondii is auxotrophic for some amino acids. The amino acid-nanoparticles (amino-NPs) were synthesized, purified and characterized following established protocols. Next, we tested to determine the anti-T. gondii activity of the amino-NPs using in vitro experimental model of infection. Overall, our data show evidence that supports enhanced and excellent selective action against the parasite versus the host cells by amino-NPs. The findings are promising and provide additional support that warrants exploring the prospects of NPs as alternative anti-parasite agents. In addition, the anti-parasite action by amino-NPs indicates that nutritional requirement of parasite may represent a viable target in the development of better alternative anti-parasite agents. Furthermore, data suggest the anti-parasite mechanism of the amino-NPs involves multiple cellular processes including the production of reactive oxygen species (ROS), modulation of hypoxia-inducing factor-1 alpha (HIF-1α) as well as the activation of kynurenine pathway. Taken together, findings highlight further, the prospects of NPs as alternative source of anti-parasite agents.

Keywords: drug discovery, infectious diseases, mode of action, nanomedicine

Procedia PDF Downloads 112
4032 Factors Affecting Online Health Seeking Behaviors in Middle-Income Class Filipino Adults

Authors: Reinzo Vittorio B. Cardenas, Heather Venice L. Abogado, Andrea Therese V. Afable, Rhea D. Avillanoza, Marie Abegail P. Ayagan, Catherine D. Bantayan

Abstract:

As the Internet provides fast and reliable health-related information, the tendency to self-diagnose increases to further understand medical jargon in a diagnosis with a physician and decreases costly consultation fees. The study aimed to explore and understand the factors affecting online health-seeking behaviors in middle-income class adults in Metro Manila. The study was conducted from March to April of 2021 with a sample size of 200 individuals aged 20 to 49 years old. The study was delivered via an online survey that used a questionnaire adapted from the research of Lee et al. (2015). Specifically, the survey consisted of three sections: assessing web-based health-seeking behaviors, consultation with health professionals, and participants' hesitancy to consult with physicians, which used a mix of a 5-point Likert-type scale with multiple responses and multiple-choice options. The results showed that the age and educational attainment of the respondents had a negative effect while presenting a positive effect of socio-economic status on health-seeking behavior. Lastly, there was a significant effect of participant’s hesitancy for professional consultation on their health-seeking behavior. The results gleaned from the study indicated that various individual and socio-economic factors might significantly affect one’s health-seeking behaviors. Although hesitancy had a significant effect on the spectrum of health-seeking behaviors, this does not imply that certain factors are specifically related to an individual’s tendency to seek health information. This information instead becomes essential in understanding the patient-physician relationship and giving patients a more holistic treatment.

Keywords: health-seeking behavior, health information, Internet, physician consultation

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4031 Physiological Response of Water-Restricted Xhosa Goats Supplemented with Vitamin C

Authors: O.F. Akinmoladun, F.N. Fon, C.T. Mpendulo, O. Okoh

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The sustainability of livestock production is under threat as a result of water scarcity, fluctuating precipitation, and high environmental temperature. These combined stressors have impacted negatively on general animal production and welfare, necessitating a very reliable and cost-effective management practices, especially in arid and water-limited regions of the world. Instead of the above, this study was designed to investigate the growth performance and physiological response of water-restricted Xhosa ear-lobe goats fed diets supplemented with single or multiple vitamin C (VC) during summer. The total forty-eight goats used for the experiment were balanced for body weight and randomly assigned to the seven treatment groups (seven goats/treatment): GI (W100%); GII (W70%); GIII (W50%); GIV (W70%+3g/day VC); GV ((W50% +3g/day VC); GVI (W70%+3g/d VC+extra 5g on every eight-day); GVII (W50%+3g/d VC+extra 5g on every eight-day). The design was a complete randomized design and VC was administered per os. At the end of the 75-day feeding trial, GIII (W50%) animals were the most affected (P<0.05) and the effect was more pronounced in their body condition scores (BCs). Weight loss and depression in feed intake due to water restriction (P<0.05) were attenuated by VC treated groups (GIV-GVII). Changes in body thermal gradient (BTG) and rectal temperature (RcT) were similar (P>0.05) across the various experimental groups. The attenuation effect of VC was significant in responses to respiratory rate (RR) and cortisol. Supplementation of VC (either single or multiple) did not significantly (P>0.05) improve water restriction effect on body condition scores (BCs) and FAMACHA©. The current study found out that Xhosa ear lobe goats can adapt to the prevailing bioclimatic changes and limited water intake. However, supplementation of vitamin C can be beneficial at modulating these stressful stimuli. Continuous consistencies in the outcome of vitamin C on water-stressed animals can help validate recommendations especially to farmers in the arid and water-limited regions across the globe.

Keywords: vitamin C, Xhosa ear-lobe, thermotolerance, water stress

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4030 Flow Behavior of a ScCO₂-Stimulated Geothermal Reservoir under in-situ Stress and Temperature Conditions

Authors: B. L. Avanthi Isaka, P. G. Ranjith

Abstract:

The development of technically-sound enhanced geothermal systems (EGSs) is identified as a viable solution for world growing energy demand with immense potential, low carbon dioxide emission and importantly, as an environmentally friendly option for renewable energy production. The use of supercritical carbon dioxide (ScCO₂) as the working fluid in EGSs by replacing traditional water-based method is promising due to multiple advantages prevail in ScCO₂-injection for underground reservoir stimulation. The evolution of reservoir stimulation using ScCO₂ and the understanding of the flow behavior of a ScCO₂-stimulated geothermal reservoir is vital in applying ScCO₂-EGSs as a replacement for water-based EGSs. The study is therefore aimed to investigate the flow behavior of a ScCO₂-fractured rock medium at in-situ stress and temperature conditions. A series of permeability tests were conducted for ScCO₂ fractured Harcourt granite rock specimens at 90ºC, under varying confining pressures from 5–60 MPa using the high-pressure and high-temperature tri-axial set up which can simulate deep geological conditions. The permeability of the ScCO₂-fractured rock specimens was compared with that of water-fractured rock specimens. The results show that the permeability of the ScCO₂-fractured rock specimens is one order higher than that of water-fractured rock specimens and the permeability exhibits a non-linear reduction with increasing confining pressure due to the stress-induced fracture closure. Further, the enhanced permeability of the ScCO₂-induced fracture with multiple secondary branches was explained by exploring the CT images of the rock specimens. However, a single plain fracture was induced under water-based fracturing.

Keywords: supercritical carbon dioxide, fracture permeability, granite, enhanced geothermal systems

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4029 A Framework for Assessing and Implementing Ecological-Based Adaptation Solutions in Urban Areas of Shanghai

Authors: Xin Li

Abstract:

The uncertainty and the complexity of the urban environment combining with the threat of climate change are contributing factors to the vulnerability in multiple-dimensions in Chinese megacities, especially in Shanghai. The urban area occupied high valuable technological infrastructure and density buildings is under the threats of climate change and can provide insufficient ecological service to remain the trade-off on urban sustainable development. Urban ecological-based adaptation (UEbA) combines practices and theoretical work and integrates ecological services into multiple-layers of urban environment planning in order to reduce the impact of the complexity and uncertainty. To understand and to respond to the challenges in the urban level, this paper considers Shanghai as the research objective. It is necessary that its urban adaptation strategies should be reflected and contain the concept and knowledge of EbA. In this paper, we firstly use software to illustrates the visualizing patterns and trends of UEBA research in the current 10 years. Specifically, Citespace software was used for interpreting the significant hubs, landmarks points of peer-reviewed literature on the context of ecological service research in recent 10 years. Secondly, 135 evidence-based EbA literature were reviewed for categorizing the methodologies and framework of evidence-based EbA by the systematic map protocol. Finally, a conceptual framework combined with culture, economic and social components was developed in order to assess the current adaptation strategies in Shanghai. This research founds that the key to reducing urban vulnerability does not only focus on co-benefit arguments but also should pay more attention to the concept of trade-off. This research concludes that the designed framework can provide key knowledge and indicates the essential gap as a valuable tool against climate variability in the process of urban adaptation in Shanghai.

Keywords: urban ecological-based adaptation, climate change, sustainable development, climate variability

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4028 Scoping Review of Biological Age Measurement Composed of Biomarkers

Authors: Diego Alejandro Espíndola-Fernández, Ana María Posada-Cano, Dagnóvar Aristizábal-Ocampo, Jaime Alberto Gallo-Villegas

Abstract:

Background: With the increase in life expectancy, aging has been subject of frequent research, and therefore multiple strategies have been proposed to quantify the advance of the years based on the known physiology of human senescence. For several decades, attempts have been made to characterize these changes through the concept of biological age, which aims to integrate, in a measure of time, structural or functional variation through biomarkers in comparison with simple chronological age. The objective of this scoping review is to deepen the updated concept of measuring biological age composed of biomarkers in the general population and to summarize recent evidence to identify gaps and priorities for future research. Methods: A scoping review was conducted according to the five-phase methodology developed by Arksey and O'Malley through a search of five bibliographic databases to February 2021. Original articles were included with no time or language limit that described the biological age composed of at least two biomarkers in those over 18 years of age. Results: 674 articles were identified, of which 105 were evaluated for eligibility and 65 were included with information on the measurement of biological age composed of biomarkers. Articles from 1974 of 15 nationalities were found, most observational studies, in which clinical or paraclinical biomarkers were used, and 11 different methods described for the calculation of the composite biological age were informed. The outcomes reported were the relationship with the same measured biomarkers, specified risk factors, comorbidities, physical or cognitive functionality, and mortality. Conclusions: The concept of biological age composed of biomarkers has evolved since the 1970s and multiple methods of its quantification have been described through the combination of different clinical and paraclinical variables from observational studies. Future research should consider the population characteristics, and the choice of biomarkers against the proposed outcomes to improve the understanding of aging variables to direct effective strategies for a proper approach.

Keywords: biological age, biological aging, aging, senescence, biomarker

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4027 Enhancing Self-Assessment and Management Potentials by Modifying Option Selections on Hartman’s Personality Test

Authors: Daniel L. Clinciu, IkromAbdulaev, Brian D. Oscar

Abstract:

Various personality profile tests are used to identify personality strengths and limits in individuals, helping both individuals and managers to optimize work and team effort in organizations. One such test, Hartman’s personality profile emphasizes four driving "core motives" influenced or affected by both strengths and limitations. The driving core motives are classified into four colors: Red-motivated by power; Blue-discipline and loyalty; White-peace; and Yellow–fun loving. Two shortcomings of Hartman’s personality test are noted; 1) only one choice for every item/situation allowed and 2) selection of a choice even if not applicable. A test taker may be as much nurturing as he is opinionated but since “opinionated” seems less attractive the individual would likely select nurturing, causing a misidentification in personality strengths and limits. Since few individuals have a "strong" personality, it is difficult to assess their true personality strengths and limits allowing either only one choice or requiring unwanted choices, undermining the potential of the test. We modified Hartman’s personality profile allowing test takers to make either multiple choices for any item/situation or leave them blank when not applying. Sixty-eight participants (38 males and 30 females), 17-49 years old, from countries in Asia, Europe, N. America, CIS, Africa, Latin America, and Oceania were included. 58 participants (85.3%) reported the modified test, allowing either multiple or no choices better identified their personality strengths and limits, while 10 participants (14.7%) expressed the original (one choice version) is sufficient. The overall results show our modified test enhanced the identification and balance of personality strengths and limits, aiding test takers, managers, and firms to better understand personality strengths and limits, particularly useful in making task-related, teamwork, and management decisions.

Keywords: organizational behavior, personality tests, personality limitations, personality strengths, task management, team work

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4026 Exploring Teachers’ Professional Identity in the Context of the Current Political Conflict in Palestine

Authors: Bihan Qaimari

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In many areas of the world there are political conflicts the consequences of which have an inevitable impact on the educational system. Palestine is one such country where the experience of political conflict, going back over many years, has had a devastating effect on the development and maintenance of a stable educational environment for children and their teachers. Up to now there have been few studies that have focussed on the effects of living and working in a war zone on the professional identity of teachers. The aim of this study is to explore how the formation of Palestinian teachers’ professional identity is affected by their experience of the current political conflict its impact on the school social culture. In order to gain an in-depth understanding of the impact of political violence on the formation of the professional identity of Palestinian teachers, a qualitative multiple case-study approach was adopted which draws on sociocultural theories of identity formation. An initial study was first conducted in six schools and this was followed by an in-depth study of teachers working in three further primary schools. Data sources included participant observation, a research diary, semi-structured group and individual interviews. Grounded theory, constant-comparative methods, and discourse analysis procedures were used to interpret the data. The findings suggest that the Palestinian primary school teachers negotiate multiple conflicting identities through their every day experiences of political conflict and the schools’ social culture. This tension is formed as a result of the historical cultural meaning that teachers construct about themselves and within the current unstable and unsettling conditions that exist in their country. In addition, the data indicate that the geographical location of the schools in relation of their proximity to the events of the political conflict also had an influence on the degree of tension inherent in teachers’ professional identity. The study makes significant theoretical, practical, and methodical contributions to the study of the formation of teachers’ professional identity in countries affected by political conflict.

Keywords: identity, political conflict, Palestine, teacher's professional identity

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4025 Consequences of Youth Bulge in Pakistan

Authors: Muhammad Farooq, Muhammad Idrees

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The present study has been designed to explore the causes and effects of Youth Bulge in Pakistan. However, youth bulge is a part of population segment which create problem for the whole society. The youth bulge is a common phenomenon in many developing countries, and in particular, in the least developed countries. It is often due to a stage of development where a country achieves success in reducing infant mortality but mothers still have a high fertility rate. The result is that a large share of the population is comprised of children and young adults, and today’s children are tomorrow’s young adults. Youth often play a prominent role in political violence and the existence of a “youth bulge” has been associated with times of political crisis. The population pyramid of Pakistan represents a large youth proportion and our government did not use that youth in positive way and did not provide them opportunity for development, this situation creates frustration in youth that leads them towards conflict, unrest and violence. This study will be focus on the opportunity and motives of the youth bulge situation in Pakistan in the lens of youth bulge theory. Moreover, it will give some suggestions to utilize youth in the development activities and avoid youth bulge situation in Pakistan. The present research was conducted in the metropolitan entities of Punjab, Pakistan. A sample of 300 respondents was taken from three randomly selected metropolitan entities (Faisalabad, Lahore and Rawalpindi) of Punjab Province of Pakistan. Information regarding demography, household, locality and other socio-cultural variables related to causes and effects of youth bulge in the state was collected through a well structured interview schedule. Mean, Standard Deviation and frequency distribution were used to check the measure of central tendency. Multiple linear regression was also applied to measure the influence of various independent variables on the response variable.

Keywords: youth bulge, violence, conflict, social unrest, crime, metropolitan entities, mean, standard deviation, multiple linear regression

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4024 The Psychological Impact of War Trauma on Refugees

Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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4023 Contribution of mTOR to Oxidative/Nitrosative Stress via NADPH Oxidase System Activation in Zymosan-Induced Systemic Inflammation in Rats

Authors: Seyhan Sahan-Firat, Meryem Temiz-Resitoglu, Demet Sinem Guden, Sefika Pinar Kucukkavruk, Bahar Tunctan, Ayse Nihal Sari, Zumrut Kocak

Abstract:

We hypothesized that mTOR inhibition may prevent the multiple organ failures following severe multiple tissue injury associated with increased NADPH oxidase system activity occur in zymosan-induced systemic inflammation. Therefore, we investigated the role of mTOR in oxidative/nitrosative stress associated with increase in NADPH oxidase activity in zymosan-induced systemic inflammation model in rats. Male Wistar rats received saline (4 ml/kg, i.p.) and zymosan (500 mg/kg, i.p.) at time 0. Saline, or zymosan-treated rats were given rapamycin (1 mg/kg, i.p.) 1 h after saline or zymosan injections. Rats were sacrified 4 h after zymosan challenge and kidney, heart, thoracic aorta, and superior mesenteric artery were collected. NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels were measured in tissue samples. Zymosan administration caused an increase in NADPH oxidase activity, p22phox, gp91phox, and p47phox protein expression and nitrotyrosine levels in kidney, heart, thoracic aorta, and superior mesenteric artery. These changes caused by zymosan reversed by rapamycin, a selective mTOR inhibitor. Rapamycin alone had no effect on the parameters measured. Our results demonstrated that zymosan-induced oxidative/nitrosative stress presumably due to enhanced activity of NADPH oxidase, expression of p22phox, gp91phox, and p47phox and production of peroxynitrite were mediated by mTOR. [This work was financially supported by Research Foundation of Mersin University (2016-2-AP3-1900)].

Keywords: oxidative stress, mTOR, nitrosative stress, zymosan

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4022 Dislocation Density-Based Modeling of the Grain Refinement in Surface Mechanical Attrition Treatment

Authors: Reza Miresmaeili, Asghar Heydari Astaraee, Fereshteh Dolati

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In the present study, an analytical model based on dislocation density model was developed to simulate grain refinement in surface mechanical attrition treatment (SMAT). The correlation between SMAT time and development in plastic strain on one hand, and dislocation density evolution, on the other hand, was established to simulate the grain refinement in SMAT. A dislocation density-based constitutive material law was implemented using VUHARD subroutine. A random sequence of shots is taken into consideration for multiple impacts model using Python programming language by utilizing a random function. The simulation technique was to model each impact in a separate run and then transferring the results of each run as initial conditions for the next run (impact). The developed Finite Element (FE) model of multiple impacts describes the coverage evolution in SMAT. Simulations were run to coverage levels as high as 4500%. It is shown that the coverage implemented in the FE model is equal to the experimental coverage. It is depicted that numerical SMAT coverage parameter is adequately conforming to the well-known Avrami model. Comparison between numerical results and experimental measurements for residual stresses and depth of deformation layers confirms the performance of the established FE model for surface engineering evaluations in SMA treatment. X-ray diffraction (XRD) studies of grain refinement, including resultant grain size and dislocation density, were conducted to validate the established model. The full width at half-maximum in XRD profiles can be used to measure the grain size. Numerical results and experimental measurements of grain refinement illustrate good agreement and show the capability of established FE model to predict the gradient microstructure in SMA treatment.

Keywords: dislocation density, grain refinement, severe plastic deformation, simulation, surface mechanical attrition treatment

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4021 Exploring the Relationships between Cyberbullying Perceptions and Facebook Attitudes of Turkish Students

Authors: Yavuz Erdoğan, Hidayet Çiftçi

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Cyberbullying, a phenomenon among adolescents, is defined as actions that use information and communication technologies such as social media to support deliberate, repeated, and hostile behaviour by an individual or group. With the advancement in communication and information technology, cyberbullying has expanded its boundaries among students in schools. Thus, parents, psychologists, educators, and lawmakers must become aware of the potential risks of this phenomenon. In the light of these perspectives, this study aims to investigate the relationships between cyberbullying perception and Facebook attitudes of Turkish students. A survey method was used for the study and the data were collected by “Cyberbullying Perception Scale”, “Facebook Attitude Scale” and “Personal Information Form”. For this purpose, study has been conducted during 2014-2015 academic year, with a total of 748 students with 493 male (%65.9) and 255 female (%34.1) from randomly selected high schools. In the analysis of data Pearson correlation and multiple regression analysis, multivariate analysis of variance (MANOVA) and Scheffe post hoc test has been used. At the end of the study, the results displayed a negative correlation between Turkish students’ Facebook attitudes and cyberbullying perception (r=-.210; p<0.05). In order to identify the predictors of students’ cyberbullying perception, multiple regression analysis was used. As a result, significant relations were detected between cyberbullying perception and independent variables (F=5.102; p<0.05). Independent variables together explain 11.0% of the total variance in cyberbullying scores. The variables that significantly predict the students’ cyberbullying perception are Facebook attitudes (t=-5.875; p<0.05), and gender (t=3.035; p<0.05). In order to calculate the effects of independent variables on students’ Facebook attitudes and cyberbullying perception MANOVA was conducted. The results of the MANOVA indicate that the Facebook attitudes and cyberbullying perception were significantly differed according to students’ gender, age, educational attainment of the mother, educational attainment of the father, income of the family and daily usage of internet.

Keywords: facebook, cyberbullying, attitude, internet usage

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4020 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017

Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

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Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

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4019 Age Estimation from Teeth among North Indian Population: Comparison and Reliability of Qualitative and Quantitative Methods

Authors: Jasbir Arora, Indu Talwar, Daisy Sahni, Vidya Rattan

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Introduction: Age estimation is a crucial step to build the identity of a person, both in case of deceased and alive. In adults, age can be estimated on the basis of six regressive (Attrition, Secondary dentine, Dentine transparency, Root resorption, Cementum apposition and Periodontal Disease) changes in teeth qualitatively using scoring system and quantitatively by micrometric method. The present research was designed to establish the reliability of qualitative (method 1) and quantitative (method 2) of age estimation among North Indians and to compare the efficacy of these two methods. Method: 250 single-rooted extracted teeth (18-75 yrs.) were collected from Department of Oral Health Sciences, PGIMER, Chandigarh. Before extraction, periodontal score of each tooth was noted. Labiolingual sections were prepared and examined under light microscope for regressive changes. Each parameter was scored using Gustafson’s 0-3 point score system (qualitative), and total score was calculated. For quantitative method, each regressive change was measured quantitatively in form of 18 micrometric parameters under microscope with the help of measuring eyepiece. Age was estimated using linear and multiple regression analysis in Gustafson’s method and Kedici’s method respectively. Estimated age was compared with actual age on the basis of absolute mean error. Results: In pooled data, by Gustafson’s method, significant correlation (r= 0.8) was observed between total score and actual age. Total score generated an absolute mean error of ±7.8 years. Whereas, for Kedici’s method, a value of correlation coefficient of r=0.5 (p<0.01) was observed between all the eighteen micrometric parameters and known age. Using multiple regression equation, age was estimated, and an absolute mean error of age was found to be ±12.18 years. Conclusion: Gustafson’s (qualitative) method was found to be a better predictor for age estimation among North Indians.

Keywords: forensic odontology, age estimation, North India, teeth

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4018 Postural Balance And Falls Risk In Persons With Multiple Sclerosis: Effect Of Gender Differences

Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

Abstract:

The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

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4017 Various Body Measurements of Hair, Boer x Hair F1 Crossbred Kids and Effects of Some Environmental Factors on These Traits

Authors: M. Bolacalı, Y. Öztürk, O. Yılmaz, M. Küçük, M. A. Karslı

Abstract:

The aim of the study was to determine various body measurements from the birth to the 30-day age of Boer x Hair goats F1 crossbred kids and pure Hair goat kids raised in Van in Eastern Anatolia region, and reveal factors such as the effects of year, dame body weight, genotype, dame age, birth type and sex on this parameter. 49 kids born in 2012 and 76 kids born in 2014 were utilized in the study. In the statistical analysis of various body measurements data was performed using the General Lineer Model procedure in SPSS software. Duncan's multiple range test was used for multiple comparisons. Boer x Hair goats F1 crossbred kids and pure Hair goat kids from various body measurements cidago height, body length, chest length, chest depth, chest circumference, circumference of leg, cannon bone circumference, chest width were determinated in general respectively 29.90 and 27.88 cm; 29.49 and 27.93 cm; 17.28 and 16.68 cm; 13.34 and 12.82 cm; 31.74 and 29.85 cm; 28.43 and 23.95 cm; 5.41 and 5.15 cm; 8.71 and 7.63 cm at birth, respectively; 35.01 and 32.98 cm; 35.20 and 33.30 cm; 18.82 and 18.17 cm; 15.64 and 14.83 cm; 39.08 and 37.30 cm; 34.29 and 29.25 cm; 5.80 and 5.42 cm; 9.87 and 8.85 cm at 30 days age, respectively. Among factors affecting cidago height in this study, the effect of dame body weight and sex were not significant, but genotype, dame age and birth type were significant (P < 0,05 and P < 0,01) at birth; dame body weight effect of the cidago height was not significant, but the effect of genotype, birth type, of dame age and sex were significant (P < 0.05, P < 0.05 and P<0.001) at 30-day age. The effect of genotype and sex of body length were not significant, but dam age, dame body weight and birth type were significant (P < 0.05, P < 0.05 and P<0.001, respectively) at birth; the effect of sex to body length was not significant, but genotype, dame age, dame body weight and birth type were significant (P < 0.01, P < 0.05, P < 0.05 and P < 0.001, respectively) at 30-day age. While circumference of leg was insignificant the effect of dame age and sex, genotype, dame body weight and type of the birth were significant (P < 0.001, P < 0.05 and P < 0.001) at birth; the circumstance of leg at 30-day age was found to be important the effect of examined other factors except for sex (P < 0.05 and P < 0.001). The obtained results, when considered in terms of a variety of body sizes, from birth to 30-day age growth period, showed that the kids of Boer x Hair Goat F1 hybrids have higher values than the kids of Hair Goats.

Keywords: Boer x hair goat F1 crossbred, hair goat, body measurements, cidago height

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4016 Numerical Method for Productivity Prediction of Water-Producing Gas Well with Complex 3D Fractures: Case Study of Xujiahe Gas Well in Sichuan Basin

Authors: Hong Li, Haiyang Yu, Shiqing Cheng, Nai Cao, Zhiliang Shi

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Unconventional resources have gradually become the main direction for oil and gas exploration and development. However, the productivity of gas wells, the level of water production, and the seepage law in tight fractured gas reservoirs are very different. These are the reasons why production prediction is so difficult. Firstly, a three-dimensional multi-scale fracture and multiphase mathematical model based on an embedded discrete fracture model (EDFM) is established. And the material balance method is used to calculate the water body multiple according to the production performance characteristics of water-producing gas well. This will help construct a 'virtual water body'. Based on these, this paper presents a numerical simulation process that can adapt to different production modes of gas wells. The research results show that fractures have a double-sided effect. The positive side is that it can increase the initial production capacity, but the negative side is that it can connect to the water body, which will lead to the gas production drop and the water production rise both rapidly, showing a 'scissor-like' characteristic. It is worth noting that fractures with different angles have different abilities to connect with the water body. The higher the angle of gas well development, the earlier the water maybe break through. When the reservoir is a single layer, there may be a stable production period without water before the fractures connect with the water body. Once connected, a 'scissors shape' will appear. If the reservoir has multiple layers, the gas and water will produce at the same time. The above gas-water relationship can be matched with the gas well production date of the Xujiahe gas reservoir in the Sichuan Basin. This method is used to predict the productivity of a well with hydraulic fractures in this gas reservoir, and the prediction results are in agreement with on-site production data by more than 90%. It shows that this research idea has great potential in the productivity prediction of water-producing gas wells. Early prediction results are of great significance to guide the design of development plans.

Keywords: EDFM, multiphase, multilayer, water body

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4015 Single Ion Transport with a Single-Layer Graphene Nanopore

Authors: Vishal V. R. Nandigana, Mohammad Heiranian, Narayana R. Aluru

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Graphene material has found tremendous applications in water desalination, DNA sequencing and energy storage. Multiple nanopores are etched to create opening for water desalination and energy storage applications. The nanopores created are of the order of 3-5 nm allowing multiple ions to transport through the pore. In this paper, we present for the first time, molecular dynamics study of single ion transport, where only one ion passes through the graphene nanopore. The diameter of the graphene nanopore is of the same order as the hydration layers formed around each ion. Analogous to single electron transport resulting from ionic transport is observed for the first time. The current-voltage characteristics of such a device are similar to single electron transport in quantum dots. The current is blocked until a critical voltage, as the ions are trapped inside a hydration shell. The trapped ions have a high energy barrier compared to the applied input electrical voltage, preventing the ion to break free from the hydration shell. This region is called “Coulomb blockade region”. In this region, we observe zero transport of ions inside the nanopore. However, when the electrical voltage is beyond the critical voltage, the ion has sufficient energy to break free from the energy barrier created by the hydration shell to enter into the pore. Thus, the input voltage can control the transport of the ion inside the nanopore. The device therefore acts as a binary storage unit, storing 0 when no ion passes through the pore and storing 1 when a single ion passes through the pore. We therefore postulate that the device can be used for fluidic computing applications in chemistry and biology, mimicking a computer. Furthermore, the trapped ion stores a finite charge in the Coulomb blockade region; hence the device also acts a super capacitor.

Keywords: graphene nanomembrane, single ion transport, Coulomb blockade, nanofluidics

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4014 Development and Characterization of Multiphase Hydrogel Systems for Wound Healing

Authors: Rajendra Jangde, Deependra Singh

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Present work was based with objective to release of the antimicrobial and debriding agent in sustained manner at the wound surface. In order to provide a long-lasting antimicrobial action and moist environment on wound space, Biocompatible moist system was developed for complete healing. In the present study, a biocompatible moist system of PVA-gelatin hydrogel was developed capable of carrying multiple drugs- Quercetin and Cabopol in controlled manner for effective and complete wound healing. Carbopol and Quercetin were prepared by thin film hydration techniques and optimized system was incorporated in PVA-Gelatin slurry. PVA-Gelatin hydrogels were prepared by freeze thaw method. The prepared dispersion was casted into films to prepare multiphase hydrogel system and characterized by in vitro and in vivo studies. Results revealed the uniform dispersion of microspheres in a three-dimensional matrix of the PVA-Gelatin hydrogel observed at different magnifications. The in vitro release data showed typical biphasic release pattern, i.e., a burst release followed by a slower sustained release for 5 days. Prepared system was found to be stable under both normal and accelerated conditions. Histopathological study showed significant (p<0.05) increase in fibroblast cells, collagen fibres and blood vessels formation. All parameters such as wound contraction, tensile strength, histopathological and biochemical parameters- hydroxyproline content, protein level, etc. were observed significant (p<0.05) in comparison to control group. Present results suggest an accelerated re-epithelialization under moist wound environment with delivery of multiple drugs effective at different stages of wound healing cascade with minimum disturbance of wound bed.

Keywords: multiphase hydrogel, optimization quercetin, wound healing

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4013 Angiogenesis and Blood Flow: The Role of Blood Flow in Proliferation and Migration of Endothelial Cells

Authors: Hossein Bazmara, Kaamran Raahemifar, Mostafa Sefidgar, Madjid Soltani

Abstract:

Angiogenesis is formation of new blood vessels from existing vessels. Due to flow of blood in vessels, during angiogenesis, blood flow plays an important role in regulating the angiogenesis process. Multiple mathematical models of angiogenesis have been proposed to simulate the formation of the complicated network of capillaries around a tumor. In this work, a multi-scale model of angiogenesis is developed to show the effect of blood flow on capillaries and network formation. This model spans multiple temporal and spatial scales, i.e. intracellular (molecular), cellular, and extracellular (tissue) scales. In intracellular or molecular scale, the signaling cascade of endothelial cells is obtained. Two main stages in development of a vessel are considered. In the first stage, single sprouts are extended toward the tumor. In this stage, the main regulator of endothelial cells behavior is the signals from extracellular matrix. After anastomosis and formation of closed loops, blood flow starts in the capillaries. In this stage, blood flow induced signals regulate endothelial cells behaviors. In cellular scale, growth and migration of endothelial cells is modeled with a discrete lattice Monte Carlo method called cellular Pott's model (CPM). In extracellular (tissue) scale, diffusion of tumor angiogenic factors in the extracellular matrix, formation of closed loops (anastomosis), and shear stress induced by blood flow is considered. The model is able to simulate the formation of a closed loop and its extension. The results are validated against experimental data. The results show that, without blood flow, the capillaries are not able to maintain their integrity.

Keywords: angiogenesis, endothelial cells, multi-scale model, cellular Pott's model, signaling cascade

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4012 Prevalence of Multidrug-resistant Escherichia coli Isolated from Ready to Eat: Crispy Fried Chicken in Jember, Indonesia

Authors: Enny Suswati, Supangat Supangat

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Background. Ready-to-eat food products are becoming increasingly popular because consumers are increasingly busy, competitive, and changing lifestyles. Examples of ready-to-eat foods include crispy fried chicken. Escherichia coli is one of the most important causes of food-borne diseases and the most frequent antibiotic-resistant pathogen globally. This study assessed the prevalence and antibiotic resistance profile of E. coli from ready-to-eat crispy fried chicken in Jember city, Indonesia. Methodology. This cross-sectional study was conducted from November 2020 to April 2021 by collecting 81crispy fried chicken samples from 27 food stalls in campus area using a simple random sampling method. Isolation and determination of E. coli use were performed by conventional culture method. An antibiotic susceptibility test was conducted using Kirby Bauer disk diffusion method on the Mueller–Hinton agar. Result. Out of 81crispy fried chicken samples, 77 (95.06%) were positive for E. coli. High E. coli drug resistance was observed on ampicillin, amoxicillin (100%) followed by cefixime (98.72%), erythromycin (97.59%), sulfamethoxazole (93.59%), azithromicin (83.33%), cefotaxime (78.28%), choramphenicol (75.64%), and cefixime (74.36%). On the other hand, there was the highest susceptibility for ciprofloxacin (64.10%). The multiple antibiotic resistance indexes of E. coli isolates varied from 0.4 to 1. The predominant antimicrobial resistance profiles of E. coli were CfmCroAmlAmpAzmCtxSxtCE (n=17), CfmCroAmlCipAmpAzmCtxSxtCE (n=16), and CfmAmlAmpAzmCtxSxtCE (n=5), respectively. Multidrug resistance was also found in the isolates' 76/77 (98.70%). Conclusion. The resistance pattern CfmCroAmlAmpAzmCtxSxtCE was the most common among the E. coli isolates, with 17 showing it. The multiple antibiotic index (MAR index) ranged from 0.4 to 1. Hygienic measures should be rigorously implemented and monitoring resistance of E. coli is required to reduce the risks related to the emergence of multi-resistant bacteria

Keywords: antibacterial drug, ready to eat, crispy fried chicken, escherichia coli

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4011 A Longitudinal Examination of the Impact of Treatment Modality on Relationship Satisfaction and Mental Health Quality of Life Outcomes among Prostate Cancer Survivors

Authors: Gabriela Ilie, Robert D. H. Rutledge

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A review of the literature reveals a need for longitudinal studies to properly understand the quality of life of prostate cancer survivors during their prostate cancer journey in order to identify opportunities for patient support and care during prostate cancer survivorship. In this study, mental health and relationship satisfaction were assessed longitudinally and by treatment modality among a population-based sample of Canadian adult men with a history of prostate cancer diagnosis. A total of 98 men, aged 51 or older with a history of prostate cancer completed an on-line 15-minute survey between May 2017 and February 2018, assessing mental health (Kessler Psychological Distress Scale) and relationship satisfaction (Dyadic Adjustment Scale) at baseline and at three months post-treatment with either active or nonactive prostate cancer treatment. Almost 1 in 6 men in this sample screened positive for mental health issues (17.34%, n=17) irrespective of treatment modality and most (n=11) were not currently on medication for depression, anxiety or both. Mental health outcomes were poorer for men with multimorbidity. For every instance of screening positive for mental health issues, 2.021 (95% CI:1.1 to 3.8) times more comorbidities were recorded. Relationship satisfaction and dyadic cohesion were statistically significantly lower from first assessment to 3 months for men who underwent multiple treatment modalities (surgery and radiation with hormonal therapy). Relationship satisfaction was also lower at 3 months for men who underwent radiation therapy. Almost 1 in 2 men in this sample (74%) indicated they did not attend a prostate cancer support group. Results suggest that treatment for mental health is underutilized in men with prostate cancer. Men who undergo multiple forms of active treatment appear more vulnerable to relationship dissatisfaction and feeling disconnected from their partner. Data points to important opportunities for patient education and care support during survivorship.

Keywords: prostate cancer survivorship, mental health, quality of life, relationship satisfaction

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4010 A Modernist Project: An Analysis on Dupont’s Translations of Faulkner’s Works

Authors: Edilei Reis, Jose Carlos Felix

Abstract:

This paper explores Waldir Dupont’s translations of William Faulkner’s novels to Brazilian Portuguese language in order to comprehend how his translation project regarding Faulkner’s works has addressed modernist traits of the novelist fiction, particularly the ambivalence of language, multiple and fragmented points of view and syntax. Wladir Dupont (1939-2014) was a prolific Brazilian journalist who benefitted from his experiences as an international correspondent living abroad (EUA and Mexico) to become an acclaimed translator later in life. He received a Jabuiti Award (Brazilian most prestigious literary award) for his translation of ‘La Otra Voz’ (1994), by Mexican poet, critic and translator Octavio Paz, a writer to whom he devoted the first years of his carrier as a translator. As Dupont pointed out in some interviews, the struggles in finding a way out to overcome linguistic and cultural obstacles in the process of translating texts from Spanish to Portuguese was paramount for ascertaining his engagement in the long-term project of translating to Brazilian Portuguese the fiction of William Faulkner. His first enterprise was the translation of Faulkner’s trilogy Snopes: The Hamlet (1940) and The Town (1957), the first two novels, were published in 1997 as O povoado and A cidade; in 1999 the last novel, The mansion (1959), was published as A mansão. In 2001, Dupont tackled what is considered one of the most challenging novels by the author due to his use of multiple points of view, As I lay dying (1930). In 2003, The Reivers (1962) was published under the title Os invictos. His enterprise finishes in 2012 with the publication of an anthology of Faulkner’s thriller short-stories Knight’s Gambit (1932) as Lance mortal. Hence, in this paper we will consider the Dupont’s trajectory as a translator, paying special attention to the way in which his identity as such is constituted through the process of translating Faulkner’s works.

Keywords: literary translation, translator’s identity, William Faulkner, Wladir DuPont

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4009 Pathological Disparities in Patients Diagnosed with Prostate Imaging Reporting and Data System 3 Lesions: A Retrospective Study in a High-Volume Academic Center

Authors: M. Reza Roshandel, Tannaz Aghaei Badr, Batoul Khoundabi, Sara C. Lewis, Soroush Rais-Bahrami, John Sfakianos, Reza Mehrazin, Ash K. Tewari

Abstract:

Introduction: Prostate biopsy is the most reliable diagnostic method for choosing the appropriate management of prostate cancer. However, discrepancies between Gleason grade groups (GG) of different biopsies remain a significant concern. This study aims to assess the association of the radiological factors with GG discrepancies in patients with index Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions, using radical prostatectomy (RP) specimens as the most accurate and informative pathology. Methods: This single-institutional retrospective study was performed on a total of 2289 consecutive prostate cancer patients with combined targeted and systematic prostate biopsy followed by radical prostatectomy (RP). The database was explored for patients with the index PI-RADS 3 lesions version 2 and 2.1. Cancers with PI-RADS 4 or 5 scoring were excluded from the study. Patient characteristics and radiologic features were analyzed by multivariable logistic regression. Number-density of lesions was defined as the number of lesions per prostatic volume. Results: Of the 151 prostate cancer cases with PI-RADS 3 index lesions, 27% and 17% had upgrades and downgrades at RP, respectively. Analysis of grade changes showed no significant associations between discrepancies and the number or the number density of PI-RADS 3 lesions. Moreover, the study showed no significant association of the GG changes with race, age, location of the lesions, or prostate volume. Conclusions: This study demonstrated that in PI-RADS 3 cancerous nodules, the chance of the pathology changes in the final pathology of RP specimens was low. Furthermore, having multiple PI-RADS 3 nodules did not change the conclusion, as the possibility of grade changes in patients with multiple nodules was similar to those with solitary lesions.

Keywords: prostate, adenocarcinoma, multiparametric MRI, Gleason score, robot-assisted surgery

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4008 Finite Element-Based Stability Analysis of Roadside Settlements Slopes from Barpak to Yamagaun through Laprak Village of Gorkha, an Epicentral Location after the 7.8Mw 2015 Barpak, Gorkha, Nepal Earthquake

Authors: N. P. Bhandary, R. C. Tiwari, R. Yatabe

Abstract:

The research employs finite element method to evaluate the stability of roadside settlements slopes from Barpak to Yamagaon through Laprak village of Gorkha, Nepal after the 7.8Mw 2015 Barpak, Gorkha, Nepal earthquake. It includes three major villages of Gorkha, i.e., Barpak, Laprak and Yamagaun that were devastated by 2015 Gorkhas’ earthquake. The road head distance from the Barpak to Laprak and Laprak to Yamagaun are about 14 and 29km respectively. The epicentral distance of main shock of magnitude 7.8 and aftershock of magnitude 6.6 were respectively 7 and 11 kilometers (South-East) far from the Barpak village nearer to Laprak and Yamagaon. It is also believed that the epicenter of the main shock as said until now was not in the Barpak village, it was somewhere near to the Yamagaun village. The chaos that they had experienced during the earthquake in the Yamagaun was much more higher than the Barpak. In this context, we have carried out a detailed study to investigate the stability of Yamagaun settlements slope as a case study, where ground fissures, ground settlement, multiple cracks and toe failures are the most severe. In this regard, the stability issues of existing settlements and proposed road alignment, on the Yamagaon village slope are addressed, which is surrounded by many newly activated landslides. Looking at the importance of this issue, field survey is carried out to understand the behavior of ground fissures and multiple failure characteristics of the slopes. The results suggest that the Yamgaun slope in Profile 2-2, 3-3 and 4-4 are not safe enough for infrastructure development even in the normal soil slope conditions as per 2, 3 and 4 material models; however, the slope seems quite safe for at Profile 1-1 for all 4 material models. The result also indicates that the first three profiles are marginally safe for 2, 3 and 4 material models respectively. The Profile 4-4 is not safe enough for all 4 material models. Thus, Profile 4-4 needs a special care to make the slope stable.

Keywords: earthquake, finite element method, landslide, stability

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4007 Complexity in a Leslie-Gower Delayed Prey-Predator Model

Authors: Anuraj Singh

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The complex dynamics is explored in a prey predator system with multiple delays. The predator dynamics is governed by Leslie-Gower scheme. The existence of periodic solutions via Hopf bifurcation with respect to delay parameters is established. To substantiate analytical findings, numerical simulations are performed. The system shows rich dynamic behavior including chaos and limit cycles.

Keywords: chaos, Hopf bifurcation, stability, time delay

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4006 An Unexpected Hand Injury with Pluridigital Fractures Due to Premature Explosion of a Ramadan Cannon

Authors: Hakan Akgul

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Purpose: The use of firecrackers (i.e., Ramadan Cannon) during the month of Ramadan is a traditional way of indicating that the fasting period is over in Muslim countries. Here, we report the rehabilitation of a case of hand injury with pluridigital fractures due to premature explosion of a Ramadan cannon. Materials and Methods: A 48-year old man admitted to the Emergency Department due to left hand injury as a result of a premature explosion of a Ramadan cannon. The patient was immediately taken to operation room because of the multiple fractures, tendon loss, and soft tissue loss in the left hand. Range of motion (ROM) of joints was measured with goniometer, pain and oedema were measured and splinting was performed. Results: Rehabilitation team took over the patient at postoperative 9th week. During the 3 month rehabilitation, range of motion increased, oedema was taken under control, pain was reduced, the colour of the skin turned to the normal tone. According to the visual analog scale (VAS), pain decreased from 9 to 4. Oedema, around the metacarpofalangeal (MCP) joints, decreased from 27,5 cm to 23,5 cm. Total active range of motion of the wrist increased from 5 degrees to 50 degrees.Total active range of motion of supination and pronation increased from 55 degrees to 70 degrees. Discussion: The rehabilitation of multiple hand injury is quite difficult. Different aspects of trauma should be taken into consideration when rehabilitation is planned. Factors such as waiting for the bone union, wound healing, and use of external fixators may delay rehabilitation process. Joint mobilization, massage for reducing oedema and preventing scar tissue, exercise within the range of motion are efficient measures. Poor patient compliance to treatment may lead to poor outcome. First of all, oedema and scar formation must be taken under control. Removing fixators should not be delayed depending on the bone union, and exercise within the range of motion should be started.

Keywords: explosion, fracture, hand, injury

Procedia PDF Downloads 243
4005 Multiple Primary Pulmonary Meningiomas: A Case Report

Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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