Search results for: idiopathic intracranial hypertension physics of CSF
257 An Entropy Stable Three Dimensional Ideal MHD Solver with Guaranteed Positive Pressure
Authors: Andrew R. Winters, Gregor J. Gassner
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A high-order numerical magentohydrodynamics (MHD) solver built upon a non-linear entropy stable numerical flux function that supports eight traveling wave solutions will be described. The method is designed to treat the divergence-free constraint on the magnetic field in a similar fashion to a hyperbolic divergence cleaning technique. The solver is especially well-suited for flows involving strong discontinuities due to its strong stability without the need to enforce artificial low density or energy limits. Furthermore, a new formulation of the numerical algorithm to guarantee positivity of the pressure during the simulation is described and presented. By construction, the solver conserves mass, momentum, and energy and is entropy stable. High spatial order is obtained through the use of a third order limiting technique. High temporal order is achieved by utilizing the family of strong stability preserving (SSP) Runge-Kutta methods. Main attributes of the solver are presented as well as details on an implementation of the new solver into the multi-physics, multi-scale simulation code FLASH. The accuracy, robustness, and computational efficiency is demonstrated with a variety of numerical tests. Comparisons are also made between the new solver and existing methods already present in FLASH framework.Keywords: entropy stability, finite volume scheme, magnetohydrodynamics, pressure positivity
Procedia PDF Downloads 338256 Chern-Simons Equation in Financial Theory and Time-Series Analysis
Authors: Ognjen Vukovic
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Chern-Simons equation represents the cornerstone of quantum physics. The question that is often asked is if the aforementioned equation can be successfully applied to the interaction in international financial markets. By analysing the time series in financial theory, it is proved that Chern-Simons equation can be successfully applied to financial time-series. The aforementioned statement is based on one important premise and that is that the financial time series follow the fractional Brownian motion. All variants of Chern-Simons equation and theory are applied and analysed. Financial theory time series movement is, firstly, topologically analysed. The main idea is that exchange rate represents two-dimensional projections of three-dimensional Brownian motion movement. Main principles of knot theory and topology are applied to financial time series and setting is created so the Chern-Simons equation can be applied. As Chern-Simons equation is based on small particles, it is multiplied by the magnifying factor to mimic the real world movement. Afterwards, the following equation is optimised using Solver. The equation is applied to n financial time series in order to see if it can capture the interaction between financial time series and consequently explain it. The aforementioned equation represents a novel approach to financial time series analysis and hopefully it will direct further research.Keywords: Brownian motion, Chern-Simons theory, financial time series, econophysics
Procedia PDF Downloads 467255 Knowledge, Technology and Empowerment in Contemporary Scenario
Authors: Samir Roy
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This paper investigates the relationship among knowledge, technology, and empowerment. In Physics power is defined as rate of doing work. In everyday use, the meaning of the word power is related to the capacity to bring change of value in the world. It appears that the popular aphorism “Knowledge is power” should be revisited in the context of contemporary states of affairs. For instance, classical mechanics is a system of knowledge, so also thermodynamics. But neither of them, per se, is sufficient to produce automobilin es. Boolean algebra, the logical foundation of digital electronic computers, was introduced by George Boole in 1847. But that knowledge was practically useless for almost one hundred years until digital electronics was developed in early twentieth century, which eventually led to invention of digital electronic computers. Empowerment of women is a burning issue in the arena of social justice. However, if we carefully analyze the functional elements of women’s empowerment, we find them to be highly technology driven as well as technology dependent in real life. On the other hand, technology has empowered modern states to maintain social order and promote democracy in an effective manner. This paper includes a few case studies to establish the close correspondence between knowledge, especially scientific knowledge, technology, and empowerment. It appears that in contemporary scenario, “Technology is power” is a more appropriate statement than the traditional aphorism “Knowledge is power”.Keywords: knowledge, science, technology, empowerment, change, social justice
Procedia PDF Downloads 31254 The Data-Driven Localized Wave Solution of the Fokas-Lenells Equation using PINN
Authors: Gautam Kumar Saharia, Sagardeep Talukdar, Riki Dutta, Sudipta Nandy
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The physics informed neural network (PINN) method opens up an approach for numerically solving nonlinear partial differential equations leveraging fast calculating speed and high precession of modern computing systems. We construct the PINN based on strong universal approximation theorem and apply the initial-boundary value data and residual collocation points to weekly impose initial and boundary condition to the neural network and choose the optimization algorithms adaptive moment estimation (ADAM) and Limited-memory Broyden-Fletcher-Golfard-Shanno (L-BFGS) algorithm to optimize learnable parameter of the neural network. Next, we improve the PINN with a weighted loss function to obtain both the bright and dark soliton solutions of Fokas-Lenells equation (FLE). We find the proposed scheme of adjustable weight coefficients into PINN has a better convergence rate and generalizability than the basic PINN algorithm. We believe that the PINN approach to solve the partial differential equation appearing in nonlinear optics would be useful to study various optical phenomena.Keywords: deep learning, optical Soliton, neural network, partial differential equation
Procedia PDF Downloads 119253 Multiscale Model of Blast Explosion Human Injury Biomechanics
Authors: Raj K. Gupta, X. Gary Tan, Andrzej Przekwas
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Bomb blasts from Improvised Explosive Devices (IEDs) account for vast majority of terrorist attacks worldwide. Injuries caused by IEDs result from a combination of the primary blast wave, penetrating fragments, and human body accelerations and impacts. This paper presents a multiscale computational model of coupled blast physics, whole human body biodynamics and injury biomechanics of sensitive organs. The disparity of the involved space- and time-scales is used to conduct sequential modeling of an IED explosion event, CFD simulation of blast loads on the human body and FEM modeling of body biodynamics and injury biomechanics. The paper presents simulation results for blast-induced brain injury coupling macro-scale brain biomechanics and micro-scale response of sensitive neuro-axonal structures. Validation results on animal models and physical surrogates are discussed. Results of our model can be used to 'replicate' filed blast loadings in laboratory controlled experiments using animal models and in vitro neuro-cultures.Keywords: blast waves, improvised explosive devices, injury biomechanics, mathematical models, traumatic brain injury
Procedia PDF Downloads 245252 Nutrition Transition in Bangladesh: Multisectoral Responsiveness of Health Systems and Innovative Measures to Mobilize Resources Are Required for Preventing This Epidemic in Making
Authors: Shusmita Khan, Shams El Arifeen, Kanta Jamil
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Background: Nutrition transition in Bangladesh has progressed across various relevant socio-demographic contextual issues. For a developing country like Bangladesh, its is believed that, overnutrition is less prevalent than undernutrition. However, recent evidence suggests that a rapid shift is taking place where overweight is subduing underweight. With this rapid increase, for Bangladesh, it will be challenging to achieve the global agenda on halting overweight and obesity. Methods: A secondary analysis was performed from six successive national demographic and health surveys to get the trend on undernutrition and overnutrition for women from reproductive age. In addition, national relevant policy papers were reviewed to determine the countries readiness for whole of the systems approach to tackle this epidemic. Results: Over the last decade, the proportion of women with low body mass index (BMI<18.5), an indicator of undernutrition, has decreased markedly from 34% to 19%. However, the proportion of overweight women (BMI ≥25) increased alarmingly from 9% to 24% over the same period. If the WHO cutoff for public health action (BMI ≥23) is used, the proportion of overweight women has increased from 17% in 2004 to 39% in 2014. The increasing rate of obesity among women is a major challenge to obstetric practice for both women and fetuses. In the long term, overweight women are also at risk of future obesity, diabetes, hyperlipidemia, hypertension, and heart disease. These diseases have serious impact on health care systems. Costs associated with overweight and obesity involves direct and indirect costs. Direct costs include preventive, diagnostic, and treatment services related to obesity. Indirect costs relate to morbidity and mortality costs including productivity. Looking at the Bangladesh Health Facility Survey, it is found that the country is bot prepared for providing nutrition-related health services, regarding prevention, screening, management and treatment. Therefore, if this nutrition transition is not addressed properly, Bangladesh will not be able to achieve the target of the NCD global monitoring framework of the WHO. Conclusion: Addressing this nutrition transition requires contending ‘malnutrition in all its forms’ and addressing it with integrated approaches. Whole of the systems action is required at all levels—starting from improving multi-sectoral coordination to scaling up nutrition-specific and nutrition-sensitive mainstreamed interventions keeping health system in mind.Keywords: nutrition transition, Bangladesh, health system, undernutrition, overnutrition, obesity
Procedia PDF Downloads 280251 Study of Exciton Binding Energy in Photovoltaic Polymers and Non-Fullerene Acceptors
Authors: Ho-Wa Li, Sai-Wing Tsang
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The excitonic effect in organic semiconductors plays a key role in determining the electronic devices performance. Strong exciton binding energy has been regarded as the detrimental factor limiting the further improvement in organic photovoltaic cells. To the best of our knowledge, only limited reported can be found in measuring the exciton binding energy in organic photovoltaic materials. Conventional sophisticated approach using photoemission spectroscopy (UPS and IPES) would limit the wide access of the investigation. Here, we demonstrate a facile approach to study the electrical and optical quantum efficiencies of a series of conjugated photovoltaic polymer, fullerene and non-fullerene materials. Quantitative values of the exciton binding energy in those prototypical materials were obtained with concise photovoltaic device structure. And the extracted binding energies have excellent agreement with those determined by the conventional photoemission technique. More importantly, our findings can provide valuable information on the excitonic dissociation in the first excited state. Particularly, we find that the high binding energy of some non-fullerene acceptors limits the combination of polymer acceptors for efficiency exciton dissociation. The results bring insight into the engineering of excitonic effect for the development of efficient organic photovoltaic cells.Keywords: organic photovoltaics, quantum efficiency, exciton binding energy, device physics
Procedia PDF Downloads 145250 The Relationship of Depression Risk and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Yu Chen Su
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Introduction: Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance in pregnant women, impacting both the mother and newborn with short and long-term effects. It increases risks of preeclampsia, hypertension, type 2 diabetes, cesarean section, and preterm birth. GDM is associated with fetal macrosomia, shoulder dystocia, neonatal hypoglycemia, and future type 2 diabetes risk. A study on 6,421 pregnant women found 12% experienced high stress, linked to maladaptive coping and depressive emotions. Women with high-risk pregnancies may experience greater stress and depression. Research suggests GDM increases depression prevalence. A study on 632 Hispanic women with GDM showed severe stress and depression tendencies. Involving 95 women with GDM, 33.4% exhibited depression symptoms. Another study compared 180 GDM women to 186 with normal glucose levels, revealing higher depression levels in GDM women. They found GDM women were 1.85 times more likely to receive antidepressants during pregnancy and 1.69 times more likely to experience postpartum depression. Maternal stress and depressive symptoms during pregnancy are significant factors. Early identification by healthcare professionals can greatly benefit GDM women, their infants, and their families. Objectives: The purpose of this study was to investigate the association between gestational diabetes mellitus (GDM) and the risk of depression. Methods: This study reviewed and analyzed relevant literature on gestational diabetes mellitus (GDM) and depression in 6,876 patients. The literature search followed PRISMA guidelines and included databases like Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library. Prospective or retrospective studies with relevant risk ratios and estimates were included, using a random-effects model for the analysis of depression risk correlation. Studies without depression data or relevant risks were excluded. The search period extended until October 2022. Results: Systematic review of 7 studies (6,876 participants) found a significant association (OR = 8.77, CI: 7.98-9.64, p < 0.05) between gestational diabetes mellitus (GDM) and higher depression risk compared to healthy pregnant women. Conclusions: Pregnancy is a significant life transition involving physiological, psychological, and social changes. Gestational diabetes poses challenges to women's physical and mental well-being. Sensitive healthcare professionals identifying issues early can greatly benefit women, babies, and the family.Keywords: gestational diabetes, depression, systematic review, neta-analysis
Procedia PDF Downloads 68249 Mixed Number Algebra and Its Application
Authors: Md. Shah Alam
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Mushfiq Ahmad has defined a Mixed Number, which is the sum of a scalar and a Cartesian vector. He has also defined the elementary group operations of Mixed numbers i.e. the norm of Mixed numbers, the product of two Mixed numbers, the identity element and the inverse. It has been observed that Mixed Number is consistent with Pauli matrix algebra and a handy tool to work with Dirac electron theory. Its use as a mathematical method in Physics has been studied. (1) We have applied Mixed number in Quantum Mechanics: Mixed Number version of Displacement operator, Vector differential operator, and Angular momentum operator has been developed. Mixed Number method has also been applied to Klein-Gordon equation. (2) We have applied Mixed number in Electrodynamics: Mixed Number version of Maxwell’s equation, the Electric and Magnetic field quantities and Lorentz Force has been found. (3) An associative transformation of Mixed Number numbers fulfilling Lorentz invariance requirement is developed. (4) We have applied Mixed number algebra as an extension of Complex number. Mixed numbers and the Quaternions have isomorphic correspondence, but they are different in algebraic details. The multiplication of unit Mixed number and the multiplication of unit Quaternions are different. Since Mixed Number has properties similar to those of Pauli matrix algebra, Mixed Number algebra is a more convenient tool to deal with Dirac equation.Keywords: mixed number, special relativity, quantum mechanics, electrodynamics, pauli matrix
Procedia PDF Downloads 355248 Access of Refugees in Rural Areas to Regular Medication during COVID-19 Era: International Organization for Migration, Jordan Experience
Authors: Rasha Shoumar
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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.Keywords: COVID-19, refugees, mobile clinics, primary health care
Procedia PDF Downloads 133247 Investigation of the Thermal Flow inside the Catalytic Combustor for Lean CH4-Air Mixture on a Platinum Catalyst with H2 Addition
Authors: Kumaresh Selvakumar, Man Young Kim
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In order to elaborate the main idea of investigating the flow physics inside the catalytic combustor, the characteristics of the catalytic surface reactions are analyzed by employing the CHEMKIN methodology with detailed gas and surface chemistries. The presence of a catalyst inside an engine enables complete combustion at lower temperatures which promotes desired chemical reactions. A single channel from the honeycomb monolith catalytic combustor is preferred to analyze the gas and surface reactions in the catalyst bed considering the fact that every channel in the honeycomb monolith behaves in similar fashion. The simplified approach with single catalyst channel using plug flow reactor can be used to predict the flow behavior inside the catalytic combustor. The hydrogen addition to the combustion reactants offers a way to light-off catalytic combustion of methane on platinum catalyst and aids to reduce the surface ignition temperature. Indeed, the hydrogen adsorption is higher on the uncovered Pt(s) surface sites because the sticking coefficient of hydrogen is larger than that of methane. The location of flame position in the catalyst bed is validated by igniting the methane fuel with the presence of hydrogen for corresponding multistep surface reactions.Keywords: catalytic combustor, hydrogen adsorption, plug flow reactor, surface ignition temperature
Procedia PDF Downloads 342246 Globally Attractive Mild Solutions for Non-Local in Time Subdiffusion Equations of Neutral Type
Authors: Jorge Gonzalez Camus, Carlos Lizama
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In this work is proved the existence of at least one globally attractive mild solution to the Cauchy problem, for fractional evolution equation of neutral type, involving the fractional derivate in Caputo sense. An almost sectorial operator on a Banach space X and a kernel belonging to a large class appears in the equation, which covers many relevant cases from physics applications, in particular, the important case of time - fractional evolution equations of neutral type. The main tool used in this work was the Hausdorff measure of noncompactness and fixed point theorems, specifically Darbo-type. Initially, the equation is a Cauchy problem, involving a fractional derivate in Caputo sense. Then, is formulated the equivalent integral version, and defining a convenient functional, using the analytic integral resolvent operator, and verifying the hypothesis of the fixed point theorem of Darbo type, give us the existence of mild solution for the initial problem. Furthermore, each mild solution is globally attractive, a property that is desired in asymptotic behavior for that solution.Keywords: attractive mild solutions, integral Volterra equations, neutral type equations, non-local in time equations
Procedia PDF Downloads 150245 Theoretical and Experimental Investigation of the Interaction Behavior of a Bouncing Ball upon a Flexible Surface Impacted in Two Dimensions
Authors: Wiwat Chumai, Perawit Boonsomchua, Kanjana Ongkasin
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The ball bouncing problem is a well-known problem in physics involving a ball dropped from a height to the ground. In this paper, the work investigates the theoretical and experimental setup that describes the dynamics of a rigid body on a chaotic elastic surface under air-damp conditions. Examination of four different types of balls is made, including marble, metal ball, tennis ball, and ping-pong ball. In this experiment, the effect of impact velocities is not considered; the ball is dropped from a fixed height. The method in this work employs the Rayleigh Dissipation Function to specify the effects of dissipative forces in Lagrangian mechanics. Our discoveries reveal that the dynamics of the ball exhibit horizontal motion while damping oscillation occurs, forming the destabilization in vertical pinch-off motion. Moreover, rotational motion is studied. According to the investigation of four different balls, the outcomes illustrate that greater mass results in more frequent dynamics, and the experimental results at some points align with the theoretical model. This knowledge contributes to our understanding of the complex fluid system and could serve as a foundation for further developments in water droplet simulation.Keywords: droplet, damping oscillation, nonlinear damping oscillation, bouncing ball problem, elastic surface
Procedia PDF Downloads 80244 Implementing Search-Based Activities in Mathematics Instruction, Grounded in Intuitive Reasoning
Authors: Zhanna Dedovets
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Fostering a mathematical style of thinking is crucial for cultivating intellectual personalities capable of thriving in modern society. Intuitive thinking stands as a cornerstone among the components of mathematical cognition, playing a pivotal role in grasping mathematical truths across various disciplines. This article delves into the exploration of leveraging search activities rooted in students' intuitive thinking, particularly when tackling geometric problems. Emphasizing both student engagement with the task and their active involvement in the search process, the study underscores the importance of heuristic procedures and the freedom for students to chart their own problem-solving paths. Spanning several years (2019-2023) at the Physics and Mathematics Lyceum of Dushanbe, the research engaged 17 teachers and 78 high school students. After assessing the initial levels of intuitive thinking in both control and experimental groups, the experimental group underwent training following the authors' methodology. Subsequent analysis revealed a significant advancement in thinking levels among the experimental group students. The methodological approaches and teaching materials developed through this process offer valuable resources for mathematics educators seeking to enhance their students' learning experiences effectively.Keywords: teaching of mathematics, intuitive thinking, heuristic procedures, geometric problem, students.
Procedia PDF Downloads 36243 Physics of Decision for Polling Place Management: A Case Study from the 2020 USA Presidential Election
Authors: Nafe Moradkhani, Frederick Benaben, Benoit Montreuil, Ali Vatankhah Barenji, Dima Nazzal
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In the context of the global pandemic, the practical management of the 2020 presidential election in the USA was a strong concern. To anticipate and prepare for this election accurately, one of the main challenges was to confront (i) forecasts of voter turnout, (ii) capacities of the facilities and, (iii) potential configuration options of resources. The approach chosen to conduct this anticipative study consists of collecting data about forecasts and using simulation models to work simultaneously on resource allocation and facility configuration of polling places in Fulton County, Georgia’s largest county. A polling place is a dedicated facility where voters cast their ballots in elections using different devices. This article presents the results of the simulations of such places facing pre-identified potential risks. These results are oriented towards the efficiency of these places according to different criteria (health, trust, comfort). Then a dynamic framework is introduced to describe risks as physical forces perturbing the efficiency of the observed system. Finally, the main benefits and contributions resulting from this simulation campaign are presented.Keywords: performance, decision support, simulation, artificial intelligence, risk management, election, pandemics, information system
Procedia PDF Downloads 144242 Visualization of Wave Propagation in Monocoupled System with Effective Negative Stiffness, Effective Negative Mass, and Inertial Amplifier
Authors: Abhigna Bhatt, Arnab Banerjee
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A periodic system with only a single coupling degree of freedom is called a monocoupled system. Monocoupled systems with mechanisms like mass in the mass system generates effective negative mass, mass connected with rigid links generates inertial amplification, and spring-mass connected with a rigid link generateseffective negative stiffness. In this paper, the representative unit cell is introduced, considering all three mechanisms combined. Further, the dynamic stiffness matrix of the unit cell is constructed, and the dispersion relation is obtained by applying the Bloch theorem. The frequency response function is also calculated for the finite length of periodic unit cells. Moreover, the input displacement signal is given to the finite length of periodic structure and using inverse Fourier transform to visualize the wave propagation in the time domain. This visualization explains the sudden attenuation in metamaterial due to energy dissipation by an embedded resonator at the resonance frequency. The visualization created for wave propagation is found necessary to understand the insights of physics behind the attenuation characteristics of the system.Keywords: mono coupled system, negative effective mass, negative effective stiffness, inertial amplifier, fourier transform
Procedia PDF Downloads 112241 Formal Group Laws and Toposes in Gauge Theory
Authors: Patrascu Andrei Tudor
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One of the main problems in high energy physics is the fact that we do not have a complete understanding of the interaction between local and global effects in gauge theory. This has an increasing impact on our ability to access the non-perturbative regime of most of our theories. Our theories, while being based on gauge groups considered to be simple or semi-simple and connected, are expected to be described by their simple local linear approximation, namely the Lie algebras. However, higher homotopy properties resulting in gauge anomalies appear frequently in theories of physical interest. Our assumption that the groups we deal with are simple and simply connected is probably not suitable, and ways to go beyond such assumptions, particularly in gauge theories, where the Lie algebra linear approximation is prevalent, are not known. We approach this problem from two directions: on one side we are explaining the potential role of formal group laws in describing certain higher homotopical properties and interferences with local or perturbative effects, and on the other side, we employ a categorical approach leading to synthetic theory and a way of looking at gauge theories. The topos approach is based on a geometry where the fundamental logic is intuitionistic logic, and hence the ‘tertium non datur’ principle is abandoned. This has a remarkable impact on understanding conformal symmetry and its anomalies in string theory in various dimensions.Keywords: Gauge theory, formal group laws, Topos theory, conformal symmetry
Procedia PDF Downloads 25240 Electronic/Optoelectronic Property Tuning in Two-Dimensional Transition Metal Dichalcogenides via High Pressure
Authors: Juan Xia, Jiaxu Yan, Ze Xiang Shen
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The tuneable interlayer interactions in two-dimensional (2D) transition metal dichlcogenides (TMDs) offer an exciting platform for exploring new physics and applications by material variety, thickness, stacking sequence, electromagnetic filed, and stress/strain. Compared with the five methods mentioned above, high pressure is a clean and powerful tool to induce dramatic changes in lattice parameters and physical properties for 2D TMD materials. For instance, high pressure can strengthen the van der Waals interactions along c-axis and shorten the covalent bonds in atomic plane, leading to the typical first-order structural transition (2Hc to 2Ha for MoS2), or metallization. In particular, in the case of WTe₂, its unique symmetry endows the significant anisotropy and the corresponding unexpected properties including the giant magnetoresistance, pressure-induced superconductivity and Weyl semimetal states. Upon increasing pressure, the Raman peaks for WTe₂ at ~120 cm⁻¹, are gradually red-shifted and totally suppressed above 10 GPa, attributed to the possible structural instability of orthorhombic Td phase under high pressure and phase transition to a new monoclinic T' phase with inversion symmetry. Distinct electronic structures near Fermi level between the Td and T' phases may pave a feasible way to achieve the Weyl state tuning in one material without doping.Keywords: 2D TMDs, electronic property, high pressure, first-principles calculations
Procedia PDF Downloads 224239 Analyzing the Impact of Bariatric Surgery in Obesity Associated Chronic Kidney Disease: A 2-Year Observational Study
Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho
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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function
Procedia PDF Downloads 352238 A Neural Network Approach to Understanding Turbulent Jet Formations
Authors: Nurul Bin Ibrahim
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Advancements in neural networks have offered valuable insights into Fluid Dynamics, notably in addressing turbulence-related challenges. In this research, we introduce multiple applications of models of neural networks, namely Feed-Forward and Recurrent Neural Networks, to explore the relationship between jet formations and stratified turbulence within stochastically excited Boussinesq systems. Using machine learning tools like TensorFlow and PyTorch, the study has created models that effectively mimic and show the underlying features of the complex patterns of jet formation and stratified turbulence. These models do more than just help us understand these patterns; they also offer a faster way to solve problems in stochastic systems, improving upon traditional numerical techniques to solve stochastic differential equations such as the Euler-Maruyama method. In addition, the research includes a thorough comparison with the Statistical State Dynamics (SSD) approach, which is a well-established method for studying chaotic systems. This comparison helps evaluate how well neural networks can help us understand the complex relationship between jet formations and stratified turbulence. The results of this study underscore the potential of neural networks in computational physics and fluid dynamics, opening up new possibilities for more efficient and accurate simulations in these fields.Keywords: neural networks, machine learning, computational fluid dynamics, stochastic systems, simulation, stratified turbulence
Procedia PDF Downloads 61237 Spectra Analysis in Sunset Color Demonstrations with a White-Color LED as a Light Source
Authors: Makoto Hasegawa, Seika Tokumitsu
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Spectra of light beams emitted from white-color LED torches are different from those of conventional electric torches. In order to confirm if white-color LED torches can be used as light sources for popular sunset color demonstrations in spite of such differences, spectra of travelled light beams and scattered light beams with each of a white-color LED torch (composed of a blue LED and yellow-color fluorescent material) and a conventional electric torch as a light source were measured and compared with each other in a 50 cm-long water tank for sunset color demonstration experiments. Suspension liquid was prepared from acryl-emulsion and tap-water in the water tank, and light beams from the white-color LED torch or the conventional electric torch were allowed to travel in this suspension liquid. Sunset-like color was actually observed when the white-color LED torch was used as the light source in sunset color demonstrations. However, the observed colors when viewed with naked eye look slightly different from those obtainable with the conventional electric torch. At the same time, with the white-color LED, changes in colors in short to middle wavelength regions were recognized with careful observations. From those results, white-color LED torches are confirmed to be applicable as light sources in sunset color demonstrations, although certain attentions have to be paid. Further advanced classes will be successfully performed with white-color LED torches as light sources.Keywords: blue sky demonstration, sunset color demonstration, white LED torch, physics education
Procedia PDF Downloads 276236 Is Obesity Associated with CKD-(unknown) in Sri Lanka? A Protocol for a Cross Sectional Survey
Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara
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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka
Procedia PDF Downloads 266235 Non-Isothermal Stationary Laminar Oil Flow Numerical Simulation
Authors: Daniyar Bossinov
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This paper considers a non-isothermal stationary waxy crude oil flow in a two-dimensional axisymmetric pipe with the transition of a Newtonian fluid to a non-Newtonian fluid. The viscosity and yield stress of waxy crude oil are highly dependent on temperature changes. During the hot pumping of waxy crude oil through a buried pipeline, a non-isothermal flow occurs due to heat transfer to the surrounding soil. This leads to a decrease in flow temperature, an increase in viscosity, the appearance of yield stress, the crystallization of wax, and the deposition of solid particles on the pipeline's inner wall. The deposition of oil solid particles reduces a pipeline flow area and leads to the appearance of a stagnant zone with thermal insulation in the near-wall area. Waxy crude oil properties change. A Newtonian fluid at low temperatures transits to a non-Newtonian fluid. The one-dimensional modeling of a non-isothermal waxy crude oil flow in a two-dimensional axisymmetric pipeline by traditional averaging of temperature and velocity over the pipeline cross-section does not allow for explaining a physics phenomenon. Therefore, in this work, a two-dimensional flow model and the heat transfer of waxy oil are constructed. The calculated data show the transition of a Newtonian fluid to a non-Newtonian fluid due to the heat exchange of waxy oil with the environment.Keywords: non-isothermal laminar flow, waxy crude oil, stagnant zone, yield stress
Procedia PDF Downloads 16234 Bulbar Conjunctival Kaposi's Sarcoma Unmasked by Immune Reconstitution Syndrome
Authors: S. Mohd Afzal, R. O'Connell
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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus
Procedia PDF Downloads 331233 An Approach for Detection Efficiency Determination of High Purity Germanium Detector Using Cesium-137
Authors: Abdulsalam M. Alhawsawi
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Estimation of a radiation detector's efficiency plays a significant role in calculating the activity of radioactive samples. Detector efficiency is measured using sources that emit a variety of energies from low to high-energy photons along the energy spectrum. Some photon energies are hard to find in lab settings either because check sources are hard to obtain or the sources have short half-lives. This work aims to develop a method to determine the efficiency of a High Purity Germanium Detector (HPGe) based on the 662 keV gamma ray photon emitted from Cs-137. Cesium-137 is readily available in most labs with radiation detection and health physics applications and has a long half-life of ~30 years. Several photon efficiencies were calculated using the MCNP5 simulation code. The simulated efficiency of the 662 keV photon was used as a base to calculate other photon efficiencies in a point source and a Marinelli Beaker form. In the Marinelli Beaker filled with water case, the efficiency of the 59 keV low energy photons from Am-241 was estimated with a 9% error compared to the MCNP5 simulated efficiency. The 1.17 and 1.33 MeV high energy photons emitted by Co-60 had errors of 4% and 5%, respectively. The estimated errors are considered acceptable in calculating the activity of unknown samples as they fall within the 95% confidence level.Keywords: MCNP5, MonteCarlo simulations, efficiency calculation, absolute efficiency, activity estimation, Cs-137
Procedia PDF Downloads 113232 Leuprolide Induced Scleroderma Renal Crisis: A Case Report
Authors: Nirali Sanghavi, Julia Ash, Amy Wasserman
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Introduction: To the best of our knowledge, there is only one case report that found an association between leuprolide and scleroderma renal crisis (SRC). Leuprolide has been noted to cause acute renal failure in some patients. Given the close timing of the leuprolide injection and the worsening renal function in our patient, leuprolide likely caused exacerbation of lupus nephritis and SRC. Interestingly, our patient on long-term hydroxychloroquine (HCQ) with normal baseline cardiac function was found to have HCQ cardiomyopathy highlighting the need for close monitoring of HCQ toxicity. We know that some of the risk factors that are involved in HCQ induced cardiomyopathy are older age, females, increased dose and >10 years of HCQ use, and pre-existing cardiac and renal insufficiency. Case presentation: A 34-year-old African American woman with a history of overlap of systemic lupus erythematosus (SLE) and scleroderma features and class III lupus nephritis presented with severe headaches, elevated blood pressure (180/120 mmHg) and worsening creatinine levels (2.07 mg/dL). The headaches started 1 month ago after she started leuprolide injections for fibroids. She was being treated with mycophenolate mofetil 1 gm twice a day, belimumab weekly, HCQ 200mg, and prednisone 5 mg daily. She has been on HCQ since her teenage years. The examination was unremarkable except for proximal interphalangeal joint contractures in the right hand and sclerodactyly of bilateral hands, unchanged from baseline. Laboratory findings include urinalysis, which showed 3+ protein, 1+ blood, 6 red blood cells, and 14 white blood cells ruling out thrombotic microangiopathy. C3 was 32 mg/dL, C4 <5 mg/dL, and +dsDNA increased >1000. She was started on captopril and discharged once creatinine and blood pressure was controlled. She was readmitted with hypertension, hyperkalemia, worsening creatinine, nephrotic range proteinuria, complaints of chest pressure, and shortness of breath with pleuritic chest pain. Physical examination and lab findings were unchanged. She was treated with pulse dose methyl prednisone followed by taper and multiple anti-hypertensive agents, including captopril, for presumed lupus nephritis flare versus SRC. Renal biopsy was consistent with SRC and class IV lupus nephritis and was started on cyclophosphamide. While cardiac biopsy showed borderline myocarditis without necrosis and cytoplasmic vacuolization consistent with HCQ cardiomyopathy, hence HCQ was discontinued. Summary: It highlights a rare association of leuprolide causing exacerbation of lupus nephritis or SRC. Although rare, the current case reinforces the importance of close monitoring for HCQ toxicity in patients with renal insufficiency.Keywords: leuprolide, lupus nephritis, scleroderma, SLE
Procedia PDF Downloads 88231 Using SMS Mobile Technology to Assess the Mastery of Subject Content Knowledge of Science and Mathematics Teachers of Secondary Schools in Tanzania
Authors: Joel S. Mtebe, Aron Kondoro, Mussa M. Kissaka, Elia Kibga
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Sub-Saharan Africa is described as the second fastest growing mobile phone penetration in the world more than in the United States or the European Union. Mobile phones have been used to provide a lot of opportunities to improve people’s lives in the region such as in banking, marketing, entertainment, and paying various bills such as water, TV, and electricity. However, the potential of using mobile phones to enhance teaching and learning has not been explored. This study presents an experience of developing and delivering SMS quizzes questions that were used to assess mastery of the subject content knowledge of science and mathematics secondary school teachers in Tanzania. The SMS quizzes were used as a follow up support mechanism to 500 teachers who participated in a project to upgrade subject content knowledge of science and mathematics subjects. Quizzes of 10-15 questions were sent to teachers each week for 8 weeks and the results were analyzed using SPSS. The results showed that chemistry and biology had better performance compared to mathematics and physics. Teachers reported some challenges that led to poor performance, invalid answers, and non-responses and they are presented. This research has several practical implications for those who are implementing or planning to use mobile phones for teaching and learning especially in rural secondary schools in sub-Saharan Africa.Keywords: mobile learning, elearning, educational technolgies, SMS, secondary education, assessment
Procedia PDF Downloads 275230 Cardiac Arrest after Cardiac Surgery
Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov
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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients
Procedia PDF Downloads 48229 Social Ties and the Prevalence of Single Chronic Morbidity and Multimorbidity among the Elderly Population in Selected States of India
Authors: Sree Sanyal
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Research in ageing often highlights the age-related health dimension more than the psycho-social characteristics of the elderly, which also influences and challenges the health outcomes. Multimorbidity is defined as the person having more than one chronic non-communicable diseases and their prevalence increases with ageing. The study aims to evaluate the influence of social ties on self-reported prevalence of multimorbidity (selected chronic non-communicable diseases) among the selected states of elderly population in India. The data is accessed from Building Knowledge Base on Population Ageing in India (BKPAI), collected in 2011 covering the self-reported chronic non-communicable diseases like arthritis, heart disease, diabetes, lung disease with asthma, hypertension, cataract, depression, dementia, Alzheimer’s disease, and cancer. The data of the above diseases were taken together and categorized as: ‘no disease’, ‘one disease’ and ‘multimorbidity’. The predicted variables were demographic, socio-economic, residential types, and the variable of social ties includes social support, social engagement, perceived support, connectedness, and importance of the elderly. Predicted probability for multiple logistic regression was used to determine the background characteristics of the old in association with chronic morbidities showing multimorbidity. The finding suggests that 24.35% of the elderly are suffering from multimorbidity. Research shows that with reference to ‘no disease’, according to the socio-economic characteristics of the old, the female oldest old (80+) from others in caste and religion, widowed, never had any formal education, ever worked in their life, coming from the second wealth quintile standard, from rural Maharashtra are more prone with ‘one disease’. From the social ties background, the elderly who perceives they are important to the family, after getting older their decision-making status has been changed, prefer to stay with son and spouse only, satisfied with the communication from their children are more likely to have less single morbidity and the results are significant. Again, with respect to ‘no disease’, the female oldest old (80+), who are others in caste, Christian in religion, widowed, having less than 5 years of education completed, ever worked, from highest wealth quintile, residing in urban Kerala are more associated with multimorbidity. The elderly population who are more socially connected through family visits, public gatherings, gets support in decision making, who prefers to spend their later years with son and spouse only but stays alone shows lesser prevalence of multimorbidity. In conclusion, received and perceived social integration and support from associated neighborhood in the older days, knowing about their own needs in life facilitates better health and wellbeing of the elderly population in selected states of India.Keywords: morbidity, multi-morbidity, prevalence, social ties
Procedia PDF Downloads 113228 Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy
Authors: Virany Diana, Martono Tri Utomo, Risa Etika
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Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock
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