Search results for: idiopathic intracranial hypertension physics of CSF

Authors: Ghirmay Teklemicheal, Samsom Mehari, Sara Tesfay

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Objectives: A total of 1074 suspected chikungunya cases were reported in Tesseney Province, Gash Barka region, Eritrea, during an outbreak. This study was aimed to assess the possible association of chikungunya severity among ABO blood groups and other potential determinants. Methods: A sex-matched and age-matched case-control study was conducted during the outbreak. For each case, one control subject had been selected from the mild Chikungunya cases. Along the same line of argument, a second control subject had also been designated through which neighborhood of cases were analyzed, scrutinized, and appeared to the scheme of comparison. Time is always the most sacrosanct element in pursuance of any study. According to the temporal calculation, this study was pursued from October 15, 2018, to November 15, 2018. Coming to the methodological dependability, calculating odds ratios (ORs) and conditional (fixed-effect) logistic regression methods were being applied. As a consequence of this, the data was analyzed and construed on the basis of the aforementioned methodological systems. Results: In this outbreak, 137 severe suspected chikungunya cases and 137 mild chikungunya suspected patients, and 137 controls free of chikungunya from the neighborhood of cases were analyzed. Non-O individuals compared to those with O blood group indicated as significant with a p-value of 0.002. Separate blood group comparison among A and O blood groups reflected as significant with a p-value of 0.002. However, there was no significant difference in the severity of chikungunya among B, AB, and O blood groups with a p-value of 0.113 and 0.708, respectively, and a strong association of chikungunya severity was found with hypertension and diabetes (p-value of < 0.0001); whereas, there was no association between chikungunya severity and asthma with a p-value of 0.695 and also no association with pregnancy (p-value =0.881), ventilator (p-value =0.181), air conditioner (p-value = 0.247), and didn’t use latrine and pit latrine (p-value = 0.318), among individuals using septic and pit latrine (p-value = 0.567) and also among individuals using flush and pit latrine (p-value = 0.194). Conclusions: Non- O blood groups were found to be at risk more than their counterpart O blood group individuals with severe form of chikungunya disease. By the same token, individuals with chronic disease were more prone to severe forms of the disease in comparison with individuals without chronic disease. Prioritization is recommended for patients with chronic diseases and non-O blood group since they are found to be susceptible to severe chikungunya disease. Identification of human cell surface receptor(s) for CHIKV is quite necessary for further understanding of its pathophysiology in humans. Therefore, molecular and functional studies will necessarily be helpful in disclosing the association of blood group antigens and CHIKV infections.

Keywords: Chikungunya, Chikungunya virus, disease outbreaks, case-control studies, Eritrea

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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

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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

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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 286

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

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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

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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

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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

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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

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Authors: Jutharat Sunprasert, Ekapong Hirunsirisawat, Narongrit Waraporn, Somporn Peansukmanee

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Metal Ship and Robotic Car is one of the hands-on activities in the course, the Fundamental of Engineering that can be divided into three parts. The first part, the metal ships, was made by using engineering drawings, physics and mathematics knowledge. The second part is where the students learned how to construct a robotic car and control it using computer programming. In the last part, the students had to combine the workings of these two objects in the final testing. This aim of study was to investigate the effectiveness of hands-on activity by integrating Science, Technology, Engineering and Mathematics (STEM) concepts to develop scientific and engineering skills. The results showed that the majority of students felt this hands-on activity lead to an increased confidence level in the integration of STEM. Moreover, 48% of all students engaged well with the STEM concepts. Students could obtain the knowledge of STEM through hands-on activities with the topics science and mathematics, engineering drawing, engineering workshop and computer programming; most students agree and strongly agree with this learning process. This indicated that the hands-on activity: “Metal Ship and Robotic Car” is a useful tool to integrate each aspect of STEM. Furthermore, hands-on activities positively influence a student’s interest which leads to increased learning achievement and also in developing scientific and engineering skills.

Keywords: hands-on activity, STEM education, computer programming, metal work

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Authors: Neelesh Bharti Shukla, Suvankar Dutta, Esha Sharma, Shrikant Ralebhat, Gurudatt Krishnamurthy

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A key component of the physical attribute of textile fibers is lustre. It is a complex phenomenon arising from the interaction of light with fibers, yarn and fabrics. It is perceived as the contrast difference between the bright areas (specular reflection) and duller backgrounds (diffused reflection). Lustre of fibers is affected by their surface structure, morphology, cross-section profile as well as the presence of any additives/registrants. Due to complexities in measurements, objective measurements such as gloss meter do not give reproducible quantification of lustre. Other instruments such as SAMBA hair systems are expensive. In light of this, lustre quantification has largely remained subjective, judged visually by experts, but prone to errors. In this development, a physics-based approach was conceptualized and demonstrated. We have developed an image analysis based technique to quantify visually observed differences in lustre of fibers. Cellulosic fibers, produced with different approaches, with visually different levels of lustre were photographed under controlled optics. These images were subsequently analyzed using a configured software system. The ratio of Intensity of light from bright (specular reflection) and dull (diffused reflection) areas was used to numerically represent lustre. In the next step, the set of samples that were not visually distinguishable easily were also evaluated by the technique and it was established that quantification of lustre is feasible.

Keywords: lustre, fibre, image analysis, measurement

Procedia PDF Downloads 169

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

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Authors: Rajat Mittal, Jung Hee Seo, Jacob Turner, Harshal Raut

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The perpetual advancement in computational capabilities, coupled with the continuous evolution of software tools and numerical algorithms, is creating novel avenues for research, exploration, and application at the nexus of computational fluid and structural mechanics. Fish leverage their remarkably flexible bodies and fins to harness energy from vortices, propelling themselves with an elegance and efficiency that captivates engineers. Bats fly with unparalleled agility and speed by using their flexible membrane wings. Wave-assisted propulsion (WAP) systems, utilizing elastically mounted hydrofoils, convert wave energy into thrust. Each of these problems involves a complex and elegant interplay between fluid dynamics and structural mechanics. Historically, investigations into such phenomena were constrained by available tools, but modern computational advancements now facilitate exploration of these multi-physics challenges with an unprecedented level of fidelity, precision, and realism. In this work, the author will discuss projects that harness the capabilities of high-fidelity sharp-interface immersed boundary methods to address a spectrum of engineering and biological challenges involving fluid-structure interaction.

Keywords: immersed boundary methods, CFD, bioflight, fluid structure interaction

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Authors: Saurabh Chaudhury, Sanjeet Kumar Sinha

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The MOSFET has been the main building block in high performance and low power VLSI chips for the last several decades. Device scaling is fundamental to technological advancements, which allows more devices to be integrated on a single die providing greater functionality per chip. Ultimately, the goal of scaling is to build an individual transistor that is smaller, faster, cheaper, and consumes less power. Scaling continued following Moore's law initially and now we see an exponential growth in today's nano scaled chip. However, device scaling to deep nano meter regime leads to exponential increase in leakage currents and excessive heat generation. Moreover, fabrication process variability causing a limitation to further scaling. Researchers believe that with a mix of chemistry, physics, and engineering, nano electronics may provide a solution to increasing fabrication costs and may allow integrated circuits to be scaled beyond the limits of the modern transistor. Carbon nano tube (CNT) and nano wires (NW) based FETs have been analyzed and characterized in laboratory and also been demonstrated as prototypes. This work presents an extensive simulation based study and analysis of CNTFET and NW-FET devices and comparison of the results with conventional MOSFET. From this study, we can conclude that these devices have got some excellent properties and favorable characteristics which will definitely lead the future semiconductor devices in post silicon era.

Keywords: carbon nanotube, nanowire FET, low power, nanoscaled devices, VLSI

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Authors: J. Kontoleon, D.Gall, M.Pidskalny

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FisherONE offers a distinct pedagogic model for senior secondary education that integrates advanced technology to meet the learning needs of Year 11 and 12 students across Catholic schools in Queensland. As a fully online platform, FisherONE employs pedagogy that combines flexibility with personalized, data-driven learning. The model leverages tools like the MaxHub hybrid interactive system and AI-powered learning assistants to create tailored learning pathways that promote student autonomy and engagement. This paper examines FisherONE’s success in employing pedagogic strategies through technology. Initial findings suggest that students benefit from the blended approach of virtual assessments and real-time support, even as AI-assisted tools remain in the proof-of-concept phase. The study outlines how FisherONE plans to continue refining its educational methods to better serve students in distance learning environments, specifically in challenging subjects like physics. The integration of technology in FisherONE enhances the effectiveness of teaching and learning, addressing common challenges in online education by offering scalable, individualized learning experiences. This approach demonstrates the future potential of technology in education and the role it can play in fostering meaningful student outcomes.

Keywords: AI-assisted learning, innovative pedagogy, personalized learning, senior education, technology in education

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Authors: L. Vujičić, Ž. Ivković, Ž. Boneta

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There is a widespread belief in everyday discourse that science subjects (physics, chemistry and biology) are, along with math, the most difficult school subjects in the education of an individual. This assumption is usually justified by the following facts: low GPA in these subjects, the number of pupils who fail these subjects is high in comparison to other subjects, and the number of pupils interested in continuing their studies in the fields with a focus on science subjects is lower compared to non-science-oriented fields. From that perspective, the project: “Could it be different? How do children explore it?” becomes extremely interesting because it is focused on young children and on the introduction of new methods, with aim of arousing interest in scientific literacy development in 10 kindergartens by applying the methodology of an action research, with an ethnographic approach. We define scientific literacy as a process of encouraging and nurturing the research and explorative spirit in children, as well as their natural potential and abilities that represent an object of scientific research: to learn about exploration by conducting exploration. Upon project completion, an evaluation questionnaire was created for the parents of the children who had participated in the project, as well as for those whose children had not been involved in the project. The purpose of the first questionnaire was to examine the level of satisfaction with the project implementation and its outcomes among those parents whose children had been involved in the project (N=142), while the aim of the second questionnaire was to find out how much the parents of the children not involved (N=154) in this activity were interested in this topic.

Keywords: documenting, early childhood education, evaluation questionnaire for parents, scientific literacy development

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Authors: F. Noto, M. Castro, R. Garraffo, An. Mirabella, A. Rizzo, G. Cuttone

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The door fan test is a verification procedure on the tightness of a room, necessary following the installation of saturation extinguishing systems and made mandatory according to the UNI 15004-1: 2019 standard whenever a gas extinguishing system is designed and installed. The door fan test was carried out at the Portopalo di Capo Passero headquarters of the Southern National Laboratories and highlighted how the Data Processing Center is perfectly up to standard, passing the door fan test in an excellent way. The Southern National Laboratories constitute a solid research reality, well established in the international scientific panorama. The CED in the Portopalo site has been expanded, so the extinguishing system has been expanded according to a detailed design. After checking the correctness of the design to verify the absence of air leaks, we carried out the door fan test. The activities of the LNS are mainly aimed at basic research in the field of Nuclear Physics, Nuclear and Particle Astrophysics. The Portopalo site will host some of the largest submarine wired scientific research infrastructures built in Europe and in the world, such as KM3NeT and EMSO ERIC; in particular, the site research laboratory in Portopalo will host the power supply and data acquisition systems of the underwater infrastructures, and a technological backbone will be created, unique in the Mediterranean, capable of allowing the connection, at abyssal depths, of dozens of real-time surveying and research structures of the marine environment deep.

Keywords: KM3Net, fire protection, door fan test, CED

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Authors: Luma Al-Tamimi, Hassan Farhat, Wessam Hasan

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A three-dimensional (3D) hybrid quasi-steady thermal lattice Boltzmann model is developed to couple the effects of surfactant, temperature, interfacial tension, and contact angle. This 3D model is an extended scheme of a previously introduced two-dimensional (2D) hybrid lattice Boltzmann model. The 3D model is used to study the combined multi-physics effects on emulsion systems flowing in rectangular microchannels with and without confinements, where the suspended phase is made of droplets, plugs, or a mixture of both. The simulation results show that emulsion systems with plugs as the suspended phase are more efficient than with droplets, whereas mixed systems that form large plugs through coalescence have even greater efficiency. The 3D contact angle model generates matching results to those of the 2D model, which were validated with experiments. Furthermore, the effects of various confinements on adhering single drop systems are investigated for delineating their influence on the power required for transporting the suspended phase through the channel. It is shown that the deeper the constriction is, the lower the system efficiency. Increasing the surfactant concentration or fluid temperature in a channel with confinement carries a substantial positive effect on oil droplet transportation.

Keywords: lattice Boltzmann method, thermal, contact angle, surfactants, high viscosity ratio, porous media

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Authors: Irina A. Gudkova, Yousra Demigha

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Scientific research is moving more and more towards the study of complex systems in several areas of economics, biology physics, and computer science. In this paper, we will work on complex systems in communication networks, Wireless Sensor Networks (WSN) that are considered as stochastic systems composed of interacting entities. The current advancements of the sensing in computing and communication systems is an investment ground for research in several tracks. A detailed presentation was made for the WSN, their use, modeling, different problems that can occur in their application and some solutions. The main goal of this work reintroduces the idea of mean field method since it is a powerful technique to solve this type of models especially systems that evolve according to a Continuous Time Markov Chain (CTMC). Modeling of a CTMC has been focused; we obtained a large system of interacting Continuous Time Markov Chain with population entities. The main idea was to work on one entity and replace the others with an average or effective interaction. In this context to make the solution easier, we consider a wireless sensor network as a multi-body problem and we reduce it to one body problem. The method was applied to a system of WSN modeled as a Markovian queue showing the results of the used technique.

Keywords: Continuous-Time Markov Chain, Hidden Markov Chain, mean field method, Wireless sensor networks

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Authors: Yaser E. Greish, Emad F. Hindawy, Maryam S. Al Nehayan

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Introductory courses such as General Chemistry I, General Physics I and General Biology need special attention as students taking these courses are usually at their first year of the university. In addition to the language barrier for most of them, they also face other difficulties if these elementary courses are taught in the traditional way. Changing the routine method of teaching of these courses is therefore mandated. In this regard, podcasting of chemistry lectures was used as an add-on to the traditional and non-traditional methods of teaching chemistry to science and non-science students. Podcasts refer to video files that are distributed in a digital format through the Internet using personal computers or mobile devices. Pedagogical strategy is another way of identifying podcasts. Three distinct teaching approaches are evident in the current literature and include receptive viewing, problem-solving, and created video podcasts. The digital format and dispensing of video podcasts have stabilized over the past eight years, the type of podcasts vary considerably according to their purpose, degree of segmentation, pedagogical strategy, and academic focus. In this regard, the whole syllabus of 'General Chemistry I' course was developed as podcasts and were delivered to students throughout the semester. Students used the podcasted files extensively during their studies, especially as part of their preparations for exams. Feedback of students strongly supported the idea of using podcasting as it reflected its effect on the overall understanding of the subject, and a consequent improvement of their grades.

Keywords: podcasting, introductory course, interactivity, flipped classroom

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Authors: Srutirekha Giri, Manoranjan Sahoo, Anuradha Das, Pravanjan Mallick, Biswajit Mallick

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Ion Beam (IB) technique is a very powerful experimental technique for both material synthesis and material modifications. In this work, 3MeV proton beam was generated using the 3MV Tandem machine of the Institute of Physics, Bhubaneswar and extracted into air for the irradiation-induced modification purpose[1]. The polymeric material can be modeled for a three-phase system viz. crystalline(I), amorphous(II) and mesomorphic(III). So far, our knowledge is concerned. There are only few techniques reported for the synthesis of this third-phase(III) of polymer. The IB induced technique is one of them and has been reported very recently [2-4]. It was observed that by irradiating polyethylene terephthalate (PET) fiber at very low proton fluence, 10¹⁰ - 10¹² p/s, possess 2D mesophase structure. This was confirmed using X-ray diffraction technique. A low-intensity broad peak was observed at small angle of about 2θ =6º, when the fiber axis was mounted parallel to the X-ray direction. Such peak vanished in the diffraction spectrum when the fiber axis was mounted perpendicular to the beam direction. The appearance of this extra peak in a particular orientation confirms that the phase is 2-dimensionally oriented (mesophase). It is well known that the mesophase is a 2-dimensionally ordered structure but 3-dimensionally disordered. Again, the crystallite of the mesophase peak particle was measured about 3nm. The MeV proton-induced 2D mesophase patterning of nanocrystallites (3nm) of PET due to irradiation was observed within the above low fluence range and failed in high proton fluence. This is mainly due to the breaking of crystallites, radiation-induced thermal degradation, etc.

Keywords: Ion irradiation, mesophase, nanocrystallites, polymer

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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

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Authors: Walaa Obaidallah Alqarafi, Wafaa Mohammed Fakieh, Alaa Abdallah Altassan

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Algebraic graph theory is defined as a bridge between algebraic structures and graphs. It has several uses in many fields, including chemistry, physics, and computer science. The prime graph is a type of graph associated with a ring R, where the vertex set is the whole ring R, and two vertices x and y are adjacent if either xRy=0 or yRx=0. However, the investigation of the prime graph over rings remains relatively limited. The behavior of this graph in extended rings, like R[x] and R[[x]], where R is a non-commutative ring, deserves more attention because of the wider applicability in algebra and other mathematical fields. To study the prime graphs over polynomials and power series rings, we used a combination of ring-theoretic and graph-theoretic techniques. This paper focuses on two invariants: the diameter and the girth of these graphs. Furthermore, the work discusses how the graph structures change when passing from R to R[x] and R[[x]]. In our study, we found that the set of strong zero-divisors of ring R represents the set of vertices in prime graphs. Based on this discovery, we redefined the vertices of prime graphs using the definition of strong zero divisors. Additionally, our results show that although the prime graphs of R[x] and R[[x]] are comparable to the graph of R, they have different combinatorial characteristics since these extensions contain new strong zero-divisors. In particular, we find conditions in which the diameter and girth of the graphs, as they expand from R to R[x] and R[[x]], do not change or do change. In conclusion, this study shows how extending a non-commutative ring R to R[x] and R[[x]] affects the structure of their prime graphs, particularly in terms of diameter and girth. These findings enhance the understanding of the relationship between ring extensions and graph properties.

Keywords: prime graph, diameter, girth, polynomial ring, power series ring

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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

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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

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Authors: Fernando Maass, Pablo Martin, Jorge Olivares

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The Bessel function J₀(x) is very important in Electrodynamics and Physics, as well as its zeros. In this work, a method to obtain high accuracy approximation is presented through an application to that function. In most of the applications of this function, the values of the zeros are very important. In this work, analytic approximations for this function have been obtained valid for all positive values of the variable x, which have high accuracy for the function as well as for the zeros. The approximation is determined by the simultaneous used of the power series and asymptotic expansion. The structure of the approximation is a combination of two rational functions with elementary functions as trigonometric and fractional powers. Here us in Pade method, rational functions are used, but now there combined with elementary functions us fractional powers hyperbolic or trigonometric functions, and others. The reason of this is that now power series of the exact function are used, but together with the asymptotic expansion, which usually includes fractional powers trigonometric functions and other type of elementary functions. The approximation must be a bridge between both expansions, and this can not be accomplished using only with rational functions. In the simplest approximation using 4 parameters the maximum absolute error is less than 0.006 at x ∼ 4.9. In this case also the maximum relative error for the zeros is less than 0.003 which is for the second zero, but that value decreases rapidly for the other zeros. The same kind of behaviour happens for the relative error of the maximum and minimum of the functions. Approximations with higher accuracy and more parameters will be also shown. All the approximations are valid for any positive value of x, and they can be calculated easily.

Keywords: analytic approximations, asymptotic approximations, Bessel functions, quasirational approximations

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Authors: Tawfiq Chekifi, Brahim Dennai, Rachid Khelfaoui

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Over the last few decades, modeling immiscible fluids such as oil and water have been a classical research topic. Droplet-based microfluidics presents a unique platform for mixing, reaction, separation, dispersion of drops, and numerous other functions. For this purpose, several devices were studied, as well as microfluidic oscillator. The latter was obtained from wall attachment microfluidic amplifiers using a feedback loop from the outputs to the control inputs, nevertheless this device have not well used for microdrops applications. In this paper, we suggest a numerical CFD study of a microfluidic oscillator with two different lengths of feedback loop. In order to produce simultaneous microdrops of gasoil on water, a typical geometry that includes double T-junction is connected to the fluidic oscillator. The generation of microdrops is computed by volume-of-fluid method (VOF). Flow oscillations of microdrops were triggered by the Coanda effect of jet flow. The aim of work is to obtain a high oscillation frequency in output of this passive device, the influence of hydrodynamics and physics parameters on the microdrops frequency in the output of our microsystem is also analyzed, The computational results show that, the length of feedback loop, applied pressure on T-junction and interfacial tension have a significant effect on the dispersion of microdrops and its oscillation frequency. Across the range of low Reynold number, the microdrops generation and its dynamics have been accurately controlled by adjusting applying pressure ratio of two phases.

Keywords: fluidic oscillator, microdrops manipulation, VOF (volume of fluid method), microfluidic oscillator

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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

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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

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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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