Search results for: left atrial appendage occlusion

Authors: Larissa M. Vargas, Julia M. Sacchi, Renata O. Pereira, Lucas S. Asano, Iara C. Araújo, Patricia Fiorino, Vera Farah

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The aim of this study was to evaluate the occurrence of subclinical organ injuries induced by high-fat diet. Male wistar rats (n=5/group) were divided in control diet group (CD), commercial rat chow, and hyperlipidic diet (30% lipids) group (HD) administrated during 8 weeks, starting after weaning. All the procedures followed the rules of the Committee of Research and Ethics of the Mackenzie University (CEUA Nº 077/03/2011). At the end of protocol the animals were euthanized by anesthesia overload and the left kidney was removed. Intrarenal lipid deposition was evaluated by histological analyses with oilred. Kidney slices were stained with picrosirius red to evaluate the area of the Bowman's capsule (AB) and space (SB), and glomerular tuft area (GT). The renal expression of sterol regulatory element–binding protein (SREBP-2) was performed by Western Blotting. Creatinine concentration (serum and urine) and lipid profile were determined by colorimetric kit (Labtest). At the end of the protocol there was no differences in body weight between the groups, however the HD showed a marked increase in lipid deposits, glomeruli and tubules, and biochemical analysis for cholesterol and triglycerides. Moreover, in the kidney, the high-fat diet induced a reduction in the AB (13%), GT (18%) and SB (17%) associated with a reduction in glomerular filtration rate (creatinine clearance). The renal SRBP2 expression was increased in HD group. These data suggests that consumption of high-fat diet starting in childhood is associated with subclinical renal damage and function.

Keywords: high-fat diet, kidney, intrarenal lipid deposition, SRBP2

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Authors: M. A. Alqahtani, D. P. Coleman, N. D. Pugh, L. D. M. Nokes

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In diagnostic ultrasound, the echo graphic B-scan texture is an important area of investigation since it can be analyzed to characterize the histological state of internal tissues. An important factor requiring consideration when evaluating ultrasonic tissue texture is the depth. The effect of attenuation with depth of ultrasound, the size of the region of interest, gain, and dynamic range are important variables to consider as they can influence the analysis of texture features. These sources of variability have to be considered carefully when evaluating image texture as different settings might influence the resultant image. The aim of this study is to investigate the effect of depth on the texture features in-vivo using a 3D ultrasound probe. The left leg medial head of the gastrocnemius muscle of 10 healthy subjects were scanned. Two regions A and B were defined at different depth within the gastrocnemius muscle boundary. The size of both ROI’s was 280*20 pixels and the distance between region A and B was kept constant at 5 mm. Texture parameters include gray level, variance, skewness, kurtosis, co-occurrence matrix; run length matrix, gradient, autoregressive (AR) model and wavelet transform were extracted from the images. The paired t –test was used to test the depth effect for the normally distributed data and the Wilcoxon–Mann-Whitney test was used for the non-normally distributed data. The gray level, variance, and run length matrix were significantly lowered when the depth increased. The other texture parameters showed similar values at different depth. All the texture parameters showed no significant difference between depths A and B (p > 0.05) except for gray level, variance and run length matrix (p < 0.05). This indicates that gray level, variance, and run length matrix are depth dependent.

Keywords: ultrasound image, texture parameters, computational biology, biomedical engineering

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Authors: Reza Behtash, Enayat Enayati

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The pool condenser is in principal a horizontal reactor, containing a bundle of U-tubes for heat exchange, coupling to low pressure steam drum. Condensation of gas takes place in a condensed pool around the tubes of the condenser. The heat of condensation is removed by the generation of low pressure steam on the inner tube side of the bundle. A circulation pump transfers ample boiler feed water to these tubes. The pressure of the steam generated influenced the heat flux. Changing the steam pressure means changing the steam condensate temperature and therefore the temperature difference between the tube side and the shell side. 2NH3 + CO2 ↔ NH2COONH4 + Heat. This reaction is exothermic and according to Le Chatelier's Principle if the heat is not removed enough, it will come back to left side and generate of the gas and so the Urea synthesis pressure will rise. The most principal reasons for high Urea synthesis pressure are non proportional of Ammonia/Dioxide Carbon ratio and too high a pressure in low pressure steam drum. Proportional of Ammonia/Dioxide Carbon ratio is 3.0 and normal pressure for low pressure steam drum is 4.5 bar. As regards these conditions were proportional but we could not control the synthesis pressure the plant endangered, therefore we had to control the steam drum pressure at about 3.5 bar. While we opened the pool condenser, we found the partition plate used to divide inlet and outlet boiler feed water to tubes, was broken partially and so amount of boiler feed water bypass the tubes and the heat was not removed totally and it resulted in the generation of gases and high pressure in synthesis.

Keywords: boiler, pressure, pool condenser, partition plate

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Authors: Fahad Almehmadi, Abdullah Alrajhi, Bader K. Alaslab, Abdullah A. Al Qurashi, Hattan A. Hassani

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Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an uncommon, inheritable cardiac disorder characterized by the progressive substitution of cardiac myocytes by fibro-fatty tissues. This pathologic substitution predisposes patients to ventricular arrhythmias and right ventricular failure. The underlying genetic defect predominantly involves genes encoding for desmosome proteins, particularly plakophilin-2 (PKP2). These aberrations lead to impaired cell adhesion, heightening the susceptibility to fibrofatty scarring under conditions of mechanical stress. Primarily, ARVD/C affects the right ventricle, but it can also compromise the left ventricle, potentially leading to biventricular heart failure. Clinical presentations can vary, spanning from asymptomatic individuals to those experiencing palpitations, syncopal episodes, and, in severe instances, sudden cardiac death. The establishment of a diagnostic criterion specifically tailored for ARVD/C significantly aids in its accurate diagnosis. Nevertheless, the task of early diagnosis is complicated by the disease's frequently asymptomatic initial stages, and the overall rarity of ARVD/C cases reported globally. In some cases, as exemplified by the adult female patient in this report, the disease may advance to terminal stages, rendering therapies like Ventricular Tachycardia (VT) ablation ineffective. This case underlines the necessity for increased awareness and understanding of ARVD/C to aid in its early detection and management. Through such efforts, we aim to decrease morbidity and mortality associated with this challenging cardiac disorder.

Keywords: ARVD/C, cardiology, interventional cardiology, cardiac electrophysiology

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Authors: Laura Lamas Abraira

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Large-scale Chinese immigration in Spain emerged in the 80's. Engaged in their own businesses or working for other Chinese migrants with long schedules, young couples had to choose between contracting or transnationalising the care labour as they were unable to combine productive and reproductive tasks. In most cases, they decided to transnationalize the care labour embodied on grandparents or children migratory paths. Either the grandparents go to Spain to take care of their grandchildren or the kids were left behind or sent to China after being born in Spain in order to be raised with their extended family members. Very little is known about how the people who have been raised in a transnational context relates their own experience and agency as care managers within the family care cycle. In order to fill this gap, this paper aims to inquire into these transnationally-reared Chinese young adults’ narratives about their own experience and expectations (past, present and future) by adopting care circulation and care cycle approach within life course framework. Drawing upon a qualitative study resulting from a multi-sited ethnography (Spain-China), we argue that young adults raised in transnational context build their narratives as a result of an otherness process related to their parents and an essentialization of their Chinese roots to use selectively among different contexts. In doing so, these family narratives constitute a part of their social identity that interact with other dimensions such as the ethnic one. We suggest when building their parent's otherness they also build their sameness among pairs, as members of the same club, marked by transnational care on a double time basis: the practices of their parents as wrong past, and their own as an amendable future.

Keywords: Chinese families, narratives, transnational care, young adults

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Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

Procedia PDF Downloads 297

Authors: Anne Gesare Timu, Megan Sheahan, Andrew Gache Mude, Rupsha Banerjee

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Women headed households are among the most vulnerable to negative climatic shocks and are often left poorer as a result. Credit provision has been recognized as one way of alleviating rural poverty and developing poor rural households’ resilience to shocks. Much has been documented about credit demand in small-holder agriculture settings in Kenya. However, little is known about demand for credit among pastoral women. This paper analyzes the determinants of demand for credit in the pastoral regions of Marsabit District of Northern Kenya. Using a five wave balanced panel data set of 820 households, a double hurdle model is employed to analyze if shocks, financial literacy and risk aversion affect credit demand among female and male headed households differently. The results show that borrowing goods on credit and monetary credit from informal market segments are the most common sources of credit in the study area. The impact of livestock loss and financial literacy on the decision to borrow and how much to borrow vary with gender. While the paper suggests that provision of credit is particularly valuable in the aftermath of a negative shock and more so for female-headed households, it also explores alternatives to the provision of credit where credit access is a constraint. It recommends further understanding of systems and institutions which could enhance access to credit, and particularly during times of stress, to enable households in the study area in particular and Northern Kenya in general to invest, engage in meaningful development and growth, and be resilient to persistent shocks.

Keywords: female headed households, pastoralism, rural financing, double hurdle model

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Authors: Natalia Pacheco Rego

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The Liezation functor is a map from the category of Leibniz algebras to the category of Lie algebras, which assigns a Leibniz algebra to the Lie algebra given by the quotient of the Leibniz algebra by the ideal spanned by the square elements of the Leibniz algebra. This functor is left adjoint to the inclusion functor that considers a Lie algebra as a Leibniz algebra. This environment fits in the framework of central extensions and commutators in semi-abelian categories with respect to a Birkhoff subcategory, where classical or absolute notions are relative to the abelianization functor. Classical properties of Leibniz algebras (properties relative to the abelianization functor) were adapted to the relative setting (with respect to the Liezation functor); in general, absolute properties have the corresponding relative ones, but not all absolute properties immediately hold in the relative case, so new requirements are needed. Following this line of research, it was conducted an analysis of central derivations of Leibniz algebras relative to the Liezation functor, called as Lie-derivations, and a characterization of Lie-stem Leibniz algebras by their Lie-central derivations was obtained. In this paper, we present an overview of these results, and we analyze some new properties concerning Lie-central derivations and almost inner Lie-derivations. Namely, a Leibniz algebra is a vector space equipped with a bilinear bracket operation satisfying the Leibniz identity. We define the Lie-bracket by [x, y]lie = [x, y] + [y, x] , for all x, y . The Lie-center of a Leibniz algebra is the two-sided ideal of elements that annihilate all the elements in the Leibniz algebra through the Lie-bracket. A Lie-derivation is a linear map which acts as a derivative with respect to the Lie-bracket. Obviously, usual derivations are Lie-derivations, but the converse is not true in general. A Lie-derivation is called a Lie-central derivation if its image is contained in the Lie-center. A Lie-derivation is called an almost inner Lie-derivation if the image of an element x is contained in the Lie-commutator of x and the Leibniz algebra. The main results we present in this talk refer to the conditions under which Lie-central derivation and almost inner Lie-derivations coincide.

Keywords: almost inner Lie-derivation, Lie-center, Lie-central derivation, Lie-derivation

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Authors: Catherine Thompson, Maryam Jalali, Peter Hills

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The allocation of visual attention is critical when driving and anything that limits attention will have a detrimental impact on safety. Engaging in a secondary task reduces the amount of attention directed to the road because drivers allocate resources towards this task, leaving fewer resources to process driving-relevant information. Yet the dangers associated with a secondary task do not end when the driver returns their attention to the road. Instead, the attentional settings adopted to complete a secondary task may persist to the road, affecting attention, and therefore affecting driver performance. This 'attentional inertia' effect was investigated in the current work. Forty drivers searched for hazards in driving video clips while their eye-movements were recorded. At varying intervals they were instructed to attend to a secondary task displayed on a tablet situated to their left-hand side. The secondary task consisted of three separate computer games that induced horizontal, vertical, and random eye movements. Visual search and hazard detection in the driving clips were compared across the three conditions of the secondary task. Results showed that the layout of information in the secondary task, and therefore the allocation of attention in this task, had an impact on subsequent search in the driving clips. Vertically presented information reduced the wide horizontal spread of search usually associated with accurate driving and had a negative influence on the detection of hazards. The findings show the additional dangers of engaging in a secondary task while driving. The attentional inertia effect has significant implications for semi-autonomous and autonomous vehicles in which drivers have greater opportunity to direct their attention away from the driving task.

Keywords: attention, eye-movements, hazard perception, visual search

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Authors: Arturo Reyes Roman, Daniza Castillo Godoy, Francisca Balarezo Olivares, Francisco Arriagada Castro, Miguel Maulen Tapia

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Mining waste–based geopolymers are a sustainable alternative to conventional cement materials due to their contribution to the valorization of mining wastes as well as to the new construction materials with reduced fingerprints. The objective of this study was to determine the potential of leaching gravel (LG) from hydrometallurgical copper processing to be used as a raw material in the manufacture of geopolymer. NaOH, Na2SiO3 (modulus 1.5), and LG were mixed and then wetted with an appropriate amount of tap water, then stirred until a homogenous paste was obtained. A liquid/solid ratio of 0.3 was used for preparing mixtures. The paste was then cast in cubic moulds of 50 mm for the determination of compressive strengths. The samples were left to dry for 24h at room temperature, then unmoulded before analysis after 28 days of curing time. The compressive test was conducted in a compression machine (15/300 kN). According to the laser diffraction spectroscopy (LDS) analysis, 90% of LG particles were below 500 μm. The X-ray diffraction (XRD) analysis identified crystalline phases of albite (30 %), Quartz (16%), Anorthite (16 %), and Phillipsite (14%). The X-ray fluorescence (XRF) determinations showed mainly 55% of SiO2, 13 % of Al2O3, and 9% of CaO. ICP (OES) concentrations of Fe, Ca, Cu, Al, As, V, Zn, Mo, and Ni were 49.545; 24.735; 6.172; 14.152, 239,5; 129,6; 41,1;15,1, and 13,1 mg kg-1, respectively. The geopolymer samples showed resistance ranging between 2 and 10 MPa. In comparison with the raw material composition, the amorphous percentage of materials in the geopolymer was 35 %, whereas the crystalline percentage of main mineral phases decreased. Further studies are needed to find the optimal combinations of materials to produce a more resistant and environmentally safe geopolymer. Particularly are necessary compressive resistance higher than 15 MPa are necessary to be used as construction unit such as bricks.

Keywords: mining waste, geopolymer, construction material, alkaline activation

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Authors: Nur Hidayah Kaz Abdul Aziz, Norhalida Hashim, Zurina Hassan

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Peripartum period is a time where women are vulnerable to depression, and stress may further increase the risk of its occurrence. Use of selective serotonin reuptake inhibitors (SSRI) in the treatment of postpartum depression is a common practice. Comparison of antidepressant treatment, however, is rarely studied between gestated and nulliparous animals exposed to stress. This study was aimed to investigate the effect of parity and stress, as well as fluoxetine (an SSRI) treatment after stress exposure on the behavior of rats. Gestating and nulliparous Sprague Dawley rats were either subjected to chronic stressors or left undisturbed throughout the gestation period. After parturition, all stressors were stopped and some of the stressed rats were treated with fluoxetine (10mg/kg). Hence, the final groups formed were: 1. Non-stressed nulliparous rats, 2. Non-stressed dams, 3. Stressed nulliparous rats, 4. Stressed dams, 5. Fluoxetine-treated stressed nulliparous rats, and 6. Fluoxetine-treated stressed dams. Rats were tested in open field test (OFT), novel object recognition test (NOR) and forced swim test (FST) after weaning of pups. Gestational stress significantly reduced the locomotor activity of rats in OFT (p<0.05), while fluoxetine significantly increased the activity in nulliparous rats (p<0.001) but not the dams. While no differences were observed in NOR, stress and parity inhibited the rats from performing swimming behavior in FST. However, climbing and immobile behaviors in FST were found to have no significant differences, although there is a tendency of effect of treatment for immobility parameter (p=0.06) where fluoxetine-treated stressed dams were being the least immobile. In conclusion, the effects of parity and stress, as well as fluoxetine treatment, depended on the type of behavioral test performed.

Keywords: stress, parity, SSRI, behavioral tests

Procedia PDF Downloads 172

Authors: Saurabh Shukla, G. N. Pandey

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In recent times, oil exploration and monitoring in on-shore areas have gained much importance considering the fact that in India the oil import is 62 percent of the total imports. Thus, architectural model like wireless sensor network to monitor on-shore deep sea oil well is being developed to get better estimate of the oil prospects. The problem we are facing nowadays that we have very few restricted areas of oil left today. Countries like India don’t have much large areas and resources for oil and this problem with most of the countries that’s why it has become a major problem when we are talking about oil exploration in on-shore areas also the increase of oil prices has further ignited the problem. For this the use of wireless network system having relative simplicity, smallness in size and affordable cost of wireless sensor nodes permit heavy deployment in on-shore places for monitoring oil wells. Deployment of wireless sensor network in large areas will surely reduce the cost it will be very much cost effective. The objective of this system is to send real time information of oil monitoring to the regulatory and welfare authorities so that suitable action could be taken. This system architecture is composed of sensor network, processing/transmission unit and a server. This wireless sensor network system could remotely monitor the real time data of oil exploration and monitoring condition in the identified areas. For wireless sensor networks, the systems are wireless, have scarce power, are real-time, utilize sensors and actuators as interfaces, have dynamically changing sets of resources, aggregate behaviour is important and location is critical. In this system a communication is done between the server and remotely placed sensors. The server gives the real time oil exploration and monitoring conditions to the welfare authorities.

Keywords: sensor, wireless sensor network, oil, sensor, on-shore level

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Authors: Hager Elsheikh, Matthias Sendler, Juliana Glaubnitz

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In pancreatitis, an inflammatory reaction occurs in the pancreatic secretory cells due to premature activation of proteases, leading to pancreatic self-digestion and necrotic cell death of acinar cells. Acute pancreatitis in patients is characterized by a severe immune reaction that could lead to serious complications, such as organ failure or septic shock, if left untreated. Chronic pancreatitis is a recurrence of episodes of acute pancreatitis resulting in a fibro-inflammatory immune response, in which the type 2 immune response is primarily driven by AAMs in the pancreas. One of the most important signaling pathways for M2 macrophage activation is the IL-4/STAT6 pathway. Pancreatic fibrosis is induced by the hyperactivation of pancreatic stellate cells by dysregulation in the inflammatory response, leading to further damage, autodigestion and possibly necrosis of pancreatic acinar cells. The aim of this research is to investigate the effect of STAT6 knockout in disease severity and development of fibrosis wound healing in the presence of different macrophage populations, regulated by the type 2 immune response, after inducing chronic and/or acute pancreatitis in mice models via cerulean injection. We further investigate the influence of the JAK/STAT6 signaling pathway on the balance of fibrosis and regeneration in STAT6 deficient and wild-type mice. The characterization of resident and recruited macrophages will provide insight into the influence of the JAK/STAT6 signaling pathway on infiltrating cells and, ultimately, tissue fibrosis and disease severity.

Keywords: acute and chronic pancreatitis, tissue regeneration, macrophage polarization, Gastroenterology

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Authors: Amir Hossein Allahdadi

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The mystical and intuitive look of Islamic artists inspired by the Koranic and mystical principles and also based on the geometry and mathematics has left unique works whose range extends across the borders of Islam. The relationship between Islamic art and music in the traditional art is of one of the concepts that can be traced back to the other arts by detection of its components. One of the links is the art of painting whose subtleties that can be applicable to both architecture and music. So, architecture and music links can be traced in other arts with a traditional foundation in order to evaluate the equivalents of traditional arts. What is the relationship between physical space of architecture and nonphysical space of music? What is musical architecture? What is the music that tends to architecture? These questions are very small samples of the questions that arise in this category, and these questions and concerns remain as long as the music is played and the architecture is made. Efforts have been made in this area, references compiled and plans drawn. As an example, we can refer to views of ‘Mansour Falamaki’ in the book of architecture and music, as well as the book transition from mud to heart by ‘Hesamodin Seraj’. The method is such that a certain melody is given to an architect and it is tried to design a specified architecture using a certain theme. This study is not to follow the architecture of a particular type of music and the formation of a volume based on a sound. In this opportunity, it is tried to briefly review the relationship between music and architecture in the Iranian original and traditional arts, using the basic definitions of arts. The musician plays, the architect designs, the actor forms his desired space and painter displays his multi-dimensional world in the form of two-dimensions. The expression language is different, but all of them can be gathered in a form, a form which has no clear boundaries. In fact, in any original art, the artist applies his art as a tool to express his insights which are nothing but achieving the world beyond this place and time.

Keywords: architecture, music, geometric proportions, mathematical proportions

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Authors: Hamidreza Hoshyarmanesh, Benjamin Durante, Alex Irwin, Sanju Lama, Kourosh Zareinia, Garnette R. Sutherland

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This study reports on a proposed method to evaluate the accuracy and precision of Excalibur I, a neurosurgery-specific haptic hand controller, designed and developed at Project neuroArm. Having an efficient and successful robot-assisted telesurgery is considerably contingent on how accurate and precise a haptic hand controller (master/local robot) would be able to interpret the kinematic indices of motion, i.e., position and orientation, from the surgeon’s upper limp to the slave/remote robot. A proposed test rig is designed and manufactured according to standard ASTM F2554-10 to determine the accuracy and precision range of Excalibur I at four different locations within its workspace: central workspace, extreme forward, far left and far right. The test rig is metrologically characterized by a coordinate measuring machine (accuracy and repeatability < ± 5 µm). Only the serial linkage of the haptic device is examined due to the use of the Structural Length Index (SLI). The results indicate that accuracy decreases by moving from the workspace central area towards the borders of the workspace. In a comparative study, Excalibur I performs on par with the PHANToM PremiumTM 3.0 and more accurate/precise than the PHANToM PremiumTM 1.5. The error in Cartesian coordinate system shows a dominant component in one direction (δx, δy or δz) for the movements on horizontal, vertical and inclined surfaces. The average error magnitude of three attempts is recorded, considering all three error components. This research is the first promising step to quantify the kinematic performance of Excalibur I.

Keywords: accuracy, advanced metrology, hand controller, precision, robot-assisted surgery, tele-operation, workspace

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Authors: Xvelian Qin

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Urban "organic renewal" based on the development of existing resources in high-density urban areas has become the mainstream of urban development in the new era. As an important stock resource of public space in high-density urban areas, promoting its value remodeling is an effective way to alleviate the shortage of public space resources. However, due to the lack of evaluation links in the process of underpass space renewal, a large number of underpass space resources have been left idle, facing the problems of low space conversion efficiency, lack of accuracy in development decision-making, and low adaptability of functional positioning to citizens' needs. Therefore, it is of great practical significance to construct the evaluation system of under-bridge space renewal potential and explore the renewal mode. In this paper, some of the under-bridge spaces in the main urban area of Chongqing are selected as the research object. Through the questionnaire interviews with the users of the built excellent space under the bridge, three types of six levels and twenty-two potential evaluation indexes of "objective demand factor, construction feasibility factor and construction suitability factor" are selected, including six levels of land resources, infrastructure, accessibility, safety, space quality and ecological environment. The analytical hierarchy process and expert scoring method are used to determine the index weight, construct the potential evaluation system of the space under the bridge in high-density urban areas of Chongqing, and explore the direction of renewal and utilization of its suitability.

Keywords: space under bridge, potential evaluation, high density urban area, updated using

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Authors: Midiya Khademi, Ali Nikoo, Shabnam Rahimnezhad Baghche Jooghi

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Cardiovascular diseases (CVDs) are the main cause of death globally. Most CVDs can be prevented by avoiding habitual risk factors. Separate from the habitual risk factors, there are some inherent factors in each individual that can increase the risk potential of CVDs. Vessel shapes and geometry are influential factors, having great impact on the blood flow and the hemodynamic behavior of the vessels. In the present study, the influence of bifurcation angle on blood flow characteristics is studied. In order to approach this topic, by simplifying the details of the bifurcation, three models with angles 30°, 45°, and 60° were created, then by using CFD analysis, the response of these models for stable flow and pulsatile flow was studied. In the conducted simulation in order to eliminate the influence of other geometrical factors, only the angle of the bifurcation was changed and other parameters remained constant during the research. Simulations are conducted under dynamic and stable condition. In the stable flow simulation, a steady velocity of 0.17 m/s at the inlet plug was maintained and in dynamic simulations, a typical LAD flow waveform is implemented. The results show that the bifurcation angle has an influence on the maximum speed of the flow. In the stable flow condition, increasing the angle lead to decrease the maximum flow velocity. In the dynamic flow simulations, increasing the bifurcation angle lead to an increase in the maximum velocity. Since blood flow has pulsatile characteristics, using a uniform velocity during the simulations can lead to a discrepancy between the actual results and the calculated results.

Keywords: coronary artery, cardiovascular disease, bifurcation, atherosclerosis, CFD, artery wall shear stress

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Authors: Angelis P. Barlampas

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Purpose: A 29 years old woman presented in the emergency department with psychiatric symptoms. The psychiatrist ordered a computed tomography scan as part of a general examination. Material and methods: The CT showed bilateral enlarged choroid plexus structures mimicking papillomata and situated in the trigones of the lateral ventricles. The left choroid plexus was heavily calcified, but the right one has no any obvious calcifications. Results: It is well kown that any brain mass can present with behavioral changes and even psychiatric symptomatology. Papillomata of the ventricular system have been described to cause psychotic episodes. According to literature, choroid plexus papillomas are seldom neuroepithelial intraventricular tumors, which are benign and categorized as WHO grade 1 tumors. They are more common in the pediatric population, but they can occur in the adults, too1. In addition, the distinction between choroid plexus papilloma and carcinoma is very difficult and impossible by imagine alone. It can only be implied with more advanced imaging, such as arterial spin labeling and MRI. The final diagnosis is, of course, after surgical excision. The usual location in adults is the fourth ventricle, but in children, it is the lateral ventricles. Their imaging appearance is that of a solid vascular tumor, which enhances intensely after the intravenous administration of contrast material. One out of fourth tumors presents speckled calcifications1. In our case, there are symmetrically sized masses at the trigones, and there are no calcifications in one of them, whereas the other one is grossly calcified. Also, there is no obvious hydrocephalus or any other evidence of increased intracranial pressure. General conclusions: When there is a new psychiatric patient, someone must undergo any possible examination, and of course, a brain CT study should be done to exclude any rare organic causes that may be responsible for the disease.

Keywords: phycosis, intraventricular masses, CT, brain calcifications

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Authors: Abhinandan Singh Gill

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Paper mill sludge is one of the major economic and environmental problems for paper and board industry, million tonnes quantity of sludge is produced in the world. It is essential to dispose these wastes safely without affecting health of human being, environment, fertile land; sources of water bodies, economy as it adversely affect the strength, durability and other properties of building materials based on them. Moreover, in developing countries like India where there is low availability of non-renewable resources and large need of building material like cement therefore it is essential to develop eco-efficient utilization of paper sludge. Primarily in functional terms paper sludge comprises of cellulose fibers, calcium carbonate, china clay, low silica, residual chemical bonds with water. The material is sticky and full of moisture content which is hard to dry. The manufacturing of paper usually produce loads of solid waste. These paper fibers are recycled in paper mills to limited number of times till they become weak to produce high quality paper. Thereafter, these left out small and weak pieces called as low quality paper fibers are detached out to become paper sludge. The material is by-product of de-inking and re-pulping of paper. This hypo sludge includes all kinds of inks, dyes, coating etc inscribed on the paper. This paper presents an overview of the published work on the use of hypo sludge in M25 concrete formulations as a supplementary cementitious material exploring its properties such as compressive strength, splitting and parameters like modulus of elasticity, density, applications and most importantly investigation of low cost concrete by using hypo sludge are presented.

Keywords: concrete, sludge waste, hypo sludge, supplementary cementitious material

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Authors: M. Qorbani

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Neuromuscular control of posture as understood through studies of responses to mechanical sudden acceleration automatically has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of acute condition has not been previously explored specially in a sudden acceleration. The aim of this study was to determine neuromuscular control pattern in those with and without unilateral acute ankle sprains. Design: Case - control. Setting: University research laboratory. The sinker–card protocol with surface translation was be used as a sudden acceleration protocol with study of EMG upon 4 posture stabilizer muscles in two sides of the body in response to sudden acceleration in forward and backward directions. 20 young adult women in two groups (10 LAS; 23.9 ± 2.03 yrs and 10 normal; 26.4 ± 3.2 yrs). The data of EMG were assessed by using multivariate test and one-way repeated measures 2×2×4 ANOVA (P< 0.05). The results showed a significant muscle by direction interaction. Higher TA activity of left and right side in LAS group than normal group in forward direction significantly be showed. Higher MGR activity in normal group than LAS group in backward direction significantly showed. These findings suggest that compared two sides of the body in two directions for 4 muscles EMG activities between and within group for neuromuscular control of posture in avoiding fall. EMG activations of two sides of the body in lateral ankle sprain (LAS) patients were symmetric significantly. Acute ankle instability following once ankle sprains caused to coordinated temporal spatial patterns and strategy selection.

Keywords: neuromuscular response, sEMG, lateral ankle sprain, posture.

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Authors: Priyanwada I. Singhapathirana

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The public land ownership is a common phenomenon in many countries in the world however, the development approaches and the institutional structures are greatly diverse. The existing scholarship around public land development has been greatly limited to Europe and advanced Asian economies. Inferences of such studies seem to be inadequate and inappropriate to comprehend the peculiarities of public land development in developing Asian economies. The absence of critical inquiry on the public land ownership and the long-established institutional structures which govern the development has restrained these countries from institutional innovations. In this context, this research investigates the issues related to public land development and the institutional responses in Sri Lanka. This study introduces the concept of ‘Institutional Responsiveness’ in Public land development, which is conceptualized as the ability of the institutions to respond to the spatial, market and fiscal stimulus. The inquiry was carried out through in-depth interviews with five key informants from apex public agencies in order to explore the responsiveness of land institutions form decision-makers' perspectives. Further, the analysis of grey literature and recent media reports are used to supplement the analysis. As per the findings, long term abandonment of public lands and high transaction costs are some of the key issues in relation to public land development. The inability of the institutions to respond to the market and fiscal stimulus has left many potential public lands underutilized. As a result, the public sector itself and urban citizens have not been able to relish the benefits of the public lands in cities. Spatial analysis at the local scale is suggested for future studies in order to capture the multiple dimensions of the responsiveness of institutions to the development stimulus.

Keywords: institutions, public land, responsiveness, under-utilization

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Authors: Monique Joyce L. Disamburum, Nicole C. Faustino, Ashley Angela A. Fazon, Jessie F. Rubonal

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Traditional jeepneys contribute significantly to air pollution in the Philippines, negatively affecting both the environment and people. In response, the researchers investigated Sphagnum moss which has high adsorbent properties and can be used as a filter. Therefore, this research aims to create a muffler filter additive to reduce the smoke density emitted by traditional jeepneys. Various materials, such as moss, cornstarch, a metal pipe, bolts, and a papermaking screen frame, were gathered. The moss underwent a blending process with a cornstarch mixture until it achieved a pulp-like consistency, subsequently molded using a papermaking screen frame and left for sun drying. Following this, a metal prototype was created by drilling holes around the tumbler and inserting bolts. The mesh wire containing the filter was carefully placed into the hole, secured by two bolts. In the final phase, there were three setups, each undergoing one trial in the LTO emission testing. Each trial consisted of six rounds of purging, and after that the average smoke density was measured. According to the findings of this study, the filter aided in lowering the average smoke density. The one layer setup produced an average of 1.521, whereas the two layer setup produced an average of 1.082. Using One-Way Anova, it was demonstrated that there is a significant difference between the setups. Furthermore, the Tukey HSD Post Hoc test revealed that Setups A and C differed significantly (p = 0.04604), with Setup C being the most successful in reducing smoke density (mean difference -1.4128). Overall, the researchers came to the conclusion that employing Sphagnum moss as a filter can lower the average smoke density released by traditional jeepneys.

Keywords: sphagnum moss, Jeepney filter, smoke density, Jeepney emission

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Joyce Onoromhenre Agofure

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Research has shown how fictional work and films reflect the destruction of the environment due to the exploitation of oil, gas, gold, and forest products by multinational companies for profits but overlook discussions on conflict resolution and peacebuilding. However, this paper examines the manner art forms project peace and conflict resolution, thereby contributing to mediation and stability geared towards changing appalling situations in the resource extraction regions of Nigeria. This paper draws from selected Nigerian films- Blood and Oil (2019), directed by Curtis Graham, Black November (2012), directed by Jeta Amata, and a novel- Death of Eternity (2007), by Adamu Kyuka Usman. The study seeks to show that the disruptions caused in the natural resource regions of Nigeria have not only left adverse effects on the social well-being of the people but require resolutions through means of peacebuilding. By adopting the theoretical insights of Social Conflict, this paper focuses on artistic processes that enhance peacebuilding and conflict resolution in non-violent ways by using scenes, visual effects, themes, and images that can educate by shaping opinions, influencing attitudes, and changing ideas and behavioral patterns of individuals and communities. Put together; the research will open up critical perceptions brought about by the artists of study to shed light on the dire need to sustain peace and actively participate in conflict resolution in natural resource extraction spaces.

Keywords: natural resource, extraction, conflict resolution, peace building

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Authors: Recep Duzsoz, Ozlem Gormez, Umit Memis, Selma Demer, Hikmet Orhan

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Stylohyoid ligament is a connective tissue extending from apex of the styloid process to small horn of the hyoid bone. The normal length of styloid process ranges from 20 to 30 mm and measurements more than 30 mm is named stylohyoid ligament calcification (SLC). Fluorosis is a health problem that arises in individuals who intake large amounts of fluor long periods of time. The aim of this study was to investigate the effects of fluorosis on SLC. This study has been conducted on 100 patients who had SLC detected on panoramic radiograph. The study group was consisted of 50 patients with dental fluorosis and control group was consisted of 50 patients without dental fluorosis. Length and thickness of SLC were measured and the type of SLC was determined on panoramic radiographs. There was no statistically significant differences between the study and control group for SLC length, thickness and type. The thickness of left and right SLC of severe dental fluorosis group was statistically significant higher than moderate dental fluorosis group (p < 0,05). Cervicopharyngeal trauma, tonsillectomy, endocrine disease in menopause, persistent mesenchymal tissue, mechanical stress have reported as etiology of SLC in the literature and studies are still ongoing. It was reported that fluorosis as a factor on calcification of some ligaments in body (posterior longitudunal ligament, ligamentum flavum and transverse atlantal ligament) previously but relationship between fluorosis with SLC was not investigated. Our study is unique because it is the first study on SLC thickness measurements on panoramic radiographs and the relationship between fluorosis and SLC to our knowledge. According to the obtained results, it is thought that fluorosis may have an effect on SLC in thickness due to the relationship between dental fluorosis severity with SLC thickness and this study will contribute to the progress of the future studies.

Keywords: calcification, fluorosis, ligament, stylohyoid

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Authors: Angeliki Vassila, Dimitrios Kalogeropoulos, Rania Rawashdeh, Nigel Hall, Najiha Rahman, Mark Fabian, Suresh Thulasidharan, Hossain Parwez

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Introduction: Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. Methods: This is a retrospective analysis that examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. Results: A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Conclusions: Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: scleritis, necrotizing scleritis, scleroderma, autoimmune disease

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Authors: Swati Bhasin, Ali Ahmed, Valence Xavier, Ben Liu

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Aims: Diarrhea is a problem that is a frequent clinic referral to the gastroenterology and surgical team from the General practitioner. To establish a diagnosis, these patients undergo colonoscopy. The current practice at our district general hospital is to perform random left and right colonic biopsies. National guidelines issued by the British Society of Gastroenterology advise all patients presenting with chronic diarrhea should have an Ileoscopy as an indicator for colonoscopy completion. Our primary aim was to check if Terminal ileum (TI) biopsy is required to establish a diagnosis of inflammatory bowel disease (IBD). Methods: Data was collected retrospectively from November 2018 to November 2019. The target population were patients who underwent colonoscopies for diarrhea. Demographic data, endoscopic and histology findings of TI were assessed and analyzed. Results: 140 patients with a mean age of 57 years (19-84) underwent a colonoscopy (M: F; 1:2.3). 92 patients had random colonic biopsies taken and based on the histological results of these, 15 patients (16%) were diagnosed with IBD. The TI was successfully intubated in 40 patients, of which 32 patients had colonic biopsies taken as well. 8 patients did not have a colonic biopsy taken. Macroscopic abnormality in the TI was detected in 5 patients, all of whom were biopsied. Based on histological results of the biopsy, 3 patients (12%) were diagnosed with IBD. These 3 patients (100%) also had colonic biopsies taken simultaneously and showed inflammation. None of the patients had a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were not done). None of the patients has a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were negative). Conclusion: TI intubation is a highly-skilled, time-consuming procedure with a higher risk of perforation, which as per our study, has little additional diagnostic value in finding IBD for symptoms of diarrhea if colonic biopsies are taken. We propose that diarrhea is a colonic symptom; therefore, colonic biopsies are positive for inflammation if the diarrhea is secondary to IBD. We conclude that all of the IBDs can be diagnosed simply with colonic biopsies.

Keywords: biopsy, colon, IBD, terminal ileum

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Authors: Guncel Ozturk

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Background: Rhinoplasty is the most commonly performed cosmetic operations in plastic surgery. Maneuvers used in rhinoplasty lead to a firm and stiff nasal tip in the early postoperative months. This unnatural stability of the nose may easily cause distortion in the reshaped nose after severe trauma. Moreover, a firm nasal tip may cause difficulties in performing activities such as touching, hugging, or kissing. Decreasing the stability and increasing the mobility of the nasal tip would help rhinoplasty patients to avoid these small but relatively important problems. Methods: We use delivery approach with closed rhinoplasty and changed positions of intranasal incisions to reach a dynamic and mobile nose. A total of 203 patients who had undergone primary closed rhinoplasty in private practice were inspected retrospectively. Posterior strut flap that was connected with connective tissues in the caudal of septum and the medial crurals were formed. Cartilage of the posterior strut graft was left 2 mm thick in the distal part of septum, it was cut vertically, and the connective tissue in the distal part was preserved. Results: The median patient age was 24 (range 17-42) years. The median follow-up period was15.2 (range12-26) months. Patient satisfaction was assessed with the 'Rhinoplasty Outcome Evaluation' (ROE) questionnaire. Twelve months after surgeries, 87.5% of patients reported excellent outcomes, according to ROE. Conclusion: The soft tissue connections between that segment and surrounding structures should be preserved to save the support of the tip while having a mobile tip at the same time with this method. These modifications would access to a mobile, non-stiff, and dynamic nasal tip in the early postoperative months. Further and prospective studies should be performed for supporting this method.

Keywords: closed rhinoplasty, dynamic, mobile, tip

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Authors: Uttam Aryal, Shekhar Thapaliya

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This research paper presents a comprehensive analysis of the factors contributing to student dropout at Makawanpur Multiple Campus, utilizing primary data collected directly from dropped out as well as regular students and academic staff. Employing a mixed-method approach, combining qualitative and quantitative methods, this study examines into the complicated issue of student dropout. Data collection methods included surveys, interviews, and a thorough examination of academic records covering multiple academic years. The study focused on students who left their programs prematurely, as well as current students and academic staff, providing a well-rounded perspective on the issue. The analysis reveals a shaded understanding of the factors influencing student dropout, encompassing both academic and non-academic dimensions. These factors include academic challenges, personal choices, socioeconomic barriers, peer influences, and institutional-related issues. Importantly, the study highlights the most influential factors for dropout, such as the pursuit of education abroad, financial restrictions, and employment opportunities, shedding light on the complex web of circumstances that lead students to discontinue their education. The insights derived from this study offer actionable recommendations for campus administrators, policymakers, and educators to develop targeted interventions aimed at reducing dropout rates and improving student retention. The study underscores the importance of addressing the diverse needs and challenges faced by students, with the ultimate goal of fostering a supportive academic environment that encourages student success and program completion.

Keywords: drop out, students, factors, opportunities, challenges

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Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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