Search results for: transient ischemic attack

Authors: Carolina Aparicio-Fernández, Alejandro Vilar Abad, Mar Cañada Soriano, Jose-Luis Vivancos

Abstract:

The building sector is responsible for 40% of the total energy consumption in the European Union (EU). Thus, implementation of strategies for quantifying and reducing buildings energy consumption is indispensable for reaching the EU’s carbon neutrality and energy efficiency goals. Each Member State has transposed the European Directives according to its own peculiarities: existing technical legislation, constructive solutions, climatic zones, etc. Therefore, in accordance with the Energy Performance of Buildings Directive, Member States have developed different Energy Performance Certificate schemes, using proposed energy simulation software-tool for each national or regional area. Energy Performance Certificates provide a powerful and comprehensive information to predict, analyze and improve the energy demand of new and existing buildings. Energy simulation software and databases allow a better understanding of the current constructive reality of the European building stock. However, Energy Performance Certificates still have to face several issues to consider them as a reliable and global source of information since different calculation tools are used that do not allow the connection between them. In this document, TRNSYS (TRaNsient System Simulation program) software is used to calculate the energy demand of a building, and it is compared with the energy labeling obtained with Spanish Official software-tools. We demonstrate the possibility of using not official software-tools to calculate the Energy Performance Certificate. Thus, this approach could be used throughout the EU and compare the results in all possible cases proposed by the EU Member States. To implement the simulations, an isolated single-family house with different construction solutions is considered. The results are obtained for every climatic zone of the Spanish Technical Building Code.

Keywords: energy demand, energy performance certificate EPBD, trnsys, buildings

Procedia PDF Downloads 108

Authors: Zong-Xian Qiu, Ta-Wui Cheng, Wei-Hao Lee, Yung-Chin Ding

Abstract:

The greenhouse effect is an important issue since it has been responsible for global warming. Carbon dioxide plays an important part of role in the greenhouse effect. Therefore, human has the responsibility for reducing CO₂ emissions in their daily operations. Except iron making and power plants, another major CO₂ production industry is cement industry. According to the statistics by EPA of Taiwan, production 1 ton of Portland cement will produce 520.29 kg of CO₂. There are over 7.8 million tons of CO₂ produced annually. Thus, trying to development low CO₂ emission green concrete is an important issue, and it can reduce CO₂ emission problems in Taiwan. The purpose of this study is trying to use marble wastes and slag as the raw materials to fabricate geopolymer green concrete. The result shows the marble based geopolymer green concrete have good workability and the compressive strength after curing for 28 days and 365 days can be reached 44MPa and 53MPa in indoor environment, 28MPa and 40.43MPa in outdoor environment. The acid resistance test shows the geopolymer green concrete have good resistance for chemical attack. The coefficient of permeability of geopolymer green concrete is better than Portland concrete. By comparing with Portland cement products, the marble based geopolymer not only reduce CO₂ emission problems but also provides great performance in practices. According to the experiment results shown that geopolymer concrete has great potential for further engineering development in the future, the new material could be expected to replace the Portland cement products in the future days.

Keywords: marble, slag, geopolymer, green concrete, CO₂ emission

Procedia PDF Downloads 112

Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

Abstract:

Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

Procedia PDF Downloads 123

Authors: Chanya Inprasit, Yi-Wen Lin

Abstract:

Inflammation causes changes of peripheral and central nervous system properties, affecting both neuronal and non-neuronal cells, resulting in inflammatory pain. Acupoint injection (AI) was developed in the 1950s and has been widely used for relieving pain. It is an acupoint-stimulating technique that utilizes anatomically based meridians derived from Chinese medicine theory. AI has been accepted as an effective treatment and is thought to display superior results when compared to traditional acupuncture methods. However, the mechanism of AI needs to be ratified by more scientific evidence in order to support the theory and its therapeutic development. In this study, we explored the effect of AI on the comorbidity of chronic pain and depression. Mice hindpaw was injected by complete Freund’s adjuvant (CFA) to induce the condition of chronic pain. Measurements of mechanical and thermal hyperalgesia and depression-like behavior were analyzed. The results indicated a positive tendency to AI treatment. The comorbidity of chronic pain and depression was investigated with relation to transient receptor potential V1 (TRPV1) mechanism through the use of TRPV1 gene deletion. The expression of nociceptors such as voltage-gated sodium channels (Navs) or TRPV1, was significantly down-regulated by AI. The expression of inflammation-activated molecules: astrocytic marker glial fibrillary acidic protein (GFAP), the microglial marker Iba-1, S100B, and related kinases, were reversed by AI in both the peripheral and central nervous system. Taken together, these data provided a detailed molecular mechanism of AI-induced analgesia and anti-inflammatory properties. This finding may be utilized for clinical practice to treat chronic pain and depression comorbidity.

Keywords: inflammatory pain, acupoint injection, TRPV1, GFAP, S100B

Procedia PDF Downloads 125

Authors: Omar Bouledroua, Djamel Zelmati, Zahreddine Hafsi, Milos B. Djukic

Abstract:

Transporting hydrogen gas through the existing natural gas pipeline network offers an efficient solution for energy storage and conveyance. Hydrogen generated from excess renewable electricity can be conveyed through the API 5L steel-made pipelines that already exist. In recent years, there has been a growing demand for the transportation of hydrogen through existing gas pipelines. Therefore, numerical and experimental tests are required to verify and ensure the mechanical integrity of the API 5L steel pipelines that will be used for pressurized hydrogen transportation. Internal pressure loading is likely to accelerate hydrogen diffusion through the internal pipe wall and consequently accentuate the hydrogen embrittlement of steel pipelines. Furthermore, pre-cracked pipelines are susceptible to quick failure, mainly under a time-dependent cyclic pressure loading that drives fatigue crack propagation. Meanwhile, after several loading cycles, the initial cracks will propagate to a critical size. At this point, the remaining service life of the pipeline can be estimated, and inspection intervals can be determined. This paper focuses on the hydrogen embrittlement of API 5L steel-made pipeline under cyclic pressure loading. Pressurized hydrogen gas is transported through a network of pipelines where demands at consumption nodes vary periodically. The resulting pressure profile over time is considered a cyclic loading on the internal wall of a pre-cracked pipeline made of API 5L steel-grade material. Numerical modeling has allowed the prediction of fatigue crack evolution and estimation of the remaining service life of the pipeline. The developed methodology in this paper is based on the ASME B31.12 standard, which outlines the guidelines for hydrogen pipelines.

Keywords: hydrogen embrittlement, pipelines, transient flow, cyclic pressure, fatigue crack growth

Procedia PDF Downloads 55

Authors: Dina A. Amu, Fifi N. Afifah, Catur Rosidati, Tirton Nefianto

Abstract:

Indonesia was shaken up by the avian influenza cases that had caused the country suffered losses of millions of dollars. The avian influenza case had even been suspected as a bioterrorism attack since it was an uncommon case in epidemiology. Furthermore, this avian influenza virus is a high pathogenic one and Indonesia has the highest case of fatality rate in the world. Bioterrorism threats or epidemic potential disease outbreaks currently does not exist in Tanjung Priok port yet. However, the surveillance system enhancement on epidemic potential diseases should be taken as a prevention, especially because Indonesia is currently facing the ASEAN Economic Society (AES). Therefore, this research evaluates the health surveillance system which is organized by Control, Quarantine and Surveillance Department, Health Office of Tanjung Priok Port. This study uses qualitative-evaluative method which utilizes Urgency Seriousness Growth (USG) method to determine priority issues and Root Cause analysis to determine the cause of prior problem. The result of this research shows that the implementation of epidemic potential disease surveillance in Tanjung Priok port has not done in the best possible way. It is because the lack of time allocation and the succinctness of the check list of ship's environmental health inspection. Therefore, Health Ministry of Indonesia should recruit more employees at the health office of Tanjung Priok port, hold a simulation of ship's inspection and simplify the list for ship's environmental health inspection.

Keywords: surveillance, epidemic potential disease, port health, bioterrorism

Procedia PDF Downloads 338

Authors: Nimmy Maria Joseph, Muhammed Hafiludheen

Abstract:

On September 16, a 22-year-old Iranian woman, Mahsa Amini, died in Tehran after she was arrested by the ‘Morality police’ for an accusation of not wearing a hijab according to the standards laid down by the Iran Government. Suspicions aroused as the incident happened while Mahsa Amini was under the custody of Iran police. People of Iran accused that she was severely beaten up by the police, which led to her death. This initiated an array of women-led protests in Iran, leading to the ignition of massive uproars in the country. The Law Enforcement Command of Iran reported that she collapsed due to a heart attack and not due to police brutality. However, as a result, Iran faced a series of conflicts between the Government of Iran and the civilians, especially women. The research paper presents the framing analysis of online news stories on Mahsa Amini’s death and the resultant protest in Iran. The researcher analysed the online news stories of two popular newspapers, Tehran Times (Iran) and The Wall Street Journal (USA). The focus of the study is to have a comparative analysis of the frames of the news stories used and find out their agenda-setting pattern. It helps to comprehend how the news stories of popular news organisations try to channelise the perception of their audience on social issues. The researcher analysed the news stories considering their frames, valence, polysemy, rhetoric devices, and technical devices.

Keywords: mahsa amini, iran protest, framing analysis, valence, rhetoric device, tehran times, the wall street journal

Procedia PDF Downloads 73

Authors: Ekki Kurniawan, Yusuf Nur Jayanto, Erna Sugesti, Efri Suhartono, Agus Ganda Permana, Jaspar Hasudungan, Jangkung Raharjo, Rintis Manfaati

Abstract:

The purpose of this research is to study the current characteristic of the electrolysis of mineral water to produce hydrogen, alkaline water, and acid water. Alkaline and hydrogen water are believed to have health benefits. Alkaline water containing hydrogen can be an anti-oxidant that captures free radicals, which will increase the immune system. In Indonesia, there are two existing types of alkaline water producing equipment, but the installation is complicated, and the price is relatively expensive. The electrolysis process is slow (6-8 hours) since they are locally made using 311 VDC full bridge rectifier power supply. This paper intends to discuss how to make hydrogen and alkaline water by a simple portable mineral water ionizer. This is an electrolysis device that is easy to carry and able to separate ions of mineral water into acidic and alkaline water. With an electric field, positive ions will be attracted to the cathode, while negative ions will be attracted to the anode. The circuit equivalent can be depicted as RLC transient ciruit. The diode component ensures that the electrolytic current is direct current. Switch S divides the switching times t1, t2, and t3. In the first stage up to t1, the electrolytic current increases exponentially, as does the inductor charging current (L). The molecules in drinking water experience magnetic properties. The direction of the dipole ions, which are random in origin, will regularly flare with the direction of the electric field. In the second stage up to t2, the electrolytic current decreases exponentially, just like the charging current of a capacitor (C). In the 3rd stage, start t3 until it tends to be constant, as is the case with the current flowing through the resistor (R).

Keywords: current electrolysis, mineral water, ions, alkaline and acid waters, inductor, capacitor, resistor

Procedia PDF Downloads 76

Authors: Boudjahem Ibtissem, Aouati Amel

Abstract:

Thaumetopoea pityocampa is one of the major insect pests of pine forests in Algeria, the Mediterranean region, and central Europe. This pest is responsible for several natural and human damages these last years. The caterpillar can feed itself during the larval stage on several species of pine or cedar. The forests attack by the insect can reduce their resistance against other forest enemies, fires, or drought conditions. In this case, the tree becomes more vulnerable to other pests. To understand the eating behavior of the insect in its ecological conditions, and its nutritional preference, we realized a study of the abundance of winter nests of the pine processionary caterpillar in four different forests: Pinus halepensis; Pinus pinaster; Pinus pinea, and Cedrus atlantica. A count of the sites affected by the processionary caterpillar was carried out on a hundred trees from the forests in different regions in Algeria; Alkala region, Mila region, Annaba region, and Blida region; the total rate and average abundance are calculated for each forest. Ecological parameters are also estimated for each infestation. The results indicated a higher rate of infestation in Pinus halepensis trees (85%) followed by Cedrus atlantica (66%) and Pinus pinaster (50%) trees. The Pinus pinea forest is the least attacked region by the pine processionary caterpillar (23%). The abundance of the pine processionary caterpillar can be influenced by the height of the trees, the climate of the region, the age of the forest but also the quality of needles.

Keywords: Thaumetopoea pityocampa, Pinus halepensis, needles, winter nests

Procedia PDF Downloads 128

Authors: Stanislaw Kosmynka

Abstract:

Although the genesis of the activity of fighting salafist radicalism in Spain dates back to the 80’s, the development of extremism of this kind manifested itself only in the next decade. Its first permanently functioning structures in this country in the second half of 90’s of 20th century came from Algieria and Syria. At the same time it should be emphasized that this distinction is in many dimensions conventional, the more so because they consisted also of immigrants from other coutries of Islam, particularly from Morocco. The paper seeks to understand the radical salafist challenge for Spain in the context of some terrorist networks consisted of immigrants from Morocco. On the eve of the new millennium Moroccan jihadists played an increasingly important role. Although the activity of these groups had for many years mainly logistical and propaganda character, the bomb attack carried out on 11 March 2004 in Madrid constituted an expression of open forms of terrorism, directed against the authorities and society of Spain and reflected the narration of representatives of the trend of the global jihad. The people involved in carrying out that act of violence were to a large extent Moroccan immigrants; also in the following years among the cells of radicals in Spain Moroccans stood out many times. That is why the forms and directions of activity of these extremists in Spain, also after 11th March 2004 and in the actual context of the impact of Islamic State, are worth presenting. The paper is focused on threats to the security of Spain and the region and remains connected with the issues of mutual relations of the society of a host country with immigrant communities which to a large degree come from this part of Maghreb.

Keywords: jihadi terrorism, Morocco, radical salafism, security, Spain, terrorist cells, threat

Procedia PDF Downloads 501

Authors: Biaou Jean-Baptiste Kouchoro, Anissa Meziane, Philippe Micheau, Mathieu Renier, Nicolas Quaegebeur

Abstract:

Numerous experimental and numerical studies have shown the interest of the local defects resonance (LDR) for the Non-Destructive Testing of metallic and composite plates. Indeed, guided ultrasonic waves such as Lamb waves, which are increasingly used for the inspection of these flat structures, enable the generation of local resonance phenomena by their interaction with a damaged area, allowing the detection of defects. When subjected to a large amplitude motion, a nonlinear behavior can predominate in the damaged area. This work presents a 2D Finite Element Model of the local resonance of a 12 mm long and 5 mm deep Flat Bottom Hole (FBH) in a 6 mm thick aluminum plate under the excitation induced by an incident A0 Lamb mode. The analysis of the transient response of the FBH enables the precise determination of its resonance frequencies and the associate modal deformations. Then, a linear parametric study varying the geometrical properties of the FBH highlights the sensitivity of the resonance frequency with respect to the plate thickness. It is demonstrated that the resonance effect disappears when the ratio of thicknesses between the FBH and the plate is below 0.1. Finally, the nonlinear behavior of the FBH is considered and studied introducing geometrical (taken into account the nonlinear component of the strain tensor) nonlinearities that occur at large vibration amplitudes. Experimental analysis allows observation of the resonance effects and nonlinear response of the FBH. The differences between these experimental results and the numerical results will be commented on. The results of this study are promising and allow to consider more realistic defects such as delamination in composite materials.

Keywords: guided waves, non-destructive testing, dynamic field testing, non-linear ultrasound/vibration

Procedia PDF Downloads 111

Authors: Olamide Shittu, Olayinka Akanle

Abstract:

Value Chain Analysis is a common method of examining the stages involved in the production of a product, mostly agricultural produce, from the input to the consumption stage including the actors involved in each stage. However, the Functional Institutional Analysis is the most common method in literature employed to analyze the value chain of products. Apart from studying the relatively neglected phenomenon of recycled polymer products in Lagos Metropolis, this paper adopted the use of social network analysis to attempt a grounded theory of the nature of social network that exists among the value chain actors of the subject matter. The study adopted a grounded theory approach by conducting in-depth interviews, administering questionnaires and conducting observations among the identified value chain actors of recycled polymer products in Lagos Metropolis, Nigeria. The thematic analysis of the collected data gave the researchers the needed background to formulate a truly representative network of the social relationships among the value chain actors of recycled polymer products in Lagos Metropolis. The paper introduced concepts such as Transient and Perennial Social Ties to explain the observed social relations among the actors. Some actors have more social capital than others as a result of the structural holes that exist in their triad network. Households and resource recoverers are at disadvantaged position in the network as they have high constraints in their relationships with other actors. The study attempted to provide a new perspective in the study of the environmental value chain by analyzing the network of actors to bring about policy action points and improve recycling in Nigeria. Government and social entrepreneurs can exploit the structural holes that exist in the network for the socio-economic and sustainable development of the state.

Keywords: recycled polymer products, social network analysis, social ties, value chain analysis

Procedia PDF Downloads 380

Authors: Efil Yusrianto, Noraini Marsi, Noraniah Kassim, Izzati Abdul Manaf, Hafizuddin Hakim Shariff

Abstract:

Today, municipal solid waste (MSW), noise pollution, and attack fire are three ongoing issues for inhabitants of urban including in Malaysia. To solve these issues, eco-friendly autoclaved aerated concrete (AAC) containing recycled ceramic and gypsum waste (CGW) as a partial replacement for sand with different ratios (0%, 5%, 10%, 15%, 20%, and 25% wt) has been prepared. The performance of samples, such as the physical, mechanical, sound absorption coefficient, and direct fire resistance, has been investigated. All samples showed normal color behavior, i.e., grey and free crack. The compressive strength was increased in the range of 6.10% to 29.88%. The maximum value of compressive strength was 2.13MPa for 15% wt of CGW. The positive effect of CGW on the compressive strength of AAC has also been confirmed by crystalline phase and microstructure analysis. The acoustic performances, such as sound absorption coefficients of samples at low frequencies (500Hz), are higher than the reference sample (RS). AAC-CGW samples are categorized as AAC material classes B and C. The fire resistance results showed the physical surface of the samples had a free crack and was not burned during the direct fire at 950ºC for 300s. The results showed that CGW succeeded in enhancing the performance of fresh AAC, such as compressive strength, crystalline phase, sound absorption coefficient, and fire resistance of samples.

Keywords: physical, mechanical, acoustic, direct fire resistance performance, autoclaved aerated concrete, recycled ceramic-gypsum waste

Procedia PDF Downloads 101

Authors: Haydar Kepekçi, Baha Zafer, Hasan Rıza Güven

Abstract:

Noise disturbance is one of the major factors considered in the fast development of aircraft technology. This paper reviews the flow field, which is examined on the 2D NACA0015 and 3D NACA0012 blade profile using SST k-ω turbulence model to compute the unsteady flow field. We inserted the time-dependent flow area variables in Ffowcs-Williams and Hawkings (FW-H) equations as an input and Sound Pressure Level (SPL) values will be computed for different angles of attack (AoA) from the microphone which is positioned in the computational domain to investigate effect of augmentation of unsteady 2D and 3D airfoil region noise level. The computed results will be compared with experimental data which are available in the open literature. As results; one of the calculated Cp is slightly lower than the experimental value. This difference could be due to the higher Reynolds number of the experimental data. The ANSYS Fluent software was used in this study. Fluent includes well-validated physical modeling capabilities to deliver fast, accurate results across the widest range of CFD and multiphysics applications. This paper includes a study which is on external flow over an airfoil. The case of 2D NACA0015 has approximately 7 million elements and solves compressible fluid flow with heat transfer using the SST turbulence model. The other case of 3D NACA0012 has approximately 3 million elements.

Keywords: 3D blade profile, noise disturbance, aeroacoustics, Ffowcs-Williams and Hawkings (FW-H) equations, k-ω-SST turbulence model

Procedia PDF Downloads 184

Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

Abstract:

Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

Procedia PDF Downloads 198

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

Abstract:

First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

Procedia PDF Downloads 43

Authors: Santosh Thapa, Sankar Gurung

Abstract:

Chaupadi is a tradition widely practiced in the far and mid-western region of Nepal. It is a practice where girls and women are not allowed to inter the house and touch the food, water and milk during their menstruation period of 4-7 days. They have to spend all the nights during the period in a specific hut (Chhaupadi Goth) which is a bit far from their residence where they faces various kinds of risk and violence like bullying, snakes and insect bite, wild animal attack etc. Sometimes the girls even do not go to school during their menstruation periods. After childbirth, the woman must stay in a cow shed for 11 days in such Chhaupadi practiced areas. This study limits the Achham district of the far western region which is the most vulnerable Chhaupadi practicing district. Several governmental and non-governmental organizations have been involving and spending huge amount of money for capacity building and awareness raising campaign for last 2 decades but still 9 out of 75 Village Development Committees (VDCs) have been partially practicing Chaupadi in the district. This study shows that the school attendance rate of the girls during the period have visibly increased which helps to increase the number of the girl graduation as well. Similarly, the practice of Chhaupadi is one of the reasons for increasing the number of cases of uterus prolapsus and poor reproductive health of women and girls. Triggering tools are the one of the best ways to accelerate the awareness campaign in the VDCs. This study recommends that the local bodies should coordinate and lead the overall awareness campaign program to sustain the Chaupadi free VDCs.

Keywords: awareness campaign, chaupadi practice, gender discrimination, violence

Procedia PDF Downloads 282

Authors: H. Boukhatem, L. Djouadi, H. Khalaf, R. M. Navarro, F. V. Ganzalez

Abstract:

Synthetic organic dyes are used in various industries, such as textile industry, leather tanning industry, paper production, hair dye production, etc. Wastewaters containing these dyes may be harmful to the environment and living organisms. Therefore, it is very important to remove or degrade these dyes before discharging them into the environment. In addition to standard technologies for the degradation and/or removal of dyes, several new specific technologies, the so-called advanced oxidation processes (AOPs), have been developed to eliminate dangerous compounds from polluted waters. AOPs are all characterized by the same chemical feature: production of radicals (•OH) through a multistep process, although different reaction systems are used. These radicals show little selectivity of attack and are able to oxidize various organic pollutants due to their high oxidative capacity (reduction potential of HO• Eo = 2.8 V). Heterogeneous photocatalysis, as one of the AOPs, could be effective in the oxidation/degradation of organic dyes. A major advantage of using heterogeneous photocatalysis for this purpose is the total mineralization of organic dyes, which results in CO2, H2O and corresponding mineral acids. In this study, nanomaterials based on montmorillonite and CuxCd1-xS with different Cu concentration (0.3 < x < 0.7) were utilized for the degradation of the commercial cationic textile dye Methylene blue (MB), used as a model pollutant. The synthesized nanomaterials were characterized by fourier transform infrared (FTIR) and thermogravimetric-differential thermal analysis (TG–DTA). Test results of photocatalysis of methylene blue under UV-Visible irradiation show that the photoactivity of nanomaterials montmorillonite/ CuxCd1-xS increases with the increasing of Cu concentration. The kinetics of the degradation of the MB dye was described with the Langmuir–Hinshelwood (L–H) kinetic model.

Keywords: heterogeneous photocatalysis, methylene blue, montmorillonite, nanomaterial

Procedia PDF Downloads 347

Authors: Matthew Ferguson, Tatyana Konkova, Ioannis Violatos

Abstract:

Microstructure analysis of additively manufactured (AM) materials is an important step in understanding the interrelationship between mechanical properties and materials performance. Literature on the effect of laser-based AM process parameters on the microstructure in the substrate-deposit interface is limited. The interface region, the adjoining area of substrate and deposit, is characterized by the presence of the fusion zone (FZ) and heat-affected zone (HAZ), experiencing rapid thermal gyrations resulting in thermal-induced transformations. Inconel 718 was utilized as work material for both the substrate and deposit. Three blocks of Inconel 718 material were deposited by Direct Energy Deposition (DED) using three different laser powers, 550W, 750W and 950W, respectively. A coupled thermo-mechanical transient approach was utilized to correlate temperature history to the evolution of microstructure. The thermal history of the deposition process was monitored with the thermocouples installed inside the substrate material. The interface region of the blocks was analyzed with Optical Microscopy (OM) and Scanning Electron Microscopy (SEM), including the electron back-scattered diffraction (EBSD) technique. Laser power was found to influence the dissolution of intermetallic precipitated phases in the substrate and grain growth in the interface region. Microstructure and thermal history data were utilized to draw conclusive comparisons between the investigated process parameters.

Keywords: additive manufacturing, direct energy deposition, electron back-scattered diffraction, finite element analysis, inconel 718, microstructure, optical microscopy, scanning electron microscopy, substrate-deposit interface region

Procedia PDF Downloads 176

Authors: Lina Paola Orozco Marin, Yuliet Montoya Osorio, John Bustamante Osorno

Abstract:

Ischemic events can culminate in acute myocardial infarction by irreversible cardiac lesions that cannot be restored due to the limited regenerative capacity of the heart. Cell therapy seeks to replace these injured or necrotic cells by transplanting healthy and functional cells. The therapeutic alternatives proposed by tissue engineering and cardiovascular regenerative medicine are the use of biomaterials to mimic the native extracellular medium, which is full of proteins, proteoglycans, and glycoproteins. The selected biomaterials must provide structural support to the encapsulated cells to avoid their migration and death in the host tissue. In this context, the present research work focused on developing a natural thermosensitive hydrogel, its physical and chemical characterization, and the determination of its biocompatibility in vitro. The hydrogel was developed by mixing hydrolyzed bovine and porcine collagen at 2% w/v, chitosan at 2.5% w/v, and beta-glycerolphosphate at 8.5% w/w and 10.5% w/w in magnetic stirring at 4°C. Once obtained, the thermosensitivity and gelation time were determined, incubating the samples at 37°C and evaluating them through the inverted tube method. The morphological characterization of the hydrogels was carried out through scanning electron microscopy. Chemical characterization was carried out employing infrared spectroscopy. The biocompatibility was determined using the MTT cytotoxicity test according to the ISO 10993-5 standard for the hydrogel’s precursors using the fetal human ventricular cardiomyocytes cell line RL-14. The RL-14 cells were also seeded on the top of the hydrogels, and the supernatants were subculture at different periods to their observation under a bright field microscope. Four types of thermosensitive hydrogels were obtained, which differ in their composition and concentration, called A1 (chitosan/bovine collagen/beta-glycerolphosphate 8.5%w/w), A2 (chitosan/porcine collagen/beta-glycerolphosphate 8.5%), B1 (chitosan/bovine collagen/beta-glycerolphosphate 10.5%) and B2 (chitosan/porcine collagen/beta-glycerolphosphate 10.5%). A1 and A2 had a gelation time of 40 minutes, and B1 and B2 had a gelation time of 30 minutes at 37°C. Electron micrographs revealed a three-dimensional internal structure with interconnected pores for the four types of hydrogels. This facilitates the exchange of nutrients, oxygen, and the exit of metabolites, allowing to preserve a microenvironment suitable for cell proliferation. In the infrared spectra, it was possible to observe the interaction that occurs between the amides of polymeric compounds with the phosphate groups of beta-glycerolphosphate. Finally, the biocompatibility tests indicated that cells in contact with the hydrogel or with each of its precursors are not affected in their proliferation capacity for a period of 16 days. These results show the potential of the hydrogel to increase the cell survival rate in the cardiac cell therapies under investigation. Moreover, the results lay the foundations for its characterization and biological evaluation in both in vitro and in vivo models.

Keywords: cardiac cell therapy, cardiac ischemia, natural polymers, thermosensitive hydrogel

Procedia PDF Downloads 164

Authors: S. M. Abdul Khader, Anurag Ayachit, Raghuvir Pai, K. A. Ahmed, V. R. K Rao, S. Ganesh Kamath

Abstract:

The numerical simulation has made tremendous advances in investigating the blood flow phenomenon through elastic arteries. Such study can be useful in demonstrating the disease progression and haemodynamics of cardiovascular diseases such as atherosclerosis. In the present study, patient specific case diagnosed with partially stenosed complete right ICA and normal left carotid bifurcation without any atherosclerotic plaque formation is considered. 3D patient specific carotid bifurcation model is generated based on CT scan data using MIMICS-4.0 and numerical analysis is performed using FSI solver in ANSYS-14.5. The blood flow is assumed to be incompressible, homogenous and Newtonian, while the artery wall is assumed to be linearly elastic. The two-way sequentially-coupled transient FSI analysis is performed using FSI solver for three pulse cycles. The haemodynamic parameters such as flow pattern, Wall Shear Stress, pressure contours and arterial wall deformation are studied at the bifurcation and critical zones such as stenosis. The variation in flow behavior is studied throughout the pulse cycle. Also, the simulation results reveals that there is a considerable increase in the flow behavior in stenosed carotid in contrast to the normal carotid bifurcation system. The investigation also demonstrates the disturbed flow pattern especially at the bifurcation and stenosed zone elevating the haemodynamics, particularly during peak systole and later part of the pulse cycle. The results obtained agree well with the clinical observation and demonstrates the potential of patient specific numerical studies in prognosis of disease progression and plaque rupture.

Keywords: fluid-structure interaction, arterial stenosis, wall shear stress, carotid artery bifurcation

Procedia PDF Downloads 554

Authors: Yahya Almurtadha, Mukhtar Ghaleb, Ahmed M. Shamsan Saleh

Abstract:

The world witnessed a fierce attack from the Covid-19 virus, which affected public life socially, economically, healthily and psychologically. The world's governments tried to confront the pandemic by imposing a number of precautionary measures such as general closure, curfews and social distancing. Scientists have also made strenuous efforts to develop an effective vaccine to train the immune system to develop antibodies to combat the virus, thus reducing its symptoms and limiting its spread. Artificial intelligence, along with researchers and medical authorities, has accelerated the vaccine development process through big data processing and simulation. On the other hand, one of the most important negatives of the impact of Covid 19 was the state of anxiety and fear due to the blowout of rumors through social media, which prompted governments to try to reassure the public with the available means. This study aims to proposed using Sentiment Analysis (AKA Opinion Mining) and deep learning as efficient artificial intelligence techniques to work on retrieving the tweets of the public from Twitter and then analyze it automatically to extract their opinions, expression and feelings, negatively or positively, about the symptoms they may feel after vaccination. Sentiment analysis is characterized by its ability to access what the public post in social media within a record time and at a lower cost than traditional means such as questionnaires and interviews, not to mention the accuracy of the information as it comes from what the public expresses voluntarily.

Keywords: deep learning, opinion mining, natural language processing, sentiment analysis

Procedia PDF Downloads 146

Authors: A. Lakshya

Abstract:

The main aim of this paper is to interpret physical education for children from 5 to 18 years. Schools have the ability to promote positive mental health by developing physical education, which helps to build individual growth, goal setting, decision making, helps in muscular development, self-discipline, stresses relief, leadership qualities that can arise with new skills, prosocial behavior and problem-solving skills. But mostly the children at these early ages ought to hold the disorders as heart attack, diabetes and obesity disorders may increase in large number. The data of P.E has got a very least place, where children are with feeble minds and they acquired a state of inactiveness. Globally, 81% of adolescents aged 11-18 years were insufficiently physically active in the year 2016. Adolescent girls were less active than boys, with the percentage of 85% vs. 78% as well. A recent study of California schools found that students are sedentary most of the time during PE classes, with just four minutes of every half-hour spent in vigorous physical activity. Additionally, active PE time decreases with larger class sizes. Students in classes with more than forty-five students are half as active as students in smaller class sizes. The children in adolescence age they acquire more creative ideas hence they create new hairstyles, cooking styles and dressing styles. Instead, all the children are engaging themselves to TV (television) and video games. The development of physical quality not only improves students ’ physical fitness but is also conducive to the psychological development of the students. Physical education teaching should pay more attention to the training of physical quality in the future.

Keywords: physical education, prosocial behavior, leadership, goal setting

Procedia PDF Downloads 114

Authors: Gerardo Sanjuan Sanjuan, Ángel Enrique Chavéz Castellanos

Abstract:

The knowledge of the rheological behavior of partially solidified metal alloy is an important issue when modeling and simulation of die filling in semisolid processes. Many experiments for like steady state, the step change in shear rate tests, shear stress ramps have been carried out leading that semi-solid alloys exhibit shear thinning, thixotropic behavior and yield stress. More advanced investigation gives evidence some viscoelastic features can be observed. The viscoelastic properties of materials are determinate by transient or dynamic methods; unfortunately, sparse information exists about oscillation experiments. The aim of this present work is to use small amplitude oscillatory tests for knowledge properties such as G´ and G´´. These properties allow providing information about materials structure. For this purpose, we investigated tin-lead alloy (Sn-15%Pb) which exhibits a similar microstructure to aluminum alloys and is the classic alloy for semisolid thixotropic studies. The experiments were performed with parallel plates rheometer AR-G2. Initially, the liquid alloy is cooled down to the semisolid range, a specific temperature to guarantee a constant fraction solid. Oscillation was performed within the linear viscoelastic regime with a strain sweep. So, the loss modulus G´´, the storage modulus G´ and the loss angle (δ) was monitored. In addition a frequency sweep at a strain below the critical strain for characterized its structure. This provides more information about the interactions among solid particles on a liquid matrix. After testing, the sample was removed then cooled, sectioned and examined metallographically. These experiments demonstrate that the viscoelasticity is sensitive to the solid fraction, and is strongly influenced by the shape and size of particles solid.

Keywords: rheology, semisolid alloys, thixotropic, viscoelasticity

Procedia PDF Downloads 347

Authors: Hansraj Bookun, Rachel Xuan, Angela Tan, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos, Jim Iliopoulos

Abstract:

Introduction: Complex endovascular aortic aneursymal repairs with fenestrated and branched endografts require customised devices to exclude the pathology while reducing morbidity and mortality, which was historically associated with open repair of complex aneurysms. Such endovascular procedures have predominantly been performed in a large volume dedicated tertiary centres. We present here our nine year multidisciplinary experience with this technology in an Australian tertiary centre. Method: This was a cross-sectional, single-centre observational study of 670 patients who had undergone complex endovascular aortic aneurysmal repairs with conventional endografts, fenestrated endografts, and iliac-branched devices from January 2010 to July 2019. Descriptive statistics were used to characterise our sample with regards to demographic and perioperative variables. Homogeneity of the sample was tested using multivariant regression, which did not identify any statistically significant confounding variables. Results: 670 patients of mean age 74, were included (592 males) and the comorbid burden was as follows: ischemic heart disease (55%), diabetes (18%), hypertension (90%), stage four or greater kidney impairment (8%) and current or ex-smoking (78%). The main indications for surgery were elective aneurysms (86%), symptomatic aneurysms (5%), and rupture aneurysms (5%). 106 patients (16%) underwent fenestrated or branched endograft repairs. The mean length of stay was 7.6 days. 2 patients experienced reactionary bleeds, 11 patients had access wound complications (6 lymph fistulae, 5 haematoms), 11 patients had cardiac complications (5 arrhythmias, 3 acute myocadial infarctions, 3 exacerbation of congestive cardiac failure), 10 patients had respiratory complications, 8 patients had renal impairment, 4 patients had gastrointestinal complications, 2 patients suffered from paraplegia, 1 major stroke, 1 minor stroke, and 1 acute brain syndrome. There were 4 vascular occlusions requiring further arterial surgery, 4 type I endoleaks, 4 type II endoleaks, 3 episodes of thromboembolism, and 2 patients who required further arterial operations in the setting of patient vessels. There were 9 unplanned returns to the theatre. Discussion: Our numbers of 10 years suggest that we are not a dedicated high volume centre focusing on aortic repairs. However, we have achieved significantly low complication rates. This can be attributed to our multidisciplinary approach with the intraoperative involvement of skilled interventional radiologists and vascular surgeons as well as postoperative protocols with particular attention to spinal cord protection. Additionally, we have a ratified perioperative pathway that involves multidisciplinary team discussions of patient-related factors and lesion-centered characteristics, which allows for holistic, patient-centered care.

Keywords: aneurysm, aortic, endovascular, fenestrated

Procedia PDF Downloads 93

Authors: Ishaq Alhassan Meriga

Abstract:

This study examined the phenomenon of mob violence and its implication for peace in Ghana. The study used the archival study of media reports and content analysis of other secondary data as well as eyewitness accounts. The study examined trends and patterns of vigilante violence within the Ghanaian context. Results showed a considerable increase in the occurrence of mob violence within the last 10 years. Theft and robbery emerged as the most frequently suspected crimes for which victims were attacked, while the LGBT community is not left out. Cases of mob violence were most frequently reported in urban areas. This study has shown that the patterns, scope, nature, and implication of mob justice in Ghana are fairly and comparatively similar to those found in other parts of Africa and the globe. Mob violence is identified as undermining the rule of law and thereby infringing on the fundamental human rights of the victims. It is confirmed to have a cycle of effects that is an impediment to the peace of the country. The study underscores the implications of mob violence in terms of disdaining human life and dignity, revisiting our justice systems and punishment procedures, resourcing, and empowering law enforcers to fight the menace of vigilantism. First, the archival study had a limitation regarding missing data. The majority of the cases used for the study lack information mostly on perpetrators and the steps taken by public authorities and security agencies after reports of a mob attack have been lodged with them. The study recommends for further research to be undertaken on the perpetrators and survivors of mob actions in order to get a holistic understanding of the phenomenon. This will give a more comprehensive view of the issue of mob violence in Ghana. From the findings, it can be concluded that mob justice is a social canker in Ghanaian communities, which has a great impact on the peace of the country.

Keywords: LGBT, mob justice, peace, vigilantism

Procedia PDF Downloads 44

Authors: Sumit Kumar Das, Laishram Ladusingh

Abstract:

Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

Procedia PDF Downloads 157

Authors: Ahmed Ismail, Mustafa Baysal

Abstract:

Although the energy source in the world is mainly based on fossil fuels today, there is a need for alternative energy generation systems, which are more economic and environmentally friendly, due to continuously increasing demand of electric energy and lacking power resources and networks. Distributed Energy Resources (DERs) such as fuel cells, wind and solar power have recently become widespread as alternative generation. In order to solve several problems that might be encountered when integrating DERs to power system, the microgrid concept has been proposed. A microgrid can operate both grid connected and island mode to benefit both utility and customers. For most distributed energy resources (DER) which are connected in parallel in LV-grid like micro-turbines, wind plants, fuel cells and PV cells electrical power is generated as a direct current (DC) and converted to an alternative currents (AC) by inverters. So the inverters are assumed to be primary components in a microgrid. There are many control techniques of parallel inverters to manage active and reactive sharing of the loads. Some of them are based on droop method. In literature, the studies are usually focused on improving the transient performance of inverters. In this study, the performance of two different controllers based on droop control method is compared for the inverters operated in parallel without any communication feedback. For this aim, a microgrid in which inverters are controlled by conventional droop controller and modified droop controller is designed. Modified controller is obtained by adding PID into conventional droop control. Active and reactive power sharing performance, voltage and frequency responses of those control methods are measured in several operational cases. Study cases have been simulated by MATLAB-SIMULINK.

Keywords: active and reactive power sharing, distributed generation, droop control, microgrid

Procedia PDF Downloads 565

Authors: Hadri Hussain, M.Nasir Ibrahim, Chee-Ming Ting, Mariani Idroas, Fuad Numan, Alias Mohd Noor

Abstract:

A biometric security system has become an important application in client identification and verification system. A conventional biometric system is normally based on unimodal biometric that depends on either behavioural or physiological information for authentication purposes. The behavioural biometric depends on human body biometric signal (such as speech) and biosignal biometric (such as electrocardiogram (ECG) and phonocardiogram or heart sound (HS)). The speech signal is commonly used in a recognition system in biometric, while the ECG and the HS have been used to identify a person’s diseases uniquely related to its cluster. However, the conventional biometric system is liable to spoof attack that will affect the performance of the system. Therefore, a multimodal biometric security system is developed, which is based on biometric signal of ECG, HS, and speech. The biosignal data involved in the biometric system is initially segmented, with each segment Mel Frequency Cepstral Coefficients (MFCC) method is exploited for extracting the feature. The Hidden Markov Model (HMM) is used to model the client and to classify the unknown input with respect to the modal. The recognition system involved training and testing session that is known as client identification (CID). In this project, twenty clients are tested with the developed system. The best overall performance at 44 kHz was 93.92% for ECG and the worst overall performance was ECG at 88.47%. The results were compared to the best overall performance at 44 kHz for (20clients) to increment of clients, which was 90.00% for HS and the worst overall performance falls at ECG at 79.91%. It can be concluded that the difference multimodal biometric has a substantial effect on performance of the biometric system and with the increment of data, even with higher frequency sampling, the performance still decreased slightly as predicted.

Keywords: electrocardiogram, phonocardiogram, hidden markov model, mel frequency cepstral coeffiecients, client identification

Procedia PDF Downloads 257

Authors: Anna Demian, Levi Howard, L. Ng, Leslie Simon, Mark Dragon, A. Desai, Timothy Devlantes, W. David Freeman

Abstract:

Introduction: Out-of-hospital cardiac arrest (OHCA) can carry a high mortality. For survivors, the most common complication is hypoxic-ischemic brain injury (HIBI). Rarely, lumbosacral spinal cord and/or other spinal cord artery ischemia can occur due to anatomic variation and variable mean arterial pressure after the return of spontaneous circulation. We present a case of an OHCA survivor who later woke up with bilateral leg weakness with preserved sensation (ASIA grade B, L2 level). Methods: We describe a clinical, radiographic, and laboratory presentation, as well as a National Library of Medicine (NLM) search engine methodology, characterizing incidence/prevalence of this entity is discussed. A 70-year-old male, a longtime smoker, and alcohol user, suddenly collapsed at a bar surrounded by friends. He had complained of chest pain before collapsing. 911 was called. EMS arrived, and the patient was in pulseless electrical activity (PEA), cardiopulmonary resuscitation (CPR) was initiated, and the patient was intubated, and a LUCAS device was applied for continuous, high-quality CPR in the field by EMS. In the ED, central lines were placed, and thrombolysis was administered for a suspected Pulmonary Embolism (PE). It was a prolonged code that lasted 90 minutes. The code continued with the eventual return of spontaneous circulation. The patient was placed on an epinephrine and norepinephrine drip to maintain blood pressure. ECHO was performed and showed a “D-shaped” ventricle worrisome for PE as well as an ejection fraction around 30%. A CT with PE protocol was performed and confirmed bilateral PE. Results: The patient woke up 24 hours later, following commands, and was extubated. He was found paraplegic below L2 with preserved sensation, with hypotonia and areflexia consistent with “spinal shock” or anterior spinal cord syndrome. MRI thoracic and lumbar spine showed a conus medullaris level spinal cord infarction. The patient was given IV steroids upon initial discovery of cord infarct. NLM search using “cardiac arrest” and “spinal cord infarction” revealed 57 results, with only 8 review articles. Risk factors include age, atherosclerotic disease, and intraaortic balloon pump placement. AoA (Artery of Adamkiewicz) anatomic variation along with existing atherosclerotic factors and low perfusion were also known risk factors. Conclusion: Acute paraplegia from anterior spinal cord infarction of the AoA territory after cardiac arrest is rare. Larger prospective, multicenter trials are needed to examine potential interventions of hypothermia, lumbar drains, which are sometimes used in aortic surgery to reduce ischemia and/or other neuroprotectants.

Keywords: cardiac arrest, spinal cord infarction, artery of Adamkiewicz, paraplegia

Procedia PDF Downloads 170