Search results for: analysis of joint wrist injury

Authors: Wenjiang Deng, Tian Mou, Yudi Pawitan, Trung Nghia Vu

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Estimation of isoform-level gene expression from RNA-seq data depends on simplifying assumptions, such as uniform reads distribution, that are easily violated in real data. Such violations typically lead to biased estimates. Most existing methods provide a bias correction step(s), which is based on biological considerations, such as GC content–and applied in single samples separately. The main problem is that not all biases are known. For example, new technologies such as single-cell RNA-seq (scRNA-seq) may introduce new sources of bias not seen in bulk-cell data. This study introduces a method called XAEM based on a more flexible and robust statistical model. Existing methods are essentially based on a linear model Xβ, where the design matrix X is known and derived based on the simplifying assumptions. In contrast, XAEM considers Xβ as a bilinear model with both X and β unknown. Joint estimation of X and β is made possible by simultaneous analysis of multi-sample RNA-seq data. Compared to existing methods, XAEM automatically performs empirical correction of potentially unknown biases. XAEM implements an alternating expectation-maximization (AEM) algorithm, alternating between estimation of X and β. For speed XAEM utilizes quasi-mapping for read alignment, thus leading to a fast algorithm. Overall XAEM performs favorably compared to other recent advanced methods. For simulated datasets, XAEM obtains higher accuracy for multiple-isoform genes, particularly for paralogs. In a differential-expression analysis of a real scRNA-seq dataset, XAEM achieves substantially greater rediscovery rates in an independent validation set.

Keywords: alternating EM algorithm, bias correction, bilinear model, gene expression, RNA-seq

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Authors: Shagufta Jahangir, Raisa Jahangir, Nadeemullah

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In many societies sports is considered inappropriate for women. It traditionally associated with mascunity. The proposed study aims at undertaking a critical situation analysis of sports women in Pakistan from a gender perspective by examining various aspects of sports women by gender including wrong social values, unstable economical position, wrong religious perspective and the role of media towards women in sports, while sports can provide a channel for informing women about their social and legal rights as well as their health issues, productive health and others. A major concern of the study is to identify the basic causes which depriving Pakistani women from sports. The Human Rights Commission of Pakistan and the Joint Action Committee for People’s Rights organized a symbolic mini marathon on 21 May 2005 in Pakistan to challenge arbitrary curbs on women’s public participation in sport and to highlight rising violence against women. Historically, sport has engaged the perception of gender-hierarchy in order to reproduce the ideology of male superiority, a notion which is often translated into ‘usual superiority’ within the superior communal order. However, it is argued here that we are presently in a state of communal instability with esteem to women's participation in sport.

Keywords: mascunity, gender, productive health, inappropriate, rights

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Authors: Naeem Khan

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In 1971 Williams in his essay titled "What Educational Planning is About in Higher Education" defined educational planning as "planning in education, as in anything else consist essentially of deciding, in advance, what you want, to do and how you are going to do in". In the “World Year book of Education”. While Anderson and Bowman in 1976 in their joint article titled "Theoretical Considerations in Educational Planning" defined it as "the process of preparing a set of decisions for future action pertaining in education". There are so many other definitions which are related to educational planning in which every one stress on the importance of educational planning. But developing countries face a lot of problems related to the educational planning and this paper is to discuss few of them.

Keywords: educational planning, problems, developing countries, education system,

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Authors: Arash Yousefi

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Experts suggest that relying exclusively on parameters to convey a situation or establish a condition may not be adequate. Assessing and appraising incidents in a system based on accident parameters, such as accident frequency, lost workdays, or fatalities, may not always be precise and occasionally erroneous. The frequency rate of accidents is a metric that assesses the correlation between the number of accidents causing work-time loss due to injuries and the total working hours of personnel over a year. Traditionally, this has been calculated based on one million working hours, but the American Occupational Safety and Health Organization has updated its standards. The new coefficient of 200/000 working hours is now used to compute the frequency rate of accidents. It's crucial to ensure that the total working hours of employees are equally represented when calculating individual event and incident numbers. The accident severity rate is a metric used to determine the amount of time lost or wasted during a given period, often a year, in relation to the total number of working hours. It measures the percentage of work hours lost or wasted compared to the total number of useful working hours, which provides valuable insight into the number of days lost or wasted due to work-related incidents for each working hour. Calculating the severity of an incident can be difficult if a worker suffers permanent disability or death. To determine lost days, coefficients specified in the "tables of days equivalent to OSHA or ANSI standards" for disabling injuries are used. The accident frequency coefficient denotes the rate at which accidents occur, while the accident severity coefficient specifies the extent of damage and injury caused by these accidents. These coefficients are crucial in accurately assessing the magnitude and impact of accidents.

Keywords: incidents, safety, analysis, frequency, severity, injuries, determine

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Authors: Pavel Bulai, Taras Pitlik, Tatsiana Kulahava, Timofei Lipski

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The method of Electrocardiography (ECG) interpretation for post-exercise recovery tracking was developed. Metabolic indices (aerobic and anaerobic) were designed using ECG-derived features. This study reports the associations between aerobic and anaerobic indices and classical parameters of the person’s physiological state, including blood biochemistry, glycogen concentration and VO2max changes. During the study 9 participants, healthy, physically active medium trained men and women, which trained 2-4 times per week for at least 9 weeks, fulfilled (i) ECG monitoring using Apple Watch Series 4 (AWS4); (ii) blood biochemical analysis; (iii) maximal oxygen consumption (VO2max) test, (iv) bioimpedance analysis (BIA). ECG signals from a single-lead wrist-wearable device were processed with detection of QRS-complex. Aerobic index (AI) was derived as the normalized slope of QR segment. Anaerobic index (ANI) was derived as the normalized slope of SJ segment. Biochemical parameters, glycogen content and VO2max were evaluated eight times within 3-60 hours after training. ECGs were recorded 5 times per day, plus before and after training, cycloergometry and BIA. The negative correlation between AI and blood markers of the muscles functional status including creatine phosphokinase (r=-0.238, p < 0.008), aspartate aminotransferase (r=-0.249, p < 0.004) and uric acid (r = -0.293, p<0.004) were observed. ANI was also correlated with creatine phosphokinase (r= -0.265, p < 0.003), aspartate aminotransferase (r = -0.292, p < 0.001), lactate dehydrogenase (LDH) (r = -0.190, p < 0.050). So, when the level of muscular enzymes increases during post-exercise fatigue, AI and ANI decrease. During recovery, the level of metabolites is restored, and metabolic indices rising is registered. It can be concluded that AI and ANI adequately reflect the physiology of the muscles during recovery. One of the markers of an athlete’s physiological state is the ratio between testosterone and cortisol (TCR). TCR provides a relative indication of anabolic-catabolic balance and is considered to be more sensitive to training stress than measuring testosterone and cortisol separately. AI shows a strong negative correlation with TCR (r=-0.437, p < 0.001) and correctly represents post-exercise physiology. In order to reveal the relation between the ECG-derived metabolic indices and the state of the cardiorespiratory system, direct measurements of VO2max were carried out at various time points after training sessions. The negative correlation between AI and VO2max (r = -0.342, p < 0.001) was obtained. These data testifying VO2max rising during fatigue are controversial. However, some studies have revealed increased stroke volume after training, that agrees with findings. It is important to note that post-exercise increase in VO2max does not mean an athlete’s readiness for the next training session, because the recovery of the cardiovascular system occurs over a substantially longer period. Negative correlations registered for ANI with glycogen (r = -0.303, p < 0.001), albumin (r = -0.205, p < 0.021) and creatinine (r = -0.268, p < 0.002) reflect the dehydration status of participants after training. Correlations between designed metabolic indices and physiological parameters revealed in this study can be considered as the sufficient evidence to use these indices for assessing the state of person’s aerobic and anaerobic metabolic systems after training during fatigue, recovery and supercompensation.

Keywords: aerobic index, anaerobic index, electrocardiography, supercompensation

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Authors: Marc Sebastián-Romagosa, Woosang Cho, Rupert Ortner, Christy Li, Christoph Guger

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Neurorehabilitation based on Brain-Computer Interfaces (BCIs) shows important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. For this publication, seven stroke patients in the chronic phase with hemiparesis in the lower extremity were recruited. All of them participated in 25 BCI sessions about 3 times a week. The BCI system was based on the Motor Imagery (MI) of the paretic ankle dorsiflexion and healthy wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes in motor improvement before, after and during the rehabilitation training. Our primary measures used for the assessment were the 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT fast velocity of 0.18 m/s IQR = [0.12 to 0.2], P = 0.016. The speed in the TUG was also significantly increased by 0.1 m/s IQR = [0.09 to 0.11], P = 0.031. The active ROM assessment increased 4.65º, and IQR = [ 1.67 - 7.4], after rehabilitation training, P = 0.029. These functional improvements persisted at least one month after the end of the therapy. These outcomes show the feasibility of this BCI approach for chronic stroke patients and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tools for stroke patients. However, the results are from only seven chronic stroke patients, so the authors believe that this approach should be further validated in broader randomized controlled studies involving more patients. MI and FES-based non-invasive BCIs are showing improvement in the gait rehabilitation of patients in the chronic stage after stroke. This could have an impact on the rehabilitation techniques used for these patients, especially when they are severely impaired and their mobility is limited.

Keywords: neuroscience, brain computer interfaces, rehabilitat, stroke

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Authors: Cristobal García

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The visual inspection of bolted joints in wind turbines is dangerous, expensive, and impractical due to the non-possibility to access the platform by workboat in certain sea state conditions, as well as the high costs derived from the transportation of maintenance technicians to offshore platforms located far away from the coast, especially if helicopters are involved. Consequently, the wind turbine operators have the need for simpler and less demanding techniques for the analysis of the bolts tightening. Vibration-based structural health monitoring is one of the oldest and most widely-used means for monitoring the health of onshore and offshore wind turbines. The core of this work is to find out if the modal parameters can be efficiently used as a key performance indicator (KPIs) for the assessment of joint bolts in a 1:50 scale tower of a floating offshore wind turbine (12 MW). A non-destructive vibration test is used to extract the vibration signals of the towers with different damage statuses. The procedure can be summarized in three consecutive steps. First, an artificial excitation is introduced by means of a commercial shaker mounted on the top of the tower. Second, the vibration signals of the towers are recorded for 8 s at a sampling rate of 20 kHz using an array of commercial accelerometers (Endevco, 44A16-1032). Third, the natural frequencies, damping, and overall vibration mode shapes are calculated using the software Siemens LMS 16A. Experiments show that the natural frequencies, damping, and mode shapes of the tower are directly dependent on the fixing conditions of the towers, and therefore, the variations of both parameters are a good indicator for the estimation of the static axial force acting in the bolt. Thus, this vibration-based structural method proposed can be potentially used as a diagnostic tool to evaluate the tightening torques of the bolted joints with the advantages of being an economical, straightforward, and multidisciplinary approach that can be applied for different typologies of connections by operation and maintenance technicians. In conclusion, TSI, in collaboration with the consortium of the FIBREGY project, is conducting innovative research where vibrations are utilized for the estimation of the tightening torque of a 1:50 scale steel-based tower prototype. The findings of this research carried out in the context of FIBREGY possess multiple implications for the assessment of the bolted joint integrity in multiple types of connections such as tower-to-nacelle, modular, tower-to-column, tube-to-tube, etc. This research is contextualized in the framework of the FIBREGY project. The EU-funded FIBREGY project (H2020, grant number 952966) will evaluate the feasibility of the design and construction of a new generation of marine renewable energy platforms using lightweight FRP materials in certain structural elements (e.g., tower, floating platform). The FIBREGY consortium is composed of 11 partners specialized in the offshore renewable energy sector and funded partially by the H2020 program of the European Commission with an overall budget of 8 million Euros.

Keywords: SHM, vibrations, connections, floating offshore platform

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Authors: Saeed Ilbeigi, Bart Van Gheluwe

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The purpose of this study was to identify the three-dimensional kinematics of the sprint start during the start phase of the sprint. The purpose of this study was to identify the three-dimensional kinematics of the sprint start during the start phase of the sprint. Moreover, the effect of anthropometrical factors such as skeletal muscle mass, thigh girth, and calf girth also were considered on the kinematics of the sprint start. Among all young sprinters involved in the national Belgium league, sixty sprinters (boys: 14.7 ± 1.8 years and girls: 14.8±1.5 years) were randomly selected. The kinematics data of the sprint start were collected with a Vicon® 620 motion analysis system equipped with 12 infrared cameras running at 250 Hz and running the Vicon Data Station software. For statistical analysis, T-tests and ANOVA׳s with Scheffé post hoc test were used and the significant level was set as p≤0.05. The results showed that the angular positions of the lower joints of the young sprinters in the set position were comparable with adult figures from literature, however, with a greater range of joint extension. The most significant difference between boys and girls was found in the set position, where the boys presented a more dorsiflexed ankle. No further gender effect was observed during the leaving the blocks and contact phase. The sprinters with a higher age, skeletal muscle mass, thigh girth, and calf girth displayed a better angular position of the lower joints (e.g. ankle, knee, hip) in the set position, a more optimal angular position for the foot and knee for absorbing impact forces at foot contact and finally a higher range of flexion/extension motion to produce force and power when leaving the blocks.

Keywords: anthropometry, kinematics, sprint start, young elite sprinters

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Authors: Antonio Piga

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This study explores the correlation between Systemic Functional Linguistics (SFL) and Critical Discourse Analysis (CDA) as tools for analysing the evolution of rhetoric in the communicative strategies adopted in a company’s Reports on social and environmental responsibility. In more specific terms, transitivity and ergativity- concepts from Systemic Functional Linguistics (SFL) - through the lenses of CDA, are employed as a theoretical means for the analysis of a longitudinal study in the communicative strategies employed by Saras SpA pre- and during the Covid-19 pandemic crisis. Saras is an Italian joint-stock company operating in oil refining and power generation. The qualitative and quantitative linguistic analysis carried out through the use of Sketch Engine software aims to identify and explain how rhetoric - and ideology - is constructed and presented through language use in Saras SpA Sustainability Reports. Specific focus is given to communication strategies to local and global communities and stakeholders in the years immediately before and during the Covid-19 pandemic. The rationale behind the study lies in the fact that 2020 and 2021 have been among the most difficult years since the end of World War II. Lives were abruptly turned upside down by the pandemic, which had grave negative effects on people’s health and on the economy. The result has been a threefold crisis involving health, the economy and social tension, with the refining sector being one of the hardest hit, since the oil refining industry was one of the most affected industries due to the general reduction in mobility and oil consumption brought about by the virus-fighting measures. Emphasis is placed on the construction of rhetorical strategies pre- and during the pandemic crisis using the representational process of transitivity and ergativity (SFL), thus revealing the close relationship between the use language in terms of Social Actors and semantic roles of syntactic transformation on the one hand, and ideological assumptions on the other. The results show that linguistic decisions regarding transitivity and ergativity choices play a crucial role in how effective writing achieves its rhetorical objectives in terms of spreading and maintaining dominant and implicit ideologies and underlying persuasive actions, and that some ideological motivation is perpetuated – if not actually overtly or subtly strengthened - in social-environmental Reports issued in the midst of the Covid-19 pandemic crisis.

Keywords: systemic functional linguistics, sustainability, critical discourse analysis, transitivity, ergativity

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Authors: Diwei Lin, Amanda Jia Hui Tan

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In 2012, testicular cancer was estimated to account for 940 disability adjusted life years in Australia; of these, 450 were years lost due to premature death and 500 were years of healthy life lost due to disease, disability or injury. Testicular choriocarcinoma is one of the rarest variants of testicular germ cell tumours, accounting for less than 1% of testicular germ cell tumours and only about 0.19% of all testicular tumours. Management involves radical orchiectomy followed by chemotherapy. Even then, the prognosis is extremely poor. This case report describes a 20-year-old male with pure testicular choriocarcinoma with pulmonary metastases.

Keywords: testicular cancer, choriocarcinoma, cryptorchidism, chemotherapy, metastatic testicular cancer

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Authors: Cody Stolle, Mojdeh Asadollahipajouh, Khaleb Pafford, Jada Iwuoha, Samantha White, Becky Mueller

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Battery-electric vehicles (BEVs) are growing in sales and popularity in the United States as an alternative to traditional internal combustion engine vehicles (ICEVs). BEVs are generally heavier than corresponding models of ICEVs, with large battery packs located beneath the vehicle floorpan, a “skateboard” chassis, and have front and rear crush space available in the trunk and “frunk” or front trunk. The geometrical and frame differences between the vehicles may lead to incompatibilities with gasoline vehicles during vehicle-to-vehicle crashes as well as run-off-road crashes with roadside barriers, which were designed to handle lighter ICEVs with higher centers-of-mass and with dedicated structural chasses. Crash data were collected from 10 states spanning a five-year period between 2017 and 2021. Vehicle Identification Number (VIN) codes were processed with the National Highway Traffic Safety Administration (NHTSA) VIN decoder to extract BEV models from ICEV models. Crashes were filtered to isolate only vehicles produced between 2010 and 2021, and the crash circumstances (weather, time of day, maximum injury) were compared between BEVs and ICEVs. In Washington, 436,613 crashes were identified, which satisfied the selection criteria, and 3,371 of these crashes (0.77%) involved a BEV. The number of crashes which noted a fire were comparable between BEVs and ICEVs of similar model years (0.3% and 0.33%, respectively), and no differences were discernable for the time of day, weather conditions, road geometry, or other prevailing factors (e.g., run-off-road). However, crashes involving BEVs rose rapidly; 31% of all BEV crashes occurred in just 2021. Results indicate that BEVs are performing comparably to ICEVs, and events surrounding BEV crashes are statistically indistinguishable from ICEV crashes.

Keywords: battery-electric vehicles, transportation safety, infrastructure crashworthiness, run-off-road crashes, ev crash data analysis

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Authors: Jacob Hatherell, Jason Matthews, Arnaud Marmier

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Anvil Staking is a cold-forming process that is used in the assembly of plain spherical bearings into a rod-end housing. This process ensures that the bearing outer lip conforms to the chamfer in the matching rod end to produce a lightweight mechanical joint with sufficient strength to meet the pushout load requirement of the assembly. Finite Element (FE) analysis is being used extensively to predict the behaviour of metal flow in cold forming processes to support industrial manufacturing and product development. On-going research aims to validate FE models across a wide range of bearing and rod-end geometries by systematically isolating and understanding the uncertainties caused by variations in, material properties, load-dependent friction coefficients and strain rate sensitivity. The improved confidence in these models aims to eliminate the costly and time-consuming process of experimental trials in the introduction of new bearing designs. Previous literature has shown that friction coefficients do not remain constant during cold forming operations, however, the understanding of this phenomenon varies significantly and is rarely implemented in FE models. In this paper, a new approach to evaluate the normal contact pressure versus friction coefficient relationship is outlined using friction calibration charts generated via iterative FE models and ring compression tests. When compared to previous research, this new approach greatly improves the prediction of forming geometry and the forming load during the staking operation. This paper also aims to standardise the FE approach to modelling ring compression test and determining the friction calibration charts.

Keywords: anvil staking, finite element analysis, friction coefficient, spherical plain bearing, ring compression tests

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Authors: M.St. Węglowski, D. Miara, S. Błacha, J. Dworak, J. Rykała, K. Kwieciński, J. Pikuła, G. Ziobro, A. Szafron, P. Zimierska-Nowak, M. Richert, P. Noga

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In the paper the results of welding of car’s air-conditioning elements are presented. These systems based on, mainly, the environmental unfriendly refrigerants. Thus, the producers of cars will have to stop using traditional refrigerant and to change it to carbon dioxide (R744). This refrigerant is environmental friendly. However, it should be noted that the air condition system working with R744 refrigerant operates at high temperature (up to 150 °C) and high pressure (up to 130 bar). These two parameters are much higher than for other refrigerants. Thus new materials, design as well as joining technologies are strongly needed for these systems. AISI 304 and 316L steels as well as aluminium alloys 5xxx are ranked among the prospective materials. As a joining process laser welding, plasma welding, electron beam welding as well as high rotary friction welding can be applied. In the study, the metallographic examination based on light microscopy as well as SEM was applied to estimate the quality of welded joints. The analysis of welding was supported by numerical modelling based on Sysweld software. The results indicated that using laser, plasma and electron beam welding, it is possible to obtain proper quality of welds in stainless steel. Moreover, high rotary friction welding allows to guarantee the metallic continuity in the aluminium welded area. The metallographic examination revealed that the grain growth in the heat affected zone (HAZ) in laser and electron beam welded joints were not observed. It is due to low heat input and short welding time. The grain growth and subgrains can be observed at room temperature when the solidification mode is austenitic. This caused low microstructural changes during solidification. The columnar grain structure was found in the weld metal. Meanwhile, the equiaxed grains were detected in the interface. The numerical modelling of laser welding process allowed to estimate the temperature profile in the welded joint as well as predicts the dimensions of welds. The agreement between FEM analysis and experimental data was achieved.  

Keywords: car’s air–conditioning, microstructure, numerical modelling, welding

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Authors: Vrinda Hari Ankolekar, Anne D. Souza, Mamatha Hosapatna

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Introduction: Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. FNA of greater than 20 degrees is considered excessive femoral anteversion, whereas a torsion angle of fewer than 10 degrees is considered femoral retroversion. Excessive femoral torsion is not uncommon and has been associated with certain neurologic and orthopedic conditions. The enlargement and maturation of the hip joint increases at the 20th week of gestation and the NSA ranges from 135- 140◦ at birth. Material and methods: 48 femurs were tagged according to the GA and two photographs for each femur were taken using Nikon digital camera. Each femur was kept on a horizontal hard desk and end on an image of the upper end was taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. The images were transferred to the computer and were stored in TIFF format. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. 1. Calculation of FNA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. The angle made by this line with the horizontal plane was measured as FNA. 2. Calculation of NSA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. A vertical line was drawn passing through the tip of the greater trochanter to the inter-condylar notch. The angle formed by these lines was calculated as NSA. Results: The paired t-test for the inter-observer variability showed no significant difference between the values of two observers. (FNA: t=-1.06 and p=0.31; NSA: t=-0.09 and p=0.9). The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t-test was applied to compare the mean angles between the second and third trimesters which did not show any statistical significance. This shows that the FNA and NSA of femur did not vary significantly during the third trimester. The FNA and NSA were correlated with the GA using Pearson’s correlation. FNA appeared to increase with the GA (r=0.5) but the increase was not statistically significant. A decrease in the NSA was also noted with the GA (r=-0.3) which was also statistically not significant. Conclusion: The present study evaluates the FNA and NSA of the femur in fetuses and correlates their development with the GA during second and third trimesters. The FNA and NSA did not vary significantly during the third trimester.

Keywords: anteversion, coxa antetorsa, femoral torsion, femur neck shaft angle

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Authors: Moses Mncwabe

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Both Public Representatives and Legislatures have an imperative role towards strengthening interventions to reduce and cease Sexual Transmitted Infections (STIs) specifically the Human Immunodeficiency Virus (HIV). Scaling-up constituency work in support of interventions earmarked for mitigating the compromising socio-economic impacts of advanced HIV is extremely essential. Though the antiretroviral treatment (ART) has saved million lives that would have perished without it, the Joint United Nations Programme on HIV/AIDS (2012) states that more efforts should be redirected to prevention strategies to close the tap of new infections. It is against this backdrop that Legislatures as law making institutions have undisputed role to play in HIV alleviation because of the position they occupy in the society. Furthermore, Public Representatives are arguably idolised by young people for the role they play hence it is incumbent upon them to use their moral and political responsibility to aid the interventions for HIV prevention (Inter-Parliamentary Union, Joint United Nations Programme on HIV/AIDS & United Nations Development Programme, 2007). Moreover, the continuous HIV infection and its devastating effects specifically in Southern African region has brought closer the disease to public representatives and demanded calculated interventions warranting both public representatives and legislatures to be more visible in various ways such as taking HIV counselling and testing publicly, oversight, reducing stigma and discrimination, partnering with civil society organisations (CSOs) and facilitating debates on HIV across parliamentary and social platforms. The effects of advanced HIV yearn for public representatives to be seen, accessed, felt, engaged, partnered and lobbied for pro-human rights legislations and ideal oversight to coerce the executive to deliver on their core responsibilities like providing basic services to the electorates (AIDS Law Project (2003). The National Democratic Institute for International Affairs and the Southern African Development Community Parliamentary Forum (2004) assert that the omission of Public Representatives and Legislatures in the HIV prevention agenda is a serious deficiency in the fight against HIV and AIDS. In light of this, this paper argues the innovative and legislative ways in which both the Public Representative and the Legislatures should play in HIV prevention.

Keywords: legislature, public representative, oversight, HIV and AIDS, constituency, service delivery

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Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

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Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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Authors: Chidiebere C. Agoha, Armstong C. Awuzie, Chukwuebuka N. Onwubuariri, Joy O. Njoku

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Spatial analysis is a field of study that utilizes geographic or spatial information to understand and analyze patterns, relationships, and trends in data. It is characterized by the use of geographic or spatial information, which allows for the analysis of data in the context of its location and surroundings. It is different from non-spatial or aspatial techniques, which do not consider the geographic context and may not provide as complete of an understanding of the data. Spatial analysis is applied in a variety of fields, which includes urban planning, environmental science, geosciences, epidemiology, marketing, to gain insights and make decisions about complex spatial problems. This review paper explores definitions of spatial analysis from various sources, including examples of its application and different analysis techniques such as Buffer analysis, interpolation, and Kernel density analysis (multi-distance spatial cluster analysis). It also contrasts spatial analysis with non-spatial analysis.

Keywords: aspatial technique, buffer analysis, epidemiology, interpolation

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Authors: Endeshaw Assefa Derso, Maria Gabriella Campolo, Angela Alibrandi

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Objectives:Early childhood malnutrition can have long-term and irreversible effects on a child's health and development. This study uses the Bayesian method with spatial variation to investigate the flexible trends of metrical covariates and to identify communities at high risk of injury. Methods: Cross-sectional data on underweight are collected from the 2016 Ethiopian Demographic and Health Survey (EDHS). The Bayesian geo-additive model is performed. Appropriate prior distributions were provided for scall parameters in the models, and the inference is entirely Bayesian, using Monte Carlo Markov chain (MCMC) stimulation. Results: The results show that metrical covariates like child age, maternal body mass index (BMI), and maternal age affect a child's underweight non-linearly. Lower and higher maternal BMI seem to have a significant impact on the child’s high underweight. There was also a significant spatial heterogeneity, and based on IDW interpolation of predictive values, the western, central, and eastern parts of the country are hotspot areas. Conclusion: Socio-demographic and community- based programs development should be considered compressively in Ethiopian policy to combat childhood underweight malnutrition.

Keywords: bayesX, Ethiopia, malnutrition, MCMC, semi-parametric bayesian analysis, spatial distribution, P- splines

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Authors: Bumjo Kim, Hyun Jin Kim, Joon Ha Kim

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The separate sewer system is that collects the wastewater as a sewer pipe and rainfall as a stormwater pipe separately, and then sewage is treated in the wastewater treatment plant, the stormwater is discharged to rivers or lakes through stormwater drainage pipes. Unfortunately, even for separate sewer systems, it is not possible to prevent Rainfall Driven Inflow/Infiltration(RDII) completely to the sewer pipe. Even if the sewerage line is renovated, there is an ineluctable RDII due to the combined sewer system in the house or the difficulty of sewage maintenance in private areas. The basic statistical analysis was performed using environmental data including rainfall, sewage, water qualities and groundwater level in the strict of Gwangju in ​South Korea. During rainfall in the target area, RDII showed an increased rate of 13.4 ~ 53.0% compared to that of a clear day and showed a rapid hydrograph response of 0.3 ~ 3.0 hr. As a result of water quality analysis, BOD5 concentration decreased by 17.3 % and salinity concentration decreased by 8.8 % at the representative spot in the project area compared to the sunny day during rainfall. In contrast to the seasonal fluctuation range of 0.38 m ~ 0.55 m in groundwater in Gwangju area and 0.58 m ~ 0.78 m in monthly fluctuation range, while the difference between groundwater level and the depth of sewer pipe laying was 2.70 m on average, which is larger than the range of fluctuation. Comprehensively, it can be concluded that the increasing of flowrate at sewer line is due to not infiltration water caused by groundwater level rise, construction failure, cracking due to joint failure or conduit deterioration, rainfall was directly inflowed into the sewer line rapidly. Acknowledgements: This work was supported by the 'Climate Technology Development and Application' research project (#K07731) through a grant provided by GIST in 2017.

Keywords: ground water, rainfall, rainfall driven inflow/infiltration, separate sewer system

Procedia PDF Downloads 159

Authors: T. Damak, S. Houidi, M. A. Ben Ayed, N. Masmoudi

Abstract:

The Versatile Video Coding standard (VVC) is actually under development by the Joint Video Exploration Team (or JVET). An Adaptive Multiple Transforms (AMT) approach was announced. It is based on different transform modules that provided an efficient coding. However, the AMT solution raises several issues especially regarding the complexity of the selected set of transforms. This can be an important issue, particularly for a future industrial adoption. This paper proposed an efficient hardware implementation of the most used transform in AMT approach: the DCT II. The developed circuit is adapted to different block sizes and can reach a minimum frequency of 192 MHz allowing an optimized execution time.

Keywords: adaptive multiple transforms, AMT, DCT II, hardware, transform, versatile video coding, VVC

Procedia PDF Downloads 147

Authors: Nihal Kartaltepe Behram, Göksel Ataman, Dila Okçu

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With the development of foreign direct investments, the social, cultural, political and economic interactions between countries and institutions have become visible and they have become determining factors for the strategic structuring and market goals. In this context the purpose of this study is to investigate the effects of cultural distance and institutions on foreign direct investment choices in terms of location and investment model. For international establishments, the concept of culture, as well as the concept of cultural distance, is taken specifically into consideration, especially in the selection of methods for entering the market. In the researches and empirical studies conducted, a direct relationship between cultural distance and foreign direct investments is set and institutions and effective variable factors are examined at the level of defining the investment types. When the detailed calculation strategies and empirical researches and studies are taken into consideration, the most common methods for determining the direct investment model, considering the cultural distances, are full-ownership enterprises and joint ventures. Also, when all of the factors affecting the investments are taken into consideration, it was seen that the effect of institutions such as Government Intervention, Intellectual Property Rights, Corruption and Contract Enforcements is very important. Furthermore agglomeration is more intense and effective on the investment, compared to other factors. China has been selected as the target country, due to its effectiveness in world economy and its contributions to developing countries, which has commercial relationships with. Qualitative research methods are used for this study conducted, to measure the effects of determinative variable factors in the hypotheses of study, on the direct foreign investors and to evaluate the findings. In this study in-depth interview is used as a data collection method and the data analysis is made through descriptive analysis. Foreign Direct Investments are so reactive to institutions and cultural distance is identified by all interviews and analysis. On the other hand, agglomeration is the most strong determiner factor on foreign direct investors in Chinese Market. The reason of this factors, which comprise the sectorial aggregate, are not the strongest factors as agglomeration that the most important finding. We expect that this study became a beneficial guideline for developed and developing countries and local and national institutions’ strategic plans.

Keywords: China, cultural distance, Foreign Direct Investments, institutions

Procedia PDF Downloads 418

Authors: J. G. Batista, T. S. Santiago, E. A. Ribeiro, G. A. P. Thé

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This work deals with parameter identification of permanent magnet motors, a class of ac motor which is particularly important in industrial automation due to characteristics like applications high performance, are very attractive for applications with limited space and reducing the need to eliminate because they have reduced size and volume and can operate in a wide speed range, without independent ventilation. By using experimental data and genetic algorithm we have been able to extract values for both the motor inductance and the electromechanical coupling constant, which are then compared to measure and/or expected values.

Keywords: modeling, AC servomotor, permanent magnet synchronous motor-PMSM, genetic algorithm, vector control, robotic manipulator, control

Procedia PDF Downloads 520

Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur

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Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.

Keywords: etomidate, intraocular pressure, thiopentone, traumatic

Procedia PDF Downloads 126

Authors: J. Wicks

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Aim: To develop a simple methodology to allow collected heart rate (HR) data from inexpensive wearable devices to be expressed in a suitable format (METs) to quantitate occupational (and recreational) activity. Introduction: Assessment of occupational activity is commonly done by utilizing questionnaires in combination with prescribed MET levels of a vast range of previously measured activities. However for any individual the intensity of performing a specific activity can vary significantly. Ideally objective measurement of individual activity is preferred. Though there are a wide range of HR recording devices there is a distinct lack methodology to allow processing of collected data to quantitate energy expenditure (EE). The HR index equation expresses METs in relation to relative HR i.e. the ratio of activity HR to resting HR. The use of this equation provides a simple utility for objective measurement of EE. Methods: During a typical occupational work period of approximately 8 hours HR data was recorded using a Polar RS 400 wrist monitor. Recorded data was downloaded to a Windows PC and non HR data was stripped from the ASCII file using ‘Notepad’. The HR data was exported to a spread sheet program and sorted by HR range into a histogram format. Three HRs were determined, namely a resting HR (the HR delimiting the lowest 30 minutes of recorded data), a mean HR and a peak HR (the HR delimiting the highest 30 minutes of recorded data). HR indices were calculated (mean index equals mean HR/rest HR and peak index equals peak HR/rest HR) with mean and peak indices being converted to METs using the HR index equation. Conclusion: Inexpensive HR recording devices can be utilized to make reasonable estimates of occupational (or recreational) EE suitable for large scale demographic screening by utilizing the HR index equation. The intrinsic value of the HR index equation is that it is independent of factors that influence absolute HR, namely fitness, smoking and beta-blockade.

Keywords: energy expenditure, heart rate histograms, heart rate index, occupational activity

Procedia PDF Downloads 296

Authors: G. La Scalia, M. Enea, R. Micale, O. Corona, L. Settanni

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The quality and condition of perishable products delivered to the market and their subsequent selling prices are directly affected by the care taken during harvesting and handling. Mechanical injury, in fact, occurs at all stages, from pre-harvest operations through post-harvest handling, packing and transport to the market. The main implications of this damage are the reduction of the product’s quality and economical losses related to the shelf life diminution. For most perishable products, the shelf life is relatively short and it is typically dictated by microbial growth related to the application of dynamic and static loads during transportation. This paper presents the correlation between vibration levels and microbiological growth on strawberries and woodland strawberries and detects the presence of volatile organic compounds (VOC) in order to develop an intelligent logistic unit capable of monitoring VOCs using a specific sensor system. Fresh fruits were exposed to vibrations by means of a vibrating table in a temperature-controlled environment. Microbiological analyses were conducted on samples, taken at different positions along the column of the crates. The values obtained were compared with control samples not exposed to vibrations and the results show that different positions along the column influence the development of bacteria, yeasts and filamentous fungi.

Keywords: microbiological analysis, shelf life, transport damage, volatile organic compounds

Procedia PDF Downloads 425

Authors: Anita Sadat Sadati Rostami, Reza Almasi Ghaleh

Abstract:

Surface electromyography (sEMG) offers important insights into muscle activation and has applications in fields including rehabilitation and human-computer interaction. The purpose of this work is to predict the degree of activation of two joints in the index finger using an LSTM-Transformer architecture trained on sEMG data from the Ninapro DB8 dataset. We apply advanced preprocessing techniques, such as multi-band filtering and customizable rectification methods, to enhance the encoding of sEMG data into features that are beneficial for regression tasks. The processed data is converted into spike patterns and simulated using Leaky Integrate-and-Fire (LIF) neuron models, allowing for neuromorphic-inspired processing. Our findings demonstrate that adjusting filtering parameters and neuron dynamics and employing the LSTM-Transformer model improves joint angle prediction performance. This study contributes to the ongoing development of deep learning frameworks for sEMG analysis, which could lead to improvements in motor control systems.

Keywords: surface electromyography, LSTM-transformer, spiking neural networks, hand kinematics, leaky integrate-and-fire neuron, band-pass filtering, muscle activity decoding

Procedia PDF Downloads 11

Authors: Zaidour Mohamed, Ghalem Ali Jr., Achit Henni Mohamed

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This project is destined to study pole junctions of reinforced concrete beams subjected to seismic loads. A literature review was made to clarify the work done by researchers in the last three decades and especially the results of the last two years that were studied for the determination of the method of calculating the transverse reinforcement in the different nodes of a structure. For implementation efforts in the columns and beams of a building R + 4 in zone 3 were calculated using the finite element method through software. These results are the basis of our work which led to the calculation of the transverse reinforcement of the nodes of the structure in question.

Keywords: beam–column joints, cyclic loading, shearing force, damaged joint

Procedia PDF Downloads 550

Authors: Yskak Nabi, Onolkan Umankulova, Ilyas Seitov

Abstract:

Tempus project about “Central Asian network for quality assurance – CANQA” had been implemented in 2009-2012. As the result of the project, two accreditation agencies were established: the agency for quality assurance in the field of education, “EdNet” in Kyrgyzstan, center of progressive technologies in Tajikistan. The importance of the research studies of the project is supported by the idea that the creation of Central-Asian network for quality assurance in education is still relevant, and results of the International forum “Global in regional: Kazakhstan in Bologna process and EU projects,” that was held in Nur-Sultan in October 2020, proves this. At the same time, the previous experience of the partnership between accreditation agencies of Central Asia shows that recommendations elaborated within the CANQA project were not theoretically justified. But there are a number of facts and arguments that prove the practical appliance of these recommendations. In this respect, joint activities of accreditation agencies of Kyrgyzstan and Kazakhstan are representative. For example, independent Kazakh agency of accreditation and rating successfully conducts accreditation of Kyrgyz universities; based on the memorandum about joint activity between the agency for quality assurance in the field of education “EdNet” (Kyrgyzstan) and Astana accreditation agency (Kazakhstan), the last one provides its experts for accreditation procedures in EdNet. Exchange of experience among the agencies shows an effective approach towards adaptation of European standards to the reality of education systems of Central Asia with consideration of not only a legal framework but also from the point of European practices view. Therefore, the relevance of the research is identified as there is a practical partnership between accreditation agencies of Central Asian countries, but the absence of theoretical justification of integrational processes in the accreditation field. As a result, the following hypothesis was put forward: “if to develop theoretical aspects for harmonization of accreditation standards, then integrational processes would be improved since the implementation of Bologna process principles would be supported with wider possibilities, and particularly, students and academic mobility would be improved.” Indeed, for example, in Kazakhstan, the total share of foreign students was 5,04% in 2020, and most of them are coming from Kyrgyzstan, Tajikistan, and Uzbekistan, and if integrational processes will be improved, then this share can increase.

Keywords: accreditation standards in education, Central Asian countries, pedagogical theory, model

Procedia PDF Downloads 199

Authors: Batul Kagalwala

Abstract:

The nervous system is made up of complex delicate structures such as the spinal cord, peripheral nerves and the brain. These are prone to various types of injury ranging from neurodegenerative diseases to trauma leading to diseases like Parkinson's, Alzheimer's, multiple sclerosis, amyotrophic lateral sclerosis (ALS), multiple system atrophy etc. Unfortunately, because of the complicated structure of nervous system, spontaneous regeneration, repair and healing is seldom seen due to which brain damage, peripheral nerve damage and paralysis from spinal cord injury are often permanent and incapacitating. Hence, innovative and standardized approach is required for advance treatment of neurological injury. Nigella sativa (N. sativa), an annual flowering plant native to regions of southern Europe and Asia; has been suggested to have neuroprotective and anti-seizures properties. Neuroregeneration is found to occur in damaged cells when treated using extract of N. sativa. Due to its proven health benefits, lots of experiments are being conducted to extract all the benefits from the plant. The flowers are delicate and are usually pale blue and white in color with small black seeds. These seeds are the source of active components such as 30–40% fixed oils, 0.5–1.5% essential oils, pharmacologically active components containing thymoquinone (TQ), ditimoquinone (DTQ) and nigellin. In traditional medicine, this herb was identified to have healing properties and was extensively used Middle East and Far East for treating diseases such as head ache, back pain, asthma, infections, dysentery, hypertension, obesity and gastrointestinal problems. Literature studies have confirmed the extract of N. sativa seeds and TQ have inhibitory effects on inducible nitric oxide synthase and production of nitric oxide as well as anti-inflammatory and anticancer activities. Experimental investigation will be conducted to understand which ingredient of N. sativa causes neuroregeneration and roots to its healing property. An aqueous/ alcoholic extract of N. sativa will be made. Seed oil is also found to have used by researchers to prepare such extracts. For the alcoholic extracts, the seeds need to be powdered and soaked in alcohol for a period of time and the alcohol must be evaporated using rotary evaporator. For aqueous extracts, the powder must be dissolved in distilled water to obtain a pure extract. The mobile phase will be the extract while the suitable stationary phase (substance that is a good adsorbent e.g. silica gels, alumina, cellulose etc.) will be selected. Different ingredients of N. sativa will be separated using High Performance Liquid Chromatography (HPLC) for treating damaged cells. Damaged brain cells will be treated individually and in different combinations of 2 or 3 compounds for different intervals of time. The most suitable compound or a combination of compounds for the regeneration of cells will be determined using DOE methodology. Later the gene will also be determined and using Polymerase Chain Reaction (PCR) it will be replicated in a plasmid vector. This plasmid vector shall be inserted in the brain of the organism used and replicated within. The gene insertion can also be done by the gene gun method. The gene in question can be coated on a micro bullet of tungsten and bombarded in the area of interest and gene replication and coding shall be studied. Investigation on whether the gene replicates in the organism or not will be examined.

Keywords: black cumin, brain cells, damage, extract, neuroregeneration, PCR, plasmids, vectors

Procedia PDF Downloads 657

Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

Abstract:

Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

Procedia PDF Downloads 47