Search results for: low back pain

Authors: M. Yavuz Hüseyinca, Şuayip Küpeli

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The Chemical Index of Alteration (CIA) values of Late Eocene-Oligocene aged sandstones that exposed on the eastern edge of Tuz Lake (Central Anatolia, Turkey) range from 49 to 59 with an average of 51. The A-CN-K diagram indicates that sandstones underwent post-depositional K-metasomatism. The original average CIA value before the K-metasomatism is calculated as 55. This value is lower than that of Post Archean Australian Shale (PAAS) and defines a low intense chemical weathering in the source-area. Extrapolation of sandstones back to the plagioclase-alkali feldspar line in the A-CN-K diagram suggests a high average plagioclase to alkali feldspar ratio in the provenance and a composition close to granodiorite. The Zr/Sc and Th/Sc ratios with the Al₂O₃-Zr-TiO₂ space do not show zircon addition that refuse both recycling of sediments and sorting effect. All these data suggest direct and rapid transportation from the source due to topographic uplift and probably arid to semi-arid climate conditions for the sandstones.

Keywords: central Anatolia, sandstone, sorting, weathering

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Authors: Marda Vidrianto, Tania Surya Utami

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Electrical Submersible Pump (ESP) is an artificial lift of choice to produce oil on Offshore Java Sea. It is selected based on the production rate capacity and running life expectation. ESP performance in a mature field is highly affected by oil well conditions. The presence of sand, scale, gas, and low influx will create unstable ESP operation hence lowering the run life expectation and system efficiency. This paper reviews the current energy usage and efficiency on every part of the ESP system. The hydraulic and electrical losses, as well as system efficiency for each well, are calculated to identify energy losses and the possibility for improvement. It is shown that high back pressure on the system and low-efficiency pump are the major contributors to energy losses. It was found that optimized production rate and the use of advanced technology on pump and motor unit could improve energy efficiency.

Keywords: advance technology, energy efficiency, ESP, mature field, production rate

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Authors: Nora Yusma Bte Mohamed Yusoff, Hussain Ali Bekhet

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The rationalization of a gradual subsidies reforms plan has been set out by the Malaysian government to achieve the high-income nation target. This paper attempts to analyze the impacts of energy subsidy reform policy on fiscal deficit and macroeconomics variables in Malaysia. The Computable General Equilibrium (CGE) Model is employed. Three simulations based on different groups of scenarios have been developed. Importantly, the overall results indicate that removal of fuel subsidy has significantly improved the real GDP and reduced the government fiscal deficit. On the other hand, the removal of the fuel subsidy has increased most of the local commodity prices, especially energy commodities. The findings of the study could provide some imperative inputs for policy makers, especially to identify the right policy mechanism. This is especially ensures the subsidy savings from subsidy removal could be transferred back into the domestic economy in the form of infrastructure development, compensation and increases in others sector output contributions towards a sustainable economic growth.

Keywords: CGE, deficit, energy, reform, subsidy

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Authors: Vishnu Pratap Singh Kirar

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Artificial Neural Network (ANN) can be trained using backpropagation (BP). It is the most widely used algorithm for supervised learning with multi-layered feed-forward networks. Efficient learning by the BP algorithm is required for many practical applications. The BP algorithm calculates the weight changes of artificial neural networks, and a common approach is to use a two-term algorithm consisting of a learning rate (LR) and a momentum factor (MF). The major drawbacks of the two-term BP learning algorithm are the problems of local minima and slow convergence speeds, which limit the scope for real-time applications. Recently the addition of an extra term, called a proportional factor (PF), to the two-term BP algorithm was proposed. The third increases the speed of the BP algorithm. However, the PF term also reduces the convergence of the BP algorithm, and criteria for evaluating convergence are required to facilitate the application of the three terms BP algorithm. Although these two seem to be closely related, as described later, we summarize various improvements to overcome the drawbacks. Here we compare the different methods of convergence of the new three-term BP algorithm.

Keywords: neural network, backpropagation, local minima, fast convergence rate

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Authors: Chiang-Ho Cheng, An-Shik Yang, Chih-Jer Lin, Chun-Ying Lee

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This paper aims to present the design, fabrication and test of a novel piezoelectric actuated, check-valves embedded micropump having the advantages of miniature size, light weight and low power consumption. This device is designed to pump gases and liquids with the capability of performing the self-priming and bubble-tolerant work mode by maximizing the stroke volume of the membrane as well as the compression ratio via minimization of the dead volume of the micropump chamber and channel. By experiment apparatus setup, we can get the real-time values of the flow rate of micropump, the displacement of the piezoelectric actuator and the deformation of the check valve, simultaneously. The micropump with check valve 0.4 mm in thickness obtained higher output performance under the sinusoidal waveform of 120 Vpp. The micropump achieved the maximum pumping rates of 42.2 ml/min and back pressure of 14.0 kPa at the corresponding frequency of 28 and 20 Hz. The presented micropump is able to pump gases with a pumping rate of 196 ml/min at operating frequencies of 280 Hz under the sinusoidal waveform of 120 Vpp.

Keywords: actuator, check-valve, micropump, piezoelectric

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Authors: Kenneth Lee

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During Buddha’s time in the 5th century BCE, the Indian society was organized by a social stratification system called “the caste system” (Skt. varna), which still exists today. The origination of the caste system can be traced back to 1500 BCE within the ancient Vedic texts of the Aryans, the Indo-European nomadic people who migrated and settled in the Indus Valley region. However, the four-tiered hierarchical nature of the caste system created inequality, privilege, and discrimination based on hereditary transmission. After renouncing his royal status as a prince, Siddhartha Gautama spent six years in the forest, practiced austerities, mastered meditation, and eventually realized enlightenment. Thereupon, now referred to as “Shakyamuni Buddha” or “sage from the tribe of Shakya who has become awake,” the Buddha founded the Sangha, a community of monks, nuns, and lay followers, where everyone was equal and treated equally. After providing a brief overview of Buddha’s time, this talk will examine Buddha’s Dharma or teachings on equality and his creation of the Sangha as “society within a society, which had a dissolving effect on society.

Keywords: equality, women, buddhism, discrimination

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Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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Authors: Viriyavudh Sim, Woo Young Jung

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The failure of roof cladding mostly occurs due to the failing of the connection between claddings and purlins, which is the pull-out of the screw connecting the two parts when the pull-out load, i.e. typhoon, is higher than the resistance of the connection screw. As typhoon disasters in Korea are constantly on the rise, probability risk assessment (PRA) has become a vital tool to evaluate the performance of civil structures. In this study, we attempted to determine the fragility of roof cladding with the screw connection. Experimental study was performed to evaluate the pull-out resistance of screw joints between honeycomb panels and back frames. Subsequently, by means of Monte Carlo Simulation method, probability of failure for these types of roof cladding was determined. The results that the failure of roof cladding was depends on their location on the roof, for example, the edge most panel has the highest probability of failure.

Keywords: Monte Carlo Simulation, roof cladding, screw pull-out strength, wind fragility

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Authors: Wilaiwan Jongwilaikasaem, Phatteera Sarakornborrirak

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While Thai television producers feel anxious about digital disruption, Love Destiny, Thai television period drama became smash hit in Thailand in 2018. Audience throughout the country not only watched the drama both offline and online but also spread the content of the drama on social media and followed cultural trends from the protagonist. Thus, the main purpose of this article is to examine the secret behind the success of Love Destiny. Data were collected from content analysis and in-depth interview. The result shows that the key success of the drama is from earned media phenomenon from the audience and marketers’ engagement. As Love Destiny has full-flavored content with traditional challenged plot, delicate production, and presentation of Thainess in a positive and tangible way; audience and marketers are enthusiastic about building up the popular trend of Love Destiny on social media and also coming back home to watch televisions when the drama was on the air.

Keywords: Thai drama, earned media, Love Destiny, television

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Authors: Turki M. Habeebullah, Abdel Hameed A. A. Awad, Said Munir, Atif M. F. Mohammed, Essam A. Morsy, Abdulaziz R. Seroji

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Street dust has been knoweldged as an important source of air pollution. It does not remain deposited in a place for long, as it is easily resuspended back into the atmosphere. Street dust is a complex mixture derived from different sources: Deposited dust, traffic, tire, and brake wear, construction and demolition processes. The present study aims to evaluate the elementals ”iron, calcium, lead, cadmium, nickel, silicon, and selenium” and microbial “bacteria and fungi” contents associated street dust at the holy mosque areas. The street dust was collected by sweeping an arera~1m2 along the both sides of the road. The particles with diameter ≤ 1.7 µm constitued the highest percentages of the total particulate ≤45 µm. Moreover, The crustal species: iron and calcium were found in the highest concentrations, and proof that demolition and constricution were the main source of street dust. Also, the low biodiversity of microorganisms is attributed to severe weather conditions and characteristics of the arid environment.

Keywords: dust, microbial, environment, street

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Authors: Hsin-Yi Kathy Cheng, Yan-Ying JU, Wann-Yun Shieh, Chin-Man Wang

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Although the coordination of swallowing and respiration has been discussed widely, the influence of the positioning angle on swallowing and respiration during feeding has rarely been investigated. This study aimed to investigate the timing and coordination of swallowing and respiration in different seat inclination angles, with liquid and bolus, to provide suggestions and guidelines for the design and develop a feedback-controlled seat angle adjustment device for the back-adjustable wheelchair. Twenty-six participants aged between 15-30 years old without any signs of swallowing difficulty were included. The combination of seat inclinations and food types was randomly assigned, with three repetitions in each combination. The trunk inclination angle was adjusted by a commercialized positioning wheelchair. A total of 36 swallows were done, with at least 30 seconds of rest between each swallow. We used a self-developed wearable device to measure the submandibular muscle surface EMG, the movement of the thyroid cartilage, and the respiratory status of the nasal cavity. Our program auto-analyzed the onset and offset of duration, and the excursion and strength of thyroid cartilage when it was moving, coordination between breathing and swallowing were also included. Variables measured include the EMG duration (DsEMG), swallowing apnea duration (SAD), total excursion time (TET), duration of 2nd deflection, FSR amplitude, Onset latency, DsEMG onset, DsEMG offset, FSR onset, and FSR offset. These measurements were done in four-seat inclination angles (5。, 15。, 30。, 45。) and three food contents (1ml water, 10ml water, and 5ml pudding bolus) for each subject. The data collected between different contents were compared. Descriptive statistics were used to describe the basic features of the data. Repeated measure ANOVAs were used to analyze the differences for the dependent variables in different seat inclination and food content combinations. The results indicated significant differences in seat inclination, mostly between 5。 and 45。, in all variables except FSR amplitude. It also indicated significant differences in food contents almost among all variables. Significant interactions between seat inclination and food contents were only found in FSR offsets. The same protocol will be applied to participants with disabilities. The results of this study would serve as clinical guidance for proper feeding positions with different food contents. The ergonomic data would also provide references for assistive technology professionals and practitioners in device design and development. In summary, the current results indicated that it is easier for a subject to lean backward during swallowing than when sitting upright and swallowing water is easier than swallowing pudding. The results of this study would serve as the clinical guidance for proper feeding position (such as wheelchair back angle adjustment) with different food contents. The same protocol can be applied to elderly participants or participants with physical disabilities. The ergonomic data would also provide references for assistive technology professionals and practitioners in device design and development.

Keywords: swallowing, positioning, assistive device, disability

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Authors: Ihsan Al-Abboodi, Tahsin Toma-Sabbagh

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Laboratory tests have been carried out to investigate the response of 2x2 pile group subjected to triangular soil movement. The pile group was instrumented with displacement and tilting devices at the pile cap and strain gauges on two piles of the group. In this paper, results from four model tests were presented to study the effects of axial loads and soil density on the lateral behavior of piles. The responses in terms of bending moment, shear force, soil pressure, deflection, and rotation of piles were compared. Test results indicate that increasing the soil strength could increase the measured moment, shear, soil pressure, and pile deformations. Most importantly, adding loads to the pile cap induces additional moment to the head of front-pile row unlike the back-pile row which was influenced insignificantly.

Keywords: pile group, passive piles, lateral soil movement, soil density, axial loads

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Authors: Okan Cakir, Ibrahim Arziman, Derya Can, Mete Erkencigil, Murat Durusu, S. Mehmet Yasar

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Introduction: Burn injuries from different types and ways commonly seen in emergency departments, approach and treatment varies from outpatient treatment to critical care unit. We wanted to mention a rare burn injury cause of air conditioner refrigerant. Case report: A 22-year-old case admitted to emergency department with a complaint of left hand burn injury and pain. In his history, he said that an accident was occurred before 30 minutes from admission while he had been trying to repair the air conditioner. Air conditioner refrigerant suddenly had erupted from its tank and burned his hand. In physical examination of extremities, second-degree burn bullae on the left hand on second and third proximal phalanx, between first and second phalanx palmar side and on hypothenar region and on third and fourth proximal phalanx and also hyperemia from hand to wrist were seen. There was no motor and sensorial deficiency. As a treatment, local silver sulfadiazine applied to the burn area and analgesic prescribed. The case called for the clinical follow-up to the plastic surgery department. Conclusion: The clinician should take a comprehensive and careful anamnesis for suitable and right management and treatment as in this case in which as well as rare and occurs different way.

Keywords: air conditioner refrigerant, burn, emergency department, rare

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Authors: Pavel Zlabek, Vaclav Mentl

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The fatigue crack growth rate evaluation is a basic experimental characteristic when assessment o f the remaining lifetime is needed. Within the repair welding technology project, the crack growth rate at cyclic loading was measured in base and weld metals and in the situation when cracks were initiated in base metal and grew into the weld metal through heat-affected zone and back to the base metal. Two welding technologies were applied and specimens in as-welded state and after heat treatment were tested. Fatigue crack growth rate measurement was performed on CrMoV pressure vessel steel and the tests were performed at room temperature. The crack growth rate was measured on CCT test specimens (see figure) for both the base and weld metals and also in the case of crack subsequent transition through all the weld zones. A 500 kN MTS controlled electro-hydraulic testing machine and Model 632.13C-20 MTS extensometer were used to perform the tests.

Keywords: cracks, fatigue, steels, weldments

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Authors: Arnault Morisson

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Innovation districts are being implemented as urban regeneration strategies in cities as diverse as Barcelona (Spain), Boston (Massachusetts), Chattanooga (Tennessee), Detroit (Michigan), Medellin (Colombia), and Montréal (Canada). Little, however, is known about the concept. This paper aims to provide a framework to define innovation districts. The research methodology is based on a qualitative approach using 22@ Barcelona as a case study. 22@ Barcelona was the first innovation district ever created and has been a model for the innovation districts of Medellin (Colombia) and Boston (Massachusetts) among others. Innovation districts based on the 22@ Barcelona’s model can be defined as top-down urban innovation ecosystems designed around four multilayered and multidimensional models of innovation: urban planning, productive, collaborative, and creative, all coordinated under strong leadership, with the ultimate objectives to accelerate the innovation process and competitiveness of a locality. Innovation districts aim to respond to a new economic paradigm in which economic production flows back to cities.

Keywords: innovation ecosystem, governance, technology park, urban planning, urban policy, urban regeneration

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Authors: Sally Shepherd, Richard De Boer, Craig Murphy

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Background: Invasive lobular carcinoma (ILC) can metastasize to atypical sites within the peritoneal cavity, gastrointestinal, or genitourinary tract. Management varies depending on the symptom presentation, extent of disease burden, particularly if the primary disease is occult, and patient wishes. Case Series: 6 patients presented with general surgical presentations of ILC, including incomplete large bowel obstruction, cholecystitis, persistent lower abdominal pain, and faecal incontinence. 3 were diagnosed with their primary and metastatic disease in the same presentation, whilst 3 patients developed metastasis from 5 to 8 years post primary diagnosis of ILC. Management included resection of the metastasis (laparoscopic cholecystectomy), excision of the primary (mastectomy and axillary clearance), followed by a combination of aromatase inhibitors, biologic therapy, and chemotherapy. Survival post diagnosis of metastasis ranged from 3 weeks to 7 years. Conclusion: Metastatic ILC must be considered with any gastrointestinal or genitourinary symptoms in patients with a current or past history of ILC. Management may not be straightforward to chemotherapy if the acute pathology is resulting in a surgically resectable disease.

Keywords: breast cancer, gastrointestinal metastasis, invasive lobular carcinoma, metastasis

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Authors: Ail Akbar Emamverdian, Neriman Özada, Atabak Rahimzadeh Ilkhchi, Zahra Emamverdian

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The reverse shoulder prosthesis is an innovative procedure design to treat of (GH) joint problems with severe rotator cuff deficiency. The original reverse shoulder prosthesis was invented by France surgery in1985 and has been in clinical use in the United States in 2004. These prostheses consist of baseplate that attached to the glenoid, in order to hold a spherical component, and humeral part consist of polyethylene insert which is flat. This prosthesis is the ‘reverse’ configuration. The indications for the reverse prosthesis are: (1) treating failed hemi arthroplasty with irrecoverable rotator cuff tears, (2) relief of painful arthritis associated with cuff tear arthropathy, (3) instauration after tumor resection, (4) pseudo paralysis because of irrecoverable rotator cuff tears (5) some fractures of the shoulder which reverse shoulder prostheses is only the option for treatment. This prosthesis resulting in relief of pain and decreasing the range of motion in above indications. However, this prosthesis and its applications such as notching of the scapula, dislocation of the prosthesis parts and acromial stress fractures. In this article the reverse shoulder prostheses, indication has been reviewed. This study can make clear aspect of reverse shoulder prosthesis that can help to find some solution in future.

Keywords: prostheses, complications, reverse shoulder prosthesis, indications

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Authors: H. R. Fazlollahi

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Dark Energy origin is unknown and so describing this mysterious component in large scale structure needs to manipulate our theories in general relativity. Although in most models, dark energy arises from extra terms through modifying Einstein-Hilbert action, maybe its origin traces back to fundamental aspects of ground energy of space-time given in quantum mechanics. Hence, diluting space-time in general relativity with quantum mechanics properties leads to the Karolyhazy relation corresponding energy density of quantum fluctuations of space-time. Through generalized uncertainty principle and an eye to Karolyhazy approach in this study we extend energy density of quantum fluctuations of space-time. Also, the application of this idea is considered in late time evolution and we have shown how extra term in generalized uncertainty principle plays as a plausible interaction term role in suggested model.

Keywords: generalized uncertainty principle, karolyhazy approach, agegraphic dark energy, cosmology

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Authors: Jeff Letcher, Dennis Tierney, Haider Raad

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Antennas are devices for transmitting and/or receiving signals which make them a necessary component of any wireless system. In this paper, a thermal deposition technique is utilized as a method to fabricate antenna structures on substrates. Thin-film deposition is achieved by evaporating a source material (metals in our case) in a vacuum which allows vapor particles to travel directly to the target substrate which is encased with a mask that outlines the desired structure. The material then condenses back to solid state. This method is used in comparison to screen printing, chemical etching, and ink jet printing to indicate advantages and disadvantages to the method. The antenna created undergoes various testing of frequency ranges, conductivity, and a series of flexing to indicate the effectiveness of the thermal deposition technique. A single band antenna that is operated at 2.45 GHz intended for wearable and flexible applications was successfully fabricated through this method and tested. It is concluded that thermal deposition presents a feasible technique of producing such antennas.

Keywords: thermal deposition, wearable antennas, bluetooth technology, flexible electronics

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Authors: Lai Ving Kam

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Many markets are maturing, consumer buying powers are weakening and customer preferences change rapidly. To survive, many adopt fast paced continuous cost reduction and competitive pricing to remain relevance. Marketers desire to push for more sales to increase revenues have intensified competitions at time cannibalize the product and market. The amazing technologies changes have created both hope and despair to the industries. The pressure to constantly reduce cost, on the one hand, create and market new products in cheaper prices and shorter life cycles, on the other has become a continuous endeavour. The twin trends appear irreconcilable. Can core strategic vision provides and adapts new directions in continuous cost reduction? This study investigates core strategic vision able to meet this need, for firms to survive and stay profitable. Under current uncertainty market, are firms falling back on their core strategic visions to take them out of the unfavourable positions?

Keywords: core strategy vision, continuous cost reduction, fashionable products industry, competitive pricing

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Authors: Shahbaz Amin, Sabir Hussain Shah, Sahib Khan

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This paper presents a thorough review concerning the design types of axial flux permanent magnet machines (AFPM) in terms of different features such as construction, design, materials, and manufacturing. Particular emphasis is given on the design and performance analysis of AFPM machines. A comparison among different permanent magnet machines is also provided. First of all, early and modern axial flux machines are mentioned. Secondly, rotor construction of different axial flux machines is described, then different stator constructions are mentioned depending upon the presence of slots and stator back iron. Then according to the arrangement of the rotor stator structure the machines are classified into single, double and multi-stack arrangements. Advantages, disadvantages and applications of each type of rotor and stator are pointed out. Finally on the basis of the reviewed literature merits, demerits, features and application of different axial flux machines structures are explained and clarified. Thus, this paper provides connection between the machines that are currently being used in industry and the developments of AFPM throughout the years.

Keywords: axial flux machines, axial flux applications, coreless machines, PM machines

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Authors: A. Bouloufa, F. Khaled, K. Djessas

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This paper presents a new structure of solar cell based on p-type microcrystalline silicon as an absorber and n-type aluminum doped zinc oxide (ZnO:Al) transparent conductive oxide as an optical window. The ZnO:Al layer deposited by rf-magnetron sputtering at room temperature yields a low resistivity about 7,64.10-2Ω.cm and more than 85% mean optical transmittance in the VIS–NIR range, with an optical band gap of 3.3 eV. These excellent optical properties of this layer in combination with an optimal contact at the front surface result in a superior light trapping yielding to efficiencies about 20%. In order to improve efficiency, we have used a p+-µc-Si thin layer highly doped as a back surface field which minimizes significantly the impact of rear surface recombination velocity on voltage and current leading to a high efficiency of 24%. Optoelectronic parameters were determined using the current density-voltage (J-V) curve by means of a numerical simulation with Analysis of Microelectronic and Photonic Structures (AMPS-1D) device simulator.

Keywords: optical window, thin film, solar cell, efficiency

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Authors: Chung-Yu Wu, Chia-Chi Chang, Wei-Ming Chen, Pu-Wei Wu, Shih-Fan Chen, Po-Chun Chen

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Electrostimulation medical devices for neural diseases require electroactive and biocompatible materials to transmit signals from electrodes to targeting tissues. Protection of surrounding tissues has become a great challenge for long-term implants. In this study, we designed back-end processes with compatible, efficient, and reliable advantages over the current state-of-the-art. We explored a hermetic packaging process with high quality of adhesion and uniformity as the biocompatible devices for long-term implantation. This approach is able to provide both excellent biocompatibility and protection to the biomedical electronic devices by performing conformal coating of biocompatible materials. We successfully developed a packaging process that is capable of exposing the stimulating electrode and cover all other faces of chip with high quality of protection to prevent leakage of devices and body fluid.

Keywords: biocompatible package, medical microelectronics, surface coating, long-term implantation

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Authors: Abdulrahman M. Homadi

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As a great source of renewable energy, solar energy is considered to be one of the most important in the world, since it will be one of solutions cover the energy shortage in the future. Photovoltaic (PV) is the most popular and widely used among solar energy technologies. However, PV efficiency is fairly low and remains somewhat expensive. High temperature has a negative effect on PV efficiency and cooling system for these panels is vital, especially in warm weather conditions. This paper presents the results of a simulation study carried out on silicon solar cells to assess the effects of elevation on enhancing the efficiency of solar panels. The study included four different terrains. The study also took into account the direction of the wind hitting the solar panels. To ensure the simulation mimics reality, six silicon solar panels are designed in two columns and three rows, facing to the south at an angle of 30 ^o. The elevations are assumed to change from 10 meters to 200 meters. The results show that maximum increase in efficiency occurs when the wind comes from the north, hitting the back of the panels.

Keywords: solar panels, elevation, wind direction, efficiency

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Authors: C. Trapp, A. Vijay, M. Khorasani

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Decentralised micro-grids with sector coupling can combat the spatial and temporal intermittence of renewable energy by combining power, transportation and infrastructure sectors. Intelligent energy conversion concepts such as electrolysers, hydrogen engines and fuel cells combined with energy storage using intelligent batteries and hydrogen storage form the back-bone of such a system. This paper describes a micro-grid based on Photo-Voltaic cells, battery storage, innovative modular and scalable Anion Exchange Membrane (AEM) electrolyzer with an efficiency of up to 73%, high-pressure hydrogen storage as well as cutting-edge combustion-engine based Combined Heat and Power (CHP) plant with more than 85% efficiency at the university campus to address the challenges of decarbonization whilst eliminating the necessity for expensive high-voltage infrastructure.

Keywords: sector coupling, micro-grids, energy self-sufficiency, decarbonization, AEM electrolysis, hydrogen CHP

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Authors: Justine A. Lloyd

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Since the onset of the Syrian Civil War in 2011, the ancient city of Dura-Europos has faced widespread destruction and looting. The site is one of many places in the country the terrorist group ISIS has specifically targeted, allegedly due to its particular representations of Syrian history and culture. However, looted art and artifacts are the extremist group’s second largest source of income, only after oil. The protection of this site is important to both academics and the millions who have called Syria a home, as it aids in the nation’s sense of identity, reveals developments in the arts, and contributes to humanity’s collective history. At a time when Syria’s culture is being flattened, this sense of cultural expression is especially important to maintain. Creating an awareness of the magnitude of the issue at hand begins with an examination of the rich history of the ancient fortress city. Located on the western bank of the Euphrates River, Dura-Europos contains artifacts dating back to the Hellenistic, Parthian, and Roman periods. Though a great deal of the art and artifacts have remained safe in institutions such as the National Museum of Damascus and the Yale University Art Gallery, hundreds of looting pits and use of heavy machinery on the site has severely set back the investigative progress made by archaeologists over the last century, as well as the prospect of future excavation. Further research draws on the current destruction of the site by both ISIS and opportunists involved with the black market. Because Dura-Europos is located in a war stricken region, the acquisition of data and possibility of immediate action is particularly challenging. Resources gained from local reports, in addition to technology such as satellite imagery, however, have provided a firm starting point for the evaluation of the state of the site. The Syrian Ministry of Culture, UNESCO, and numerous Syrian and global organizations provide insight into the historic city’s past, present issues, and future plans to ensure that the cultural integrity of the site is upheld. Though over seventy percent of Dura-Europos has been completely decimated, this research challenges the notion that physically destroyed sites are lost forever. This paper assesses preventative measures that can take place to ensure the preservation of the site’s art and architecture, including examining possible solutions to the damage, such as digital reconstruction, replication, and distribution of information through exhibitions and other forms of publically accessible information. In order to investigate any possible retribution, research also includes the necessary information pertaining the global laws and regulations dealing with cultural heritage, as it directly affects the ways in which this situation can be dealt with. With the countless experts and citizens dedicated to the importance of cultural heritage, the prospect of honoring and valuing elements of Dura-Europos is possible—whether physically preserved or otherwise.

Keywords: antiquities law, archaeological sites, restitution, Syrian Civil War

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Authors: Ali Baker, Russel Krawitz

Abstract:

This paper describes a rare occurrence where a potentially fatal complication of COVID-19 infection (MIS-A) was misdiagnosed as an acute abdomen. As most patients with this syndrome present with fever and gastrointestinal symptoms, they may inadvertently fall under the care of the surgical unit. However, unusual imaging findings and a poor response to anti-microbial therapy should prompt clinicians to suspect a non-surgical etiology. More than half of MIS-A patients require ICU admission and vasopressor support. Prompt referral to a physician is key, as the cornerstone of treatment is IVIG and corticosteroid therapy. A 32 year old woman presented with right sided abdominal pain and fevers. She had also contracted COVID-19 two months earlier. Abdominal examination revealed generalised right sided tenderness. The patient had raised inflammatory markers, but other blood tests were unremarkable. CT scan revealed extensive lymphadenopathy along the ileocolic chain. The patient proved to be a diagnostic dilemma. She was reviewed by several surgical consultants and discussed with several inpatient teams. Although IV antibiotics were commenced, the right sided abdominal pain, and fevers persisted. Pan-culture returned negative. A mild cholestatic derangement developed. On day 5, the patient underwent preparation for colonoscopy to assess for a potential intraluminal etiology. The following day, the patient developed sinus tachycardia and hypotension that was refractory to fluid resuscitation. That patient was transferred to ICU and required vasopressor support. Repeat CT showed peri-portal edema and a thickened gallbladder wall. On re-examination, the patient was Murphy’s sign positive. Biliary ultrasound was equivocal for cholecystitis. The patient was planned for diagnostic laparoscopy. The following morning, a marked rise in cardiac troponin was discovered, and a follow-up echocardiogram revealed moderate to severe global systolic dysfunction. The impression was post-COVID MIS with myocardial involvement. IVIG and Methylprednisolone infusions were commenced. The patient had a great response. Vasopressor support was weaned, and the patient was discharged from ICU. The patient continued to improve clinically with oral prednisolone, and was discharged on day 17. Although MIS following COVID-19 infection is well-described syndrome in children, only recently has it come to light that it can occur in adults. The exact incidence is unknown, but it is thought to be rare. A recent systematic review found only 221 cases of MIS-A, which could be included for analysis. Symptoms vary, but the most frequent include fever, gastrointestinal, and mucocutaneous. Many patients progress to multi-organ failure and require vasopressor support. 7% succumb to the illness. The pathophysiology of MIS is only partly understood. It shares similarities with Kawasaki disease, macrophage activation syndrome, and cytokine release syndrome. Importantly, by definition, the patient must have an absence of severe respiratory symptoms. It is thought to be due to a dysregulated immune response to the virus. Potential mechanisms include reduced levels of neutralising antibodies and autoreactive antibodies that promote inflammation. Further research into MIS-A is needed. Although rare, this potentially fatal syndrome should be considered in the unwell surgical patient who has recently contracted COVID-19 and poses a diagnostic dilemma.

Keywords: acute-abdomen, MIS, COVID-19, ICU

Procedia PDF Downloads 102

Authors: Paul M. H. J. Roekaerts

Abstract:

In recent years, it became clear that much intensive care (ICU) survivors develop a post-intensive care syndrome (PICS) consisting of psychiatric, cognitive and physical problems for a prolonged period after their ICU stay. Physical inactivity and delirium during the ICU stay are the main determinants of the post-ICU PICS. This presentation will focus on delirium, its epidemiology, prevalence, effect on outcome, risk factors and the current standard of care for managing delirium. Because ICU delirium is a predictor of prolonged length-of-stay in the ICU and of death, the use of a delirium prevention bundle (DPB) becomes mandatory in every ICU. In this presentation, a DPB bundle will be discussed consisting of six components: pain, sedation, sleep, sensory and intellectual stimulation, early mobilization, and hydration. For every of the six components, what to do and what not to do will be discussed. The author will present his own institutional policy on pharmacological and non-pharmacological interventions in the management of delirium. The component ‘early mobilization’ will be discussed more in detail, as this component is extremely important in the prevention of delirium as well as in the prevention of the PICS. The author will conclude his presentation with the remaining areas of uncertainties/work and research to be done.

Keywords: delirium, delirium prevention bundle, early mobilisation in intensive care (ICU), post-intensive care syndrome (PICS)

Procedia PDF Downloads 295

Authors: Boonyalitpun P., Pruckpattranon P., Thonghom A., Rotpenpian N.

Abstract:

Osteoarthritis is a musculoskeletal and neuromuscular abnormality, masticatory muscle, and other tissue that causes pain and breaks down the articular surface of the temporomandibular joint (TMJ). The aim of this study is to investigate the change in the mandibular condyle, in terms of thickness and porosity, and osteoclast marker in the mandibular condyle of TMJ induced osteoarthritis mice (TMJ-OA mice). We investigated the bony changes in the TMJ structure of a complete Freund adjuvant (CFA)-injected TMJ in a mice model over 28 days. On day 28, we observed any change in the TMJ by a micro computed tomography scan (micro-CT scan) in the parameters of trabecular microarchitecture. Then we studied the thickness of the condyles by hematoxylin and eosin staining. Moreover, we calculated the area around the TMJ’s condylar head containing the osteoclast expression by TRAP (Tartrate-resistant acid phosphatase) immunohistochemistry staining. The result found that the parameter of a micro-CT scan was no different from microarchitecture in the TMJ compared with the control group; however, mandibular condyles of the TMJ-OA group was significantly thinner than the control groups, and the osteoclast expression significantly increased in the TMJ-OA group. Therefore, our findings suggest that CFA-induced TMJ-OA represents an expression of osteoclast mandibular condyle of the TMJ, which is the proposed mechanism for a TMJ-OA model.

Keywords: condyle, osteoarthritis, osteoclast, temporomandibular joint

Procedia PDF Downloads 80

Authors: S. Zolghadri, H. Yousefnia, A. R. Jalilian

Abstract:

Bone metastases are observed in a wide range of cancers leading to intolerable pain. While early detection can help the physicians in the decision of the type of treatment, various radiopharmaceuticals using phosphonates like ⁶⁸Ga-EDTMP have been developed. In this work, due to the importance of absorbed dose, human absorbed dose of this new agent was calculated for the first time based on biodistribution data in Wild-type rats. ⁶⁸Ga was obtained from ⁶⁸Ge/⁶⁸Ga generator with radionuclidic purity and radiochemical purity of higher than 99%. The radiolabeled complex was prepared in the optimized conditions. Radiochemical purity of the radiolabeled complex was checked by instant thin layer chromatography (ITLC) method using Whatman No. 2 paper and saline. The results indicated the radiochemical purity of higher than 99%. The radiolabelled complex was injected into the Wild-type rats and its biodistribution was studied up to 120 min. As expected, major accumulation was observed in the bone. Absorbed dose of each human organ was calculated based on biodistribution in the rats using RADAR method. Bone surface and bone marrow with 0.112 and 0.053 mSv/MBq, respectively, received the highest absorbed dose. According to these results, the radiolabeled complex is a suitable and safe option for PET bone imaging.

Keywords: absorbed dose, EDTMP, ⁶⁸Ga, rats

Procedia PDF Downloads 183