Search results for: fuzzy set methods

Authors: Apoorva Bamal, Agnieszka Indiana Olbert

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Floods are known to be one of the most devastating hydro-climatic events, impacting a wide range of stakeholders in terms of environmental, social and economic losses. With difference in inundation durations and level of impact, flood hazards are of different degrees and strength. Amongst various set of domains being impacted by floods, environmental degradation in terms of water quality deterioration is one of the majorly effected but less highlighted domains across the world. The degraded water quality is caused by numerous natural and anthropogenic factors that are both point and non-point sources of pollution. Therefore, it is essential to understand the nature and source of the water pollution due to flooding. The major impact of floods is not only on the physico-chemical water quality parameters, but also on the biological elements leading to a vivid influence on the aquatic ecosystem. This deteriorated water quality is impacting many water categories viz. agriculture, drinking water, aquatic habitat, and miscellaneous services requiring an appropriate water quality to survive. This study identifies, reviews, evaluates and assesses multiple researches done across the world to determine the impact of floods on water quality. With a detailed statistical analysis of top relevant researches, this study is a synopsis of the methods used in assessment of impact of floods on water quality in different geographies, and identifying the gaps for further abridgement. As per majority of the studies, different flood magnitudes have varied impact on the water quality parameters leading to either increased or decreased values as compared to the recommended values for various categories. There is also an evident shift of the biological elements in the impacted waters leading to a change in its phenology and inhabitants of the specified water body. This physical, chemical and biological water quality degradation by floods is dependent upon its duration, extent, magnitude and flow direction. Therefore, this research provides an overview into the multiple impacts of floods on water quality, along with a roadmap of way forward to an efficient and uniform linkage of floods and impacted water quality dynamics.

Keywords: floods, statistical analysis, water pollution, water quality

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Authors: Temosho Promise Chuene, T. Chitura

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Background: Foot and mouth disease is a real challenge in South Africa. The disease is a serious threat to the viability of livestock farming initiatives and affects local and international livestock trade. In Limpopo Province, the Kruger National Park and other game reserves are home to the African buffalo (Syncerus caffer), a notorious reservoir of the picornavirus, which causes foot and mouth disease. Out of the virus’s seven (7) distinct serotypes, Southern African Territories (SAT) 1, 2, and 3 are commonly endemic in South Africa. The broad objective of the study was to establish the trend of foot and mouth disease in Limpopo Province over a seven-year period (2014-2020), as well as the adoption and comprehensive reporting of the measures that are taken to contain disease outbreaks in the study area. Methods: The study used secondary data from the World Organization for Animal Health (WOAH) on reported cases of foot and mouth disease in South Africa. Descriptive analysis (frequencies and percentages) and Analysis of variance (ANOVA) were used to present and analyse the data. Result: The year 2020 had the highest prevalence of foot and mouth disease (3.72%), while 2016 had the lowest prevalence (0.05%). Serotype SAT 2 was the most endemic, followed by SAT 1. Findings from the study demonstrated the seasonal nature of foot and mouth disease in the study area, as most disease cases were reported in the summer seasons. Slaughter of diseased and at-risk animals was the only documented disease control strategy, and information was missing for some of the years. Conclusion: The study identified serious underreporting of the adopted control strategies following disease outbreaks. Adoption of comprehensive disease control strategies coupled with thorough reporting can help to reduce outbreaks of foot and mouth disease and prevent losses to the livestock farming sector of South Africa and Limpopo Province in particular.

Keywords: livestock farming, African buffalo, prevalence, serotype, slaughter

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Authors: Amessalu Atenafu Gelaw, Nele Rath

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Currently, laser hardening process is becoming among the most efficient and effective hardening technique due to its significant advantages. The source where heat is generated, the absence of cooling media, self-quenching property, less distortion nature due to localized heat input, environmental friendly behavior and less time to finish the operation are among the main benefits to adopt this technology. This day, a variety of injection machines are used in plastic, textile, electrical and mechanical industries. Due to the fast growing of composite technology, fiber reinforced polymer matrix becoming optional solution to use in these industries. Due, to the abrasion nature of fiber reinforced polymer matrix composite on the injection components, many parts are outdated before the design period. Niko, a company specialized in injection molded products, suffers from the short lifetime of the injection nozzles of the molds, due to the use of fiber reinforced and, therefore, more abrasive polymer matrix. To prolong the lifetime of these molds, hardening the susceptible component like the injecting nozzles was a must. In this paper, the laser hardening process is investigated on Unimax, a type of stainless steel. The investigation to get optimal results for the nozzle-case was performed in three steps. First, the optimal parameters for maximum possible hardenability for the investigated nozzle material is investigated on a flat sample, using experimental testing as well as thermal simulation. Next, the effect of an inclination on the maximum temperature is analyzed both by experimental testing and validation through simulation. Finally, the data combined and applied for the nozzle. This paper describes possible strategies and methods for laser hardening of the nozzle to reach hardness of at least 720 HV for the material investigated. It has been proven, that the nozzle can be laser hardened to over 900 HV with the option of even higher results when more precise positioning of the laser can be assured.

Keywords: absorptivity, fiber reinforced matrix, laser hardening, Nd:YAG laser

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Authors: Hannah S. Elizabeth, D. Gnanasekaran, M. R. Manju Gowda, Antony George

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Phytoremediation a new technology of remediating the contaminated soil, water and air using plants and serves as a green technology with environmental friendly approach. The main aim of this technique is cleansing and detoxifying of organic compounds, organo-phosphorous pesticides, heavy metals like arsenic, iron, cadmium, gold, radioactive elements which cause teratogenic and life threatening diseases to mankind and animal kingdom when consume the food crops, vegetables, fruits, cerals, and millets obtained from the contaminated soil. Also, directly they may damage the genetic materials thereby alters the biosynthetic pathways of secondary metabolites and other phytoconstituents which may have different pharmacological activities which lead to lost their efficacy and potency as well. It would reflect in mutagenicity, drug resistance and affect other antagonistic properties of normal metabolism. Is the technology for real clean-up of contaminated soils and the contaminants which are potentially toxic. It reduces the risks produced by a contaminated soil by decreasing contaminants using plants as a source. The advantages are cost-effectiveness and less ecosystem disruption. Plants may also help to stabilize contaminants by accumulating and precipitating toxic trace elements in the roots. Organic pollutants can potentially be chemically degraded and ultimately mineralized into harmless biological compounds. Hence, the use of plants to revitalize contaminated sites is gaining more attention and preferred for its cost-effective when compared to other chemical methods. The introduction of harmful substances into the environment has been shown to have many adverse effects on human health, agricultural productivity, and natural ecosystems. Because the costs of growing a crop are minimal compared to those of soil removal and replacement, the use of plants to remediate hazardous soils is seen as having great promise.

Keywords: cost effective, eco-friendly, phytoremediation, secondary metabolites

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Authors: Ajay Gogia, Svs Deo, Dn Sharma, Atul Batra, Ashutash Mishra

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Background and Aims: Breast cancer in women aged less than 25 years (defined as very young breast cancer, VYBC) is rare and accounts for 0.25% of all breast cancer in the West. There is no data available on VYBC from developing countries. The aim of this study was to analyze the clinical, pathological, and prognostic factors and outcomes in VYBC. Methods: This retrospective analysis was performed on 80 patients aged 25 years or less (screened 8000 files of female BC) who were registered at All India Institute of Medical Sciences (AIIMS), New Delhi, India, over a 15-year period between 2011 and 2023. Results: The median age was 21.5 years (range 16-25). A positive family history (siblings and parents) was elicited in 30% of cases, and breast cancer gene (BRCA1/2) mutation was found in 33% of cases patients. Ten patients (12.5%) patients have pregnancy-associated breast cancer (BC detected during pregnancy or 1 year after postpartum period). The TNM stage distribution was Stage I was 0, stage II -30%, stage III –60% and Stage IV -10 %patients. Seventy percent of tumors were high grade, and 90% had pathological node-positive disease. Estrogen, Progesterone, and human epidermal growth factor receptor 2 (HER2)/neu positivity were 25%,25% and 35%, respectively. Triple-negative breast cancer constituted 40% of patients. With a median follow-up of 42 months, 3 years, relapse-free survival (nonmetastatic disease), progression-free survival (metastatic disease) and overall survival were 30%, 15% and 50%, respectively. Conclusions: Very young women constituted 1% of all breast cancer cases. Advanced disease at presentation and high-risk pathological features result in poor outcomes. One-third of VYBCs are associated with BRCA mutation, which requires genetic counseling and risk reduction surgery if required. Due to the aggressive behavior of BC in this age group, need early diagnosis and prompt treatment

Keywords: very young, breast cancer, outcome, developing country, India

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Authors: Kevin T. Inks

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India’s Brahmaputra River Valley has, since independence, experienced consistent low-intensity guerrilla warfare between ethnic and religious groups. These groups are often organized around perceived ethnic territoriality, and target civilians, communities, and especially migrants belonging to other ethnic and religious groups. Intense flooding and erosion have led to widespread displacement, and disaster relief funds are largely tied to legal land tenure. Displaced residents of informal settlements receive little or no resettlement aid, and their subsequent migration strategies and risk from guerrilla violence are poorly understood. Semi-structured interviews and comprehensive surveys focused on perceptions of risk, efficacy of disaster relief, and migration and adaptation strategies were conducted with households identified as being ‘at-risk’ of catastrophic flooding and erosion in Majuli District, Assam. Interviews with policymakers and government workers were conducted to assess disaster relief efforts in informal settlements, and remote sensing methods were used to identify informal settlement and hydrogeomorphic change. The results show that various ethnic and religious groups have differential strategies and preferences for resettlement. However, these varying strategies are likely to lead to differential levels of risk from guerrilla violence. Members of certain ethnic groups residing in informal settlements, in the absence of resettlement assistance, are more likely to seek out unofficial settlement on land far from the protection of the state and experience greater risk of becoming victims of political violence. As climate change and deforestation are likely to increase the severity of the displacement crisis in the Brahmaputra River Valley, more comprehensive disaster relief and surveying efforts are vital for limiting migration and informal settlement in potential sites of guerrilla warfare.

Keywords: climate, displacement, flooding, India, violence

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Authors: Ramin Zargarbashi, Hamid Rabie, Behnam Panjavi, Hooman Kamran, Seyedarad Mosalamiaghili, Zohre Erfani, Seyed Peyman Mirghaderi, Maryam Salimi

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Background: Posterior shoulder dislocation is one of the disabling complications of brachial plexus birth injury (BPBI), and various treatment options, including capsule and surrounding muscles release for open reduction, humeral derotational osteotomy, and tendon transfers, have been recommended to manage it. In the present study, we aimed to determine the clinical outcome of open reduction with soft tissue release, tendon transfer, and glenoid osteotomy inpatients with BPBI and posterior shoulder dislocation or subluxation. Methods: From 2018 to 2020, 33 patients that underwent open reduction, glenoid osteotomy, and tendon transfer were included. The glenohumeral deformity was classified according to the Waters radiographic classification. Functional assessment was performed using the Mallet grading system before and at least two years after the surgery. Results: The patients were monitored for 26.88± 5.47 months. Their average age was 27.5±14 months. Significant improvement was seen in the overall Mallet score (from 13.5 to 18.91 points) and its segments, including hand to mouth, hand to the neck, global abduction, global external rotation, abduction degree, and external rotation degree. Hand-to-back score and the presence of trumpet sign were significantly decreased in the post-operation phase (all p values<0.001). The above-mentioned variables significantly changed for both infantile and non-infantile dislocations. Conclusion: Our study demonstrated that open reduction along with glenoid osteotomy improves retroversion, and muscle strengthening with different muscle transfers is an effective technique for BPBI.

Keywords: birth injuries, nerve injury, brachial plexus birth palsy, Erb palsy, tendon transfer

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Authors: Ricardo Pinto Mario Covele, Patricio V. Langa, Patrick Swanzy

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The English language has been recognized as a universal medium of instruction in academia, especially in Higher Education Institutions (HEIs) hence exerting enormous influence within the context of research and publication. By extension, the English Language has been embraced by scholars from non-English speaking countries. The purpose of this review was to synthesize the discussions using four databases. Discussion in the English language in the career development of academics, particularly in non-English speaking universities, is largely less visible. This paper seeks to fill this gap and to improve the visibility of the English language in the career development of academics focusing on non-English language speaking universities by undertaking a systematic literature review. More specifically, the paper addresses the language policy, English language learning model as a second language, sociolinguistic field and career development, methods, as well as its main findings. This review analyzed 75 relevant resources sourced from Western Cape’s Library, Scopus, Google scholar, and web of science databases from November 2020 to July 2021 using the PQRS framework as an analytical lens. The paper’s findings demonstrate that, while higher education continues to be under-challenges of English language usage, literature targeting non-English speaking universities remains less discussed than it is often described. The findings also demonstrate the dominance of English language policy, both for knowledge production and dissemination of literature challenging emerging scholars from non-English speaking HEIs. Hence, the paper argues for the need to reconsider the context of non-English language speakers in the English language in the career development of academics’ research, both as empirical fields and as emerging knowledge producers. More importantly, the study reveals two bodies of literature: (1) the instrumentalist approach to English Language learning and (2) Intercultural approach to the English Language for career opportunities, classified as the appropriate to explain the English language learning process and how is it perceived towards scholars’ academic careers in HEIs.

Keywords: English language, public and private universities, language policy, career development, non-English speaking countries

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Authors: Shahla Rostamirad

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Purpose: Giardiasis is a widespread infection in humans caused by Giardia lamblia. The prevalence of this parasite among children in Isfahan of Iran is unknown. This study intended to estimate Giardia lamblia infection prevalence and identify possible associated risk factors in a healthy pediatric population living in the Isfahan, a metropolitan city of Iran. Methods: Between September 2010 and March 2012, 1448 stool sample from children with clinical manifestation that refer to clinical lab in Isfahan city for stool examination were collected and analyzed. About 1218 samples were positive for parasitic disease. All of samples were examined and diagnosed by direct examination and formalin-ether concentration of stools. Results: A total of 1218 positive cases were analyzed in this study. The findings showed that 92.5% of patients were infected by protozoa and 7.5 percent with helminth infection. The highest and lowest rate of infection belongs to Giardia lamblia and Entamoeba histolytica with 75% and 1.1%, respectively. Other infection cases were included of Blastocystys hominis 9.9%, E. coli 6.5%, H. nana 1.3%, Enterobious vermicolaris 4% and Ascaris lumbricoides 2.2% percent. The population studied revealed a gender distribution of 53.2% male and 46.8% female. Age distribution was 57.3% between 0-5 years and 42.7% between 6-15 years.The prevalence was higher among children aged 0-5 years (57.8%), than among older children (42.2%). Conclusion: The prevalence of protozoan parasite, especially Giardiasis, in children residing in the region of Isfahan is high. Several risk factors were associated with this prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between Giardia lamblia and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies. Other risk factor include presence of Helicobacter pylori infection, living in houses with own drainage system and reported household, pet contact, especially with cat and dog.

Keywords: Giardia duodenalis, prevalence, risk factors, children, Isfahan, Iran

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Authors: Shareefa Abdullah Al-Maqtari, Ruzaika Omar Basaree, Rafeah Legino

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A pictorial representation of hybrid forms in science-art collaboration has become a crucial issue in the course of exploring a new painting technique development. This is straight related to the reception of an invisible-recognition phenomenology. In hybrid pictorial representation of invisible-recognition phenomenology, the challenging issue is how to depict the pictorial features of indescribable objects from its mental source, modality and transparency. This paper proposes the hybrid technique of painting Demonstrate, Resemble, and Synthesize (DRS) through a combination of the hybrid aspect-recognition representation of understanding picture, demonstrative mod, the number theory, pattern in the modular arithmetic system, and the coherence theory of visual attention in the dynamic scenes representation. Multi-methods digital gaze data analyses, pattern-modular table operation design, and rotation parameter were used for the visualization. In the scientific processes, Eye-trackingvideo-sections based was conducted using Tobii T60 remote eye tracking hardware and TobiiStudioTM analysis software to collect and analyze the eye movements of ten participants when watching the video clip, Alexander Paulikevitch’s performance’s ‘Tajwal’. Results: we found that correlation of fixation count in section one was positively and moderately correlated with section two Person’s (r=.10, p < .05, 2-tailed) as well as in fixation duration Person’s (r=.10, p < .05, 2-tailed). However, a paired-samples t-test indicates that scores were significantly higher for the section one (M = 2.2, SD = .6) than for the section two (M = 1.93, SD = .6) t(9) = 2.44, p < .05, d = 0.87. In the visual process, the exported data of gaze number N was resembled the hybrid forms of visuospatial attention using the table-mod-analyses operation. The explored hybrid guideline was simply applicable, and it could be as alternative approach to the sustainability of contemporary visual arts.

Keywords: science-art collaboration, hybrid forms, pictorial representation, visuospatial attention, modular arithmetic

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Authors: Ghaem Zamani, Farveh Aghaye Nezhad, Amin Barari

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The installation process of caissons has usually been a challenging step in the design phase, especially in the case of suction-assisted installation. The engineering practice for estimating the caisson penetration resistance is primarily controlled by the resistance governed by inner and outer skirt friction and the tip resistance. Different methods have been proposed in the literature to evaluate the above components, while the CPT-based methodology has attained notable popularity among others. In this method, two empirical coefficients are suggested, k𝒻 and kp, which relate the frictional resistance and tip resistance to the cone penetration resistance (q𝒸), respectively. A series of jacking installation and uninstallation experiments for different soil densities were carried out in the offshore geotechnical laboratory of Aalborg University, Denmark. The main goal of these tests was to find appropriate values for empirical coefficients of the CPT-based method for the buckets with large embedment ratio (i.e., d/D=1, where d is the skirt length and D is the diameter) and increased tip area penetrated into dense sand deposits. The friction resistance effects were isolated during the pullout experiments; hence, the k𝒻 was back-measured from the tests in the absence of tip resistance. The actuator force during jacking installation equals the sum of frictional resistance and tip resistance. Therefore, the tip resistance of the bucket is calculated by subtracting the back-measured frictional resistance from penetration resistance; hence the relevant coefficient kp would be achieved. The cone penetration test was operated at different points before and after each installation attempt to measure the cone penetration resistance (q𝒸), and the average value of q𝒸 is used for calculations. The experimental results of the jacking installation tests indicated that a larger friction area considerably increased the penetration resistance; however, this effect was completely diminished when foundation suction-assisted penetration was used. Finally, the values measured for the empirical coefficient of the CPT-based method are compared with the highest expected and most probable values suggested by DNV(1992) for uniform thickness buckets.

Keywords: suction caisson, offshore geotechnics, cone penetration test, wind turbine foundation

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Authors: B. M. Pardeshi

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Introduction: Minerals and trace elements are chemical elements required by our bodies for numerous biological and physiological processes that are necessary for the maintenance of health. Medicinal plants are highly beneficial for the maintenance of good health and prevention of diseases. They are known as potential sources of minerals and vitamins. 30 to 40% of today’s conventional drugs used in the medicinal and curative properties of various plants are employed in herbal supplement botanicals, nutraceuticals and drug. Aim: The authors explored the mineral element content of some herbs, because mineral elements may have significant role in the development and treatment of gastrointestinal diseases, and a close connection between the presence or absence of mineral elements and inflammatory mediators was noted. Methods: Present study deals with the elemental analysis of medicinal plants by Instrumental Neutron activation Analysis and Atomic Absorption Spectroscopy. Medicinal herbals prescribed for skin diseases were purchased from markets and were analyzed by Instrumental Neutron Activation Analysis (INAA) using 252Cf Californium spontaneous fission neutron source (flux* 109 n s-1) and the induced activities were counted by γ-ray spectrometry and Atomic Absorption Spectroscopy (AAS) techniques (Perkin Elmer 3100 Model) available at Department of Chemistry University of Pune, India, was used for the measurement of major, minor and trace elements. Results: 15 elements viz. Al, K, Cl, Na, Mn by INAA and Cu, Co, Pb Ni, Cr, Ca, Fe, Zn, Hg and Cd by AAS were analyzed from different medicinal plants from India. A critical examination of the data shows that the elements Ca , K, Cl, Al, and Fe are found to be present at major levels in most of the samples while the other elements Na, Mn, Cu, Co, Pb, Ni, Cr, Ca, Zn, Hg and Cd are present in minor or trace levels. Conclusion: The beneficial therapeutic effect of the studied herbs may be related to their mineral element content. The elemental concentration in different medicinal plants is discussed.

Keywords: instrumental neutron activation analysis, atomic absorption spectroscopy, medicinal plants, trace elemental analysis, mineral contents

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Authors: Vivianne Aggestam

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Purpose: Organic dairy products have steadily increased with consumer popularity in recent years in Sweden, permitting more transport activities. The main aim of this study was to compare the transport costs and the environmental emissions made by the organic and conventional dairy production in Sweden. The objective was to evaluate differences and environmental impacts of transport between the two different production systems, allowing a more transparent understanding of the real impact of transport within the supply chain. Methods: A partial attributional Life Cycle Assessment has been conducted based on a comprehensive survey of Swedish farmers, dairies and consumers regarding their transport needs and costs. Interviews addressed the farmers and dairies. Consumers were targeted through an online survey. Results: Higher transport inputs from conventional dairy transportation are mainly via feed and soil management on farm level. The regional organic milk brand illustrate less initial transport burdens on farm level, however, after leaving the farm, it had equal or higher transportation requirements. This was mainly due to the location of the dairy farm and shorter product expiry dates, which requires more frequent retail deliveries. Organic consumers tend to use public transport more than private vehicles. Consumers using private vehicles for shopping trips primarily bought conventional products for which price was the main deciding factor. Conclusions: Organic dairy products that emphasise its regional attributes do not ensure less transportation and may therefore not be a more “climate smart” option for the consumer. This suggests that the idea of localism needs to be analysed from a more systemic perspective. Fuel and regional feed efficiency can be further implemented, mainly via fuel type and the types of vehicles used for transport.

Keywords: supply chains, distribution, transportation, organic food productions, conventional food production, agricultural fossil fuel use

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Authors: James Ladzekpo

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Background: The urgent need to identify new pharmacological targets for diabetes treatment and prevention has been amplified by the disease's extensive impact on individuals and healthcare systems. A deeper insight into the biological underpinnings of diabetes is crucial for the creation of therapeutic strategies aimed at these biological processes. Current predictive models based on genetic variations fall short of accurately forecasting diabetes. Objectives: Our study aims to pinpoint key epigenetic factors that predispose individuals to diabetes. These factors will inform the development of an advanced predictive model that estimates diabetes risk from genetic profiles, utilizing state-of-the-art statistical and data mining methods. Methodology: We have implemented a recursive feature elimination with cross-validation using the support vector machine (SVM) approach for refined feature selection. Building on this, we developed six machine learning models, including logistic regression, k-Nearest Neighbors (k-NN), Naive Bayes, Random Forest, Gradient Boosting, and Multilayer Perceptron Neural Network, to evaluate their performance. Findings: The Gradient Boosting Classifier excelled, achieving a median recall of 92.17% and outstanding metrics such as area under the receiver operating characteristics curve (AUC) with a median of 68%, alongside median accuracy and precision scores of 76%. Through our machine learning analysis, we identified 31 genes significantly associated with diabetes traits, highlighting their potential as biomarkers and targets for diabetes management strategies. Conclusion: Particularly noteworthy were the Gradient Boosting Classifier and Multilayer Perceptron Neural Network, which demonstrated potential in diabetes outcome prediction. We recommend future investigations to incorporate larger cohorts and a wider array of predictive variables to enhance the models' predictive capabilities.

Keywords: diabetes, machine learning, prediction, biomarkers

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Authors: O’Day Luke

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Purpose: To validate virtual non-contrast reconstructions generated from dual-layer spectral computed tomography (DL-CT) data as an alternative for the acquisition of a dedicated true non-contrast dataset during multiphase contrast studies. Material and methods: Thirty-three patients underwent a routine multiphase clinical CT examination, using Dual-Layer Spectral CT, from March to August 2021. True non-contrast (TNC) and virtual non-contrast (VNC) datasets, generated from both portal venous and arterial phase imaging were evaluated. For every patient in both true and virtual non-contrast datasets, a region-of-interest (ROI) was defined in aorta, liver, fluid (i.e. gallbladder, urinary bladder), kidney, muscle, fat and spongious bone, resulting in 693 ROIs. Differences in attenuation for VNC and TNV images were compared, both separately and combined. Consistency between VNC reconstructions obtained from the arterial and portal venous phase was evaluated. Results: Comparison of CT density (HU) on the VNC and TNC images showed a high correlation. The mean difference between TNC and VNC images (excluding bone results) was 5.5 ± 9.1 HU and > 90% of all comparisons showed a difference of less than 15 HU. For all tissues but spongious bone, the mean absolute difference between TNC and VNC images was below 10 HU. VNC images derived from the arterial and the portal venous phase showed a good correlation in most tissue types. The aortic attenuation was somewhat dependent however on which dataset was used for reconstruction. Bone evaluation with VNC datasets continues to be a problem, as spectral CT algorithms are currently poor in differentiating bone and iodine. Conclusion: Given the increasing availability of DL-CT and proven accuracy of virtual non-contrast processing, VNC is a promising tool for generating additional data during routine contrast-enhanced studies. This study shows the utility of virtual non-contrast scans as an alternative for true non-contrast studies during multiphase CT, with potential for dose reduction, without loss of diagnostic information.

Keywords: dual-layer spectral computed tomography, virtual non-contrast, true non-contrast, clinical comparison

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Authors: A. Čelan, M. Ćosić, D. Rušić, N. Kuzmanić

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Conducting crystallization in an agitated vessel requires a proper selection of mixing parameters that would result in a production of crystals of specific properties. In dual impeller systems, which are characterized by a more complex hydrodynamics due to the possible fluid flow interactions, revealing a clear link between mixing parameters and crystallization kinetics is still an open issue. The aim of this work is to establish this connection by investigating how fluid flow patterns, generated by two impellers mounted on the same shaft, reflect on metastable zone width of borax decahydrate, one of the most important parameters of the crystallization process. Investigation was carried out in a 15-dm³ bench scale batch cooling crystallizer with an aspect ratio (H/T) equal to 1.3. For this reason, two radial straight blade turbines (4-SBT) were used for agitation. Experiments were conducted at different impeller spacings at the state of complete suspension. During the process of an unseeded batch cooling crystallization, solution temperature and supersaturation were continuously monitored what enabled a determination of the metastable zone width. Hydrodynamic conditions in the vessel achieved at different impeller spacings investigated were analyzed in detail. This was done firstly by measuring the mixing time required to attain the desired level of homogeneity. Secondly, fluid flow patterns generated in a described dual impeller system were both photographed and simulated by VisiMix Turbulent software. Also, a comparison of these two visualization methods was performed. Experimentally obtained results showed that metastable zone width is definitely affected by the hydrodynamics in the crystallizer. This means that this crystallization parameter can be controlled not only by adjusting the saturation temperature or cooling rate, as is usually done, but also by choosing a suitable impeller spacing that will result in a formation of crystals of wanted size distribution.

Keywords: dual impeller crystallizer, fluid flow pattern, metastable zone width, mixing time, radial impeller

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Authors: Arezoo Fallahi, Siamak Derakhshan, Parvaneh Taymoori, Babak Nematshahrbabaki

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Background: Osteoporosis, the most common metabolic bone disease, is an important health care issue. Not only the cost of disease is high but also is one of the causes of disability and mortality and effect on quality of life. Although self-care is effective on disease, s control and treatment but still effective factors on self-care of patient, s viewpoint have not been survey. The aim of this study was to explore effective factors on self-care in women with osteoporosis. Materials and methods: This study was done by conventional content analysis approach in year 2014. Through purposeful sampling 15 women referred to bone mass densitometry centers participated in this study. Inclusion criteria were: Women older than 50 years old with osteoporosis, final diagnosis of osteoporosis for over six –month period, T-score index below -2.5 (lower back or hip), drug use by patients with a physician’s prescription, ability in speaking and attending to participate in the study. Data was collected by face to face and group semi-structure deep interviews and analyzed via content analysis method. To support of rigor of data, criteria credibility, confirmability and transferability were used. Results: during data analysis five categories developed: “hope and disability in the face of illness”, “mutual roles of physician”, “role of family” and “administrative centers and organizations”. To perform self-care behaviors, the participations of this study emphasized on pay attention to their own healthy, regarding patients' rights by physician, pay attention to women's health by men, and the role of media especially radio and television. Conclusion: the finding of the study showed that women’s responsibility with osteoporosis for their health is not a factor but it is multifactorial. Increasing life expectancy in patients, attention to patients needs by physician, increasing health promotion programs in the media and enhancing role of family may provide conditions and infrastructure to empowerment women in doing self-care behavior.

Keywords: women, osteoporosis, self-care, content analysis

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Authors: Ghada Ben Hamad, Zohir Younsi, Hassane Naji, Noureddine Lebaz, Naoual Belouaggadia

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This study deals with a bifunctional micro-encapsulated phase change (MCP) material, capric-stearic acid/graphene oxide-TiO2, which has been successfully developed by in situ hydrolysis and polycondensation of tetrabutyl titanate and modification of graphene oxide (GO) on the TiO2 doped shell. The use of graphene and doped TiO2 is a promising approach to provide photocatalytic activity under visible light and improve the microcapsules physicochemical properties. The morphology and chemical structure of the resulting microcapsule samples were determined by using Fourier transform infrared (FT-IR) spectroscopy, scanning electronic microscope (SEM), and X-ray diffractometer (XRD) methods. The ultraviolet, visible spectrophotometer (UV–vis), the differential scanning calorimeter (DSC) and the thermogravimetric analyzer (TGA) were used to investigate the absorption of visible and ultraviolet (UV), the thermal properties, and thermal stabilities of the microcapsules. Note that, the visible light photocatalytic activity was assessed for the toluene and benzene gaseous removal in a suitable test room. The microcapsules exhibit an interesting spherical morphology and an average diameter of 15 to 25 μm. The addition of graphene can enhance the rigidity of the shell and improve the microcapsules thermal reliability. At the same time, the thermal analysis tests showed that the synthesized microcapsules had a high solar thermal energy-storage and better thermal stability. In addition, the capric-stearic acid microcapsules exhibited high solar photocatalytic activity with respect to atmospheric pollutants under natural sunlight. The fatty acid samples obtained with the GO/TiO2 shell showed great potential for applications of solar energy storage, solar photocatalytic degradation of air pollutants and buildings energy conservation.

Keywords: thermal energy storage, microencapsulation, titanium dioxide, photocatalysis, graphene oxide

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Authors: Eric Jacob Bacon, Chaoyang Jin, Dianning He, Shuaishuai Hu, Lanbo Wang, Han Li, Shouliang Qi

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Objective: Refractory epilepsy is a complicated type of epilepsy that can be difficult to diagnose. Recent technological advancements have made resting-state functional magnetic resonance (rsfMRI) a vital technique for studying brain activity. However, there is still much to learn about rsfMRI. Investigating rsfMRI connectivity may aid in the detection of abnormal activities. In this paper, we propose studying the functional connectivity of rsfMRI candidates to diagnose epilepsy. Methods: 45 rsfMRI candidates, comprising 26 with refractory epilepsy and 19 healthy controls, were enrolled in this study. A data-driven approach known as independent component analysis (ICA) was used to achieve our goal. First, rsfMRI data from both patients and healthy controls were analyzed using group ICA. The components that were obtained were then spatially sorted to find and select meaningful ones. A two-sample t-test was also used to identify abnormal networks in patients and healthy controls. Finally, based on the fractional amplitude of low-frequency fluctuations (fALFF), a chi-square statistic test was used to distinguish the network properties of the patient and healthy control groups. Results: The two-sample t-test analysis yielded abnormal in the default mode network, including the left superior temporal lobe and the left supramarginal. The right precuneus was found to be abnormal in the dorsal attention network. In addition, the frontal cortex showed an abnormal cluster in the medial temporal gyrus. In contrast, the temporal cortex showed an abnormal cluster in the right middle temporal gyrus and the right fronto-operculum gyrus. Finally, the chi-square statistic test was significant, producing a p-value of 0.001 for the analysis. Conclusion: This study offers evidence that investigating rsfMRI connectivity provides an excellent diagnosis option for refractory epilepsy.

Keywords: ICA, RSN, refractory epilepsy, rsfMRI

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Authors: Khalifa Abdunaser, Salem Eljawashi

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Study area is threatened by numerous petroleum activities. The most important risk is associated with dramatic dangers of misuse and oil and gas pollutions, such as significant volumes of produced water, which refers to waste water generated during the production of oil and natural gas and disposed on the surface surrounded oil and gas fields. This work concerns the impact of oil exploration and production activities on the physical and environment fate of the area, focusing on the investigation and observation of crude oil migration as toxic fluid. Its penetration in groundwater resulted from the produced water impacted by oilfield operations disposed to the earth surface in Al Wahat area. Describing the areal distribution of the dominant groundwater quality constituents has been conducted to identify the major hydro-geochemical processes that affect the quality of water and to evaluate the relations between rock types and groundwater flow to the quality and geochemistry of water in Post-Eocene aquifer. The chemical and physical characteristics of produced water, where it is produced, and its potential impacts on the environment and on oil and gas operations have been discussed. Field work survey was conducted to identify and locate a large number of monitoring wells previously drilled throughout the study area. Groundwater samples were systematically collected in order to detect the fate of spills resulting from the various activities at the oil fields in the study area. Spatial distribution maps of the water quality parameters were built using Kriging methods of interpolation in ArcMap software. Thematic maps were generated using GIS and remote sensing techniques, which were applied to include all these data layers as an active database for the area for the purpose of identifying hot spots and prioritizing locations based on their environmental conditions as well as for monitoring plans.

Keywords: Sirt Basin, produced water, Al Wahat area, Ground water

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Authors: Muhammad Nouman, Fahad Tiwana, Muhammad Irfan, Mohsin Tiwana

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Traffic congestion has been increasing significantly in major metropolitan areas as a result of increased motorization, urbanization, population growth and changes in the urban density. Traffic congestion compromises efficiency of transport infrastructure and causes multiple traffic concerns; including but not limited to increase of travel time, safety hazards, air pollution, and fuel consumption. Traffic management has become a serious challenge for federal and provincial governments, as well as exasperated commuters. Effective, flexible, efficient and user-friendly traffic information/database management systems characterize traffic conditions by making use of traffic counts for storage, processing, and visualization. While, the emerging data collection technologies continue to proliferate, its accuracy can be guaranteed through the comparison of observed data with the manual handheld counters. This paper presents the design of tablet based manual traffic counting application and framework for development of traffic database management system for Pakistan. The database management system comprises of three components including traffic counting android application; establishing online database and its visualization using Google maps. Oracle relational database was chosen to develop the data structure whereas structured query language (SQL) was adopted to program the system architecture. The GIS application links the data from the database and projects it onto a dynamic map for traffic conditions visualization. The traffic counting device and example of a database application in the real-world problem provided a creative outlet to visualize the uses and advantages of a database management system in real time. Also, traffic data counts by means of handheld tablet/ mobile application can be used for transportation planning and forecasting.

Keywords: manual count, emerging data sources, traffic information quality, traffic surveillance, traffic counting device, android; data visualization, traffic management

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Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

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The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

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Authors: Charlene Petersen, Herman Grobler, Karel Botha

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Restorative intervention with adolescents from a family violence context is a much needed resource given the limited access to mental health services in South Africa. In this research article the qualitative component which formed part of a mixed methods design of an overall research study, is discussed. A qualitative case study design was used. This article explores a psycho-education strategy, using a visual creative medium as a method for reconstructing identity in the context of family violence. The aim of this psycho-education strategy was to move away from interventions based on the biomedical model, but focused more on meaning-making about violent traumatic events adolescents have experienced, and to develop more positive, adaptive views about themselves in the present, and experience hope about the future. The research question that was asked was how the meaning, that adolescents from a specific community in South Africa give to family violence, contribute to defining their identity? Twelve participants were purposively selected for the study and included both male and female adolescents with ages ranging from 15 to 18 years from three secondary schools. The strategy was applied over five sessions with the intention to bring about awareness of different selves, identifying and naming the selves, and becoming aware of the configuration of identity that could lead to a redefined identity. The data were thematically and visually analyzed. Through the process of tailoring which forms the basis for reconstruction process, participants could identify the different selves, become aware of how they configure in the field. Through the process of tailoring the different self-parts, the sense of self became more self-cohesive and allowed the individual to become aware of the role of certain. Through identifying and naming the future self and resilient self the participants were able to accomplish some order and meaning in their lives. It provided them with a sense of predictability and an optimistic and hopefulness towards the future. The research findings indicated that this strategy can be used as a method for reconstructing identity in the context of family violence.

Keywords: identity, family violence, self-configuration, reconstructing identity, psycho-education strategy

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Authors: S. P. Rana

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Objectives: For the manufacture of a very thin strip or a strip with a high-quality finish, the stainless steel sheet that is called billet is re-rolled in re-rolling mill to make stainless steel sheet of 18 gauges. The rolls of re-rolling mill exert tremendous pressure over the sheet and there is likely chance of breaking of stainless steel strip from the sheet. The objective of the study was to minimise the number of accidents in steel re-rolling mills due to ejection of stainless steel strip and to minimize the pollution caused by the pickling process used in these units. Methods: Looking into the high rate of frequency and severity of accidents as well as pollution hazard in re-rolling and pickling mills, it becomes essential to make necessary arrangements for prevention of accidents in such type of industry. The author carried out survey/inspections of a large number of re-rolling and pickling mills and allied units. During the course of inspection, the working of these steel re-rolling and pickling mills was closely studied and monitored. A number of accidents involving re-rolling mills were investigated and subsequently remedial measures to prevent the occurrence of such accidents were suggested. Assessment of occupational safety and health system of these units was carried out and compliance level of the statutory requirements was checked. The workers were medically examined and monitored to ascertain their health conditions. Results: Proper use of safety gadgets by workers, machine guarding and regular training brought down the risk to an acceptable level and discharged effluent pollution was brought down to permissible limits. The fatal accidents have been reduced by 83%. Conclusions: Effective enforcement and implementation of the directions/suggestions given to the managements of such units brought down the no. of accidents to a rational level. The number of fatal accidents has reduced by 83% during the study period. The effective implementation of pollution control device curtailed the pollution level to an acceptable level.

Keywords: re-rolling mill, hazard, accident, health hazards

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Authors: Nagwa E. Abd Elazim, Maha S. El-naggar, Rania H. Mohamed, Sara M. Awad

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Background: Radiodermatitis is a common side effect of radiation therapy for breast cancer. However, there is no current consensus about effective standard therapy for the prevention and management of radiation dermatitis. Topical ectoine has demonstrated efficacy in the treatment of atopic dermatitis owing to its anti-inflammatory activity. Objective: To evaluate the efficacy of topical ectoine in comparison to traditional topical dexpanthenol treatment in the management of acute radiodermatitis in breast cancer patients undergoing adjuvant radiotherapy. Methods: Fifty patients were randomized to use either dexpanthenol 0.5% cream (25 patients), or ectoin 7% cream (25 patients), applied twice daily to the irradiated area during the radiation period and continued for 2 weeks after cessation of radiotherapy. Assessment of radiation skin toxicity using Common Terminology Criteria of Adverse Events (CTCAE) v4.0, radiation-associated symptoms, and adverse events were undertaken weekly during radiotherapy and 2 weeks after the end of radiotherapy. Results: Topical ectoine showed some clinical benefit over dexpanthenol, as shown by delayed time to onset (at week 3 versus week 2, respectively) and larger number of patients who reached grade 0 at the end of treatment (64% vs. 48%, respectively). The clinical symptoms of pain (p = 0.003) and itching (p = 0.001) attributable to radiation were less pronounced with ectoine than with dexpanthenol. Burning and hyperpigmentation were the most common side effects with ectoine. However, no significant difference between dexpanthenol and ectoine treatments was found in any of the side effects (p = 0.1). Conclusion: Ectoin was overall more effective in improving radiation dermatitis than topical dexpanthenol in breast cancer patients. Ectoin could be proposed as a preventive or curative treatment for patients undergoing postoperative irradiation for breast cancer. Further clinical studies with a larger number of patients are recommended for the confirmation of these preliminary results.

Keywords: breast cancer, dexapanthenol, ectoin, radiation dermatitis

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Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

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Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

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Authors: Alexey Yu. Martynov, Sulejman Bayramov

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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.

Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina

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Authors: Dagnew Dessie Mengie

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The purpose of this study was to investigate German tourists' demand for Ethiopian tourism destinations. The author has made every effort to identify the differences in the preferences of German visitors’ demand in Ethiopia comparing with Egypt, Kenya, Tanzania, and South African tourism sectors if they are invited to visit at the same time. However, the demand for international tourism for Ethiopia currently lags behind these African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government and tour and travel operators need to understand the important factors that affect international tourists’ decision to visit Ethiopian tourist destinations. The aim of this study was to analyze German Tourists’ Demand for Ethiopian destinations. The researcher aimed to identify the demand for German tourists’ preference for Ethiopian tourist destinations compared to the above-mentioned African countries. For collecting and analysing data for this study, both quantitative and qualitative methods of research are being used in this study. The most significant data are collected by using the primary data collection method i.e. survey and interviews which are the most and large number of potential responses and feedback from nine German active tourists,12 Ethiopian tourism officials, four African embassies, and four well functioning private tour companies and secondary data collected from books, journals, previous research and electronic websites. Based on the data analysis of the information gathered from interviews and questionnaires, the study disclosed that the majority of German tourists do have not that high demand for Ethiopian Tourist destinations due to the following reasons: (1) Many Germans are fascinated by adventures and safari and simply want to lie on the beach and relax. These interests have leaded them to look for other African countries which have these accesses. (2) Uncomfortable infrastructure and transport problems are attributed to the decreasing number of German tourists in the country. (3) Inadequate marketing operation of the Ethiopian Tourism Authority and its delegates in advertising and clarifying the above irregularities which are raised by the tourists.

Keywords: environmental benefits of tourism, social benefits of tourism, economic benefits of tourism, political factors on tourism

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Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

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Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size

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Authors: Mitra Assadi, Md. Faan

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Background: Autism Spectrum Disorder (ASD) in a common neurodevelopmental disorder with limited pharmacological interventions. Transcranial Magnetic Stimulation (rTMS) has produced promising results in ASD, although there is no consensus regarding optimal targets or stimulation paradigms. A prevailing theory in ASD attributes the core deficits to dysfunction of the mirror neurons located in the inferior parietal lobule (IPL) and inferior frontal gyrus (IFG). Methods: Thus far, 11 subjects with ASD, 10 boys and 1 girl with the mean age of 13.36 years have completed the study by receiving 10 session of high frequency rTMS to the IPL. The subjects were randomized to receive stimulation on the left or right IPL and sham stimulation to the opposite side. The outcome measures included the Social Responsiveness Scale – Second Edition (SRS-2) and Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency task. Results: None of the 11 subjects experienced any adverse effects. The rTMS did not produce any improvement in verbal fluency, nor there was any statistically significant difference between the right versus left sided stimulation. Analysis of social awareness on SRS-2 (SRS-AWR) indicated a close to significant effect of the treatment with a small to medium effect size. After removing a single subject with Level 3 ASD, we demonstrated a close to significant improvement on SRS-AWR with a large effect size. The analysis of the data 3-month post TMS demonstrated return of the SRS-AWR values to baseline. Conclusion: This preliminary analysis of the 11 subjects who have completed our study thus far shows a favorable response to high frequency rTMS stimulation of the mirror neurons/IPL on social awareness. While the decay of the response noted during the 3-month follow-up may be considered a limitation of rTMS, the presence of the improvement, especially the effect size despite the small sample size, is indicative of the efficacy of this technique.

Keywords: rTMS, autism, scoial cognition, mirror neurons

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