Search results for: ultrasound computed tomography (USCT)

Authors: Ana Clara Santos, Maria Manuela Portela, Bettina Schaefli

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This work assesses the performance of an analytical model framework to generate daily flow duration curves, FDCs, based on climatic characteristics of the catchments and on their streamflow recession coefficients. According to the analytical model framework, precipitation is considered to be a stochastic process, modeled as a marked Poisson process, and recession is considered to be deterministic, with parameters that can be computed based on different models. The analytical model framework was tested for three case studies with different hydrological regimes located in Switzerland: pluvial, snow-dominated and glacier. For that purpose, five time intervals were analyzed (the four meteorological seasons and the civil year) and two developments of the model were tested: one considering a linear recession model and the other adopting a nonlinear recession model. Those developments were combined with recession coefficients obtained from two different approaches: forward and inverse estimation. The performance of the analytical framework when considering forward parameter estimation is poor in comparison with the inverse estimation for both, linear and nonlinear models. For the pluvial catchment, the inverse estimation shows exceptional good results, especially for the nonlinear model, clearing suggesting that the model has the ability to describe FDCs. For the snow-dominated and glacier catchments the seasonal results are better than the annual ones suggesting that the model can describe streamflows in those conditions and that future efforts should focus on improving and combining seasonal curves instead of considering single annual ones.

Keywords: analytical streamflow distribution, stochastic process, linear and non-linear recession, hydrological modelling, daily discharges

Procedia PDF Downloads 144

Authors: Shuo Wang

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The hydrogeological parameters of the engineering site and the hydraulic connection between the aquifers can be obtained by the pumping test. Through the recovery test, the characteristics of water level recovery and the law of surface subsidence recovery can be understood. The above two tests can provide the basis for subsequent engineering design. At present, the deformation of deep soil caused by pumping tests is often neglected. However, some studies have shown that the maximum settlement subject to groundwater drawdown is not necessarily on the surface but in the deep soil. In addition, the law of settlement recovery of each soil layer subject to water level recovery is not clear. If the deformation-sensitive structure is deep in the test site, safety accidents may occur. In this study, the pumping test and recovery test of a confined aquifer in Shanghai are introduced. The law of measured groundwater changes and surface subsidence are analyzed. In addition, the fluid-solid coupling model was established by ABAQUS based on the Biot consolidation theory. The models are verified by comparing the computed and measured results. Further, the variation law of water level and the deformation law of deep soil during pumping and recovery tests under different site conditions and different times and spaces are discussed through the above model. It is found that the maximum soil settlement caused by pumping in a confined aquifer is related to the permeability of the overlying aquitard and pumping time. There is a lag between soil deformation and groundwater changes, and the recovery rate of settlement deformation of each soil layer caused by the rise of water level is different. Finally, some possible research directions are proposed to provide new ideas for academic research in this field.

Keywords: coupled hydro-mechanical analysis, deep ground settlement, numerical simulation, pumping test, recovery test

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Authors: Parvin Goli, Amirhosein Kefayat, Rezvan Goli

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Background: It is well established that parents can influence their offspring's neurodevelopment. It is shown that paternal environment and lifestyle is beneficial for the progeny's fitness and might affect their metabolic mechanisms; however, the effects of paternal exercise on the brain in the offspring have not been explored in detail. Objective: This study aims to review the impact of paternal physical exercise on memory and learning, neuroplasticity, as well as DNA methylation levels in the off-spring's hippocampus. Study design: In this systematic review and meta-analysis, an electronic literature search was conducted in databases including PubMed, Scopus, and Web of Science. Eligible studies were those with an experimental design, including an exercise intervention arm, with the assessment of any type of memory function, learning ability, or any type of brain plasticity as the outcome measures. Standardized mean difference (SMD) and 95% confidence intervals (CI) were computed as effect size. Results: The systematic review revealed the important role of environmental enrichment in the behavioral development of the next generation. Also, offspring of exercised fathers displayed higher levels of memory ability and lower level of brain-derived neurotrophic factor. A significant effect of paternal exercise on the hippocampal volume was also reported in the few available studies. Conclusion: These results suggest an intergenerational effect of paternal physical activity on cognitive benefit, which may be associated with hippocampal epigenetic programming in offspring. However, the biological mechanisms of this modulation remain to be determined.

Keywords: hippocampal plasticity, learning ability, memory, parental exercise

Procedia PDF Downloads 194

Authors: Jinghua Zhang

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Shaft-tunnel junction is a typical case of the structural nonuniformity in underground structures. The shaft and the tunnel possess greatly different structural features. Even under uniform excitations, they tend to behave discrepantly. Studies on shaft-tunnel junctions are mainly performed numerically. Shaking table tests are also conducted. Although many numerical and experimental data are obtained, an analytical solution still has great merits of gaining more insights into the shaft-tunnel problem. This paper will try to remedy the situation. Since the seismic responses of shaft-tunnel junctions are very related to directions of the excitations, they are studied in two scenarios: the longitudinal-excitation scenario and the transverse-excitation scenario. The former scenario will be addressed in this paper. Given that responses of the tunnel are highly dependent on the shaft, the analytical solutions would be developed firstly for the vertical shaft. Then, the seismic responses of the tunnel would be discussed. Since vertical shafts bear a resemblance to rigid caissons, the solution proposed in this paper is derived by introducing terms of shaft-tunnel and soil-tunnel interactions into equations originally developed for rigid caissons. The validity of the solution is examined by a validation model computed by finite element method. The mutual influence between the shaft and the tunnel is introduced. The soil-structure interactions are discussed parametrically based on the proposed equations. The shaft-tunnel relative displacement and the soil-tunnel relative stiffness are found to be the most important parameters affecting the magnitudes and distributions of the internal forces of the tunnel. A hinge-joint at the shaft-tunnel junction could significantly reduce the degree of stress concentration compared with a rigid joint.

Keywords: analytical solution, longitudinal excitation, numerical validation , shaft-tunnel junction

Procedia PDF Downloads 137

Authors: Fu Jia

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The effects of soil-structure interaction (SSI) are often studied using axial-symmetric three-dimensional (3D) models to avoid the high computational cost of the more realistic, fully 3D models, which require 2-3 orders of magnitude more computer time and storage. This paper analyzes the error and presents correction factors for system frequency, system damping, and peak amplitude of structural response computed by axisymmetric models, embedded in uniform or layered half-space. The results are compared with those for fully 3D rectangular foundations of different aspect ratios. Correction factors are presented for a range of the model parameters, such as fixed-base frequency, structure mass, height and length-to-width ratio, foundation embedment, soil-layer stiffness and thickness. It is shown that the errors are larger for stiffer, taller and heavier structures, deeper foundations and deeper soil layer. For example, for a stiff structure like Millikan Library (NS response; length-to-width ratio 1), the error is 6.5% in system frequency, 49% in system damping and 180% in peak amplitude. Analysis of a case study shows that the NEHRP-2015 provisions for reduction of base shear force due to SSI effects may be unsafe for some structures and need revision. The presented correction factor diagrams can be used in practical design and other applications.

Keywords: 3D soil-structure interaction, correction factors for axisymmetric models, length-to-width ratio, NEHRP-2015 provisions for reduction of base shear force, rectangular embedded foundations, SSI system frequency, SSI system damping

Procedia PDF Downloads 242

Authors: Harsha Kumar H. N., Anshu Kumar Jha, Khushboo Kamal Taneja, Krishan Kabra, Mohamed Hafeez Sadiq

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Introduction: The increasing use of preservatives and flavouring agents has the potential to cause health problem among the people. There are no published studies from India exploring the awareness, safety perception, & practices about Food Preservatives (FPs) and Flavouring Agents (FAs). So this study was conducted with the objectives of assessing the awareness, safety perceptions & practices about Food Preservatives (FPs), Flavouring Agents (FAs) in commonly bought / purchased packed food items. Materials & method: This cross-sectional study was conducted in January 2012. Sample size of 126 was computed using the formula for infinite population. People who bought packed food items in malls were approached and requested to fill a pre-tested semi-structured questionnaire. The questionnaire explored awareness, safety perception & practices of FPs & FAs. Data was then analyzed using SPSS version 10.0. Chi-square test was used to know if the observed differences were statistically significant. ‘p’ value <0.05 was considered significant. Results: Totally 123 people (males- 48.8% and females-51.2%) participated (response rate of 97.6%) in the study. Majority of the people were aware about presence of ‘FPs’ (91.7%) and ‘FAs’ (84.9%) though their knowledge was inadequate. Breakup of the study subjects according to level of awareness about FPs was as follows (%): Good (37.4), Satisfactory (40.6), Poor (22) & FAs (%): Good (49.6), Satisfactory (36) & Poor (14). Distribution according to type of practices for FPs was as follows (%): Favourable (14), Unfavourable (86) & FAs (%): Favourable (30.5), Unfavourable (69.5). There was a gap between knowledge and practices. Conclusion: Though there was awareness, the knowledge was inadequate. Unfavourable practices were observed. The gaps in the knowledge and unhealthy practices need to be addressed by public awareness campaign.

Keywords: food preservatives, flavouring agents, knowledge and practices, general population

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Authors: Keisuke Konishi, Yoshinari Hiroshiro, Kento Terashima, Atsushi Tsutsumi

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Imazu Bay plays an important role for endangered species such as horseshoe crabs and black-faced spoonbills that stay in the bay for spawning or the passing of winter. However, this bay is semi-enclosed with slow water exchange, which could lead to eutrophication under the condition of excess nutrient inflow to the bay. Therefore, quantification of nutrient inflow is of great importance. Generally, analysis of nutrient inflow to the bays takes into consideration nutrient inflow from only the river, but that from groundwater should not be ignored for more accurate results. The main objective of this study is to estimate the amounts of nutrient inflow from river and groundwater to Imazu Bay by analyzing water budget in Zuibaiji River Basin and loads of T-N, T-P, NO3-N and NH4-N. The water budget computation in the basin is performed using groundwater recharge model and quasi three-dimensional two-phase groundwater flow model, and the multiplication of the measured amount of nutrient inflow with the computed discharge gives the total amount of nutrient inflow to the bay. In addition, in order to evaluate nutrient inflow to the bay, the result is compared with nutrient inflow from geologically similar river basins. The result shows that the discharge is 3.50×107 m3/year from the river and 1.04×107 m3/year from groundwater. The submarine groundwater discharge accounts for approximately 23 % of the total discharge, which is large compared to the other river basins. It is also revealed that the total nutrient inflow is not particularly large. The sum of NO3-N and NH4-N loadings from groundwater is less than 10 % of that from the river because of denitrification in groundwater. The Shin Seibu Sewage Treatment Plant located below the observation points discharges treated water of 15,400 m3/day and plans to increase it. However, the loads of T-N and T-P from the treatment plant are 3.9 mg/L and 0.19 mg/L, so that it does not contribute a lot to eutrophication.

Keywords: Eutrophication, groundwater recharge model, nutrient inflow, quasi three-dimensional two-phase groundwater flow model, submarine groundwater discharge

Procedia PDF Downloads 437

Authors: Célia Barreto Carvalho, Carolina da Motta, José Pinto-Gouveia, Ermelindo Bernardo Peixoto

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Auditory hallucinations among the most invalidating and distressing experiences reported by patients diagnosed with schizophrenia, leading to feelings of powerlessness and helplessness towards their illness. In more severe cases, these auditory hallucinations can take the form of commanding voices, which are often related to high suicidality rates in these patients. Several authors propose that the meanings attributed to the hallucinatory experience, rather than characteristics like form and content, can be determinant in patients’ reactions to hallucinatory activity, particularly in the case of voice-hearing experiences. In this study, 48 patients diagnosed with paranoid schizophrenia presenting auditory hallucinations were studied. Multiple regression analyses were computed to study the influence of several developmental aspects, such as family and social dynamics, bullying, depression, and socio-cognitive variables on the auditory hallucinations, on patients’ attributions and relationships with their voices, and on the resulting invalidation of hallucinatory experience. Overall, results showed how relationships with voices can mirror several aspects of interpersonal relationship with others, and how self-schemas, depression and actual social relationships help shaping the voice-hearing experience. Early experiences of victimization and submission help predict the attributions of omnipotence of the voices, and increased hostility from parents seems to increase the malevolence of the voices, suggesting that socio-cognitive factors can significantly contribute to the etiology and maintenance of auditory hallucinations. The understanding of the characteristics of auditory hallucinations and the relationships patients established with their voices can allow the development of more promising therapeutic interventions that can be more effective in decreasing invalidation caused by this devastating mental illness.

Keywords: auditory hallucination, beliefs, life events, schizophrenia

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Authors: Maria L. G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal sepsis is a systemic response of acute infection by bacteria that may lead to high mortality in a litter. This study aims to report a case of sepsis by alpha-hemolytic Streptococcus and Mannheimia haemolytica in neonate dogs. A pregnant, mixed-breed bitch at approximately the 60th day of pregnancy was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, and subjected to a c-section due to uterine atony and fetuses no heartbeats on the ultrasound examination. The mother presented leukopenia of 1.6 thousand leukocytes, and there was no other information regarding previous clinical history. Among the offspring, four were stillborn, and five were born alive. On clinical examination, neonates weighed between 312 and 384 grams. Reflexes were present, and the newborn's body temperature was between 89.9 ºF and 96.4 ºF. Neonates also presented clinical signs of neonatal infection: omphalitis, abdomen, and extremities with cyanotic color, hematuria, and diarrhea (meconium). Complementary tests revealed leukopenia. The presence of alpha hemolytic streptococcus and Mannheimia haemolytica was revealed in the bacterial culture. The bacteria were sensitive to cephalosporins and penicillin on the antibiogram. Treatment for sepsis was instituted with the drug ceftriaxone, at a dose of 50 mg per kilogram, administered intravenous (jugular vein). Subsequently administered subcutaneous, every 12 hours, for seven days. Heated fluid therapy was performed, with Ringer lactate, at a dose of 4 ml per 100 grams of weight, intravenous. Heating measures were instituted. Blood plasma was also administered, at a dose of 2 mL per 100 grams of weight, administered subcutaneous, as a source of passive immunity. A maternal milk substitute was instituted, and lactation was discontinued since the mother was unable to nurse due to the infection. The mother was neutered during the c-section and treated with ceftriaxone (50 mg/kg). After seven days, the newborns presented normal clinical signs and no alterations in the hemogram. Early diagnosis and intervention were essential for the survival of these patients.

Keywords: neonatal infection, puppies, bacteria, newborn

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Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, João Casaca

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Using a geographic information system (GIS), the relations between a georeferenced data set of Culex pipiens sl. mosquitoes collected in Portugal mainland during seven years (2006-2012) and meteorological and physiographic parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures), daily total rainfall, altitude, land use/land cover and proximity to water bodies are evaluated. Focus is on the mosquito females; the characterization of its habitat is the key for the planning of chirurgical non-aggressive prophylactic countermeasures to avoid ambient degradation. The GIS allow for the spatial determination of the zones were the mosquito mean captures has been above average; using the meteorological values at these coordinates, the limits of each parameter are identified/computed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the thresholds obtained for each parameter. The intersection of the maps obtained for each month show the evolution of the area favorable to the species through the mosquito season, which is from May to October at these latitudes. In parallel, mean and above average captures were related to the physiographic parameters. Three levels of risk could be identified for each parameter, using above average captures as an index. The results were applied to the suitability meteorological maps of each month. The Culex pipiens critical niche is delimited, reflecting the critical areas and the level of risk for transmission of the pathogens to which they are competent vectors (West Nile virus, iridoviruses, rheoviruses and parvoviruses).

Keywords: Culex pipiens, ecological niche, risk assessment, risk management

Procedia PDF Downloads 521

Authors: Amine Ben Slama, Aymen Mouelhi, Sondes Manoubi, Chiraz Mbarek, Hedi Trabelsi, Mounir Sayadi, Farhat Fnaiech

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Vertigo is a sensation of feeling off balance; the cause of this symptom is very difficult to interpret and needs a complementary exam. Generally, vertigo is caused by an ear problem. Some of the most common causes include: benign paroxysmal positional vertigo (BPPV), Meniere's disease and vestibular neuritis (VN). In clinical practice, different tests of videonystagmographic (VNG) technique are used to detect the presence of vestibular neuritis (VN). The topographical diagnosis of this disease presents a large diversity in its characteristics that confirm a mixture of problems for usual etiological analysis methods. In this study, a vestibular neuritis analysis method is proposed with videonystagmography (VNG) applications using an estimation of pupil movements in the case of an uncontrolled motion to obtain an efficient and reliable diagnosis results. First, an estimation of the pupil displacement vectors using with Hough Transform (HT) is performed to approximate the location of pupil region. Then, temporal and frequency features are computed from the rotation angle variation of the pupil motion. Finally, optimized features are selected using Fisher criterion evaluation for discrimination and classification of the VN disease.Experimental results are analyzed using two categories: normal and pathologic. By classifying the reduced features using the Support Vector Machine (SVM), 94% is achieved as classification accuracy. Compared to recent studies, the proposed expert system is extremely helpful and highly effective to resolve the problem of VNG analysis and provide an accurate diagnostic for medical devices.

Keywords: nystagmus, vestibular neuritis, videonystagmographic system, VNG, Fisher criterion, support vector machine, SVM

Procedia PDF Downloads 125

Authors: Madeleine Cox

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Objective: discussion of diagnosis of vernix caseosa peritonitis, recovery and subsequent caesarean seciton Case: 30 year old G4P1 presented in labour at 40 weeks, planning a vaginal birth afterprevious caesarean section. She underwent an emergency caesarean section due to concerns for fetal wellbeing on CTG. She was found to have a thin lower segment with a very small area of dehiscence centrally. The operation was uncomplicated, and she recovered and went home 2 days later. She then represented to the emergency department day 6 post partum feeling very unwell, with significant abdominal pain, tachycardia as well as urinary retention. Raised white cell count of 13.7 with neutrophils of 11.64, CRP of 153. An abdominal ultrasound was poorly tolerated by the patient and did not aide in the diagnosis. Chest and abdominal xray were normal. She underwent a CT chest and abdomen, which found a small volume of free fluid with no apparent collection. Given no obvious cause of her symptoms were found and the patient did not improve, she had a repeat CT 2 days later, which showed progression of free fluid. A diagnostic laparoscopy was performed with general surgeons, which reveled turbid fluid, an inflamed appendix which was removed. The patient improved remarkably post operatively. The histology showed periappendicitis with acute appendicitis with marked serosal inflammatory reaction to vernix caseosa. Following this, the patient went on to recover well. 4 years later, the patient was booked for an elective caesarean section, on entry into the abdomen, there were very minimal adhesions, and the surgery and her subsequent recovery was uncomplicated. Discussion: this case represents the diagnostic dilemma of a patient who presents unwell without a clear cause. In this circumstance, multiple modes of imaging did not aide in her diagnosis, and so she underwent diagnostic surgery. It is important to evaluate if a patient is or is not responding to the typical causes of post operative pain and adjust management accordingly. A multiteam approach can help to provide a diagnosis for these patients. Conclusion: Vernix caseosa peritonitis is a rare cause of acute abdomen post partum. There are few reports in the literature of the initial presentation and no reports on the possible effects on future pregnancies. This patient did not have any complications in her following pregnancy or delivery secondary to her diagnosis of vernix caseosa peritonitis. This may assist in counselling other women who have had this uncommon diagnosis.

Keywords: peritonitis, obstetrics, caesarean section, pain

Procedia PDF Downloads 79

Authors: Fameli Kyriaki-Maria, Assimakopoulos D. Vasiliki, Kotroni Vassiliki

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The Greater Athens Area (GAA) faces photochemical and particulate pollution episodes as a result of the combined effects of local pollutant emissions, regional pollution transport, synoptic circulation and topographic characteristics. The area has undergone significant changes since the Athens 2004 Olympic Games because of large scale infrastructure works that lead to the shift of population to areas previously characterized as rural, the increase of the traffic fleet and the operation of highways. However, no recent modelling studies have been performed due to the lack of an accurate, updated emission inventory. The photochemical modelling system MM5/CAMx was applied in order to study the photochemical and particulate pollution characteristics above the GAA for two distinct ten-day periods in the summer of 2006 and 2010, where air pollution episodes occurred. A new updated emission inventory was used based on official data. Comparison of modeled results with measurements revealed the importance and accuracy of the new Athens emission inventory as compared to previous modeling studies. The model managed to reproduce the local meteorological conditions, the daily ozone and particulates fluctuations at different locations across the GAA. Higher ozone levels were found at suburban and rural areas as well as over the sea at the south of the basin. Concerning PM10, high concentrations were computed at the city centre and the southeastern suburbs in agreement with measured data. Source apportionment analysis showed that different sources contribute to the ozone levels, the local sources (traffic, port activities) affecting its formation.

Keywords: photochemical modelling, urban pollution, greater Athens area, MM5/CAMx

Procedia PDF Downloads 262

Authors: Nicholas Fletcher, Zachary Houston, Yongmei Zhao, Christopher Howard, Kristofer Thurecht

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One promising approach to enhance nanomedicine therapeutic efficacy is to include a targeting agent, such as an antibody, to increase accumulation at the tumor site. However, the application of such targeted nanomedicines remains limited, in part due to difficulties involved with biomolecule conjugation to synthetic nanomaterials. One approach recently developed to overcome this has been to engineer bispecific antibodies (BsAbs) with dual specificity, whereby one portion binds to methoxy polyethyleneglycol (mPEG) epitopes present on synthetic nanomedicines, while the other binds to molecular disease markers of interest. In this way, noncovalent complexes of nanomedicine core, comprising a hyperbranched polymer (HBP) of primarily mPEG, decorated with targeting ligands are able to be produced by simple mixing. Further work in this area has now demonstrated such complexes targeting the breast cancer marker epidermal growth factor receptor (EGFR) to show enhanced binding to tumor cells both in vitro and in vivo. Indeed the enhanced accumulation at the tumor site resulted in improved therapeutic outcomes compared to untargeted nanomedicines and free chemotherapeutics. The current work on these BsAb-HBP conjugates focuses on further probing antibody-nanomaterial interactions and demonstrating broad applicability to a range of cancer types. Herein are reported BsAb-HBP materials targeted towards prostate-specific membrane antigen (PSMA) and study of their behavior in vivo using ⁸⁹Zr positron emission tomography (PET) in a dual-tumor prostate cancer xenograft model. In this model mice bearing both PSMA+ and PSMA- tumors allow for PET imaging to discriminate between nonspecific and targeted uptake in tumors, and better quantify the increased accumulation following BsAb conjugation. Also examined is the potential for formation of these targeted complexes in situ following injection of individual components? The aim of this approach being to avoid undesirable clearance of proteinaceous complexes upon injection limiting available therapeutic. Ultimately these results demonstrate BsAb functionalized nanomaterials as a powerful and versatile approach for producing targeted nanomedicines for a variety of cancers.

Keywords: bioengineering, cancer, nanomedicine, polymer chemistry

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Authors: Abhishek Kumar Gupta

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Atomistic Molecular Dynamics (MD) Simulations have been performed to study the effect of monovalent salt i.e. NaCl concentration (Cs) and chain degree of neutralization (f) on the structure and dynamics of anionic poly(methacrylic acid) (PMA) in dilute aqueous solutions. In the present study, the attention is to unveil the conformational structure, hydrogen-bonding, local polyion-counterion structure, h-bond dynamics, chain dynamics and thermodynamic enthalpy of solvation of a-PMA in dilute aqueous solutions as a function of salt concentration, Cs and f. The results have revealed that at low salt concentration, the conformational radius of gyration (Rg) increases and then decreases reaching a maximum in agreement with the reported light scattering experimental results. The Rg at f = 1 shows a continual decrease and acquire a plateau value at higher salt concentration in agreement with results obtained by light scattering experiments. The radial distribution functions between PMA, salt and water atoms has been computed with respect to atom and centre-of-mass to understand the intermolecular structure in detail. The results pertaining to PMA chain conformations and hydrogen bond autocorrelation function showcasing the h-bond dynamics will be presented. The results pertaining to chain dynamics will be presented. The results pertaining to counterion condensation on the PMA chain shows greater condensation of Na+ ions on to the carboxylate ions with increase in salt concentration. Moreover, the solvation enthalpy of the system as a function of salt concentration will be presented.

Keywords: conformations, molecular dynamics simulations, NaCl concentration, radial distribution functions

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Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

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This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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Authors: Muhammad Asif ShakoorI, Maogang He, Aamir Shahzad

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Dusty (complex) plasmas contained micro-sized charged dust particles in addition to ions, electrons, and neutrals. It is typically low-temperature plasma and exists in a wide variety of physical systems. In this work, the effects of an external electric field on the diffusion coefficient and share viscosity are investigated through equilibrium molecular dynamics (EMD) simulations in three-dimensional (3D) strongly coupled (SC) dusty plasmas (DPs). The effects of constant and varying normalized electric field strength (E*) have been computed along with different combinations of plasma states on the diffusion of dust particles using EMD simulations. Diffusion coefficient (D) and share viscosity (η) along with varied system sizes, in the limit of varying E* values, is accounted for an appropriate range of plasma coupling (Γ) and screening strength (κ) parameters. At varying E* values, it is revealed that the 3D diffusion coefficient increases with increasing E* and κ; however, it decreases with an increase of Γ but within statistical limits. The share viscosity increases with increasing E*and Γ and decreases with increasing κ. New simulation results are outstanding that the combined effects of electric field and screening strengths give well-matched values of Dandη at low-intermediate to large Γ with varying small-intermediate to large N. The current EMD simulation outcomes under varying electric field strengths are in satisfactory well-matched with previous known simulation data of EMD simulations of the SC-DPs. It has been shown that the present EMD simulation data enlarged the range of E* strength up to 0.1 ≤ E*≤ 1.0 in order to find the linear range of the DPs system and to demonstrate the fundamental nature of electric field linearity of 3D SC-DPs.

Keywords: strongly coupled dusty plasma, diffusion coefficient, share viscosity, molecular dynamics simulation, electric field strength

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Authors: Dhananjoy Shaw, Seema Sharma (Kaushik)

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Anthropometry helps in associating the physical properties of an individual with their racial, cultural, and psychological attributes. Numerous research studies have included different skeletal diameters as a variable. However, most of the studies suggest their inclusion describing specific characteristics/traits of the body. However, there seems to be a scarcity of literature related to the effect of any kind of longitudinal physical training on human skeletal diameters. Hence, the present investigation was conducted to study the variability of covariance of selected skeletal diameters of females in a longitudinal physical training programme. The sample for the study was 78 college going students of the University of Delhi, classified equally in three groups, i.e. viz. (a) Progressive load of training or conditioning group coded as PLT; (b) Constant load of training or non-conditioning group coded as CLT; and (c) No-load or control or sedentary group coded as NL. Collectively, mean age of the sample was 19.54±1.79 years. The randomly selected samples were given maximum consideration to maintain their homogeneity. The variables included biacromial diameter, biiliocristal diameter, bitrochantaerion diameter, humeral bicondylar, femoral bicondylar, wrist diameter, ankle diameter, and foot breadth. Multi-group repeated measure design was adopted for the experimentation. Each group was measured four times after completion of each of the three meso-cycles of six-weeks duration. The measurements were taken following the standard landmarks and procedures. Mean, standard deviation, analysis of co-variance and its post-hoc analysis were computed to analyze the data statistically. The study concluded that both the progressive and constant load of physical training bring changes in the selected skeletal diameters of females. It also reflected the increase due to growth also along with training.

Keywords: longitudinal, physical training, skeletal diameters, step progression load

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Authors: Md. Rezaul Karim, Md. Ashikur Rahman, Dewan Mahmud Mim

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Scarcity of potable water as the result of rapid climate change and saltwater intrusion in groundwater has been a major problem in the coastal regions over the world. In equinoctial countries like Bangladesh, where sunlight is available for more than 10 hours a day, Solar Distillation provides a promising sustainable way for safe drinking water supply in coastal poor households with negligible major cost and difficulty of construction and maintenance. In this paper, two passive type solar stills- a Conventional Single Slope Solar still (CSS) and a Pyramid Solar Sill (PSS) is used and relationship is established between distill water output corresponding to four different factors- temperature, solar intensity, relative humidity and wind speed for Gazipur, Bangladesh. Comparison is analyzed between the two different still outputs for nine months period (January- September) and efficiency is calculated. Later a thermal mathematical model is developed and the distilled water output for Khulna, Bangladesh is computed. Again, difference between the output of the two cities- Gazipur and Khulna is demonstrated and finally an economic analysis is prepared. The distillation output has a positive correlation with temperature and solar intensity, inverse relation with relative humidity and wind speed has nugatory consequence. The maximum output of Conventional Solar Still is obtained 3.8 L/m2/day and Pyramid still is 4.3 L/m2/day for Gazipur and almost 15% more efficiency is found for Pyramid still. Productivity in Khulna is found almost 20% more than Gazipur. Based on economic analysis, taking 10 BDT, per liter, the net profit, benefit cost ratio, payback period all indicates that both stills are feasible but pyramid still is more feasible than Conventional Still. Finally, for a 3-4 member family, area of 4 m2 is suggested for Conventional Still and 3m2 for Pyramid Solar Still.

Keywords: solar distillation, household water supply, saline zones, Bangladesh

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Authors: Larry V. Aceres, Jesryl B. Paulite, Emelie M. Pelicano, J. B. Anciano, J. A. Esteban

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Enhancing the population of beneficial arthropods under less diverse agroecosystem is the most sought by many researchers and plant growers. This strategy was done through the establishment of pintoi peanut, Arachis pintoi as live mulch or cover crop in pummelo orchard of the University of Southeastern Philippines (USeP), Mabini, Compostela Valley Province, Philippines. This study was conducted to compare and compute population dynamics and diversity of beneficial arthropods in pummelo in with and without Arachis pintoi cover crop. Data collections were done for the 12-month period (from June 2013 to May 2014) at the pummelo orchard of USeP Mabini Campus, COMVAL Province, Philippines and data were analyzed using the Independent Samples T-Test to compare the effect of the presence and absence of Arachis pintoi on beneficial arthropods incidence in pummelo orchard. Moreover, diversity and family richness analyses were computed using the Margalef’s diversity index for family richness; the Shannon index of general diversity and the evenness index; and the Simpson index of dominance. Results revealed numerically and statistically higher density of important beneficial arthropods such as microhymenopterans, macrohymenopterans, spiders, tachinid flies and ground beetles were recorded in pummelo orchard with Arachis pintoi than from without Arachis pintoi cover crop for the 12-month observation period. Further, the result of the study revealed the high family richness and diversity index with more or less even distribution of individuals within the family and low dominance index were documented in pummelo with Arachis pintoi cover crop than from pummelo without Arachis pintoi cover crop. The study revealed that planting A. pintoi in pummelo orchard could enhance natural enemy populations.

Keywords: Arachis pintoi, cover crop, beneficial arthropods, pummelo

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Authors: Humaira Mujeeb, Farah Qadir

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The present study aimed to explore the association between interpersonal relationship and postpartum depression with a special focus on gender of the infant among women in Gilgit, Gilgit-Baltistan, Pakistan. The research was quantitative in nature. It was a correlation study with a cross-sectional study design. The target population was women between six weeks to six months after the delivery of a baby. The sample size of 158 women has been computed by using G*Power (3.0.10 version). The sample was taken through quota sampling technique which was used to gather data according to the specifically predefined groups (79 women with female infants and 79 women with male infants). The sample was selected non-randomly according to the fixed quota. A protocol which had demographic and interpersonal relationship variables alongside with the Urdu version Edinburgh postnatal depression scale was used to collect the relevant data. The data was analyzed by using SPSS 16.0 software package. A statistically significant association between the attachment with husband in women who had a female infant and postpartum depression has been found. The association between the husband’s emotional and physical support in women who had a female infant and postpartum depression had also been found significant. In case of women with a male infant, the association between support of in-laws and postpartum depression is statistically significant. An association between the violence/discrimination based on the basis of infant's gender in women who had a female infant and postpartum depression is also found. These findings points out that when studying the correlates of postpartum depression, it is imperative to carry out an analysis in the context of gender by considering gender of the infant especially in societies where strict gender preferences exists.

Keywords: infant, gender, attachment, husband, in-laws, support, violence, discrimination, Edinburgh postnatal depression scale, Gilgit, Pakistan

Procedia PDF Downloads 583

Authors: Nahla Al-Bayyari, Rae’d Hailat

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Vitamin D deficiency and overweight are common in women suffering from polycystic ovary syndrome (PCOS). Weight gain in PCOS is an important factor for the development of menstrual dysfunction and signs of hyperandrogenism and alopecia. Features of PCOS such as oligomenorrhea can be predicted by anthropometric measurements as body mass index (BMI). Therefore, the aim of this trial was to study the effect of 50,000 IU/week of vitamin D₃ supplementation on the body composition and on the anthropometric measurements of overweight women with PCOS and to examine the impact of this effect on ovaries ultrasonography and menstrual cycle regularity. The study design was a prospective randomized, double-blinded placebo-controlled clinical trial conducted on 60 overweight Jordanian women aged (18-49) years with PCOS and vitamin D deficiency. The study participants were divided into two groups; vitamin D group (n = 30) who were assigned to receive 50,000 IU/week of vitamin D₃ and placebo group (n = 30) who were assigned to receive placebo tablets orally for 90 days. The anthropometric measurements and body composition were measured at baseline and after treatment for the PCOS and vitamin D deficient women. Also, assessment of the participants’ picture of ovaries by ultrasound and menstrual cycle regulatory were performed before and after treatment. Results showed that there were no significant (p > 0.05) differences between the placebo and vitamin D group basal 25(OH)D levels, body composition and anthropometric parameters. After treatment, vitamin D group serum levels of 25(OH)D increased (12.5 ± 0.61 to 50.2 ± 2.04 ng/mL, (p < 0.001), and decreased (50.2 ± 2.04 to 48.2 ± 2.03 ng/mL, p < 0.001) after 14 days of vitamin D₃ treatment cessation. There were no significant changes in the placebo group. In the vitamin D group, there were significant (p < 0.001) decreases in body weight, BMI, waist, and hip circumferences and fat mass. In addition, there were significant increases (p < 0.05) in fat free mass and total body water. These improvements in both anthropometric and body composition as well as in 25(OH)D concentrations, resulted in significant improvements in the picture of PCOS women ovaries ultrasonography and in menstrual cycle regularity, where nearly most of them (93%) had regular cycles after vitamin D₃ supplementation. In the placebo group, there were only significant decreases (p < 0.05) in waist and hip circumferences. It can be concluded that vitamin D supplementation improving serum 25(OH)D levels and PCOS prognosis by reducing body weight of overweight PCOS women and regulating their menstrual cycle.

Keywords: anthropometric, overweight, polycystic ovary syndrome, vitamin D₃

Procedia PDF Downloads 94

Authors: Okuyade Ighoroje Wilson Ata

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Magneto-hydrodynamic mixed convective chemically reacting fluid flow through two parallel vertical plates channel with Hall, radiation, and chemical reaction effects are examined. The fluid is assumed to be chemically reactive, electrically conducting, magnetically susceptible, viscous, incompressible, and Newtonian; the plates are porous, electrically conductive, and heated to a high-temperature regime to generate thermal rays. The flow system is highly interactive, such that cross/double diffusion is present. The governing equations are partial differential equations transformed into ordinary differential equations using similarity transformation and solved by the method of Homotopy Perturbation. Expressions for the concentration, temperature, velocity, Nusselt number, Sherwood number, and Wall shear stress are obtained, computed, and presented graphically and tabularly. The analysis of results shows, amongst others, that an increase in the Raleigh number increases the main velocity and temperature but decreases the concentration. More so, an increase in chemical reaction rate increases the main velocity, temperature, rate of heat transfer from the terminal plate, the rate of mass transfer from the induced plate, and Wall shear stress on both the induced and terminal plates, decreasing the concentration, and the mass transfer rate from the terminal plate. Some of the obtained results are benchmarked with those of existing literature and are in consonance.

Keywords: chemical reaction, hall effect, magneto-hydrodynamic, radiation, vertical plates channel

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Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

Procedia PDF Downloads 197

Authors: Carol Anne Hargreaves

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A key issue in stock investment is how to select representative features for stock selection. The objective of this paper is to firstly determine whether an automated stock investment system, using machine learning techniques, may be used to identify a portfolio of growth stocks that are highly likely to provide returns better than the stock market index. The second objective is to identify the technical features that best characterize whether a stock’s price is likely to go up and to identify the most important factors and their contribution to predicting the likelihood of the stock price going up. Unsupervised machine learning techniques, such as cluster analysis, were applied to the stock data to identify a cluster of stocks that was likely to go up in price – portfolio 1. Next, the principal component analysis technique was used to select stocks that were rated high on component one and component two – portfolio 2. Thirdly, a supervised machine learning technique, the logistic regression method, was used to select stocks with a high probability of their price going up – portfolio 3. The predictive models were validated with metrics such as, sensitivity (recall), specificity and overall accuracy for all models. All accuracy measures were above 70%. All portfolios outperformed the market by more than eight times. The top three stocks were selected for each of the three stock portfolios and traded in the market for one month. After one month the return for each stock portfolio was computed and compared with the stock market index returns. The returns for all three stock portfolios was 23.87% for the principal component analysis stock portfolio, 11.65% for the logistic regression portfolio and 8.88% for the K-means cluster portfolio while the stock market performance was 0.38%. This study confirms that an automated stock investment system using machine learning techniques can identify top performing stock portfolios that outperform the stock market.

Keywords: machine learning, stock market trading, logistic regression, cluster analysis, factor analysis, decision trees, neural networks, automated stock investment system

Procedia PDF Downloads 138

Authors: D. F. Carvalho, A. O. Uscamayta, J. C. Guerrero, H. F. Oliveira, P. M. Azevedo-Marques

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The creation of vector contours slices (ROIs) on body silhouettes in oncologic patients is an important step during the radiotherapy planning in clinic and hospitals to ensure the accuracy of oncologic treatment. The radiotherapy planning of patients is performed by complex softwares focused on analysis of tumor regions, protection of organs at risk (OARs) and calculation of radiation doses for anomalies (tumors). These softwares are supplied for a few manufacturers and run over sophisticated workstations with vector processing presenting a cost of approximately twenty thousand dollars. The Brazilian project SIPRAD (Radiotherapy Planning System) presents a proposal adapted to the emerging countries reality that generally does not have the monetary conditions to acquire some radiotherapy planning workstations, resulting in waiting queues for new patients treatment. The SIPRAD project is composed by a set of integrated and interoperabilities softwares that are able to execute all stages of radiotherapy planning on simple personal computers (PCs) in replace to the workstations. The goal of this work is to present an image processing technique, computationally feasible, that is able to perform an automatic contour delineation in patient body silhouettes (SIPRAD-Body). The SIPRAD-Body technique is performed in tomography slices under grayscale images, extending their use with a greedy algorithm in three dimensions. SIPRAD-Body creates an irregular polyhedron with the Canny Edge adapted algorithm without the use of preprocessing filters, as contrast and brightness. In addition, comparing the technique SIPRAD-Body with existing current solutions is reached a contours similarity at least 78%. For this comparison is used four criteria: contour area, contour length, difference between the mass centers and Jaccard index technique. SIPRAD-Body was tested in a set of oncologic exams provided by the Clinical Hospital of the University of Sao Paulo (HCRP-USP). The exams were applied in patients with different conditions of ethnology, ages, tumor severities and body regions. Even in case of services that have already workstations, it is possible to have SIPRAD working together PCs because of the interoperability of communication between both systems through the DICOM protocol that provides an increase of workflow. Therefore, the conclusion is that SIPRAD-Body technique is feasible because of its degree of similarity in both new radiotherapy planning services and existing services.

Keywords: radiotherapy, image processing, DICOM RT, Treatment Planning System (TPS)

Procedia PDF Downloads 281

Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

Procedia PDF Downloads 76

Authors: Gelacio JuáRez-Luna, Daniel Enrique GonzáLez-RamíRez, Enrique Tenorio-Montero

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Frame elements coupled with springs elements are used for modelling the development of hinges in segmented tunnels, the spring elements modelled the rotational, transversal and axial failure. These spring elements are equipped with constitutive models to include independently the moment, shear force and axial force, respectively. These constitutive models are formulated based on damage mechanics and experimental test reported in the literature review. The mesh of the segmented tunnels was discretized in the software GID, and the nonlinear analyses were carried out in the finite element software ANSYS. These analyses provide the capacity curve of the primary and secondary lining of a segmented tunnel. Two numerical examples of segmented tunnels show the capability of the spring elements to release energy by the development of hinges. The first example is a segmental concrete lining discretized with frame elements loaded until hinges occurred in the lining. The second example is a tunnel with primary and secondary lining, discretized with a double ring frame model. The outer ring simulates the segmental concrete lining and the inner ring simulates the secondary cast-in-place concrete lining. Spring elements also modelled the joints between the segments in the circumferential direction and the ring joints, which connect parallel adjacent rings. The computed load vs displacement curves are congruent with numerical and experimental results reported in the literature review. It is shown that the modelling of a tunnel with primary and secondary lining with frame elements and springs provides reasonable results and save computational cost, comparing with 2D or 3D models equipped with smeared crack models.

Keywords: damage, hinges, lining, tunnel

Procedia PDF Downloads 374

Authors: Emil Iskandarov, Nazrin Agayeva

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Background: The effectiveness of hormone suppressive therapy (HST) in patients with nodular goiter (NG) is controversial. The aim of this study was to identify the impact of long-time HST on the Quality of Life (QoL) of patients with NG. Material and Methods: A retrospective analysis of 146 patients with NG showed treated with HST showed that in 38,4% of cases, HST was not effective. Nodules were increased in size and moreover, and new nodules were developed. Statistical procedure identified the predictors of resistant nodules: only one nodule in the left lobe; nodule size >17mm; calcinate within the nodule. 174 patients with NG, by whom predictors of resistant nodules were established, were informed about the results of previous research and surgery was suggested. Eighty-eight patients (the basic group) agreed with surgery and thyroidectomy was led. 86 patients (control group) ignored the suggestion and wished to receive HST. 3, 6 and 12 months after starting HST; control group patients were examined. HST was non-effective and patients, due to developing symptoms, were operated on. Patients in both groups were followed up 3, 6 and 12 months after thyroidectomy. Quality of Life was checked with the SF-36 survey form and compared between groups. The statistical analysis was performed with the non-parametric Mann–Whitney U test and with the Student t-test. P values ＜0.05 were considered statistically significant. Results and Discussions: QoL of patients in the basic and control groups 3 months after surgery was almost the same. However, Emotional problems severely interfered with patients in a control group with normal social activities with family, friends, and neighbors. The causes were related to the non-effective HST treatment before surgery: stress for forgetting to take drugs timely every day for a long time; blood tests for thyroid hormone level; needle biopsies of nodules for cancer screening and regular ultrasound investigations, which showed that nodules not diminished in size. Changing the treatment method after 1-year non-effective HST and delayed surgery negatively impacted patient's QoL. Social role functioning and mental health in the control group were also impaired and the difference between the results in the basic group was statistically significant (p <0.05). Conclusion: Predictors, such as only one nodule, the width of nodules more than 17mm, and the existence of calcinate within the nodule, are able to forecast the resistant nodules. HST in patients with resistant nodules is non-effective and surgery is suggested in patients with resistant nodules in the thyroid gland. Long time HST has a negative impact on the QoL patient after surgery.

Keywords: thyroid gland, nodule, hormone suppressive therapy, quality of life

Procedia PDF Downloads 111