Search results for: bilateral back projection
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2079

Search results for: bilateral back projection

759 Older Adult Grandparents' Voices as a Principle Care Giver in a Skipped-Generation Family

Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

Abstract:

In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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758 Enabling Cloud Adoption Based Secured Mobile Banking through Backend as a Service

Authors: P. S. Jagadeesh Kumar, S. Meenakshi Sundaram

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With the increase of prevailing non-traditional rivalry, mobile banking experiences an ever changing commercial backdrop. Substantial customer demands have established to be more intricate as customers request more expediency and superintend over their banking services. To enterprise advance and modernization in mobile banking applications, it is gradually obligatory to deeply leapfrog the scuffle using business model transformation. The dramaturgical vicissitudes taking place in mobile banking entail advanced traditions to exploit security. By reforming and transforming older back office into integrated mobile banking applications, banks can engender a supple and nimble banking environment that can rapidly respond to new business requirements over cloud computing. Cloud computing is transfiguring ecosystems in numerous industries, and mobile banking is no exemption providing services innovation, greater flexibility to respond to improved security and enhanced business intelligence with less cost. Cloud technology offer secure deployment possibilities that can provision banks in developing new customer experiences, empower operative relationship and advance speed to efficient banking transaction. Cloud adoption is escalating quickly since it can be made secured for commercial mobile banking transaction through backend as a service in scrutinizing the security strategies of the cloud service provider along with the antiquity of transaction details and their security related practices.

Keywords: cloud adoption, backend as a service, business intelligence, secured mobile banking

Procedia PDF Downloads 237
757 Evaluation of Nematicidal Action of Some Botanicals on Plant-Parasitic Nematode

Authors: Lakshmi, Yakshita Awasthi, Deepika, Lovleen Jha, Archna Kumar

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From the back of centuries, plant-parasitic nematodes (PPN) have been recognized as a major threat to agriculturalists globally. It causes 21.3% global food loss annually. The utilization of harmful chemical pesticides to minimize the nematode population may cause acute and delayed health hazards and harmful impacts on human health. In recent years, a variety of plants have been evaluated for their nematicidal properties and efficacy in the management of plant-parasitic nematodes. Several Phyto-nematicides are available, but most of them are incapable of sustainable management of PPN, especially Meloidogyne spp. Thus, there is a great need for a new eco-friendly, highly efficient, sustainable control measure for this nematode species. Keeping all these facts and after reviewing the literature, aqueous extract of Cymbopogon citratus, Tagetes erecta, and Azadirachta indica were prepared by adding distilled water (1 g sample mixed with 10ml of water). In vitro studies were conducted to evaluate the efficacious nature of targeted botanicals against PPN Meloidogyne spp. The mortality status of PPN was recorded by counting the live and dead individuals after applying 100μl of selected extract. The impact was observed at different time durations, i.e., 24h and 48h. The result showed that the highest 100% mortality was at 48h in all three extracts. Thus, these extracts, with the addition of a suitable shelf-life enhancer, may be exploited in different nematode control programs as an economical, sustainable measure.

Keywords: Meloidogyne, Cymbopogon citratus, Tagetes erecta, Azadirachta indica, nematicidal

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756 Mitigation Measures for the Acid Mine Drainage Emanating from the Sabie Goldfield: Case Study of the Nestor Mine

Authors: Rudzani Lusunzi, Frans Waanders, Elvis Fosso-Kankeu, Robert Khashane Netshitungulwana

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The Sabie Goldfield has a history of gold mining dating back more than a century. Acid mine drainage (AMD) from the Nestor mine tailings storage facility (MTSF) poses a serious threat to the nearby ecosystem, specifically the Sabie River system. This study aims at developing mitigation measures for the AMD emanating from the Nestor MTSF using materials from the Glynns Lydenburg MTSF. The Nestor MTSF (NM) and the Glynns Lydenburg MTSF (GM) each provided about 20 kg of bulk composite samples. Using samples from the Nestor MTSF and the Glynns Lydenburg MTSF, two mixtures were created. MIX-A is a mixture that contains 25% weight percent (GM) and 75% weight percent (NM). MIX-B is the name given to the second mixture, which contains 50% AN and 50% AG. The same static test, i.e., acid–base accounting (ABA), net acid generation (NAG), and acid buffering characteristics curve (ABCC) was used to estimate the acid-generating probabilities of samples NM and GM for MIX-A and MIX-B. Furthermore, the mineralogy of the Nestor MTSF samples consists of the primary acid-producing mineral pyrite as well as the secondary minerals ferricopiapite and jarosite, which are common in acidic conditions. The Glynns Lydenburg MTSF samples, on the other hand, contain primary acid-neutralizing minerals calcite and dolomite. Based on the assessment conducted, materials from the Glynns Lydenburg are capable of neutralizing AMD from Nestor MTSF. Therefore, the alkaline tailings materials from the Glynns Lydenburg MTSF can be used to rehabilitate the acidic Nestor MTSF.

Keywords: Nestor Mine, acid mine drainage, mitigation, Sabie River system

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755 Analysis of the Relationship between Micro-Regional Human Development and Brazil's Greenhouse Gases Emission

Authors: Geanderson Eduardo Ambrósio, Dênis Antônio Da Cunha, Marcel Viana Pires

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Historically, human development has been based on economic gains associated with intensive energy activities, which often are exhaustive in the emission of Greenhouse Gases (GHGs). It requires the establishment of targets for mitigation of GHGs in order to disassociate the human development from emissions and prevent further climate change. Brazil presents itself as one of the most GHGs emitters and it is of critical importance to discuss such reductions in intra-national framework with the objective of distributional equity to explore its full mitigation potential without compromising the development of less developed societies. This research displays some incipient considerations about which Brazil’s micro-regions should reduce, when the reductions should be initiated and what its magnitude should be. We started with the methodological assumption that human development and GHGs emissions arise in the future as their behavior was observed in the past. Furthermore, we assume that once a micro-region became developed, it is able to maintain gains in human development without the need of keep growing GHGs emissions rates. The human development index and the carbon dioxide equivalent emissions (CO2e) were extrapolated to the year 2050, which allowed us to calculate when the micro-regions will become developed and the mass of GHG’s emitted. The results indicate that Brazil must throw 300 GT CO2e in the atmosphere between 2011 and 2050, of which only 50 GT will be issued by micro-regions before it’s develop and 250 GT will be released after development. We also determined national mitigation targets and structured reduction schemes where only the developed micro-regions would be required to reduce. The micro-region of São Paulo, the most developed of the country, should be also the one that reduces emissions at most, emitting, in 2050, 90% less than the value observed in 2010. On the other hand, less developed micro-regions will be responsible for less impactful reductions, i.e. Vale do Ipanema will issue in 2050 only 10% below the value observed in 2010. Such methodological assumption would lead the country to issue, in 2050, 56.5% lower than that observed in 2010, so that the cumulative emissions between 2011 and 2050 would reduce by 130 GT CO2e over the initial projection. The fact of associating the magnitude of the reductions to the level of human development of the micro-regions encourages the adoption of policies that favor both variables as the governmental planner will have to deal with both the increasing demand for higher standards of living and with the increasing magnitude of reducing emissions. However, if economic agents do not act proactively in local and national level, the country is closer to the scenario in which emits more than the one in which mitigates emissions. The research highlighted the importance of considering the heterogeneity in determining individual mitigation targets and also ratified the theoretical and methodological feasibility to allocate larger share of contribution for those who historically emitted more. It is understood that the proposals and discussions presented should be considered in mitigation policy formulation in Brazil regardless of the adopted reduction target.

Keywords: greenhouse gases, human development, mitigation, intensive energy activities

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754 Effective Affordable Housing Finance in Developing Economies: An Integration of Demand and Supply Solutions

Authors: Timothy Akinwande, Eddie Hui, Karien Dekker

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Housing the urban poor remains a persistent challenge, despite evident research attention over many years. It is, therefore, pertinent to investigate affordable housing provision challenges with novel approaches. For innovative solutions to affordable housing constraints, it is apposite to thoroughly examine housing solutions vis a vis the key elements of the housing supply value chain (HSVC), which are housing finance, housing construction and land acquisition. A pragmatic analysis will examine affordable housing solutions from demand and supply perspectives to arrive at consolidated solutions from bilateral viewpoints. This study thoroughly examined informal housing finance strategies of the urban poor and diligently investigated expert opinion on affordable housing finance solutions. The research questions were: (1) What mutual grounds exist between informal housing finance solutions of the urban poor and housing expert solutions to affordable housing finance constraints in developing economies? (2) What are effective approaches to affordable housing finance in developing economies from an integrated demand - supply perspective? Semi-structured interviews were conducted in the 5 largest slums of Lagos, Nigeria, with 40 informal settlers for demand-oriented solutions, while focus group discussion and in-depth interviews were conducted with 12 housing experts in Nigeria for supply-oriented solutions. Following a rigorous thematic, content and descriptive analyses of data using NVivo and Excel, findings ascertained mutual solutions from both demand and supply standpoints that can be consolidated into more effective affordable housing finance solutions in Nigeria. Deliberate finance models that recognise and include the finance realities of the urban poor was found to be the most significant supply-side housing finance solution, representing 25.4% of total expert responses. Findings also show that 100% of sampled urban poor engage in vocations where they earn little irregular income or zero income, limiting their housing finance capacities and creditworthiness. Survey revealed that the urban poor are involved in community savings and employ microfinance institutions within the informal settlements to tackle their housing finance predicaments. These are informal finance models of the urban poor, revealing common grounds between demand and supply solutions for affordable housing financing. Effective, affordable housing approach will be to modify, institutionalise and incorporate the informal finance strategies of the urban poor into deliberate government policies. This consolidation of solutions from demand and supply perspectives can eliminate the persistent misalliance between affordable housing demand and affordable housing supply. This study provides insights into mutual housing solutions from demand and supply perspectives, and findings are informative for effective, affordable housing provision approaches in developing countries. This study is novel in consolidating affordable housing solutions from demand and supply viewpoints, especially in relation to housing finance as a key component of HSVC. The framework for effective, affordable housing finance in developing economies from a consolidated viewpoint generated in this study is significant for the achievement of sustainable development goals, especially goal 11 for sustainable, resilient and inclusive cities. Findings are vital for future housing studies.

Keywords: affordable housing, affordable housing finance, developing economies, effective affordable housing, housing policy, urban poor, sustainable development goal, sustainable affordable housing

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753 Feasibility Study of Friction Stir Welding Application for Kevlar Material

Authors: Ahmet Taşan, Süha Tirkeş, Yavuz Öztürk, Zafer Bingül

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Friction stir welding (FSW) is a joining process in the solid state, which eliminates problems associated with the material melting and solidification, such as cracks, residual stresses and distortions generated during conventional welding. Among the most important advantages of FSW are; easy automation, less distortion, lower residual stress and good mechanical properties in the joining region. FSW is a recent approach to metal joining and although originally intended for aluminum alloys, it is investigated in a variety of metallic materials. The basic concept of FSW is a rotating tool, made of non-consumable material, specially designed with a geometry consisting of a pin and a recess (shoulder). This tool is inserted as spinning on its axis at the adjoining edges of two sheets or plates to be joined and then it travels along the joining path line. The tool rotation axis defines an angle of inclination with which the components to be welded. This angle is used for receiving the material to be processed at the tool base and to promote the gradual forge effect imposed by the shoulder during the passage of the tool. This prevents the material plastic flow at the tool lateral, ensuring weld closure on the back of the pin. In this study, two 4 mm Kevlar® plates which were produced with the Kevlar® fabrics, are analyzed with COMSOL Multiphysics in order to investigate the weldability via FSW. Thereafter, some experimental investigation is done with an appropriate workbench in order to compare them with the analysis results.

Keywords: analytical modeling, composite materials welding, friction stir welding, heat generation

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752 Providing Reliability, Availability and Scalability Support for Quick Assist Technology Cryptography on the Cloud

Authors: Songwu Shen, Garrett Drysdale, Veerendranath Mannepalli, Qihua Dai, Yuan Wang, Yuli Chen, David Qian, Utkarsh Kakaiya

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Hardware accelerator has been a promising solution to reduce the cost of cloud data centers. This paper investigates the QoS enhancement of the acceleration of an important datacenter workload: the webserver (or proxy) that faces high computational consumption originated from secure sockets layer (SSL) or transport layer security (TLS) procession in the cloud environment. Our study reveals that for the accelerator maintenance cases—need to upgrade driver/firmware or hardware reset due to hardware hang; we still can provide cryptography services by switching to software during maintenance phase and then switching back to accelerator after maintenance. The switching is seamless to server application such as Nginx that runs inside a VM on top of the server. To achieve this high availability goal, we propose a comprehensive fallback solution based on Intel® QuickAssist Technology (QAT). This approach introduces an architecture that involves the collaboration between physical function (PF) and virtual function (VF), and collaboration among VF, OpenSSL, and web application Nginx. The evaluation shows that our solution could provide high reliability, availability, and scalability (RAS) of hardware cryptography service in a 7x24x365 manner in the cloud environment.

Keywords: accelerator, cryptography service, RAS, secure sockets layer/transport layer security, SSL/TLS, virtualization fallback architecture

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751 A Research on the Benefits of Drone Usage in Industry by Determining Companies Using Drone in the World

Authors: Ahmet Akdemir, Güzide Karakuş, Leyla Polat

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Aviation that has been arisen in accordance with flying request that is existing inside of people, has not only made life easier by making a great contribution to humanity; it has also accelerated globalization by reducing distances between countries. It is seen that the growth rate of aviation industry has reached the undreamed level when it is looked back on. Today, the last point in aviation is unmanned aerial vehicles that are self-ventilating and move in desired coordinates without any onboard pilot. For those vehicles, there are two different control systems are developed. In the first type of control, an unmanned aerial vehicle (UAV) moves according to instructions of a remote control. UAV that moves with a remote control is named as drone; it can be used personally. In the second one, there is a flight plan that is programmed and placed inside of UAV before flight. Recently, drones have started to be used in unimagined areas and utilize specific, important benefits for any industry. Within this framework, this study answers the question that is drone usage would be beneficial for businesses or not. To answer this question, applied basic methodologies are determining businesses using drone in the world, their purposes to use drone, and then, comparing their economy as before drone and after drone. In the end of this study, it is seen that many companies in different business areas use drone in logistics support, and it makes their work easier than before. This paper has contributed to academic literature about this subject, and it has introduced the benefits of drone usage for businesses. In addition, it has encouraged businesses that they keep pace with this technological age by following the developments about drones.

Keywords: aviation, drone, drone in business, unmanned aerial vehicle

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750 Motor Vehicle Accidents During Pregnancy: Analysis of Maternal and Fetal Outcome at a University Hospital

Authors: Manjunath Attibele, Alsawafi Manal, Al Dughaishi Tamima

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Introduction: The purpose of this study was to describe the clinical characteristics and types of mechanisms of injuries caused by Motor vehicle accidents (MVA) during pregnancy. To analyze the patterns of accidents during pregnancy and its adverse consequences on both maternal and fetal outcome. Methods: This was a retrospective cohort study on pregnant patients who met with MVAs The study period was from January 1, 2010, to December 31, 2019. All relevant data were retrieved from electronic patients’ records from the hospital information system and from the antenatal ward admission register Results: Out of 168 women who had motor vehicle accidents during the study period, of which, 39 (23.2%) women during pregnancy. Twenty-one (53.8%) women were over 30 years old. Thirty-five (89.7%) women were Omanis, and 27 (69.2%) were in their third trimester. Twenty-three (59%) of accidents happened at night, and 31 (79.5%) of them happened on a weekday. Twenty-two (56.4%) of women were driving themselves, and 24 (61.5%) of them were not using any seatbelt. Accident related abdominal & back pain was seen in 23(59%) women. Regarding the outcome of pregnancy, 23 (74.2%) had a normal vaginal delivery. The mean accident to delivery interval was 7 weeks. Thirty (96.7%) of involved newborns were relatively healthy. One woman (3.2%) had a ruptured uterusleading to fetal death (3.2%). Conclusion: This study showed that the incidence of motor vehicle accidents during pregnancy is around 23.2% . Majority had trauma-associated pain. One serious injury to a woman causing a ruptured uterus which lead to fetal death. Majority of involved newborns were relatively healthy. No reported maternal death.

Keywords: motor vehicle accidents, pregnancy, maternal outcome, fetal outcome

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749 Voice Liveness Detection Using Kolmogorov Arnold Networks

Authors: Arth J. Shah, Madhu R. Kamble

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Voice biometric liveness detection is customized to certify an authentication process of the voice data presented is genuine and not a recording or synthetic voice. With the rise of deepfakes and other equivalently sophisticated spoofing generation techniques, it’s becoming challenging to ensure that the person on the other end is a live speaker or not. Voice Liveness Detection (VLD) system is a group of security measures which detect and prevent voice spoofing attacks. Motivated by the recent development of the Kolmogorov-Arnold Network (KAN) based on the Kolmogorov-Arnold theorem, we proposed KAN for the VLD task. To date, multilayer perceptron (MLP) based classifiers have been used for the classification tasks. We aim to capture not only the compositional structure of the model but also to optimize the values of univariate functions. This study explains the mathematical as well as experimental analysis of KAN for VLD tasks, thereby opening a new perspective for scientists to work on speech and signal processing-based tasks. This study emerges as a combination of traditional signal processing tasks and new deep learning models, which further proved to be a better combination for VLD tasks. The experiments are performed on the POCO and ASVSpoof 2017 V2 database. We used Constant Q-transform, Mel, and short-time Fourier transform (STFT) based front-end features and used CNN, BiLSTM, and KAN as back-end classifiers. The best accuracy is 91.26 % on the POCO database using STFT features with the KAN classifier. In the ASVSpoof 2017 V2 database, the lowest EER we obtained was 26.42 %, using CQT features and KAN as a classifier.

Keywords: Kolmogorov Arnold networks, multilayer perceptron, pop noise, voice liveness detection

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748 Effects of Using Alternative Energy Sources and Technologies to Reduce Energy Consumption and Expenditure of a Single Detached House

Authors: Gul Nihal Gugul, Merih Aydinalp-Koksal

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In this study, hourly energy consumption model of a single detached house in Ankara, Turkey is developed using ESP-r building energy simulation software. Natural gas is used for space heating, cooking, and domestic water heating in this two story 4500 square feet four-bedroom home. Hourly electricity consumption of the home is monitored by an automated meter reading system, and daily natural gas consumption is recorded by the owners during 2013. Climate data of the region and building envelope data are used to develop the model. The heating energy consumption of the house that is estimated by the ESP-r model is then compared with the actual heating demand to determine the performance of the model. Scenarios are applied to the model to determine the amount of reduction in the total energy consumption of the house. The scenarios are using photovoltaic panels to generate electricity, ground source heat pumps for space heating and solar panels for domestic hot water generation. Alternative scenarios such as improving wall and roof insulations and window glazing are also applied. These scenarios are evaluated based on annual energy, associated CO2 emissions, and fuel expenditure savings. The pay-back periods for each scenario are also calculated to determine best alternative energy source or technology option for this home to reduce annual energy use and CO2 emission.

Keywords: ESP-r, building energy simulation, residential energy saving, CO2 reduction

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747 The Concepts of Ibn Taymiyyah in Halal and Haram and Their Relevance to Contemporary Issues

Authors: Muhammad Fakhrul Arrazi

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Ibn Taymiyyah is a great figure in Islam. His works have become the reference for many Muslims in implementing the fiqh of Ibadah and Muamalat. This article reviews the concepts that Ibn Taymiyyah has initiated in Halal and Haram, long before the books on Halal and Haram are written by contemporary scholars. There are at least four concepts of Halal and Haram ever spawned by Ibn Taymiyyah. First, the belief of a jurist (Faqih) in a matter that is Haram does not necessarily make the matter Haram. Haram arises from the Quran, Sunnah, Ijma’ and Qiyas as the tarjih. Due to the different opinions among the ulama, we should revisit this concept. Second, if a Muslim involves in a transaction (Muamalat), believes it permissible and gets money from such transaction, then it is legal for other Muslims to transact with the property of this Muslim brother, even if he does not believe that the transactions made by his Muslims brother are permissible. Third, Haram is divided into two; first is Haram because of the nature of an object, such as carrion, blood, and pork. If it is mixed with water or food and alters their taste, color, and smell, the food and water become Haram. Second is Haram because of the way it is obtained such as a stolen item and a broken aqad. If it is mixed with the halal property, the property does not automatically become Haram. Fourth, a treasure whose owners cannot be traced back then it is used for the benefit of the ummah. This study used the secondary data from the classics books by Ibn Taymiyyah, particularly those entailing his views on Halal and Haram. The data were then analyzed by using thematic and comparative approach. It is found that most of the concepts proposed by Ibn Taymiyyah in Halal and Haram correspond the majority’s views in the schools. However, some of his concepts are also in contrary to other scholars. His concepts will benefit the ummah, should it be applied to the contemporary issues.

Keywords: fiqh Muamalat, halal, haram, Ibn Taymiyyah

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746 Using Cyclic Structure to Improve Inference on Network Community Structure

Authors: Behnaz Moradijamei, Michael Higgins

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Identifying community structure is a critical task in analyzing social media data sets often modeled by networks. Statistical models such as the stochastic block model have proven to explain the structure of communities in real-world network data. In this work, we develop a goodness-of-fit test to examine community structure's existence by using a distinguishing property in networks: cyclic structures are more prevalent within communities than across them. To better understand how communities are shaped by the cyclic structure of the network rather than just the number of edges, we introduce a novel method for deciding on the existence of communities. We utilize these structures by using renewal non-backtracking random walk (RNBRW) to the existing goodness-of-fit test. RNBRW is an important variant of random walk in which the walk is prohibited from returning back to a node in exactly two steps and terminates and restarts once it completes a cycle. We investigate the use of RNBRW to improve the performance of existing goodness-of-fit tests for community detection algorithms based on the spectral properties of the adjacency matrix. Our proposed test on community structure is based on the probability distribution of eigenvalues of the normalized retracing probability matrix derived by RNBRW. We attempt to make the best use of asymptotic results on such a distribution when there is no community structure, i.e., asymptotic distribution under the null hypothesis. Moreover, we provide a theoretical foundation for our statistic by obtaining the true mean and a tight lower bound for RNBRW edge weights variance.

Keywords: hypothesis testing, RNBRW, network inference, community structure

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745 Midterm Clinical and Functional Outcomes After Treatment with Ponseti Method for Idiopathic Clubfeet: A Prospective Cohort Study

Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur

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Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

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744 The Role of Development in Settling Migration Crisis: The Preventive Approach of the European Union in Relations with Sub-Saharan African States

Authors: Artsiom Zinchanka

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The world faces now one of the largest migration crisis and the European Union meets challenges in accepting the flow of migrants that could not be handled finally at this step. This crisis is complicated with many factors, such as military conflict in the Middle East; absence of the appropriate conditions in the refugees’ camps; but also with the complicity of the migration flow consisting of the Sub-Saharan migrants. This type of migrants leave their homelands for many reasons including poverty, not appropriate level of social and economic conditions, absence of infrastructure and access to the education and medical care. In practice, when the restrictive approach directed to limit the flow of illicit migration and to send illicit migrants back to their homelands is not always working, the approach directed to the root causes of the migration crisis can be more effective in settling the crisis. The Cotonou Agreement and the following treaties concluded between the European Union, and Sub-Saharan states show that the European Union considers the development of human rights and appropriate social and economic conditions in the Sub-Saharan states as one of the most important factors addressing the migration crisis. The preventive approach as the efforts of the European Union to develop appropriate social and economic conditions in Sub-Saharan states is considered in this article, as well as its evolution and current condition. This article also considers pros and cons of this approach and the obstacles that this approach faces. The research methods include review of literature and documents, analytical and descriptive methods.

Keywords: migration crisis, preventive approach, Sub-Saharan States, the European Union

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743 Injury Prevention among Construction Workers: A Case Study on Iranian Steel Bar Bending Workers

Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl

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Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.

Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method

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742 Health Hazards in SME Garment Industries in India

Authors: Pranab Kumar Goswami

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According to WHO, over 1000 million people worldwide are employed in small-scale industries. The ‘garment’ industry’ is one such industry in developing countries. These garment SMEs are mostly run by private establishments in the unorganized sector to avoid legal obligations of OSH provisions. The OSH standards are very poor and even basic health and safety provisions are not provided in such units. The study has been conducted in India among workers employed in the ‘garment’ industry with the objectives to analyze the types and extent of occupational health hazards of the garment workers and to assess the relationship of sociodemographic and occupational factors with various health hazards. The survey method, the tabular method followed by applying simple statistical technique, has been taken into account to analyze the data collected from three SME garment industries in Delhi (India-Asia). The study was conducted in Delhi from August-2019 to October-2020. A random sampling of 70 workers from three factories has been chosen for this study. The study shows that most of the workers were males (82%) and were in the 18-50 age group (78%), with none below 18 years of age. It was found that 26% of the workers were illiterate and most of them belonged to poor socioeconomic status. The study revealed that the nature of the hazards in garment industries in India is mostly physical and mechanical. We found that musculoskeletal problems (54%) were the commonest health problem. The body areas commonly affected were neck, low back, hand, wrist, finger, and shoulder. If garment workers’ health is affected by occupational hazards, it will impact on national health and economic growth of developing countries. Health is a joint responsibility of both government and employing authority.

Keywords: garment, MSD, health hazard, social factor

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741 Artificial Neural Network in Ultra-High Precision Grinding of Borosilicate-Crown Glass

Authors: Goodness Onwuka, Khaled Abou-El-Hossein

Abstract:

Borosilicate-crown (BK7) glass has found broad application in the optic and automotive industries and the growing demands for nanometric surface finishes is becoming a necessity in such applications. Thus, it has become paramount to optimize the parameters influencing the surface roughness of this precision lens. The research was carried out on a 4-axes Nanoform 250 precision lathe machine with an ultra-high precision grinding spindle. The experiment varied the machining parameters of feed rate, wheel speed and depth of cut at three levels for different combinations using Box Behnken design of experiment and the resulting surface roughness values were measured using a Taylor Hobson Dimension XL optical profiler. Acoustic emission monitoring technique was applied at a high sampling rate to monitor the machining process while further signal processing and feature extraction methods were implemented to generate the input to a neural network algorithm. This paper highlights the training and development of a back propagation neural network prediction algorithm through careful selection of parameters and the result show a better classification accuracy when compared to a previously developed response surface model with very similar machining parameters. Hence artificial neural network algorithms provide better surface roughness prediction accuracy in the ultra-high precision grinding of BK7 glass.

Keywords: acoustic emission technique, artificial neural network, surface roughness, ultra-high precision grinding

Procedia PDF Downloads 291
740 On the convergence of the Mixed Integer Randomized Pattern Search Algorithm

Authors: Ebert Brea

Abstract:

We propose a novel direct search algorithm for identifying at least a local minimum of mixed integer nonlinear unconstrained optimization problems. The Mixed Integer Randomized Pattern Search Algorithm (MIRPSA), so-called by the author, is based on a randomized pattern search, which is modified by the MIRPSA for finding at least a local minimum of our problem. The MIRPSA has two main operations over the randomized pattern search: moving operation and shrinking operation. Each operation is carried out by the algorithm when a set of conditions is held. The convergence properties of the MIRPSA is analyzed using a Markov chain approach, which is represented by an infinite countable set of state space λ, where each state d(q) is defined by a measure of the qth randomized pattern search Hq, for all q in N. According to the algorithm, when a moving operation is carried out on the qth randomized pattern search Hq, the MIRPSA holds its state. Meanwhile, if the MIRPSA carries out a shrinking operation over the qth randomized pattern search Hq, the algorithm will visit the next state, this is, a shrinking operation at the qth state causes a changing of the qth state into (q+1)th state. It is worthwhile pointing out that the MIRPSA never goes back to any visited states because the MIRPSA only visits any qth by shrinking operations. In this article, we describe the MIRPSA for mixed integer nonlinear unconstrained optimization problems for doing a deep study of its convergence properties using Markov chain viewpoint. We herein include a low dimension case for showing more details of the MIRPSA, when the algorithm is used for identifying the minimum of a mixed integer quadratic function. Besides, numerical examples are also shown in order to measure the performance of the MIRPSA.

Keywords: direct search, mixed integer optimization, random search, convergence, Markov chain

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739 Reconstructing the Trace of Mesozoic Subduction and Its Implication on Stratigraphy Correlation between Deep Marine Sediment and Granite: Case Study of Garba Complex, South Sumatera

Authors: Fadlan Atmaja Nursiwan, Ugi Kurnia Gusti

Abstract:

Garba Hill, located in Tekana Village, South Sumatera Province is comprised to South Sumatra Basin and classified as back arc basin. This area is entered as an active margin of Sundaland which experiences subduction several times since Mesozoic to recent time. The traces of Mesozoic subduction in the southern part of Sumatra island are exposed in Garba Hill area. The aim of this investigation is to study the tectonic changes in the first phase in Mesozoic era at the active margin of Sundaland which causes the rocks assemblage in Garba hill consist of continental and oceanic plate rocks which the correlation between those rocks show indistinct relation. This investigation is conducted by field observation in Tekana village and Lubar Village, Muara Dua, South Sumatra along with laboratory analysis included fossil and geochemistry analysis of radiolarian chert, petrography analysis of granite and basalt, and structural modelling. Fossil and geochemistry analysis of radiolarian chert and geochemistry of granite rocks shown the relation between the two rocks and Mesozoic subduction of Woyla terrane on western margin of Sundaland. Petrography analysis from granite and basalt depict the tectonic affinity of rocks. Moreover, structural analysis showed the changes of lineation direction from N-S to WNW-ESE.

Keywords: granite, mesozoic, radiolarian, subduction traces

Procedia PDF Downloads 315
738 Valorization of Waste Reverse Osmosis Desalination Brine and Crystallization Sequence Approach for Kainite Recovery

Authors: Ayoub Bouazza, Ali Faddouli, Said Amal, Rachid Benhida, Khaoula Khaless

Abstract:

Brine waste generated from reverse osmosis (RO) desalination plants contains various valuable compounds, mainly salts, trace elements, and organic matter. These wastes are up to two times saltier than standard seawater. Therefore, there is a strong economic interest in recovering these salts. The current practice in desalination plants is to reject the brine back to the sea, which affects the marine ecosystem and the environment. Our study aims to bring forth a reliable management solution for the valorisation of waste brines. Natural evaporation, isothermal evaporation at 25°C and 50°C, and evaporation using continuous heating were used to crystallize valuable salts from a reverse osmosis desalination plant brine located on the Moroccan Atlantic coast. The crystallization sequence of the brine was studied in comparison with standard seawater. The X-Ray Diffraction (XRD) of the precipitated solid phases showed similar results, where halite was the main solid phase precipitated from both the brine and seawater. However, Jänecke diagram prediction, along with FREZCHEM simulations, showed that Kainite should crystallize before Epsomite and Carnallite. As the absence of kainite formation in many experiments in the literature has been related to the metastability of kainite and the critical relative humidity conditions, and the precipitation of K–Mg salts is very sensitive to climatic conditions. An evaporation process is proposed as a solution to achieve the predicted crystallization path and to affirm the recovery of Kainite.

Keywords: salts crystallization, reverse osmosis, solar evaporation, frezchem, ZLD

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737 An Intelligent Scheme Switching for MIMO Systems Using Fuzzy Logic Technique

Authors: Robert O. Abolade, Olumide O. Ajayi, Zacheaus K. Adeyemo, Solomon A. Adeniran

Abstract:

Link adaptation is an important strategy for achieving robust wireless multimedia communications based on quality of service (QoS) demand. Scheme switching in multiple-input multiple-output (MIMO) systems is an aspect of link adaptation, and it involves selecting among different MIMO transmission schemes or modes so as to adapt to the varying radio channel conditions for the purpose of achieving QoS delivery. However, finding the most appropriate switching method in MIMO links is still a challenge as existing methods are either computationally complex or not always accurate. This paper presents an intelligent switching method for the MIMO system consisting of two schemes - transmit diversity (TD) and spatial multiplexing (SM) - using fuzzy logic technique. In this method, two channel quality indicators (CQI) namely average received signal-to-noise ratio (RSNR) and received signal strength indicator (RSSI) are measured and are passed as inputs to the fuzzy logic system which then gives a decision – an inference. The switching decision of the fuzzy logic system is fed back to the transmitter to switch between the TD and SM schemes. Simulation results show that the proposed fuzzy logic – based switching technique outperforms conventional static switching technique in terms of bit error rate and spectral efficiency.

Keywords: channel quality indicator, fuzzy logic, link adaptation, MIMO, spatial multiplexing, transmit diversity

Procedia PDF Downloads 131
736 Large Eddy Simulations for Flow Blurring Twin-Fluid Atomization Concept Using Volume of Fluid Method

Authors: Raju Murugan, Pankaj S. Kolhe

Abstract:

The present study is mainly focusing on the numerical simulation of Flow Blurring (FB) twin fluid injection concept was proposed by Ganan-Calvo, which involves back flow atomization based on global bifurcation of liquid and gas streams, thus creating two-phase flow near the injector exit. The interesting feature of FB injector spray is an insignificant effect of variation in atomizing air to liquid ratio (ALR) on a spray cone angle. Besides, FB injectors produce a nearly uniform spatial distribution of mean droplet diameter and are least susceptible to variation in thermo-physical properties of fuels, making it a perfect candidate for fuel flexible combustor development. The FB injector working principle has been realized through experimental flow visualization techniques only. The present study explores potential of ANSYS Fluent based Large Eddy Simulation(LES) with volume of fluid (VOF) method to investigate two-phase flow just upstream of injector dump plane and spray quality immediate downstream of injector dump plane. Note that, water and air represent liquid and gas phase in all simulations and ALR is varied by changing the air mass flow rate alone. Preliminary results capture two phase flow just upstream of injector dump plane and qualitative agreement is observed with the available experimental literature.

Keywords: flow blurring twin fluid atomization, large eddy simulation, volume of fluid, air to liquid ratio

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735 China Pakistan Economic Corridor: An Unfolding Fiasco in World Economy

Authors: Debarpita Pande

Abstract:

On 22nd May 2013 Chinese Premier Li Keqiang on his visit to Pakistan tabled a proposal for connecting Kashgar in China’s Xinjiang Uygur Autonomous Region with the south-western Pakistani seaport of Gwadar via the China Pakistan Economic Corridor (hereinafter referred to as CPEC). The project, popularly termed as 'One Belt One Road' will encompass within it a connectivity component including a 3000-kilometre road, railways and oil pipeline from Kashgar to Gwadar port along with an international airport and a deep sea port. Superficially, this may look like a 'game changer' for Pakistan and other countries of South Asia but this article by doctrinal method of research will unearth some serious flaws in it, which may change the entire economic system of this region heavily affecting the socio-economic conditions of South Asia, further complicating the complete geopolitical situation of the region disturbing the world economic stability. The paper besets with a logical analyzation of the socio-economic issues arising out of this project with an emphasis on its impact on the Pakistani and Indian economy due to Chinese dominance, serious tension in international relations, security issues, arms race, political and provincial concerns. The research paper further aims to study the impact of huge burden of loan given by China towards this project where Pakistan already suffers from persistent debts in the face of declining foreign currency reserves along with that the sovereignty of Pakistan will also be at stake as the entire economy of the country will be held hostage by China. The author compares this situation with the fallout from projects in Sri Lanka, Tajikistan, and several countries of Africa, all of which are now facing huge debt risks brought by Chinese investments. The entire economic balance will be muddled by the increment in Pakistan’s demand of raw materials resulting to the import of the same from China, which will lead to exorbitant price-hike and limited availability. CPEC will also create Chinese dominance over the international movement of goods that will take place between the Atlantic and the Pacific oceans and hence jeopardising the entire economic balance of South Asia along with Middle Eastern countries like Dubai. Moreover, the paper also analyses the impact of CPEC in the context of international unrest and arms race between Pakistan and India as well as India and China due to border disputes and Chinese surveillance. The paper also examines the global change in economic dynamics in international trade that CPEC will create in the light of U.S.-China relationship. The article thus reflects the grave consequences of CPEC on the international economy, security and bilateral relations, which surpasses the positive impacts of it. The author lastly suggests for more transparency and proper diplomatic planning in the execution of this mega project, which can be a cause of economic complexity in international trade in near future.

Keywords: China, CPEC, international trade, Pakistan

Procedia PDF Downloads 157
734 Effects of Tramadol Administration on the Ovary of Adult Rats and the Possible Recovery after Tramadol Withdrawal: A Light and Electron Microscopic Study

Authors: Heba Kamal Mohamed

Abstract:

Introduction: Tramadol is a weak -opioid receptor agonist with an analgesic effect because of the inhibition of uptake of norepinephrine and serotonin. Nowadays, tramadol hydrochloride is frequently used as a pain reliever. Tramadol is recommended for the management of acute and chronic pain of moderate to severe intensity associated with a variety of diseases or problems, including osteoarthritis, diabetic neuropathy, neuropathic pain, and even perioperative pain in human patients. In obstetrics and gynecology, tramadol is used extensively to treat postoperative pain. Aim of the study: This study was undertaken to investigate the histological (light and electron microscopic) and immunohistochemical effects of long term tramadol treatment on the ovary of adult rats and the possible recovery after tramadol withdrawal. Design: Experimental study. Materials and methods: Thirty adult female albino rats were used in this study. They were classified into three main groups (10 rats each). Group I served as the control group. Group II, rats were subcutaneously injected with tramadol 40 mg/kg three times per week for 8 weeks. Group III, rats were subcutaneously injected with tramadol 40 mg/kg three times per week for 8 weeks then were kept for another 8 weeks without treatment for recovery. At the end of the experiment rats were sacrificed and bilateral oophorectomy was carried out; the ovaries were processed for histological study (light and electron microscopic) and immunohistochemical reaction for caspase-3 (apoptotic protein). Results: Examination of the ovary of tramadol-treated rats (group II) revealed many atretic ovarian follicles, some follicles showed detachment of the oocyte from surrounding granulosa cells and others showed loss of the oocyte. Many follicles revealed degenerated vacuolated oocytes and vacuolated theca folliculi cells. Granulosa cells appeared shrunken, disrupted and loosely attached with vacuolated cytoplasm and pyknotic nuclei. Some follicles showed separation of granulosa cells from the theca folliculi layer. The ultrastructural study revealed the presence of granulosa cells with electron dense indented nuclei, damaged mitochondria and granular vacuolated cytoplasm. Other cells showed accumulation of large amount of lipid droplets in their cytoplasm. Some follicles revealed rarifaction of the cytoplasm of oocytes and absent zona pellucida. Moreover, apoptotic changes were detected by immunohistochemical staining in the form of increased staining intensity to caspase-3 (apoptotic protein). With Masson's Trichrome stain, there was an increased collagen fibre deposition in the ovarian cortical stroma. The wall of blood vessels appeared thickened. In the withdrawal group (group III), there was a little improvement in the histological and immunohistochemical changes. Conclusion: Tramadol had serious deleterious effects on ovarian structure. Thus, it should be used with caution, especially when a long term treatment is indicated. Withdrawal of tramadol led to a little improvement in the structural impairment of the ovary.

Keywords: tramadol, ovary, withdrawal, rats

Procedia PDF Downloads 277
733 Non-Linear Assessment of Chromatographic Lipophilicity and Model Ranking of Newly Synthesized Steroid Derivatives

Authors: Milica Karadzic, Lidija Jevric, Sanja Podunavac-Kuzmanovic, Strahinja Kovacevic, Anamarija Mandic, Katarina Penov Gasi, Marija Sakac, Aleksandar Okljesa, Andrea Nikolic

Abstract:

The present paper deals with chromatographic lipophilicity prediction of newly synthesized steroid derivatives. The prediction was achieved using in silico generated molecular descriptors and quantitative structure-retention relationship (QSRR) methodology with the artificial neural networks (ANN) approach. Chromatographic lipophilicity of the investigated compounds was expressed as retention factor value logk. For QSRR modeling, a feedforward back-propagation ANN with gradient descent learning algorithm was applied. Using the novel sum of ranking differences (SRD) method generated ANN models were ranked. The aim was to distinguish the most consistent QSRR model that can be found, and similarity or dissimilarity between the models that could be noticed. In this study, SRD was performed with average values of retention factor value logk as reference values. An excellent correlation between experimentally observed retention factor value logk and values predicted by the ANN was obtained with a correlation coefficient higher than 0.9890. Statistical results show that the established ANN models can be applied for required purpose. This article is based upon work from COST Action (TD1305), supported by COST (European Cooperation in Science and Technology).

Keywords: artificial neural networks, liquid chromatography, molecular descriptors, steroids, sum of ranking differences

Procedia PDF Downloads 299
732 Promotion of the Arabic language in India: MES Mampad College - A Torchbearer

Authors: Junaid C, Sabique MK

Abstract:

Introduction: MES Mamapd College is an autonomous college established in 1964 affiliated with the University of Calicut run by the Muslim Educational Society Kerala. The department of Arabic of the college is having a pivotal role in promoting Arabic language learning, teaching, research, and other allied academic activities. State of Problem: Department of Arabic of the college introduced before the academic committee the culture of international seminars. The department connected the academic community with foreign scholars and introduced industry-academia collaboration programs which are beneficial to the job seekers. These practices and innovations should be documented. Objectives: Create awareness of innovative practices implemented for the promotion of the Arabic language. Infuse confidence in learners in learning of Arabic language. Showcase the distinctive academic programs initiated by the department Methodology: Data will be collected from archives, souvenirs, and reports. Survey methods and interviews with authorities and beneficiaries will be collected for the data analysis. Major results: MES Mampad College introduced before its stakeholders different unique academic practices related to the Arabic language and literature. When the unprecedented pandemic situation pulled back all of the academic community, the department come forward with numerous academic initiatives utilizing the virtual space. Both arenas will be documented. Conclusion: This study will help to make awareness on the promotion of the Arabic language studies and related practices initiated by the department of Arabic MES Mampad College. These practices and innovations can be modeled and replicated.

Keywords: teaching Arabic language, MES mampad college, Arabic webinars, pandemic impacts in literature

Procedia PDF Downloads 70
731 Back to Basics: Redefining Quality Measurement for Hybrid Software Development Organizations

Authors: Satya Pradhan, Venky Nanniyur

Abstract:

As the software industry transitions from a license-based model to a subscription-based Software-as-a-Service (SaaS) model, many software development groups are using a hybrid development model that incorporates Agile and Waterfall methodologies in different parts of the organization. The traditional metrics used for measuring software quality in Waterfall or Agile paradigms do not apply to this new hybrid methodology. In addition, to respond to higher quality demands from customers and to gain a competitive advantage in the market, many companies are starting to prioritize quality as a strategic differentiator. As a result, quality metrics are included in the decision-making activities all the way up to the executive level, including board of director reviews. This paper presents key challenges associated with measuring software quality in organizations using the hybrid development model. We introduce a framework called Prevention-Inspection-Evaluation-Removal (PIER) to provide a comprehensive metric definition for hybrid organizations. The framework includes quality measurements, quality enforcement, and quality decision points at different organizational levels and project milestones. The metrics framework defined in this paper is being used for all Cisco systems products used in customer premises. We present several field metrics for one product portfolio (enterprise networking) to show the effectiveness of the proposed measurement system. As the results show, this metrics framework has significantly improved in-process defect management as well as field quality.

Keywords: quality management system, quality metrics framework, quality metrics, agile, waterfall, hybrid development system

Procedia PDF Downloads 155
730 Case Report of Left Atrial Myxoma Diagnosed by Bedside Echocardiography

Authors: Anthony S. Machi, Joseph Minardi

Abstract:

We present a case report of left atrial myxoma diagnosed by bedside transesophageal (TEE) ultrasound. Left atrial myxoma is the most common benign cardiac tumor and can obstruct blood flow and cause valvular insufficiency. Common symptoms consist of dyspnea, pulmonary edema and other features of left heart failure in addition to thrombus release in the form of tumor fragments. The availability of bedside ultrasound equipment is essential for the quick diagnosis and treatment of various emergency conditions including cardiac neoplasms. A 48-year-old Caucasian female with a four-year history of an untreated renal mass and anemia presented to the ED with two months of sharp, intermittent, bilateral flank pain radiating into the abdomen. She also reported intermittent vomiting and constipation along with generalized body aches, night sweats, and 100-pound weight loss over last year. She had a CT in 2013 showing a 3 cm left renal mass and a second CT in April 2016 showing a 3.8 cm left renal mass along with a past medical history of diverticulosis, chronic bronchitis, dyspnea on exertion, uncontrolled hypertension, and hyperlipidemia. Her maternal family history is positive for breast cancer, hypertension, and Type II Diabetes. Her paternal family history is positive for stroke. She was a current everyday smoker with an 11 pack/year history. Alcohol and drug use were denied. Physical exam was notable for a Grade II/IV systolic murmur at the right upper sternal border, dyspnea on exertion without angina, and a tender left lower quadrant. Her vitals and labs were notable for a blood pressure of 144/96, heart rate of 96 beats per minute, pulse oximetry of 96%, hemoglobin of 7.6 g/dL, hypokalemia, hypochloremia, and multiple other abnormalities. Physicians ordered a CT to evaluate her flank pain which revealed a 7.2 x 8.9 x 10.5 cm mixed cystic/solid mass in the lower pole of the left kidney and a filling defect in the left atrium. Bedside TEE was ordered to follow up on the filling defect. TEE reported an ejection fraction of 60-65% and visualized a mobile 6 x 3 cm mass in the left atrium attached to the interatrial septum extending into the mitral valve. Cardiothoracic Surgery and Urology were consulted and confirmed a diagnosis of left atrial myxoma and clear cell renal cell carcinoma. The patient returned a week later due to worsening nausea and vomiting and underwent emergent nephrectomy, lymph node dissection, and colostomy due to a necrotic colon. Her condition declined over the next four months due to lung and brain metastases, infections, and other complications until she passed away.

Keywords: bedside ultrasound, echocardiography, emergency medicine, left atrial myxoma

Procedia PDF Downloads 312