Search results for: severe crash
1859 Successful Cesarean Delivery with Veno-Venous Extracorporeal Membrane Oxygenation Support in a Pregnant Woman with Severe Acute Respiratory Distress Syndrome and Heart Failure Complicated by a Rare Condition of Pre-B Cell Acute Lymphoblastic Leukemia in P
Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier
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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas
Procedia PDF Downloads 731858 Assessment of Acute Cardiovascular Responses to Moderate and Vigorous Intensity Aerobic Exercises in Sedentary Adults and Amateur Athletes
Authors: Caner Yilmaz, Zuhal Didem Takinaci
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Introduction: Today, our knowledge about the effects of physical activity performed at the different intensity of the cardiovascular system are still not clear. Therefore, to contribute to the literature, in our study, sedentary individuals and amateur athletes were assessed in a single session with the aim of evaluating the cardiovascular effects of the moderate and severe exercise. Methods: 80 participants (40 amateur athletes and 40 sedentary, young adults) participated in our study. Participants were divided into two groups: amateur athletes (mean age: 25.0 ± 3.6 yrs) and sedentary in group II (mean age: 23.8 ± 3.7 yrs). Participants in both groups were assessed twice, namely, firstly, at moderate intensity (5km/h 30 min. walking) and secondly at the vigorous intensity (8km/h 20 min. jogging). Participants’ SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), HR (Heart Rate), SpO₂ (Oxygen Saturation), BT (Body Temperature) and RR (Respiratory Rate) were measured. Results: In our study, the findings showed that after moderate-intensity aerobic exercise, change in SBP, DBP, and SpO₂ were significantly higher in Group II (p < 0.05). After the severe intensity aerobic exercises, change in SBP, SpO₂, HR, and RR was significantly higher in Group II (p < 0.05). The BORG score of Group II was significantly higher after both moderate and severe intensity aerobic exercise (p < 0.05). Conclusion: The cardiovascular responses of amateur athletes were closer to initial values, and the differences between the two groups were increased in direct proportion to the intensity of the exercise. Both exercise intensities could be adequate.Keywords: aerobic, exercise, sedantary, cardi̇ovascular
Procedia PDF Downloads 2901857 Characteristics of Old-Growth and Secondary Forests in Relation to Age and Typhoon Disturbance
Authors: Teng-Chiu Lin, Pei-Jen Lee Shaner, Shin-Yu Lin
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Both forest age and physical damages due to weather events such as tropical cyclones can influence forest characteristics and subsequently its capacity to sequester carbon. Detangling these influences is therefore a pressing issue under climate change. In this study, we compared the compositional and structural characteristics of three forests in Taiwan differing in age and severity of typhoon disturbances. We found that the two forests (one old-growth forest and one secondary forest) experiencing more severe typhoon disturbances had shorter stature, higher wood density, higher tree species diversity, and lower typhoon-induced tree mortality than the other secondary forest experiencing less severe typhoon disturbances. On the other hand, the old-growth forest had a larger amount of woody debris than the two secondary forests, suggesting a dominant role of forest age on woody debris accumulation. Of the three forests, only the two experiencing more severe typhoon disturbances formed new gaps following two 2015 typhoons, and between these two forests, the secondary forest gained more gaps than the old-growth forest. Consider that older forests generally have more gaps due to a higher background tree mortality, our findings suggest that the age effects on gap dynamics may be reversed by typhoon disturbances. This study demonstrated the effects of typhoons on forest characteristics, some of which could negate the age effects and rejuvenate older forests. If cyclone disturbances were to intensity under climate change, the capacity of older forests to sequester carbon may be reduced.Keywords: typhoon, canpy gap, coarse woody debris, forest stature, forest age
Procedia PDF Downloads 2691856 Interaction between Cognitive Control and Language Processing in Non-Fluent Aphasia
Authors: Izabella Szollosi, Klara Marton
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Aphasia can be defined as a weakness in accessing linguistic information. Accessing linguistic information is strongly related to information processing, which in turn is associated with the cognitive control system. According to the literature, a deficit in the cognitive control system interferes with language processing and contributes to non-fluent speech performance. The aim of our study was to explore this hypothesis by investigating how cognitive control interacts with language performance in participants with non-fluent aphasia. Cognitive control is a complex construct that includes working memory (WM) and the ability to resist proactive interference (PI). Based on previous research, we hypothesized that impairments in domain-general (DG) cognitive control abilities have negative effects on language processing. In contrast, better DG cognitive control functioning supports goal-directed behavior in language-related processes as well. Since stroke itself might slow down information processing, it is important to examine its negative effects on both cognitive control and language processing. Participants (N=52) in our study were individuals with non-fluent Broca’s aphasia (N = 13), with transcortical motor aphasia (N=13), individuals with stroke damage without aphasia (N=13), and unimpaired speakers (N = 13). All participants performed various computer-based tasks targeting cognitive control functions such as WM and resistance to PI in both linguistic and non-linguistic domains. Non-linguistic tasks targeted primarily DG functions, while linguistic tasks targeted more domain specific (DS) processes. The results showed that participants with Broca’s aphasia differed from the other three groups in the non-linguistic tasks. They performed significantly worse even in the baseline conditions. In contrast, we found a different performance profile in the linguistic domain, where the control group differed from all three stroke-related groups. The three groups with impairment performed more poorly than the controls but similar to each other in the verbal baseline condition. In the more complex verbal PI condition, however, participants with Broca’s aphasia performed significantly worse than all the other groups. Participants with Broca’s aphasia demonstrated the most severe language impairment and the highest vulnerability in tasks measuring DG cognitive control functions. Results support the notion that the more severe the cognitive control impairment, the more severe the aphasia. Thus, our findings suggest a strong interaction between cognitive control and language. Individuals with the most severe and most general cognitive control deficit - participants with Broca’s aphasia - showed the most severe language impairment. Individuals with better DG cognitive control functions demonstrated better language performance. While all participants with stroke damage showed impaired cognitive control functions in the linguistic domain, participants with better language skills performed also better in tasks that measured non-linguistic cognitive control functions. The overall results indicate that the level of cognitive control deficit interacts with the language functions in individuals along with the language spectrum (from severe to no impairment). However, future research is needed to determine any directionality.Keywords: cognitive control, information processing, language performance, non-fluent aphasia
Procedia PDF Downloads 1221855 The Possibility of Using Somatosensory Evoked Potential(SSEP) as a Parameter for Cortical Vascular Dementia
Authors: Hyunsik Park
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As the rate of cerebrovascular disease increases in old populations, the prevalence rate of vascular dementia would be expected. Therefore, authors designed this study to find out the possibility of somatosensory evoked potentials(SSEP) as a parameter for early diagnosis and prognosis prediction of vascular dementia in cortical vascular dementia patients. 21 patients who met the criteria for vascular dementia according to DSM-IV,ICD-10and NINDS-AIREN with the history of recent cognitive impairment, fluctuation progression, and neurologic deficit. We subdivided these patients into two groups; a mild dementia and a severe dementia groups by MMSE and CDR score; and analysed comparison between normal control group and patient control group who have been cerebrovascular attack(CVA) history without dementia by using N20 latency and amplitude of median nerve. In this study, mild dementia group showed significant differences on latency and amplitude with normal control group(p-value<0.05) except patient control group(p-value>0.05). Severe dementia group showed significant differences both normal control group and patient control group.(p-value<0.05, <001). Since no significant difference has founded between mild dementia group and patient control group, SSEP has limitation to use for early diagnosis test. However, the comparison between severe dementia group and others showed significant results which indicate SSEP can predict the prognosis of vascular dementia in cortical vascular dementia patients.Keywords: SSEP, cortical vascular dementia, N20 latency, N20 amplitude
Procedia PDF Downloads 3041854 Experimental Study on Mechanical Properties of Commercially Pure Copper Processed by Severe Plastic Deformation Technique-Equal Channel Angular Extrusion
Authors: Krishnaiah Arkanti, Ramulu Malothu
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The experiments have been conducted to study the mechanical properties of commercially pure copper processing at room temperature by severe plastic deformation using equal channel angular extrusion (ECAE) through a die of 90oangle up to 3 passes by route BC i.e. rotating the sample in the same direction by 90o after each pass. ECAE is used to produce from existing coarse grains to ultra-fine, equiaxed grains structure with high angle grain boundaries in submicron level by introducing a large amount of shear strain in the presence of hydrostatic pressure into the material without changing billet shape or dimension. Mechanical testing plays an important role in evaluating fundamental properties of engineering materials as well as in developing new materials and in controlling the quality of materials for use in design and construction. Yield stress, ultimate tensile stress and ductility are structure sensitive properties and vary with the structure of the material. Microhardness and tensile tests were carried out to evaluate the hardness, strength and ductility of the ECAE processed materials. The results reveal that the strength and hardness of commercially pure copper samples improved significantly without losing much ductility after each pass.Keywords: equal channel angular extrusion, severe plastic deformation, copper, mechanical properties
Procedia PDF Downloads 1891853 A Study of the Impact of Discrimination Experience on Life Satisfaction in Korean Women with Severe Disabilities
Authors: Soungwan Kim
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The present study analyzed the effect of discrimination experience on the life satisfaction in women with severe disabilities and the mediating effect of disability acceptance. In verifying this mediating effect of disability acceptance between discrimination experience and life satisfaction, both discrimination experience and disability acceptance were found to be statistically significant in the first and second phases. Disability acceptance was found to have a mediating effect on the relationship between discrimination experience and life satisfaction. Based on this finding, measures for enhancing the quality of life in individuals with disabilities that experience low levels of life satisfaction were proposed.Keywords: disability discrimination, disability acceptance, life satisfaction, mediating effect
Procedia PDF Downloads 3841852 Breast Cancer as a Response to Distress in Women with or without a History of Precancerous Breast Disease
Authors: Viacheslav Sushko, Viktor Sushko
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Pre-cancerous breast diseases are pathological changes that precede the appearance of adenocarcinoma. The most common benign breast disease is mastopathy. We examined the life and disease history of 114 women aged 58-69 who were diagnosed with adenocarcinoma of the breast at different stages of development. They filled out the Reeder Scale to determine the level of stress. The results of the study revealed that 62 of them had mastopathy at the age of 30-45 years old. These women refused surgical treatment for mastopathy. Five to six years before their diagnosis of adenocarcinoma of the mammary gland, 84 women had experienced severe stress (death of a beloved close relative, torture accompanied by rape, prolonged stay in extreme conditions (under bombardment and bombardment). In the assessment of data from completed Reeder scales, 114 women had a high level of mental stress, with a score from 1-1.72. The 84 women who suffered from severe stress showed overeating or a significant decrease in food intake, insomnia, apathy, increased irritability and restlessness, loss of interest in sexual relationships, forgetfulness, difficulty in performing routine work, prolonged uncontrollable headaches, unexplained fatigue, heart pain, reduced capacity for work. In conclusion, it is important to provide psychotherapy for breast cancer patients as the diagnosis, and the different stages of treatment are very stressful. It is also advisable to see a psychiatrist at an early stage and prevent distress and treat precancerous breast disease.Keywords: breast cancer, distress, mastopathy, severe stress
Procedia PDF Downloads 1351851 Frequency of Problem Drinking and Depression in Males with a History of Alcohol Consumption Admitted to a Tertiary Care Setting in Southern Sri Lanka
Authors: N. H. D. P. Fonseka, I. H. Rajapakse, A. S. Dissanayake
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Background: Problem drinking, namely alcohol dependence (AD) and alcohol abuse (AA) are associated with major medical, social and economic adverse consequences. Problem drinking behavior is noted among those admitted to hospitals due to alcohol-related medical/surgical complaints as well as those with unrelated complaints. Literature shows an association between alcohol consumption and depression. Aims of this study were to determine the frequency of problem drinking and depression among males with a history of alcohol consumption tertiary care setting in Southern Sri Lanka. Method: Two-hundred male patients who consumed alcohol, receiving care in medical and surgical wards in Teaching Hospital Galle, were assessed. A validated J12 questionnaire of the Mini International Neuropsychiatric Interview was administered to determine frequency AA and AD. A validated PHQ 9 questionnaire to determine the prevalence and severity of depression. Results: Sixty-three participants (31%) had problem drinking. Of them, 61% had AD, and 39% had AA. Depression was noted in 39 (19%) subjects. In those who reported alcohol consumption not amounting to problem drinking, depression was noted in 23 (16%) participants. Mild depression was seen in 17, moderate in five and moderately severe in one. Among those who had problem drinking, 16 (25%) had depression. Mild depression was seen in four, moderate in seven, moderately severe in three and severe in two. Conclusions: A high proportion alcohol users had problem drinking. Adverse consequences associated with problem drinking places a major strain on the health system especially in a low resource setting where healthcare spending is limited and alcohol cessation support services are not well organised. Thus alcohol consumption and problem drinking behaviour need to be inquired into all medical consultations. Community prevalence of depression in Sri Lanka is approximately 10%. Depression among those consuming alcohol was two times higher compared to the general population. The rates of depression among those with problem drinking were especially high being 2.5 times more common than in the general population. A substantial proportion of these patients with depression had moderately severe or severe depression. When depression coexists with problem drinking, it may increase the tendency to consume alcohol as well as act as a barrier to the success of alcohol cessation interventions. Thus screening all patients who consume alcohol for depression, especially those who are problem drinkers becomes an important step in their clinical evaluation. In addition, in view of the high prevalence of problem drinking and coexistent depression, the need to organize a structured alcohol cessation support service in Sri Lanka as well as the need for increasing access to psychological evaluation and treatment of those with problem drinking are highlighted.Keywords: alcohol abuse, alcohol, depression, problem drinking
Procedia PDF Downloads 1601850 The Effects of Inoculation and N Fertilization on Soybean (Glycine max (L.) Merr.) Seed Yield and Protein Concentration under Drought Stress
Authors: Oqba Basal, Andras Szabo
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Using mineral fertilization is increasing worldwide, as it is claimed to be majorly responsible for achieving high yields; however, the negative impacts of mineral fertilization on soil and environment are becoming more obvious, with alternative methods being more necessary and applicable, especially with the current climatic changes which have imposed serious abiotic stresses, such as drought. An experiment was made during 2017 growing season in Debrecen, Hungary to investigate the effects of inoculation and N fertilization on the seed yield and protein concentration of the soybean (Glycine max (L.) Merr.) cultivar (Panonia Kincse) under three different irrigation regimes: severe drought stress (SD), moderate drought stress (MD) and control with no drought stress (ND). Three N fertilizer rates were applied: no N fertilizer (0 N), 35 kg ha⁻¹ of N fertilizer (35 N) and 105 kg ha⁻¹ of N fertilizer (105 N). Half of the seeds in each treatment was inoculated with Bradyrhizobium japonicum inoculant, and the other half was not inoculated. The results showed significant differences in the seed yield associated with inoculation, irrigation and the interaction between them, whereas there were no significant differences in the seed yield associated with fertilization alone or in interaction with inoculation or irrigation or both. When seeds were inoculated, yield was increased when (35 N) was applied compared to (0 N) but not significantly; however, the high rate of N fertilizer (105 N) reduced the yield to a level even less than (0 N). When seeds were not inoculated, the highest rate of N increased the yield the most compared to the other two N fertilizer rates whenever the drought was present (moderate or severe). Under severe drought stress, inoculation was positively and significantly correlated with yield; however, adding N fertilizer increased the yield of uninoculated plants compared to the inoculated ones, regardless of the rate of N fertilizer. Protein concentration in the seeds was significantly affected by irrigation and by fertilization, but not by inoculation. Protein concentration increased as the N fertilization rate increased, regardless of the inoculation or irrigation treatments; moreover, increasing the N rate reduced the correlation coefficient of protein concentration with the irrigation. It was concluded that adding N fertilizer is not always recommended, especially when seeds are inoculated before being sown; however, it is very important under severe drought stress to sustain yield. Enhanced protein concentrations could be achieved by applying N fertilization, whether the seeds were pre-inoculated or not.Keywords: drought stress, N fertilization, protein concentration, soybean
Procedia PDF Downloads 1541849 Obsessive-Compulsive Disorder: Development of Demand-Controlled Deep Brain Stimulation with Methods from Stochastic Phase Resetting
Authors: Mahdi Akhbardeh
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Synchronization of neuronal firing is a hallmark of several neurological diseases. Recently, stimulation techniques have been developed which make it possible to desynchronize oscillatory neuronal activity in a mild and effective way, without suppressing the neurons' firing. As yet, these techniques are being used to establish demand-controlled deep brain stimulation (DBS) techniques for the therapy of movement disorders like severe Parkinson's disease or essential tremor. We here present a first conceptualization suggesting that the nucleus accumbens is a promising target for the standard, that is, permanent high-frequency, DBS in patients with severe and chronic obsessive-compulsive disorder (OCD). In addition, we explain how demand-controlled DBS techniques may be applied to the therapy of OCD in those cases that are refractory to behavioral therapies and pharmacological treatment.Keywords: stereotactic neurosurgery, deep brain stimulation, obsessive-compulsive disorder, phase resetting
Procedia PDF Downloads 5121848 Clinical Use of Opioid Analgesics in China: An Adequacy of Consumption Measure
Authors: Mengjia Zhi, Xingmei Wei, Xiang Gao, Shiyang Liu, Zhiran Huang, Li Yang, Jing Sun
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Background: To understand the consumption trend of opioid analgesics and the consumption adequacy of opioid analgesic treatment for moderate to severe pain in China, as well as the pain control level of China with international perspective. Importance: To author’s best knowledge, this is the first study in China to measure the adequacy of opioid analgesic treatment for moderate to severe pain considering disease pattern and with the standardized pain treatment guideline. Methods: A retrospective analysis was carried out to show the consumption frequency (daily defined doses, DDDs) of opioid analgesics and its trend in China from 2006 to 2016. Adequacy of consumption measure (ACM) was used to measure the number of needed morphine equivalents and the overall adequacy of opioid analgesic treatment of moderate to severe pain in China, and compared with international data. Results: The consumption frequency of opioid analgesics (DDDs) in China increased from 13,200,000 DDDs in 2006 to 44,200,000 DDDs in 2016, and showed an increasing trend. The growth rate was faster at first, especially in 2013, then slowed down, decreased slightly in 2015. The ACM of China increased from 0.0032 in 2006 to 0.0074 in 2016, with an overall trend of growth. The ACM level of China has been always a very poor level during 2006-2016. Conclusion: The consumption of opioid analgesics for the treatment of moderate to severe pain in China has always been inadequate. There is a huge gap between China and the international level. There are many reasons behind this problem, which lie in different aspects, including medical staff, patients and the public, health systems and social & cultural aspects. It is necessary to strengthen the training and education of medical staff and the patients, to use mass media to disseminate scientific knowledge of pain management, to encourage communications between doctors and patients, to improve regulatory system for the controlled medicines and the overall health systems, and to balance the regulatory goal for avoidance of abuse, and the social goal of meeting the increasing needs of the people for better life.Keywords: opioid analgesics, adequate consumption measure, pain control, China
Procedia PDF Downloads 2101847 Ultrasound Guided Treatment of Carpal Tunnel Syndrome
Authors: Kazem Shakouri, Alireza Pishgahi, Homayoun Sadeghi-bBazargani, Shahla Dareshiri
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Introduction: Carpal Tunnel Syndrome has numerous nonsurgical treatments including splint, physical therapy and corticosteroid injections. Aim: The purpose of this study was to evaluate the effectiveness of an ultrasound guided treatment procedure, for individuals with severe carpal tunnel syndrome. Materials and Method: 20 patients with an electrodiagnostic evidence of severe carpal tunnel syndrome were treated by an office-based ultrasound guided procedure (combination of percutaneous needle release of carpal tunnel and corticosteroid injection). Electrodiagnostic (nerve conduction study), clinical (Boston Carpal Tunnel Questionnaire, grip strength) and ultrasonic (median nerve and carpal tunnel cross-sectional area) measurements were recorded at baseline and one month after intervention. Results: Our preliminary data analysis showed that in one month follow up, patients had a significantly smaller cross-sectional area of the median nerve compared to pretreatment values (mean difference 0.06; 95%CI: 0.02-0.1; p < 0.001). In addition, patients had significantly less functional impairment (mean difference 35; 95% CI:28.7-43.4 ; p < 0.001), and an improved hand grip strength in one month follow up (mean difference 5.4; 95%CI: 3.1-7.8; p < 0.001;). There were no significant complications. Conclusion: Patients with severe carpal tunnel syndrome, who are candidates for surgical intervention, can consider office-based ultrasound guided needle release of carpal tunnel as an alternative safe treatment.Keywords: Carpal Tunnel Syndrome, needle release, pain, ultrasound
Procedia PDF Downloads 2471846 Improving the Crashworthiness Characteristics of Long Steel Circular Tubes Subjected to Axial Compression by Inserting a Helical Spring
Authors: Mehdi Tajdari, Farzad Mokhtarnejad, Fatemeh Moradi, Mehdi Najafizadeh
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Nowadays, energy absorbing devices have been widely used in all vehicles and moving parts such as railway couches, aircraft, ships and lifts. The aim is to protect these structures from serious damages while subjected to impact loads, or to minimize human injuries while collision is occurred in transportation systems. These energy-absorbing devices can dissipate kinetic energy in a wide variety of ways like friction, facture, plastic bending, crushing, cyclic plastic deformation and metal cutting. On the other hand, various structures may be used as collapsible energy absorbers. Metallic cylindrical tubes have attracted much more attention due to their high stiffness and strength combined with the low weight and ease of manufacturing process. As a matter of fact, favorable crash worthiness characteristics for energy dissipation purposes can be achieved from axial collapse of tubes while they crush progressively in symmetric modes. However, experimental and theoretical results have shown that depending on various parameters such as tube geometry, material properties of tube, boundary and loading conditions, circular tubes buckle in different modes of deformation, namely, diamond and Euler collapsing modes. It is shown that when the tube length is greater than the critical length, the tube deforms in overall Euler buckling mode, which is an inefficient mode of energy absorption and needs to be avoided in crash worthiness applications. This study develops a new method with the aim of improving energy absorption characteristics of long steel circular tubes. Inserting a helical spring into the tubes is proved experimentally to be an efficient solution. In fact when a long tube is subjected to axial compression load, the spring prevents of undesirable Euler or diamond collapsing modes. This is because the spring reinforces the internal wall of tubes and it causes symmetric deformation in tubes. In this research three specimens were prepared and three tests were performed. The dimensions of tubes were selected so that in axial compression load buckling is occurred. In the second and third tests a spring was inserted into tubes and they were subjected to axial compression load in quasi-static and impact loading, respectively. The results showed that in the second and third tests buckling were not happened and the tubes deformed in symmetric modes which are desirable in energy absorption.Keywords: energy absorption, circular tubes, collapsing deformation, crashworthiness
Procedia PDF Downloads 3401845 Poor Cognitive Flexibility as Suggested Basis for Learning Difficulties among Children with Moderate-INTO-Severe Asthma: Evidence from WCSTPerformance
Authors: Haitham Taha
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The cognitive flexibility of 27 asthmatic children with learning difficulties was tested by using the Wisconsin card sorting test (WCST) and compared to the performances of 30 non-asthmatic children who have persistence learning difficulties also. The results revealed that the asthmatic group had poor performance through all the WCST psychometric parameters and especially the preservative errors one. The results were discussed in light of the postulation that poor executive functions and specifically poor cognitive flexibility are in the basis of the learning difficulties of asthmatic children with learning difficulties. Neurophysiologic framework was suggested for explaining the etiology of poor executive functions and cognitive flexibility among children with moderate into severe asthma.Keywords: asthma, learning disabilities, executive functions, cognitive flexibility, WCST
Procedia PDF Downloads 5021844 Prognosis of Interstitial Lung Disease (ILD) Based on Baseline Pulmonary Function Test (PFT) Results in Omani Adult Patients Diagnosed with ILD In Sultan Qaboos University Hospital
Authors: Manal Al Bahri, Saif Al Mubahisi, Shamsa Al Shahaimi, Asma Al Qasabi, Jamal Al Aghbari
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Introduction: ILD is a common disease worldwide and in Oman. No previous Omani study was published regarding ILD prognosis based on baseline PFT results and other factors. This study aims to determine the severity of ILD by the baseline PFT, correlate between baseline PFT and outcome, and study other factors that influence disease mortality. Method: It is a retrospective cohort study; data was collected from January 2011 to December 2021 from electronic patient records (EPR). Means, Standard Deviations, frequencies, and Chi-square tests were used to examine the different variables in the study. Results: The total population of the study was 146 patients; 87 (59.6%) were females, and 59 (40.4%) were males. The median age was 59 years. Age at diagnosis, CVA, rheumatological disease, and baseline FVC were found to be statistically significant predictors of mortality .59.6% of the patients are diagnosed with IPF. Most of our study patients had mild disease based on baseline FVC. Death was higher with the more severe disease based on FVC. In mild disease (FVC >70%), 26.9% of the patients died. In moderate disease (FVC 50-69%),55.7% of the patients died, and in the severe group (FVC <50 %), 55.1% died. This was statistically significant with a P value of 0. 001. There is no statistically significant difference in the overall survival distribution between the different groups of DLCO. Conclusion: In our study, we found that ILD is more common among females, but death is more common among males. Based on baseline PFT, we can predict mortality by FVC level, as moderate to severe limitation is associated with a lower survival rate. DLCO was not a statistically significant parameter associated with mortality.Keywords: PFT, ILD, FVC, DLCO, mortality
Procedia PDF Downloads 321843 A United Nations Safety Compliant Urban Vehicle Design
Authors: Marcelo R. G. Duarte, Marcilio Alves
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Pedestrians are the fourth group among road traffic users that most suffer accidents. Their death rate is even higher than the motorcyclists group. This gives motivation for the development of an urban vehicle capable of complying with the United Nations Economic Commission for Europe pedestrian regulations. The conceptual vehicle is capable of transporting two passengers and small parcels for 100 km at a maximum speed of 90 km/h. This paper presents the design of this vehicle using the finite element method specially in connection with frontal crash test and car to pedestrian collision. The simulation is based in a human body FE.Keywords: electric urban vehicle, finite element method, global human body model, pedestrian safety, road safety
Procedia PDF Downloads 1891842 Influence of Different Asymmetric Rolling Processes on Shear Strain
Authors: Alexander Pesin, Denis Pustovoytov, Mikhail Sverdlik
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Materials with ultrafine-grained structure and unique physical and mechanical properties can be obtained by methods of severe plastic deformation, which include processes of asymmetric rolling (AR). Asymmetric rolling is a very effective way to create ultrafine-grained structures of metals and alloys. Since the asymmetric rolling is a continuous process, it has great potential for industrial production of ultrafine-grained structure sheets. Basic principles of asymmetric rolling are described in detail in scientific literature. In this work finite element modeling of asymmetric rolling and metal forming processes in multiroll gauge was performed. Parameters of the processes which allow achieving significant values of shear strain were defined. The results of the study will be useful for the research of the evolution of ultra-fine metal structure in asymmetric rolling.Keywords: asymmetric rolling, equivalent strain, FEM, multiroll gauge, profile, severe plastic deformation, shear strain, sheet
Procedia PDF Downloads 2641841 Study of seum Tumor Necrosis Factor Alpha in Pediatric Patients with Hemophilia A
Authors: Sara Mohammad Atef Sabaika
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Background: The development of factor VIII (FVIII) inhibitor and hemophilic arthropathy in patients with hemophilia A (PWHA) are a great challenge for hemophilia care. Both genetic and environmental factors led to complications in PWHA. The development of inhibitory antibodies is usually induced by the immune response. Tumor necrosis factor α (TNF-α), one of the cytokines, might contribute to its polymorphism. Aim: Study the association between tumor necrosis alpha level and genotypes in pediatric patients with hemophilia A and its relation to inhibitor development and joint status. Methods: A cross-sectional study was conducted among a sufficient number of PWHA attending the Pediatric Hematology and Oncology Unit, Pediatric department in Menoufia University hospital. The clinical parameters, FVIII, FVIII inhibitor, and serum TNF-α level were assessed. The genotyping of −380G > A TNF-α gene polymorphism was performed using real time polymerase chain reaction. Results: Among the 50 PWHA, 28 (56%) were identified as severe PWHA. The FVIII inhibitor was identified in 6/28 (21.5%) of severe PWHA. There was a significant correlation between serum TNF-α level and the development of inhibitor (p = 0:043). There was significant correlation between polymorphisms of −380G > A TNF-α gene and hemophilic arthropathy development (p = 0:645). Conclusion: The prevalence of FVIII inhibitor in severe PWHA in Menoufia was 21.5%. The frequency of replacement therapy is a risk factor for inhibitor development. Serum TNF-α level and its gene polymorphism might be used to predict inhibitor development and joint status in pediatric patients with hemophilia A.Keywords: hemophilic arthropathy, TNF alpha., patients witb hemophilia A PWHA, inhibitor
Procedia PDF Downloads 941840 Vehicle to Vehicle Communication: Collision Avoidance Scenarios
Authors: Ahmed Emad, Ahmed Salah, Abdelrahman Magdy, Omar Rashid, Mohammed Adel
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This research paper discusses vehicle-to-vehicle technology as an important application of linear algebra. This communication technology represents an efficient and promising application to help to ensure the safety of the drivers by warning them when a crash possibility is close. The major link that combines our topic with linear algebra is the Laplacian matrix. Some main definitions used in the V2V were illustrated, such as VANET and its characteristics. The V2V technology could be applied in different applications with different traffic scenarios and various ways to warn car drivers. These scenarios were simulated programs such as MATLAB and Python to test how the V2V system would respond to the different scenarios and warn the car drivers exposed to the threat of collisions.Keywords: V2V communication, vehicle to vehicle scenarios, VANET, FCW, EEBL, IMA, Laplacian matrix
Procedia PDF Downloads 1631839 Stochastic Pi Calculus in Financial Markets: An Alternate Approach to High Frequency Trading
Authors: Jerome Joshi
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The paper presents the modelling of financial markets using the Stochastic Pi Calculus model. The Stochastic Pi Calculus model is mainly used for biological applications; however, the feature of this model promotes its use in financial markets, more prominently in high frequency trading. The trading system can be broadly classified into exchange, market makers or intermediary traders and fundamental traders. The exchange is where the action of the trade is executed, and the two types of traders act as market participants in the exchange. High frequency trading, with its complex networks and numerous market participants (intermediary and fundamental traders) poses a difficulty while modelling. It involves the participants to seek the advantage of complex trading algorithms and high execution speeds to carry out large volumes of trades. To earn profits from each trade, the trader must be at the top of the order book quite frequently by executing or processing multiple trades simultaneously. This would require highly automated systems as well as the right sentiment to outperform other traders. However, always being at the top of the book is also not best for the trader, since it was the reason for the outbreak of the ‘Hot – Potato Effect,’ which in turn demands for a better and more efficient model. The characteristics of the model should be such that it should be flexible and have diverse applications. Therefore, a model which has its application in a similar field characterized by such difficulty should be chosen. It should also be flexible in its simulation so that it can be further extended and adapted for future research as well as be equipped with certain tools so that it can be perfectly used in the field of finance. In this case, the Stochastic Pi Calculus model seems to be an ideal fit for financial applications, owing to its expertise in the field of biology. It is an extension of the original Pi Calculus model and acts as a solution and an alternative to the previously flawed algorithm, provided the application of this model is further extended. This model would focus on solving the problem which led to the ‘Flash Crash’ which is the ‘Hot –Potato Effect.’ The model consists of small sub-systems, which can be integrated to form a large system. It is designed in way such that the behavior of ‘noise traders’ is considered as a random process or noise in the system. While modelling, to get a better understanding of the problem, a broader picture is taken into consideration with the trader, the system, and the market participants. The paper goes on to explain trading in exchanges, types of traders, high frequency trading, ‘Flash Crash,’ ‘Hot-Potato Effect,’ evaluation of orders and time delay in further detail. For the future, there is a need to focus on the calibration of the module so that they would interact perfectly with other modules. This model, with its application extended, would provide a basis for researchers for further research in the field of finance and computing.Keywords: concurrent computing, high frequency trading, financial markets, stochastic pi calculus
Procedia PDF Downloads 771838 Pharmacokinetics and Safety of Pacritinib in Patients with Hepatic Impairment and Healthy Volunteers
Authors: Suliman Al-Fayoumi, Sherri Amberg, Huafeng Zhou, Jack W. Singer, James P. Dean
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Pacritinib is an oral kinase inhibitor with specificity for JAK2, FLT3, IRAK1, and CSF1R. In clinical studies, pacritinib was well tolerated with clinical activity in patients with myelofibrosis. The most frequent adverse events (AEs) observed with pacritinib are gastrointestinal (diarrhea, nausea, and vomiting; mostly grade 1-2 in severity) and typically resolve within 2 weeks. A human ADME mass balance study demonstrated that pacritinib is predominantly cleared via hepatic metabolism and biliary excretion (>85% of administered dose). The major hepatic metabolite identified, M1, is not thought to materially contribute to the pharmacological activity of pacritinib. Hepatic diseases are known to impair hepatic blood flow, drug-metabolizing enzymes, and biliary transport systems and may affect drug absorption, disposition, efficacy, and toxicity. This phase 1 study evaluated the pharmacokinetics (PK) and safety of pacritinib and the M1 metabolite in study subjects with mild, moderate, or severe hepatic impairment (HI) and matched healthy subjects with normal liver function to determine if pacritinib dosage adjustments are necessary for patients with varying degrees of hepatic insufficiency. Study participants (aged 18-85 y) were enrolled into 4 groups based on their degree of HI as defined by Child-Pugh Clinical Assessment Score: mild (n=8), moderate (n=8), severe (n=4), and healthy volunteers (n=8) matched for age, BMI, and sex. Individuals with concomitant renal dysfunction or progressive liver disease were excluded. A single 400 mg dose of pacritinib was administered to all participants. Blood samples were obtained for PK evaluation predose and at multiple time points postdose through 168 h. Key PK parameters evaluated included maximum plasma concentration (Cmax), time to Cmax (Tmax), area under the plasma concentration time curve (AUC) from hour zero to last measurable concentration (AUC0-t), AUC extrapolated to infinity (AUC0-∞), and apparent terminal elimination half-life (t1/2). Following treatment, pacritinib was quantifiable for all study participants at 1 h through 168 h postdose. Systemic pacritinib exposure was similar between healthy volunteers and individuals with mild HI. However, there was a significant difference between those with moderate and severe HI and healthy volunteers with respect to peak concentration (Cmax) and plasma exposure (AUC0-t, AUC0-∞). Mean Cmax decreased by 47% and 57% respectively in participants with moderate and severe HI vs matched healthy volunteers. Similarly, mean AUC0-t decreased by 36% and 45% and mean AUC0-∞ decreased by 46% and 48%, respectively in individuals with moderate and severe HI vs healthy volunteers. Mean t1/2 ranged from 51.5 to 74.9 h across all groups. The variability on exposure ranged from 17.8% to 51.8% across all groups. Systemic exposure of M1 was also significantly decreased in study participants with moderate or severe HI vs. healthy participants and individuals with mild HI. These changes were not significantly dissimilar from the inter-patient variability in these parameters observed in healthy volunteers. All AEs were grade 1-2 in severity. Diarrhea and headache were the only AEs reported in >1 participant (n=4 each). Based on these observations, it is unlikely that dosage adjustments would be warranted in patients with mild, moderate, or severe HI treated with pacritinib.Keywords: pacritinib, myelofibrosis, hepatic impairment, pharmacokinetics
Procedia PDF Downloads 2981837 Optimization Based Obstacle Avoidance
Authors: R. Dariani, S. Schmidt, R. Kasper
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Based on a non-linear single track model which describes the dynamics of vehicle, an optimal path planning strategy is developed. Real time optimization is used to generate reference control values to allow leading the vehicle alongside a calculated lane which is optimal for different objectives such as energy consumption, run time, safety or comfort characteristics. Strict mathematic formulation of the autonomous driving allows taking decision on undefined situation such as lane change or obstacle avoidance. Based on position of the vehicle, lane situation and obstacle position, the optimization problem is reformulated in real-time to avoid the obstacle and any car crash.Keywords: autonomous driving, obstacle avoidance, optimal control, path planning
Procedia PDF Downloads 3691836 The Impact of Intimate Partner Violence on Women’s Mental Health in Kenya
Authors: Josephine Muchiri, Makena Muriithi
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Adverse mental health consequences are experienced by those that have been touched by Intimate Partner Violence (IPV), whether directly or indirectly. These negative effects are felt not only in the short term but in years to come. It is important to examine the prevalence and co-occurrence of mental disorders in order to provide strategic interventions for women who have experienced IPV. The aim of this study was to examine the prevalence and comorbidity of post-traumatic stress disorder (PTSD), Depression, and Anxiety among women who had experienced intimate Partner violence in two selected informal settlements in Nairobi County, Kenya. Participants were 116 women (15-60 years) selected through purposive and snowball sampling from the low social, economic settlements (Kawangware and Kibera) in Nairobi, Kenya. A social demographic questionnaire and the Woman Abuse Screening Tool (WAST) were used to collect data on intimate partner violence experiences. The PTSD Checklist for DSM-5 (PCL-5), Beck’s Depression Inventory, and the Beck’s Anxiety Inventory assessed for post-traumatic stress disorder, depression, and anxiety, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 29, utilizing descriptive and correlation analyses. Findings indicated that the women had undergone various forms of abuse from their intimate partners, which were physical abuse 111(92.5%), sexual abuse 70(88.6%), and verbal abuse 92(93.9%). The prevalence of the mental disorders was PTSD 47(32.4%); M= 44.11, S.D =14.67, depression was the highest at n=131(90.3%; M=33.37±9.98) with the levels of depression having varying prevalence rates where severe depression had the highest representation [moderate: n= 35; 24.1%, severe: n=69 (47.6%) and extremely severe: n=27(18.6%)]. Anxiety had the second highest prevalence of n=99 (68.8%; M= 28.55±13.63) with differing prevalence rates in the levels of anxiety which were normal anxiety: 45(31.3%), moderate anxiety n=62(43.1%) and severe anxiety: n=37(25.7%). Regarding comorbidities, the Pearson correlation test showed that there was a significant (p=0.000) positive relationship between PTSD and depression (r=0.379; p=.000), PTSD and anxiety (r=0.624; p=.000), and depression and anxiety (r=0.386; p=.000) such that increase in one disorder concomitantly led to increase of the other two disorders; hence comorbidity of the three disorders was ascertained. Conclusion: The study asserted the adverse impacts of IPV on women’s mental well-being, where the prevalence of PTSD, depression, and anxiety was established. Almost all the women had depressive symptoms; whereas more than half had anxiety and slightly more than a third had PTSD. Regarding the severity levels of anxiety and depression, almost half of the women with depression had severe depression whereas moderate anxiety was more prevalent for those with anxiety. The three disorders were found to co-occur where comorbidities of PTSD and anxiety had the highest probability of co-occurrence. It is thus recommended that mental health interventions with a focus on the three disorders be offered for women undergoing IPV.Keywords: anxiety, comorbidity, depression, intimate partner violence, post-traumatic stress disorder
Procedia PDF Downloads 791835 Nutritional Status of Surgical and Orthopedic Patients: 3B Ward
Authors: Jitaree Tantiyasawatdikul, Bantita Jadnok, Sarunya Tijana
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Background: Nutritional status is an important factor before, during, and after an operation. It can help wound healing. If the patients have good nutritional status before and after an operation, wound healing can occur more easily. It can strengthen the immune system leading to decreased infection, reduced length of stay, and reducing the cost to patients and caregivers. Therefore, screening to evaluate the nutritional status of patients in 3B becomes the database for further developing the treatment and also will lead to excellent service from the interdisciplinary team. Objective: To study the nutritional status of patients in surgical ward 3B at Surgical and Orthopedics Nursing Division, Srinagarind Hospital. Method: A descriptive study, to evaluate the nutritional status of 86 patients admitted in 3B between October 2014 and March 2015.The instruments used in this study consisted of two parts: 1) personal data, 2) Screening nutritional status. The data were analyzed by percentage and mean. Results: A sample population of 86 patients aged 22-81 years old, mean age 52.59years, 90.69% are married, female were 55.81%, regular diet 70.93%, patients with no problem oral cavity was 87.21%.The sample population had high incidence of CA 47.67% and secondly cardiovascular disease 36.05 %. Patients with high-risk nutrition was 12.79 % including 45.45% cardiovascular disease and 36.36% CA. Screening of nutritional status of high-risk nutrition was 39.36% severe triceps skinfold (TSF), severe mid-arm muscle circumference(MAMC) 9.09% and severe total lymphocyte 39.36%. Conclusion: The result of nutritional status screening of surgical ward 3B found 12.79% patients with high-risk nutrition including 45.45% with cardiovascular disease .There was no problem with oral cavity and eating.Keywords: nutritional status, screening, surgical patients, 3B ward, Srinagarind Hospital
Procedia PDF Downloads 3261834 Mitigation of Size Effects in Woven Fabric Composites Using Finite Element Analysis Approach
Authors: Azeez Shaik, Yagnik Kalariya, Amit Salvi
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High-performance requirements and emission norms were forcing the automobile industry to opt for lightweight materials which improve the fuel efficiency and absorb energy during crash applications. In such scenario, the woven fabric composites are providing better energy absorption compared to metals. Woven fabric composites have a repetitive unit cell (RUC) and the mechanical properties of these materials are highly dependent on RUC. This work investigates the importance of detailed modelling of the RUC, the size effects associated and the mitigation techniques to avoid them using Finite element analysis approach.Keywords: repetitive unit cell, representative volume element, size effects, cohesive zone, finite element analysis
Procedia PDF Downloads 2551833 Parameter Estimation with Uncertainty and Sensitivity Analysis for the SARS Outbreak in Hong Kong
Authors: Afia Naheed, Manmohan Singh, David Lucy
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This work is based on a mathematical as well as statistical study of an SEIJTR deterministic model for the interpretation of transmission of severe acute respiratory syndrome (SARS). Based on the SARS epidemic in 2003, the parameters are estimated using Runge-Kutta (Dormand-Prince pairs) and least squares methods. Possible graphical and numerical techniques are used to validate the estimates. Then effect of the model parameters on the dynamics of the disease is examined using sensitivity and uncertainty analysis. Sensitivity and uncertainty analytical techniques are used in order to analyze the affect of the uncertainty in the obtained parameter estimates and to determine which parameters have the largest impact on controlling the disease dynamics.Keywords: infectious disease, severe acute respiratory syndrome (SARS), parameter estimation, sensitivity analysis, uncertainty analysis, Runge-Kutta methods, Levenberg-Marquardt method
Procedia PDF Downloads 3611832 The Impact of COVID-19 on the Mental Health of Residents of Saudi Arabia
Authors: Khaleel Alyahya, Faizah Alotaibi
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The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress
Procedia PDF Downloads 1031831 An Analysis of Motorcycle Accidents in Spain (2006-2011)
Authors: Francisco Toledo-Castillo, María Josefa Sospedra-Baeza, Sergio Hidalgo-Fuentes
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Motorcycles constitute about 9% of all motorized vehicles in Spain and are generally overrepresented in traffic accidents, accounting for 21% of total accidents. Six years of motorcycle accident data were obtained through the national accident database of Spain (Dirección General de Tráfico). Some of the studied factors are age, gender, helmet wearing, alcohol consumption, speeding, subject’s driving license and for how long it has been held, the trip purpose, and the presence of a passenger on the vehicle. Key findings show helmet use, unsafe speed, the trip purpose, weather, distraction, collision type and other variables play significant roles in crash-injury outcomes. Finally, we examine evolution of mortality and severity from 2006 to 2011.Keywords: motorcycle accidents, risk factors, statistics, Spain
Procedia PDF Downloads 3641830 The Relationship between Quality of Life and Sexual Satisfaction in Women with Severe Burns
Authors: Jafar Kazemzadeh, Soheila Rabiepoor, Saeedeh Alizadeh
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Introduction: Burn, especially in women, can affect the quality of life and their quality of life due to a change in appearance. This study was designed to investigate the relationship between quality of life and sexual satisfaction in women with burn. Methods: This was a descriptive-analytical cross-sectional study conducted on 101 women with severe burns referring to Imam Khomeini Hospital in Urmia in 2016. The data gathering scales were demographic questionnaire, burn specific health scale-brief (BSHS-B) and index of sexual satisfaction (ISS). The data were analyzed using SPSS software version 16. Results: Mean score of quality of life was 102.94 ± 20.88 and sexual satisfaction was 57.03 ± 25.91. Also, there was a significant relationship between quality of life and its subscales with sexual satisfaction and some demographic variables (p < 0.05). Conclusion: According to the results of this study, it should be noted that interventional efforts for improving sexual satisfaction and thus improving the quality of life in these patients are important. The findings of this study appear to be effective in planning for women with a history of burns.Keywords: burn, quality of life, sexual satisfaction, women
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