Search results for: ratio of the L6/L7 length

Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

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Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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Authors: Ahmed Hamzi, Bryan Norman

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Having scribes help document patient records in electronic health record systems can improve hospitalists’ productivity. But hospitals need to determine the optimum number of scribes to hire to maximize scribe cost effectiveness. Scribe attendance uncertainty due to planned and unplanned absences is a primary challenge. This paper presents simulation and analytical models to determine the optimum number of scribes for a hospital to hire. Scribe staffing practices vary from one context to another; different staffing scenarios are considered where having extra attending scribes provides or does not provide additional value and utilizing on-call scribes to fill in for potentially absent scribes. These staffing scenarios are assessed for different scribe revenue ratios (ratio of the value of the scribe relative to scribe costs) ranging from 100% to 300%. The optimum solution depends on the absenteeism rate, revenue ratio, and desired service level. The analytical model obtains solutions easier and faster than the simulation model, but the simulation model is more accurate. Therefore, the analytical model’s solutions are compared with the simulation model’s solutions regarding both the number of scribes hired and cost-effectiveness. Additionally, an Excel tool has been developed to facilitate decision-makers in easily obtaining solutions using the analytical model.

Keywords: hospitalists, workload, optimization cost, economic analysis

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Authors: Gelu Varghese, Khizer Saeed

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Biodiesel is as a mixture of mono-alkyl esters of long chain fatty acids derived from vegetable oils or animal fats. Recent studies in the literature suggest that end property of biodiesel such as its oxidative stability (OS) is highly influenced by the structure and composition of its alkyl esters than by environmental conditions. The structure and composition of these long chain fatty acid components have been also associated with trends in Cetane number, heat of combustion, cold flow properties viscosity, and lubricity. In the present work, detailed investigation has been carried out to decouple and correlate the fatty acid structure indices of biodiesel such as degree of unsaturation, chain length, double bond orientation, and composition with its oxidative stability. Measurements were taken using the EN14214 established Rancimat oxidative stability test method (EN141120). Firstly, effects of the degree of unsaturation, chain length and bond orientation were tested for the pure fatty acids to establish their oxidative stability. Results for pure Fatty acid show that Saturated FAs are more stable than unsaturated ones to oxidation; superior oxidative stability can be achieved by blending biodiesel fuels with relatively high in saturated fatty acid contents. A lower oxidative stability is noticed when a greater quantity of double bonds is present in the methyl ester. A strong inverse relationship with the number of double bonds and the Rancimat IP values can be identified. Trans isomer Methyl elaidate shows superior stability to oxidation than its cis isomer methyl oleate (7.2 vs. 2.3). Secondly, the effects of the variation in the composition of the biodiesel were investigated and established. Finally, biodiesels with varying structure and composition were investigated and correlated.

Keywords: biodiesel, fame, oxidative stability, fatty acid structure, acid composition

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Authors: Y. H. Mugahed Amran, Raizal S. M. Rashid, Farzad Hejazi, Nor Azizi Safiee, A. A. Abang Ali

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Experimental and analytical studies were carried out to investigate the structural behavior of precast foamed concrete sandwich panels (PFCSP) of total number (6) as one-way action slab tested under lateral load. The details of the test setup and procedures were illustrated. The results obtained from the experimental tests were discussed which include the observation of cracking patterns and influence of aspect ratio (L/b). Analytical study of finite element analysis was implemented and degree of composite action of the test panels was also examined in both experimental and analytical studies. Result shows that crack patterns appeared in only one-direction, similar to reports on solid slabs, particularly when both concrete wythes act in a composite manner. Foamed concrete was briefly reviewed and experimental results were compared with the finite element analyses data which gives a reasonable degree of accuracy. Therefore, based on the results obtained, PFCSP slab can be used as an alternative to conventional flooring system.

Keywords: aspect ratio (L/b), finite element analyses (FEA), foamed concrete (FC), precast foamed concrete sandwich panel (PFCSP), ultimate flexural strength capacity

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Authors: Anjana R. Menon, Anjana Bhasi

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This paper deals with the numerical analysis of Prefabricated Horizontal Drain (PHD) induced consolidation of clayey deposits, using ABAQUS. PHDs are much like Prefabricated Vertical Drains (PVDs) installed in horizontal layers, used mainly for enhancing the consolidation of clayey fill embankments, and dredged mud deposits. The efficiency of the system depends mainly on the spacing and layout of the drain. Hence, two spacing related parameters are defined, namely WH (width to horizontal spacing ratio) and VH (vertical to horizontal spacing ratio), and the finite element models are developed based on plane strain unit cell conditions under various combinations of these parameters. The analysis results, in terms of degree of consolidation (U), are compared with the established theories. Based on the analysis, a set of equations are proposed to analyse the PHD induced consolidation. The proposed method is found to be reasonably accurate. Further, the effect of PHDs at different spacing ratios, in accelerating consolidation of a clayey embankment fill is analysed in terms of pore pressure dissipation rate, and settlement. The PHD is found to accelerate the rate of pore pressure dissipation by more than 50%, thus reducing the time for final settlement significantly.

Keywords: ABAQUS, consolidation, plane strain, prefabricated horizontal drain

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Authors: Colin S. Chen, Chien-Jung Tien, Hsin-Jan Huang

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For weathering studies, the change of chemical constituents by biodegradation effect in diesel-contaminated soils are important factors to be considered, especially when there is a prolonged period of weathering processes. The objective was to evaluate biodegradation effects onto hydrocarbon fingerprinting and distribution patterns of diesel fuels, fuel source screening and differentiation, source-specific marker compounds, and diagnostic ratios of diesel fuel constituents by laboratory and field studies. Biodegradation processes of diesel contaminated soils were evaluated by experiments lasting for 15 and 12 months, respectively. The degradation of diesel fuel in top soils was affected by organic carbon content and biomass of microorganisms in soils. Higher depletion of total petroleum hydrocarbon (TPH), n-alkanes, and polynuclear aromatic hydrocarbons (PAHs) and their alkyl homologues was observed in soils containing higher organic carbon content and biomass. Decreased ratio of selected isoprenoids (i.e., pristane (Pr) and phytane (Ph)) including n-C17/pristane and n-C18/phytane was observed. The ratio of pristane/phytane was remained consistent for a longer period of time. At the end of the experimental period, a decrease of pristane/phytane was observed. Biomarker compounds of bicyclic sesquiterpanes (BS) were less susceptible to the effects of biodegradation. The ratios of characteristic factors such as C15 sesquiterpane/ 8β(H)-drimane (BS3/BS5), C15 sesquiterpane/ 8β(H)-drimane (BS4/BS5), 8β(H)-drimane/8β(H)-homodrimane (BS5/BS10), and C15 sesquiterpane/8β(H)-homodrimane (BS3/BS10) could be adopted for source identification of diesel fuels in top soil. However, for biodegradation processes lasted for six months but shorter than nine months, only BS3/BS5 and BS3/BS10 could be distinguished in two diesel fuels. In subsoil experiments (contaminated soil located 50 cm below), the ratios of characteristic factors including BS3/BS5, BS4/BS5, and BS5/BS10 were valid for source identification of two diesel fuels for nine month biodegradation. At the early stage of contamination, biomass of soil decreased significantly. However, 6 and 7 dominant species were found in soils in top soil experiments, respectively. With less oxygen and nutrients in subsoil, less biomass of microorganisms was observed in subsoils. Only 2 and 4 diesel-degrading species of microorganisms were identified in two soils, respectively. Parameters of double ratio such as fluorene/C1-fluorene: C2-phenanthrene/C3-phenanthrene (C0F/C1F:C2P/C3P) in both top and subsoil, C2-naphthalene/C2-phenanthrene: C1-phenanthrene/C3-phenanthrene (C2N/C2P:C1P/C3P), and C1-phenanthrene/C1-fluorene: C3-naphthalene/C3-phenanthrene (C1P/C1F:C3N/C3P) in subsoil could serve as forensic indicators in diesel contaminated sites. BS3/BS10:BS4/BS5 could be used in 6 to 9 months of biodegradation processes. Results of principal component analysis (PCA) indicated that source identification of diesel fuels in top soil could only be perofrmed for weathering process less than 6 months. For subsoil, identification can be conducted for weathering process less than 9 months. Ratio of isoprenoids (pristane and phytane) and PAHs might be affected by biodegradation in spilled sites. The ratios of bicyclic sesquiterpanes could serve as forensic indicators in diesel-contaminated soils. Finally, source identification was attemped for samples collected from different fuel contaminated sites by using the unique pattern of sesquiterpanes. It was anticipated that the information generated from this study would be adopted by decision makers to evaluate the liability of cleanup in diesel contaminated sites.

Keywords: biodegradation, diagnostic ratio, diesel fuel, environmental forensics

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Authors: Olatundun Bukola Ezekiel, Adejumo Olusoji

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A feeding trial was conducted with 100 two-weeks old broiler chicken to evaluate the influence of inclusion in broiler diets at 0, 2.5, 5, 7.5 and 10% neem kernel (used to replace equal quantity of maize) on their performance, organ weight and gut morphometry. The birds were randomly allotted to five dietary treatments, each treatment having four replicates consisting of five broilers in a completely randomized design. The diets were formulated to be iso-nitrogenous (23% CP). Weekly feed intake and changes in body weight were calculated and feed efficiency determined. At the end of the 28-day feeding trial, four broilers per treatment were selected and sacrificed for carcass evaluation. Results were subjected to statistical analysis using the analysis of variance procedures of Statistical Analysis Software The treatment means were presented with group standard errors of means and where significant, were compared using the Duncan multiple range test of the same software. The results showed that broilers fed 2.5% neem kernel inclusion diets had growth performance statistically comparable to those fed the control diet. Birds on 5, 7.5 and 10% neem kernel diets showed significant (P<0.05) increase in relative weight of liver. The absolute weight of spleen also increased significantly (P<0.05) in birds on 10 % neem kernel diet. More than 5 % neem kernel diets gave significant (P<0.05) increase in the relative weight of the kidney. The length of the small intestine significantly increased in birds fed 7.5 and 10% neem kernel diets. Significant differences (P<0.05) did not occur in the length of the large intestine, right and left caeca. It is recommended that neem kernel can be included up to 2.5% in broiler chicken diet without any deleterious effects on the performance and physiological status of the birds.

Keywords: broiler chicken, growth performance, gut morphometry, neem kernel, organ weight

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Authors: Zongyao Sha

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Green vegetation plays a vital role in energy flows and matter cycles in terrestrial ecosystems, and vegetation phenology may not only be influenced by but also impose active feedback on climate changes. The phenological events of vegetation, such as the start of the season (SOS), end of the season (EOS), and length of the season (LOS), can respond to climate changes and affect gross primary productivity (GPP). Here we coupled satellite remote sensing imagery with FLUXNET observations to systematically map the shift of SOS, EOS, and LOS in global vegetated areas and explored their response to climate fluctuations and feedback on GPP during the last two decades. Results indicated that SOS advanced significantly, at an average rate of 0.19 days/year at a global scale, particularly in the northern hemisphere above the middle latitude (≥30°N) and that EOS was slightly delayed during the past two decades, resulting in prolonged LOS in 72.5% of the vegetated area. The climate factors, including seasonal temperature and precipitation, are attributed to the shifts in vegetation phenology but with a high spatial and temporal difference. The study revealed interactions between vegetation phenology and climate changes. Both temperature and precipitation affect vegetation phenology. Higher temperature as a direct consequence of global warming advanced vegetation green-up date. On the other hand, 75.9% and 20.2% of the vegetated area showed a positive correlation and significant positive correlation between annual GPP and length of vegetation growing season (LOS), likely indicating an enhancing effect on vegetation productivity and thus increased carbon uptake from the shifted vegetation phenology. Our study highlights a comprehensive view of the vegetation phenology changes of the global terrestrial ecosystems during the last two decades. The interactions between the shifted vegetation phenology and climate changes may provide useful information for better understanding the future trajectory of global climate changes. The feedback on GPP from the shifted vegetation phenology may serve as an adaptation mechanism for terrestrial ecosystems to mitigate global warming through improved carbon uptake from the atmosphere.

Keywords: vegetation phenology, growing season, NPP, correlation analysis

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Authors: Bulcha Belay Etana

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Electromyography is used to measure the electrical activity of muscles for various health monitoring applications using surface electrodes or needle electrodes. Recent developments in electromyogram signal acquisition using textile electrodes open the door for wearable health monitoring which enables patients to monitor and control their health issues outside of traditional healthcare facilities. The aim of this research is therefore to develop and analyze wearable textile electrodes for the acquisition of electromyography signals for Parkinson’s patients and apply an appropriate thermal stimulus to relieve muscle cramping. In order to achieve this, textile electrodes are sewn with a silver-coated thread in an overlapping zigzag pattern into an inextensible fabric, and stainless steel knitted textile electrodes attached to a sleeve were prepared and its electrical characteristics including signal to noise ratio were compared with traditional electrodes. To relieve muscle cramping, a heating element using stainless steel conductive yarn Sewn onto a cotton fabric, coupled with a vibration system were developed. The system was integrated using a microcontroller and a Myoware muscle sensor so that when muscle cramping occurs, measured by the system activates the heating elements and vibration motors. The optimum temperature considered for treatment was 35.50c, so a Temperature measurement system was incorporated to deactivate the heating system when the temperature reaches this threshold, and the signals indicating muscle cramping have subsided. The textile electrode exhibited a signal to noise ratio of 6.38dB while the signal to noise ratio of the traditional electrode was 7.05dB. The rise time of the developed heating element was about 6 minutes to reach the optimum temperature using a 9volt power supply. The treatment of muscle cramping in Parkinson's patients using heat and muscle vibration simultaneously with a wearable electromyography signal acquisition system will improve patients’ livelihoods and enable better chronic pain management.

Keywords: electromyography, heating textile, vibration therapy, parkinson’s disease, wearable electronic textile

Procedia PDF Downloads 135

Authors: Sima Cheraghi Dehdezi, Nasser Hamdami

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Air-drying is the most widely employed method for preserving fruits and vegetables. Most of the dried products must be rehydrated by immersion in water prior to their use, so the study of rehydration kinetics in order to optimize rehydration phenomenon has great importance. Rehydration typically composes of three simultaneous processes: the imbibition of water into dried material, the swelling of the rehydrated products and the leaching of soluble solids to rehydration medium. In this research, squash (Cucurbita pepo) fruits were cut into 0.4 cm thick and 4 cm diameter slices. Then, squash slices were blanched in a steam chamber for 4 min. After cooling to room temperature, squash slices were dehydrated in a hot air dryer, under air flow 1.5 m/s and air temperature of 60°C up to moisture content of 0.1065 kg H2O per kg d.m. Dehydrated samples were kept in polyethylene bags and stored at 4°C. Squash slices with specified weight were rehydrated by immersion in distilled water at different temperatures (25, 50, and 75°C), various dry matter-water ratios (1:25, 1:50, and 1:100), which was agitated at 100 rpm. At specified time intervals, up to 300 min, the squash samples were removed from the water, and the weight, moisture content and rehydration indices of the sample were determined.The texture characteristics were examined over a 180 min period. The results showed that rehydration time and temperature had significant effects on moisture content, water absorption capacity (WAC), dry matter holding capacity (DHC), rehydration ability (RA), maximum force and stress in dried squash slices. Dry matter-water ratio had significant effect (p˂0.01) on all squash slice properties except DHC. Moisture content, WAC and RA of squash slices increased, whereas DHC and texture firmness (maximum force and stress) decreased with rehydration time. The maximum moisture content, WAC and RA and the minimum DHC, force and stress, were observed in squash slices rehydrated into 75°C water. The lowest moisture content, WAC and RA and the highest DHC, force and stress, were observed in squash slices immersed in water at 1:100 dry matter-water ratio. In general, for all rehydration conditions of squash slices, the highest water absorption rate occurred during the first minutes of process. Then, this rate decreased. The highest rehydration rate and amount of water absorption occurred in 75°C.

Keywords: dry matter-water ratio, squash, maximum force, rehydration ability

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Authors: Florge Francis A. Sy

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Acute pancreatitis (AP) is an inflammatory condition of the pancreas with local and systemic complications. Severe acute pancreatitis (SAP) has a higher mortality rate. Laboratory parameters like the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV) have been associated with SAP but with conflicting results. This study aims to determine the predictive value of these parameters on the severity and in-hospital mortality of AP. This retrospective, cross-sectional study was done in a private hospital in Cebu City, Philippines. One-hundred five patients were classified according to severity based on the modified Marshall scoring. The admitting hemogram, including the NLR, RDW, and MPV, was obtained from the complete blood count (CBC). Cut-off values for severity and in-hospital mortality were derived from the ROC. Association between NLR, RDW, and MPV with SAP and mortality were determined with a p-value of < 0.05 considered significant. The mean age for AP was 47.6 years, with 50.5% being male. Most had an unknown cause (49.5%), followed by a biliary cause (37.1%). Of the 105 patients, 23 patients had SAP, and 4 died. Older age, longer in-hospital duration, congestive heart failure, elevated creatinine, urea nitrogen, and white blood cell count were seen in SAP. The NLR was associated with in-hospital mortality using a cut-off of > 10.6 (OR 1.133, 95% CI, p-value 0.003) with 100% sensitivity, 70.3% specificity, 11.76% PPV and 100% NPV (AUC 0.855). The NLR was not associated with SAP. The RDW and MPV were not associated with SAP and mortality. The admitting NLR is, therefore, an easily accessible parameter that can predict in-hospital mortality in acute pancreatitis. Although the present study did not show an association of NLR with SAP nor RDW and MPV with both SAP and mortality, further studies are suggested to establish their clinical value.

Keywords: acute pancreatitis, mean platelet volume, neutrophil-lymphocyte ratio, red cell distribution width

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Authors: J. B. Minari, O. B. Oloyede, A. A. Odutuga

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Myeloperoxidase is the most abundant enzyme found in the polymorphonuclear neutrophil and is known to play a central role in the host defense system of the leukocyte. The enzyme has been reported to interact with some drugs to generate free radical which inhibits its activity. This study investigated the effects of artesunate on the activity of the enzyme and the subsequent effect on the host immune system. In investigating the effects of the drugs on myeloperoxidase, the influence of concentration, pH, partition ratio estimation and kinetics of inhibition were studied. This study showed that artesunate is concentration-dependent inhibitor of myeloperoxidase with an IC50 of 0.078mM. Partition ratio estimation showed that 60 enzymatic turnover cycles are required for complete inhibition of myeloperoxidase in the presence of artesunate. The influence of pH on the effect of artesunate on the enzyme showed least activity of myeloperoxidase at physiological pH. The kinetic inhibition studies showed that artesunate caused a competitive inhibition with an increase in the Km value from 0.12mM to 0.26mM and no effect on the Vmax value. The Ki value was estimated to be 2.5mM. The results obtained from this study show that artesunate is a potent inhibitor of myeloperoxidase and it is capable of inactivating the enzyme. It is considered that the inhibition of myeloperoxidase in the presence of artesunate as revealed in this study may partly explain the impairment of polymorphonuclear neutrophil and consequent reduction of the strength of the host defense system against secondary infections.

Keywords: myeloperoxidase, artesunate, inhibition, nuetrophill

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Authors: Jodie Bradnam, Mark Edwards, Bruce Watt

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Mobile technologies have emerged as tools to create and sustain social and romantic relationships. The integration of technologies in close relationships has been of particular research interest with findings supporting the positive role of mobile phones in nurturing feelings of closeness and connection. More recently, the use of text messaging to manage conflict has become a focus of research attention. Four hundred and eleven adults in committed romantic relationships completed a series of questionnaires measuring attachment orientation, relationship quality, texting frequencies, attitudes, and response expectations. Attachment orientation, relationship length, texting for connection and disconnection were significant predictors of relationship quality, specifically relationship intimacy. Text frequency varied as a function of attachment orientation, with high attachment anxiety associated with high texting frequencies and with low relationship quality. Sending text messages of love and support was related to higher intimacy and relationship satisfaction scores, while sending critical or impersonal texts was associated with significantly lower intimacy and relationship satisfaction scores. The use of texting to manage relational conflict was a stronger negative predictor of relationship satisfaction than was the use of texting to express love and affection. Consistent with research on face-to-face communication in couples, the expression of negative sentiments via text were related to lower relationship quality, and these negative sentiments had a stronger and more enduring impact on relationship quality than did the expression of positive sentiments. Attachment orientation, relationship length and relationship status emerged as variables of interest in understanding the use of mobile technologies in romantic relationships.

Keywords: attachment, destructive conflict, intimacy, mobile communication, relationship quality, relationship satisfaction, texting

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: E. Erdem, M. Şahin, M. Saçak

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Smectite is a layered silicate and modified with alkyl ammonium salts to make both the hydrophilic silicate surfaces organophilic, and to expand the clay layers. Thus, a nanocomposite structure can be formed enabling to enter various types of polymers between the layers. In this study, Na-smectite crystals were prepared by purification of bentonite. Benzyltributylammonium bromide (BTBAB) was used as a swelling agent. The mixing time and additive concentration were changed during the swelling process. It was determined that the 4 h of mixing time and 0.2 g of BTBAB were sufficient and the usage of higher amounts of salt did not increase the interlayer space between the clay layers. Then, the conductive poly(o-toluidine) (POT)/smectite nanocomposite was prepared in the presence of swollen Na-smectite using ammonium persulfate (APS) as oxidant in aqueous acidic medium. The POT content and conductivity of the prepared nanocomposite were systematically investigated as a function of polymerization conditions such as the treatment time of swollen smectite in monomer solution and o-toluidine/APS mol ratio. The POT content and conductivity of nanocomposite increased with increasing monomer/oxidant mol ratio up to 1 and did not change at higher ratios. The maximum polymer yield and the highest conductivity value of the composite were 26.0% and 4.0×10-5 S/cm, respectively. The structural and morphological analyses of the POT/smectite nanocomposite were carried out by XRD, FTIR and SEM techniques, respectively.

Keywords: clay, composite, conducting polymer, poly(o-anisidine)

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Authors: K. Anas, M. Selvakumar, Samson David, R. R. Babu, S. Chattopadhyay

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The dynamic deformation of a visco elastic material can cause heat generation. This heat generation is aspect energy dissipation. The present work investigates the contribution of various factors like; elastomer structure, cross link type and density, filler networking, reinforcement potential and temperature at energy dissipation mechanism. The influences of these elements are investigated using very high frequency analyzer (VHF ) and dynamical mechanical analysis(DMA).VHF follows transmissibility and vibration isolation principle whereas DMA works on dynamical mechanical deformation principle. VHF analysis of different types of elastomers reveals that elastomer can act as a transmitter or damper of energy depending on the applied frequency ratio (ω/ωn). Dynamic modulus (G') of low damping rubbers like natural rubber does not varies rapidly with frequency but vice-versa for high damping rubber like butyl rubber (IIR). VHF analysis also depicts that polysulfidic linkages has high damping ratio (ζ) than mono sulfidic linkages due to its dissipative nature. At comparable cross link density, mono sulfidic linkages shows higher glass transition temperature (Tg) than poly sulfidic linkages. The intensity and location of loss modulus (G'') peak of different types of carbon black filled natural rubber compounds suggests that segmental relaxation at glass transition temperature (Tg) is seldom affected by filler particles, but the filler networks can influence the cross link density by absorbing the curatives. The filler network breaking and reformation during a dynamic strain is a thermally activated process. Thus, stronger aggregates are highly dissipative in nature. Measurements indicate that at lower temperature regimes polymeric chain friction is highly dissipative in nature.

Keywords: damping ratio, natural frequency, crosslinking density, segmental motion, surface activity, dissipative, polymeric chain friction

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Authors: Masoud Rafiee

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Study of the effect of vermin compost on yield, and Land equivalent ration (LER) of chickpea-barley mixed cropping under normal dry land condition can be useful in order to increase qualitative and quantitative performance. In this case, two factors include fertilizer (vermicompost biological fertilizer, ammonium phosphate chemical fertilizer, vermicompost + %75 chemical fertilizer) and chickpea + barley mixed cropping (sole chickpea, %75 chickpea: %25 barley, %50 chickpea: %50 barley, %25 chickpea: %75 barley, and sole barley) in RCBD in three replications in two experiments include normal and dry land conditions were studied. Result showed that total LER base on dry matter was affected by environment and mixed cropping interaction and was more than 1 in all mixed cropping treatments. In different mixed cropping rates, wet forage yield decreased by decreasing chickpea ratio as well as increasing barley ratio. Total LER mean in base on forage dry matter in mixed-, chemical-, and vermicompost fertilizer treatments were 1.12, 1.05 and 1.10 in normal condition and 1.15, 1.08 and 1.14 in dry land condition, respectively, represented the important of biological fertilizer in mixed cropping systems.

Keywords: land equivalent ration, biological fertilizer, mixed cropping systems, water stress

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Authors: C. O. Agu, C. C. Okafor

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Maize and soybean flours were produced using different methods of processing which include fermentation (FWF), roasting (RWF) and malting (MWF). Products from the different methods were mixed in the ratio 60:40 maize/soybean, respectively. These composites mixed with other ingredients such as sugar, vegetable oil, vanilla flavour and vitamin mix were analyzed for proximate composition, physical/functional, sensory and nutritional properties. The results for the protein content ranged between 6.25% and 16.65% with sample RWF having the highest value. Crude fibre values ranged from 3.72 to 10.0%, carbohydrate from 58.98% to 64.2%, ash from 1.27 to 2.45%. Physical and functional properties such as bulk density, wettability, gelation capacity have values between 0.74 and 0.76g/ml, 20.33 and 46.33 min and 0.73 to 0.93g/ml, respectively. On the sensory quality colour, flavour, taste, texture and general acceptability were determined. In terms of colour and flavour there was no significant difference (P < 0.05) while the values for taste ranged between 4.89 and 7.1 l, texture 5.50 to 8.38 and general acceptability 6.09 and 7.89. Nutritionally there is no significant difference (P < 0.05) between sample RWF and the control in all parameters considered. Samples FWF and MWF showed significantly (P < 0.5) lower values in all parameters determined. In the light of the above findings, roasting method is highly recommend in the production of weaning foods.

Keywords: fermentation, malting, ratio, roasting, wettability

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Authors: Ow Tze Weng, Suhaila Isaak, Yusmeeraz Yusof

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The trend of health care screening devices in the world is increasingly towards the favor of portability and wearability, especially in the most common electrocardiogram (ECG) monitoring system. This is because these wearable screening devices are not restricting the patient’s freedom and daily activities. While the demand of low power and low cost biomedical system on chip (SoC) is increasing in exponential way, the front end ECG sensors are still suffering from flicker noise for low frequency cardiac signal acquisition, 50 Hz power line electromagnetic interference, and the large unstable input offsets due to the electrode-skin interface is not attached properly. In this paper, a high performance CMOS amplifier for ECG sensors that suitable for low power wearable cardiac screening is proposed. The amplifier adopts the highly stable folded cascode topology and later being implemented into RC feedback circuit for low frequency DC offset cancellation. By using 0.13 µm CMOS technology from Silterra, the simulation results show that this front end circuit can achieve a very low input referred noise of 1 pV/√Hz and high common mode rejection ratio (CMRR) of 174.05 dB. It also gives voltage gain of 75.45 dB with good power supply rejection ratio (PSSR) of 92.12 dB. The total power consumption is only 3 µW and thus suitable to be implemented with further signal processing and classification back end for low power biomedical SoC.

Keywords: CMOS, ECG, amplifier, low power

Procedia PDF Downloads 248

Authors: O. Abiodun Adeyinka, B. Adeyemo Adesesan

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The forensic use of handwriting depends on the analysis, comparison, and evaluation decisions made by forensic document examiners. When using biometric technology in forensic applications, it is necessary to compute Likelihood Ratio (LR) for quantifying strength of evidence under two competing hypotheses, namely the prosecution and the defense hypotheses wherein a set of assumptions and methods for a given data set will be made. It is therefore important to know how repeatable and reproducible our estimated LR is. This paper evaluated the accuracy and reproducibility of examiners' decisions. Confidence interval for the estimated LR were presented so as not get an incorrect estimate that will be used to deliver wrong judgment in the court of Law. The estimate of LR is fundamentally a Bayesian concept and we used two LR estimators, namely Logistic Regression (LoR) and Kernel Density Estimator (KDE) for this paper. The repeatability evaluation was carried out by retesting the initial experiment after an interval of six months to observe whether examiners would repeat their decisions for the estimated LR. The experimental results, which are based on handwriting dataset, show that LR has different confidence intervals which therefore implies that LR cannot be estimated with the same certainty everywhere. Though the LoR performed better than the KDE when tested using the same dataset, the two LR estimators investigated showed a consistent region in which LR value can be estimated confidently. These two findings advance our understanding of LR when used in computing the strength of evidence in handwriting using forensics.

Keywords: confidence interval, handwriting, kernel density estimator, KDE, logistic regression LoR, repeatability, reproducibility

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Authors: Ibtissem Hosni, Lilia Bennaceur Farah, Saber Mohamed Naceur

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In order to assess the water availability in the soil, it is crucial to have information about soil distributed moisture content; this parameter helps to understand the effect of humidity on the exchange between soil, plant cover and atmosphere in addition to fully understanding the surface processes and the hydrological cycle. On the other hand, aerodynamic roughness length is a surface parameter that scales the vertical profile of the horizontal component of the wind speed and characterizes the surface ability to absorb the momentum of the airflow. In numerous applications of the surface hydrology and meteorology, aerodynamic roughness length is an important parameter for estimating momentum, heat and mass exchange between the soil surface and atmosphere. It is important on this side, to consider the atmosphere factors impact in general, and the natural erosion in particular, in the process of soil evolution and its characterization and prediction of its physical parameters. The study of the induced movements by the wind over soil vegetated surface, either spaced plants or plant cover, is motivated by significant research efforts in agronomy and biology. The known major problem in this side concerns crop damage by wind, which presents a booming field of research. Obviously, most models of soil surface require information about the aerodynamic roughness length and its temporal and spatial variability. We have used a bi-dimensional multi-scale (2D MLS) roughness description where the surface is considered as a superposition of a finite number of one-dimensional Gaussian processes each one having a spatial scale using the wavelet transform and the Mallat algorithm to describe natural surface roughness. We have introduced multi-layer aspect of the humidity of the soil surface, to take into account a volume component in the problem of backscattering radar signal. As humidity increases, the dielectric constant of the soil-water mixture increases and this change is detected by microwave sensors. Nevertheless, many existing models in the field of radar imagery, cannot be applied directly on areas covered with vegetation due to the vegetation backscattering. Thus, the radar response corresponds to the combined signature of the vegetation layer and the layer of soil surface. Therefore, the key issue of the numerical estimation of soil moisture is to separate the two contributions and calculate both scattering behaviors of the two layers by defining the scattering of the vegetation and the soil blow. This paper presents a synergistic methodology, and it is for estimating roughness and soil moisture from C-band radar measurements. The methodology adequately represents a microwave/optical model which has been used to calculate the scattering behavior of the aerodynamic vegetation-covered area by defining the scattering of the vegetation and the soil below.

Keywords: aerodynamic, bi-dimensional, vegetation, synergistic

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Authors: Eda K. Murathan, Gulten Manioglu

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In the building design process, reducing heating and cooling energy consumption according to the climatic region conditions of the building are important issues to be considered in order to provide thermal comfort conditions in the indoor environment. Applying a phase-change material (PCM) on the surface of a building envelope is the new approach for controlling heat transfer through the building envelope during the year. The transparency ratios of the window are also the determinants of the amount of solar radiation gain in the space, thus thermal comfort and energy expenditure. In this study, a simulation-based evaluation was carried out by using Energyplus to determine the effect of coupling PCM and transparency ratio when integrated into the building envelope. A three-storey building, a 30m x 30m sized floor area and 10m x 10m sized courtyard are taken as an example of the courtyard building model, which is frequently seen in the traditional architecture of hot climatic regions. 8 zones (10m x10m sized) with 2 exterior façades oriented in different directions on each floor were obtained. The percentage of transparent components on the PCM applied surface was increased at every step (%30, %40, %50). For every zone differently oriented, annual heating, cooling energy consumptions, and thermal comfort based on the Fanger method were calculated. All calculations are made for the zones of the intermediate floor of the building. The study was carried out for Diyarbakır provinces representing the hot-dry climate region and Antalya representing the hot-humid climate region. The increase in the transparency ratio has led to a decrease in heating energy consumption but an increase in cooling energy consumption for both provinces. When PCM is applied to all developed options, It was observed that heating and cooling energy consumption decreased in both Antalya (6.06%-19.78% and %1-%3.74) and Diyarbakır (2.79%-3.43% and 2.32%-4.64%) respectively. When the considered building is evaluated under passive conditions for the 21st of July, which represents the hottest day of the year, it is seen that the user feels comfortable between 11 pm-10 am with the effect of night ventilation for both provinces.

Keywords: building envelope, heating and cooling energy consumptions, phase change material, transparency ratio

Procedia PDF Downloads 176

Authors: Aime Philombe Zapji Ymele

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Servicing public debt is a significant budgetary burden. In the sense that the payment of interest charges is a liability on the balance sheet of the public budget and affects fiscal policy. Interest charges can sometimes become a burden if they crowd out private activities. In order to analyse and understand the determinants of the debt burden and its impact on the sustainability of public finances, the present work focuses on OECD countries. It is noted from the literature that the factors that determine interest charges are macroeconomic (inflation, GDP growth, and interest rates) and public finances (primary balance and public debt). After analysing a panel of 33 OECD countries and using ordinary least squares (OLS), we find that public debt, inflation, and long-term interest rates are positively correlated with interest charges. An increase in any of these variables leads to an increase in debt charges. On the other hand, a growth in GDP is negatively associated with interest charges. Indeed, an increase in GDP generates enough revenue to meet the repayment of debt charges. According to the empirical analysis, we can say that, despite the large and growing debt-to-GDP ratio of major OECD countries, interest charges are not a threat to the sustainability of public finances. However, it is important for these countries to reduce the ratio of public debt to GDP because, in the face of the many challenges (health, aging population, etc.) that are looming on the horizon, an increase in interest rates could bring with it considerable burdens that would threaten the budgetary balance of these states.

Keywords: interest charges, sustainability, public debt, interest rates

Procedia PDF Downloads 123

Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame

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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.

Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain

Procedia PDF Downloads 87

Authors: Cosmas Nathanailides, Fotini Kakali, Kostas Karipoglou

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The filleting yield and the chemical composition of farmed sea bass (Dicentrarchus labrax); rainbow trout (Oncorynchus mykiss) and meagre (Argyrosomus regius) was investigated in farmed fish in NW Greece. The results provide an estimate of the quantity of fish required to produce one kilogram of fillet weight, an estimation which is required for the operational management of fish processing companies. Furthermore in this work, the ratio of feed input required to produce one kilogram of fish fillet (FFCR) is presented for the first time as a useful indicator of the ecological footprint of consuming farmed fish. The lowest lipid content appeared in meagre (1,7%) and the highest in trout (4,91%). The lowest fillet yield and fillet yield feed conversion ratio (FYFCR) was in meagre (FY=42,17%, FFCR=2,48), the best fillet yield (FY=53,8%) and FYFCR (2,10) was exhibited in farmed rainbow trout. This research has been co-financed by the European Union (European Social Fund – ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF) - Research Funding Program: ARCHIMEDES III. Investing in knowledge society through the European Social Fund.

Keywords: farmed fish, flesh quality, filleting yield, lipid

Procedia PDF Downloads 309

Authors: Tamrat Balcha Balla

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Background: Tablets are still the most preferred means of drug delivery. The search for new and improved direct compression tablet excipients is an area of research focus. Taro Boloso-I is a variety of Colocasia esculenta (L. Schott) yielding 67% more than the other varieties (Godare) in Ethiopia. This study aimed to enhance the flowability while keeping the compressibility and compactibility of the pregelatinized Taro Boloso-I starch. Methods: Central composite design was used for the optimization of two factors which were the temperature and duration of pregelatinization against 5 responses. The responses were angle of repose, Hausner ratio, Kawakita compressibility index, mean yield pressure and tablet breaking force. Results and Discussions: An increase in both temperature and time resulted in decrease in the angle of repose. The increase in temperature was shown to decrease the Hausner ratio and to decrease the Kawakita compressibility index. The mean yield pressure was observed to increase with increasing levels of both temperature and time. The pregelatinized (optimized) Taro Boloso-I starch could show desired flow property and compressibility. Conclusions: Pregelatinized Taro Boloso - I starch could be regarded as a potential direct compression excipient in terms of flowability, compressibility and compactibility.

Keywords: starch, compression, pregelatinization, Taro Boloso-I

Procedia PDF Downloads 113

Authors: Mustafa M. Donma, Orkide Donma

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The examination of both serum lipid fractions and body’s lipid composition are quite informative during the evaluation of obesity stages. Within this context, alterations in lipid parameters are commonly observed. The variations in the fat distribution of the body are also noteworthy. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are considered as the basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information and different messages during discrete health states. Ratios are also derived from distinct fat distribution in these areas. Trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are the most recently introduced ratios. In this study, lipid fractions and TLFR, as well as TAFR, were evaluated, and the distinctions among healthy, obese (OB), and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted from a population aged 6 to 18 years. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were obtained and recorded during the physical examination. Body mass index values were calculated. Total, trunk, leg, and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including TC, TRG, LDL-C, HDL-C, and insulin were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as statistically significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR (r=0.396; p=0.037) as well as TAFR values (r=0.413; p=0.029) in MO group. When adjusted for SBP and DBP, partial correlations were calculated as (r=0.421; p=0.032) and (r=0.438; p=0.025) for LDL-TLFR as well as LDL-TAFR, respectively. Much stronger partial correlations were obtained for the same couples (r=0.475; p=0.019 and r=0.473; p=0.020, respectively) upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio

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Authors: Shahriar Ghammamy, Masomeh Shahsavary

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In this paper, the optimized geometries and frequencies of the stationary point and the minimum energy paths of C13H12F7ClN2O are calculated by using the DFT (B3LYP) methods with LANL2DZ basis sets. B3LYP/ LANL2DZ calculation results indicated that some selected bond length and bond angles values for the C13H12F7ClN2O.

Keywords: C13H12F7ClN2O, vatural bond orbital, fluorous compounds, functional calculations

Procedia PDF Downloads 336

Authors: Marcin Jakiel, Maria Kurek, Karolina Gutkowska, Sylwia Sanakiewicz, Dominika Stolarczyk, Jakub Batko, Rafał Jakiel, Mateusz K. Hołda

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The geometry of RVOT is extremely complicated. It is an irregular block with an ellipsoidal cross-section, whose dimensions decrease toward the pulmonary valve and measure 33.82 (IQR 30,51-39,36), 28.82 (IQR 26,11-32,22), 27.95 ± 4,11 for width [mm] and 33.41 ± 6,14, 26.99 ± 4,41, 26.91 ± 4,00 [mm] for depth, in the basal, middle and subpulmonary parts, respectively. In a sagittal section view, the RVOT heads upward and slightly backward. Its anterior perimeter has an average length of 41.96 mm and inclines to the transverse plane at an angle of 50.77° (IQR 46,53°-58,70°). In the posterior region, the RVOT is shorter (18.17mm) and flexes anteriorly. Therefore, the slope of the upper part of the rear wall to the transverse plane is an acute angle (open toward the rear) of 44,58° (IQR 37,30°-51,25°), while in the lower part it is an angle close to a right angle of 94,30°±15,44°. In addition, the thickness of the RVOT wall in the diastolic phase, at the posterior perimeter at the base, in the middle of the length and subpulmonary measure 3,80 mm ± 0,88 mm, 3,56 mm ± 0,73 mm, 3,56 mm ± 0,65 mm, respectively. In frontal cross-section, the RVOT rises on the interventricular septum, which makes it possible to distinguish the septal and supraseptal parts on its left periphery. The angles (facing the vertices to the right) of the inclination of these parts to the transverse plane are 75.5° (IQR 66,44°-81,11°) and 107.01° (IQR 99,09 – 115,23°), respectively, which allows us to conclude that the direction of the RVOT long axis changes from left to right. The above analysis shows that there is no single RVOT axis. Two axes can be distinguished, the one for the upper RVOT being more backward and leftward. The aforementioned forward deflection of the posterior wall and the RVOT's elevation over the interventricular septum, suggest that access to the subpulmonary region may be difficult. It should be emphasized that this area is often the target for ablation of ventricular arrhythmias. The small thickness of the RVOT posterior wall, with its difficult geometry, may favor its perforation into the pericardium or ascending aorta.

Keywords: angle, geometry, operation access, position, RVOT, shape

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Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

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Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

Procedia PDF Downloads 131