Search results for: left bundle branch block

Authors: Yousef Reda

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Pancreatic cancer has an overall dismal prognosis. CT, MRI and Endoscopic Ultrasound are most often used to establish the diagnosis. We present a case of a patient found on abdominal CT and MRI to have an 8 mm cystic lesion within the head of the pancreas which was thought to be a benign intraductal papillary mucinous neoplasm (IPMN). Further evaluation by EUS demonstrated a 1 cm predominantly solid mass that was proven to be an adenocarcinoma by EUS-guided FNA. The patient underwent a Whipple procedure. The final pathology confirmed a 1 cm pT1 N0 pancreatic ductal adenocarcinoma. Case: A 63-year-old male presented with left upper quadrant pain and an abdominal CT demonstrated an 8 mm lesion within the head of the pancreas that was thought to represent a side branch IPMN. An MRI also showed similar findings. Four months later due to ongoing symptoms an EUS was performed to re-evaluate the pancreatic lesion. EUS revealed a predominantly solid hypoechoic, homogeneous mass measuring 12 mm x 9 mm. EUS-guided FNA was performed and was positive for adenocarcinoma. The patient underwent a Whipple procedure that confirmed it to be a ductal adenocarcinoma, pT1N0. The solid mass was noted to be adjacent to a cystic dilation with no papillary architecture and scant epithelium. The differential diagnosis resided between cystic degeneration of a primary pancreatic adenocarcinoma versus malignant degeneration within a side-branch IPMN. Discussion: The reported sensitivity of CT for pancreatic cancer is approximately 90%. For pancreatic tumors, less than 3 cm the sensitivity of CT is reduced ranging from 67-77%. MRI does not significantly improve overall detection rates compared to CT. EUS, however is superior to CT in the detection of pancreatic cancer, in particular among lesions smaller than 3 cm. EUS also outperforms CT and MRI in distinguishing neoplastic from non-neoplastic cysts. In this case, both MRI and CT failed to detect a small pancreatic adenocarcinoma. The addition of EUS and FNA to abdominal imaging can increase overall accuracy for the diagnosis of neoplastic pancreatic lesions. It may be prudent that when small lesions although appearing as a benign IPMN should further be evaluated by EUS as this would lead to potentially identifying earlier stage pancreatic cancers and improve survival in a disease which has a dismal prognosis.

Keywords: IPMN, MRI, EUS, CT

Procedia PDF Downloads 264

Authors: Keshab Shrestha, Hung-Suck Park

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Emergy accounting of the systems networks is guided by a definite rule called ‘emergy algebra’. The systems networks consist of two types of branching. These are the co-product branching and split branching. The emergy accounting procedure for both the branching types is different. According to the emergy algebra, each branch in the co-product branching has different transformity values whereas the split branching has the same transformity value. After the transformity value of each branch is determined, the emergy is calculated by multiplying this with the energy. The aim of this research is to solve the problems in determining the transformity values in the co-product branching through the introduction of a new methodology, the modified physical quantity method. Initially, the existing methodologies for emergy accounting in the co-product branching is discussed and later, the modified physical quantity method is introduced with a case study of the Eucalyptus pulp production. The existing emergy accounting methodologies in the co-product branching has wrong interpretations with incorrect emergy calculations. The modified physical quantity method solves those problems of emergy accounting in the co-product branching systems. The transformity value calculated for each branch is different and also applicable in the emergy calculations. The methodology also strictly follows the emergy algebra rules. This new modified physical quantity methodology is a valid approach in emergy accounting particularly in the multi-production systems networks.

Keywords: co-product branching, emergy accounting, emergy algebra, modified physical quantity method, transformity value

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Authors: Medet K. Khamitov, Marat M. Ospanov, Vasiliy M. Lozovoy, Zhenis N. Sakuov, Dastan Z. Rustemov

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With a high rectosigmoid transitional zone in children with Hirschsprung’s disease, the upper rectal, sigmoid, left colon arteries are ligated during the pull-through of the descending part of the colon. As a result, the inferior mesenteric artery ceases to participate in the blood supply to the descending part of the colon. As a result, the reduced colon is supplied with blood only by the middle colon artery, which originates from the superior mesenteric artery. Insufficiency of blood supply to the reduced colon is the cause of the development of chronic hypoxia of the intestinal wall or necrosis of the reduced descending colon. Some surgeons prefer to preserve the left colon artery. However, it is possible to stretch the mesentery, which can lead to bowel retraction to anastomotic leaks and stenosis. Chronic hypoxia of the reduced colon, in turn, is the cause of acquired (secondary) aganglionosis. The highest frequency of anastomotic leaks is observed in children older than five years. The purpose is to reduce the risk of complications in the pull-through procedure of the descending part of the colon in patients with Hirschsprung’s disease by ensuring its sufficient mobility and maintaining blood supply to the lower mesenteric artery. Methodology and events. Two children aged 5 and 7 years with Hirschsprung’s disease were operated under the conditions of the hospital in Nur-Sultan. The diagnosis was made using x-ray contrast enema and histological examination. Operational technique. After revision of the left part of the colon and assessment of the architectonics of its blood vessels, parietal mobilization of the affected sigmoid and rectum was performed on laparotomy access, while maintaining the arterial and venous terminal arcades of the sigmoid vessels. Then, the descending branch of the left colon artery was crossed (if there is an insufficient length of the reduced intestine, the left colonic artery itself may also be crossed). This manipulation provides additional mobility of the pull-through descending part of the colon. The resulting "windows" in the mesentery of the reduced intestine were sutured to prevent the development of an internal hernia. Formed a full-blooded, sufficiently long transplant from the transverse loops of the splenic angle and the descending parts of the colon with blood supply from the upper and lower mesenteric artery, freely, without tension, is reduced to the rectal zone with the coloanal anastomosis 1.5 cm above the dentate line. Results. The postoperative period was uneventful. Patients were discharged on the 7th day. The observation was carried out for six months. In no case, there was a bowel retraction, anastomotic leak, anastomotic stenosis, or other complications. Conclusion. The presented technique of mobilization of the colon for the pull-through procedure in a high transitional rectosigmoid zone of Hirschsprung’s disease allows to maintain normal blood supply to the distal part of the colon and to avoid the tension of the colon. The technique allows reducing the risk of anastomotic leak, bowel necrosis, chronic ischemia, to exclude colon retraction and anastomotic stenosis.

Keywords: blood supply, children, colon mobilization, Hirschsprung's disease, pull-through

Procedia PDF Downloads 147

Authors: Zhan Chen, Wenquan Bi, Xiaoyun Wang

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The Midori family of light weight block cipher is proposed in ASIACRYPT2015. It has attracted the attention of numerous cryptanalysts. There are two versions of Midori: Midori64 which takes a 64-bit block size and Midori128 the size of which is 128-bit. In this paper an improved 10-round impossible differential attack on Midori64 is proposed. Pre-whitening keys are considered in this attack. A better impossible differential path is used to reduce time complexity by decreasing the number of key bits guessed. A hash table is built in the pre-computation phase to reduce computational complexity. Partial abort technique is used in the key seiving phase. The attack requires 259 chosen plaintexts, 214.58 blocks of memory and 268.83 10-round Midori64 encryptions.

Keywords: cryptanalysis, impossible differential, light weight block cipher, Midori

Procedia PDF Downloads 350

Authors: Xiaolin Zeng, Lei Cheng, Zhirong Li, Xueping Liu

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Aiming at the problem of low accuracy and susceptibility to cultural relic diseases in the generation of high-resolution archaeology drawings by current image generation algorithms, an archaeology drawings generation algorithm based on a conditional generative adversarial network is proposed. An attention mechanism is added into the high-resolution image generation network as the backbone network, which enhances the line feature extraction capability and improves the accuracy of line drawing generation. A dual-branch parallel architecture consisting of two backbone networks is implemented, where the semantic translation branch extracts semantic features from orthophotographs of cultural relics, and the gradient screening branch extracts effective gradient features. Finally, the fusion fine-tuning module combines these two types of features to achieve the generation of high-quality and high-resolution archaeology drawings. Experimental results on the self-constructed archaeology drawings dataset of grotto temple statues show that the proposed algorithm outperforms current mainstream image generation algorithms in terms of pixel accuracy (PA), structural similarity (SSIM), and peak signal-to-noise ratio (PSNR) and can be used to assist in drawing archaeology drawings.

Keywords: archaeology drawings, digital heritage, image generation, deep learning

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Authors: Jagadish Rao Padubidri, Mehak Bhandary, Sowmya J. Rao

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Introduction: The significance of the human foot and its measurements in identifying an individual has been proved a lot of times by different studies in different geographical areas and its association to the stature and gender of the individual has been justified by many researches. In our study we have used different foot measurements including the length, width, malleol height and navicular height for establishing its association to stature and gender and to find out its accuracy. The purpose of this study is to show the relation of foot measurements with stature and gender, and to derive Multiple and Logistic regression equations for stature and gender estimation in South Indian population. Materials and Methods: The subjects for this study were 200 South Indian students out of which 100 were females and 100 were males, aged between 18 to 24 years. The data for the present study included the stature, foot length, foot breath, foot malleol height, foot navicular height of both right and left foot. Descriptive statistics, T-test and Pearson correlation coefficients were derived between stature, gender and foot measurements. The stature was estimated from right and left foot measurements for both male and female South Indian population using multiple regression analysis and logistic regression analysis for gender estimation. Results: The means, standard deviation, stature, right and left foot measurements and T-test in male population were higher than in females. LFL (Left foot length) is more than RFL (Right Foot length) in male groups, but in female groups the length of both foot are almost equal [RFL=226.6, LFL=227.1]. There is not much of difference in means of RFW (Right foot width) and LFW (Left foot width) in both the genders. Significant difference were seen in mean values of malleol and navicular height of right and left feet in male gender. No such difference was seen in female subjects. Conclusions: The study has successfully demonstrated the correlation of foot length in stature estimation in all the three study groups in both right and left foot. Next in parameters are Foot width and malleol height in estimating stature among male and female groups. Navicular height of both right and left foot showed poor relationship with stature estimation in both male and female groups. Multiple regression equations for both right and left foot measurements to estimate stature were derived with standard error ranging from 11-12 cm in males and 10-11 cm in females. The SEE was 5.8 when both male and female groups were pooled together. The logistic regression model which was derived to determine gender showed 85% accuracy and 92.5% accuracy using right and left foot measurements respectively. We believe that stature and gender can be estimated with foot measurements in South Indian population.

Keywords: foot length, gender, stature, South Indian

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Authors: Garadi Ahmed, Boubakar S. Bouazza

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The Zero Cross-Correlation (C, w) code is a family of binary sequences of length C and constant Hamming-weight, the cross correlation between any two sequences equal zero. In this paper, we evaluate the performance of ZCC code based on Balanced Incomplete Block Design (BIBD) for Spectral Amplitude Coding Optical Code Division Multiple Access (SAC-OCDMA) system using direct detection. The BER obtained is better than 10-9 for five simultaneous users.

Keywords: spectral amplitude coding-optical code-division-multiple-access (SAC-OCDMA), phase induced intensity noise (PIIN), balanced incomplete block design (BIBD), zero cross-correlation (ZCC)

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Authors: Althaf Marsoof

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The blocking injunction, giving rise to a ‘notice and block’ regime, has become the new approach to curtail the infringement of Intellectual Property rights on the Internet. As such, the blocking injunction is an addition to the arsenal of copyright owners, and more recently has also benefited trademark owners, in their battle against piracy and counterfeiting. Yet, the blocking injunction, notwithstanding the usefulness of its ‘notice and block’ outcome, is not without limitations. In the circumstances, it is argued that ‘notice and takedown’, the approach that has been adopted by right-holders for some years, is still an important remedy against the proliferation of online content that infringe the rights of copyright and trademark owners, which is both viable and effective. Thus, it is suggested that the battle against online piracy and counterfeiting could be won only if both the blocking injunction and the practice of ‘notice and takedown’ are utilised by right-holders as complementary and simultaneous remedies.

Keywords: blocking injunctions, internet intermediaries, notice and takedown, intellectual property

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Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

Procedia PDF Downloads 131

Authors: Li Li, Ahmed A. Abd El-Latif, Aya El-Fatyany, Mohamed Amin

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This paper proposes a new secret image sharing method based on integer discrete cosine transform (IntDCT). It first transforms the original image into the frequency domain (DCT coefficients) using IntDCT, which are operated on each block with size 8*8. Then, it generates shares among each DCT coefficients in the same place of each block, that is, all the DC components are used to generate DC shares, the ith AC component in each block are utilized to generate ith AC shares, and so on. The DC and AC shares components with the same number are combined together to generate DCT shadows. Experimental results and analyses show that the proposed method can recover the original image lossless than those methods based on traditional DCT and is more sensitive to tiny change in both the coefficients and the content of the image.

Keywords: secret image sharing, integer DCT, lossless recovery, sensitivity

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Authors: Tayfun Çay, Yasar İnceyol, Abdurrahman Özbeyaz

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Land reallocation is one of the most important steps in land consolidation projects. Many different models were proposed for land reallocation in the literature such as Fuzzy Logic, block priority based land reallocation and Spatial Decision Support Systems. A model including four parts is considered for automatic block reallocation with genetic algorithm method in land consolidation projects. These stages are preparing data tables for a project land, determining conditions and constraints of land reallocation, designing command steps and logical flow chart of reallocation algorithm and finally writing program codes of Genetic Algorithm respectively. In this study, we designed the first three steps of the considered model comprising four steps.

Keywords: land consolidation, landholding, land reallocation, optimization, genetic algorithm

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Authors: El Asnaoui Khalid, Chawki Youness, Aksasse Brahim, Ouanan Mohammed

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In these recent decades, the important and fast growth in the development and demand of multimedia products is contributing to an insufficient in the bandwidth of device and network storage memory. Consequently, the theory of data compression becomes more significant for reducing the data redundancy in order to save more transfer and storage of data. In this context, this paper addresses the problem of the lossless and the near-lossless compression of images. This proposed method is based on Block SVD Power Method that overcomes the disadvantages of Matlab's SVD function. The experimental results show that the proposed algorithm has a better compression performance compared with the existing compression algorithms that use the Matlab's SVD function. In addition, the proposed approach is simple and can provide different degrees of error resilience, which gives, in a short execution time, a better image compression.

Keywords: image compression, SVD, block SVD power method, lossless compression, near lossless

Procedia PDF Downloads 388

Authors: Mahdi Sadeghian, Somaye Sadeghian, Reza Dinarvand

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This paper is going to discuss two issues encountered in using PLAXIS. Both issues were monitored during application of PLAXIS to estimate the excavation-induced displacement. Column Soil Mixing (CSM) was applied to stabilise the excavation. It was understood that the estimated excavation induced deformation at the top of the CSM blocks highly depends on the material type defining pavement material adjacent to the CSM blocks. Cohesive material for pavement will result in the unrealistic connection between pavement and CSM even by defining an interface element. To find the most realistic approach, the interface defined in three different manners (1) no interface elements were applied (2) a non-cohesive soil layer was defined between pavement and CSM block to represent the friction between these materials (3) built-in interface elements in PLAXIS was used to define the boundary between the pavement and the CSM block. The result showed that the option 2 would result in more realistic results. The second issue was in the modelling of the contact line between the CSM block and an inclined layer underneath. The analysis result showed that the excavation-induced deformation highly depends on how the PLAXIS user defines the contact area. It was understood that if the contact area had defined as a point in which CSM block had intersected the layer underneath the estimated lateral displacement of CSM block would be unrealistically lower than the model in which the contact area was defined as a line.

Keywords: PLAXIS, FEM, CSM, Excavation-Induced Deformation

Procedia PDF Downloads 165

Authors: Hooman Dabirmanesh, Attila M. Zsaki

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The toppling failure mode in a rock mass is considerably different from the most common sliding failure type along an existing or an induced slip plane. Block toppling is observed in a rock mass which consists of both a widely-spaced basal cross-joint set and a closely-spaced discontinuity set dipping into the slope. For this case, failure occurs when the structure cannot bear the tensile portion of bending stress, and the columns or blocks overturn by their own weight. This paper presents a particle-based discrete element model of rock blocks subjected to a toppling failure where geometric conditions and interaction among blocks are investigated. A series of parametric studies have been conducted on particles’ size, arrangement and bond contact among of particles which are made the blocks. Firstly, a numerical investigation on a one-block system was verified. Afterward, a slope consisting of multi-blocks was developed to study toppling failure and interaction forces between blocks. The results show that the formation of blocks, especially between the block and basal plane surface, can change the process of failure. The results also demonstrate that the initial configuration of particles used to form the blocks has a significant role in achieving accurate simulation results. The size of particles and bond contacts have a considerable influence to change the progress of toppling failure.

Keywords: block toppling failure, contact interaction, discrete element, particle size, random generation

Procedia PDF Downloads 203

Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

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Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

Procedia PDF Downloads 359

Authors: Kizito Ugochukwu Nwajeri

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This paper explores the application of hybrid block methods for solving boundary value problems (BVPs), which are prevalent in various fields such as science, engineering, and applied mathematics. Traditionally, numerical approaches such as finite difference and shooting methods, often encounter challenges related to stability and convergence, particularly in the context of complex and nonlinear BVPs. To address these challenges, we propose a hybrid block method that integrates features from both single-step and multi-step techniques. This method allows for the simultaneous computation of multiple solution points while maintaining high accuracy. Specifically, we employ a combination of polynomial interpolation and collocation strategies to derive a system of equations that captures the behavior of the solution across the entire domain. By directly incorporating boundary conditions into the formulation, we enhance the stability and convergence properties of the numerical solution. Furthermore, we introduce an adaptive step-size mechanism to optimize performance based on the local behavior of the solution. This adjustment allows the method to respond effectively to variations in solution behavior, improving both accuracy and computational efficiency. Numerical tests on a variety of boundary value problems demonstrate the effectiveness of the hybrid block methods. These tests showcase significant improvements in accuracy and computational efficiency compared to conventional methods, indicating that our approach is robust and versatile. The results suggest that this hybrid block method is suitable for a wide range of applications in real-world problems, offering a promising alternative to existing numerical techniques.

Keywords: hybrid block methods, boundary value problem, polynomial interpolation, adaptive step-size control, collocation methods

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Authors: Idris Adamu Idris

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The Nigerian construction industry is faced with problems of failure of structures/buildings. These failures are attributed to the use of low quality construction materials of which sand crate bock is inclusive. The research was conducted to determine the compressive strength of hollow sand crate block (6”) using locally made cement (Sokoto cement). Samples were tested for 7, 14, 21 and 28 days for mix ratio of 1:3 to 1:12. From the laboratory results obtained, a mix ratio of 1:10 corresponding to a minimum compressive strength of 1.9N/mm2 at 7 days should be adopted. This satisfies the BS 2028, 1364 1986 which specified a minimum compressive strength of 1.8N/mm2 at 7 days. At 28 days of curing, the same mix ratio meets the minimum BS standard of 2.5N/mm2 .

Keywords: buildings, cement, construction, hollow sand crate block, Nigeria

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Authors: Gulam Anwer Khan, A. Gautam

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Background: The arch of aorta is a large artery that arches over the root of the left lung and connects the ascending aorta and descending aorta. It is situated in the superior mediastinum behind the manubrium sterni. It gives off three major branches i.e. brachiocephalic trunk, left common carotid artery and left subclavian artery arising from the superior surface of arch of aorta from right to left. Material and Methods: This was a descriptive study. It was carried out in 44 cadavers, obtained during dissections for undergraduates of Department of Anatomy, Chitwan Medical College, Bharatpur, Chitwan, between March 2015 to October 2016. Cadavers of both sexes were included in the present study. The arch of aorta was dissected and exposed according to the methods described by Romanes in Cunningham’s manual of practical anatomy. Results: Out of 44 dissected cadavers, 35 (79.54%) were male and 9 (20.46%) were female cadavers. The normal branching pattern of the arch of aorta was encountered in 28 (63.64%) cadavers and the remaining 16 (36.36%) cadavers showed variations in the branching pattern of arch of aorta. Two different types of variations on the branching pattern of arch of aorta were noted in the present study, in which 12 (27.27%) cadavers had common trunk of the Arch of Aorta. In 3 (5.00%) male cadavers, we found the origin of the Thyroid ima artery. This variation was noted in 1(1.66%) female cadaver. Conclusion: The present study carried out on adult human cadavers’ revealed wide variations in the branching pattern of the arch of ao rta. These variations are of clinical significance and also very useful for the anatomists, radiologists, anesthesiologists, surgeons for practice during angiography, instrumentation, supra-aortic thoracic, head and neck surgery.

Keywords: arch of aorta, brachiocephalic trunk, left common carotid artery, left subclavian artery, Thyroidea ima artery

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Authors: Eman A. Embaby, Amira A. A. Abdallah

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Background: Occupational standing is associated with low back pain (LBP) development. Yet, trunk and gluteus-medius muscles’ fatigability has not been extensively studied during occupational standing. This study examined and correlated the rectus abdominus (RA), erector-spinae (ES), external oblique (EO), and gluteus-medius (GM) muscles’ fatigability on both sides while standing in a confined area for 30 min Methods: Median frequency EMG data were collected from 15 female clinical instructors with chronic LBP (group A) and 15 asymptomatic controls (group B) (mean age 29.53±2.4 vs. 29.07±2.4 years, weight 63.6±7 vs. 60±7.8 kg, and height 162.73±4 vs. 162.8±6 cm respectively) using a spectrum analysis program. Data were collected in the first and last 5min of the standing task. Results: Using Mixed three-way ANOVA, group A showed significantly (p<0.05) lower frequencies for the right and left ES, and right GM in the last 5 min and significantly higher frequencies for the left RA in the first and last 5min than group B. In addition, the left ES and right EO, ES and GM in group B showed significantly higher frequencies and the left ES in group A showed significantly lower frequencies in the last 5min compared with the first. Moreover, the right RA showed significantly higher frequencies than the left in the last 5min in group B. Finally, there were significant (p<0.05) correlations among the median frequencies of the tested four muscles on the same side and between both sides in both groups. Discussion/Conclusions: Clinical instructors with LBP are more liable to have higher trunk and gluteus-medius muscle fatigue than asymptomatic individuals. Thus, endurance training for these muscles should be included in the rehabilitation of such patients.

Keywords: EMG, fatigability, gluteus-medius, LBP, standing, trunk

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Authors: Supattra Kanchanopast

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The purpose of this research is to develop and design a management information system for 7 eleven shop in Bangkok. The system was designed and developed to meet users’ requirements via the internet network by use of application software such as My SQL for database management, Apache HTTP Server for Web Server and PHP Hypertext Preprocessor for an interface between web server, database and users. The system was designed into two subsystems as the main system, or system for head office, and the branch system for branch shops. These consisted of three parts which are classified by user management as shop management, inventory management and Point of Sale (POS) management. The implementation of the MIS for the mini-mart shop, can lessen the amount of paperwork and reduce repeating tasks so it may decrease the capital of the business and support an extension of branches in the future as well.

Keywords: convenience store, the management information system, inventory management, 7 eleven shop

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Authors: Pamela Chia, Tay Yoong Chuan

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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

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Authors: Z. B. Ibrahim, N. Ismail, K. I. Othman

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Fuzzy Differential Equations (FDEs) play an important role in modelling many real life phenomena. The FDEs are used to model the behaviour of the problems that are subjected to uncertainty, vague or imprecise information that constantly arise in mathematical models in various branches of science and engineering. These uncertainties have to be taken into account in order to obtain a more realistic model and many of these models are often difficult and sometimes impossible to obtain the analytic solutions. Thus, many authors have attempted to extend or modified the existing numerical methods developed for solving Ordinary Differential Equations (ODEs) into fuzzy version in order to suit for solving the FDEs. Therefore, in this paper, we proposed the development of a fuzzy version of three-point block method based on Block Backward Differentiation Formulas (FBBDF) for the numerical solution of first order FDEs. The three-point block FBBDF method are implemented in uniform step size produces three new approximations simultaneously at each integration step using the same back values. Newton iteration of the FBBDF is formulated and the implementation is based on the predictor and corrector formulas in the PECE mode. For greater efficiency of the block method, the coefficients of the FBBDF are stored at the start of the program. The proposed FBBDF is validated through numerical results on some standard problems found in the literature and comparisons are made with the existing fuzzy version of the Modified Simpson and Euler methods in terms of the accuracy of the approximated solutions. The numerical results show that the FBBDF method performs better in terms of accuracy when compared to the Euler method when solving the FDEs.

Keywords: block, backward differentiation formulas, first order, fuzzy differential equations

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Authors: Khaled Alabduljabbar

Abstract:

Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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Authors: Jiahui Song

Abstract:

There have been decades of research into the action potential block in nerves. To our best knowledge electrical voltages can reversibly block the conduction of action potentials across whole animal nerves. Blocking biological electrical signaling pathways can have a variety of applications in muscular and sensory incapacitation and clinical research, including urethral pressure reduction and relieving chronic pain relief from a peripheral nerve injury. The cessation ability has been used in muscle activation and fatigue reduction. Ultrashort, high-intensity electric pulses modulate the membrane conductivity to block nerve conduction through the electroporation process. Nanopore formation on the membrane surface would increase the local membrane conductivity and effectively "short-out" the trans-membrane potential of a nerve that inhibits action potential propagation. This block would be similar in concept to stopping the propagation of an air-pressure wave down a "leaky" pipe. This research focuses on a distributed electrical model with an additional time-dependent membrane conductance to calculate the poration induced by the ultrashort, high-intensity electric pulses. The changes in membrane conductivity are used to predict changes in action potential transmission. A "strength-duration (SD)" curve is generated for action potential blockage and would be used as a design guide for benchmarking safety thresholds or setting the pulse voltage and/or durations necessary for neuro-muscular incapacitation.

Keywords: action potential, ultrashort, high-intensity, nerve, strength-duration

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Authors: U. V. S. Seshavatharam, S. Lakshminarayana

Abstract:

In a unified approach observed cosmic red shift can be re-interpreted as an index of cosmological galactic atomic light emission phenomenon. By increasing the applications of Hubble volume in cosmology as well as in quantum physics, concepts of ‘Black Hole Cosmology’ can be well-confirmed. Clearly speaking ‘quantum mechanics’ can be shown to be a branch of ‘black hole cosmology’. In Big Bang Model, confirmation of all the observations directly depend on the large scale galactic distances that are beyond human reach and raise ambiguity in all respects. The subject of modern black hole physics is absolutely theoretical. Advantage of Black hole cosmology lies in confirming its validity through the ground based atomic and nuclear experimental results.

Keywords: Hubble volume, black hole cosmology, CMBR energy density, Planck’s constant, fine structure ratio, cosmic time, nuclear charge radius, unification

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Authors: Kyoungok Jung, Chang Hong Bak, Gyeong Cheon Jo, Jin-Baek Kim

Abstract:

Nanostructured arrays have drawn extensive attention because of their unique properties resulting from nanoscale features. However, it is difficult to achieve uniform and freestanding 1D nanostrcutures over a large area. Here, a simple and novel method was developed for fabrication of universal nanoporous templates for high-density nanostructure arrays, by combining self-assembly of a Si-containing block copolymer with a bilayer lithography system. We introduced a dually responsive photoresist bottom layer into which the nanopatterns of block copolymer are transferred by oxygen reactive ion etching. Because the dually responsive layer becomes cross-linked by heating, it can be used as a hard template during the etching process. It becomes soluble again by chain scission upon exposure to light. Therefore, it can be easily removed by the lift-off process. The template was applicable to the various conducting substrates due to the compatibility of the photoresist with a wide range of substrates and was used in electrodeposition for well-aligned and high-density inorganic and organic nanoarrays. We successfully obtained vertically aligned and highly ordered gold nanorods and polypyrrole dots on the substrate without aggregation, and these arrays did not collapse after removing the dually responsive templates by the simple lift-off process.

Keywords: block copolymer, dually responsive, nanostructure, photoresist

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Authors: Do Chi Thanh, Dang Ngoc Huy

Abstract:

Nowadays, there are more and more variable speed drive systems in small-scale and large-scale applications such as the electric vehicle industry, household appliances, medical equipment, and other industrial fields led to the development of BLDC (Brushless DC) motors. BLDC drive has many advantages, such as higher efficiency, better speed torque characteristics, high power density, and low maintenance cost compared to other conventional motors. Most BLDC motors use a proportional-integral (PI) controller and a pulse width modulation (PWM) scheme for speed control. This article describes the simulation model of BLDC motor drive control with the help of MATLAB - SIMULINK simulation software. The built simulation model includes a BLDC motor dynamic block, Hall sensor signal generation block, inverter converter block, and PI controller.

Keywords: brushless DC motor, BLDC, six-step inverter, PI speed

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Authors: Daoudi Abdelaziz, Mahmoudi Saïd, Chikh Mohamed Amine

Abstract:

This paper presents a fully automatic segmentation method of the left ventricle at End Systolic (ES) and End Diastolic (ED) in the ultrasound images by means of an implicit deformable model (level set) based on Geodesic Active Contour model. A pre-processing Gaussian smoothing stage is applied to the image, which is essential for a good segmentation. Before the segmentation phase, we locate automatically the area of the left ventricle by using a detection approach based on the Hough Transform method. Consequently, the result obtained is used to automate the initialization of the level set model. This initial curve (zero level set) deforms to search the Endocardial border in the image. On the other hand, quantitative evaluation was performed on a data set composed of 15 subjects with a comparison to ground truth (manual segmentation).

Keywords: level set method, transform Hough, Gaussian smoothing, left ventricle, ultrasound images.

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Authors: Rotimi Sunday Ajani, Omowumi Femi-Akinlosotu

Abstract:

Background: The usually paired human kidneys are retroperitoneal urinary organs with some endocrine functions. Standard text books of anatomy ascribe single value to each of the dimension of length, width and thickness. Research questions: These values do not give consideration to racial and genetic variability in human morphology. They may thus be erroneous to students and clinicians working on Nigerians. Objectives: The study aimed at establishing reference values of the kidney length, width and thickness for Nigerians using the cadaveric model. Methodology: The length, width, thickness and weight of sixty kidneys harvested from cadavers of thirty adult Nigerians (Male: Female; 27: 3) were measured. Respective volume was calculated using the ellipsoid formula. Results: The mean length of the kidney was 9.84±0.89 cm (9.63±0.88 {right}; 10.06±0.86 {left}), width- 5.18±0.70 cm (5.21±0.72 {right}; 5.14±0.70 {left}), thickness-3.45±0.56 cm (3.36±0.58 {right}, 3.53±0.55 {left}), weight-125.06±22.34 g (122.36±21.70 {right}; 127.76 ±24.02 {left}) and volume of 95.45± 24.40 cm3 (91.73± 26.84 {right}; 99.17± 25.75 {left}). Discussion: Though the values of the parameters measured were higher for the left kidney (except for the width), they were not statistically significant. The various parameters obtained by this study differ from those of similar studies from other continents. Conclusion: Stating single value for each of the parameter of length, width and thickness of the kidney as currently obtained in textbooks of anatomy may be incomplete information and hence misleading. Thus, there is the need to emphasize racial differences when stating the normal values of kidney dimensions in textbooks of anatomy. Implication for Research and Innovation: The results of the study showed the dimensions of the kidney (length, width and thickness) have interracial vagaries as they were different from those of similar studies and values stated in standard textbooks of human anatomy. Future direction: This is a preliminary report and the study will continue so that more data will be obtained.

Keywords: kidney dimensions, cadaveric estimation, adult nigerians, racial differences

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Authors: Aditya Sethi, Vaibhav Sethi, Shenouda Girgis

Abstract:

We present a case of a 31-year-old female who presented with a three week history of left eye blurry vision following a fever. She was diagnosed with Typhoid fever, confirmed by a positive Widal test report. On examination, her best corrected visual acuity in the right eye was 20/20 and in the left eye was 20/60. Fundus examination of the right eye showed a focal area of retinitis with retinal haemorrhages along the superior arcade within the macula. There was also focal area of retinitis with superficial retinal haemorrhages along the superior arcade vessels. There was also presence of multiple yellowish white exudates within the adjacent retinal artery arranged in a beaded pattern, suggestive of Kyrieleis' vasculitis. Optical Coherence Tomography (OCT) of the left eye demonstrated cystoid macula edema with serous foveal detachment.

Keywords: typhoid retinitis, Kyrieleis’ vasculitis, immune-mediated retinitis, post-fever retinitis, typhoid retinopathy, retinitis

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