Search results for: clinical characteristic

Authors: M. Muneer, Waseem Raza

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Nano-crystalline materials of pure and metal-doped semiconducting materials have been successfully synthesized using sol gel and hydrothermal methods. The prepared materials were characterized by standard analytical techniques, i.e., XRD, SEM, EDX, UV–vis Spectroscopy and FTIR. The (XRD) analysis showed that the obtained particles are present in partial crystalline nature and exhibit no other impurity phase. The EDX and (SEM) images depicted that metals have been successfully loaded on the surface of the semiconductor. FTIR showed an additional absorption band at 910 cm−1, characteristic of absorption band indicating the incorporation of dopant into the lattice in addition to a broad and strong absorption band in the region of 410–580 cm−1 due to metal–O stretching. The UV–vis absorption spectra of synthesized particles indicate that the doping of metals into the lattice shift the absorption band towards the visible region. Thermal analysis, measurement of the synthesized sample showed that the thermal stability of pure semiconducting material is decreased due to increase in dopant concentration. The photocatalytic activity of the synthesized particles was studied by measuring the change in concentration of three different chromophoric dyes as a function of irradiation time. The photocatalytic activity of doped materials were found to increase with increase in dopant concentration.

Keywords: photocatalysis, metal doped semicondcutors, dye degradation, visible light active materials

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Authors: Zhixiang Li, Shuguang Yao, Wen Ma

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Coupler rubber buffer has been widely applied on the high-speed trains and the main function of the rubber buffer is dissipating the impact energy between vehicles. The rubber buffer consists of two groups of rubbers, which are both pre-compressed and then installed into the frame body. This paper focuses on the energy absorption characteristics of the rubber buffers particularly. Firstly, the quasi-static compression tests were carried out for 1 and 3 pairs of rubber sheets and some energy absorption responses relationship, i.e. Eabn = n×Eab1, Edissn = n×Ediss1, and Ean = Ea1, were obtained. Next, a series of quasi-static tests were performed for 1 pair of rubber sheet to investigate the energy absorption performance with different compression ratio of the rubber buffers. Then the impact tests with five impact velocities were conducted and the coupler knuckle was destroyed when the impact velocity was 10.807 km/h. The impact tests results showed that with the increase of impact velocity, the Eab, Ediss and Ea of rear buffer increased a lot, but the three responses of front buffer had not much increase. Finally, the results of impact tests and quasi-static tests were contrastively analysed and the results showed that with the increase of the stroke, the values of Eab, Ediss, and Ea were all increase. However, the increasing rates of impact tests were all larger than that of quasi-static tests. The maximum value of Ea was 68.76% in impact tests, it was a relatively high value for vehicle coupler buffer. The energy capacity of the rear buffer was determined for dynamic loading, it was 22.98 kJ.

Keywords: rubber buffer, coupler, energy absorption, impact tests

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Authors: Waziralilah N. Fathiah, A. Aminudin, U. Alyaa Hashim, T. Vikneshvaran D. Shakirah Shukor

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This paper presents the experimental analysis conducted on a structure borne noise in a rectangular enclosure prototype made by joining of sheet aluminum metal and plywood. The study is significant as many did not realized the annoyance caused by structural borne-noise. In this study, modal analysis is carried out to seek the structure’s behaviour in order to identify the characteristics of enclosure in frequency domain ranging from 0 Hz to 200 Hz. Here, numbers of modes are identified and the characteristic of mode shape is categorized. Modal experiment is used to diagnose the structural behaviour while microphone is used to diagnose the sound. Spectral testing is performed on the enclosure. It is acoustically excited using shaker and as it vibrates, the vibrational and noise responses sensed by tri-axis accelerometer and microphone sensors are recorded respectively. Experimental works is performed on each node lies on the gridded surface of the enclosure. Both experimental measurement is carried out simultaneously. The modal experimental results of the modal modes are validated by simulation performed using MSC Nastran software. In pursuance of reducing the structure borne-noise, mitigation method is used whereby the stiffener plates are perpendicularly placed on the sheet aluminum metal. By using this method, reduction in structure borne-noise is successfully made at the end of the study.

Keywords: enclosure, modal analysis, sound analysis, structure borne-noise

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Authors: S. Sakhri

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Background: The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggest that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated. Methods. From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N=438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test. Result: The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff. We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, -The pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. The average duration of overall survival was also significantly in the subgroup (Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. -Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. Conclusion The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.

Keywords: HER2+, RH+, breast cancer, tyrosine kinase

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Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

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Authors: Mariana Volpini, Volker Bartenbach, Marcos Pinotti, Robert Riener

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Restoration of gait ability is an important task in the rehabilitation of people with neurological disorders presenting a great impact in the quality of life of an individual. Based on the motor learning concept, robotic assisted treadmill training has been introduced and found to be a feasible and promising therapeutic option in neurological rehabilitation but unfortunately it is not available for most patients in developing countries due to the high cost. This paper presents the concept of a low cost rehabilitation robot to help consolidate the robotic-assisted gait training as a reality in clinical practice in most countries. This work indicates that it is possible to build a simpler rehabilitation device respecting the physiological trajectory of the ankle.

Keywords: bioengineering, gait therapy, low cost rehabilitation robot, rehabilitation robotics

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Authors: Grace C. Kuroki, Yixin Hu, Bailey Surtees, Rebecca Krimins, Nicholas J. Durr, Dara L. Kraitchman

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The purpose of this study was to perform a Phase I veterinary clinical trial with a low-cost, carbon-dioxide-based, passive thaw cryoablation device as proof-of-principle for application in pets and translation to third-world treatment of breast cancer. This study was approved by the institutional animal care and use committee. Client-owned dogs with subcutaneous masses, primarily lipomas or mammary cancers, were recruited for the study. Inclusion was based on clinical history, lesion location, preanesthetic blood work, and fine needle aspirate or biopsy confirmation of mass. Informed consent was obtained from the owners for dogs that met inclusion criteria. Ultrasound assessment of mass extent was performed immediately prior to mass cryoablation. Dogs were placed under general anesthesia and sterilely prepared. A stab incision was created to insert a custom 4.19 OD x 55.9 mm length cryoablation probe (Kubanda Cryotherapy) into the mass. Originally designed for treating breast cancer in low resource settings, this device has demonstrated potential in effectively necrosing subcutaneous masses. A dose escalation study of increasing freeze-thaw cycles (5/4/5, 7/5/7, and 10/7/10 min) was performed to assess the size of the iceball/necrotic extent of cryoablation. Each dog was allowed to recover for ~1-2 weeks before surgical removal of the mass. A single mass was treated in seven dogs (2 mammary masses, a sarcoma, 4 lipomas, and 1 adnexal mass) with most masses exceeding 2 cm in any dimension. Mass involution was most evident in the malignant mammary and adnexal mass. Lipomas showed minimal shrinkage prior to surgical removal, but an area of necrosis was evident along the cryoablation probe path. Gross assessment indicated a clear margin of cryoablation along the cryoprobe independent of tumor type. Detailed histopathology is pending, but complete involution of large lipomas appeared to be unlikely with a 10/7/10 protocol. The low-cost, carbon dioxide-based cryotherapy device permits a minimally invasive technique that may be useful for veterinary applications but is also informative of the unlikely resolution of benign adipose breast masses that may be encountered in third world countries.

Keywords: cryoablation, cryotherapy, interventional oncology, veterinary technology

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Authors: Sina Saadati, Mohammadreza Razzazi

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In this article, we have tried to present an agent-based model of human muscle. A suitable model of muscle is necessary for the analysis of mankind's movements. It can be used by clinical researchers who study the influence of motion sicknesses, like Parkinson's disease. It is also useful in the development of a prosthesis that receives the electromyography signals and generates force as a reaction. Since we have focused on computational efficiency in this research, the model can compute the calculations very fast. As far as it concerns prostheses, the model can be known as a charge-efficient method. In this paper, we are about to illustrate an agent-based model. Then, we will use it to simulate the human gait cycle. This method can also be done reversely in the analysis of gait in motion sicknesses.

Keywords: agent-based modeling and simulation, human muscle, gait cycle, motion sickness

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Authors: Yuanhao Chang, Senbo Xiao, Zhiliang Zhang, Jianying He

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The role of nanoparticles (NPs) in enhanced oil recovery (EOR) is being increasingly emphasized. In this study, the motion of NPs and local stress distribution of tapped oil droplet/nanofluid in nanochannels are studied with coarse-grained modeling and molecular dynamic simulations. The results illustrate three motion patterns for NPs: hydrophilic NPs are more likely to adsorb on the channel and stay near the three-phase contact areas, hydrophobic NPs move inside the oil droplet as clusters and more mixed NPs are trapped at the oil-water interface. NPs in each pattern affect the flow of fluid and the interfacial thickness to various degrees. Based on the calculation of atomistic stress, the characteristic that the higher value of stress occurs at the place where NPs aggregate can be obtained. Different occurrence patterns correspond to specific local stress distribution. Significantly, in the three-phase contact area for hydrophilic NPs, the local stress distribution close to the pattern of structural disjoining pressure is observed, which proves the existence of structural disjoining pressure in molecular dynamics simulation for the first time. Our results guide the design and screen of NPs for EOR and provide a basic understanding of nanofluid applications.

Keywords: local stress distribution, nanoparticles, enhanced oil recovery, molecular dynamics simulation, trapped oil droplet, structural disjoining pressure

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Authors: Ritula Thakur, Babankumar S. Bansod, Puneet Mehta, S. Chatterji

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Moisture plays an important role in storage, harvesting and processing of food grains and related agricultural products. It is an important characteristic of most agricultural products for maintenance of quality. Accurate knowledge of the moisture content can be of significant value in maintaining quality and preventing contamination of cereal grains. The present work reports the design and development of microcontroller based low cost non-destructive moisture meter, which uses complex impedance measurement method for moisture measurement of wheat using parallel plate capacitor arrangement. Moisture can conveniently be sensed by measuring the complex impedance using a small parallel-plate capacitor sensor filled with the kernels in-between the two plates of sensor, exciting the sensor at 30 KHz and 100 KHz frequencies. The effects of density and temperature variations were compensated by providing suitable compensations in the developed algorithm. The results were compared with standard dry oven technique and the developed method was found to be highly accurate with less than 1% error. The developed moisture meter is low cost, highly accurate, non-destructible method for determining the moisture of grains utilizing the fast computing capabilities of microcontroller.

Keywords: complex impedance, moisture content, electrical properties, safety of food

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Authors: Bhanu Pant, Sanjay H. Upadhyay

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Titanium alloys, owing to their high specific strength coupled with excellent resistance to corrosion in many severe environments, find extensive usage in the aerospace sector. Alpha and beta lean Titanium alloys have an additional characteristic of exhibiting high toughness with an NTS/ UTS ratio greater than one down to liquid oxygen and liquid helium temperatures. The cryogenic stage of high-performance rockets utilizes cryo-fluid submerged pressurizing tanks to improve volume to mass performance factor. A superior volume-to-mass ratio is achieved for LH2-submerged pressurizing tanks as compared to those submerged in LOX. Such high-efficiency tanks for LH2 submerged application necessitate the use of difficult to process alpha type Ti5Al2.5Sn-ELI alloy, which requires close control of process parameters to develop the tanks. In the present paper, a comparison of this alpha-type cryogenic Titanium alloy has been brought out with conventional alpha-beta Ti6Al4V-ELI alloy, which is usable up to LOX temperatures. Specific challenges faced during the development of these cryogenic pressurizing tanks for a launch vehicle based on the author's experience are included in the paper on the comparatively lesser-studied alpha Ti5Al2.5Sn-ELI alloy.

Keywords: cryogenic tanks, titanium Alloys, NTS/UTS ratio, alpha and alpha-beta ELI alloys

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Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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Authors: Ranjana Dani

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Brand communication narratives in India has evolved today to reflect the vibrant and intriguing tone of voice inspired by a rich cultural heritage while addressing the culturally alert attitude of the contemporary global Indian. Brands are strongly associated with the organization's values, vision, and mission and portray this through specific ‘look and feel’ and ‘tone of voice’. It is within the brand’s visual language that COLOUR has evolved to become a most powerful weapon in the designer’s arsenal. Color is big business in Brand Design! A brand is a ‘collection of perceptions’, meaningful brand connect is about striving to occupy head and heart space in consumers. The persona of the young Indian reflects a deep attachment to cultural roots as seen through the characteristic of ‘Indie Pride,’ blended with the ambitious, aspirational traits of a modern ‘global citizen’.Studies on ‘Color Perceptions’ indicate a trend that amplifies this, and hence brands reflect a GLOCAL palette, a Global and Local Blend. This paper establishes this through case studies that expand the inspirations, selection processes, and use of innovative color palettes crafted by some dynamic brand designers. This throws light on the role of color as it generates visual impact and recall for successful brands.

Keywords: colour palettes, brand design and business, cultural context, colour perceptions, glocal, contemporaneity

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Authors: Nouh Zeggai, Lucas Debrux, Fabien Parrain, Brahim Dkhil, Martino Lobue, Morgan Almanza

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Refrigeration and air conditioning are some of the most used energies in our daily life, especially vapor compression refrigeration. Electrocaloric material might appears as an alternative towards solid-state cooling. polyvinylidene fluoride (PVDF) based polymer has shown promising adiabatic temperature change (∆T) and entropy change (∆S). There is practically no limit to the electric field that can be applied, except the one that the material can withstand. However, when working with a large surface as required in a device, the chance to have a defect is larger and can drastically reduce the voltage breakdown, thus reducing the electrocaloric properties. In this work, we propose to study how the characteristic of a single film are transposed when going to multilayer. The laminator and the hot press appear as two interesting processes that have been investigating to achieve a multilayer film. The study is mainly focused on the breakdown field and the adiabatic temperature change, but the phase and crystallinity have also been measured. We process one layer-based PVDF and assemble them to obtain a multilayer. Pressing at hot temperature method and lamination were used for the production of the thin films. The multilayer film shows higher breakdown strength, temperature change, and crystallinity (beta phases) using the hot press technique.

Keywords: PVDF-TrFE-CFE, multilayer, electrocaloric effect, hot press, cooling device

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Authors: Yu Zhang, Il Kim

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Polypeptides with defined peptide sequences illustrate the power of remarkable applications in drug delivery, tissue engineering, sensing and catalysis. Especially the cyclic polypeptides, the distinctive topological architecture imparts many characteristic properties comparing to linear polypeptides. Here, a facile and highly efficient strategy for the synthesis of linear and cyclic polypeptides is reported using N-heterocyclic carbenes (NHCs)-mediated ring-opening polymerization (ROP) of α-amino acid N-carboxyanhydrides (NCA) in the presence or absence of primary amine initiator. The polymerization proceeds rapidly in a quasi-living manner, allowing access to linear and cyclic polypeptides of well-defined chain length and narrow polydispersity, as evidenced by nuclear magnetic resonance spectrum (1H NMR and 13C NMR spectra) and size exclusion chromatography (SEC) analysis. The cyclic architecture of the polypeptides was further verified by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectra (MALDI-TOF MS) and electrospray ionization (ESI) mass spectra, as well as viscosity studies. This approach can also simplify workup procedures and make bulk scale synthesis possible, which thereby opens avenues for practical uses in diverse areas, opening up the new generation of polypeptide synthesis.

Keywords: α-amino acid N-carboxyanhydrides, living polymerization, polypeptides, N-heterocyclic carbenes, ring-opening polymerization

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Authors: Laila Ozola, Evita Straumite

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Celiac disease is a permanent enteropathy caused by the ingestion of gluten, a protein occurring in wheat, rye and barley. The only way of the effective daily treatment is a strict gluten-free diet. From the investigation of products available in the local market, it was found that Latvian producers do not offer gluten-free products. The aim of this research was to study and analyze changes of celiac patient’s attitude to gluten-free product quality and availability in the Latvian market and purchasing habits. The survey was designed using website www.visidati.lv, and a questionnaire was sent to people suffering from celiac disease. The first time the respondents were asked to fill in the questionnaire in 2011, but now repeatedly from the beginning of September 2013 till the end of January 2014. The questionnaire was performed with 75 celiac patients, respondents were from all Latvian regions and they answered 16 questions. One of the most important questions was aimed to find out consumers’ opinion about quality of gluten-free products, consumption patterns of gluten-free products, and, moreover, their interest in products made in Latvia. Respondents were asked to name gluten-free products they mainly buy and give specific purchase locations, evaluate the quality of products and necessity for products produced in Latvia. The results of questionnaire show that the consumers are satisfied with the quality of gluten-free flour, flour blends, sweets and pasta, but are not satisfied with the quality of bread and confectionery available in the Latvian markets.

Keywords: consumers, gluten-free products, quality, survey

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: Mai Ali

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The abstract underscores the critical importance of junior paediatricians acquiring expertise in handling paediatric emergencies, with a particular focus on Diabetic Ketoacidosis (DKA). Existing literature reveals a wealth of research on healthcare professionals' knowledge regarding DKA, encompassing diverse cultural backgrounds and medical specialties. Consistently, challenges such as the absence of standardized protocols and inadequacies in training emerge as common issues across healthcare centres. This research proposal seeks to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom in managing DKA within various clinical contexts. The primary objective is to assess their level of competence and propose effective strategies to enhance DKA training comprehensively.

Keywords: DKA, knowledge, Junior paediatricians, local protocols

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Authors: Anika Zafiah M. Rus, S. Shafizah

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This study was developed to compare the behavior and the ability of polymer foam composites towards sound absorption test of Shorea leprosula wood (SL) of acid hydrolysis treatment with particle size < 355µm. Three different weight ratio of polyol to wood particle has been selected which are 10wt%, 15wt%, and 20wt%. The acid hydrolysis treatment is to optimize the surface interaction of a wood particle with polymer foam matrix. In addition, the acoustic characteristic of sound absorption coefficient (Į) was determined. Further treatment is to expose the polymer composite in UV irradiation by using UV-Weatherometer. Polymer foam composite of untreated shorea leprosula particle (SL-B) with respective percentage loading shows uniform pore structure as compared with treated wood particle (SL-A). As the filler percentage loading in polymer foam increases, the Į value approaching 1 for both samples. Furthermore, SL-A shows better Į value at 3500-4500 frequency absorption level(Hz), meanwhile Į value for SL-B is maximum at 4000-5000 Hz. The frequencies absorption level for both SL-B and SL-A after UV exposure was increased with the increasing of exposure time from 0-1000 hours. It is, therefore, concluded that the Į for each sound absorbing material, with or without acid hydrolysis treatment of wood particles and it’s percentages loading in polymer matrix effect the sound absorption behavior.

Keywords: polymer foam composite, sound absorption coefficient, UV-irradiation, wood

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Authors: C. Fernanda da S. Sampaio, M. Gabriela Sadith Perez Paredes, V. Antonio de O. Martins

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Today the transport sector is undergoing a revolution, with the rise of Advanced Driver Assistance Systems (ADAS), industry and society itself will undergo a major transformation. However, the technological development of these applications is a challenge that requires new techniques and great machine learning and artificial intelligence. The study proposes to develop a vehicular perception system called Veibra, which consists of two front cameras for day/night viewing and an embedded device capable of working with Yolov2 image processing algorithms with low computational cost. The strategic version for the market is to assist the driver on the road with the detection of day/night objects, such as road signs, pedestrians, and animals that will be viewed through the screen of the phone or tablet through an application. The system has the ability to perform real-time driver detection and recognition to identify muscle movements and pupils to determine if the driver is tired or inattentive, analyzing the student's characteristic change and following the subtle movements of the whole face and issuing alerts through beta waves to ensure the concentration and attention of the driver. The system will also be able to perform tracking and monitoring through GSM (Global System for Mobile Communications) technology and the cameras installed in the vehicle.

Keywords: advanced driver assistance systems, tracking, traffic signal detection, vehicle perception system

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Authors: Chingwen Yeh, Chang Ning Hung

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This paper aims to analysis the aesthetic qualities of Dancing Ink (2017) performed by Miao-Hsuan Dance Group in Taiwan. The premiere was performed at Taichung Seaport Art Center Exhibition Hall Room A, in Taichung Taiwan on March 11th, 2017. What calligraphic elements were applied into the contemporary dance choreography was examed by these authors. Although calligraphy and dance are two different art forms, one can see in Dancing Ink that the beauty of Yin Yang force circling; the flow of Chi from inner meditation to the outer physical action are resonated in both art forms. The aesthetic experience was documented through qualitative research methods. In-depth interviews were conducted within a focus group including the calligrapher, the choreographer, the participated professional dancers and the appreciators. Subject matter, movement qualities, characteristic and meaning are the four main areas of interpretation originated from Janet Adshead’s dance analytical theory. Based on all the research data collection and analysis, this research found: 1) Making invisible spirituality visible in relations to creative process, 2) An artistic symbol that transforms from two-dimensional into three-dimensional generates a new aesthetic value, 3) Choreography and calligraphy require different artistic skills and disciplines but expressed the similar dynamic and rhythm in their movement.

Keywords: Chi, Dancing Ink, Miao Hsuan Dance Group, Yin Yang force

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Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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Authors: Magdy I. A. Alshourbagi

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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.

Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)

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Authors: Nicole Nazario Bayon, Prathima Prabhu Tumkur, Nithin Krisshna Gunasekaran, Krishnan Prabhakaran, Joseph C. Hall, Govindarajan T. Ramesh

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Titanium nitride (TiN) nanoparticles have sparked interest over the past decade due to their characteristics such as thermal stability, extreme hardness, low production cost, and similar optical properties to gold. In this study, TiN nanoparticles were synthesized via a thermal benzene route to obtain a black powder of nanoparticles. The final product was drop cast onto conductive carbon tape and sputter coated with gold/palladium at a thickness of 4 nm for characterization by field emission scanning electron microscopy (FE-SEM) with energy dispersive X-Ray spectroscopy (EDX) that revealed they were spherical. ImageJ software determined the average size of the TiN nanoparticles was 79 nm in diameter. EDX revealed the elements present in the sample and showed no impurities. Further characterization by X-ray diffraction (XRD) revealed characteristic peaks of cubic phase titanium nitride, and crystallite size was calculated to be 14 nm using the Debye-Scherrer method. Dynamic light scattering (DLS) analysis revealed the size and size distribution of the TiN nanoparticles, with average size being 154 nm. Zeta potential concluded the surface of the TiN nanoparticles is negatively charged. Biocompatibility studies using MTT(3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide) assay showed TiN nanoparticles are not cytotoxic at low concentrations (2, 5, 10, 25, 50, 75 mcg/well), and cell viability began to decrease at a concentration of 100 mcg/well.

Keywords: biocompatibility, characterization, cytotoxicity, nanoparticles, synthesis, titanium nitride

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Authors: Yun-Hsiang Lee

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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).

Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy

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Authors: Mohammad Reza Dawoudi

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With the increasing rate of patients suffering from chronic pain, several methods for evaluating of chronic pain are suggested. Motion of morbid has been defined as the rate of pine and it is linked with various co-morbid conditions. This study provides a summary of procedure useful to statistics performing direct behavioral observation in hospital settings. We describe the need for and usefulness of comprehensive “morbid motions” observations; provide a primer on the identification, definition, and assessment of morbid behaviors; and outline and discuss specific statistical procedures, including formulating referral motions, describing and conducting the observation. We also provide practical devices for observing and analyzing the obtained information into a report that guides clinical intervention.

Keywords: assessing pain, DNA modeling, image matching technique, pain scale

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Authors: Hossein Bakhtiari, Mathias Cehlin, Jan Akander

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Envelopes with low thermal performance is a common characteristic in many European historic buildings which leads to higher energy demand for heating and cooling as well as insufficient thermal comfort for the occupants. This paper presents the results of a study on the thermal comfort in the City Hall (Rådhuset) in Gävle, Sweden. This historic building is currently used as an office building. It is equipped with two relatively modern mechanical heat recovery ventilation systems with displacement ventilation supply devices in the offices. The district heating network heats the building via pre-heat supply air and radiators. Summer cooling comes from an electric heat pump that rejects heat into the exhaust ventilation air. A building management system controls HVAC equipment (heating, ventilation and air conditioning). The methodology is based on on-site measurements, data logging on the management system and evaluating the occupants’ perception of a summer and a winter period indoor environment using a standardized questionnaire. The main aim of the study is to investigate whether or not it is enough to have modernized HVAC systems to get adequate thermal comfort in a historic building with poor envelope performance used as an office building in Nordic climate conditions.

Keywords: historic buildings, on-site measurements, standardized questionnaire, thermal comfort

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Authors: Ferreira R., Rocha K.

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Ozone therapy is indicated for improving skin aesthetics, adjusting oxidative tissue levels, increasing collagen production, and even skin volumizing. This paper aims to carry out a case report that demonstrates the positive results of ozone therapy in association with superficial peeling. The application in association showed positive results for bio-stimulating activities in the reported case demonstrating to be a viable clinical technique. The bio-stimulating effect of ozone therapy in association with peeling is a promising aesthetic therapeutic modality with fast and safe results as an aesthetic therapeutic option.

Keywords: bio-stimulating effect, ozone therapy, neocollagenesis, peeling

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Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

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Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

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Authors: M. Ghanbari, S. Hossainpour, G. Rezazadeh

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In this paper, longitudinal vibration of a micro-beam in micro-scale fluid media has been investigated. The proposed mathematical model for this study is made up of a micro-beam and a micro-plate at its free end. An AC voltage is applied to the pair of piezoelectric layers on the upper and lower surfaces of the micro-beam in order to actuate it longitudinally. The whole structure is bounded between two fixed plates on its upper and lower surfaces. The micro-gap between the structure and the fixed plates is filled with fluid. Fluids behave differently in micro-scale than macro, so the fluid field in the gap has been modeled based on micro-polar theory. The coupled governing equations of motion of the micro-beam and the micro-scale fluid field have been derived. Due to having non-homogenous boundary conditions, derived equations have been transformed to an enhanced form with homogenous boundary conditions. Using Galerkin-based reduced order model, the enhanced equations have been discretized over the beam and fluid domains and solve simultaneously in order to obtain force response of the micro-beam. Effects of micro-polar parameters of the fluid as characteristic length scale, coupling parameter and surface parameter on the response of the micro-beam have been studied.

Keywords: micro-polar theory, Galerkin method, MEMS, micro-fluid

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