Search results for: open treatment of carpal tunnel syndrome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11836

Search results for: open treatment of carpal tunnel syndrome

11656 Functional Neurocognitive Imaging (fNCI): A Diagnostic Tool for Assessing Concussion Neuromarker Abnormalities and Treating Post-Concussion Syndrome in Mild Traumatic Brain Injury Patients

Authors: Parker Murray, Marci Johnson, Tyson S. Burnham, Alina K. Fong, Mark D. Allen, Bruce McIff

Abstract:

Purpose: Pathological dysregulation of Neurovascular Coupling (NVC) caused by mild traumatic brain injury (mTBI) is the predominant source of chronic post-concussion syndrome (PCS) symptomology. fNCI has the ability to localize dysregulation in NVC by measuring blood-oxygen-level-dependent (BOLD) signaling during the performance of fMRI-adapted neuropsychological evaluations. With fNCI, 57 brain areas consistently affected by concussion were identified as PCS neural markers, which were validated on large samples of concussion patients and healthy controls. These neuromarkers provide the basis for a computation of PCS severity which is referred to as the Severity Index Score (SIS). The SIS has proven valuable in making pre-treatment decisions, monitoring treatment efficiency, and assessing long-term stability of outcomes. Methods and Materials: After being scanned while performing various cognitive tasks, 476 concussed patients received an SIS score based on the neural dysregulation of the 57 previously identified brain regions. These scans provide an objective measurement of attentional, subcortical, visual processing, language processing, and executive functioning abilities, which were used as biomarkers for post-concussive neural dysregulation. Initial SIS scores were used to develop individualized therapy incorporating cognitive, occupational, and neuromuscular modalities. These scores were also used to establish pre-treatment benchmarks and measure post-treatment improvement. Results: Changes in SIS were calculated in percent change from pre- to post-treatment. Patients showed a mean improvement of 76.5 percent (σ= 23.3), and 75.7 percent of patients showed at least 60 percent improvement. Longitudinal reassessment of 24 of the patients, measured an average of 7.6 months post-treatment, shows that SIS improvement is maintained and improved, with an average of 90.6 percent improvement from their original scan. Conclusions: fNCI provides a reliable measurement of NVC allowing for identification of concussion pathology. Additionally, fNCI derived SIS scores direct tailored therapy to restore NVC, subsequently resolving chronic PCS resulting from mTBI.

Keywords: concussion, functional magnetic resonance imaging (fMRI), neurovascular coupling (NVC), post-concussion syndrome (PCS)

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11655 Determining the Effectiveness of Positive Psychology Education on Social Welfare of High School Girls with Premenstrual Syndrome (PMS)

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Mina Gholampour, Majid Saffarinia, Tayebeh Mohtashami, Amin Asadi Hieh

Abstract:

The study aimed to assess the impact of positive psychology education on the social well-being of high school girls experiencing premenstrual syndrome (PMS). The statistical population comprised high school girls with PMS, with 30 randomly selected participants divided into two groups: 15 in the experimental group and 15 in the control group. The research employed a pre-test and post-test design using a standard questionnaire to evaluate premenstrual syndrome symptoms over a 7-day period before menstruation to a maximum of 2 days after menstruation, along with the Social Keys welfare questionnaire. During the study, the experimental group underwent an 8-session positive psychology group program. Data analysis was conducted using analysis of covariance. The results indicated a significant positive effect of positive psychology training on enhancing the social well-being of girls (p < 0.05). In conclusion, the findings suggest that positive psychology interventions can effectively increase social well-being among high school girls experiencing premenstrual syndrome.

Keywords: positive psychology, premenstrual syndrome, social welfare, girls

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11654 The Impact of Undisturbed Flow Speed on the Correlation of Aerodynamic Coefficients as a Function of the Angle of Attack for the Gyroplane Body

Authors: Zbigniew Czyz, Krzysztof Skiba, Miroslaw Wendeker

Abstract:

This paper discusses the results of aerodynamic investigation of the Tajfun gyroplane body designed by a Polish company, Aviation Artur Trendak. This gyroplane has been studied as a 1:8 scale model. Scaling objects for aerodynamic investigation is an inherent procedure in any kind of designing. If scaling, the criteria of similarity need to be satisfied. The basic criteria of similarity are geometric, kinematic and dynamic. Despite the results of aerodynamic research are often reduced to aerodynamic coefficients, one should pay attention to how values of coefficients behave if certain criteria are to be satisfied. To satisfy the dynamic criterion, for example, the Reynolds number should be focused on. This is the correlation of inertial to viscous forces. With the multiplied flow speed by the specific dimension as a numerator (with a constant kinematic viscosity coefficient), flow speed in a wind tunnel research should be increased as many times as an object is decreased. The aerodynamic coefficients specified in this research depend on the real forces that act on an object, its specific dimension, medium speed and variations in its density. Rapid prototyping with a 3D printer was applied to create the research object. The research was performed with a T-1 low-speed wind tunnel (its diameter of the measurement volume is 1.5 m) and a six-element aerodynamic internal scales, WDP1, at the Institute of Aviation in Warsaw. This T-1 wind tunnel is low-speed continuous operation with open space measurement. The research covered a number of the selected speeds of undisturbed flow, i.e. V = 20, 30 and 40 m/s, corresponding to the Reynolds numbers (as referred to 1 m) Re = 1.31∙106, 1.96∙106, 2.62∙106 for the angles of attack ranging -15° ≤ α ≤ 20°. Our research resulted in basic aerodynamic characteristics and observing the impact of undisturbed flow speed on the correlation of aerodynamic coefficients as a function of the angle of attack of the gyroplane body. If the speed of undisturbed flow in the wind tunnel changes, the aerodynamic coefficients are significantly impacted. At speed from 20 m/s to 30 m/s, drag coefficient, Cx, changes by 2.4% up to 9.9%, whereas lift coefficient, Cz, changes by -25.5% up to 15.7% if the angle of attack of 0° excluded or by -25.5% up to 236.9% if the angle of attack of 0° included. Within the same speed range, the coefficient of a pitching moment, Cmy, changes by -21.1% up to 7.3% if the angles of attack -15° and -10° excluded or by -142.8% up to 618.4% if the angle of attack -15° and -10° included. These discrepancies in the coefficients of aerodynamic forces definitely need to consider while designing the aircraft. For example, if load of certain aircraft surfaces is calculated, additional correction factors definitely need to be applied. This study allows us to estimate the discrepancies in the aerodynamic forces while scaling the aircraft. This work has been financed by the Polish Ministry of Science and Higher Education.

Keywords: aerodynamics, criteria of similarity, gyroplane, research tunnel

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11653 Experimental Study of Flag Flutter in Uniform Flow

Authors: A. Sadeghi, M. Sedghi, M. R. Emami Azadi, R. Gharraei Khosroshahi

Abstract:

Flags are objects with very low bending stiffness and under wind forces start to vibrate and finally to flutter. Even in lower velocities of wind their flutter can be seen. In this research physical property of fabric is determined by performing tensile tests. Then with performing laboratory experiments in wind tunnel, determination of initial flapping speed and also study of displacement amplitude at leech and calculation of their frequency would be targeted. Laboratory tests are performed in a wind tunnel and with different velocities of wind flow for specimens with different dimensions. The results show that extension of specimens' width increase flutter initiation velocity and increase of specimen length decreases it. Also by increasing wind velocity displacement amplitude at leech of specimens are decreased. This displacement has a straight relation with specimens' length and width.

Keywords: flag, flutter, wind velocity, flutter amplitudes, wind tunnel

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11652 Lumbar Tuberculous Spondylitis in a Child Treated by Posterior Osteosynthesis: Apropos of a Case

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Tuberculous spondylodiscitis is an infection of the spine by Mycobacterium tuberculosis. Tuberculous spondylodiscitis still remains a topical disease in developing countries and continues to pose a public health problem in endemic countries. Materials and methods: Clinical case: This is a 12-year-old child followed in pediatrics for weight loss and progressively worsening low back pain. The neurological examination found an irritative pyramidal syndrome in both lower limbs with a severe lumbar spinal syndrome. The radiological assessment: (Rx of the spine supplemented by CT and MRI) shows L1L2 spondylodiscitis. Treatment: The child is put on anti-tuberculosis treatment, and the spine is restrained with a corset. Control MRI shows a worsening of the dorsal kyphosis with a backward movement of the posterior wall and spinal cord compression. The child is operated on via the posterior approach (the operative procedure consists of an L1 laminectomy and D11 L3 osteosynthesis). Results: Spinal cord décompression and stabilization of the spine. Conclusion: Tuberculous spondylodiscitis in children remains a rare, aggressive, and progressive condition. The prognosis depends on the diagnosis's precocity and the therapeutic management quality.

Keywords: tuberculous spondylodiscitis, mycobacterium tuberculosis, laminectomy, MRI

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11651 Computational Fluid Dynamics Simulation to Study the Effect of Ambient Temperature on the Ventilation in a Metro Tunnel

Authors: Yousef Almutairi, Yajue Wu

Abstract:

Various large-scale trends have characterized the current century thus far, including increasing shifts towards urbanization and greater movement. It is predicted that there will be 9.3 billion people on Earth in 2050 and that over two-thirds of this population will be city dwellers. Moreover, in larger cities worldwide, mass transportation systems, including underground systems, have grown to account for the majority of travel in those settings. Underground networks are vulnerable to fires, however, endangering travellers’ safety, with various examples of fire outbreaks in this setting. This study aims to increase knowledge of the impacts of extreme climatic conditions on fires, including the role of the high ambient temperatures experienced in Middle Eastern countries and specifically in Saudi Arabia. This is an element that is not always included when assessments of fire safety are made (considering visibility, temperatures, and flows of smoke). This paper focuses on a tunnel within Riyadh’s underground system as a case study and includes simulations based on computational fluid dynamics using ANSYS Fluent, which investigates the impact of various ventilation systems while identifying smoke density, speed, pressure and temperatures within this tunnel.

Keywords: fire, subway tunnel, CFD, mechanical ventilation, smoke, temperature, harsh weather

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11650 Jarcho-Levin Syndrome: A Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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11649 Gastrointestinal Disturbances in Postural Orthostatic Tachycardia Syndrome (POTS)

Authors: Chandralekha Ashangari, Amer Suleman

Abstract:

Background and Purpose: The Postural Orthostatic Tachycardia Syndrome (POTS) affects primarily young women. POTS is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. POTS is a form of orthostatic intolerance that is associated with many Gastrointestinal disturbances. The aim of this study is to determine the Gastrointestinal disturbances in Postural Orthostatic Tachycardia Syndrome (POTS) patients.2. Methods: 249 patients referred to our clinic from January to November with POTS. Reviewed the medical records of 249 POTS patients and gastrointestinal symptoms. Results: however out of 249 patients, 226 patients are female (90.76%; average age 32.69), 23 patients are male (9.24%; average age 27.91) Data analysis: Out of 249 patients 189 patients (76%) had vomiting or nausea, 150 patients (60%) had irritable bowel syndrome, 128 patients (51%) had bloating, 125 patients (50%) had constipation , 80 patients (32%) had abdominal pain, 56 patients (22%) had delayed gastric emptying, 24 patients (10%) had lactose intolerance, 8 patients (3%) had Gastroesophageal reflux disease, 5 patients (2%) had Iron deficiency anemia, 6 patients (2%) had Peptic ulcer disease, 4 patients (2%) had Celiac Disease. Conclusion: Patients with POTS have a very high prevalence of gastrointestinal symptoms however the majority of abnormalities appear to be motility related. Motility testing should be performed be performed in POTS patients. The diagnostic yield of endoscopic procedures appears to be low.

Keywords: gastrointestinal disturbances, Postural Orthostatic Tachycardia Syndrome (POTS), celiac disease, POTS patients

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11648 Potential and Development of Children with Atypical Rett Syndrome (CDKL5 Gene Mutation) and Augmentative and Alternative Communication

Authors: Anna Amato

Abstract:

Every child needs communication. If spoken language is not or not fully available due to congenital or acquired limitations, those affected need appropriate ways. These can be found in many possibilities of Augmentative and Alternative Communications (AAC). In the communication promotion of severely impaired children, who can use their own body communication forms only to a limited extent for the differentiated understanding, computers with eye control play an essential role. It takes some time to understand the individual forms of communication of the child. Children who depend on the AAC need competent support to learn to communicate in a motivated way in their everyday life. The aim of the present parents' survey (n = 4), which was evaluated descriptively, is to demonstrate the development of communicative abilities as well as the motivation to use complex communication aids with eye control by patients with atypical Rett Syndrome. An increase in communication skills, well-being, self-reliance, and self-esteem, an improvement in social participation, as well as a reduction in anger and screaming events, were noted. The complex visual communication tools were available daily for 3 out of 4 patients with atypical Rett Syndrome. It raises research questions regarding speech understanding and the ability to drive eye control technology in a larger group of atypical Rett Syndrome patients.

Keywords: augmentative and alternative communications, AAC, atypical Rett-syndrome, children, development

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11647 Application of Artificial Ground-Freezing to Construct a Passenger Interchange Tunnel for the Subway Line 14 in Paris, France

Authors: G. Lancellotta, G. Di Salvo, A. Rigazio, A. Davout, V. Pastore, G. Tonoli, A. Martin, P. Jullien, R. Jagow-Klaff, R. Wernecke

Abstract:

Artificial ground freezing (AGF) technique is a well-proven soil improvement approach used worldwide to construct shafts, tunnels and many other civil structures in difficult subsoil or ambient conditions. As part of the extension of Line 14 of the Paris subway, a passenger interchange tunnel between the new station at Porte de CI ichy and the new Tribunal the Grand Instance has been successfully constructed using this technique. The paper presents the successful application of AGF by Liquid Nitrogen and Brine implemented to provide structural stability and groundwater cut-off around the passenger interchange tunnel. The working conditions were considered to be rather challenging, due to the proximity of a hundred-year-old existing service tunnel of the Line 13, and subsoil conditions on site. Laboratory tests were carried out to determine the relevant soil parameters for hydro-thermal-mechanical aspects and to implement numerical analyses. Monitoring data were used in order to check and control the development and the efficiency of the freezing process as well as to back analyze the parameters assumed for the design, both during the freezing and thawing phases.

Keywords: artificial ground freezing, brine method, case history, liquid nitrogen

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11646 Paralysis from an Ear Infection: A Severe Case of Otitis Externa Leading to Acute Complete Cervical Cord Syndrome

Authors: Rachael Collins, George Lafford

Abstract:

We report a case of a generally fit and a well 54-year-old gentleman who presented with a two-day history of worsening left-sided otorrhea, headache, neck stiffness, vomiting and pyrexia on the background of a seven-week history of OE. His condition progressed dramatically as he developed symptoms consistent with acute complete cervical cord syndrome with radiological evidence of skull base osteomyelitis, parapharyngeal, retropharyngeal and paravertebral abscesses and sigmoid sinus thrombus. Ultimately he made a significant, although not complete, recovery. This case is unique in demonstrating how OE can develop into a potentially life-threatening condition. It emphasizes the importance of early diagnosis and treatment of OE, the recognition of ‘red flag’ symptoms and highlights the importance of a multi-disciplinary team (MDT) approach when managing complex complications of OE.

Keywords: ENT, neurology, otology, MDT

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11645 Bone Mineral Density and Frequency of Low-Trauma Fractures in Ukrainian Women with Metabolic Syndrome

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

Abstract:

Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m2), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

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11644 Author Self-Archiving in Open Access Institutional Repositories for Awareness Creation in Universities

Authors: Kwame Kodua-Ntim

Abstract:

The study explored the authors self-archiving to create awareness of open-access institutional repositories in universities. The qualitative approach of the study was informed by the interpretive paradigm as well as the case research design. The target population for the study was all twelve (12) open-access institutional repositories managers and administrators purposively selected from the five (5) universities in Ghana. The universities were chosen since they were the only ones listed in the Directory of Open Access Repositories. Interviews were conducted using a semi-structured interview guide and data were analyzed using thematic analysis. The study revealed that academics had some information about self-archiving in open-access institutional repositories and university libraries with open-access institutional repositories were using DSpace software. Managers and administrators of open-access institutional repositories mediated content uploaded and believed that author self-archiving could improve awareness of open-access institutional repositories. The study recommended that universities should fully implement the author’s self-archiving protocol, and academics should be trained to be able to upload research works onto open-access institutional repositories. Furthermore, the university and university library should provide rigorous policies on author self-archiving and incentives for author self-archiving in the open access institutional repositories.

Keywords: author, awareness, institutional repositories, open access, open archive, self-archiving

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11643 The Correlation between Air Pollution and Tourette Syndrome

Authors: Mengnan Sun

Abstract:

It is unclear about the association between air pollution and Tourette Syndrome (TS), although people have suspected that air pollution might trigger TS. TS is a type of neural system disease usually found among children. The number of TS patients has significantly increased in recent decades, suggesting an importance and urgency to examine the possible triggers or conditions that are associated with TS. In this study, the correlation between air pollution and three allergic diseases---asthma, allergic conjunctivitis (AC), and allergic rhinitis (AR)---is examined. Then, a correlation between these allergic diseases and TS is proved. In this way, this study establishes a positive correlation between air pollution and TS. Measures the public can take to help TS patients are also analyzed at the end of this article. The article hopes to raise people’s awareness to reduce air pollution for the good of TS patients or people with other disorders that are associated with air pollution.

Keywords: air pollution, allergic diseases, climate change, Tourette Syndrome

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11642 Plasma Actuator Application to Control Surfaces of a Model Aircraft

Authors: Yuta Moriyama, Etsuo Morishita

Abstract:

Plasma actuator is very effective to recover stall flows over an upper airfoil surface. We first manufacture the actuator, test the stability of the device by trial and error basis and find the conditions for steady operations. We visualize the flow around an airfoil in the smoke tunnel and observe the stall recovery. The plasma actuator is stationary device and has no moving parts, and it might be an ideal device to control a model aircraft. We can use the actuator not only as a stall recovery device but also as a spoiler. We put the actuator near the leading edge of an elevator of a model aircraft as a spoiler, and measure the aerodynamic forces by a three-component balance. We observe the effect of the plasma actuator on the aerodynamic forces and the device effectiveness changes depending on the angle of attack whether it is positive or negative. We also visualize the flow caused by the plasma actuator by a desk-top Schlieren photography which is otherwise very difficult in a low-speed wind tunnel experiment.

Keywords: aerodynamics, plasma actuator, model aircraft, wind tunnel

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11641 Sexual Satifaction in Women with Polycystic Ovarian Syndrome

Authors: Nashi Khan, Amina Khalid

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Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.

Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome

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11640 The Sociological and Legal Study of Sexual Assault in Nigeria

Authors: Adeshina Francis Akindutre, Adebolarin Adekanle

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Sexual assault is often considered as the most extreme form of violence that degrades and humiliates women in society. It is a widespread public health and psychological problem in Nigeria. Criminologically, sexual assaults have been considered as one of the several violent crimes targeted specifically at women and perpetrated by men. This paper attempts to examine the types of sexual assaults in Nigeria, the strategies used by the offenders, the causes, the psychological effects on the victims and the possible solutions of sexual assaults. This work also, examines the law prohibiting sexual assault in Nigeria. The authors made use of three theories: the victim precipitation approach, the feminist approach, and the psychological approach which explain why sexual assault takes place in society. Finally, it takes the Stockholm Syndrome into consideration (the treatment of victims).

Keywords: feminist, victims, offenders, psychological, sexual assault, Stockholm Syndrome

Procedia PDF Downloads 558
11639 Vagal Nerve Stimulator as a Treatment Approach in CHARGE Syndrome: A Case Report

Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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11638 Aerodynamic Analysis of Vehicles

Authors: E. T. L. Cöuras Ford, V. A. C. Vale, J. U. L. Mendes

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Two of the objective principal in the study of the aerodynamics of vehicles are the safety and the acting. Those objectives can be reached through the development of devices modify the drainage of air about of the vehicle and also through alterations in the way of the external surfaces. The front lowest profile of the vehicle, for instance, has great influence on the coefficient of aerodynamic penetration (Cx) and later on great part of the pressure distribution along the surface of the vehicle. The objective of this work was of analyzing the aerodynamic behavior that it happens on some types the trucks of vehicles, based on experimentation in aerodynamic tunnel, seeking to determine the aerodynamic efficiency of each one of them.

Keywords: aerodynamic, vehicles, wind tunnel, safety, acting

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11637 Numerical Simulations of Acoustic Imaging in Hydrodynamic Tunnel with Model Adaptation and Boundary Layer Noise Reduction

Authors: Sylvain Amailland, Jean-Hugh Thomas, Charles Pézerat, Romuald Boucheron, Jean-Claude Pascal

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The noise requirements for naval and research vessels have seen an increasing demand for quieter ships in order to fulfil current regulations and to reduce the effects on marine life. Hence, new methods dedicated to the characterization of propeller noise, which is the main source of noise in the far-field, are needed. The study of cavitating propellers in closed-section is interesting for analyzing hydrodynamic performance but could involve significant difficulties for hydroacoustic study, especially due to reverberation and boundary layer noise in the tunnel. The aim of this paper is to present a numerical methodology for the identification of hydroacoustic sources on marine propellers using hydrophone arrays in a large hydrodynamic tunnel. The main difficulties are linked to the reverberation of the tunnel and the boundary layer noise that strongly reduce the signal-to-noise ratio. In this paper it is proposed to estimate the reflection coefficients using an inverse method and some reference transfer functions measured in the tunnel. This approach allows to reduce the uncertainties of the propagation model used in the inverse problem. In order to reduce the boundary layer noise, a cleaning algorithm taking advantage of the low rank and sparse structure of the cross-spectrum matrices of the acoustic and the boundary layer noise is presented. This approach allows to recover the acoustic signal even well under the boundary layer noise. The improvement brought by this method is visible on acoustic maps resulting from beamforming and DAMAS algorithms.

Keywords: acoustic imaging, boundary layer noise denoising, inverse problems, model adaptation

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11636 Experimental Investigation of Cup Anemometer under Static and Dynamic Wind Direction Changes: Evaluation of Directional Sensitivity

Authors: Vaibhav Rana, Nicholas Balaresque

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The 3-cup anemometer is the most commonly used instrument for wind speed measurement and, consequently, for the wind resource assessment. Though the cup anemometer shows accurate measurement under quasi-static conditions, there is uncertainty in the measurement when subjected to field measurement. Sensitivity to the angle of attacks with respect to horizontal plane, dynamic response, and non-linear behavior in calibration due to friction. The presented work aimed to identify the sensitivity of anemometer to non-horizontal flow. The cup anemometer was investigated under low wind speed wind tunnel, first under the static flow direction changes and second under the dynamic direction changes, at a different angle of attacks, under the similar conditions of reference wind tunnel speeds. The cup anemometer response under both conditions was evaluated and compared. The results showed the anemometer under dynamic wind direction changes is highly sensitive compared to static conditions.

Keywords: wind energy, cup anemometer, directional sensitivity, dynamic behavior, wind tunnel

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11635 Study on the Influence of Different Lengths of Tunnel High Temperature Zones on Train Aerodynamic Resistance

Authors: Chong Hu, Tiantian Wang, Zhe Li, Ourui Huang, Yichen Pan

Abstract:

When the train is running in a high geothermal tunnel, changes in the temperature field will cause disturbances in the propagation and superposition of pressure waves in the tunnel, which in turn have an effect on the aerodynamic resistance of the train. The aim of this paper is to investigate the effect of the changes in the lengths of the high-temperature zone of the tunnel on the aerodynamic resistance of the train, clarifying the evolution mechanism of aerodynamic resistance of trains in tunnels with high ground temperatures. Firstly, moving model tests of trains passing through wall-heated tunnels were conducted to verify the reliability of the numerical method in this paper. Subsequently, based on the three-dimensional unsteady compressible RANS method and the standard k-ε two-equation turbulence model, the change laws of the average aerodynamic resistance under different high-temperature zone lengths were analyzed, and the influence of frictional resistance and pressure difference resistance on total resistance at different times was discussed. The results show that as the length of the high-temperature zone LH increases, the average aerodynamic resistance of a train running in a tunnel gradually decreases; when LH = 330 m, the aerodynamic resistance can be reduced by 5.7%. At the moment of maximum resistance, the total resistance, differential pressure resistance, and friction resistance all decrease gradually with the increase of LH and then remain basically unchanged. At the moment of the minimum value of resistance, with the increase of LH, the total resistance first increases and then slowly decreases; the differential pressure resistance first increases and then remains unchanged, while the friction resistance first remains unchanged and then gradually decreases, and the ratio of the differential pressure resistance to the total resistance gradually increases with the increase of LH. The results of this paper can provide guidance for scholars who need to investigate the mechanism of aerodynamic resistance change of trains in high geothermal environments, as well as provide a new way of thinking for resistance reduction in non-high geothermal tunnels.

Keywords: high-speed trains, aerodynamic resistance, high-ground temperature, tunnel

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11634 Computational Pipeline for Lynch Syndrome Detection: Integrating Alignment, Variant Calling, and Annotations

Authors: Rofida Gamal, Mostafa Mohammed, Mariam Adel, Marwa Gamal, Marwa kamal, Ayat Saber, Maha Mamdouh, Amira Emad, Mai Ramadan

Abstract:

Lynch Syndrome is an inherited genetic condition associated with an increased risk of colorectal and other cancers. Detecting Lynch Syndrome in individuals is crucial for early intervention and preventive measures. This study proposes a computational pipeline for Lynch Syndrome detection by integrating alignment, variant calling, and annotation. The pipeline leverages popular tools such as FastQC, Trimmomatic, BWA, bcftools, and ANNOVAR to process the input FASTQ file, perform quality trimming, align reads to the reference genome, call variants, and annotate them. It is believed that the computational pipeline was applied to a dataset of Lynch Syndrome cases, and its performance was evaluated. It is believed that the quality check step ensured the integrity of the sequencing data, while the trimming process is thought to have removed low-quality bases and adaptors. In the alignment step, it is believed that the reads were accurately mapped to the reference genome, and the subsequent variant calling step is believed to have identified potential genetic variants. The annotation step is believed to have provided functional insights into the detected variants, including their effects on known Lynch Syndrome-associated genes. The results obtained from the pipeline revealed Lynch Syndrome-related positions in the genome, providing valuable information for further investigation and clinical decision-making. The pipeline's effectiveness was demonstrated through its ability to streamline the analysis workflow and identify potential genetic markers associated with Lynch Syndrome. It is believed that the computational pipeline presents a comprehensive and efficient approach to Lynch Syndrome detection, contributing to early diagnosis and intervention. The modularity and flexibility of the pipeline are believed to enable customization and adaptation to various datasets and research settings. Further optimization and validation are believed to be necessary to enhance performance and applicability across diverse populations.

Keywords: Lynch Syndrome, computational pipeline, alignment, variant calling, annotation, genetic markers

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11633 Sport-Related Hand and Wrist Injuries Treatment

Authors: Sergei Kosarev

Abstract:

Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

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11632 A Rare Atypical Presentation of Iichthyosis Follicularis, Alopecia, and Photophobia Syndrome

Authors: D. R. Apoorva

Abstract:

Ichthyosis follicularis, alopecia, and photophobia (IFAP) syndrome is a rare oculocutaneous disorder of genetic origin. This disorder results from mutations in the membrane-bound transcription factor protease site, two genes that impair cholesterol homeostasis, and the ability to cope with endoplasmic reticulum stress. We report a rare case of IFAP syndrome with an atypical presentation, and it was interesting to note that the child had patchy non-scarring alopecia over the scalp along with unilateral madarosis. To our best knowledge, this unique presentation has not been described earlier. The child presented with photophobia and unilateral ptosis. The child also had short stature and intellectual disability. Skin histopathology was nonspecific and consisted of dilated hair follicles with keratin plugs extending above the skin surface. This rare oculocutaneous disorder requires proper documentation so that identification of its variants may be possible in the future. Early recognition of atypical presentations can help in preventing cardiovascular complications, which remain the major cause of death.

Keywords: alopecia, photophobia, ichthyosis follicularis, IFAP syndrome

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11631 Development of an Experimental Model of Diabetes Co-Existing with Metabolic Syndrome in Rats

Authors: Rajesh Kumar Suman, Ipseeta Ray Mohanty, Manjusha K. Borde, Ujjawala maheswari, Y. A. Deshmukh

Abstract:

Background: Metabolic syndrome encompasses cluster of risk factors for cardiovascular disease which includes abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. The incidence of metabolic syndrome is on the rise globally. Objective: The present study was designed to develop a unique animal model that will mimic the pathological features seen in a large pool of individuals with diabetes and metabolic syndrome; suitable for pharmacological screening of drugs beneficial in this condition. Material and Methods: A combination of high fat diet (HFD) and low dose of streptozotocin (STZ) at 30, 35 and 40 mg/kg was used to induce metabolic syndrome co-existing with diabetes mellitus in Wistar rats. Results: The 40 mg/kg STZ produced sustained hyperglycemia and the dose was thus selected for our study to induce diabetes mellitus. Rat fed HFD (HF-DC) group showed significant (p < 0.001) increase in body weight on 4th and 7th week as compared with NC (Normal Control) group rats. However, the increase in body weight of HF-DC group rats was not sustained at the end of 10th weeks. Various components of metabolic syndrome such as dyslipidemia {(Increased Triglyceride, total Cholesterol, LDL Cholesterol and decreased HDL Cholesterol)}, diabetes mellitus (Blood Glucose, HbA1c, Serum Insulin, C-peptide), hypertension {Systolic Blood pressure (p < 0.001)} were mimicked in the developed model of metabolic syndrome co existing with diabetes mellitus. In addition significant cardiac injury as indicated by CPK-MB levels, artherogenic index, hs-CRP. The decline in hepatic function {(p < 0.01) increase in the level of SGPT (U/L)} and renal function {(increase in creatinine levels (p < 0.01)} when compared to NC group rats. The histopathological assessment confirmed presence of edema, necrosis and inflammation in Heart, Pancreas, Liver and Kidney of HFD-DC group as compared to NC. Conclusion: The present study has developed a unique rodent model of metabolic syndrome; with diabetes as an essential component.

Keywords: diabetes, metabolic syndrome, high fat diet, streptozotocin, rats

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11630 Case Presentation Ectopic Cushing's Syndrome Secondary to Thymic Neuroendocrine Tumors Secreting ACTH

Authors: Hasan Frookh Jamal

Abstract:

This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

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11629 Bullous Pyoderma Gangrenosum in a Patient with Anti-Phospholipid Syndrome: A Case Report and Literature Review

Authors: Yousef Alwashahi, Ahmed Almoqbali, Mayar Albahrani, Asma Alajmi

Abstract:

We report a rare case of a 49-year-old Omani woman who is a known case of primary anti-phospholipid syndrome, glucose-6-phosphate dehydrogenase deficiency, and iron deficiency anaemia. During cannulation, she was found to develop bulla that progressed to ulcerations. With chronicity and recurrent abscess formation that usually increase after surgical intervention, a pathergy phenomenon was postulated. High suspicion of pyoderma gangrenosum was considered. Fortunately, the rapid progression of the disease was slowed down with corticosteroids, cyclosporin, and biological agents.

Keywords: anti-phospholipid syndrome, pyoderma gangrenosum, bullous pyoderma gangrenosum, pathergy, pathergy phenomenon

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11628 A Concept of Rational Water Management at Local Utilities: The Use of RO for Water Supply and Wastewater Treatment/Reuse

Authors: N. Matveev, A. Pervov

Abstract:

Local utilities often face problems of local industrial wastes, storm water disposal due to existing strict regulations. For many local industries, the problem of wastewater treatment and discharge into surface reservoirs can’t be solved through the use of conventional biological treatment techniques. Current discharge standards require very strict removal of a number of impurities such as ammonia, nitrates, phosphate, etc. To reach this level of removal, expensive reagents and sorbents are used. The modern concept of rational water resources management requires the development of new efficient techniques that provide wastewater treatment and reuse. As RO membranes simultaneously reject all dissolved impurities such as BOD, TDS, ammonia, phosphates etc., they become very attractive for the direct treatment of wastewater without biological stage. To treat wastewater, specially designed membrane "open channel" modules are used that do not possess "dead areas" that cause fouling or require pretreatment. A solution to RO concentrate disposal problem is presented that consists of reducing of initial wastewater volume by 100 times. Concentrate is withdrawn from membrane unit as sludge moisture. The efficient use of membrane RO techniques is connected with a salt balance in water system. Thus, to provide high ecological efficiency of developed techniques, all components of water supply and wastewater discharge systems should be accounted for.

Keywords: reverse osmosis, stormwater treatment, open-channel module, wastewater reuse

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11627 Cytogenetic Investigation of Patients with Disorder of Sexual Development Using G-Banding Karyotype and Fluorescence In situ Hybridization

Authors: Riksa Parikrama, Bremmy Laksono, Dadang S. H. Effendi

Abstract:

Disorder of sexual development (DSD) covers various conditions with a specific term such as Klinefelter syndrome, Turner syndrome, androgen insensitivity syndrome, and many more. The techniques to accurately diagnose those conditions has developed extensively. However, conventional karyotype and fluorescence in situ hybridization (FISH) are still widely used in many genetic laboratories as the basic method to determine chromosomal condition of DSD patients. Cytogenetic study was conducted on 36 DSD patients in Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Most of the patients referred to the laboratory diagnosed with primary amenorrhea, hypospadias, micropenis, genitalia ambiguity, or congenital adrenal hyperplasia. The study used G-banding technique to acquire complete karyotype and followed by FISH as either confirmation or comparison method. Among 36 patients, G-banding karyotype and FISH results showed that two were diagnosed with 45, X (Turner syndrome); three with 47, XXY (Klinefelter syndrome); five with 46, XX DSD; 22 with 46, XY DSD; and four with 46,XY complete androgen insensitivity syndrome. G-banding karyotype analysis were paired with FISH using X and Y chromosome probe produced similar results. The present analysis showed that FISH is a reliable method to attain a rapid and accurate chromosome analysis result of DSD patients. Nevertheless, conventional karyotype technique is still vital if other condition appeared in DSD patients in order to get more detailed karyotype result which FISH method cannot achieve.

Keywords: chromosome, DSD, FISH, karyotype

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