Search results for: manufacturing scale technology development
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 26334

Search results for: manufacturing scale technology development

5094 Remote Learning During Pandemic: Malaysian Classroom

Authors: Hema Vanita Kesevan

Abstract:

The global spread of Covid-19 virus in early 2020 has led to major changes in many walks of life, including the education system. Traditional face to face lessons that were carried out for years has been replaced by online learning. Although online learning has been used before the pandemic, it has not been the only source of teaching and learning. This drastic change has brought significant impact to the process of teaching and learning in many classrooms around the world. Likewise, in country like Malaysia that that has been promoting online learning but has not utilize it fully due to many restrictions in terms of technology, accessibility, and online literacy, the sudden change to full online platform learning in all educational sector has definitely caused Issues in terms of its adaptation and usage. Although many studies have been conducted to explore the efficiency and impact of online learning during the pandemic, studies focusing on the same are limited in Malaysian classroom context, especially in English language classrooms. Thus, this study seeks to explore on the efficacy and effectiveness of online learning tools in ESL classroom contexts during the pandemic. The aim of this study is to understand the educator's and student's perceptions on the implementation of online learning tools in the teaching and learning process and the types of online learning tools that were used to assist the teaching and learning process during the pandemic. Particularly, this study focused to explore the types of online learning tools used in Malaysian schools and university during the online teaching and learning process and further explores how the various types of tools used impacted the students' participation in the lessons conducted. The participants of this study are secondary school students, teachers, and university students. Data will be collected in terms of survey questionnaire and interviews. The survey data intends to obtain information on the types of online learning used in ESL teaching and learning practices during the pandemic, how the various types of online tools influence students' participation during lessons. The interview data from the teachers serves to provide information about the selection of online learning tools, challenges of using it to conduct online lessons, and other arising issues. A mixed method design will be used to analysed the data obtained. The questionnaire will be analysed quantitatively using descriptive analysis meanwhile, the interview data will be analysed qualitatively.

Keywords: Covid 19, online learning tools, ESL classroom, effectiveness, efficacy

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5093 Examining the Effects of Increasing Lexical Retrieval Attempts in Tablet-Based Naming Therapy for Aphasia

Authors: Jeanne Gallee, Sofia Vallila-Rohter

Abstract:

Technology-based applications are increasingly being utilized in aphasia rehabilitation as a means of increasing intensity of treatment and improving accessibility to treatment. These interactive therapies, often available on tablets, lead individuals to complete language and cognitive rehabilitation tasks that draw upon skills such as the ability to name items, recognize semantic features, count syllables, rhyme, and categorize objects. Tasks involve visual and auditory stimulus cues and provide feedback about the accuracy of a person’s response. Research has begun to examine the efficacy of tablet-based therapies for aphasia, yet much remains unknown about how individuals interact with these therapy applications. Thus, the current study aims to examine the efficacy of a tablet-based therapy program for anomia, further examining how strategy training might influence the way that individuals with aphasia engage with and benefit from therapy. Individuals with aphasia are enrolled in one of two treatment paradigms: traditional therapy or strategy therapy. For ten weeks, all participants receive 2 hours of weekly in-house therapy using Constant Therapy, a tablet-based therapy application. Participants are provided with iPads and are additionally encouraged to work on therapy tasks for one hour a day at home (home logins). For those enrolled in traditional therapy, in-house sessions involve completing therapy tasks while a clinician researcher is present. For those enrolled in the strategy training group, in-house sessions focus on limiting cue use in order to maximize lexical retrieval attempts and naming opportunities. The strategy paradigm is based on the principle that retrieval attempts may foster long-term naming gains. Data have been collected from 7 participants with aphasia (3 in the traditional therapy group, 4 in the strategy training group). We examine cue use, latency of responses and accuracy through the course of therapy, comparing results across group and setting (in-house sessions vs. home logins).

Keywords: aphasia, speech-language pathology, traumatic brain injury, language

Procedia PDF Downloads 191
5092 Education for Sustainability: Implementing a Place-Based Watershed Science Course for High School Students

Authors: Dina L. DiSantis

Abstract:

Development and implementation of a place-based watershed science course for high school students will prove to be a valuable experience for both student and teacher. By having students study and assess the watershed dynamics of a local stream, they will better understand how human activities affect this valuable resource. It is important that students gain tangible skills that will help them to have an understanding of water quality analysis and the importance of preserving our Earth's water systems. Having students participate in real world practices is the optimal learning environment and can offer students a genuine learning experience, by cultivating a knowledge of place, while promoting education for sustainability. Additionally, developing a watershed science course for high school students will give them a hands-on approach to studying science; which is both beneficial and more satisfying to students. When students conduct their own research, collect and analyze data, they will be intimately involved in addressing water quality issues and solving critical water quality problems. By providing students with activities that take place outside the confines of the indoor classroom, you give them the opportunity to gain an appreciation of the natural world. Placed-based learning provides students with problem-solving skills in everyday situations while enhancing skills of inquiry. An overview of a place-based watershed science course and its impact on student learning will be presented.

Keywords: education for sustainability, place-based learning, watershed science, water quality

Procedia PDF Downloads 141
5091 Influence of Annealing on the Mechanical Properties of Polyester-Cotton Friction Spun Yarn

Authors: Sujit Kumar Sinha, R. Chattopadhyay

Abstract:

In the course of processing phases and use, fibres, yarns, or fabrics are subjected to a variety of stresses and strains, which cause the development of internal stresses. Given an opportunity, these inherent stresses try to bring back the structure to the original state. As an example, a twisted yarn always shows a tendency to untwist whenever its one end is made free. If the yarn is not held under tension, it may form snarls due to the presence of excessive torque. The running performance of such yarn or thread may, therefore, get negatively affected by it, as a snarl may not pass through the knitting or sewing needle smoothly, leading to an end break. A fabric shows a tendency to form wrinkles whenever squeezed. It may also shrink when brought to a relaxed state. In order to improve performance (i.e., dimensional stability or appearance), stabilization of the structure is needed. The stabilization can be attained through the release of internal stresses, which can be brought about by the process of annealing and/or other finishing treatments. When a fabric is subjected to heat, a change in the properties of the fibers, yarns, and fabric is expected. The degree to which the properties are affected would depend upon the condition of heat treatment and on the properties & structure of fibres, yarns, and fabric. In the present study, an attempt has been made to investigate the effect of annealing treatment on the properties of polyester cotton yarns with varying sheath structures.

Keywords: friction spun yarn, annealing, tenacity, structural integrity, decay

Procedia PDF Downloads 42
5090 Observing Upin and Ipin Animation Roles in Early Childhood Education

Authors: Juhanita Jiman

Abstract:

Malaysia is a unique country with multifaceted society; rich with its beautiful cultural values. It has been a long assimilation process for Malaysia to emerge its national identity. Malaysian government has been working hard for centuries to keep its people together in harmony. Cultural identity is identified to be ‘container’ that brings Malaysians together. The uniqueness of Malaysian cultures can actually be exploited for the benefit of the nation. However, this unique culture is somehow being threatened by those imported foreign values. If not closely monitored, these foreign influences can bring more damages than good. This paper aims to study elements in Upin and Ipin animation series and investigate how this series could help to educate local children with good moral and behaviour without being too serious and sententious. Upin and Ipin is chosen as a study to investigate the effectiveness of animation as a media of communication to promote positive values amongst pre-school children. Purposive sampling method was employed to determine the sample of studies hence pre-school children from Putrajaya Presint 9(2) school were chosen to take part in this study. The findings of this study demonstrate positive suggestions on how animation programmes being shown on TV can play significant roles in children social development and inculcate good moral behaviour as well as social skills among children and people around them.

Keywords: animation characters, children informal education, foreign influences, moral values

Procedia PDF Downloads 165
5089 Relationship Salt Sensitivity and с825т Polymorphism of gnb3 Gene in Patients with Essential Hypertension

Authors: Aleksandr Nagay, Gulnoz Khamidullayeva

Abstract:

It is known that an unbalanced intake of salt (NaCI), lifestyle and genetic predisposition to pathology is a key component of the risk and the development of essential hypertension (EH). Purpose: To study the relationship between salt-sensitivity and blood pressure (BP) on systolic (SBP) and diastolic (DBP) blood pressure, depending on the C825T polymorphism of GNB3 in individuals of Uzbek nationality with EH. Method: studied 148 healthy and 148 patients with EH with I-II degree (WHO/ISH, 2003) with disease duration 6,5±1,3 years. Investigation of the gene GNB3 was produced by PCR-RFLP method. Determination of salt-sensitivity was performed by the method of R. Henkin. Results: For a comparative analysis of BP, the groups with carriage of CТ and TT genotypes were combined. The analysis showed that carriers of CC genotype and low salt-sensitivity were determined by higher levels of SBP compared with carriers of CT and TT genotypes, and low salt-sensitivity of SBP: 166,2±4,3 against 158,2±9,1 mm Hg (p=0,000). A similar analysis on the values of DBP also showed significantly higher values of blood pressure in carriers of CC genotype DBP: 105,8±10,6 vs. 100,5±7,2 mm Hg, respectively (p=0,001). The average values of SBP and DBP in groups with carriers of CC genotype at medium or high salt-sensitivity in comparison with carriers of CT or TT genotype did not differ statistically SBP: 165,0±0,1 vs. 160,0±8,6 mm Hg (p=0,275) and DBP: 100,1±0,1 vs. 101,6±7,6 mm Hg (p=0,687), respectively. Conclusion: It is revealed that in patients with EH CC genotype of the gene GNB3 given salt-sensitivity has a negative effect on blood pressure profile. Since patients with EH with the CC genotype of GNB3 gene with low-salt taste sensitivity is determined by a higher level of blood pressure, both on SBP and DBP.

Keywords: salt sensitivity, essential hypertension EH, blood pressure BP, genetic predisposition

Procedia PDF Downloads 261
5088 Perfectly Matched Layer Boundary Stabilized Using Multiaxial Stretching Functions

Authors: Adriano Trono, Federico Pinto, Diego Turello, Marcelo A. Ceballos

Abstract:

Numerical modeling of dynamic soil-structure interaction problems requires an adequate representation of the unbounded characteristics of the ground, material non-linearity of soils, and geometrical non-linearities such as large displacements due to rocking of the structure. In order to account for these effects simultaneously, it is often required that the equations of motion are solved in the time domain. However, boundary conditions in conventional finite element codes generally present shortcomings in fully absorbing the energy of outgoing waves. In this sense, the Perfectly Matched Layers (PML) technique allows a satisfactory absorption of inclined body waves, as well as surface waves. However, the PML domain is inherently unstable, meaning that it its instability does not depend upon the discretization considered. One way to stabilize the PML domain is to use multiaxial stretching functions. This development is questionable because some Jacobian terms of the coordinate transformation are not accounted for. For this reason, the resulting absorbing layer element is often referred to as "uncorrected M-PML” in the literature. In this work, the strong formulation of the "corrected M-PML” absorbing layer is proposed using multiaxial stretching functions that incorporate all terms of the coordinate transformation. The results of the stable model are compared with reference solutions obtained from extended domain models.

Keywords: mixed finite elements, multiaxial stretching functions, perfectly matched layer, soil-structure interaction

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5087 Fabrication of Fe3O4core-meso SiO2/TiO2 Double Shell for Dye Pollution Remediation

Authors: Mohamed Habila, Ahmed Mohamed El-Toni, Mohamed Sheikh Moshab, Abdulrhman Al-Awadi, Zeid AL Othman

Abstract:

Water pollution with dyes is a critical environmental issue because off the huge amount of dyes disbarred annually, which cause severe damage for the ecosystem and human life. The main raison for this severs pollution is the rapid industrial development which led to more production of harmful pollutants. on the other hand, the core shell based magnetic materials have showed amazing character for controlling the material synthesis with the targeted structure to enhance the adsorptive removal of pollutants. Herein, the Fe3O4core-meso SiO2/TiO2 double shell have been prepared for methylene blue dye adsorption. the preparation procedure is controlled to prepare the magnetic core with further coating layers from silica and titania. The prepared Fe3O4core-meso SiO2/TiO2 double shell showed adsorption capacity for methylene blue removal about 50 mg/g at pH 6 after 80 min contact time form 50 ppm methylene blue solution. The adsorption process of methylene blue onto Fe3O4core-meso SiO2/TiO2 double shell was well fitted with the pseudo-second-order kinetic model and freundlish isotherm, indicating a quick and multilayer adsorption mechanism.

Keywords: magnetic core, silica shell, titania shell, water treatment, methylene blue, solvo-thermal process, adsorption

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5086 Metabolic and Adaptive Laboratory Evolutionary Engineering (ALE) of Saccharomyces cerevisiae for Second Generation Biofuel Production

Authors: Farnaz Yusuf, Naseem A. Gaur

Abstract:

The increase in environmental concerns, rapid depletion of fossil fuel reserves and intense interest in achieving energy security has led to a global research effort towards developing renewable sources of fuels. Second generation biofuels have attracted more attention recently as the use of lignocellulosic biomass can reduce fossil fuel dependence and is environment-friendly. Xylose is the main pentose and second most abundant sugar after glucose in lignocelluloses. Saccharomyces cerevisiae does not readily uptake and use pentose sugars. For an economically feasible biofuel production, both hexose and pentose sugars must be fermented to ethanol. Therefore, it is important to develop S. cerevisiae host platforms with more efficient xylose utilization. This work aims to construct a xylose fermenting yeast strains with engineered oxido-reductative pathway for xylose metabolism. Engineered strain was further improved by adaptive evolutionary engineering approach. The engineered strain is able to grow on xylose as sole carbon source with the maximum ethanol yield of 0.39g/g xylose and productivity of 0.139g/l/h at 96 hours. The further improvement in strain development involves over expression of pentose phosphate pathway and protein engineering of xylose reductase/xylitol dehydrogenase to change their cofactor specificity in order to reduce xylitol accumulation.

Keywords: biofuel, lignocellulosic biomass, saccharomyces cerevisiae, xylose

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5085 Legal Warranty in Real Estate Registry in Albania

Authors: Elona Saliaj

Abstract:

The registration of real estate in Albania after the 90's has been a long process in time and with high cost for the country. Passing the registration system from a centralized system to a free market private system, it’s accompanied by legal uncertainties that have led to economic instability. The reforms that have been undertaken in terms of property rights have been numerous and continuous throughout the years. But despite the reforms, the system of registration of real estate, has failed to be standards requirements established by the European Union. The completion of initial registration of real estate, legal treatment of previous owners or legalization of illegal constructions remain among the main problems that prevent the development of the country in its economic sector. The performance of the registration of real estate system and dealing with issues that have appeared in the Court of First Instance, the civil section of the Albanian constitute the core of handling this analysis. This paper presents a detailed analysis on the registration system that is chosen to be applied in our country for real estate. In its content it is also determined the institution that administrates these properties, the management technique and the law that determinate its functionality. The strategy is determined for creating a modern and functional registration system and for the country remains a challenge to achieve. Identifying practical problems and providing their solutions are also the focus of reference in order to improve and modernize this important system to a state law that aims to become a member of the European Union.

Keywords: real estates registration system, comparative aspects, cadastral area, property certificate, legal reform

Procedia PDF Downloads 480
5084 Defining a Framework for Holistic Life Cycle Assessment of Building Components by Considering Parameters Such as Circularity, Material Health, Biodiversity, Pollution Control, Cost, Social Impacts, and Uncertainty

Authors: Naomi Grigoryan, Alexandros Loutsioli Daskalakis, Anna Elisse Uy, Yihe Huang, Aude Laurent (Webanck)

Abstract:

In response to the building and construction sectors accounting for a third of all energy demand and emissions, the European Union has placed new laws and regulations in the construction sector that emphasize material circularity, energy efficiency, biodiversity, and social impact. Existing design tools assess sustainability in early-stage design for products or buildings; however, there is no standardized methodology for measuring the circularity performance of building components. Existing assessment methods for building components focus primarily on carbon footprint but lack the comprehensive analysis required to design for circularity. The research conducted in this paper covers the parameters needed to assess sustainability in the design process of architectural products such as doors, windows, and facades. It maps a framework for a tool that assists designers with real-time sustainability metrics. Considering the life cycle of building components such as façades, windows, and doors involves the life cycle stages applied to product design and many of the methods used in the life cycle analysis of buildings. The current industry standards of sustainability assessment for metal building components follow cradle-to-grave life cycle assessment (LCA), track Global Warming Potential (GWP), and document the parameters used for an Environmental Product Declaration (EPD). Developed by the Ellen Macarthur Foundation, the Material Circularity Indicator (MCI) is a methodology utilizing the data from LCA and EPDs to rate circularity, with a "value between 0 and 1 where higher values indicate a higher circularity+". Expanding on the MCI with additional indicators such as the Water Circularity Index (WCI), the Energy Circularity Index (ECI), the Social Circularity Index (SCI), Life Cycle Economic Value (EV), and calculating biodiversity risk and uncertainty, the assessment methodology of an architectural product's impact can be targeted more specifically based on product requirements, performance, and lifespan. Broadening the scope of LCA calculation for products to incorporate aspects of building design allows product designers to account for the disassembly of architectural components. For example, the Material Circularity Indicator for architectural products such as windows and facades is typically low due to the impact of glass, as 70% of glass ends up in landfills due to damage in the disassembly process. The low MCI can be combatted by expanding beyond cradle-to-grave assessment and focusing the design process on disassembly, recycling, and repurposing with the help of real-time assessment tools. Design for Disassembly and Urban Mining has been integrated within the construction field on small scales as project-based exercises, not addressing the entire supply chain of architectural products. By adopting more comprehensive sustainability metrics and incorporating uncertainty calculations, the sustainability assessment of building components can be more accurately assessed with decarbonization and disassembly in mind, addressing the large-scale commercial markets within construction, some of the most significant contributors to climate change.

Keywords: architectural products, early-stage design, life cycle assessment, material circularity indicator

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5083 Strategies and Difficulties to Integrate Renewable Energy into Recreational Open Spaces

Authors: A. Tereci, M. Atmaca

Abstract:

Recreational spaces designed or build for refreshment of the users through natural riches and/or activities. Those places contribute to the quality of city life by providing relaxation point for citizens and maintaining the environmental equilibrium. The elements which constitute the recreational areas also promote long-term environmental and social sustainability of cities. Preservation and creation of the recreation open spaces are important for water and air quality, natural habitat and also social communication. On this point, it is also a good area for promoting the renewable energy sources through comprehension of the sustainable development which is possible only with using nature and technic together. Energy production is mainly technical issue, and architectural design of these elements to the site always ignores or avoid. The main problems for integration of renewable energy sources are the system suitability, security, durability, and resiliency. In this paper, one of the city recreational open spaces in Konya, Turkey was evaluated for integration of possible renewable energy sources. It shows that the solar energy potential is high and PV integration is the best option. On the other hand wind, energy power and area is not suitable for wind turbine, so wind belts were decided to integrate on the design. According to recreational activities, the chosen elements was designed for site application, and their performance was calculated. According to possible installation on the furniture, there is 50 MWh/a electricity production capacity.

Keywords: energy, integrated design, recreational space, renewables

Procedia PDF Downloads 143
5082 Fiber Optic Asparagine Biosensor for Fruit Juices by Co-Immobilization of L-Asparaginase and Phenol Red

Authors: Mandeep Kataria, Ritu Narula, Navneet Kaur

Abstract:

Asparagine is vital amino acid which is required for the development of brain and it regulates the equilibrium of central nervous system. Asparagine is the chief amino acid that forms acrylamide in baked food by reacting with reducing sugars at high temperature ( Millard Reaction i.e. amino acids and sugars give new flavors at high temperature). It can also be a parameter of freshness in fruit juices because on storage of juices at 37°C caused an 87% loss in the total free amino acids and major decrease was recorded in asparagine contents. With this significance of monitoring asparagine, in the present work a biosensor for determining asparagine in fruit juices is developed. For the construction of biosensor L-asparaginase enzyme (0.5 IU) was co-immobilized with phenol red on TEOS chitosan sol-gel plastic disc and fixed on the fiber optic tip. Tip was immersed in a cell having 5ml of substrate and absorption was noted at response time of 5 min with 10-1 - 10-10 M concentrations of asparagine at 538 nm. L-asparaginase was extracted and from Solanum nigrum Asparagine biosensor was applied fruit juices on the monitoring asparagine contents. L-asparagine concentration found to be present in fruit juices like Guava Juice, Apple Juice, Mango Juice, Litchi juice, Strawberry juice, Pineapple juice Lemon juice, and Orange juice. Hence the developed biosensor has commercial aspects in quality insurance of fruit juices.

Keywords: fiber optic biosensor, chitosan, teos, l-asparaginase

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5081 Use of Indigenous Knowledge System (IKS) by Farmers for Selected Arable Crops Production in Ondo State

Authors: A. M. Omoare, E. O. Fakoya

Abstract:

This study sought to determine the use of indigenous knowledge for selected arable crops production in Ondo Sate. A multistage sampling method was used and 112 arable crops farmers were systematically selected. Data were analyzed using both descriptive and inferential statistics. The results showed that majority of the sampled farmers were male (75.90%). About 75% were married with children. Large proportion of them (62.61%) were within the ages of 30-49 years. Most of them have spent about 10 years in farming (58.92%). The highest raw scores of use of indigenous knowledge were found in planting on mound in yam production, use of native medicine and scare crow method in controlling birds in rice production, timely planting of locally developed resistant varieties in cassava production and soaking of maize seeds in water to determine their viability with raw scores of 313, 310, 305, 303, and 300 respectively, while the lowest raw scores was obtained in use of bell method in controlling birds in rice production with raw scores of 210. The findings established that proverbs (59.8%) and taboos (55.36%) were the most commonly used media in transmitting indigenous knowledge by arable crop farmers. The multiple regression analysis result revealed that age of the farmers and farming experience had a significant relationship with the use of indigenous knowledge of the farmers which gave R2 = 0.83 for semi log function form of equation which is the land equation. The policy implication is that indigenous knowledge should provide basis for designing modern technologies to enhance sustainable agricultural development.

Keywords: crop production, extent of use, indigenous knowledge, arable crops

Procedia PDF Downloads 646
5080 The Shared Breath Project: Inhabiting Each Other’s Words and Being

Authors: Beverly Redman

Abstract:

With the Theatre Season of 2020-2021 cancelled due to COVID-19 at Purdue University, Fort Wayne, IN, USA, faculty directors found themselves scrambling to create theatre production opportunities for their students in the Department of Theatre. Redman, Chair of the Department, found her community to be suffering from anxieties brought on by a confluence of issues: the global-scale Covid-19 Pandemic, the United States’ Black Lives Matter protests erupting in cities all across the country and the coming Presidential election, arguably the most important and most contentious in the country’s history. Redman wanted to give her students the opportunity to speak not only on these issues but also to be able to record who they were at this time in their personal lives, as well as in this broad socio-political context. She also wanted to invite them into an experience of feeling empathy, too, at a time when empathy in this world seems to be sorely lacking. Returning to a mode of Devising Theatre she had used with community groups in the past, in which storytelling and re-enactment of participants’ life events combined with oral history documentation practices, Redman planned The Shared Breath Project. The process involved three months of workshops, in which participants alternated between theatre exercises and oral history collection and documentation activities as a way of generating original material for a theatre production. The goal of the first half of the project was for each participant to produce a solo piece in the form of a monologue after many generations of potential material born out of gammes, improvisations, interviews and the like. Along the way, many film and audio clips recorded the process of each person’s written documentation—documentation prepared by the subject him or herself but also by others in the group assigned to listen, watch and record. Then, in the second half of the project—and only once each participant had taken their own contributions from raw improvisatory self-presentations and through the stages of composition and performative polish, participants then exchanged their pieces. The second half of the project involved taking on each other’s words, mannerisms, gestures, melodic and rhythmic speech patterns and inhabiting them through the rehearsal process as their own, thus the title, The Shared Breath Project. Here, in stage two the acting challenges evolved to be those of capturing the other and becoming the other through accurate mimicry that embraces Denis Diderot’s concept of the Paradox of Acting, in that the actor is both seeming and being simultaneous. This paper shares the carefully documented process of making the live-streamed theatre production that resulted from these workshops, writing processes and rehearsals, and forming, The Shared Breath Project, which ultimately took the students’ Realist, life-based pieces and edited them into a single unified theatre production. The paper also utilizes research on the Paradox of Acting, putting a Post-Structuralist spin on Diderot’s theory. Here, the paper suggests the limitations of inhabiting the other by allowing that the other is always already a thing impenetrable but nevertheless worthy of unceasing empathetic, striving and delving in an epoch in which slow, careful attention to our fellows is in short supply.

Keywords: otherness, paradox of acting, oral history theatre, devised theatre, political theatre, community-based theatre, peoples’ theatre

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5079 Rectus Sheath Block to Extend the Effectiveness of Post Operative Epidural Analgesia

Authors: Sugam Kale, Arif Uzair Bin Mohammed Roslan, Cindy Lee, Syed Beevee Mohammed Ismail

Abstract:

Preemptive analgesia is an established concept in the modern practice of anaesthesia. To be most effective, it is best instituted earlier than the surgical stimulus and should last beyond the offset of surgically induced pain till healing is complete. Whereas the start of afferent pain blockade with regional anaesthesia is common, its effect often falls short to cover the entire period of pain impulses making their way to CNS in the post-operative period. We tried to use a combination of two regional anaesthetic techniques used sequentially to overcome this handicap. Madam S., a 56 year old lady, was scheduled for elective surgery for pancreatic cancer. She underwent laparotomy and distal pancreatectomy, splenectomy, bilateral salpingo oophorectomy, and sigmoid colectomy. Surgery was expected to be extensive, and it was presumed that the standard pain relief with PCA with opiates and oral analgesics would not be adequate. After counselling the patient pre-operative about the technique of regional anaesthesia techniques, including epidural catheterization and rectus sheath catheter placement, their benefits, and potential complications, informed consent was obtained. Epidural catheter was placed awake, and general anaesthesia was then induced. Epidural infusion of local anaesthetics was started prior to surgical incision and was continued till 60 hours into the postoperative period. Before skin closure, the surgeons inserted commercially available rectus sheath catheters bilaterally along the midline incision used for laparotomy. After 46 hours post-op, local anaesthetic infusion via these was started as bridging while the epidural infusion rate was tapered off. The epidural catheter was removed at 75 hours. Elastomeric pumps were used to provide local anaesthetic infusion with the ability to vary infusion rates. Acute pain service followed up the patient’s vital signs and effectiveness of pain relief twice daily or more frequently as required. Rectus sheath catheters were removed 137 hours post-op. The patient had good post-op analgesia with the minimal additional analgesic requirement. For the most part, the visual analog score (VAS) for pain remained at 1-3 on a scale of 1 to 10. Haemodynamics remained stable, and surgical recovery was as expected. Minimal opiate requirement after an extensive laparotomy also translates to the early return of intestinal motility. Our experience was encouraging, and we are hoping to extend this combination of two regional anaesthetic techniques to patients undergoing similar surgeries. Epidural analgesia is denser and offers excellent pain relief for both visceral and somatic pain in the first few days after surgery. As the pain intensity grows weaker, rectus sheath block and oral analgesics provide almost the same degree of pain relief after the epidural catheter is removed. We discovered that the background infusion of local anaesthetic down the rectus sheath catherter largely reduced the requirement for other classes of analgesics. We aim to study this further with a larger patient cohort and hope that it may become an established clinical practice that benefits patients everywhere.

Keywords: rectus sheath, epidural infusion, post operative analgesia, elastomeric

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5078 Mathematical Modeling of the Operating Process and a Method to Determine the Design Parameters in an Electromagnetic Hammer Using Solenoid Electromagnets

Authors: Song Hyok Choe

Abstract:

This study presented a method to determine the optimum design parameters based on a mathematical model of the operating process in a manual electromagnetic hammer using solenoid electromagnets. The operating process of the electromagnetic hammer depends on the circuit scheme of the power controller. Mathematical modeling of the operating process was carried out by considering the energy transfer process in the forward and reverse windings and the electromagnetic force acting on the impact and brake pistons. Using the developed mathematical model, the initial design data of a manual electromagnetic hammer proposed in this paper are encoded and analyzed in Matlab. On the other hand, a measuring experiment was carried out by using a measurement device to check the accuracy of the developed mathematical model. The relative errors of the analytical results for measured stroke distance of the impact piston, peak value of forward stroke current and peak value of reverse stroke current were −4.65%, 9.08% and 9.35%, respectively. Finally, it was shown that the mathematical model of the operating process of an electromagnetic hammer is relatively accurate, and it can be used to determine the design parameters of the electromagnetic hammer. Therefore, the design parameters that can provide the required impact energy in the manual electromagnetic hammer were determined using a mathematical model developed. The proposed method will be used for the further design and development of the various types of percussion rock drills.

Keywords: solenoid electromagnet, electromagnetic hammer, stone processing, mathematical modeling

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5077 Ultrasonic Techniques to Characterize and Monitor Water-in-Oil Emulsion

Authors: E. A. Alshaafi, A. Prakash

Abstract:

Oil-water emulsions are commonly encountered in various industrial operations and at different stages of crude oil production and processing. Emulsions are often difficult to track and treat and can cause a number of costly problems which need to be avoided. The characteristics of the emulsion phase can vary with crude composition and types of impurities present in oil. The objectives of this study are the development of ultrasonic techniques to track and characterize emulsion phase generated during production and cleaning of crude oil. The position of emulsion layer is monitored with the help of ultrasonic probes suitably placed in the vessel. The sensitivity of the technique and its potential has been demonstrated based on extensive testing with different oil samples. The technique is also being developed to monitor emulsion phase characteristics such as stability, composition, and droplet size distribution. The ultrasonic parameters recorded are changes in acoustic velocity, signal attenuation and its frequency spectrum. Emulsion has been prepared with light mineral oil sample and the effects of various factors including mixing speed, temperature, surfactant, and solid particles concentrations have been investigated. The applied frequency for ultrasonic waves has been varied from 1 to 5 MHz to carry out a sensitivity analysis. Emulsion droplet structure is observed with optical microscopy and stability is examined by tracking the changes in ultrasonic parameters with time. A model based on ultrasonic attenuation spectroscopy is being developed and tested to track changes in droplet size distribution with time.

Keywords: ultrasonic techniques, emulsion, characterization, droplet size

Procedia PDF Downloads 157
5076 Sustainability in Hospitality: An Inevitable Necessity in New Age with Big Environmental Challenges

Authors: Majid Alizadeh, Sina Nematizadeh, Hassan Esmailpour

Abstract:

The mutual effects of hospitality and the environment are undeniable, so that the tourism industry has major harmful effects on the environment. Hotels, as one of the most important pillars of the hospitality industry, have significant effects on the environment. Green marketing is a promising strategy in response to the growing concerns about the environment. A green hotel marketing model was proposed using a grounded theory approach in the hotel industry. The study was carried out as a mixed method study. Data gathering in the qualitative phase was done through literature review and In-depth, semi-structured interviews with 10 experts in green marketing using snowball technique. Following primary analysis, open, axial, and selective coding was done on the data, which yielded 69 concepts, 18 categories and six dimensions. Green hotel (green product) was adopted as the core phenomenon. In the quantitative phase, data were gleaned using 384 questionnaires filled-out by hotel guests and descriptive statistics and Structural equation modeling (SEM) were used for data analysis. The results indicated that the mediating role of behavioral response between the ecological literacy, trust, marketing mix and performance was significant. The green marketing mix, as a strategy, had a significant and positive effect on guests’ behavioral response, corporate green image, and financial and environmental performance of hotels.

Keywords: green marketing, sustainable development, hospitality, grounded theory, structural equations model

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5075 Thermodynamic Modeling of Cryogenic Fuel Tanks with a Model-Based Inverse Method

Authors: Pedro A. Marques, Francisco Monteiro, Alessandra Zumbo, Alessia Simonini, Miguel A. Mendez

Abstract:

Cryogenic fuels such as Liquid Hydrogen (LH₂) must be transported and stored at extremely low temperatures. Without expensive active cooling solutions, preventing fuel boil-off over time is impossible. Hence, one must resort to venting systems at the cost of significant energy and fuel mass loss. These losses increase significantly in propellant tanks installed on vehicles, as the presence of external accelerations induces sloshing. Sloshing increases heat and mass transfer rates and leads to significant pressure oscillations, which might further trigger propellant venting. To make LH₂ economically viable, it is essential to minimize these factors by using advanced control techniques. However, these require accurate modelling and a full understanding of the tank's thermodynamics. The present research aims to implement a simple thermodynamic model capable of predicting the state of a cryogenic fuel tank under different operating conditions (i.e., filling, pressurization, fuel extraction, long-term storage, and sloshing). Since this model relies on a set of closure parameters to drive the system's transient response, it must be calibrated using experimental or numerical data. This work focuses on the former approach, wherein the model is calibrated through an experimental campaign carried out on a reduced-scale model of a cryogenic tank. The thermodynamic model of the system is composed of three control volumes: the ullage, the liquid, and the insulating walls. Under this lumped formulation, the governing equations are derived from energy and mass balances in each region, with mass-averaged properties assigned to each of them. The gas-liquid interface is treated as an infinitesimally thin region across which both phases can exchange mass and heat. This results in a coupled system of ordinary differential equations, which must be closed with heat and mass transfer coefficients between each control volume. These parameters are linked to the system evolution via empirical relations derived from different operating regimes of the tank. The derivation of these relations is carried out using an inverse method to find the optimal relations that allow the model to reproduce the available data. This approach extends classic system identification methods beyond linear dynamical systems via a nonlinear optimization step. Thanks to the data-driven assimilation of the closure problem, the resulting model accurately predicts the evolution of the tank's thermodynamics at a negligible computational cost. The lumped model can thus be easily integrated with other submodels to perform complete system simulations in real time. Moreover, by setting the model in a dimensionless form, a scaling analysis allowed us to relate the tested configurations to a representative full-size tank for naval applications. It was thus possible to compare the relative importance of different transport phenomena between the laboratory model and the full-size prototype among the different operating regimes.

Keywords: destratification, hydrogen, modeling, pressure-drop, pressurization, sloshing, thermodynamics

Procedia PDF Downloads 78
5074 Association of Phosphorus and Magnesium with Fat Indices in Children with Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

Abstract:

Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention, particularly in the pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. Twenty-eight, 29, 34, and 34 children were involved in Group 1 (healthy), 2 (obese), 3 (morbid obese), and 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the participants. The classification of obese groups was performed based upon the recommendations of the World Health Organization. Metabolic syndrome components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by a body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference, and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index, and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, the group, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: children, fat mass, fat-free mass, macrominerals, obesity

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5073 Addressing Head Transplantation and Its Legal, Social and Neuroethical Implications

Authors: Joseph P. Mandala

Abstract:

This paper examines the legal and medical ethics concerns, which proponents of human head transplantation continue to defy since the procedure was first attempted on dogs in 1908. Despite recent bioethical objections, proponents have proceeded with radical experimentation, claiming transplantation would treat incurable diseases and improve patients’ quality of life. In 2018, Italian neurosurgeon, Sergio Canavero, and Dr. Xiaoping Ren claimed to have performed a head transplant on a corpse in China. Content analysis of literature shows that the procedure failed to satisfy scientific, legal, and bioethical elements because, unlike humans, corpses cannot coordinate function. Putting a severed head onto a body that has been dead for several days is not equivalent to a transplant which would require successfully reconnecting and restoring function to a spinal cord. While reconnection without restoration of bodily function is not transplantation, the publicized procedure on animals and corpses could leapfrog to humans, sparking excitement in society likely to affect organ donors and recipients from territorial jurisdictions with varying legal and ethical regimes. As neurodiscoveries generate further excitement, the need to preemptively address the legal and medical ethics impact of head transplantation in our society cannot be overstated. A preemptive development of methods to address the impact of head transplantation will help harmonizing national and international laws on organ donations, advance directives, and laws affecting end of life.

Keywords:

Procedia PDF Downloads 125
5072 Application to Monitor the Citizens for Corona and Get Medical Aids or Assistance from Hospitals

Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge

Abstract:

It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.

Keywords: blockchain, deep learning, NLP, monitoring system

Procedia PDF Downloads 125
5071 Robotic Exoskeleton Response During Infant Physiological Knee Kinematics

Authors: Breanna Macumber, Victor A. Huayamave, Emir A. Vela, Wangdo Kim, Tamara T. Chamber, Esteban Centeno

Abstract:

Spina bifida is a type of neural tube defect that affects the nervous system and can lead to problems such as total leg paralysis. Treatment requires physical therapy and rehabilitation. Robotic exoskeletons have been used for rehabilitation to train muscle movement and assist in injury recovery; however, current models focus on the adult populations and not on the infant population. The proposed framework aims to couple a musculoskeletal infant model with a robotic exoskeleton using vacuum-powered artificial muscles to provide rehabilitation to infants affected by spina bifida. The study that drove the input values for the robotic exoskeleton used motion capture technology to collect data from the spontaneous kicking movement of a 2.4-month-old infant lying supine. OpenSim was used to develop the musculoskeletal model, and Inverse kinematics was used to estimate hip joint angles. A total of 4 kicks (A, B, C, D) were selected, and the selection was based on range, transient response, and stable response. Kicks had at least 5° of range of motion with a smooth transient response and a stable period. The robotic exoskeleton used a Vacuum-Powered Artificial Muscle (VPAM) the structure comprised of cells that were clipped in a collapsed state and unclipped when desired to simulate infant’s age. The artificial muscle works with vacuum pressure. When air is removed, the muscle contracts and when air is added, the muscle relaxes. Bench testing was performed using a 6-month-old infant mannequin. The previously developed exoskeleton worked really well with controlled ranges of motion and frequencies, which are typical of rehabilitation protocols for infants suffering with spina bifida. However, the random kicking motion in this study contained high frequency kicks and was not able to accurately replicate all the investigated kicks. Kick 'A' had a greater error when compared to the other kicks. This study has the potential to advance the infant rehabilitation field.

Keywords: musculoskeletal modeling, soft robotics, rehabilitation, pediatrics

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5070 Uncertainty Quantification of Corrosion Anomaly Length of Oil and Gas Steel Pipelines Based on Inline Inspection and Field Data

Authors: Tammeen Siraj, Wenxing Zhou, Terry Huang, Mohammad Al-Amin

Abstract:

The high resolution inline inspection (ILI) tool is used extensively in the pipeline industry to identify, locate, and measure metal-loss corrosion anomalies on buried oil and gas steel pipelines. Corrosion anomalies may occur singly (i.e. individual anomalies) or as clusters (i.e. a colony of corrosion anomalies). Although the ILI technology has advanced immensely, there are measurement errors associated with the sizes of corrosion anomalies reported by ILI tools due limitations of the tools and associated sizing algorithms, and detection threshold of the tools (i.e. the minimum detectable feature dimension). Quantifying the measurement error in the ILI data is crucial for corrosion management and developing maintenance strategies that satisfy the safety and economic constraints. Studies on the measurement error associated with the length of the corrosion anomalies (in the longitudinal direction of the pipeline) has been scarcely reported in the literature and will be investigated in the present study. Limitations in the ILI tool and clustering process can sometimes cause clustering error, which is defined as the error introduced during the clustering process by including or excluding a single or group of anomalies in or from a cluster. Clustering error has been found to be one of the biggest contributory factors for relatively high uncertainties associated with ILI reported anomaly length. As such, this study focuses on developing a consistent and comprehensive framework to quantify the measurement errors in the ILI-reported anomaly length by comparing the ILI data and corresponding field measurements for individual and clustered corrosion anomalies. The analysis carried out in this study is based on the ILI and field measurement data for a set of anomalies collected from two segments of a buried natural gas pipeline currently in service in Alberta, Canada. Data analyses showed that the measurement error associated with the ILI-reported length of the anomalies without clustering error, denoted as Type I anomalies is markedly less than that for anomalies with clustering error, denoted as Type II anomalies. A methodology employing data mining techniques is further proposed to classify the Type I and Type II anomalies based on the ILI-reported corrosion anomaly information.

Keywords: clustered corrosion anomaly, corrosion anomaly assessment, corrosion anomaly length, individual corrosion anomaly, metal-loss corrosion, oil and gas steel pipeline

Procedia PDF Downloads 295
5069 Comparative Antibacterial Property of Matured Trunk and Stem Bark Extract of Tamarindus indica L., Preformulation, Development and Quality Control of Cream

Authors: A. M. T. Jacinto, M.O. Osi

Abstract:

Tamarind has various medicinal properties among which is its antibacterial property. Its bark contains saponins, alkaloids, sesquiterpenes and tannins. It is rich in phlobapenes which is responsible for antibacterial property. The objective of the study was to determine which bark will produce the highest antibacterial property, develop it into a topical cream and evaluate its quality and characteristics. Powdered barks of Tamarind were extracted by soxhlet method using 70% acetone. Stem bark produced a higher yield than trunk bark (5.85 g vs. 4.73 g). It was found that the trunk bark was more sensitive than stem bark to microorganisms namely Staphylococcus aureus, Corynebacterium minutissimum, and Streptococcus spp. Sensitivity of trunk bark can be attributed to a more developed phytoconstituents. Dermal sensitization test on both sexes of rabbits using the following concentrations: 100%, 40% and 20% of extract showed that Tamarind has no irritating property and therefore safe for formulation into an antibacterial cream. Excipients used for formulation such as methyl paraben, propyl paraben, stearyl alcohol and white petrolatum were compatible with the Tamarind acetone extract through Differential Scanning Calorimetry except sodium lauryl sulfate that exhibited crystallization when subjected at 200˚C. The method of manufacture used in cream is fusion, therefore strict compliance of processing temperature should be observed to prevent polymorphism. Quality control tests of formulated cream based on USP 30 and Philippine Pharmacopeia were satisfactory.

Keywords: antibacterial, differential scanning calorimetry, tannins, dermal sensitization

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5068 Suppression of Immunostimulatory Function of Dendritic Cells and Prolongation of Skin Allograft Survival by Dryocrassin

Authors: Hsin-Lien Lin, Ju-Hui Fu

Abstract:

Dendritic cells (DCs) are the major professional antigen-presenting cells for the development of optimal T-cell immunity. DCs can be used as pharmacological targets to screen novel biological modifiers for the treatment of harmful immune responses, such as transplantation rejection. Dryopteris crassirhizoma Nakai (Aspiadaceae) is used for traditional herbal medicine in the region of East Asia. The root of this fern plant has been listed for treating inflammatory diseases. Dryocrassin is the tetrameric phlorophenone component derived from Dryopteris. Here, we tested the immunomodulatory potential of dryocrassin on lipopolysaccharide (LPS)-stimulated activation of mouse bone marrow-derived DCs in vitro and in skin allograft transplantation in vivo. Results demonstrated that dryocrassin reduced the secretion of tumor necrosis factor-α, interleukin-6, and interleukin-12p70 by LPS-stimulated DCs. The expression of LPS-induced major histocompatibility complex class II, CD40, and CD86 on DCs was also blocked by dryocrassin. Moreover, LPS-stimulated DC-elicited allogeneic T-cell proliferation was lessened by dryocrassin. In addition, dryocrassin inhibited LPS-induced activation of IϰB kinase, JNK/p38 mitogen-activated protein kinase, as well as the translocation of NF-ϰB. Treatment with dryocrassin obviously diminished 2,4-dinitro-1-fluorobenzene- induced delayed-type hypersensitivity and prolonged skin allograft survival. Dryocrassin may be one of the potent immunosuppressive agents for transplant rejection through the destruction of DC maturation and function.

Keywords: dryocrassin, dendritic cells, immunosuppression, skin allograft

Procedia PDF Downloads 374
5067 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning

Authors: Umamaheswari Shanmugam, Silvia Ronchi

Abstract:

Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

Procedia PDF Downloads 77
5066 Effects of Fishbone Creative Thinking Strategy on Problem-Solving Skills of Teaching Personnel in Ogun State, Nigeria

Authors: Olusegun Adeleke Adenuga

Abstract:

The study examined effect of fishbone creative thinking strategy on problem-solving skills of public teachers in Ogun state, Nigeria. A 2x2x2 factorial design was employed for the study which consisted of 80 participants made up of 40 male and 40 female public teachers randomly selected among public teaching personnel from the two local government area headquarters (Ijebu-ode and Ijebu-Igbo) within Ogun East Senatorial District. Each treatment group received 45minutes instructions and training per week for 8weeks. Data was collected from participants with the use of standardized instrument tagged ‘Problem Solving Inventory’ (PSI) developed by the researchers prior to the training to form a pre-test and immediately after eight weeks of training to form a post-test. One hypothesis was tested; the data obtained was analyzed using Analysis of Covariance (ANCOVA) tested at significance level of 0.05. The result of the data analysis shows that there was a significant effect of the fishbone creative thinking technique on the participants (F (2,99) = 12.410; p <.05). Based on the findings, it is therefore recommended that the report of this study be used to effect organizational change and development of teaching service in Nigeria through teachers’ retraining and capacity building.

Keywords: fishbone, creative thinking strategy, and problem-solving skills, public teachers

Procedia PDF Downloads 337
5065 Amyloid Angiopathy and Golf: Two Opposite but Close Worlds

Authors: Andrea Bertocchi, Alessio Barnaba Di Fonzo, Davide Talarico, Simone Rivaroli, Jeff Konin

Abstract:

The patient is a 89 years old male (180cm/85kg) retired notary former golfer with no past medical history. He describes a progressive ideomotor slowdown for 14 months. The disorder is characterized by short-term memory deficits and, for some months, also by unstable walking with a broad base with skidding and risk of falling at directional changes and urinary urgency. There were also episodes of aggression towards his wife and staff. At the time, the patient takes no prescribed medications. He has difficulty eating, dressing, and some problems with personal hygiene. In the initial visit, the patient was alert, cooperating, and performed simple tasks; however, he has a hearing impairment, slowed spontaneous speech, and amnestic deficit to the short story. Ideomotor apraxia is not present. He scored 20 points in the MMSE. From a motor function, he has deficits using Medical Research Council (MRC) 3-/5 in bilateral lower limbs and requires maximum assistance from sit to stand with existing premature fatigue. He’s unable to walk for about 1 month. Tremors and hypertonia are absent. BERG was unable to be administered, and BARTHEL was obtained 45/100. An Amyloid Angiopathy is suspected and then confirmed at the neurological examination. Therehabilitation objectives were the recovery of mobility and reinforcement of the UE/LE, especially legs, for recovery of standing and walking. The cognitive aspect was also an essential factor for the patient's recovery. The literature doesn’t demonstrate any particular studies regarding motor and cognitive rehabilitation on this pathology. Failing to manage his attention on exercise and tending to be disinterested and falling asleep constantly, we used golf-specific gestures to stimulate his mind to work and get results because the patient has memory recall of golf related movement. We worked for 4 months with a frequency of 3 sessions per week. Every session lasted for 45 minutes. After 4 months of work, the patient walked independently with the use of a stick for about 120 meters without stopping. MRC 4/5 AI bilaterally andpostural steps performed independently with supervision. BERG 36/56. BARTHEL 65/100. 6 Minutes Walking Test (6MWT), at the beginning, it wasn’t measurable, now, he performs 151,5m with Numeric Rating Scale 4 at the beginning and 7 at the end. Cognitively, he no longer has episodes of aggression, although the short-term memory and concentration deficit remains. Amyloid Angiopathy is a mix of motor and cognitive disorder. It is worth the thought that cerebral amyloid angiopathy manifests with functional deficits due to strokes and bleedings and, as such, has an important rehabilitation indication, as classical stroke is not associated with amyloidosis. Exploring the motor patterns learned at a young age and remained in the implicit and explicit memory of the patient allowed us to set up effective work and to obtain significant results in the short-middle term. Surely many studies will still be done regarding this pathology and its rehabilitation, but the importance of the cognitive sphere applied to the motor sphere could represent an important starting point.

Keywords: amyloid angiopathy, cognitive rehabilitation, golf, motor disorder

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