Search results for: multiple conditions diagnosis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15808

Search results for: multiple conditions diagnosis

13318 Modeling Aerosol Formation in an Electrically Heated Tobacco Product

Authors: Markus Nordlund, Arkadiusz K. Kuczaj

Abstract:

Philip Morris International (PMI) is developing a range of novel tobacco products with the potential to reduce individual risk and population harm in comparison to smoking cigarettes. One of these products is the Tobacco Heating System 2.2 (THS 2.2), (named as the Electrically Heated Tobacco System (EHTS) in this paper), already commercialized in a number of countries (e.g., Japan, Italy, Switzerland, Russia, Portugal and Romania). During use, the patented EHTS heats a specifically designed tobacco product (Electrically Heated Tobacco Product (EHTP)) when inserted into a Holder (heating device). The EHTP contains tobacco material in the form of a porous plug that undergoes a controlled heating process to release chemical compounds into vapors, from which an aerosol is formed during cooling. The aim of this work was to investigate the aerosol formation characteristics for realistic operating conditions of the EHTS as well as for relevant gas mixture compositions measured in the EHTP aerosol consisting mostly of water, glycerol and nicotine, but also other compounds at much lower concentrations. The nucleation process taking place in the EHTP during use when operated in the Holder has therefore been modeled numerically using an extended Classical Nucleation Theory (CNT) for multicomponent gas mixtures. Results from the performed simulations demonstrate that aerosol droplets are formed only in the presence of an aerosol former being mainly glycerol. Minor compounds in the gas mixture were not able to reach a supersaturated state alone and therefore could not generate aerosol droplets from the multicomponent gas mixture at the operating conditions simulated. For the analytically characterized aerosol composition and estimated operating conditions of the EHTS and EHTP, glycerol was shown to be the main aerosol former triggering the nucleation process in the EHTP. This implies that according to the CNT, an aerosol former, such as glycerol needs to be present in the gas mixture for an aerosol to form under the tested operating conditions. To assess if these conclusions are sensitive to the initial amount of the minor compounds and to include and represent the total mass of the aerosol collected during the analytical aerosol characterization, simulations were carried out with initial masses of the minor compounds increased by as much as a factor of 500. Despite this extreme condition, no aerosol droplets were generated when glycerol, nicotine and water were treated as inert species and therefore not actively contributing to the nucleation process. This implies that according to the CNT, an aerosol cannot be generated without the help of an aerosol former, from the multicomponent gas mixtures at the compositions and operating conditions estimated for the EHTP, even if all minor compounds are released or generated in a single puff.

Keywords: aerosol, classical nucleation theory (CNT), electrically heated tobacco product (EHTP), electrically heated tobacco system (EHTS), modeling, multicomponent, nucleation

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13317 Anti-Phospholipid Antibody Syndrome Presenting with Seizure, Stroke and Atrial Mass: A Case Report

Authors: Rajish Shil, Amal Alduhoori, Vipin Thomachan, Jamal Teir, Radhakrishnan Renganathan

Abstract:

Background: Antiphospholipid antibody syndrome (APS) has a broad spectrum of thrombotic and non-thrombotic clinical manifestations. We present a case of APS presenting with seizure, stroke, and atrial mass. Case Description: A 38-year-old male presented with headache of 10 days duration and tonic-clonic seizure. The neurological examination was normal. Magnetic resonance imaging of brain showed small acute right cerebellar infarct. Magnetic resonance angiography of brain and neck showed a focal narrowing in the origin of the internal carotid artery bilaterally. Electroencephalogram was normal. He was started on aspirin, atorvastatin, and carbamazepine. Transthoracic and trans-esophageal echocardiography showed a pedunculated and lobular atrial mass, measuring 1 X 1.5 cm, which was freely mobile across mitral valve opening across the left ventricular inflow. Autoimmune screening showed positive Antiphospholipid antibodies in high titer (Cardiolipin IgG > 120 units/ml, B2 glycoprotein IgG 90 units/mL). Anti-nuclear antibody was negative. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Platelet count was low (111 x 109/L). The patient underwent successful surgical removal of the mass, which looked like a thrombotic clot, and Histopathological analysis confirmed it as a fibrinous clot, with no evidence of tumor cells. The patient was started on full anticoagulation treatment and was followed up regularly in the clinic, where our patient did not have any further complications from the disease. Discussion: Our patient was diagnosed to have APS based on the features of high positive anticardiolipin antibody IgG and B2 glycoprotein IgG levels, Stroke, thrombocytopenia, and abnormal echo findings. Thrombotic vegetation can mimic an atrial myxoma on echo. Conclusion: APS can present with neurological and cardiac manifestations, and therefore a high index of suspicion is necessary for a diagnosis of the disease as it can affect both short and long term treatment plans and prognosis. Therefore, in patients presenting with neurological symptoms like seizures, weakness and radiological diagnosis of stroke in a young patient, where atrial masses could be thought to be the cause of stroke, they should be screened for any concomitant findings of thrombocytopenia and/or activated partial thromboplastin time prolongation, which should raise the suspicion of vasculitis, specifically APS to be the primary cause of the clinical presentation.

Keywords: antiphospholipid syndrome, seizures, atrial mass, stroke

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13316 Imaging Based On Bi-Static SAR Using GPS L5 Signal

Authors: Tahir Saleem, Mohammad Usman, Nadeem Khan

Abstract:

GPS signals are used for navigation and positioning purposes by a diverse set of users. However, this project intends to utilize the reflected GPS L5 signals for location of target in a region of interest by generating an image that highlights the positions of targets in the area of interest. The principle of bi-static radar is used to detect the targets or any movement or changes. The idea is confirmed by the results obtained during MATLAB simulations. A matched filter based technique is employed in the signal processing to improve the system resolution. The simulation is carried out under different conditions with moving receiver and targets. Noise and attenuation is also induced and atmospheric conditions that affect the direct and reflected GPS signals have been simulated to generate a more practical scenario. A realistic GPS L5 signal has been simulated, the simulation results verify that the detection and imaging of targets is possible by employing reflected GPS using L5 signals and matched filter processing technique with acceptable spatial resolution.

Keywords: GPS, L5 Signal, SAR, spatial resolution

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13315 Investigation of Bremsstrahlung, Braking Radiation from Beta-Emitting Radioactive Sources

Authors: Metin Kömsöken, Ayşe Güneş Tanır, Onur Karaman

Abstract:

Usage of high energy charged particles for diagnosis and treatment has been widespread in medicine. The main purpose is to investigate that Bremsstrahlung which occurs by tissue interactions with charged particles should not be neglected. Nuclear stopping power (Bremsstrahlung) was calculated for lung, brain, skin, muscle, bone (cortical) and water targets for the energies of electrons obtained from LINAC used in radiotherapy and of β+ sources used in positron emission tomography (PET). These calculations were done by using the four different analytical functions including classical Bethe-Bloch, Tsoulfanidis, modified Bethe-Bloch and modified Tsoulfanidis equations. It was concluded that obtained results were compatible with that of National Institute of Standards and Technology (NIST-ESTAR).

Keywords: β- emitting source, bremsstrahlung, therapeutic radionuclides, LINAC

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13314 Islamic Equity Markets Response to Volatility of Bitcoin

Authors: Zakaria S. G. Hegazy, Walid M. A. Ahmed

Abstract:

This paper examines the dependence structure of Islamic stock markets on Bitcoin’s realized volatility components in bear, normal, and bull market periods. A quantile regression approach is employed, after adjusting raw returns with respect to a broad set of relevant global factors and accounting for structural breaks in the data. The results reveal that upside volatility tends to exert negative influences on Islamic developed-market returns more in bear than in bull market conditions, while downside volatility positively affects returns during bear and bull conditions. For emerging markets, we find that the upside (downside) component exerts lagged negative (positive) effects on returns in bear (all) market regimes. By and large, the dependence structures turn out to be asymmetric. Our evidence provides essential implications for investors.

Keywords: cryptocurrency markets, bitcoin, realized volatility measures, asymmetry, quantile regression

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13313 Contribution to the Success of the Energy Audit in the Industrial Environment: A Case Study about Audit of Interior Lighting for an Industrial Site in Morocco

Authors: Abdelkarim Ait Brik, Abdelaziz Khoukh, Mustapha Jammali, Hamid Chaikhy

Abstract:

The energy audit is the essential initial step to ensure a good definition of energy control actions. The in-depth study of the various energy-consuming equipments makes it possible to determine the actions and investments with best cost for the company. The analysis focuses on the energy consumption of production equipment and utilities (lighting, heating, air conditioning, ventilation, transport). Successful implementation of this approach requires, however, to take into account a number of prerequisites. This paper proposes a number of useful recommendations concerning the energy audit in order to achieve better results, and a case study concerning the lighting audit of a Moroccan company by showing the gains that can be made through this audit.

Keywords: energy audit, energy diagnosis, consumption, electricity, energy efficiency, lighting audit

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13312 Air Breakdown Voltage Prediction in Post-arcing Conditions for Compact Circuit Breakers

Authors: Jing Nan

Abstract:

The air breakdown voltage in compact circuit breakers is a critical factor in the design and reliability of electrical distribution systems. This voltage determines the threshold at which the air insulation between conductors will fail or 'break down,' leading to an arc. This phenomenon is highly sensitive to the conditions within the breaker, such as the temperature and the distance between electrodes. Typically, air breakdown voltage models have been reliable for predicting failure under standard operational temperatures. However, in conditions post-arcing, where temperatures can soar above 2000K, these models face challenges due to the complex physics of ionization and electron behaviour at such high-energy states. Building upon the foundational understanding that the breakdown mechanism is initiated by free electrons and propelled by electric fields, which lead to ionization and, potentially, to avalanche or streamer formation, we acknowledge the complexity introduced by high-temperature environments. Recognizing the limitations of existing experimental data, a notable research gap exists in the accurate prediction of breakdown voltage at elevated temperatures, typically observed post-arcing, where temperatures exceed 2000K.To bridge this knowledge gap, we present a method that integrates gap distance and high-temperature effects into air breakdown voltage assessment. The proposed model is grounded in the physics of ionization, accounting for the dynamic behaviour of free electrons which, under intense electric fields at elevated temperatures, lead to thermal ionization and potentially reach the threshold for streamer formation as Meek's criterion. Employing the Saha equation, our model calculates equilibrium electron densities, adapting to the atmospheric pressure and the hot temperature regions indicative of post-arc temperature conditions. Our model is rigorously validated against established experimental data, demonstrating substantial improvements in predicting air breakdown voltage in the high-temperature regime. This work significantly improves the predictive power for air breakdown voltage under conditions that closely mimic operational stressors in compact circuit breakers. Looking ahead, the proposed methods are poised for further exploration in alternative insulating media, like SF6, enhancing the model's utility for a broader range of insulation technologies and contributing to the future of high-temperature electrical insulation research.

Keywords: air breakdown voltage, high-temperature insulation, compact circuit breakers, electrical discharge, saha equation

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13311 Analysis of Risks in Financing Agriculture a Case of Agricultural Cooperatives in Benue State, Nigeria

Authors: Odey Moses Ogah, Felix Terhemba Ikyereve

Abstract:

The study was carried out to analyzed risks in financing agriculture by agricultural cooperatives in Benue State, Nigeria. The study made use of research questionnaires for data collection. A multistage sampling technique was used to select a sample of 210 respondents from 21 agricultural cooperatives. Both descriptive and inferential statistics were employed in data analysis. Loan defaulting (66.7%) and reduction in savings by members (51.4%) were the major causes of risks faced by agricultural cooperatives in financing agriculture in the study area. Other causes include adverse changes in commodity prices (48.6%), disaster (45.7%), among others. It was found that risks adversely influence the profitability and competition of agricultural cooperatives (82.9%). Multiple regression analysis results showed that the coefficient of multiple determinations was 0.67, implying that the explanatory variables included in the model accounted for 67% of the variation in the level of profitability of agricultural cooperatives. The number of loans, average amount of loan and the interest rate were significant and important determinants of profitability of the cooperatives. The majority of the respondents (88.6%) made use of loan guarantors as a strategy of managing loan default/no repayment. It was found that the majority (70%) of the respondents were faced with the challenge of lack of insurance cover. The study recommends that agricultural cooperative officials should be encouraged to undergo formal training and education to easily acquire administrative skills in the management of agricultural loans; Farmer's loan size should be increased and released on time to enable them to use it effectively. Policies that enhance insuring farm activities should be put in place to discourage farmers from risk aversion.

Keywords: agriculture, analysis, cooperative, finance, risks

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13310 Compact Dual-band 4-MIMO Antenna Elements for 5G Mobile Applications

Authors: Fayad Ghawbar

Abstract:

The significance of the Multiple Input Multiple Output (MIMO) system in the 5G wireless communication system is essential to enhance channel capacity and provide a high data rate resulting in a need for dual-polarization in vertical and horizontal. Furthermore, size reduction is critical in a MIMO system to deploy more antenna elements requiring a compact, low-profile design. A compact dual-band 4-MIMO antenna system has been presented in this paper with pattern and polarization diversity. The proposed single antenna structure has been designed using two antenna layers with a C shape in the front layer and a partial slot with a U-shaped cut in the ground to enhance isolation. The single antenna is printed on an FR4 dielectric substrate with an overall size of 18 mm×18 mm×1.6 mm. The 4-MIMO antenna elements were printed orthogonally on an FR4 substrate with a size dimension of 36 × 36 × 1.6 mm3 with zero edge-to-edge separation distance. The proposed compact 4-MIMO antenna elements resonate at 3.4-3.6 GHz and 4.8-5 GHz. The s-parameters measurement and simulation results agree, especially in the lower band with a slight frequency shift of the measurement results at the upper band due to fabrication imperfection. The proposed design shows isolation above -15 dB and -22 dB across the 4-MIMO elements. The MIMO diversity performance has been evaluated in terms of efficiency, ECC, DG, TARC, and CCL. The total and radiation efficiency were above 50 % across all parameters in both frequency bands. The ECC values were lower than 0.10, and the DG results were about 9.95 dB in all antenna elements. TARC results exhibited values lower than 0 dB with values lower than -25 dB in all MIMO elements at the dual-bands. Moreover, the channel capacity losses in the MIMO system were depicted using CCL with values lower than 0.4 Bits/s/Hz.

Keywords: compact antennas, MIMO antenna system, 5G communication, dual band, ECC, DG, TARC

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13309 The Effectiveness of Traditional Music as Therapy and Alternative to Traditional Forms of Therapy in Treatment of Anxiety and Depression

Authors: Helen Johnson-Egemba

Abstract:

This paper will discuss the current effectiveness of music therapy for a range of conditions, such as depression and anxiety. Indeed, traditional forms of therapy have often been effective in treating various mental and physical health conditions. However, they are not with their limitations. Music therapy, on the other hand, is a non-invasive and cost-effective alternative that can produce similar or even better results. Music therapy can produce longer-lasting results. The research also highlights the underlying mechanisms of traditional music therapy, such as its complementary treatment. A systematic review of existing literature was conducted to gather relevant studies and establish a comprehensive understanding of the topic. Various research methods, including experimental studies, qualitative research, surveys, were utilized to explore the therapeutic potential of traditional music interventions. The findings reveal that traditional music therapy shows promise in managing anxiety and depression symptoms, with positive outcomes impacting brain activity, emotions, and stress regulation. The outcomes of this study contribute to evidence-based practice, providing insights for clinicians and therapists to incorporate traditional music therapy into their treatment approaches. Furthermore, the research promotes awareness and acceptance of traditional music as a legitimate and effective therapeutic intervention for anxiety and depression, potentially enhancing access to alternative and complementary treatment options. Overall, this study demonstrates the potential benefits of traditional music therapy in addressing anxiety and depression, offering valuable implications for mental health care and improving the well-being of individuals struggling with these conditions.

Keywords: anxiety, effectiveness, depression, traditional music, therapy, treatment

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13308 Effect of Non-Regulated pH on the Dynamics of Dark Fermentative Biohydrogen Production with Suspended and Immobilized Cell Culture

Authors: Joelle Penniston, E. B. Gueguim-Kana

Abstract:

Biohydrogen has been identified as a promising alternative to the use of non-renewable fossil reserves, owing to its sustainability and non-polluting nature. pH is considered as a key parameter in fermentative biohydrogen production processes, due to its effect on the hydrogenase activity, metabolic activity as well as substrate hydrolysis. The present study assesses the influence of regulating pH on dark fermentative biohydrogen production. Four experimental hydrogen production schemes were evaluated. Two were implemented using suspended cells under regulated pH growth conditions (Sus_R) and suspended and non-regulated pH (Sus_N). The two others regimes consisted of alginate immobilized cells under pH regulated growth conditions (Imm_R) and immobilized and non-pH regulated conditions (Imm_N). All experiments were carried out at 37.5°C with glucose as sole source of carbon. Sus_R showed a lag time of 5 hours and a peak hydrogen fraction of 36% and a glucose degradation of 37%, compared to Sus_N which showed a peak hydrogen fraction of 44% and complete glucose degradation. Both suspended culture systems showed a higher peak biohydrogen fraction compared to the immobilized cell system. Imm_R experiments showed a lag phase of 8 hours, a peak biohydrogen fraction of 35%, while Imm_N showed a lag phase of 5 hours, a peak biohydrogen fraction of 22%. 100% glucose degradation was observed in both pH regulated and non-regulated processes. This study showed that biohydrogen production in batch mode with suspended cells in a non-regulated pH environment results in a partial degradation of substrate, with lower yield. This scheme has been the culture mode of choice for most reported studies in biohydrogen research. The relatively lower slope in pH trend of the non-regulated pH experiment with immobilized cells (Imm_N) compared to Sus_N revealed that that immobilized systems have a better buffering capacity compared to suspended systems, which allows for the extended production of biohydrogen even under non-regulated pH conditions. However, alginate immobilized cultures in flask systems showed some drawbacks associated to high rate of gas production that leads to increased buoyancy of the immobilization beads. This ultimately impedes the release of gas out of the flask.

Keywords: biohydrogen, sustainability, suspended, immobilized

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13307 Problem, Policy and Polity in Agenda Setting: Analyzing Safe Motherhood Program in India

Authors: Vanita Singh

Abstract:

In developing countries, there are conflicting political agendas; policy makers have to prioritize issues from a list of issues competing for the limited resources. Thus, it is imperative to understand how some issues gain attention, and others lose in the policy circles. Multiple-Streams Theory of Kingdon (1984) is among the influential theories that help to understand the public policy process and is utilitarian for health policy makers to understand how certain health issues emerge on the policy agendas. The issue of maternal mortality was long standing in India and was linked with high birth rate thus the focus of maternal health policy was on family planning since India’s independence. However, a paradigm shift was noted in the maternal health policy in the year 1992 with the launch of Safe Motherhood Programme and then in the year 2005, when the agenda of maternal health policy became universalizing institutional deliveries and phasing-out of Traditional Birth Attendants (TBAs) from the health system. There were many solutions proposed by policy communities other than universalizing of institutional deliveries, including training of TBAs and improving socio-economic conditions of pregnant women. However, Government of India favored medical community, which was advocating for the policy of universalizing institutional delivery, and neglected the solutions proposed by other policy communities. It took almost 15 years for the advocates of institutional delivery to transform their proposed solution into a program - the Janani Suraksha Yojana (JSY), a safe-motherhood program promoting institutional delivery through cash incentives to pregnant women. Thus, the case of safe motherhood policy in India is worth studying to understand how certain issues/problems gain political attention and how advocacy work in policy circles. This paper attempts to understand the factors that favored the agenda of safe-motherhood in the policy circle in India, using John Kingdon’s Multiple-Stream model of agenda-setting. Through document analysis and literature review, the paper traces the evolution of safe motherhood program and maternal health policy. The study has used open source documents available on the website of Ministry of Health and Family Welfare, media reports (Times of India Archive) and related research papers. The documents analyzed include National health policy-1983, National Health Policy-2002, written reports of Ministry of Health and Family Welfare Department, National Rural Health Mission (NRHM) document, documents related to Janani Suraksha Yojana and research articles related to maternal health programme in India. The study finds that focusing events and credible indicators coupled with media attention has the potential to recognize a problem. The political elites favor clearly defined and well-accepted solutions. The trans-national organizations affect the agenda-setting process in a country through conditional resource provision. The closely-knit policy communities and political entrepreneurship are required for advocating solutions high on agendas. The study has implications for health policy makers in identifying factors that have the potential to affect the agenda-setting process for a desired policy agenda and identify the challenges in generating political priorities.

Keywords: agenda-setting, focusing events, Kingdon’s model, safe motherhood program India

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13306 Study on NOₓ Emission Characteristics of Internal Gas Recirculation Technique

Authors: DaeHae Kim, MinJun Kwon, Sewon Kim

Abstract:

This study is aimed to develop ultra-low NOₓ burner using the internal recirculation of flue gas inside the combustion chamber that utilizes the momentum of intake fuel and air. Detailed experimental investigations are carried out to study these fluid dynamic effects on the emission characteristics of newly developed burner in industrial steam boiler system. Experimental parameters are distance of Venturi tube from burner, Coanda nozzle gap distance, and air sleeve length at various fuel/air ratio and thermal heat load conditions. The results showed that NOₓ concentration decreases as the distance of Venturi tube from burner increases. The CO concentration values at all operating conditions were negligible. In addition, the increase of the Coanda nozzle gap distance decreased the NOₓ concentration. It is experimentally found out that both fuel injection recirculation and air injection recirculation technique was very effective in reducing NOₓ formation.

Keywords: Coanda effect, combustion, burner, low NOₓ

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13305 Traits and Dilemma: Feminism and Multiple Demands in Young Chinese Female-Directed Films

Authors: Deng Qiaoshan

Abstract:

With the rise of feminism in the global film industry, feminist expressions in Chinese films have also evolved, reflecting societal focus on gender issues. This article focuses on young Chinese female directors such as Yang Lina, Teng Congcong, and Yang Mingming. Their films now present richer female perspectives and consciously incorporate unique female life experiences. They highlight women's real-life struggles, portraying ’struggling’ female identities—characters facing professional failures and desire identity issues, ultimately returning to family roles. These films commonly explore the ‘mother-daughter relationship’, with some using genre storytelling for commercial appeal and others deconstructing the ‘myth of motherhood’ to reflect reality, rewriting traditional maternal roles. The ‘struggling’ female identity in these directors' films shows an aesthetic of ‘pseudo-reality’, blending realistic situations with poetic, lyrical elements, reflecting their creative traits and internal conflicts. These contradictions are closely related to the unique creative context of Chinese cinema in which they operate. Emerging under China's strict film censorship system, film industrialization, consumerist culture, and internet environment, new-generation directors face multiple demands. How to ‘survive’ amidst complex commercial requirements while creating films with a clear feminist consciousness is the fundamental dilemma faced by young Chinese female directors.

Keywords: female directors, feminism film, female dilemma, film censorship system

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13304 Enzyme Immobilization: A Strategy to Overcome Enzyme Limitations and Expand Their Applications

Authors: Charline Monnier, Rudolf Andrys, Irene Castellino, Lucie Zemanova

Abstract:

Due to their inherent sustainability and compatibility with green chemistry principles, enzymes are attracting increasing attention for various applications like bioremediation or biocatalysis. These natural catalysts boast remarkable substrate specificity and operate under mild biological conditions. However, their intrinsic limitations, such as instability at high temperatures or in organic solvents, impede their wider applicability. Enzyme immobilization on supportive matrices emerges as a promising strategy to address these challenges. This approach not only facilitates enzyme reusability but also offers the potential to modulate their stability, activity, and selectivity. The present study investigates the immobilization and application of two distinct groups of hydrolases on supportive matrices: PETases, naturally capable of PolyEthylene Terephthalate (PET) degradation, and cholinesterases (ChEs), key enzymes in neurotransmitter regulation. All tested enzymes will be immobilized on porous and non-porous particles using both covalent and non-covalent methods. Additionally, the stability of PETases and cholinesterases will be explored, followed by exposure to denaturing conditions to assess their resilience under harsh conditions. Furthermore, due to the exceptional catalytic efficiency and selectivity, their biocatalytic efficiency will be tested using xenobiotic substrates, aiming to establish them as replacements for conventional chemical catalysts in environmentally friendly processes. By exploiting the power of enzyme immobilization, this research strives to unlock the full potential of these biocatalysts for sustainable and efficient technological advancements.

Keywords: biocatalysis, bioremediation, enzyme efficiency, enzyme immobilization, green chemistry

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13303 Modeling of in 738 LC Alloy Mechanical Properties Based on Microstructural Evolution Simulations for Different Heat Treatment Conditions

Authors: M. Tarik Boyraz, M. Bilge Imer

Abstract:

Conventionally cast nickel-based super alloys, such as commercial alloy IN 738 LC, are widely used in manufacturing of industrial gas turbine blades. With carefully designed microstructure and the existence of alloying elements, the blades show improved mechanical properties at high operating temperatures and corrosive environment. The aim of this work is to model and estimate these mechanical properties of IN 738 LC alloy solely based on simulations for projected heat treatment conditions or service conditions. The microstructure (size, fraction and frequency of gamma prime- γ′ and carbide phases in gamma- γ matrix, and grain size) of IN 738 LC needs to be optimized to improve the high temperature mechanical properties by heat treatment process. This process can be performed at different soaking temperature, time and cooling rates. In this work, micro-structural evolution studies were performed experimentally at various heat treatment process conditions, and these findings were used as input for further simulation studies. The operation time, soaking temperature and cooling rate provided by experimental heat treatment procedures were used as micro-structural simulation input. The results of this simulation were compared with the size, fraction and frequency of γ′ and carbide phases, and grain size provided by SEM (EDS module and mapping), EPMA (WDS module) and optical microscope for before and after heat treatment. After iterative comparison of experimental findings and simulations, an offset was determined to fit the real time and theoretical findings. Thereby, it was possible to estimate the final micro-structure without any necessity to carry out the heat treatment experiment. The output of this microstructure simulation based on heat treatment was used as input to estimate yield stress and creep properties. Yield stress was calculated mainly as a function of precipitation, solid solution and grain boundary strengthening contributors in microstructure. Creep rate was calculated as a function of stress, temperature and microstructural factors such as dislocation density, precipitate size, inter-particle spacing of precipitates. The estimated yield stress values were compared with the corresponding experimental hardness and tensile test values. The ability to determine best heat treatment conditions that achieve the desired microstructural and mechanical properties were developed for IN 738 LC based completely on simulations.

Keywords: heat treatment, IN738LC, simulations, super-alloys

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13302 Diagnosis Of Static, Dynamic, And Mixed Eccentricity In Line Start Permanent Magnet Synchronous Motor By Using FEM

Authors: Mohamed Moustafa Mahmoud Sedky

Abstract:

In line start permanent magnet synchronous motor, eccentricity is a common fault that can make it necessary to remove the motor from the production line. However, because the motor may be inaccessible, diagnosing the fault is not easy. This paper presents an FEM that identifies different models, static eccentricity, dynamic eccentricity, and mixed eccentricity, at no load and full load. The method overcomes the difficulty of applying FEMs to transient behavior. It simulates motor speed, torque and flux density distribution along the air gap for SE, DE, and ME. This paper represents the various effects of different eccentricities types on the transient performance.

Keywords: line start permanent magnet, synchronous machine, static eccentricity, dynamic eccentricity, mixed eccentricity

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13301 Friction and Wear Behavior of Zr-Nb Alloy Under Different Conditions

Authors: Bharat Kumar, Deepak Kumar, Vijay Chaudhry

Abstract:

Zirconium alloys are generally used for designing the core components of nuclear reactors due to their good mechanical and tribological properties. Some core components are subjected to flow-induced vibrations resulting in wear of these components due to their interaction with one another. To simulate these conditions, low amplitude reciprocating wear tests are conducted at room temperature and high temperature (260 degrees Celsius) between Zr-2.5Nb alloy and SS-410. The tests are conducted at a frequency range of 5 Hz to 25 Hz and an amplitude range of 200 µm to 600 µm. Friction and wear responses were recorded and correlated with the change in parameters. Worn surfaces are analysed using scanning electron microscopy (SEM) and optical profilometer. Elemental changes on the worn surfaces were determined using energy dispersive spectroscopy (EDS). The coefficient of friction (COF) increases with increasing temperature and decreases with increasing frequency. Adhesive wear is found to be the dominant wear mechanism which increases at high temperature.

Keywords: nuclear reactor, Zr-2.5Nb, SS-410, friction and wear

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13300 Analysing Environmental Licensing of Infrastructure Projects in Brazil

Authors: Ronaldo Seroa Da Motta, Gabriela Santiago

Abstract:

The main contribution of this study is the identification of the factors influencing the environmental licensing process of infrastructure projects in Brazil. These factors will be those that reflect the technical characteristics of the project, the corporate governance of the entrepreneur, and the institutional and regulatory governance of the environmental agency, including the number of interventions by non-licensing agencies. The model conditions these variables to the licensing processing time of 34 infrastructure projects. Our results indicated that the conditions would be more sensitive to the type of enterprise, complexity as in gas pipelines and hydroelectric plants in the most vulnerable biome with a greater value of the enterprise or the entrepreneur's assets, together with the number of employees of the licensing agency. The number of external interventions by other non-licensing institutions does not affect the licensing time. Such results challenge the current criticism that environmental licensing has been often pointed out as a barrier to speed up investments in infrastructure projects in Brazil due to the participation of civil society and other non-licensing institutions.

Keywords: environmental licensing, condionants, Brazil, timing process

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13299 The Integration Challenges of Women Refugees in Sweden from Socio-Cultural Perspective

Authors: Khadijah Saeed Khan

Abstract:

One of the major current societal issues of Swedish society is to integrate newcomer refugees well into the host society. The cultural integration issue is one of the under debated topic in the literature, and this study intends to meet this gap from the Swedish perspective. The purpose of this study is to explore the role and types of cultural landscapes of refugee women in Sweden and how these landscapes help or hinder the settlement process. The cultural landscapes are referred to as a set of multiple cultural activities or practices which refugees perform in a specific context and circumstances (i.e., being in a new country) to seek, share or use relevant information for their settlement. Information plays a vital role in various aspects of newcomers' lives in a new country. This article has an intention to highlight the importance of multiple cultural landscapes as a source of information (regarding employment, language learning, finding accommodation, immigration matters, health concerns, school and education, family matters, and other everyday matters) for refugees to settle down in Sweden. Some relevant theories, such as information landscapes and socio-cultural theories, are considered in this study. A qualitative research design is employed, including semi-structured deep interviews and participatory observation with 20 participants. The initial findings show that the refugee women encounter many information-related and integration-related challenges in Sweden and have built a network of cultural landscapes in which they practice various co-ethnic cultural and religious activities at different times of the year. These landscapes help them to build a sense of belonging with people from their own or similar land and assist them to seek and share relevant information in everyday life in Sweden.

Keywords: cultural integration, cultural landscapes, information, women refugees

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13298 The Protective Role of Decoy Receptor 3 Analogue on Rat Steatotic Liver against Ischemia-Reperfusion Injury by Blocking M1/Th1 Polarization and Multiple Upstream Pathogenic Cascades

Authors: Tzu-Hao Li, Shie-Liang Hsieh, Han-Chieh Lin, Ying-Ying Yang

Abstract:

TNF superfamily-stimulated pathogenic cascades and macrophage (M1)/kupffer cells (KC) polarization are important in the pathogenesis of ischemia-reperfusion (IR) liver injury in animals with hepatic steatosis (HS). Decoy receptor 3 (DcR3) is a common upstream inhibitor of the above-mentioned pathogenic cascades. The study evaluated whether modulation of these DcR3-related cascades was able to protect steatotic liver from IR injury. Serum and hepatic DcR3 levels were lower in patients and animals with HS. Accordingly, the effects of pharmacologic and genetic DcR3 replacement on the IR-related pathogenic changes were measured. Significantly, DcR3 replacement protected IR-Zucker(HS) rats and IR-DcR3-Tg(HS) mice from IR liver injury. The beneficial effects of DcR3 replacement were accompanied by decreased serum/hepatic TNF, soluble TNF-like cytokine 1A (TL1A), Fas ligand (Fas-L) and LIGHT, T-helper-cell-1 cytokine (INF) levels, neutrophil infiltration, M1 polarization, neutrophil-macrophage/KC-T-cell interaction, hepatocyte apoptosis and improved hepatic microcirculatory failure among animals with IR-injured steatotic livers. Additionally, TL1A, Fas-L, LIGHT and TLR4/NFB signals were found to mediate the DcR3-related protective effects of steatotic livers from IR injury. Using multimodal in vivo and in vitro approaches, we found that DcR3 was a potential agent to protect steatotic livers from IR injury by simultaneous blocking the multiple IR injury-related pathogenic changes.

Keywords: Decoy 3 receptor, ischemia-reperfusion injury, M1 polarization, TNF superfamily

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13297 A Systematic Review on the Effect of Climate Change on Rice Farming in Nepal

Authors: Tulsi Ram Bhusal

Abstract:

Global climate change is known to have a huge impact on agriculture due to changing in rainfall pattern and elevated air temperature that lead to drought and/or flooding. This systematic study has focused on agriculture in Nepal. The study has shown that the trend of current climatic change is affecting rice production, while the farmers with technological access have tried to adapt to the changing conditions at their level. There is insufficient intervention from the government side in terms of policies and schemes. The lack of sufficient funds is one of the significant reasons in terms of governance. The climatic trends and the way it is affecting the annual riceyieldinNepal has been discussed in this study thoroughly. This study has reviewed published studies and ferred important points regarding the Nepal’s status on rice production. Mainly due to the increasing graph of average temperature and other physical conditions needed for the proper cultivation of ricearechanging due to which there is significant dropofannual rice production. Although from corners of the country, many farmers have attempted to adapt the methods of cultivation to the changing climatic conditions, lack of access to technologies, and fund allocation from the governmental level, it is difficult for the mtobringchanges in rice production by the crown without any institutional help. This systematic study effectively presents the magnitude of the impact on rice cultivation due to climatic changes inrecenttimesinNepal. This review aims to bring the current scenarioofNepal’sricefarming, and it impacts due to changing climate, which can subsequently contribute in devising plans for proper governance, formulating policies, and allocation of funds for the betterment.

Keywords: rice, climate change, rice production, nepal, agriculture

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13296 Need for Eye Care Services, Clinical Characteristics, Surgical Outcome and Prognostic Predictors of Cataract in Adult Participants with Intellectual Disability

Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

Abstract:

Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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13295 Collaborative Governance in Dutch Flood Risk Management: An Historical Analysis

Authors: Emma Avoyan

Abstract:

The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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13294 Experiences of Family Carers of People Intellectual Disabilities During the COVID-19 Pandemic

Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

Abstract:

Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

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13293 Real Time Classification of Political Tendency of Twitter Spanish Users based on Sentiment Analysis

Authors: Marc Solé, Francesc Giné, Magda Valls, Nina Bijedic

Abstract:

What people say on social media has turned into a rich source of information to understand social behavior. Specifically, the growing use of Twitter social media for political communication has arisen high opportunities to know the opinion of large numbers of politically active individuals in real time and predict the global political tendencies of a specific country. It has led to an increasing body of research on this topic. The majority of these studies have been focused on polarized political contexts characterized by only two alternatives. Unlike them, this paper tackles the challenge of forecasting Spanish political trends, characterized by multiple political parties, by means of analyzing the Twitters Users political tendency. According to this, a new strategy, named Tweets Analysis Strategy (TAS), is proposed. This is based on analyzing the users tweets by means of discovering its sentiment (positive, negative or neutral) and classifying them according to the political party they support. From this individual political tendency, the global political prediction for each political party is calculated. In order to do this, two different strategies for analyzing the sentiment analysis are proposed: one is based on Positive and Negative words Matching (PNM) and the second one is based on a Neural Networks Strategy (NNS). The complete TAS strategy has been performed in a Big-Data environment. The experimental results presented in this paper reveal that NNS strategy performs much better than PNM strategy to analyze the tweet sentiment. In addition, this research analyzes the viability of the TAS strategy to obtain the global trend in a political context make up by multiple parties with an error lower than 23%.

Keywords: political tendency, prediction, sentiment analysis, Twitter

Procedia PDF Downloads 238
13292 Risk Factors Associated with Increased Emergency Department Visits and Hospital Admissions Among Child and Adolescent Patients

Authors: Lalanthica Yogendran, Manassa Hany, Saira Pasha, Benjamin Chaucer, Simarpreet Kaur, Christopher Janusz

Abstract:

Children and adolescent patients visit the Psychiatric Emergency Department (ED) for multiple reasons. Visiting the Psychiatric ED itself can be a traumatic experience that can affect an adolescents mental well-being, regardless of a history of mental illness. Despite this, limited research exists in this domain. Prospective studies have correlated adverse psychosocial determinants among adolescents to risk factors for poor well-being and unfavorable behavior outcomes. Studies have also shown that physiological stress is a contributor in the development of health problems and an increase in substance abuse in adolescents. This study aimed to retrospectively determine which psychosocial factors are associated with an increase in psychiatric ED visits. 600 charts of patients who had a psychiatric ED and inpatient admission visit from January 2014 through December 2014 were reviewed. Sociodemographics, diagnoses, ED visits and inpatient admissions were collected. Descriptive statistics, chi-square tests and independent t-test analyses were utilized to examine differences in the sample to determine which factors affected ED visits and admissions. The sample was 50% female, 35.2% self-identified black, and had a mean age of 13 years. The majority, 85%, went to public school and 17% were in special education. Attention Deficit Hyperactivity Disorder was the most common admitting diagnosis, found in 132(23%) responders. Most patients came from single parent household 305 (53%). The mean ages of patients that were sexually active, with legal issues, and reporting marijuana substance abuse were 15, 14.35, and 15 years respectively. Patients from two biological parent households had significantly fewer ED visits (1.2 vs. 1.7, p < 0.01) and admissions (0.09 vs. 0.26, p < 0.01). Among social factors, those who reported sexual, physical or emotional abuse had a significantly greater number of ED visits (2.1 vs. 1.5, p < 0.01) and admissions (0.61 vs. 0.14, p < 0.01) than those who did not. Patients that were sexually active or had legal issues or substance abuse with marijuana had a significantly greater number of admissions (0.43 vs. 0.17, p < 0.01), (0.54 vs. .18, p < 0.01) and (0.46 vs. 0.18, p < 0.01) respectively. This data supports the theory of the stability of a two parent home. Dual parenting plays a role in creating a safe space where a child can develop; this is shown by subsequent decreases in psychiatric ED visits and admissions. This may highlight the psychological protective role of a two parent household. Abuse can exacerbate existing psychiatric illness or initiate the onset of new disease. Substance abuse and legal issues result in early induction to the criminal system. Results show that this causes an increase in frequency of visits and severity of symptoms. Only marijuana, but not other illicit substances, correlated with higher incidence of psychiatric ED visits. This may speak to the psychotropic nature of tetrahydrocannabinols and their role in mental illness. This study demonstrates the array of psychosocial factors that lead to increased ED visits and admissions in children and adolescents.

Keywords: adolescent, child psychiatry, emergency department, substance abuse

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13291 Analysis of the Vibration Behavior of a Small-Scale Wind Turbine Blade under Johannesburg Wind Speed

Authors: Tolulope Babawarun, Harry Ngwangwa

Abstract:

The wind turbine blade may sustain structural damage from external loads such as high winds or collisions, which could compromise its aerodynamic efficiency. The wind turbine blade vibrates at significant intensities and amplitudes under these conditions. The effect of these vibrations on the dynamic flow field surrounding the blade changes the forces operating on it. The structural dynamic analysis of a small wind turbine blade is considered in this study. It entails creating a finite element model, validating the model, and doing structural analysis on the verified finite element model. The analysis is based on the structural reaction of a small-scale wind turbine blade to various loading sources. Although there are many small-scale off-shore wind turbine systems in use, only preliminary structural analysis is performed during design phases; these systems' performance under various loading conditions as they are encountered in real-world situations has not been properly researched. This will allow us to record the same Equivalent von Mises stress and deformation that the blade underwent. A higher stress contour was found to be more concentrated near the middle span of the blade under the various loading scenarios studied. The highest stress that the blade in this study underwent is within the range of the maximum stress that blade material can withstand. The maximum allowable stress of the blade material is 1,770 MPa. The deformation of the blade was highest at the blade tip. The critical speed of the blade was determined to be 4.3 Rpm with a rotor speed range of 0 to 608 Rpm. The blade's mode form under loading conditions indicates a bending mode, the most prevalent of which is flapwise bending.

Keywords: ANSYS, finite element analysis, static loading, dynamic analysis

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13290 Crop Leaf Area Index (LAI) Inversion and Scale Effect Analysis from Unmanned Aerial Vehicle (UAV)-Based Hyperspectral Data

Authors: Xiaohua Zhu, Lingling Ma, Yongguang Zhao

Abstract:

Leaf Area Index (LAI) is a key structural characteristic of crops and plays a significant role in precision agricultural management and farmland ecosystem modeling. However, LAI retrieved from different resolution data contain a scaling bias due to the spatial heterogeneity and model non-linearity, that is, there is scale effect during multi-scale LAI estimate. In this article, a typical farmland in semi-arid regions of Chinese Inner Mongolia is taken as the study area, based on the combination of PROSPECT model and SAIL model, a multiple dimensional Look-Up-Table (LUT) is generated for multiple crops LAI estimation from unmanned aerial vehicle (UAV) hyperspectral data. Based on Taylor expansion method and computational geometry model, a scale transfer model considering both difference between inter- and intra-class is constructed for scale effect analysis of LAI inversion over inhomogeneous surface. The results indicate that, (1) the LUT method based on classification and parameter sensitive analysis is useful for LAI retrieval of corn, potato, sunflower and melon on the typical farmland, with correlation coefficient R2 of 0.82 and root mean square error RMSE of 0.43m2/m-2. (2) The scale effect of LAI is becoming obvious with the decrease of image resolution, and maximum scale bias is more than 45%. (3) The scale effect of inter-classes is higher than that of intra-class, which can be corrected efficiently by the scale transfer model established based Taylor expansion and Computational geometry. After corrected, the maximum scale bias can be reduced to 1.2%.

Keywords: leaf area index (LAI), scale effect, UAV-based hyperspectral data, look-up-table (LUT), remote sensing

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13289 Kawasaki Disease in a Two Months Kuwaiti Girl: A Case Report ‎and Literature Review.‎

Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

Abstract:

Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

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