Search results for: senior year

Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

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Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

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Authors: Livia Eisler, Cristiane C. B. Alves, Cristina L. F. Ortolani, Kurt Faltin Jr.

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Purpose: This paper proposes a technically simple diagnosis method among orthodontists and maxillofacial surgeons in order to evaluate discrete bone alterations. The methodology consists of a protocol to optimize the diagnosis and minimize the possibility for orthodontic and ortho-surgical retreatment. Materials and Methods: A protocol of image processing and analysis, through ImageJ software and its plugins, was applied to 20 pairs of lateral cephalometric images obtained from cone beam computerized tomographies, before and 1 year after undergoing orthognathic surgery. The optical density of the images was analyzed in the condylar region to determine possible bone alteration after surgical correction. Results: Image density was shown to be altered in all image pairs, especially regarding the condyle contours. According to measures, condyle had a gender-related density reduction for p=0.05 and condylar contours had their alterations registered in mm. Conclusion: A simple, viable and cost-effective technique can be applied to achieve the more detailed image-based diagnosis, not depending on the human eye and therefore, offering more reliable, quantitative results.

Keywords: bone resorption, computer-assisted image processing, orthodontics, orthognathic surgery

Procedia PDF Downloads 160

Authors: Ghada Esheba, Bayan Hafiz, Ashwaq Al-Qarni, Abdulelah AlMalki, Esraa Kaheel

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Hydatid disease is caused by genus Echinococcus, it is transmitted to human through sheep and cattle. People who lived in an endemic area should be suspected to have the disease. Pulmonary hydatid disease can be presented by respiratory manifestations as in our case. We report a case of child, 13 years old, who was presented by shortness of breath and non-productive cough 2 months ago. The patient had an attack of hemoptysis 3 months ago but there is no history of fever, other constitutional symptoms or any medical illness. The patient has had a close contact with a horse. On examination, the patient was oriented and vitally stable. Both side of chest were moving equally with decrease air entry on the left side of the chest. Cervical lymph node enlargement was also detected. The case was provisionally diagnosed as tuberculosis. The x-ray was normal, while CT scan showed two cysts in the left side. The patient was treated surgically with resection of both cysts without lobectomy. Broncho-alveolar lavage was done and together with plural effusion and both cysts were sent for histopathology. The patient received the following medication: albendazole 200MG/BID/Orally for 30 days and Cefuroxime 250MG/Q12H/Orally for 10 days.

Keywords: Echinococcus granulosus, hydatid disease, pediatrics, pulmonary hydatid cyst

Procedia PDF Downloads 272

Authors: Mochammad Indra Permana, Andhiani Sharfina Arnellya, Dika Pramita Destiani, Budhi Prihartanto

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Cardiovascular disease is the cause of the highest mortality rates in the world. The number of cardiovascular disease patients is increasing every year. Data obtained from World Health Organization (WHO) that 17,5 million people died from this disease. The condition of cardiovascular diseases such as atrial fibrillation, myocardial infarction, venous thromboembolism, and several other conditions need anticoagulant therapy. Results of the anticoagulant therapy are measured not only by the effectiveness of International Normalized Ratio (INR) value but also by the quality of life of the patients. The purpose of this study was to determine the quality of life of patients on oral anticoagulant therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This is a cross-sectional study with collecting data from the quality of life questionnaire and medical record of the patients. The results of this study showed that 28 patients (46,7%) had a good quality of life, 30 patients (50%) had a moderate quality of life, and 2 patients (3,3%) had a poor quality of life with no significant differences in quality of life based on age, gender, diagnosis, and duration of drug use.

Keywords: anticoagulant, cardiovascular diseases, INR, quality of life

Procedia PDF Downloads 314

Authors: Mousa Keshavarz, Abdul-Reza Dabbagh, Maryam Soyuf Jahromi

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The diversity of mangrove macrobenthos assemblages at mudflat and mangrove ecosystems of Port Khamir, Iran were investigated for one year. During this period, we measured physicochemical properties of water temperature, salinity, pH, DO and the density and distribution of the macrobenthos. We sampled a total of 9 transects, at three different topographic levels along the intertidal zone at three stations. Assemblages at class level were compared. The five most diverse and abundant classes were Foraminifers (54%), Gastropods (23%), Polychaetes (10%), Bivalves (8%) & Crustaceans (5%), respectively. Overall densities were 1869 ± 424 ind/m2 (26%) in spring, 2544 ± 383 ind/m2(36%) in summer, 1482 ± 323 ind/m2 (21%) in autumn and 1207 ± 80 ind/m2 (17%) in winter. Along the intertidal zone, the overall relative density of individuals at high, intermediate, and low topographic levels was 40, 30, and 30% respectively. Biodiversity indices were used to compare different classes: Gastropoda (Shannon index: 0.33) and Foraminifera (Simpson index: 0.28) calculated the highest scores. It was also calculated other bio-indices. With the exception of bivalves, filter feeders were associated with coarser sediments at higher intertidal levels, while deposit feeders were associated with finer sediments at lower levels. Salinity was the most important factor acting on community structure, while DO and pH had little influence.

Keywords: macrobenthos, biodiversity, mangrove forest, Khamir Port

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Authors: Boonsri Lertviriyachit

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The objective of this research is to investigate the treatment of psoriasis through Thai traditional medicine in the selected areas of 2 east coast provinces; Samudprakarn Province and Chantaburi Province. The informants in this study were two famous and accepted Thai traditional doctors, who have more than 20 year experiences. Data were collected by in depth interviews and participant-observation method. The research instrument included unstructured interviews, camera, and cassette tape to collect data analyzed by descriptive statistics. The results revealed that the 2 Thai traditional doctors were 54 and 85 years old with 25 and 45 years of treatment experiences. The knowledge of Thai traditional medicine was transferred from generations to generations in the family. The learning process was through close observation as an apprentice with the experience ones and assisted them in collecting herbs and learning by handling real case in individual situations. Before being doctors, they had to take exam to get the Thai traditional medical certificate. Knowledge of being Thai traditional doctors included diagnosis and find to the suitable way of treatment. They have to look into disorder physical fundamental factors such as blood circulation, lymph, emotion, and food consumption habit. It is important that the treatment needs to focus on balancing the fundamental factors and to observe contraindication.

Keywords: Thai traditional medicine, psoriasis, Samudprakarn Province, Chantaburi Province

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Authors: E. K. Naseela, B. M. Dodamani, Chaithra Chandran

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The GIS and remote sensing techniques facilitate accurate estimation of surface runoff from watershed. In the present study an attempt has been made to evaluate the applicability of Natural Resources Service Curve Number method using GIS and Remote sensing technique in the upper Krishna basin (69,425 Sq.km). Landsat 7 (with resolution 30 m) satellite data for the year 2012 has been used for the preparation of land use land cover (LU/LC) map. The hydrologic soil group is mapped using GIS platform. The weighted curve numbers (CN) for all the 5 subcatchments calculated on the basis of LU/LC type and hydrologic soil class in the area by considering antecedent moisture condition. Monthly rainfall data was available for 58 raingauge stations. Overlay technique is adopted for generating weighted curve number. Results of the study show that land use changes determined from satellite images are useful in studying the runoff response of the basin. The results showed that there is no significant difference between observed and estimated runoff depths. For each subcatchment, statistically positive correlations were detected between observed and estimated runoff depth (0.6Keywords: curve number, GIS, remote sensing, runoff

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Authors: Abishek Poudel

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Human-tiger conflicts are serious issues of conflicts between local people and park authority and the conflicting situation potentially play negative role in park management. The study aimed (1) To determine the trend and nature of human-tiger conflicts (2) To understand people's perception and mitigation measures towards tiger conservation. Both primary and secondary information were used to determine human- tiger conflicts in Chitwan National Park. Systematic random sampling with 5% intensity was done to collect the perception of the villagers regarding human-tiger conflicts. The study sites were selected based on frequencies of incidences of human attacks and livestock depredation viz. Rajahar and Ayodhyapuri VDCs respectively. The trend of human casualties by tiger has increased in last five year whereas the trend of livestock has decreased. Reportedly, between 2008 and 2012, tigers killed 22 people, injured 10 and killed at least 213 livestock. Conflict was less common in the park and more intense in the sub-optimal habitats of Buffer Zone. Goat was the most vulnerable livestock followed by cattle. The livestock grazing and human intrusion into tiger habitat were the causes of conflicts. Developing local stewardship and support for tiger conservation, livestock insurance, and compensation policy simplification may help reduce human-tiger conflicts.

Keywords: livestock depredation, sub optimal habitat, human-tiger, local stewardship

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Authors: Mariyam Arif, Ye Liu, Israr Ul Haq, Ahsan Ashfaq

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High cost of fossil fuels and intensifying installations of alternate energy generation sources are intimidating main challenges in power systems. Making accurate load forecasting an important and challenging task for optimal energy planning and management at both distribution and generation side. There are many techniques to forecast load but each technique comes with its own limitation and requires data to accurately predict the forecast load. Artificial Neural Network (ANN) is one such technique to efficiently forecast the load. Comparison between two different ranges of input datasets has been applied to dynamic ANN technique using MATLAB Neural Network Toolbox. It has been observed that selection of input data on training of a network has significant effects on forecasted results. Day-wise input data forecasted the load accurately as compared to year-wise input data. The forecasted load is then distributed among the six generators by using the linear programming to get the optimal point of generation. The algorithm is then verified by comparing the results of each generator with their respective generation limits.

Keywords: artificial neural networks, demand-side management, economic dispatch, linear programming, power generation dispatch

Procedia PDF Downloads 189

Authors: Bellali Assia, Bellali Fatima

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Speaking is one of the most difficult English skills for non-English learners. This study investigated English-speaking difficulties encountered by non-English secondary school students in a private school in Casablanca, Morocco. The subjects were students of 63 (male and female) from 2ed year classes level. It also aims to investigate the degree of main speaking difficulties and the factors effecting non-English students to speak English. This research used a descriptive qualitative and quantitative approach with a questionnaire and an interview to collect the data. In linguistically related difficulties, there were four difficulties, namely vocabulary, grammar, conversation and pronunciation. The results revealed that there were 40.32% of students agreed that they do not have sufficient grammar knowledge, 45.16% of students agreed that they do not have enough vocabulary, 45.90% of students agreed that they have difficulty in conversation, and 39.34% of students agreed that they have poor pronunciation. Also, the results indicated that 63.33 % of students agreed that they have problems with self-confidence. The factors causing the problem of speaking English in this study were lack of general knowledge, lack of speaking practice, fear of mistakes and grammar practice, low participation, shyness, nervousness, fear of criticism, and unfamiliar word pronunciation. Furthermore, recommendations and suggestions were presented to solve the problem and eliminate difficulties for teachers and students.

Keywords: English speaking, difficulties, factors, non-English students

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Authors: Andra Blumberga, Uldis Bariss, Anna Kubule, Dagnija Blumberga

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European Union Energy Efficiency Directive provides a set of binding energy efficiency measures to reach. Each of the member states can use either energy efficiency obligation scheme or alternative policy measures or combination of both. Latvian government has decided to divide savings among obligation scheme (65%) and alternative measures (35%). This decision might lead to significant energy tariff increase hence impact on the national economy. To assess impact of alternative policy measures focusing on energy management scheme based on ISO 50001 and ability to decrease share of obligation scheme a System Dynamics modeling was used. Simulation results show that energy efficiency goal can be met with alternative policy measure to large energy consumers in industrial, tertiary and public sectors by applying the energy tax exemption for implementers of energy management system. A delay in applying alternative policy measures plays very important role in reaching the energy efficiency goal. One year delay in implementation of this policy measure reduces cumulative energy savings from 2016 to 2017 from 5200 GWh to 3000 GWh in 2020.

Keywords: system dynamics, energy efficiency, policy measure, energy management system, obligation scheme

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Authors: Bilha Paryente, Roni Gez Langerman

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Background and Objectives: The current study focused on how kindergarten children have experienced the COVID-19 pandemic. The main goals were understanding children’s emotions, coping strategies, and thoughts regarding the presence of the COVID-19 virus in their daily lives, using the salute genic approach to study their sense of coherence, and to promote relevant professional instruction. Design and Method: Semistructured in-depth interviews were held with 130 five- to six-year-old children, with an equal number of boys and girls. All of the children were recruited from kindergartens affiliated with the state's secular education system. Results: Data were structured into three themes: 1) the child’s pandemic perception as manageable through meaningful accompanying and missing figures; 2) the child’s comprehension of the virus as dangerous, age differentiating, and contagious. 3) the child’s emotional processing of the pandemic as arousing fear of death and, through images, as thorny and as a monster. Conclusions: Results demonstrate the young children’s sense of coherence, characterized as extrapersonal perception, interpersonal coping, and intrapersonal emotional processing, and the need for greater acknowledgement of child-parent educators' informed interventions that could give children a partial feeling of the adult’s awareness of their needs.

Keywords: kindergarten children, continuous stress, COVID-19, salutogenic approach

Procedia PDF Downloads 177

Authors: Mohammad Vahed, Ana Sadeghitohidi, Majid Vahed, Hiroki Takahashi

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In the genomics field, the huge amounts of data have produced by the next-generation sequencers (NGS). Data volumes are very rapidly growing, as it is postulated that more than one billion bases will be produced per year in 2020. The growth rate of produced data is much faster than Moore's law in computer technology. This makes it more difficult to deal with genomics data, such as storing data, searching information, and finding the hidden information. It is required to develop the analysis platform for genomics big data. Cloud computing newly developed enables us to deal with big data more efficiently. Hadoop is one of the frameworks distributed computing and relies upon the core of a Big Data as a Service (BDaaS). Although many services have adopted this technology, e.g. amazon, there are a few applications in the biology field. Here, we propose a new algorithm to more efficiently deal with the genomics big data, e.g. sequencing data. Our algorithm consists of two parts: First is that BDaaS is applied for handling the data more efficiently. Second is that the hybrid method of MapReduce and Fuzzy logic is applied for data processing. This step can be parallelized in implementation. Our algorithm has great potential in computational analysis of genomics big data, e.g. de novo genome assembly and sequence similarity search. We will discuss our algorithm and its feasibility.

Keywords: big data, fuzzy logic, MapReduce, Hadoop, cloud computing

Procedia PDF Downloads 299

Authors: Thamo Sutharssan, Diogo Montalvao, Wen-Chung Wang, Yong Chen, Claudia Pisac

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A combined heat and power (CHP) system is an efficient and clean way to generate power (electricity). Heat produced by the CHP system can be used for water and space heating. The CHP system which uses hydrogen as fuel produces zero carbon emission. Its’ efficiency can reach more than 80% whereas that of a traditional power station can only reach up to 50% because much of the thermal energy is wasted. The other advantages of CHP systems include that they can decentralize energy generation, improve energy security and sustainability, and significantly reduce the energy cost to the users. This paper presents the economic benefits of using a CHP system in the domestic environment. For this analysis, natural gas is considered as potential fuel as the hydrogen fuel cell based CHP systems are rarely used. UK government incentives for CHP systems are also considered as the added benefit. Results show that CHP requires a significant initial investment in return it can reduce the annual energy bill significantly. Results show that an investment may be paid back in 7 years. After the back period, CHP can run for about 3 years as most of the CHP manufacturers provide 10-year warranty.

Keywords: combined heat and power, clean energy, hydrogen fuel cell, economic analysis of CHP, zero emission

Procedia PDF Downloads 385

Authors: Rosa Christodoulaki, Irene Koronaki, Panagiotis Tsekouras

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The aim of this study is to analyze the energy performance of a spherical Stationary Reflector / Tracking Absorber (SRTA) solar concentrator. This type of collector consists of a segment of a spherical mirror placed in a stationary position facing the sun and a cylindrical absorber that tracks the sun by a simple pivoting motion about the center of curvature of the reflector. The energy analysis is performed through the development of a dynamic simulation model in TRNSYS software that calculates the annual heat production and the efficiency of the SRTA solar concentrator. The effect of solar concentrator design features and characteristics, such the reflector material, the reflector diameter, the receiver type, the solar radiation level and the concentration ratio, are discussed in details. Moreover, the energy performance curve of the SRTA solar concentrator, for various temperature differences between the mean fluid temperature and the ambient temperature and radiation intensities is drawn. The results are shown in diagrams, visualizing the effect of solar, optical and thermal parameters to the overall performance of the SRTA solar concentrator throughout the year. The analysis indicates that the SRTA solar concentrator can operate efficiently under a wide range of operating conditions.

Keywords: concentrating solar collector, energy analysis , stationary reflector, tracking absorber

Procedia PDF Downloads 201

Authors: Khandoker Upama Kabir, Mohammad Fuhad Anwar Sinha

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Dhaka, the capital of Bangladesh, is known not only for its fast growing economy, lively atmosphere, rich history, and culture but is also known for having a reputation of being a vastly populated city. The historic city centre of Dhaka (currently known as Puran Dhaka or Old Dhaka) which was conceived around the Pre-Mughal era and holds a lot of history and heritage of the region. This historic site has further been neglected, and most of the urban development has been done without integrating this part of the city into the plans. As a result, the festivals that take place traditionally throughout the year in this area create a greater impact on the urban fabric of the whole city. These festivals generate a huge amount of visitors and play a huge role in shaping the identity of the people. This paper will attempt to look at the importance of these traditions, the way these festivals are influencing the urban life of the community, and whether or not it has any significant effect on the economy. Through the use of both primary and secondary sources and SWOT analysis, this paper will attempt to identify the issues faced during these festivals. This paper will also try to suggest some basic remedies based on general comparisons between case studies of similar festivals celebrated globally and how these countries are dealing with such issues while also promoting tourism.

Keywords: urban fabric, festivals, cultural celebration, impact, historic city centre urban memory, mega events

Procedia PDF Downloads 153

Authors: Sudhanshu Kumar, Raghvendra Chandrakar, Arun Chakraborty

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In the ocean, the temperature extremes have the potential to devastate marine habitats, ecosystems together with ensuing socioeconomic consequences. In recent years, these extreme events are more frequent and intense globally and their increasing trend is expected to continue in the upcoming decades. It recently attracted public interest, as well as scientific researchers, which motivates us to analyze the current marine heatwave (MHW) events in the Bay of Bengal region. we have isolated 107 MHW events (above 90th percentile threshold) in this region of the Indian Ocean and investigated the variation in duration, intensity, and frequency of MHW events during our test period (1982-2021). Our study reveals that in the study region the average of three MHW events per year with an increasing linear trend of 1.11 MHW events per decade. In the analysis, we found the longest MHW event which lasted about 99 days, which is far greater than an average MHW event duration. The maximum intensity was 5.29°C (above the climatology-mean), while the mean intensity was 2.03°C. In addition, we observed net heat flux accompanied by anticyclonic eddies to be the primary cause of these events. Moreover, we concluded that these events affect sea surface height and oceanic productivity, highlighting the adverse impact of MHWs on marine ecosystems.

Keywords: marine heatwaves, global warming, climate change, sea surface temperature, marine ecosystem

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Authors: B. Khorsandi Talab, M. Kordi

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It is highly deplorable that every year, theft behavior among employees of the insurance industry is growing throughout the world. A very significant source of contraction (despite many costly technological and widespread security measures) needs to be addressed and prevented. Employee and agent theft cannot be ignored as it causes significant losses to employers. This study investigates the workplace factors that affect the insurance employee and agent theft behavior. Although identifying theft is difficult, this study will help employers to further understand employees’ theft behavior. This study was conducted in two service small and medium organizations (two branches of insurance companies) in ALBORZ’s capital city, KARAJ. Data has been collected via questionnaire from 30 employees and agents consisting employees and supervisors of branches and agencies. According to the results, it must be acknowledged that compensation, organizational justice, internal control systems, penalties and personal characteristics were associated with employees' theft behavior, it is despite the fact that, no effect could be assumed for organizational ethics and requirement in this case. Nevertheless, poor financial status cannot be considered as the driving factor in pushing employees to steal property as well as increasing their theft behavior. As mentioned earlier, the purpose of this study was to determine the factors contributing to employees’ theft (insurance employees and agencies) behavior in insurance organizations in Karaj.

Keywords: service theft, employee theft behavior, work theft, insurance agency, SMEs

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Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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Authors: Eti Gilad, Shosh Millet

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In light of the technological development and its introduction into the field of education, an online course was designed in parallel to the 'conventional' course for teaching the ''Qualitative Research Methods''. This course aimed to characterize learning-teaching processes in a 'Qualitative Research Methods' course studied in two different frameworks. Moreover its objective was to explore the difference between the culture of a physical learning environment and that of online learning. The research monitored four learner groups, a total of 72 students, for two years, two groups from the two course frameworks each year. The courses were obligatory for M.Ed. students at an academic college of education and were given by one female-lecturer. The research was conducted in the qualitative method as a case study in order to attain insights about occurrences in the actual contexts and sites in which they transpire. The research tools were open-ended questionnaire and reflections in the form of vignettes (meaningful short pictures) to all students as well as an interview with the lecturer. The tools facilitated not only triangulation but also collecting data consisting of voices and pictures of teaching and learning. The most prominent findings are: differences between the two courses in the change features of the learning environment culture for the acquisition of contents and qualitative research tools. They were manifested by teaching methods, illustration aids, lecturer's profile and students' profile.

Keywords: face to face course, online course, qualitative research, vignettes

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Authors: Luna Moni Das

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This paper is an attempt to study the channel dynamics in the area bounded by the foothills of the eastern Himalayas in the north, the Brahmaputra in the south and southeast and eastern side and the Subansiri River in the west. There are many streams in this region and only a few are perennial. There are two major anabranches of the Brahmaputra called Kharkutia Xuti and Charikoria. All of these makes it a very dynamic area. The analysis done in this paper is based on the remote sensing data and mapping of the channel planforms in GIS environment. The temporal trend of the change in channel planform has been produced. This study shows that, during the period from 1973 to 2013, the streams/rivers originating in the north have experienced a reduction in the total length. The other most important result is that even though the western edge of Majuli Island is eroding faster there is a formation of a larger island in between Charikoria and Brahmaputra, that comprises of Majuli island and parts of Dhakuakhana subdivision of Lakhimpur District along the south of Charikoria river. The field study shows that the Kharkutia Xuti, that divides Majuli from Dhakuakhana, do not experience any flow from the Brahmaputra for the major portion of the year and Charikoria has developed as a major anabranch of the Brahmaputra.

Keywords: channel dynamics, Brahmaputra river, Majuli Island, sinuosity

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Authors: Taikchan Lildar, Ayesha Samad, Suraj Sookhu

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Atrial fibrillation with rapid ventricular response results in the loss of atrial kick and shortened ventricular filling time, which often leads to decompensated heart failure. Pharmacologic rhythm control is the treatment of choice, and patients frequently benefit from the restoration of sinus rhythm. When pharmacologic treatment is unsuccessful or a patient declines hemodynamically, direct cardioversion is the treatment of choice. Torsades de pointes or “twisting of the points'' in French, is a rare but under-appreciated risk of cardioversion therapy and accounts for a significant number of sudden cardiac death each year. A 61-year-old female with no significant past medical history presented to the Emergency Department with worsening dyspnea. An electrocardiogram showed atrial fibrillation with rapid ventricular response, and a chest X-ray was significant for bilateral pulmonary vascular congestion. Full-dose anticoagulation and diuresis were initiated with moderate improvement in symptoms. A transthoracic echocardiogram revealed biventricular systolic dysfunction with a left ventricular ejection fraction of 30%. After consultation with an electrophysiologist, the consensus was to proceed with the restoration of sinus rhythm, which would likely improve the patient’s heart failure symptoms and possibly the ejection fraction. A transesophageal echocardiogram was negative for left atrial appendage thrombus; the patient was treated with a loading dose of amiodarone and underwent successful direct current cardioversion with 200 Joules. The patient was placed on telemetry monitoring for 24 hours and was noted to have frequent premature ventricular contractions with subsequent degeneration to torsades de pointes. The patient was found unresponsive and pulseless; cardiopulmonary resuscitation was initiated with cardioversion, and return of spontaneous circulation was achieved after four minutes to normal sinus rhythm. Post-cardiac arrest electrocardiogram showed sinus bradycardia with heart-rate corrected QT interval of 592 milliseconds. The patient continued to have frequent premature ventricular contractions and required two additional cardioversions to achieve a return of spontaneous circulation with intravenous magnesium and lidocaine. An automatic implantable cardioverter-defibrillator was subsequently implanted for secondary prevention of sudden cardiac death. The backup pacing rate of the automatic implantable cardioverter-defibrillator was set higher than usual in an attempt to prevent premature ventricular contractions-induced torsades de pointes. The patient did not have any further ventricular arrhythmias after implantation of the automatic implantable cardioverter-defibrillator. Overdrive pacing is a method utilized to treat premature ventricular contractions-induced torsades de pointes by preventing a patient’s susceptibility to R on T-wave-induced ventricular arrhythmias. Pacing at a rate of 90 beats per minute succeeded in controlling the arrhythmia without the need for traumatic cardiac defibrillation. In our patient, conversion of atrial fibrillation with rapid ventricular response to normal sinus rhythm resulted in a slower heart rate and an increased probability of premature ventricular contraction occurring on the T-wave and ensuing ventricular arrhythmia. This case highlights direct current cardioversion for atrial fibrillation with rapid ventricular response resulting in persistent ventricular arrhythmia requiring an automatic implantable cardioverter-defibrillator placement with overdrive pacing to prevent a recurrence.

Keywords: refractory atrial fibrillation, atrial fibrillation, overdrive pacing, torsades de pointes

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Authors: Maria Vinca Novenia

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The number of school-aged children with autism in Indonesia has been increasing each year. Autism is a developmental disorder which can be diagnosed in childhood. One of the symptoms is the lack of communication skills. Music therapy is known as an effective treatment for children with autism. Music elements and structures create a good space for children with autism to express their feelings and communicate their thoughts. School-aged children are expected to be able to communicate non-verbally very well, but children with autism experience the difficulties of communicating non-verbally. The aim of this research is to analyze the significance of music therapy treatment to improve non-verbal communication tools for children with autism. This research informs teachers and parents on how music can be used as a media to communicate with children with autism. The qualitative method is used to analyze this research, while the result is described with the microanalysis technique. The result is measured specifically from the whole experiment, hours of every week, minutes of every session, and second of every moment. The samples taken are four school-aged children with autism in the age range of six to 11 years old. This research is conducted within four months started with observation, interview, literature research, and direct experiment. The result demonstrates that music therapy could be effectively used as a non-verbal communication tool for children with autism, such as changes of body gesture, eye contact, and facial expression.

Keywords: autism, improvisation, microanalysis, music therapy, nonverbal communication, school-aged

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Authors: Ossama Al-Maliki

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Europay, MasterCard, and Visa (EMV) is one of the most popular payment protocol in the world. The EMV protocol supports Chip and PIN Transactions, Chip and Signature transactions, and Contactless transactions. This protocol suffers from tens of £ millions of lost per year due to many fraudulent payments. This is due to several reported vulnerable points in the protocols used for such payments that allow skimming, replay, cloning, Mole Point of Sale (POS), relay, and other attacks to be conducted. In this paper, we are focusing on the EMV contactless specification and we have proposed two proposal solutions to the addition of a localization factor to enhance the payment authentication of such transactions designed to prevent relay, cloning, and Mole-POS attacks. Our proposed solution is a back-end localization scheme to help the Issuer-Bank compare the location of the genuine cardholder in relation to the used POS. Our scheme uses 'something you have' which is the Cardholder Smartphone (CSP) to provide the location of the cardholder at the time of the transaction and without impacting the contactless payment time/protocol. The Issuer-bank obtain the CSP Location using tried and tested localization techniques, and independently of the cardholder. Both of our proposal solutions do not require infrastructure changes, and it uses existing EMV/SP protocol messages to communicate our scheme information.

Keywords: NFC, RFID, contactless card, authentication, location, EMV

Procedia PDF Downloads 242

Authors: D. Jablonskytė-Raščė, A. Mankevičienė, S. Supronienė, I. Kerienė, S. Maikštėnienė, S. Bliznikas, R. Česnulevičienė

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Organic farming does not allow the use of conventional mineral fertilizers and crop protection products. As a result, in our experiments we chose to grow different species of cereals and to see how cereal species affects mycotoxin accumulation. From the phytopathological and entomological viewpoint, the glumes of spelt grain perform a positive role since they protect grain from the infection of pathogenic microorganisms. On the background of the above-mentioned infection, there were more Fusarium–affected grains of spelt than of common wheat. It can be assumed that spelt is more susceptible to the Fusarium fungi infection than common wheat. This study describes the occurrence of DON, ZEA and T2/HT2 toxin in a survey of spelt and common wheat and their bran as well as flour. The analysis was conducted using the enzyme-linked immunosorbent assay (ELISA) method. The concentrations of DON, ZEA, and T2/HT2 in Triticum spelta and Triticum aestivum are influenced by species, cereal type and year interaction. The highest concentration of mycotoxin was found in spelt grain with glumes. The obtained results indicate the significantly higher concentrations of Fusarium toxins in glumes than in dehulled grain which implicate the possible protective effect of spelt wheat glumes. The lowest DON, ZEA, and T2/HT2 concentration was determined in spelt grain without glumes.

Keywords: Fusarium mycotoxins, organic farming, spelt

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Authors: Irene Bruna Seu

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This paper draws on a three-year research project investigating everyday moral reasoning in relation to donations and prosocial behaviour in the humanitarian context. The analysis focuses on the principle of deservingness by which members of the public decide who and under which conditions to help and illustrates how the speakers engage in ideological dilemmas. The paper focuses on the theme ‘Something for nothing’ to examine how the position of ‘deserving’ and the speaker’s rights and duties in relation to victims of humanitarian crises are negotiated. Discursive analyses of this dilemmatic storyline of deservingness illuminate the cultural and ideological resources buttressing this construction. They also illustrate how humanitarianism intersects and clashes with other ideologies and value systems. The presentation will focus on the role of Individualism underpinned by Neo-liberalism ideology. The data propose that neo-liberal ideology, which endorses self-gratification, materialistic and individualistic ethics play an important role in decisions regarding humanitarian helping. The paper argues for the need for psychological research to engage more actively with the dilemmatic nature of moral reasoning in the humanitarian context, and to contextualize decisions about giving and helping within the socio-cultural and ideological landscape in which the helpers operate.

Keywords: humanitarianism, individualism, ideological dilemmas, discourse, neo-liberalism, prosocial behaviour

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Authors: Roland Benedict Reyes, Marc Edsel Ayes, Regina Berba, Cybele Lara Abad

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Background: Three AIDS-defining malignancies have been associated with the human immunodeficiency virus (HIV): Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and cervical carcinoma. However, new cases of non-AIDS defining malignancies also have been increasingly associated with HIV. One of these is a rare intracranial malignancy, meningeal hemangiopericyotma. Case Description: A 32-year old HIV-positive male, not on highly active antiretroviral therapy, was admitted to our hospital due to generalized weakness and sudden onset hearing loss. Cranial MRI was done, which revealed a temporal nodule with the following considerations: granuloma, meningioma or metastases. A craniotomy was performed and the mass excised. Results from the biopsy showed meningeal hemangiopericytoma. The patient was then started on antiretroviral therapy (Lamivudine, Tenofovir, and Efavirenz) and was discharged for radiation therapy and metastatic work-up as an outpatient. On follow-up seven months later, metastatic work up revealed multiple hepatic foci not previously documented suggestive of metastasis short of biopsy sampling. Conclusions: This case of an intracranial hemangiopericytoma in an HIV-positive patient is the second case thus far presented, based on our systematic and extensive search of the literature.

Keywords: Hemangiopericytoma, Human Immunodeficiency Virus, Meningeal hemangiopericytoma, Neoplasm

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Authors: Ana Katrina C. Longos, Jarungchai Anton S. Vatanagul

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Objectives: To present a case of two Filipino male siblings initially seen with parkinsonism and eventually with dystonia and to present botulinum A toxin as part of the treatment for X-linked dystonia parkinsonism in Cebu City. Discussion: A 54 year old man presented initially with parkinsonian symptoms and later developed oromandibular and truncal dystonia. Further history revealed that he had an older brother who also presented with the same symptoms. Neuroimaging done on both patients revealed CVD infarcts in the pons and corona radiata respectively which where were not compatible with their symptoms. Family history revealed that their mother was originally from Panay and a diagnosis of X-linked dystonia parkinsonism (XDP) was made. Both patients were able to receive botulinum A toxin injections which provided temporary relief of symptoms. Conclusion: XDP was considered in 2 Filipino male siblings who presented with oromandibular dystonia, truncal dystonia, shuffling gait, resting tremors with ancestry from Panay on the maternal side. There is no cure for XDP, only symptomatic treatment. Until recently, only oral chemotherapy was available in Cebu. Botulinum A toxin injection done in both patients afforded temporary resolution of symptoms.

Keywords: XDP, dystonia of Panay, lubag, dystonia parkinsonism, botulinum a toxin

Procedia PDF Downloads 504

Authors: Ayliana Dharmawan, Heng Yong Sheng, Zhang Xiaojin, Tan Thai Lian

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To facilitate discharge planning, doctors are presently required to assign an Estimated Discharge Date (EDD) for each patient admitted to the hospital. This assignment of the EDD is largely based on the doctor’s judgment. This can be difficult for cases which are complex or relatively new to the doctor. It is hypothesized that a data-driven approach would be able to facilitate the doctors to make accurate estimations of the discharge date. Making use of routinely collected data on inpatient discharges between January 2013 and May 2016, a predictive model was developed using machine learning techniques to predict the Length of Stay (and hence the EDD) of inpatients, at the point of admission. The predictive performance of the model was compared to that of the clinicians using accuracy measures. Overall, the best performing model was found to be able to predict EDD with an accuracy improvement in Average Squared Error (ASE) by -38% as compared to the first EDD determined by the present method. It was found that important predictors of the EDD include the provisional diagnosis code, patient’s age, attending doctor at admission, medical specialty at admission, accommodation type, and the mean length of stay of the patient in the past year. The predictive model can be used as a tool to accurately predict the EDD.

Keywords: inpatient, estimated discharge date, EDD, prediction, data-driven

Procedia PDF Downloads 174

Authors: Xiaozhou Liu, Guangyu Zhu, Yu Zhang, Hongwei Wu

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The wind-box is one of the important components of a Circulating Fluidized Bed (CFB) boiler. The uniformity of air flow in the wind-box of is very important for highly efficient operation of the CFB boiler. Non-uniform air flow distribution within the wind-box can reduce the boiler's thermal efficiency, leading to higher energy consumptions. An effective measure to solve this problem is to install an air flow distributing device in the wind-box. In order to validate the effectiveness of the air flow distributing device, visual and velocity distribution uniformity experiments have been carried out under five different test conditions by using a 1:64 scale model of a 220t/hr CFB boiler. It has been shown that the z component of flow velocity remains almost the same at control cross-sections of the wind-box, with a maximum variation of less than 10%. Moreover, the same methodology has been carried out to a full-scale 220t/hr CFB boiler. The hot test results depict that the thermal efficiency of the boiler has increased from 85.71% to 88.34% when tested with an air flow distributing device in place, which is equivalent to a saving of 5,000 tons of coal per year. The economic benefits of this energy-saving technology have been shown to be very significant, which clearly demonstrates that the technology is worth applying and popularizing.

Keywords: circulating fluidized bed, CFB, wind-box, air flow distributing device, visual experiment, velocity distribution uniformity experiment, hot test

Procedia PDF Downloads 176