Search results for: clinical prediction rule
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6343

Search results for: clinical prediction rule

3673 Numerical Modeling of Structural Failure of a Ship During the Collision Event

Authors: Adjal Yassine, Semmani Amar

Abstract:

During the last decades, The risk of collision has been increased, especially in high maritime traffic. As the consequence, the demand is required for safety at sea and environmental protection. For this purpose, the consequences prediction of ship collisions is recommended in order to minimize structural failure. additionally, at the design stage of the ship, damage generated during the collision event must be taken into consideration. This structural failure, in some cases, can develop into the progressive collapse of other structural elements and generate catastrophic consequences. The present study investigates the progressive collapse of ships damaged by collisions using the Non -linear finite element method. The failure criteria are taken into account. The impacted area has a refined mesh in order to have more reliable results. Finally, a parametric study was conducted in this study to highlight the effect of the ship's speed, as well as the different impacted areas of double-bottom ships.

Keywords: collsion, strucural failure, ship, finite element analysis

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3672 A Retrospective Study of the Effects of Xenophobia on South Africa-Nigeria Relations

Authors: O. Fayomi, F. Chidozie, C. Ayo

Abstract:

The underlying causes of xenophobia are complex and varied. Xenophobia has to do with being contemptuous of that which is foreign, especially of strangers or of people from different countries or cultures. Unemployment and mounting poverty among South Africans at the bottom of the economic ladder have provoked fears of the competition that better educated and experienced migrants can represent. South Africa’s long track-record of violence as a means of protest and the targeting of foreigners in particular, and, the documented tensions over migration policy and the scale of repatriation serve a very good explanation for its xenophobia. It was clear that while most of the attacks were directed against foreign, primarily African, migrants, this was not the rule. Attacks were also noted against Chinese-speakers, Pakistani migrants as well as against South Africans from minority language groups (in the conflict areas). Settlements that have recently experienced the expression of ‘xenophobic’ violence have also been the site of violent and other forms of protest around other issues, most notably service delivery. The failure of government in service delivery was vexed on this form of xenophobia. Due to the increase in migration, this conflict is certainly not temporary in nature. Xenophobia manifests in different regions and communities with devastating effects on the affected nationals. Nigerians living in South Africa have been objects of severe attacks and assault as a result of this xenophobic attitude. It is against this background that this study seeks to investigate the xenophobic attacks against Nigerians in South Africa. The methodology is basically qualitative with the use of secondary sources such as books, journals, newspapers and internet sources.

Keywords: xenophobia, unemployment, poverty, Nigeria, South Africa

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3671 Combination of Geological, Geophysical and Reservoir Engineering Analyses in Field Development: A Case Study

Authors: Atif Zafar, Fan Haijun

Abstract:

A sequence of different Reservoir Engineering methods and tools in reservoir characterization and field development are presented in this paper. The real data of Jin Gas Field of L-Basin of Pakistan is used. The basic concept behind this work is to enlighten the importance of well test analysis in a broader way (i.e. reservoir characterization and field development) unlike to just determine the permeability and skin parameters. Normally in the case of reservoir characterization we rely on well test analysis to some extent but for field development plan, the well test analysis has become a forgotten tool specifically for locations of new development wells. This paper describes the successful implementation of well test analysis in Jin Gas Field where the main uncertainties are identified during initial stage of field development when location of new development well was marked only on the basis of G&G (Geologic and Geophysical) data. The seismic interpretation could not encounter one of the boundary (fault, sub-seismic fault, heterogeneity) near the main and only producing well of Jin Gas Field whereas the results of the model from the well test analysis played a very crucial rule in order to propose the location of second well of the newly discovered field. The results from different methods of well test analysis of Jin Gas Field are also integrated with and supported by other tools of Reservoir Engineering i.e. Material Balance Method and Volumetric Method. In this way, a comprehensive way out and algorithm is obtained in order to integrate the well test analyses with Geological and Geophysical analyses for reservoir characterization and field development. On the strong basis of this working and algorithm, it was successfully evaluated that the proposed location of new development well was not justified and it must be somewhere else except South direction.

Keywords: field development plan, reservoir characterization, reservoir engineering, well test analysis

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3670 Application of Compressed Sensing and Different Sampling Trajectories for Data Reduction of Small Animal Magnetic Resonance Image

Authors: Matheus Madureira Matos, Alexandre Rodrigues Farias

Abstract:

Magnetic Resonance Imaging (MRI) is a vital imaging technique used in both clinical and pre-clinical areas to obtain detailed anatomical and functional information. However, MRI scans can be expensive, time-consuming, and often require the use of anesthetics to keep animals still during the imaging process. Anesthetics are commonly administered to animals undergoing MRI scans to ensure they remain still during the imaging process. However, prolonged or repeated exposure to anesthetics can have adverse effects on animals, including physiological alterations and potential toxicity. Minimizing the duration and frequency of anesthesia is, therefore, crucial for the well-being of research animals. In recent years, various sampling trajectories have been investigated to reduce the number of MRI measurements leading to shorter scanning time and minimizing the duration of animal exposure to the effects of anesthetics. Compressed sensing (CS) and sampling trajectories, such as cartesian, spiral, and radial, have emerged as powerful tools to reduce MRI data while preserving diagnostic quality. This work aims to apply CS and cartesian, spiral, and radial sampling trajectories for the reconstruction of MRI of the abdomen of mice sub-sampled at levels below that defined by the Nyquist theorem. The methodology of this work consists of using a fully sampled reference MRI of a female model C57B1/6 mouse acquired experimentally in a 4.7 Tesla MRI scanner for small animals using Spin Echo pulse sequences. The image is down-sampled by cartesian, radial, and spiral sampling paths and then reconstructed by CS. The quality of the reconstructed images is objectively assessed by three quality assessment techniques RMSE (Root mean square error), PSNR (Peak to Signal Noise Ratio), and SSIM (Structural similarity index measure). The utilization of optimized sampling trajectories and CS technique has demonstrated the potential for a significant reduction of up to 70% of image data acquisition. This result translates into shorter scan times, minimizing the duration and frequency of anesthesia administration and reducing the potential risks associated with it.

Keywords: compressed sensing, magnetic resonance, sampling trajectories, small animals

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3669 Development of Generalized Correlation for Liquid Thermal Conductivity of N-Alkane and Olefin

Authors: A. Ishag Mohamed, A. A. Rabah

Abstract:

The objective of this research is to develop a generalized correlation for the prediction of thermal conductivity of n-Alkanes and Alkenes. There is a minority of research and lack of correlation for thermal conductivity of liquids in the open literature. The available experimental data are collected covering the groups of n-Alkanes and Alkenes.The data were assumed to correlate to temperature using Filippov correlation. Nonparametric regression of Grace Algorithm was used to develop the generalized correlation model. A spread sheet program based on Microsoft Excel was used to plot and calculate the value of the coefficients. The results obtained were compared with the data that found in Perry's Chemical Engineering Hand Book. The experimental data correlated to the temperature ranged "between" 273.15 to 673.15 K, with R2 = 0.99.The developed correlation reproduced experimental data that which were not included in regression with absolute average percent deviation (AAPD) of less than 7 %. Thus the spread sheet was quite accurate which produces reliable data.

Keywords: N-Alkanes, N-Alkenes, nonparametric, regression

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3668 Overconfidence and Self-Attribution Bias: The Difference among Economic Students at Different Stage of the Study and Non-Economic Students

Authors: Vera Jancurova

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People are, in general, exposed to behavioral biases, however, the degree and impact are affected by experience, knowledge, and other characteristics. The purpose of this article is to study two of defined behavioral biases, the overconfidence and self-attribution bias, and its impact on economic and non-economic students at different stage of the study. The research method used for the purpose of this study is a controlled field study that contains questions on perception of own confidence and self-attribution and estimation of limits to analyse actual abilities. The results of the research show that economic students seem to be more overconfident than their non–economic colleagues, which seems to be caused by the fact the questionnaire was asking for predicting economic indexes and own knowledge and abilities in financial environment. Surprisingly, the most overconfidence was detected by the students at the beginning of their study (1st-semester students). However, the estimations of real numbers do not point out, that economic students have better results by the prediction itself. The study confirmed the presence of self-attribution bias at all of the respondents.

Keywords: behavioral finance, overconfidence, self-attribution, heuristics and biases

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3667 Performance of High Density Genotyping in Sahiwal Cattle Breed

Authors: Hamid Mustafa, Huson J. Heather, Kim Eiusoo, Adeela Ajmal, Tad S. Sonstegard

Abstract:

The objective of this study was to evaluate the informativeness of Bovine high density SNPs genotyping in Sahiwal cattle population. This is a first attempt to assess the Bovine HD SNP genotyping array in any Pakistani indigenous cattle population. To evaluate these SNPs on genome wide scale, we considered 777,962 SNPs spanning the whole autosomal and X chromosomes in Sahiwal cattle population. Fifteen (15) non related gDNA samples were genotyped with the bovine HD infinium. Approximately 500,939 SNPs were found polymorphic (MAF > 0.05) in Sahiwal cattle population. The results of this study indicate potential application of Bovine High Density SNP genotyping in Pakistani indigenous cattle population. The information generated from this array can be applied in genetic prediction, characterization and genome wide association studies of Pakistani Sahiwal cattle population.

Keywords: Sahiwal cattle, polymorphic SNPs, genotyping, Pakistan

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3666 Prediction-Based Midterm Operation Planning for Energy Management of Exhibition Hall

Authors: Doseong Eom, Jeongmin Kim, Kwang Ryel Ryu

Abstract:

Large exhibition halls require a lot of energy to maintain comfortable atmosphere for the visitors viewing inside. One way of reducing the energy cost is to have thermal energy storage systems installed so that the thermal energy can be stored in the middle of night when the energy price is low and then used later when the price is high. To minimize the overall energy cost, however, we should be able to decide how much energy to save during which time period exactly. If we can foresee future energy load and the corresponding cost, we will be able to make such decisions reasonably. In this paper, we use machine learning technique to obtain models for predicting weather conditions and the number of visitors on hourly basis for the next day. Based on the energy load thus predicted, we build a cost-optimal daily operation plan for the thermal energy storage systems and cooling and heating facilities through simulation-based optimization.

Keywords: building energy management, machine learning, operation planning, simulation-based optimization

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3665 Utilizing Federated Learning for Accurate Prediction of COVID-19 from CT Scan Images

Authors: Jinil Patel, Sarthak Patel, Sarthak Thakkar, Deepti Saraswat

Abstract:

Recently, the COVID-19 outbreak has spread across the world, leading the World Health Organization to classify it as a global pandemic. To save the patient’s life, the COVID-19 symptoms have to be identified. But using an AI (Artificial Intelligence) model to identify COVID-19 symptoms within the allotted time was challenging. The RT-PCR test was found to be inadequate in determining the COVID status of a patient. To determine if the patient has COVID-19 or not, a Computed Tomography Scan (CT scan) of patient is a better alternative. It will be challenging to compile and store all the data from various hospitals on the server, though. Federated learning, therefore, aids in resolving this problem. Certain deep learning models help to classify Covid-19. This paper will have detailed work of certain deep learning models like VGG19, ResNet50, MobileNEtv2, and Deep Learning Aggregation (DLA) along with maintaining privacy with encryption.

Keywords: federated learning, COVID-19, CT-scan, homomorphic encryption, ResNet50, VGG-19, MobileNetv2, DLA

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3664 Stress and Coping among Adolescents in Selected Schools in the Capital City of India

Authors: N. Mathew, A. Qureshi, D. C. Khakha, R. Sagar

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Adolescents in India, account for one-fifth of the total population and are a significant human resource. Present study was conducted to find out various life stressors of adolescents, coping strategies adopted by them and the impact of stress on adolescent mental health. A descriptive, cross sectional study conducted on schools in the south zone of Delhi, capital city of the country. Data was collected on 360 adolescents between the age group of 13-17 years on socio-demographic profile, Adolescent life event stress scale, brief cope and youth self report for ages 11-18. Adolescents had significantly higher stress on uncontrollable events such as family events, relocation events, accident events and ambiguous events as compared to controllable events such as sexual events, deviance events and autonomy events (p<0.01).Adolescent stress was significantly correlated with various demographic variables in the study. The most frequently used coping strategies by the adolescents were positive reframing, planning, active coping, and instrumental support. It has also been found that the stress has a significant impact on adolescent mental health in the form of either internalizing problems such as anxious, withdrawn and somatic problems or externalizing problems such as rule breaking and aggressive behaviors. Out of the total sample of 360 adolescents 150 were identified as having psycho-social morbidity, including 59 borderline cases and 91 high-risk cases Study pointed out the need for mental health screening among the adolescents and also indicated the need for mental health inputs in educational institutions.

Keywords: adolecents, stress, coping, mental health

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3663 Impact of Religious Struggles on Life Satisfaction among Young Muslims: The Mediating Role of Psychological Wellbeing

Authors: Sarwat Sultan, Frasat Kanwal, Motasem Mirza

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The impact of religiosity on people’s lives has always been found complex because some of them turn to religion to get comfort and relief from their fear, guilt, and illness, whereas some become away due to the perception that God is revengeful and distant for their conduct. The overarching aim of this study was to know whether the relationship between religious struggles (comfort/strain) and life satisfaction is mediated by psychological well-being. The participants of this study were 529 Muslim students who provided their responses on the measures of religious comfort/strain, psychological well-being, and life satisfaction. Results revealed that religious comfort predicted well-being and life satisfaction positively, while religious strain predicted negatively. Findings showed that psychological well-being mediated the prediction of religious comfort and strain for life satisfaction. These findings have implications for students’ mental health because their teachers and professionals can enhance their well-being by teaching them positive aspects of religion and God.

Keywords: attitude towards god, religious comfort, religious strain, life satisfaction, psychological wellbeing

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3662 Medical Student's Responses to Emotional Content in Doctor-Patient Communication: To Explore Differences in Communication Training of Medical Students and Its Impact on Doctor-Patient Communication

Authors: Stephanie Yun Yu Law

Abstract:

Background: This study aims to investigate into communication between trainee doctors and patients, especially how doctor’s reaction to patient’s emotional issues expressed in the consultation affect patient’s satisfaction. Objectives: Thus, there are three aims in this study, 1.) how do trainee doctors react to patients emotional cues in OSCE station? 2.) Any differences in the respond type to emotional cues between first year students and third year students? 3.) Is response type (reducing space) related to OSCE outcome (patient satisfaction and expert rating)? Methods: Fifteen OSCE stations was videotaped, in which 9 were stations with first-year students and 6 were with third-year students. OSCE outcomes were measured by Communication Assessment Tool and Examiners Checklist. Analyses: All patient’s cues/concerns and student’s reaction were coded by Verona Coding Definitions of Emotional Sequence. Descriptive data was gathered from Observer XT and logistic regression (two-level) was carried out to see if occurrence of reducing space response can be predicted by OSCE outcomes. Results: Reducing space responses from all students were slightly less than a half in total responses to patient’s cues. The mean percentage of reducing space behaviours was lower among first year students when compared to third year students. Patient’s satisfaction significantly (p<0.05) and negatively predicted reducing space behaviours. Conclusions: Most of the medical students, to some extent, did not provide adequate responses for patient’s emotional cues. But first year students did provide more space for patients to talk about their emotional issues when compared to third year students. Lastly, patients would feel less satisfied if trainee doctors use more reducing space responses in reaction to patient’s expressed emotional cues/concerns. Practical implications: Firstly, medical training programme can be tailored on teaching students how to detect and respond appropriately to emotional cues in order to improve underperformed student’s communication skills in healthcare setting. Furthermore, trainee doctor’s relationship with patients in clinical practice can also be improved by reacting appropriately to patient’s emotive cues in consultations (such as limit the use of reducing space behaviours).

Keywords: doctors-patients communication, applied clinical psychology, health psychology, healthcare professionals

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3661 Inhibitory Effect of Hydroalcoholic Extract of Cestrum Nocturnum on α-Amylase Activity

Authors: Rajesh Kumar, Anil Kamboj

Abstract:

Inhibition of α- amylase play a vital role in the clinical management of postprandial hyperglycemia. Although, powerful synthetic inhibitors are available, natural inhibitors are potentially safer. The present study was carried out to evaluate α- amylase inhibition activity from hydroalcoholic extracts from aerial parts of Cestrum nocturnum. Hydroalcoholic extract was prepared by Soxhletation Method. The extract showed strong inhibition towards α- amylase activity and IC50 value were 45.9 µg. This In vitro studies indicate the potential of C. nocturnum in the development of effective anti-diabetic agents.

Keywords: α- amylase, cestrum nocturnum, hyperglycemia, hydroalcoholic extracts, diabetes

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3660 Development of a Plug-In Hybrid Powertrain System with Double Continuously Variable Transmissions

Authors: Cheng-Chi Yu, Chi-Shiun Chiou

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This study developed a plug-in hybrid powertrain system which consisted of two continuous variable transmissions. By matching between the engine, motor, generator, and dual continuous variable transmissions, this integrated power system can take advantages of the components. The hybrid vehicle can be driven by the internal combustion engine, or electric motor alone, or by these two power sources together when the vehicle is driven in hard acceleration or high load. The energy management of this integrated hybrid system controls the power systems based on rule-based control strategy to achieve better fuel economy. When the vehicle driving power demand is low, the internal combustion engine is operating in the low efficiency region, so the internal combustion engine is shut down, and the vehicle is driven by motor only. When the vehicle driving power demand is high, internal combustion engine would operate in the high efficiency region; then the vehicle could be driven by internal combustion engine. This strategy would operate internal combustion engine only in optimal efficiency region to improve the fuel economy. In this research, the vehicle simulation model was built in MATLAB/ Simulink environment. The analysis results showed that the power coupled efficiency of the hybrid powertrain system with dual continuous variable transmissions was better than that of the Honda hybrid system on the market.

Keywords: plug-in hybrid power system, fuel economy, performance, continuously variable transmission

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3659 Estimation of Location and Scale Parameters of Extended Exponential Distribution Based on Record Statistics

Authors: E. Krishna

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An Extended form of exponential distribution using Marshall and Olkin method is introduced.The location scale family of these distributions is considered. For location scale free family, exact expressions for single and product moments of upper record statistics are derived. The mean, variance and covariance of record values are computed for various values of the shape parameter. Using these the BLUE's of location and scale parameters are derived.The variances and covariance of estimates are obtained.Through Monte Carlo simulation the con dence intervals for location and scale parameters are constructed.The Best liner unbiased Predictor (BLUP) of future records are also discussed.

Keywords: BLUE, BLUP, con dence interval, Marshall-Olkin distribution, Monte Carlo simulation, prediction of future records, record statistics

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3658 A Double-Blind, Randomized, Controlled Trial on N-Acetylcysteine for the Prevention of Acute Kidney Injury in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Authors: Sara Ataei, Molouk Hadjibabaie, Amirhossein Moslehi, Maryam Taghizadeh-Ghehi, Asieh Ashouri, Elham Amini, Kheirollah Gholami, Alireza Hayatshahi, Mohammad Vaezi, Ardeshir Ghavamzadeh

Abstract:

Acute kidney injury (AKI) is one of the complications of hematopoietic stem cell transplantation and is associated with increased mortality. N-acetylcysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties that has been investigated for the prevention of AKI in several clinical settings. In the present study, we evaluated the effects of intravenous NAC on the prevention of AKI in allogeneic hematopoietic stem cell transplantation patients. A double-blind randomized placebo-controlled trial was conducted, and 80 patients were recruited to receive 100 mg/kg/day NAC or placebo as intermittent intravenous infusion from day -6 to day +15. AKI was determined on the basis of the Risk-Injury-Failure-Loss-Endstage renal disease and AKI Network criteria as the primary outcome. We assessed urine neutrophil gelatinase-associated lipocalin (uNGAL) on days -6, -3, +3, +9, and +15 as the secondary outcome. Moreover, transplant-related outcomes and NAC adverse reactions were evaluated during the study period. Statistical analysis was performed using appropriate parametric and non-parametric methods including Kaplan–Meier for AKI and generalized estimating equation for uNGAL. At the end of the trial, data from 72 patients were analyzed (NAC: 33 patients and placebo: 39 patients). Participants of each group were not different considering baseline characteristics. AKI was observed in 18% of NAC recipients and 15% of placebo group patients, and the occurrence pattern was not significantly different (p = 0.73). Moreover, no significant difference was observed between groups for uNGAL measures (p = 0.10). Transplant-related outcomes were similar for both groups, and all patients had successful engraftment. Three patients did not tolerate NAC because of abdominal pain, shortness of breath and rash with pruritus and were dropped from the intervention group before transplantation. However, the frequency of adverse reactions was not significantly different between groups. In conclusion, our findings could not show any clinical benefits from high-dose NAC particularly for AKI prevention in allogeneic hematopoietic stem cell transplantation patients.

Keywords: acute kidney injury, N-acetylcysteine, hematopoietic stem cell transplantation, urine neutrophil gelatinase-associated lipocalin, randomized controlled trial

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3657 Pellegrini-Stieda Syndrome: A Physical Medicine and Rehabilitation Approach

Authors: Pedro Ferraz-Gameiro

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Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

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3656 Machine Learning Application in Shovel Maintenance

Authors: Amir Taghizadeh Vahed, Adithya Thaduri

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Shovels are the main components in the mining transportation system. The productivity of the mines depends on the availability of shovels due to its high capital and operating costs. The unplanned failure/shutdowns of a shovel results in higher repair costs, increase in downtime, as well as increasing indirect cost (i.e. loss of production and company’s reputation). In order to mitigate these failures, predictive maintenance can be useful approach using failure prediction. The modern mining machinery or shovels collect huge datasets automatically; it consists of reliability and maintenance data. However, the gathered datasets are useless until the information and knowledge of data are extracted. Machine learning as well as data mining, which has a major role in recent studies, has been used for the knowledge discovery process. In this study, data mining and machine learning approaches are implemented to detect not only anomalies but also patterns from a dataset and further detection of failures.

Keywords: maintenance, machine learning, shovel, conditional based monitoring

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3655 Mesenteric Ischemia Presenting as Acalculous Cholecystitis: A Case Review of a Rare Complication and Aberrant Anatomy

Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa

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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.

Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia

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3654 Impact of COVID-19 Disease on Reproductive Health in Women

Authors: Mikailzade Parvin, Gurbanova Jamila, Alizade Samaya, Hasanova Afat

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It is known that in March 2020, the World Health Organization (WHO) declared a global pandemic of the 2019 coronovirus disease COVID-19, caused by the severe acute respiratory syndrome coronovirus (SARS-CoV-2). In this period, ensuring the safety of pregnancy and childbirth has become one of the necessary issues. The measures taken in this direction naturally consisted of strengthening and improving preventive measures among pregnant women. It should be noted that the lethality of SARS-CoV-2 infection among women reached 25%. The relevance of studying the effect of COVID-19 on reproductive health in women is due to its wide spread worldwide, severe clinical course, and the occurrence of numerous complications or lethality. It is of urgent importance to study the impact of the mentioned coronavirus infection on the health of pregnant women and the serious complications caused by it.Taking these into account, 230 pregnant women infected with the COVID-19 virus infection were registered. The average age of the pregnant women included in the study was: 29.24±6.0. The diagnosis of corona virus infection was made on the basis of polymerase chain reaction (PCR), serological tests (IgG, IgM). In 57.4% of cases, bilateral pneumonia was recorded in pregnant women and confirmed on the basis of radiological (RH) examination. RH examination revealed pneumonia with infiltrate in the lungs. Among clinical symptoms in pregnant women infected with COVID-19 virus infection: in 86 (37.4%) cases, symptoms such as high fever (t-39.0oC), shortness of breath, fatigue, and hypoxia were noted in pregnant women. A decrease in SpO2 to a minimal level was recorded. Laboratory-instrumental examinations were carried out. The obtained results showed: the average limit of D-dimer was 0.8±0.5; prothrombin time 13.2±1.1 seconds; INR 0.98±0.08, prothrombin index 104.3±19.5%, EHS - 34.8±13.6 mm/s. It should be noted that respiratory distress syndrome (RDS), premature birth, malformed and extremely malformed newborns, asphyxia or hypoxia have been reported in infants born to pregnant women infected with the coronavirus disease.Thus, from the obtained indicators, it is known that pregnant women infected with the virus have a high risk of serious illness and death for both themselves and their babies. It has been proven that the majority of babies born to SARS-CoV-2 positive mothers have a negative impact on their health.

Keywords: Covid 19, reproductive health, preqnancy, premature birth

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3653 The Role of Authority's Testimony in Preschoolers' Ownership Judgment: A Study with Conflicting Cues Method

Authors: Zhanxing Li, Liqi Zhu

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Authorities often intervene in children’s property conflicts, which may affect young children’s ownership understanding. First possession is a typical rule of ownership judgment. We recruited Chinese preschoolers as subjects and investigated their ownership reasoning regarding first possession, by setting three conditions via a conflicting cues method, in which a third party (mother or peer friend)’s testimony was always opposite to the cue of first possession (authority/non-authority testimony condition), or only the cue of first possession was present (no testimony condition). In Study A, we examined forty-two 3- and 5-year olds’ attribution and justification of ownership. The results showed while 5-year olds gave more support for the first possessor as the owner across three conditions, 3-year olds’ choice for the first possessor had no difference from the non-first possessor in the authority testimony condition. Moreover, 3-year olds tended to justify by reference to what mother said in the authority testimony condition, 5-year olds consistently referred to the first possession in three conditions. In Study B, we added two ownership questions to quantify children’s ability of ownership reasoning with four age groups (n = 32 for the 3-year-olds, n = 33 for the 4-year-olds, n = 27 for the 5-year olds and n = 30 for the adults) to explore the developmental trajectory further. It revealed that while 5-year olds’ performances were similar to the adults’ and always judged the first possessor as owner in three conditions, 3- and 4-year olds’ performed at chance level in the authority testimony condition. The results imply that Chinese young preschooler’s ownership reasoning was susceptible to authority’s testimony. Family authority may play an important role in diluting children’s adherence to ownership principles, which will be helpful for children to learn to share with others.

Keywords: authority, ownership judgment, preschoolers, testimony

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3652 Efficacy of Opicapone and Levodopa with Different Levodopa Daily Doses in Parkinson’s Disease Patients with Early Motor Fluctuations: Findings from the Korean ADOPTION Study

Authors: Jee-Young Lee, Joaquim J. Ferreira, Hyeo-il Ma, José-Francisco Rocha, Beomseok Jeon

Abstract:

The effective management of wearing-off is a key driver of medication changes for patients with Parkinson’s disease (PD) treated with levodopa (L-DOPA). While L-DOPA is well tolerated and efficacious, its clinical utility over time is often limited by the development of complications such as dyskinesia. Still, common first-line option includes adjusting the daily L-DOPA dose followed by adjunctive therapies usually counting for the L-DOPA equivalent daily dose (LEDD). The LEDD conversion formulae are a tool used to compare the equivalence of anti-PD medications. The aim of this work is to compare the effects of opicapone (OPC) 50 mg, a catechol-O-methyltransferase (COMT) inhibitor, and an additional 100 mg dose of L-DOPA in reducing the off time in PD patients with early motor fluctuations receiving different daily L-DOPA doses. OPC was found to be well tolerated and efficacious in advanced PD population. This work utilized patients' home diary data from a 4-week Phase 2 pharmacokinetics clinical study. The Korean ADOPTION study randomized (1:1) patients with PD and early motor fluctuations treated with up to 600 mg of L-DOPA given 3–4 times daily. The main endpoint was change from baseline in off time in the subgroup of patients receiving 300–400 mg/day L-DOPA at baseline plus OPC 50 mg and in the subgroup receiving >300 mg/day L-DOPA at baseline plus an additional dose of L-DOPA 100 mg. Of the 86 patients included in this subgroup analysis, 39 received OPC 50 mg and 47 L-DOPA 100 mg. At baseline, both L-DOPA total daily dose and LEDD were lower in the L-DOPA 300–400 mg/day plus OPC 50 mg group than in the L-DOPA >300 mg/day plus L-DOPA 100 mg. However, at Week 4, LEDD was similar between the two groups. The mean (±standard error) reduction in off time was approximately three-fold greater for the OPC 50 mg than for the L-DOPA 100 mg group, being -63.0 (14.6) minutes for patients treated with L-DOPA 300–400 mg/day plus OPC 50 mg, and -22.1 (9.3) minutes for those receiving L-DOPA >300 mg/day plus L-DOPA 100 mg. In conclusion, despite similar LEDD, OPC demonstrated a significantly greater reduction in off time when compared to an additional 100 mg L-DOPA dose. The effect of OPC appears to be LEDD independent, suggesting that caution should be exercised when employing LEDD to guide treatment decisions as this does not take into account the timing of each dose, onset, duration of therapeutic effect and individual responsiveness. Additionally, OPC could be used for keeping the L-DOPA dose as low as possible for as long as possible to avoid the development of motor complications which are a significant source of disability.

Keywords: opicapone, levodopa, pharmacokinetics, off-time

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3651 Experimental Chip/Tool Temperature FEM Model Calibration by Infrared Thermography: A Case Study

Authors: Riccardo Angiuli, Michele Giannuzzi, Rodolfo Franchi, Gabriele Papadia

Abstract:

Temperature knowledge in machining is fundamental to improve the numerical and FEM models used for the study of some critical process aspects, such as the behavior of the worked material and tool. The extreme conditions in which they operate make it impossible to use traditional measuring instruments; infrared thermography can be used as a valid measuring instrument for temperature measurement during metal cutting. In the study, a large experimental program on superduplex steel (ASTM A995 gr. 5A) cutting was carried out, the relevant cutting temperatures were measured by infrared thermography when certain cutting parameters changed, from traditional values to extreme ones. The values identified were used to calibrate a FEM model for the prediction of residual life of the tools. During the study, the problems related to the detection of cutting temperatures by infrared thermography were analyzed, and a dedicated procedure was developed that could be used during similar processing.

Keywords: machining, infrared thermography, FEM, temperature measurement

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3650 Electronic Six-Minute Walk Test (E-6MWT): Less Manpower, Higher Efficiency, and Better Data Management

Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

Abstract:

Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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3649 Is the Addition of Computed Tomography with Angiography Superior to a Non-Contrast Neuroimaging Only Strategy for Patients with Suspected Stroke or Transient Ischemic Attack Presenting to the Emergency Department?

Authors: Alisha M. Ebrahim, Bijoy K. Menon, Eddy Lang, Shelagh B. Coutts, Katie Lin

Abstract:

Introduction: Frontline emergency physicians require clear and evidence-based approaches to guide neuroimaging investigations for patients presenting with suspected acute stroke or transient ischemic attack (TIA). Various forms of computed tomography (CT) are currently available for initial investigation, including non-contrast CT (NCCT), CT angiography head and neck (CTA), and CT perfusion (CTP). However, there is uncertainty around optimal imaging choice for cost-effectiveness, particularly for minor or resolved neurological symptoms. In addition to the cost of CTA and CTP testing, there is also a concern for increased incidental findings, which may contribute to the burden of overdiagnosis. Methods: In this cross-sectional observational study, analysis was conducted on 586 anonymized triage and diagnostic imaging (DI) reports for neuroimaging orders completed on patients presenting to adult emergency departments (EDs) with a suspected stroke or TIA from January-December 2019. The primary outcome of interest is the diagnostic yield of NCCT+CTA compared to NCCT alone for patients presenting to urban academic EDs with Canadian Emergency Department Information System (CEDIS) complaints of “symptoms of stroke” (specifically acute stroke and TIA indications). DI reports were coded into 4 pre-specified categories (endorsed by a panel of stroke experts): no abnormalities, clinically significant findings (requiring immediate or follow-up clinical action), incidental findings (not meeting prespecified criteria for clinical significance), and both significant and incidental findings. Standard descriptive statistics were performed. A two-sided p-value <0.05 was considered significant. Results: 75% of patients received NCCT+CTA imaging, 21% received NCCT alone, and 4% received NCCT+CTA+CTP. The diagnostic yield of NCCT+CTA imaging for prespecified clinically significant findings was 24%, compared to only 9% in those who received NCCT alone. The proportion of incidental findings was 30% in the NCCT only group and 32% in the NCCT+CTA group. CTP did not significantly increase the yield of significant or incidental findings. Conclusion: In this cohort of patients presenting with suspected stroke or TIA, an NCCT+CTA neuroimaging strategy had a higher diagnostic yield for clinically significant findings than NCCT alone without significantly increasing the number of incidental findings identified.

Keywords: stroke, diagnostic yield, neuroimaging, emergency department, CT

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3648 The Effect of Material Properties and Volumetric Changes in Phase Transformation to the Final Residual Stress of Welding Process

Authors: Djarot B. Darmadi

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The wider growing Finite Element Method (FEM) application is caused by its benefits of cost saving and environment friendly. Also, by using FEM a deep understanding of certain phenomenon can be achieved. This paper observed the role of material properties and volumetric change when Solid State Phase Transformation (SSPT) takes place in residual stress formation due to a welding process of ferritic steels through coupled Thermo-Metallurgy-Mechanical (TMM) analysis. The correctness of FEM residual stress prediction was validated by experiment. From parametric study of the FEM model, it can be concluded that the material properties change tend to over-predicts residual stress in the weld center whilst volumetric change tend to underestimates it. The best final result is the compromise of both by incorporates them in the model which has a better result compared to a model without SSPT.

Keywords: residual stress, ferritic steels, SSPT, coupled-TMM

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3647 The Origin, Diffusion and a Comparison of Ordinary Differential Equations Numerical Solutions Used by SIR Model in Order to Predict SARS-CoV-2 in Nordic Countries

Authors: Gleda Kutrolli, Maksi Kutrolli, Etjon Meco

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SARS-CoV-2 virus is currently one of the most infectious pathogens for humans. It started in China at the end of 2019 and now it is spread in all over the world. The origin and diffusion of the SARS-CoV-2 epidemic, is analysed based on the discussion of viral phylogeny theory. With the aim of understanding the spread of infection in the affected countries, it is crucial to modelize the spread of the virus and simulate its activity. In this paper, the prediction of coronavirus outbreak is done by using SIR model without vital dynamics, applying different numerical technique solving ordinary differential equations (ODEs). We find out that ABM and MRT methods perform better than other techniques and that the activity of the virus will decrease in April but it never cease (for some time the activity will remain low) and the next cycle will start in the middle July 2020 for Norway and Denmark, and October 2020 for Sweden, and September for Finland.

Keywords: forecasting, ordinary differential equations, SARS-COV-2 epidemic, SIR model

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3646 Erectile Dysfunction in A Middle Aged Man 6 Years After Bariatric Surgery: A Case Report

Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya

Abstract:

Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.

Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido

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3645 The Yield of Neuroimaging in Patients Presenting to the Emergency Department with Isolated Neuro-Ophthalmological Conditions

Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

Abstract:

Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

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3644 Characteristics of Clinical and Diagnostic Aspects of Benign Diseases of Cervi̇x in Women

Authors: Gurbanova J., Majidova N., Ali-Zade S., Hasanova A., Mikailzade P.

Abstract:

Currently, the problem of oncogynecological diseases is widespread and remains relevant in terms of quantitative growth. It is known that due to the increase in the number of benign diseases of the cervix, the development of precancerous conditions occurs. Benign diseases of the cervix represent the most common gynecological problem, which are often precursors of malignant neoplasms, especially cervical cancer. According to statistics, benign diseases of the cervix cover 25-45% of all gynecological diseases. Among women's oncogynecological diseases, cervical cancer ranks second in the world after breast cancer and ranks first in the mortality rate among oncological diseases in economically underdeveloped countries. We performed a comprehensive clinical and laboratory examination of 130 women aged 18 to 73 with benign cervical diseases. 59 (38.5%) women of reproductive age, as well as 39 (30%) premenopausal and 41 (31.5%) menopausal patients, participated in the study. Detailed anamnesis was collected from all patients, objective and gynecological examination was performed, laboratory and instrumental examinations (USM, IPV DNA, smear microscopy, and PCR bacteriological examination of sexually transmitted infections), simple and extended colposcopy, liquid-based РАР-smear smear and РАР-classic smear examinations were conducted. As a result of the research, the following nosological forms were found in women with benign diseases of the cervix: non-specific vaginitis in 10 (7.7%) cases; ectopia, endocervicitis - 60(46.2%); cervical ectropion - 7(5.4%); cervical polyp - 9(6.9%); cervical leukoplakia - 15(11.5%); atrophic vaginitis - 7(5.4%); condyloma - 12(9.2%); cervical stenosis - 2(1.5%); endometriosis of the cervix - was noted in 8 (6.2%) cases (p<0.001), respectively. Characteristics of the menstrual cycle among the examined women: normal cycle in 97 (74.6%) cases; oligomenorrhea – 23 (17.7%); polymenorrhea – 4(3.1%); algomenorrhea – noted in 6 (4.6%) cases (p<0.001). Cytological examination showed that: the specificity of liquid-based cytology was 76.2%, and the traditional PAP test was set at 70.6%. The overall diagnostic value was calculated to be 86% in liquid-based cytology and 78.5% in conventional PAP tests. Treatment of women with benign diseases of the cervix was carried out by diathermocoagulation method and "FOTEK EA 141M" device. It should be noted that 6 months after the treatment, after treatment with the "FOTEK EA 141M" device, there was no relapse in any patient. Recurrence was found in 23.7% of patients after diathermoelectrocoagulation. Thus, it is clear from the above that the study of cervical pathologies, the determination of optimal examinations, and effective treatment methods is one of the urgent problems facing obstetrics and gynecology.

Keywords: cervical cancer, cytological examination, PAP-smear, non-specific vaginitis

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