Search results for: Conor Blunt
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 48

Search results for: Conor Blunt

48 An Autopsy Case of Blunt Chest Trauma from a Traffic Accident Complicated by Chest Compression Due to Resuscitation Attempts

Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

Abstract:

Coronary artery dissection leading to acute myocardial infarction after blunt chest trauma is extremely rare. A 67-year-old woman suffered blunt chest trauma following a traffic accident. The electrocardiogram revealed acute posterior ST-segment elevation and myocardial infarction and coronary angiography demonstrated acute right coronary artery dissection. Following the death of the victim an autopsy was performed after cardiopulmonary support had been carried out. In this case report, we describe the case of a woman with blunt chest trauma, who developed an acute myocardial infarction secondary to right coronary artery dissection. Although there was additional the blunt chest trauma due to chest compression, we confirmed the injury at autopsy and by histological findings.

Keywords: blunt chest trauma, right coronary artery dissection, coronary angiography, autopsy, histological examination

Procedia PDF Downloads 605
47 Chemical and Vibrational Nonequilibrium Hypersonic Viscous Flow around an Axisymmetric Blunt Body

Authors: Rabah Haoui

Abstract:

Hypersonic flows around spatial vehicles during their reentry phase in planetary atmospheres are characterized by intense aerothermodynamics phenomena. The aim of this work is to analyze high temperature flows around an axisymmetric blunt body taking into account chemical and vibrational non-equilibrium for air mixture species and the no slip condition at the wall. For this purpose, the Navier-Stokes equations system is resolved by the finite volume methodology to determine the flow parameters around the axisymmetric blunt body especially at the stagnation point and in the boundary layer along the wall of the blunt body. The code allows the capture of shock wave before a blunt body placed in hypersonic free stream. The numerical technique uses the Flux Vector Splitting method of Van Leer. CFL coefficient and mesh size level are selected to ensure the numerical convergence.

Keywords: hypersonic flow, viscous flow, chemical kinetic, dissociation, finite volumes, frozen and non-equilibrium flow

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46 When Talk Is the Cure for the Morning After: Talking Therapy in Conor Mcpherson’s Dublin Carol and Shining City

Authors: Maha Hamoud Alatawi

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Drawing on the work of John McLeod and Ariel Watson, this paper explains the relationship between narrative and psychotherapy in two plays by the Irish playwright Conor McPherson. Dublin Carol presents John’s chequered past through his reminiscences of alcohol addiction and Shining City tells the story of John who is haunted by the ghost of his wife, recently died in a car accident, and who seeks the help of Ian, a therapist. At first, the significance of storytelling as an integral part of Irish culture is highlighted. Such a tradition features prominently in contemporary Irish drama. The paper concludes that it is the power of narrative and its therapeutic impact and not the act of psychotherapy and treatment which brings signs of change to characters’ lives.

Keywords: Conor McPherson, drama, psychotherapy, storytelling

Procedia PDF Downloads 273
45 Analysis of Brain Specific Creatine Kinase of Postmortem Cerebrospinal Fluid and Serum in Blunt Head Trauma Cases

Authors: Rika Susanti, Eryati Darwin, Dedi Afandi, Yanwirasti, Syahruddin Said, Noverika Windasari, Zelly Dia Rofinda

Abstract:

Introduction: Blunt head trauma is one of the leading causes of death associated with murders and other deaths involved in criminal acts. Creatine kinase (CKBB) levels have been used as a biomarker for blunt head trauma. Therefore, it is now used as an alternative to an autopsy. The aim of this study is to investigate CKBB levels in cerebrospinal fluid (CSF) and post-mortem serum in order to deduce the cause and time of death. Method: This investigation was conducted through post-test–only group design involving deaths caused by blunt head trauma, which was compared to deaths caused by ketamine poisoning. Results: There were eight treatment groups, each consisting of six adult rats (Rattus norvegicus) Sprague-Dawley strain. Examinations were done at 0 hours, 1 hour, 2 hours, and 3 hours post-mortem, which followed by brain tissue observation. Data were then analyzed statistically with a repeated-measures general linear model. Conclusion: There were increases in the level of CKBB in CSF and postmortem serum in both blunt head trauma and ketamine poisoning treatment groups. However, there were no significant differences between these two groups.

Keywords: blunt head trauma, CKBB, the cause of death, estimated time of death

Procedia PDF Downloads 168
44 Hypersonic Flow of CO2-N2 Mixture around a Spacecraft during the Atmospheric Reentry

Authors: Zineddine Bouyahiaoui, Rabah Haoui

Abstract:

The aim of this work is to analyze a flow around the axisymmetric blunt body taken into account the chemical and vibrational nonequilibrium flow. This work concerns the entry of spacecraft in the atmosphere of the planet Mars. Since the equations involved are non-linear partial derivatives, the volume method is the only way to solve this problem. The choice of the mesh and the CFL is a condition for the convergence to have the stationary solution.

Keywords: blunt body, finite volume, hypersonic flow, viscous flow

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43 Effect of Mesh Size on the Supersonic Viscous Flow Parameters around an Axisymmetric Blunt Body

Authors: Haoui Rabah

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The aim of this work is to analyze a viscous flow around the axisymmetric blunt body taken into account the mesh size both in the free stream and into the boundary layer. The resolution of the Navier-Stokes equations is realized by using the finite volume method to determine the flow parameters and detached shock position. The numerical technique uses the Flux Vector Splitting method of Van Leer. Here, adequate time stepping parameter, CFL coefficient and mesh size level are selected to ensure numerical convergence. The effect of the mesh size is significant on the shear stress and velocity profile. The best solution is obtained with using a very fine grid. This study enabled us to confirm that the determination of boundary layer thickness can be obtained only if the size of the mesh is lower than a certain value limits given by our calculations.

Keywords: supersonic flow, viscous flow, finite volume, blunt body

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42 Aerodynamic Heating Analysis of Hypersonic Flow over Blunt-Nosed Bodies Using Computational Fluid Dynamics

Authors: Aakash Chhunchha, Assma Begum

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The qualitative aspects of hypersonic flow over a range of blunt bodies have been extensively analyzed in the past. It is well known that the curvature of a body’s geometry in the sonic region predominantly dictates the bow shock shape and its standoff distance from the body, while the surface pressure distribution depends on both the sonic region and on the local body shape. The present study is an extension to analyze the hypersonic flow characteristics over several blunt-nosed bodies using modern Computational Fluid Dynamics (CFD) tools to determine the shock shape and its effect on the heat flux around the body. 4 blunt-nosed models with cylindrical afterbodies were analyzed for a flow at a Mach number of 10 corresponding to the standard atmospheric conditions at an altitude of 50 km. The nose radii of curvature of the models range from a hemispherical nose to a flat nose. Appropriate numerical models and the supplementary convergence techniques that were implemented for the CFD analysis are thoroughly described. The flow contours are presented highlighting the key characteristics of shock wave shape, shock standoff distance and the sonic point shift on the shock. The variation of heat flux, due to different shock detachments for various models is comprehensively discussed. It is observed that the more the bluntness of the nose radii, the farther the shock stands from the body; and consequently, the less the surface heating at the nose. The results obtained from the CFD analyses are compared with approximated theoretical engineering correlations. Overall, a satisfactory agreement is observed between the two.

Keywords: aero-thermodynamics, blunt-nosed bodies, computational fluid dynamics (CFD), hypersonic flow

Procedia PDF Downloads 116
41 Trauma Scores and Outcome Prediction After Chest Trauma

Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

Abstract:

Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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40 Predictors of Pelvic Vascular Injuries in Patients with Pelvic Fractures from Major Blunt Trauma

Authors: Osama Zayed

Abstract:

Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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39 Traumatic Brachiocephalic Artery Pseudoaneurysm

Authors: Sally Shepherd, Jessica Wong, David Read

Abstract:

Traumatic brachiocephalic artery aneurysm is a rare injury that typically occurs as a result of a blunt chest injury. A 19-year-old female sustained a head-on, high speed motor vehicle crash into a tree. Upon release after 45 minutes of entrapment, she was tachycardic but normotensive, with a significant seatbelt sign across her chest and open deformed right thigh with weak pulses in bilateral lower limbs. A chest XR showed mild upper mediastinal widening. A CT trauma series plus gated CT chest revealed a grade 3a aortic arch transection with brachiocephalic pseudoaneurysm. Endovascular repair of the brachiocephalic artery was attempted post-presentation but was unsuccessful as the first stent migrated to the infrarenal abdominal aorta and the second stent across the brachiocephalic artery origin had a persistent leak at the base. She was transferred to Intensive Care for strict blood pressure control. She returned to theatre 5 hours later for a median sternotomy, aortic arch repair with an 8mm graft extraction, and excision of the innominate artery pseudoaneurysm. She had an uncomplicated post-operative recovery. This case highlights that brachiocephalic artery injury is a rare but potentially lethal injury as a result of blunt chest trauma. Safe management requires a combined Vascular and Cardiothoracic team approach, as stenting alone may be insufficient.

Keywords: blunt chest injury, Brachiocephalic aneurysm, innominate artery, trauma

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38 Experimental Investigation of Plane Jets Exiting Five Parallel Channels with Large Aspect Ratio

Authors: Laurentiu Moruz, Jens Kitzhofer, Mircea Dinulescu

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The paper aims to extend the knowledge about jet behavior and jet interaction between five plane unventilated jets with large aspect ratio (AR). The distance between the single plane jets is two times the channel height. The experimental investigation applies 2D Particle Image Velocimetry (PIV) and static pressure measurements. Our study focuses on the influence of two different outlet nozzle geometries (triangular shape with 2 x 7.5° and blunt geometry) with respect to variation of Reynolds number from 5500 - 12000. It is shown that the outlet geometry has a major influence on the jet formation in terms of uniformity of velocity profiles downstream of the sudden expansion. Furthermore, we describe characteristic regions like converging region, merging region and combined region. The triangular outlet geometry generates most uniform velocity distributions in comparison to a blunt outlet nozzle geometry. The blunt outlet geometry shows an unstable behavior where the jets tend to attach to one side of the walls (ceiling) generating a large recirculation region on the opposite side. Static pressure measurements confirm the observation and indicate that the recirculation region is connected to larger pressure drop.

Keywords: 2D particle image velocimetry, parallel jet interaction, pressure drop, sudden expansion

Procedia PDF Downloads 244
37 Blunt Abdominal Trauma Management in Adult Patients: An Investigation on Safety of Discharging Patients with Normal Initial Findings

Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

Abstract:

Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

Procedia PDF Downloads 341
36 Listening to Circles, Playing Lights: A Study of Cross-Modal Perception in Music

Authors: Roni Granot, Erica Polini

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Music is often described in terms of non-auditory adjectives such as a rising melody, a bright sound, or a zigzagged contour. Such cross modal associations have been studied with simple isolated musical parameters, but only rarely in rich musical contexts. The current study probes cross sensory associations with polarity based dimensions by means of pairings of 10 adjectives: blunt-sharp, relaxed-tense, heavy-light, low (in space)-high, low (pitch)-high, big-small, hard-soft, active-passive, bright-dark, sad-happy. 30 participants (randomly assigned to one of two groups) were asked to rate one of 27 short saxophone improvisations on a 1 to 6 scale where 1 and six correspond to the opposite pole of each dimension. The 27 improvisations included three exemplars for each of three dimensions (size, brightness, sharpness), played by three different players. Here we focus on the question of whether ratings of scales corresponding with the musical dimension were consistently rated as such (e.g. music improvised to represent a white circle rated as bright in contrast with music improvised to represent a dark circle rated as dark). Overall the average scores by dimension showed an upward trend in the equivalent verbal scale, with a low rating for small, bright and sharp musical improvisations and higher scores for large, dark and blunt improvisations. Friedman tests indicate a statistically significant difference for brightness (χ2 (2) = 19.704, p = .000) and sharpness dimensions (χ2 (2) = 15.750, p = .000), but not for size (χ2 (2) = 1.444, p = .486). Post hoc analysis with Wilcoxon signed-rank tests within the brightness dimension, show significant differences among all possible parings resulted in significant differences: the rankings of 'bright' and 'dark' (Z = -3.310, p = .001), of 'bright' and 'medium' (Z = -2.438, p = .015) and of 'dark' and 'medium' music (Z = -2.714, p = .007); but only differences between the extreme contrasts within the sharpness dimension : 'sharp' and 'blunt' music (Z = -3.147, p = .002) and between 'sharp' and 'medium' music rated on the sharpness scale (Z = - 3.054, p = .002), but not between 'medium' and 'blunt' music (Z = -.982, p = .326). In summary our study suggests a privileged link between music and the perceptual and semantic domain of brightness. In contrast, size seems to be very difficult to convey in music, whereas sharpness seems to be mapped onto the two extremes (sharp vs. blunt) rather than continuously. This is nicely reflected in the musical literature in titles and texts which stress the association between music and concepts of light or darkness rather than sharpness or size.

Keywords: audiovisual, brightness, cross-modal perception, cross-sensory correspondences, size, visual angularity

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35 Biostimulant and Abiotic Plant Stress Interactions in Malting Barley: A Glasshouse Study

Authors: Conor Blunt, Mariluz del Pino-de Elias, Grace Cott, Saoirse Tracy, Rainer Melzer

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The European Green Deal announced in 2021 details agricultural chemical pesticide use and synthetic fertilizer application to be reduced by 50% and 20% by 2030. Increasing and maintaining expected yields under these ambitious goals has strained the agricultural sector. This intergovernmental plan has identified plant biostimulants as one potential input to facilitate this new phase of sustainable agriculture; these products are defined as microorganisms or substances that can stimulate soil and plant functioning to enhance crop nutrient use efficiency, quality and tolerance to abiotic stresses. Spring barley is Ireland’s most widely sown tillage crop, and grain destined for malting commands the most significant market price. Heavy erratic rainfall is forecasted in Ireland’s climate future, and barley is particularly susceptible to waterlogging. Recent findings suggest that plant receptivity to biostimulants may depend on the level of stress inflicted on crops to elicit an assisted plant response. In this study, three biostimulants of different genesis (seaweed, protein hydrolysate and bacteria) are applied to ‘RGT Planet’ malting barley fertilized at three different rates (0 kg/ha, 40 kg/ha, 75 kg/ha) of calcium ammonium nitrogen (27% N) under non-stressed and waterlogged conditions. This 4x3x2 factorial trial design was planted in a completed randomized block with one plant per experimental unit. Leaf gas exchange data and key agronomic and grain quality parameters were analyzed via ANOVA. No penalty on productivity was evident on plants receiving 40 kg/ha of N and bio stimulant compared to 75 kg/ha of N treatments. The main effects of nitrogen application and waterlogging provided the most significant variation in the dataset.

Keywords: biostimulant, Barley, malting, NUE, waterlogging

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34 Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents: An Autopsy Study

Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

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33 Observational Versus Angioembolisation in Blunt Splenic Trauma: A Systematic Review

Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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32 Predictive Value of Coagulopathy in Patients with Isolated Blunt Traumatic Brain Injury: A Cohort of Pakistani Population

Authors: Muhammad Waqas, Shahan Waheed, Mohsin Qadeer, Ehsan Bari, Salman Ahmed, Iqra Patoli

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Objective: To determine the value of aPTT, platelets and INR as the predictor of unfavorable outcomes in patients with blunt isolated traumatic brain injury. Methods: This was an observational cohort study conducted in a tertiary care facility from 1st January 2008 to 31st December 2012. All the patients with isolated traumatic brain injury presenting within 24 hours of injury were included in the study. Coagulation parameters at presentation were recorded and Glasgow Outcome Scale calculated on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Relationship of coagulopathy with GOS and unfavorable outcomes was calculated using Spearman`s correlation and area under curve ROC analysis. Results: 121 patients were included in the study. The incidence of coagulopathy was found to be 6 %. aPTT was found to a significantly associated with unfavorable outcomes with an AUC = 0.702 (95%CI = 0.602-0.802). Predictive value of platelets and INR was not found to be significant. Conclusion: Incidence of coagulopathy was found to be low in current population compared to data from the West. aPTT was found to be a good predictor of unfavorable outcomes compared with other parameters of coagulation.

Keywords: aPTT, coagulopathy, unfavorable outcomes, parameters

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31 Death Due to Ulnar Artery Injury by Glassdoor: A Case Report

Authors: Ashok Kumar Rastogi

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Glass is a material commonly used for Glassdoor, glass bottles, cookware, and containers. It can be harmful, as it is a hard and blunt object. Glass has been associated with severe injury and is a common cause of injuries warranting hospital visits to the emergency department (ED). These injuries can be accidental or intentionally inflicted. Broken glass injuries can be severe, even deadly. If broken glass shards fall out on your arm, it may cause fatal injuries. Case history: A 20-year-old male dead body was found aside the road, police informed, and a video recording ceased during an investigation. In the video recording, the person was in a drunken state (unable to walk and disoriented), wandering in the residential area road. He saw a barber shop, the shop door made of Glass. Suddenly, he hit the Glassdoor with his right hand forcefully. The Glassdoor broke into multiple pieces, and multiple injuries were seen over the right hand. Observations: Multiple small and large lacerations were seen over the right anterior part of the elbow. The main injury looked like an incised wound caused by a hard and sharp object. The main injury was noted as a laceration of size 13 x 06 cm bone deep, placed obliquely over the anteromedial aspect of the right elbow joint, its medial end at medial end of elbow joint while its anterior end was 04 cm below the elbow joint with laceration of underline brachialis muscles and complete transaction of ulnar artery and vein, skin margins looking sharply cut with irregular margins with tiny cuts at the medial lower border of laceration. Injuries were antemortem and fresh in nature, caused by hard and blunt objects but looking like hard and sharp objects. All organs were found pale, and the cause of death was shock and hemorrhage because of ulnar vessel injury. Conclusion: The findings of this case report highlight the potentially lethal consequences of glass injuries, especially those involving Glassdoors. The study underscores the importance of accurate interpretation and identification of wounds caused by Glass, as they may resemble injuries caused by other objects. It emphasizes the challenges faced by autopsy surgeons when determining the cause and manner of death in cases where visual evidence of injury is absent or when the weapon is not recovered. Ultimately, this case report serves as a reminder of the potential dangers posed by Glass and the importance of comprehensive forensic examinations.

Keywords: glassdoor, incised, wound, laceration, autopsy

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30 The Relationship between Conceptual Organizational Culture and the Level of Tolerance in Employees

Authors: M. Sadoughi, R. Ehsani

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The aim of the present study is examining the relationship between conceptual organizational culture and the level of tolerance in employees of Islamic Azad University of Shahre Ghods. This research is a correlational and analytic-descriptive one. The samples included 144 individuals. A 24-item standard questionnaire of organizational culture by Cameron and Queen was used in this study. This questionnaire has six criteria and each criterion includes four items that each item indicates one cultural dimension. Reliability coefficient of this questionnaire was normed using Cronbach's alpha of 0.91. Also, the 25-item questionnaire of tolerance by Conor and Davidson was used. This questionnaire is in a five-degree Likert scale form. It has seven criteria and is designed to measure the power of coping with pressure and threat. It has the needed content reliability and its reliability coefficient is normed using Cronbach's alpha of 0.87. Data were analyzed using Pearson correlation coefficient and multivariable regression. The results showed among various dimensions of organizational culture, there is a positive significant relationship between three dimensions (family, adhocracy, bureaucracy) and tolerance, there is a negative significant relationship between dimension of market and tolerance and components of organizational culture have the power of prediction and explaining the tolerance. In this explanation, the component of family is the most effective and the best predictor of tolerance.

Keywords: adhocracy, bureaucracy, organizational culture, tolerance

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29 A Rare Neck Trauma by Bicycle Handlebar in Road Traffic Accident

Authors: Parthasarathi Pramanik

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Paediatric blunt abdominal trauma associated with superficial bruise, hematoma, or laceration and internal organ damage secondary to bicycle handlebar is widely documented in the literature. In this article, we have presented a case of bicycle handlebar inflicted fatal neck laceration in a road accident. The deceased sustained a horizontally placed laceration injury over the front and both sides of the middle third of neck (13 cm x 5-8 cm x 2-3.5 cm).The margins of the wound were irregular and focally abraded. The right corner of the injury was pointed whereas the left one was ended with a skin flap. Multiple graze abrasions, contusions and lacerations were found on different parts of body. Autopsy findings and other circumstantial evidences revealed that the victim died due to exsanguination because of severance of carotid artery and jugular vein of both sides. Analysis of the wound suggests the decease sustained the wound by the revolving bicycle handle bar while he had lost the balance.

Keywords: bicycle handle bar, neck injury, lacerated injury, road acident

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28 Unsteady Forced Convection Flow and Heat Transfer Past a Blunt Headed Semi-Circular Cylinder at Low Reynolds Numbers

Authors: Y. El Khchine, M. Sriti

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In the present work, the forced convection heat transfer and fluid flow past an unconfined semi-circular cylinder is investigated. The two-dimensional simulation is employed for Reynolds numbers ranging from 10 ≤ Re ≤ 200, employing air (Pr = 0.71) as an operating fluid with Newtonian constant physics property. Continuity, momentum, and energy equations with appropriate boundary conditions are solved using the Computational Fluid Dynamics (CFD) solver Ansys Fluent. Various parameters flow such as lift, drag, pressure, skin friction coefficients, Nusselt number, Strouhal number, and vortex strength are calculated. The transition from steady to time-periodic flow occurs between Re=60 and 80. The effect of the Reynolds number on heat transfer is discussed. Finally, a developed correlation of Nusselt and Strouhal numbers is presented.

Keywords: forced convection, semi-circular cylinder, Nusselt number, Prandtl number

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27 Object-Based Flow Physics for Aerodynamic Modelling in Real-Time Environments

Authors: William J. Crowther, Conor Marsh

Abstract:

Object-based flow simulation allows fast computation of arbitrarily complex aerodynamic models made up of simple objects with limited flow interactions. The proposed approach is universally applicable to objects made from arbitrarily scaled ellipsoid primitives at arbitrary aerodynamic attitude and angular rate. The use of a component-based aerodynamic modelling approach increases efficiency by allowing selective inclusion of different physics models at run-time and allows extensibility through the development of new models. Insight into the numerical stability of the model under first order fixed-time step integration schemes is provided by stability analysis of the drag component. The compute cost of model components and functions is evaluated and compared against numerical benchmarks. Model static outputs are verified against theoretical expectations and dynamic behaviour using falling plate data from the literature. The model is applied to a range of case studies to demonstrate the efficacy of its application in extensibility, ease of use, and low computational cost. Dynamically complex multi-body systems can be implemented in a transparent and efficient manner, and we successfully demonstrate large scenes with hundreds of objects interacting with diverse flow fields.

Keywords: aerodynamics, real-time simulation, low-order model, flight dynamics

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26 Desktop High-Speed Aerodynamics by Shallow Water Analogy in a Tin Box for Engineering Students

Authors: Etsuo Morishita

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In this paper, we show shallow water in a tin box as an analogous simulation tool for high-speed aerodynamics education and research. It is customary that we use a water tank to create shallow water flow. While a flow in a water tank is not necessarily uniform and is sometimes wavy, we can visualize a clear supercritical flow even when we move a body manually in stationary water in a simple shallow tin box. We can visualize a blunt shock wave around a moving circular cylinder together with a shock pattern around a diamond airfoil. Another interesting analogous experiment is a hydrodynamic shock tube with water and tea. We observe the contact surface clearly due to color difference of the two liquids those are invisible in the real gas dynamics experiment. We first revisit the similarities between high-speed aerodynamics and shallow water hydraulics. Several educational and research experiments are then introduced for engineering students. Shallow water experiments in a tin box simulate properly the high-speed flows.

Keywords: aerodynamics compressible flow, gas dynamics, hydraulics, shock wave

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25 Wall Pressure Fluctuations in Naturally Developing Boundary Layer Flows on Axisymmetric Bodies

Authors: Chinsuk Hong

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This paper investigates the characteristics of wall pressure fluctuations in naturally developing boundary layer flows on axisymmetric bodies experimentally. The axisymmetric body has a modified ellipsoidal blunt nose. Flush-mounted microphones are used to measure the wall pressure fluctuations in the boundary layer flow over the body. The measurements are performed in a low noise wind tunnel. It is found that the correlation between the flow regime and the characteristics of the pressure fluctuations is distinct. The process from small fluctuation in laminar flow to large fluctuation in turbulent flow is investigated. Tollmien-Schlichting wave (T-S wave) is found to generate and develop in transition. Because of the T-S wave, the wall pressure fluctuations in the transition region are higher than those in the turbulent boundary layer.

Keywords: wall pressure fluctuation, boundary layer flow, transition, turbulent flow, axisymmetric body, flow noise

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24 Challenges and Opportunities for University Management Brought by 2016 Presidential Campaign Immigration Policies and Politics within the United States

Authors: Autumn Tooms Cypres

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Throughout the 2016 presidential campaign, Republican nominee Donald Trump, capitalizing on his reputation for blunt and brash comments, created a political brand based on unedited statements and sweeping promises. While he vowed to 'Make America Great Again,' for many, the candidate’s discourse invoked legacies of marginalization and exclusion. As a result, this discussion focuses on Trump’s anti-immigration discourse (one of the primary foci of his campaign platform) and its influence across educational settings. The purpose of this effort is to demonstrate the power of political discourses relative to educational settings and to discuss the resulting everyday leadership challenges and opportunities. Discourse analysis frameworks are used to unpack the socio-political implications of the presidential campaign. In particular, they examine a serious of emails that a university administrator received post-election. The discussion concludes that leaders in education have a critical role to maintaining democratic institutions and ensuring inclusivity and belonging for all educational stakeholders.

Keywords: educational managment, politics, immigration, discourse

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23 The Impact of Virtual Schooling Due to COVID-19 Restrictions on Children’s Mood and Behavior

Authors: Rahaf Alasiri, Tarek Alghamdi, Abdullah Zarkan

Abstract:

Background: Due to measures such as school closure, social distancing, and virtual teaching during the pandemic, primary school children's psychological well-being is greatly affected. These measures have short and long-term consequences on the children's well-being and mental health. Identifying these consequences is important. Aim: This study aimed to evaluate mood and behavior changes in children who attended school virtually. Subjects and methods: This is a cross-sectional study conducted among children and their parents who visited the outpatient clinic. A self-administered questionnaire was given to the parents of children aged between 6 to 14 years. The questionnaire includes socio-demographic characteristics, Conor's modifies scale to assess the attention deficit hyperactivity disorder (ADHD) of children, and the parental stress scale (PSS) to assess the stress symptoms of the parents. Results: Of the 66 surveyed children, 60.6% were aged between 10 to 14 years old, with the female being dominant (77.3%). The most common medical condition was asthma (7.6%), and nearly two-thirds (63.6%) indicated good health conditions during the pandemic. There was a significant inverse correlation observed between ADHD score and PSS score (r=-0.387). No significant differences are in ADHD and PSS scores in relation to the socio-demographic characteristics of the children, including age, gender, and having an associated medical condition (p>0.05). Conclusion: During the pandemic, children who attended virtual classes did not seem to affect even with restrictions. Most children indicated good health conditions during the pandemic. However, it is surprising to know that in spite of children’s high spirits during the pandemic, their parents were seen to have an increased level of stress. Strategies to address parents’ psychological disorders during the pandemic are warranted.

Keywords: children's mood, COVID-19, ADHD, parental stress

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22 Smart Demand Response: A South African Pragmatic, Non-Destructive and Alternative Advanced Metering Infrastructure-Based Maximum Demand Reduction Methodology

Authors: Christo Nicholls

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The National Electricity Grid (NEG) in South Africa has been under strain for the last five years. This overburden of the NEG led Eskom (the State-Owned Entity responsible for the NEG) to implement a blunt methodology to assist them in reducing the maximum demand (MD) on the NEG, when required, called Loadshedding. The challenge of this methodology is that not only does it lead to immense technical issues with the distribution network equipment, e.g., transformers, due to the frequent abrupt off and on switching, it also has a broader negative fiscal impact on the distributors, as their key consumers (commercial & industrial) are now grid defecting due to the lack of Electricity Security Provision (ESP). This paper provides a pragmatic alternative methodology utilizing specific functionalities embedded within direct-connect single and three-phase Advanced Meter Infrastructure (AMI) Solutions deployed within the distribution network, in conjunction with a Multi-Agent Systems Based AI implementation focused on Automated Negotiation Peer-2-Peer trading. The results of this research clearly illustrate, not only does methodology provide a factual percentage contribution towards the NEG MD at the point of consideration, it also allows the distributor to leverage the real-time MD data from key consumers to activate complex, yet impact-measurable Demand Response (DR) programs.

Keywords: AI, AMI, demand response, multi-agent

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21 Clinicopathological Findings of Partuberclosis in Camels: Possible Steps for Control Strategy

Authors: A. M. Almujalli, G. M. Al-Ghamdi

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Mycobacterium avium subspecies paratuberculosis causes paratuberculosis, a chronic debilitating granulomatous enteritis, in camels as well as domestic and wild ruminants. The clinical manifestation of the disease in camel is not well characterized, therefore this study was aimed to investigate the clinical and pathological pictures of camels that are suffering from partuberculosis. Twelve young camels that were presented to the Veterinary Teaching Hospital, King Faisal University were investigated. Clinical and pathological examination were performed. The results revealed highly significant increase in creatinine, blood urea nitrogen, magnesium, AST and ALT in diseased camels, while glucose, total protein and albumin were highly significantly decreased in diseased camels when compared to healthy ones. Post-mortem testing indicated thickening, corrugation of the intestinal wall, folded mucosa, enlarged and oedemated ileocaecal and mesenteric lymph nodes. The microscopic findings detected short, blunt and distorted intestinal villi with hyperactive goblet cells of the villi and the crypts of lieberkuhn contained mucin droplets. The lamina propria was heavily infiltrated with mononuclear cells mostly macrophages. This clinical picture of paratuberculosis may be used to initiate control strategy to limit the spread of the disease in camel herds.

Keywords: camel, partuberclosis, control, Saudi Arabia

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20 Intraoperative Inter Pectoral and Sub Serratus Nerve Blocks Reduce Post Operative Opiate Requirements in Breast Augmentation Surgery

Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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19 The Relationship between Human Neutrophil Elastase Levels and Acute Respiratory Distress Syndrome in Patients with Thoracic Trauma

Authors: Wahyu Purnama Putra, Artono Isharanto

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Thoracic trauma is trauma that hits the thoracic wall or intrathoracic organs, either due to blunt trauma or sharp trauma. Thoracic trauma often causes impaired ventilation-perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of acute respiratory distress syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins, and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. This study aims to predict the incidence of acute respiratory distress syndrome (ARDS) through human neutrophil elastase levels. This study examines the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. Data analysis uses the Pearson correlation test and ROC curve (receiver operating characteristic curve). It can be concluded that there is a significant (p= 0.000, r= -0.988) relationship between elastase levels and BGA-3. If the value of elastase levels is limited to 23.79 ± 3.95, the patient will experience mild ARDS. While if the value of elastase levels is limited to 57.68 ± 18.55, in the future, the patient will experience moderate ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Neutrophil elastase levels correlate with the degree of severity of ARDS incidence.

Keywords: ARDS, human neutrophil elastase, severity, thoracic trauma

Procedia PDF Downloads 108