Search results for: Echo Parent-Racine
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 123

Search results for: Echo Parent-Racine

63 Challenging the Stereotypes: A Critical Study of Chotti Munda, His Arrow, and Sula

Authors: Khushboo Gokani, Renu Josan

Abstract:

Mahasweta Devi and Toni Morrison are the two stalwarts of the Indian-English and the Afro-American literature respectively. The writings of these two novelists are authentic and powerful records of the lives of the people because much of their personal experiences have gone into the making of their works. Devi, a representative force of the Indian English literature, is also a social activist working with the tribals of Bihar, Jharkhand, Orissa and West Bengal. Most of her works echo the lives and struggles of the subalterns as is evident in her 'best-beloved book' Chotti Munda and His Arrow. The novelist focuses on the struggle of the tribals against the colonial and the feudal powers to create their identity, thereby, embarking on the ideological project called Setting the Record Straight. The Nobel laureate Toni Morrison, on the other hand, brings to the fore the crucial issues of gender, race, and class in many of her significant works. In one of her representative works, Sula, the protagonist emerges as a non-conformist and directly confronts the notion of a ‘good woman’ nurtured by the community of the Blacks. In addition to this, the struggle of the Blacks against the White domination, also become an important theme of the text. The thrust of the paper lies in making a critical analysis of the portrayal of the heroic attempts of the subaltern protagonist and the artistic endeavor of the novelists in challenging the stereotypes.

Keywords: the struggle of the muted groups, subaltern, center and periphery, challenging the stereotypes

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62 Comparison of Dose Rate and Energy Dependence of Soft Tissue Equivalence Dosimeter with Electron and Photon Beams Using Magnetic Resonance Imaging

Authors: Bakhtiar Azadbakht, Karim Adinehvand, Amin Sahebnasagh

Abstract:

The purpose of this study was to evaluate dependence of PAGAT polymer gel dosimeter 1/T2 on different electron and photon energies as well as on different mean dose rates for a standard clinically used Co-60 therapy unit and an ELECTA linear accelerator. A multi echo sequence with 32 equidistant echoes was used for the evaluation of irradiated polymer gel dosimeters. The optimal post-manufacture irradiation and post imaging times were both determined to be one day. The sensitivity of PAGAT polymer gel dosimeter with irradiation of photon and electron beams was represented by the slope of calibration curve in the linear region measured for each modality. The response of PAGAT gel with photon and electron beams is very similar in the lower dose region. The R2-dose response was linear up to 30Gy. In electron beams the R2-dose response for doses less than 3Gy is not exact, but in photon beams the R2-dose response for doses less than 2Gy is not exact. Dosimeter energy dependence was studied for electron energies of 4, 12 and 18MeV and photon energies of 1.25, 4, 6 and 18MV. Dose rate dependence was studied in 6MeV electron beam and 6MV photon beam with the use of dose rates 80, 160, 240, 320, 400, and 480cGy/min. Evaluation of dosimeters were performed on Siemens Symphony, Germany 1.5T Scanner in the head coil. In this study no trend in polymer-gel dosimeter 1/T2 dependence was found on mean dose rate and energy for electron and photon beams.

Keywords: polymer gels, PAGAT gel, electron and photon beams, MRI

Procedia PDF Downloads 453
61 Evaluation of Prevalence of the Types of Thyroid Disorders Using Ultrasound and Pathology of One-Humped Camel in Iran: Camelus dromedarius

Authors: M. Yadegari

Abstract:

The thyroid gland is the largest classic endocrine organ that effects many organs of the body and plays a significant role in the process of Metabolism in animals. The aim of this study was to investigate the prevalence of thyroid disorders diagnosed by ultrasound and microscopic Lesions of the thyroid during the slaughter of apparently healthy One Humped Camels (Camelus dromedarius) in Iran. Randomly, 520 male camels (With an age range of 4 to 8 years), were studied in 2012 to 2013. The Camels’ thyroid glands were evaluated by sonographic examination. In both longitudinal and transverse view and then tissue sections were provide and stained with H & E and finally examined by light microscopy. The results obtained indicated the following: hyperplastic goiter (21%), degenerative changes (12%), follicular cysts (8%), follicular atrophy (4%), nodular hyperplasia (3%), adenoma (1%), carcinoma (1%) and simple goiter colloid (1%). Ultrasound evaluation of thyroid gland in adenoma and carcinoma showed enlargement and irregular of the gland, decreased echogenicity, and the heterogeneous thyroid parenchyma. Also, in follicular cysts were observed in the enlarged gland with no echo structures of different sizes and decreased echogenicity as a local or general. In nodular hyperplasia, increase echogenicity and heterogeneous parenchymal were seen. These findings suggest the use of Ultrasound as a screening test in the diagnosis of complications of thyroid disorders. Pathology also to be used for the diagnosis of thyroid problems and other side effects.

Keywords: thyroid gland, one humped camel, sonography, pathology

Procedia PDF Downloads 482
60 Epicardial Fat Necrosis in a Young Female: A Case Report

Authors: Tayyibah Shah Alam, Joe Thomas, Nayantara Shenoy

Abstract:

Presenting a case that we would like to share, the answer is straight forward but the path taken to get to the diagnosis is where it gets interesting. A 31-year-old lady presented to the Rheumatology Outpatient department with left-sided chest pain associated with left-sided elbow joint pain intensifying over the last 2 days. She had been having a prolonged history of chest pain with minimal intensity since 2016. The pain is intermittent in nature. Aggravated while exerting, lifting heavy weights and lying down. Relieved while sitting. Her physical examination and laboratory tests were within normal limits. An electrocardiogram (ECG) showed normal sinus rhythm and a chest X-ray with no significant abnormality was noted. The primary suspicion was recurrent costochondritis. Cardiac blood inflammatory markers and Echo were normal, ruling out ACS. CT chest and MRI Thorax contrast showed small ill-defined STIR hyperintensity with thin peripheral enhancement in the anterior mediastinum in the left side posterior to the 5th costal cartilage and anterior to the pericardium suggestive of changes in the fat-focal panniculitis. Confirming the diagnosis as Epicardial fat necrosis. She was started on Colchicine and Nonsteroidal anti-inflammatory drugs for 2-3 weeks, following which a repeat CT showed resolution of the lesion and improvement in her. It is often under-recognized or misdiagnosed. CT scan was collectively used to establish the diagnosis. Making the correct diagnosis prospectively alleviates unnecessary testing in favor of conservative management.

Keywords: EFN, panniculitis, unknown etiology, recurrent chest pain

Procedia PDF Downloads 66
59 Efficacy of Heart Failure Reversal Treatment Followed by 90 Days Follow up in Chronic Heart Failure Patients with Low Ejection Fraction

Authors: Rohit Sane, Snehal Dongre, Pravin Ghadigaonkar, Rahul Mandole

Abstract:

The present study was designed to evaluate efficacy of heart failure reversal therapy (HFRT) that uses herbal procedure (panchakarma) and allied therapies, in chronic heart failure (CHF) patients with low ejection fraction. Methods: This efficacy study was conducted in CHF patients (aged: 25-65 years, ejection fraction (EF) < 30%) wherein HFRT (60-75 minutes) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara(concoction dripping treatment) and basti(enema) was administered twice daily for 7 days. During this therapy and next 30 days, patients followed the study dinarcharya and were prescribed ARJ kadha in addition to their conventional treatment. The primary endpoint of this study was evaluation of maximum aerobic capacity uptake (MAC) as assessed by 6-minute walk distance (6MWD) using Cahalins equation from baseline, at end of 7 day treatment, follow-up after 30 days and 90 days. EF was assessed by 2D Echo at baseline and after 30 days of follow-up. Results: CHF patients with < 30% EF (N=52, mean [SD] age: 58.8 [10.8], 85% men) were enrolled in the study. There was a 100% compliance to study therapy. A significant improvement was observed in MAC levels (7.11%, p =0.029), at end of 7 day therapy as compared to baseline. This improvement was maintained at two follow-up visits. Moreover, ejection fraction was observed to be increased by 6.38%, p=0,012 as compared to baseline at day 7 of the therapy. Conclusions: This 90 day follow up study highlights benefit of HFRT, as a part of maintenance treatment for CHF patients with reduced ejection fraction.

Keywords: chronic heart failure, functional capacity, heart failure reversal therapy, oxygen uptake, panchakarma

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58 Bio-Surfactant Production and Its Application in Microbial EOR

Authors: A. Rajesh Kanna, G. Suresh Kumar, Sathyanaryana N. Gummadi

Abstract:

There are various sources of energies available worldwide and among them, crude oil plays a vital role. Oil recovery is achieved using conventional primary and secondary recovery methods. In-order to recover the remaining residual oil, technologies like Enhanced Oil Recovery (EOR) are utilized which is also known as tertiary recovery. Among EOR, Microbial enhanced oil recovery (MEOR) is a technique which enables the improvement of oil recovery by injection of bio-surfactant produced by microorganisms. Bio-surfactant can retrieve unrecoverable oil from the cap rock which is held by high capillary force. Bio-surfactant is a surface active agent which can reduce the interfacial tension and reduce viscosity of oil and thereby oil can be recovered to the surface as the mobility of the oil is increased. Research in this area has shown promising results besides the method is echo-friendly and cost effective compared with other EOR techniques. In our research, on laboratory scale we produced bio-surfactant using the strain Pseudomonas putida (MTCC 2467) and injected into designed simple sand packed column which resembles actual petroleum reservoir. The experiment was conducted in order to determine the efficiency of produced bio-surfactant in oil recovery. The column was made of plastic material with 10 cm in length. The diameter was 2.5 cm. The column was packed with fine sand material. Sand was saturated with brine initially followed by oil saturation. Water flooding followed by bio-surfactant injection was done to determine the amount of oil recovered. Further, the injection of bio-surfactant volume was varied and checked how effectively oil recovery can be achieved. A comparative study was also done by injecting Triton X 100 which is one of the chemical surfactant. Since, bio-surfactant reduced surface and interfacial tension oil can be easily recovered from the porous sand packed column.

Keywords: bio-surfactant, bacteria, interfacial tension, sand column

Procedia PDF Downloads 381
57 An Interactive Institutional Framework for Evolution of Enterprise Technological Innovation Capabilities System: A Complex Adaptive Systems Approach

Authors: Sohail Ahmed, Ke Xing

Abstract:

This research theoretically explored the evolution mechanism of enterprise technological innovation capability system (ETICS) from the perspective of complex adaptive systems (CAS). This research proposed an analytical framework for ETICS, its concepts, and theory by integrating CAS methodology into the management of the technological innovation capability of enterprises and discusses how to use the principles of complexity to analyze the composition, evolution, and realization of the technological innovation capabilities in complex dynamic environments. This paper introduces the concept and interaction of multi-agent, the theoretical background of CAS, and summarizes the sources of technological innovation, the elements of each subject, and the main clusters of adaptive interactions and innovation activities. The concept of multi-agents is applied through the linkages of enterprises, research institutions, and government agencies with the leading enterprises in industrial settings. The study was exploratory and based on CAS theory. Theoretical model is built by considering technological and innovation literature from foundational to state of the art projects of technological enterprises. On this basis, the theoretical model is developed to measure the evolution mechanism of the enterprise's technological innovation capability system. This paper concludes that the main characteristics for evolution in technological systems are based on the enterprise’s research and development personnel, investments in technological processes, and innovation resources are responsible for the evolution of enterprise technological innovation performance. The research specifically enriched the application process of technological innovation in institutional networks related to enterprises.

Keywords: complex adaptive system, echo model, enterprise technological innovation capability system, research institutions, multi-agents

Procedia PDF Downloads 99
56 Effect of Depth on Texture Features of Ultrasound Images

Authors: M. A. Alqahtani, D. P. Coleman, N. D. Pugh, L. D. M. Nokes

Abstract:

In diagnostic ultrasound, the echo graphic B-scan texture is an important area of investigation since it can be analyzed to characterize the histological state of internal tissues. An important factor requiring consideration when evaluating ultrasonic tissue texture is the depth. The effect of attenuation with depth of ultrasound, the size of the region of interest, gain, and dynamic range are important variables to consider as they can influence the analysis of texture features. These sources of variability have to be considered carefully when evaluating image texture as different settings might influence the resultant image. The aim of this study is to investigate the effect of depth on the texture features in-vivo using a 3D ultrasound probe. The left leg medial head of the gastrocnemius muscle of 10 healthy subjects were scanned. Two regions A and B were defined at different depth within the gastrocnemius muscle boundary. The size of both ROI’s was 280*20 pixels and the distance between region A and B was kept constant at 5 mm. Texture parameters include gray level, variance, skewness, kurtosis, co-occurrence matrix; run length matrix, gradient, autoregressive (AR) model and wavelet transform were extracted from the images. The paired t –test was used to test the depth effect for the normally distributed data and the Wilcoxon–Mann-Whitney test was used for the non-normally distributed data. The gray level, variance, and run length matrix were significantly lowered when the depth increased. The other texture parameters showed similar values at different depth. All the texture parameters showed no significant difference between depths A and B (p > 0.05) except for gray level, variance and run length matrix (p < 0.05). This indicates that gray level, variance, and run length matrix are depth dependent.

Keywords: ultrasound image, texture parameters, computational biology, biomedical engineering

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55 Analgesic Efficacy of IPACK Block in Primary Total Knee Arthroplasty (90 CASES)

Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

Abstract:

 Background and aims: Peripheral regional anesthesia has been integrated into most analgesia protocols for total knee arthroplasty which considered among the most painful surgeries with a huge potential for chronicization. The adductor canal block (ACB) has gained popularity. Similarly, the IPACK block has been described to provide analgesia of the posterior knee capsule. This study aimed to evaluate the analgesic efficacy of this block in patients undergoing primary PTG. Methods: 90 patients were randomized to receive either an IPACK, an anterior sciatic block, or a sham block (30 patients in each group + multimodal analgesia and a catheter in the KCA adductor canal). GROUP 1 KCA GROUP 2 KCA+BSA GROUP 3 KCA+IPACK The analgesic blocks were done under echo-guidance preoperatively respecting the safety rules, the dose administered was 20 cc of ropivacaine 0.25% was used. We were to assess posterior knee pain 6 hours after surgery. Other endpoints included quality of recovery after surgery, pain scores, opioid requirements (PCA morphine)(EPI info 7.2 analysis). Results: -groups were matched -A predominance of women (4F/1H). -average age: 68 +/-7 years -the average BMI =31.75 kg/m2 +/- 4. -70% of patients ASA2 ,20% ASA3. -The average duration of the intervention: 89 +/- 19 minutes. -Morphine consumption (PCA) significantly higher in group 1 (16mg) & group 2 (8mg) group 3 (4mg) - The groups were matched . -There was a correlation between the use of the ipack block and postoperative pain Conclusions :In a multimodal analgesic protocol, the addition of IPACK block decreased pain scores and morphine consumption ,

Keywords: regional anesthesia, analgesia, total knee arthroplasty, the adductor canal block (acb), the ipack block, pain

Procedia PDF Downloads 41
54 A Multi-Cluster Enterprise Framework for Evolution of Knowledge System among Enterprises, Governments and Research Institutions

Authors: Sohail Ahmed, Ke Xing

Abstract:

This research theoretically explored the evolution mechanism of enterprise technological innovation capability system (ETICS) from the perspective of complex adaptive systems (CAS). Starting from CAS theory, this study proposed an analytical framework for ETICS, its concepts and theory by integrating CAS methodology into the management of technological innovation capability of enterprises and discusses how to use the principles of complexity to analyze the composition, evolution and realization of the technological innovation capabilities in complex dynamic environment. This paper introduces the concept and interaction of multi-agent, the theoretical background of CAS and summarizes the sources of technological innovation, the elements of each subject and the main clusters of adaptive interactions and innovation activities. The concept of multi-agents is applied through the linkages of enterprises, research institutions and government agencies with the leading enterprises in industrial settings. The study was exploratory based on CAS theory. Theoretical model is built by considering technological and innovation literature from foundational to state of the art projects of technological enterprises. On this basis, the theoretical model is developed to measure the evolution mechanism of enterprise technological innovation capability system. This paper concludes that the main characteristics for evolution in technological systems are based on enterprise’s research and development personal, investments in technological processes and innovation resources are responsible for the evolution of enterprise technological innovation performance. The research specifically enriched the application process of technological innovation in institutional networks related to enterprises.

Keywords: complex adaptive system, echo model, enterprise knowledge system, research institutions, multi-agents.

Procedia PDF Downloads 40
53 Clinical and Radiological Features of Adenomyosis and Its Histopathological Correlation

Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

Abstract:

Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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52 Puerto Rico and Pittsburg: A Social Psychology Perspective on How Perceived Infringement on Job and Cultural Identity Unite Racially Different Working-Class Groups

Authors: Reagan Rodriguez

Abstract:

With a growing divide between political echo chambers in the United States, exacerbated by race and income inequality, it might seem to be unfathomable to draw connections that tie working class in an industrial city and a U.S. territory. Yet, in regions where either the economy has been hit due to dwindling job infrastructure or natural disasters have left indelible marks on an island already once marked by colonial imperialism, a larger social shared identity is at play. Fracking has long been an intergenerational and stable work opportunity for many in the Pittsburg PA, yet the rising severity of global climate change may soon impact the policy and even presidential elections which could result in the reduction of jobs in the industry. Cock-fighting, considered a cultural mainstay within the island of Puerto Rico, has already had legislation banning activity and thus cutting out one of the most lucrative aspects of a severely injured economy. Insecurity, infringement, and isolation while being tied to a working-class bracket with no other opportunities in proximity have left both groups expressing similar frustration and while another larger shared identity politic is giving little other options to develop social mobility. This paper utilizes a thematic analysis and compares convergent and divergent themes on internet forums amongst unionized fracking workers in Pittsburg and cockfighters in Puerto Rico. This research examines how group identity in relation to job and cultural identity is most strong and at which points its most malleable; when intergenerational job identity becomes a part of one’s cultural identity, its override may be strongest when it is perceived as threatened. Final findings and limitations were comprehensively outlined.

Keywords: identity threat, social psychology, group identity, culture and social mobility

Procedia PDF Downloads 127
51 Cardiovascular Disease Is Common among Patients with Systemic Lupus Erythematosus

Authors: Fathia Ehmouda Zaid, Reim Abudelnbi

Abstract:

Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Patients and method: Cross-section study (68) patients diagnosed as systemic lupus erythematosus (SLE), who visited the outpatient clinic of rheumatology, these patients were interviewed with a structured questionnaire about their past and current clinically for presence of Cardiovascular disease in systemic lupus and use SLEDAI, specific tests [ECG –ECHO –CXRAY] the data are analyzed statistically by Pearson's correlation coefficient was calculated and statistical significance was defined as P< 0.05,during period (2013-2014). Objective: Estimation Cardiovascular disease manifestation of systemic lupus erythematosus, correlation with disease activity, morbidity, and mortality. Result: (68) Patients diagnosed as systemic lupus erythematosus' age range from (18-48 years), M=(13±29Y), Sex were female 66/68 (97.1%), male 2/68 (2.9%),duration of disease range[1-15year], M =[7±8y], we found Cardiovascular disease manifestation of systemic lupus erythematosus 32/68 (47.1%), correlation with disease activity use SLEDAI,(r= 476** p=0.000),Morbidity,(r= .554**; p=0.000) and mortality (r=.181; p=.139), Cardiovascular disease manifestations of systemic lupus erythematosus are pericarditis 8/68 (11.8%), pericardial effusion 6/68 (8.8%), myocarditis 4/68 (5.9 %), valvular lesions (endocarditis) 1/68 (1.5%), pulmonary hypertension (PAH) 12/68 (17.6%), coronary artery disease 1/68 (1.5%), none of patients have conduction abnormalities involvement. Correlation with disease activity use SLEDAI, pericarditis (r= .210, p=.086), pericardial effusion (r= 0.079, p=.520), myocarditis (r= 272*, p=.027), valvular lesions (endocarditis) (r= .112, p= .362), pulmonary hypertension (PAH) (r= .257*, p=.035) and coronary artery disease (r=.075, p=.544) correlation between cardiovascular disease manifestations of systemic lupus erythematosus and specific organ involvement we found Mucocutaneous (r=.091 p= .459), musculoskeletal (MSK) (r=.110 p=.373), Renal disease (r=.278*, p=.022), neurologic disease (r=.085, p=.489) and Hematologic disease (r=-.264*, p=.030). Conclusion: Cardiovascular manifestation is more frequent symptoms with systemic lupus erythematosus (SLE) is 47 % correlation with disease activity and morbidity but not with mortality. Recommendations: Focus research to evaluation and an adequate assessment of cardiovascular complications on the morbidity and mortality of the patients with SLE are still required.

Keywords: cardiovascular disease, systemic lupus erythematosus, disease activity, mortality

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50 Misdiagnosed Mammary Analogue Secretory Carcinoma of the Salivary Gland: A Case Report with a Review of the Literature

Authors: Yaya Gao, Jifeng Liu, Yafeng Liu

Abstract:

Objectives: This study aimed to improve clinicians' understanding and diagnosis of the Mammary analogue secretory carcinoma of the salivary gland(MASC). Methods: The clinical features of a MASC patient who was admitted to WestChina Hospital of Sichuan University in July 2020 were reviewed and analyzed. A 49-year-old woman with left upper neck pain for three months was admitted to the hospital. She underwent adenoma resection of the left submandibular gland 14 years ago and mucoepidermoid carcinoma resection surgery five years ago. Three months before admission, the patient developed pain in the left mandibular angle after "fatigue" and gradually developed radiation pain in the left ear, which could be relieved after rest. A mass of 1cm could be touched at the mandibular, with tenderness, poor mobility, and hard texture. No swelling, heat, pain, rupture, or pus was found on the surrounding skin. Color doppler ultrasonography of the salivary gland indicated a weak echo mass of 23*14*17mm in the left parotid gland. Results: Surgical excision was completed. Immunohistochemistry of the tumor samples after operation showed that P63(a few,+), CK7(+), S100(+), DOG1(-), Ki67(MIB-1)(+,5%),pan-TRK(+), PAS(+) . ETV-6 gene translocation was detected in FISH in postoperative pathology, which indicated MASC. After this diagnosis, the patient sent the postoperative specimen of the second submandibular tumor to our hospital for consultation. The morphology of the two was similar. FISH detected ETV-6 gene translocation, so the second pathological diagnosis was revised to MASC. Conclusion: MASC of the salivary gland is a rare salivary gland tumor whose diagnosis depends on the result of the ETV6-NTRK3 fusion gene.

Keywords: mammary analogue secretory carcinoma, ETV6-NTRK3, salivary gland, misdiagnosed

Procedia PDF Downloads 43
49 Experimental Validation of Computational Fluid Dynamics Used for Pharyngeal Flow Patterns during Obstructive Sleep Apnea

Authors: Pragathi Gurumurthy, Christina Hagen, Patricia Ulloa, Martin A. Koch, Thorsten M. Buzug

Abstract:

Obstructive sleep apnea (OSA) is a sleep disorder where the patient suffers a disturbed airflow during sleep due to partial or complete occlusion of the pharyngeal airway. Recently, numerical simulations have been used to better understand the mechanism of pharyngeal collapse. However, to gain confidence in the solutions so obtained, an experimental validation is required. Therefore, in this study an experimental validation of computational fluid dynamics (CFD) used for the study of human pharyngeal flow patterns during OSA is performed. A stationary incompressible Navier-Stokes equation solved using the finite element method was used to numerically study the flow patterns in a computed tomography-based human pharynx model. The inlet flow rate was set to 250 ml/s and such that a flat profile was maintained at the inlet. The outlet pressure was set to 0 Pa. The experimental technique used for the validation of CFD of fluid flow patterns is phase contrast-MRI (PC-MRI). Using the same computed tomography data of the human pharynx as in the simulations, a phantom for the experiment was 3 D printed. Glycerol (55.27% weight) in water was used as a test fluid at 25°C. Inflow conditions similar to the CFD study were simulated using an MRI compatible flow pump (CardioFlow-5000MR, Shelley Medical Imaging Technologies). The entire experiment was done on a 3 T MR system (Ingenia, Philips) with 108 channel body coil using an RF-spoiled, gradient echo sequence. A comparison of the axial velocity obtained in the pharynx from the numerical simulations and PC-MRI shows good agreement. The region of jet impingement and recirculation also coincide, therefore validating the numerical simulations. Hence, the experimental validation proves the reliability and correctness of the numerical simulations.

Keywords: computational fluid dynamics, experimental validation, phase contrast-MRI, obstructive sleep apnea

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48 Alcohol Septal Ablation in a 19-Year-Old with Hypertrophic Obstructive Cardiomyopathy Patient: A Case Report

Authors: Christine Ysabelle G. Roman, Pauline Torres

Abstract:

Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

Procedia PDF Downloads 52
47 A Rare Entity: Case Report on Anaesthetic Management in Robinow Syndrome

Authors: Vidhi Chandra, Arshpreet Singh Grewal

Abstract:

A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

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46 Practice Educators' Perspective: Placement Challenges in Social Work Education in England

Authors: Yuet Wah Echo Yeung

Abstract:

Practice learning is an important component of social work education. Practice educators are charged with the responsibility to support and enable learning while students are on placement. They also play a key role in teaching students to integrate theory and practice, as well as assessing their performance. Current literature highlights the structural factors that make it difficult for practice educators to create a positive learning environment for students. Practice educators find it difficult to give sufficient attention to their students because of the lack of workload relief, the increasing emphasis on managerialism and bureaucratisation, and a range of competing organisational and professional demands. This paper reports the challenges practice educators face and how they manage these challenges in this context. Semi-structured face-to-face interviews were conducted with thirteen practice educators who support students in statutory and voluntary social care settings in the Northwest of England. Interviews were conducted between April and July 2017 and each interview lasted about 40 minutes. All interviews were recorded and transcribed. All practice educators are experienced social work practitioners with practice experience ranging from 6 to 42 years. On average they have acted as practice educators for 13 years and all together have supported 386 students. Our findings reveal that apart from the structural factors that impact how practice educators perform their roles, they also faced other challenges when supporting students on placement. They include difficulty in engaging resistant students, complexity in managing power dynamics in the context of practice learning, and managing the dilemmas of fostering a positive relationship with students whilst giving critical feedback. Suggestions to enhance the practice educators’ role include support from organisations and social work teams; effective communication with university tutors, and a forum for practice educators to share good practice and discuss placement issues.

Keywords: social work education, placement challenges, practice educator, practice learning

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45 Drug-Based Nanoparticles: Comparative Study of the Effect Drug Type on Release Kinetics and Cell Viability

Authors: Chukwudalu C. Nwazojie, Wole W. Soboyejo, John Obayemi, Ali Salifu Azeko, Sandra M. Jusu, Chinyerem M. Onyekanne

Abstract:

The conventional methods for the diagnosis and treatment of breast cancer include bulk systematic mammography, ultrasound, dynamic contrast-enhanced fast 3D gradient-echo (GRE) magnetic resonance imaging (MRI), surgery, chemotherapy, and radiotherapy. However, nanoparticles and drug-loaded polymer microspheres for disease (cancer) targeting and treatment have enormous potential to enhance the approaches that are used today. The goal is to produce an implantable biomedical device for localized breast cancer drug delivery within Africa and the world. The main advantage of localized delivery is that it reduces the amount of drug that is needed to have a therapeutic effect. Polymer blends of poly (D,L-lactide-co-glycolide) (PLGA) and polycaprolactone (PCL), which are biodegradable, is used as a drug excipient. This work focuses on the development of PLGA-PCL (poly (D,L-lactide-co-glycolide) (PLGA) blended with based injectable drug microspheres and are loaded with anticancer drugs (prodigiosin (PG), and paclitaxel (PTX) control) and also the conjugated forms of the drug functionalized with LHRH (luteinizing hormone-releasing hormone) (PG-LHRH, and PTX- LHRH control), using a single-emulsion solvent evaporation technique. The encapsulation was done in the presence of PLGA-PCL (as a polymer matrix) and poly-(vinyl alcohol) (PVA) (as an emulsifier). Comparative study of the various drugs release kinetics and degradation mechanisms of the PLGA-PCL with an encapsulated drug is achieved, and the implication of this study is for the potential application of prodigiosin PLGA-PCL loaded microparticles for controlled delivery of cancer drug and treatment to prevent the regrowth or locoregional recurrence, following surgical resection of triple-negative breast tumor.

Keywords: cancer, polymers, drug kinetics, nanoparticles

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44 Evaluation of Hepatic Metabolite Changes for Differentiation Between Non-Alcoholic Steatohepatitis and Simple Hepatic Steatosis Using Long Echo-Time Proton Magnetic Resonance Spectroscopy

Authors: Tae-Hoon Kim, Kwon-Ha Yoon, Hong Young Jun, Ki-Jong Kim, Young Hwan Lee, Myeung Su Lee, Keum Ha Choi, Ki Jung Yun, Eun Young Cho, Yong-Yeon Jeong, Chung-Hwan Jun

Abstract:

Purpose: To assess the changes of hepatic metabolite for differentiation between non-alcoholic steatohepatitis (NASH) and simple steatosis on proton magnetic resonance spectroscopy (1H-MRS) in both humans and animal model. Methods: The local institutional review board approved this study and subjects gave written informed consent. 1H-MRS measurements were performed on a localized voxel of the liver using a point-resolved spectroscopy (PRESS) sequence and hepatic metabolites of alanine (Ala), lactate/triglyceride (Lac/TG), and TG were analyzed in NASH, simple steatosis and control groups. The group difference was tested with the ANOVA and Tukey’s post-hoc tests, and diagnostic accuracy was tested by calculating the area under the receiver operating characteristics (ROC) curve. The associations between metabolic concentration and pathologic grades or non-alcoholic fatty liver disease(NAFLD) activity scores were assessed by the Pearson’s correlation. Results: Patient with NASH showed the elevated Ala(p<0.001), Lac/TG(p < 0.001), TG(p < 0.05) concentration when compared with patients who had simple steatosis and healthy controls. The NASH patients were higher levels in Ala(mean±SEM, 52.5±8.3 vs 2.0±0.9; p < 0.001), Lac/TG(824.0±168.2 vs 394.1±89.8; p < 0.05) than simple steatosis. The area under the ROC curve to distinguish NASH from simple steatosis was 1.00 (95% confidence interval; 1.00, 1.00) with Ala and 0.782 (95% confidence interval; 0.61, 0.96) with Lac/TG. The Ala and Lac/TG levels were well correlated with steatosis grade, lobular inflammation, and NAFLD activity scores. The metabolic changes in human were reproducible to a mice model induced by streptozotocin injection and a high-fat diet. Conclusion: 1H-MRS would be useful for differentiation of patients with NASH and simple hepatic steatosis.

Keywords: non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, 1H MR spectroscopy, hepatic metabolites

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43 Foucault and the Archaeology of Transhumanism

Authors: Michel Foucault, Friedrich Nietzsche, Max More, Natasha Vita-More, Francesca Ferrando

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During the early part of his intellectual and academic career (1950s and 1960s), Michel Foucault developed an interest for what we can call the ‘anthropological question’, or how our modernity deals with human nature from an epistemological standpoint. The great originality of Foucault’s thought here lies in the fact that he approaches this question not from the perspective of this ‘sovereign subject’ (that has characterized the History of Western thought) he wishes to disclose and ‘denounce’, but rather at the level of discourses and the way they constitute who we are, so to speak. This led him, in turn, to formulate a series of though-provoking statements during his so-called ‘archaeological period’ of the 1960s concerning what we call ‘man’ in the West, such as that he is an ‘invention of recent date’ (as a proper object of concern and reflection), and, perhaps more importantly, that he might disappear in the near future, ‘like a face drawn in sand at the edge of the sea’. Foucault is following on the footsteps of Nietzsche in that regard, who had famously announced in the 19th ce. the ‘death of God’ and the need for the future generations to surpass (so to speak) the traditional ‘Christian-centred’ Western conception of the human. While Foucault exposed such insights more than half a century ago, they appear to be more actual than ever today with the development and rise in popularity of intellectual movements such as Transhumanism and Posthumanism, which seek to question and propose an alternative to the concepts of ‘man’ or ‘human nature’ in our culture. They rely for that on the same assumption as Foucault and Nietzsche that those concepts (and the meaning we attribute to them) have become ‘obsolete’ as it is and thus must be overcome (at a conceptual, but also a more practical level). Hence, those movements not only echo the important Foucauldian reflection of the 1950s and 1960s on the ‘anthropological question’ but seem to have been literally announced by it, so to speak. The aim of this paper will therefore be to show the relevance of Foucault (and in particular his archaeological method) in understanding the nature of Transhumanism (and Posthumanism), for instance, by analysing and assessing it as a form of discourse that is literally reshaping the way we understand ourselves as human beings in our (post)modern age, drawing for that on a number of key texts including from the early productions of Foucault.

Keywords: foucault, nietzsche, archaeology, transhumanism, posthumanism

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42 Working with Interpreters: Using Role Play to Teach Social Work Students

Authors: Yuet Wah Echo Yeung

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Working with people from minority ethnic groups, refugees and asylum seeking communities who have limited proficiency in the language of the host country often presents a major challenge for social workers. Because of language differences, social workers need to work with interpreters to ensure accurate information is collected for their assessment and intervention. Drawing from social learning theory, this paper discusses how role play was used as an experiential learning exercise in a training session to help social work students develop skills when working with interpreters. Social learning theory posits that learning is a cognitive process that takes place in a social context when people observe, imitate and model others’ behaviours. The roleplay also helped students understand the role of the interpreter and the challenges they may face when they rely on interpreters to communicate with service users and their family. The first part of the session involved role play. A tutor played the role of social worker and deliberately behaved in an unprofessional manner and used inappropriate body language when working alongside the interpreter during a home visit. The purpose of the roleplay is not to provide a positive role model for students to ‘imitate’ social worker’s behaviours. Rather it aims to active and provoke internal thinking process and encourages students to critically consider the impacts of poor practice on relationship building and the intervention process. Having critically reflected on the implications for poor practice, students were then asked to play the role of social worker and demonstrate what good practice should look like. At the end of the session, students remarked that they learnt a lot by observing the good and bad example; it showed them what not to do. The exercise served to remind students how practitioners can easily slip into bad habits and of the importance of respect for the cultural difference when working with people from different cultural backgrounds.

Keywords: role play, social learning theory, social work practice, working with interpreters

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41 An Echo of Eco: Investigating the Effectiveness of Eco-Friendly Advertising Media of Fashion Brand Communication

Authors: Vaishali Joshi

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In the past, companies and buyers operated as if there was infinite availability of natural resources for usage, which has resulted in the loss of our globe's natural ecosystem. People's consciousness of ecological concerns had increased, which showed the way for the evolution of the green revolution with the objective of discontinuing the use of products that are harmful to the ecosystem of the earth. This green revolution has made the consumers head toward those companies which are providing eco-friendly products s/service s through less eco-harmful ways. Studies show that companies started gaining a reputation in the market through their eco-friendly activities in their business. Hence companies should be alert to understand the consumer's environmentally friendly consumption behavior to survive and be in the game of the competition. Green marketing efforts guarantee beneficial exchanges without harmful consequences for current and /or upcoming generations. This hits the green policies of those companies which are claiming environmental concern. This means that these companies not only focus on the impact of their production and products on the ecosystem but also on every small activity in their value chain. One of the most ignored parts of the value chain is the medium through which the marketing of products/services is done. These companies should also take into account to what degree their selection of advertising media affects the ecosystem of the earth. In this study, a hypothetical fashion apparel brand known as "Dolphin" will be studied. In particular, the following objectives are framed: i) to study the brand attitude of the given fashion brand due to its selection of eco-friendly advertising medium ii) to study the advertisement attitude of the given fashion brand due to its selection of eco-friendly advertising medium and iii) to study the purchase intention of the given fashion brand due to its selection of eco-friendly advertising medium. An online experiment will be conducted. Respondents between the ages of 20-and 64 years will be selected randomly from the online consumer panel database. The findings of this study will have a great impact on the companies that are claiming environmental concerns by understanding how the advertising media is affecting the company’s brand image in the long run.

Keywords: eco-friendly advertising media, fashion, attitude, purchase intention

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40 In vitro Characterization of Mice Bone Microstructural Changes by Low-Field and High-Field Nuclear Magnetic Resonance

Authors: Q. Ni, J. A. Serna, D. Holland, X. Wang

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The objective of this study is to develop Nuclear Magnetic Resonance (NMR) techniques to enhance bone related research applied on normal and disuse (Biglycan knockout) mice bone in vitro by using both low-field and high-field NMR simultaneously. It is known that the total amplitude of T₂ relaxation envelopes, measured by the Carr-Purcell-Meiboom-Gill NMR spin echo train (CPMG), is a representation of the liquid phase inside the pores. Therefore, the NMR CPMG magnetization amplitude can be transferred to the volume of water after calibration with the NMR signal amplitude of the known volume of the selected water. In this study, the distribution of mobile water, porosity that can be determined by using low-field (20 MHz) CPMG relaxation technique, and the pore size distributions can be determined by a computational inversion relaxation method. It is also known that the total proton intensity of magnetization from the NMR free induction decay (FID) signal is due to the water present inside the pores (mobile water), the water that has undergone hydration with the bone (bound water), and the protons in the collagen and mineral matter (solid-like protons). Therefore, the components of total mobile and bound water within bone that can be determined by low-field NMR free induction decay technique. Furthermore, the bound water in solid phase (mineral and organic constituents), especially, the dominated component of calcium hydroxyapatite (Ca₁₀(OH)₂(PO₄)₆) can be determined by using high-field (400 MHz) magic angle spinning (MAS) NMR. With MAS technique reducing NMR spectral linewidth inhomogeneous broadening and susceptibility broadening of liquid-solid mix, in particular, we can conduct further research into the ¹H and ³¹P elements and environments of bone materials to identify the locations of bound water such as OH- group within minerals and bone architecture. We hypothesize that with low-field and high-field magic angle spinning NMR can provide a more complete interpretation of water distribution, particularly, in bound water, and these data are important to access bone quality and predict the mechanical behavior of bone.

Keywords: bone, mice bone, NMR, water in bone

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39 Multiphase Flow Regime Detection Algorithm for Gas-Liquid Interface Using Ultrasonic Pulse-Echo Technique

Authors: Serkan Solmaz, Jean-Baptiste Gouriet, Nicolas Van de Wyer, Christophe Schram

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Efficiency of the cooling process for cryogenic propellant boiling in engine cooling channels on space applications is relentlessly affected by the phase change occurs during the boiling. The effectiveness of the cooling process strongly pertains to the type of the boiling regime such as nucleate and film. Geometric constraints like a non-transparent cooling channel unable to use any of visualization methods. The ultrasonic (US) technique as a non-destructive method (NDT) has therefore been applied almost in every engineering field for different purposes. Basically, the discontinuities emerge between mediums like boundaries among different phases. The sound wave emitted by the US transducer is both transmitted and reflected through a gas-liquid interface which makes able to detect different phases. Due to the thermal and structural concerns, it is impractical to sustain a direct contact between the US transducer and working fluid. Hence the transducer should be located outside of the cooling channel which results in additional interfaces and creates ambiguities on the applicability of the present method. In this work, an exploratory research is prompted so as to determine detection ability and applicability of the US technique on the cryogenic boiling process for a cooling cycle where the US transducer is taken place outside of the channel. Boiling of the cryogenics is a complex phenomenon which mainly brings several hindrances for experimental protocol because of thermal properties. Thus substitute materials are purposefully selected based on such parameters to simplify experiments. Aside from that, nucleate and film boiling regimes emerging during the boiling process are simply simulated using non-deformable stainless steel balls, air-bubble injection apparatuses and air clearances instead of conducting a real-time boiling process. A versatile detection algorithm is perennially developed concerning exploratory studies afterward. According to the algorithm developed, the phases can be distinguished 99% as no-phase, air-bubble, and air-film presences. The results show the detection ability and applicability of the US technique for an exploratory purpose.

Keywords: Ultrasound, ultrasonic, multiphase flow, boiling, cryogenics, detection algorithm

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38 Computed Tomography Myocardial Perfusion on a Patient with Hypertrophic Cardiomyopathy

Authors: Jitendra Pratap, Daphne Prybyszcuk, Luke Elliott, Arnold Ng

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Introduction: Coronary CT angiography is a non-invasive imaging technique for the assessment of coronary artery disease and has high sensitivity and negative predictive value. However, the correlation between the degree of CT coronary stenosis and the significance of hemodynamic obstruction is poor. The assessment of myocardial perfusion has mostly been undertaken by Nuclear Medicine (SPECT), but it is now possible to perform stress myocardial CT perfusion (CTP) scans quickly and effectively using CT scanners with high temporal resolution. Myocardial CTP is in many ways similar to neuro perfusion imaging technique, where radiopaque iodinated contrast is injected intravenously, transits the pulmonary and cardiac structures, and then perfuses through the coronary arteries into the myocardium. On the Siemens Force CT scanner, a myocardial perfusion scan is performed using a dynamic axial acquisition, where the scanner shuffles in and out every 1-3 seconds (heart rate dependent) to be able to cover the heart in the z plane. This is usually performed over 38 seconds. Report: A CT myocardial perfusion scan can be utilised to complement the findings of a CT Coronary Angiogram. Implementing a CT Myocardial Perfusion study as part of a routine CT Coronary Angiogram procedure provides a ‘One Stop Shop’ for diagnosis of coronary artery disease. This case study demonstrates that although the CT Coronary Angiogram was within normal limits, the perfusion scan provided additional, clinically significant information in regards to the haemodynamics within the myocardium of a patient with Hypertrophic Obstructive Cardio Myopathy (HOCM). This negated the need for further diagnostics studies such as cardiac ECHO or Nuclear Medicine Stress tests. Conclusion: CT coronary angiography with adenosine stress myocardial CTP was utilised in this case to specifically exclude coronary artery disease in conjunction with accessing perfusion within the hypertrophic myocardium. Adenosine stress myocardial CTP demonstrated the reduced myocardial blood flow within the hypertrophic myocardium, but the coronary arteries did not show any obstructive disease. A CT coronary angiogram scan protocol that incorporates myocardial perfusion can provide diagnostic information on the haemodynamic significance of any coronary artery stenosis and has the potential to be a “One Stop Shop” for cardiac imaging.

Keywords: CT, cardiac, myocardium, perfusion

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37 Exploring the History of Chinese Music Acoustic Technology through Data Fluctuations

Authors: Yang Yang, Lu Xin

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The study of extant musical sites can provide a side-by-side picture of historical ethnomusicological information. In their data collection on Chinese opera houses, researchers found that one Ming Dynasty opera house reached a width of nearly 18 meters, while all opera houses of the same period and after it was far from such a width, being significantly smaller than 18 meters. The historical transient fluctuations in the data dimension of width that caused Chinese theatres to fluctuate in the absence of construction scale constraints have piqued the interest of researchers as to why there is data variation in width. What factors have contributed to the lack of further expansion in the width of theatres? To address this question, this study used a comparative approach to conduct a venue experiment between this theater stage and another theater stage for non-heritage opera performances, collecting the subjective perceptions of performers and audiences at different theater stages, as well as combining BK Connect platform software to measure data such as echo and delay. From the subjective and objective results, it is inferred that the Chinese ancients discovered and understood the acoustical phenomenon of the Haas effect by exploring the effect of stage width on musical performance and appreciation of listening states during the Ming Dynasty and utilized this discovery to serve music in subsequent stage construction. This discovery marked a node of evolution in Chinese architectural acoustics technology driven by musical demands. It is also instructive to note that, in contrast to many of the world's "unsuccessful civilizations," China can use a combination of heritage and intangible cultural research to chart a clear, demand-driven course for the evolution of human music technology, and that the findings of such research will complete the course of human exploration of music acoustics. The findings of such research will complete the journey of human exploration of music acoustics, and this practical experience can be applied to the exploration and understanding of other musical heritage base data.

Keywords: Haas effect, musical acoustics, history of acoustical technology, Chinese opera stage, structure

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36 Role of Tele-health in Expansion of Medical Care

Authors: Garima Singh, Kunal Malhotra

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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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35 Berberine Ameliorates Glucocorticoid-Induced Hyperglycemia: An In-Vitro and In-Vivo Study

Authors: Mrinal Gupta, Mohammad Rumman, Babita Singh Abbas Ali Mahdi, Shivani Pandey

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Introduction: Berberine (BBR), a bioactive compound isolated from Coptidis Rhizoma, possesses diverse pharmacological activities, including anti-bacterial, anti-inflammatory, antitumor, hypolipidemic, and anti-diabetic. However, its role as an anti-diabetic agent in animal models of dexamethasone (Dex)-induced diabetes remains unknown. Studies have shown that natural compounds, including aloe, caper, cinnamon, cocoa, green and black tea, and turmeric, can be used for treating Type 2 diabetes mellitus (DM). Compared to conventional drugs, natural compounds have fewer side effects and are easily available. Herein, we studied the anti-diabetic effects of BBR in a mice model of Dex-induced diabetes. Methods: HepG2 cell line was used for glucose release and glycogen synthesis studies. Cell proliferation was measured by methylthiotetrazole (MTT) assay. For animal studies, mice were treated with Dex (2 mg/kg, i.m.) for 30 days and the effect of BBR at the doses 100, 200, and 500 mg/kg (p.o.) was analyzed. Glucose, insulin, and pyruvate tests were performed to evaluate the development of the diabetic model. An echo MRI was performed to assess the fat mass. Further, to elucidate the mechanism of action of BBR, mRNA expression of genes regulating gluconeogenesis, glucose uptake, and glycolysis were analyzed. Results: In vitro BBR had no impact on cell viability up to a concentration of 50μM. Moreover, BBR suppressed the hepatic glucose release and improved glucose tolerance in HepG2 cells. In vivo, BBR improved glucose homeostasis in diabetic mice, as evidenced by enhanced glucose clearance, increased glycolysis, elevated glucose uptake, and decreased gluconeogenesis. Further, Dex treatment increased the total fat mass in mice, which was ameliorated by BBR treatment. Conclusion: BBR improves glucose tolerance by increasing glucose clearance, inhibiting hepatic glucose release, and decreasing obesity. Thus, BBR may become a potential therapeutic agent for treating glucocorticoid-induced diabetes and obesity in the future.

Keywords: glucocorticoid, hyperglycemia, berberine, HepG2 cells, insulin resistance, glucose

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

Authors: Matheus Madureira Matos, Alexandre Rodrigues Farias

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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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