Search results for: dilatation curve
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1067

Search results for: dilatation curve

797 Neuroimaging Markers for Screening Former NFL Players at Risk for Developing Alzheimer's Disease / Dementia Later in Life

Authors: Vijaykumar M. Baragi, Ramtilak Gattu, Gabriela Trifan, John L. Woodard, K. Meyers, Tim S. Halstead, Eric Hipple, Ewart Mark Haacke, Randall R. Benson

Abstract:

NFL players, by virtue of their exposure to repetitive head injury, are at least twice as likely to develop Alzheimer's disease (AD) and dementia as the general population. Early recognition and intervention prior to onset of clinical symptoms could potentially avert/delay the long-term consequences of these diseases. Since AD is thought to have a long preclinical incubation period, the aim of the current research was to determine whether former NFL players, referred to a depression center, showed evidence of incipient dementia in their structural imaging prior to diagnosis of dementia. Thus, to identify neuroimaging markers of AD, against which former NFL players would be compared, we conducted a comprehensive volumetric analysis using a cohort of early stage AD patients (ADNI) to produce a set of brain regions demonstrating sensitivity to early AD pathology (i.e., the “AD fingerprint”). A cohort of 46 former NFL players’ brain MRIs were then interrogated using the AD fingerprint. Brain scans were done using a T1-weighted MPRAGE sequence. The Free Surfer image analysis suite (version 6.0) was used to obtain the volumetric and cortical thickness data. A total of 55 brain regions demonstrated significant atrophy or ex vacuo dilatation bilaterally in AD patients vs. healthy controls. Of the 46 former NFL players, 19 (41%) demonstrated a greater than expected number of atrophied/dilated AD regions when compared with age-matched controls, presumably reflecting AD pathology.

Keywords: alzheimers, neuroimaging biomarkers, traumatic brain injury, free surfer, ADNI

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796 Antecedents of MNE Performance and Managing Firm-Specific and Country-Specific Advantages: An Empirical Study of Optoelectronics Industry in Taiwan

Authors: Jyh-Yi Shih, Chie-Bein Chen, Kuang-Yi Lin, Yu-Wei Huang

Abstract:

Because of the trend toward globalization, Taiwanese companies have gradually focused more on overseas market operations. Overseas market performance has gradually increased as a proportion of Taiwanese companies’ total business revenues. Existing international investment theories cannot explain numerous new phenomena in this domain. Opinions are inconsistent, and contradictory positions exist regarding the antecedents of multinational enterprise (MNE) performance. This study applied contemporary internalization theory to establish and extend approaches adopted by previous relevant studies. In the context of the overseas market, the influence that MNE investment in research and development (R&D) and marketing has on enterprise performance was investigated from the firm-specific advantages (FSAs) and country-specific advantages (CSAs) perspectives. CSAs and internationalization speed were addressed as moderators, and hypotheses regarding how internationalization and performance were achieved through MNE overseas market operation were explored to ensure the completeness of the investigation. The list of enterprises was sourced from the Taiwan Economic Journal. After examining the relevant data, the following conclusions were obtained: (a) The relationship between the level of FSAs in R&D and enterprise performance exhibited an S-shaped curve. (b) The relationship between the level of FSAs in marketing and enterprise performance displayed a U-shaped curve. (c) The extent to which potential CFAs were obtained positively moderated the relationship between enterprise investment in R&D to gain FSAs and MNE performance. (d) Internationalization speed positively moderated the relationship between MNEs and enterprise investment in R&D and marketing to gain FSAs.

Keywords: multinational corporation, firm-specific advantages, country-specific advantages, international speed

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795 How Hormesis Impacts Practice of Ecological Risk Assessment and Food Safety Assessment

Authors: Xiaoxian Zhang

Abstract:

Guidelines of ecological risk assessment (ERA) and food safety assessment (FSA) used nowadays, based on an S-shaped threshold dose-response curve (SDR), fail to consider hormesis, a reproducible biphasic dose-response model represented as a J-shaped or an inverted U-shaped curve, that occurs in the real-life environment across multitudinous compounds on cells, organisms, populations, and even the ecosystem. Specifically, in SDR-based ERA and FSA practice, predicted no effect concentration (PNEC) is calculated separately for individual substances from no observed effect concentration (NOEC, usually equivalent to 10% effect concentration (EC10) of a contaminant or food condiment) over an assessment coefficient that is bigger than 1. Experienced researchers doubted that hormesis in the real-life environment might lead to a waste of limited human and material resources in ERA and FSA practice, but related data are scarce. In this study, hormetic effects on bioluminescence of Aliivibrio fischeri (A. f) induced by sulfachloropyridazine (SCP) under 40 conditions to simulate the real-life scenario were investigated, and hormetic effects on growth of human MCF-7 cells caused by brown sugar and mascavado sugar were found likewise. After comparison of related parameters, it has for the first time been proved that there is a 50% probability for safe concentration (SC) of contaminants and food condiments to fall within the hormetic-stimulatory range (HSR) or left to HSR, revealing the unreliability of traditional parameters in standardized (eco)toxicological studies, and supporting qualitatively and quantitatively the over-strictness of ERA and FSA resulted from misuse of SDR. This study provides a novel perspective for ERA and FSA practitioners that hormesis should dominate and conditions where SDR works should only be singled out on a specific basis.

Keywords: dose-response relationship, food safety, ecological risk assessment, hormesis

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794 Characterization of Fe Doped ZnO Synthesised by Sol-Gel and Combustion Routes

Authors: M. Ravindiran, P. Shankar

Abstract:

This paper deals with the comparison of two synthesis methods, namely, sol-gel, and combustion to prepare Fe doped ZnO nano material. Characterization results for structural, optical and magnetic properties were analyzed for the sol gel and combustion synthesis derived materials. Magnetic studies of the prepared compounds reveal that the combustion synthesis derived material has good magnetization of 50 emu/gm with a better hysteresis loop curve.

Keywords: DMS, combustion, ferromagnetic, synthesis methods

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793 Design and Analysis of Semi-Active Isolation System in Low Frequency Excitation Region for Vehicle Seat to Reduce Discomfort

Authors: Andrea Tonoli, Nicola Amati, Maria Cavatorta, Reza Mirsanei, Behzad Mozaffari, Hamed Ahani, Akbar Karamihafshejani, Mohammad Ghazivakili, Mohammad Abuabiah

Abstract:

The vibrations transmitted to the drivers and passengers through vehicle seat seriously effect on the level of their attention, fatigue and physical health and reduce the comfort and efficiency of the occupants. Recently, some researchers have focused on vibrations at low excitation frequency(0.5-5 Hz) which are considered to be the main risk factors for lumbar part of the backbone but they were not applicable to A and B-segment cars regarding to the size and weight. A semi-active system with two symmetric negative stiffness structures (NSS) in parallel to a positive stiffness structure and actuators has been proposed to attenuate low frequency excitation and makes system flexible regarding to different weight of passengers which is applicable for A and B-Segment cars. Here, the 3 degree of freedom system is considered, dynamic equation clearly is presented, then simulated in MATLAB in order to analysis of performance of the system. The design procedure is derived so that the resonance peak of frequency–response curve shift to the left, the isolating range is increased and especially, the peak of the frequency–response curve is minimized. According to ISO standard different class of road profile as an input is applied to the system to evaluate the performance of the system. To evaluate comfort issues, we extract the RMS value of the vertical acceleration acting on the passenger's body. Then apply the band-pass filter, which takes into account the human sensitivity to acceleration. According to ISO, this weighted acceleration is lower than 0.315 m/s^2, so the ride is considered as comfortable.

Keywords: low frequency excitation, negative stiffness, seat vehicle, vibration isolation

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792 The Effects of Ellagic Acid on Rat Liver Induced Tobacco Smoke

Authors: Nalan Kaya, Elif Erdem, Mehmet Ali Kisacam, Gonca Ozan, Enver Ozan

Abstract:

Tobacco smokers continuously inhale thousands of carcinogens and free radicals. It is estimated that about 1017 oxidant molecules are present in each puff of tobacco smoke. It is known that smoking has adverse effects on the structure and functions of the liver. Ellagic acid (EA) has antioxidant, antiapoptotic, anticarcinogenic, antibacterial and antiinflammatory effects. The aim of our study was to investigate the possible protective effect of ellagic acid against tobacco smoke-mediated oxidative stress in the rat liver. Twenty-four male adult (8 weeks old) Spraque-Dawley rats were divided randomly into 4 equal groups: group I (control), group II (tobacco smoke), group III (tobacco smoke + corn oil) and group IV (tobacco smoke + ellagic acid). The rats in group II, III and IV, were exposed to tobacco smoke 1 hour twice a day for 12 weeks. In addition to tobacco smoke exposure, 12 mg/kg ellagic acid (dissolved in corn oil), was applied to the rats in group IV by oral gavage. An equal amount of corn oil used in solving ellagic acid was applied to the rats by oral gavage in group III. At the end of the experimental period, rats were decapitated, and liver tissues were removed. Histological and biochemical analyzes were performed. Sinusoidal dilatation, inflammatory cell infiltration in portal area, increased Kuppfer cells were examined in tobacco smoke group and tobacco smoke+ corn oil groups. The results, observed in tobacco smoke and tobacco smoke+corn oil groups, were found significantly decreased in tobacco smoke+EA group. Group-II and group-III MDA levels were significantly higher, and GSH activities were not different than group-I. Compared to group-II, group-IV MDA level was decreased, and GSH activities was increased significantly. The results indicate that ellagic acid could protect the liver tissue from the tobacco smoke harmful effects.

Keywords: ellagic acid, liver, rat, tobacco smoke

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791 The Effect of Foundation on the Earth Fill Dam Settlement

Authors: Masoud Ghaemi, Mohammadjafar Hedayati, Faezeh Yousefzadeh, Hoseinali Heydarzadeh

Abstract:

Careful monitoring in the earth dams to measure deformation caused by settlement and movement has always been a concern for engineers in the field. In order to measure settlement and deformation of earth dams, usually, the precision instruments of settlement set and combined Inclinometer that is commonly referred to IS instrument will be used. In some dams, because the thickness of alluvium is high and there is no possibility of alluvium removal (technically and economically and in terms of performance), there is no possibility of placing the end of IS instrument (precision instruments of Inclinometer-settlement set) in the rock foundation. Inevitably, have to accept installing pipes in the weak and deformable alluvial foundation that leads to errors in the calculation of the actual settlement (absolute settlement) in different parts of the dam body. The purpose of this paper is to present new and refine criteria for predicting settlement and deformation in earth dams. The study is based on conditions in three dams with a deformation quite alluvial (Agh Chai, Narmashir and Gilan-e Gharb) to provide settlement criteria affected by the alluvial foundation. To achieve this goal, the settlement of dams was simulated by using the finite difference method with FLAC3D software, and then the modeling results were compared with the reading IS instrument. In the end, the caliber of the model and validate the results, by using regression analysis techniques and scrutinized modeling parameters with real situations and then by using MATLAB software and CURVE FITTING toolbox, new criteria for the settlement based on elasticity modulus, cohesion, friction angle, the density of earth dam and the alluvial foundation was obtained. The results of these studies show that, by using the new criteria measures, the amount of settlement and deformation for the dams with alluvial foundation can be corrected after instrument readings, and the error rate in reading IS instrument can be greatly reduced.

Keywords: earth-fill dam, foundation, settlement, finite difference, MATLAB, curve fitting

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790 Fluvial Stage-Discharge Rating of a Selected Reach of Jamuna River

Authors: Makduma Zahan Badhan, M. Abdul Matin

Abstract:

A study has been undertaken to develop a fluvial stage-discharge rating curve for Jamuna River. Past Cross-sectional survey of Jamuna River reach within Sirajgonj and Tangail has been analyzed. The analysis includes the estimation of discharge carrying capacity, possible maximum scour depth and sediment transport capacity of the selected reaches. To predict the discharge and sediment carrying capacity, stream flow data which include cross-sectional area, top width, water surface slope and median diameter of the bed material of selected stations have been collected and some are calculated from reduced level data. A well-known resistance equation has been adopted and modified to a simple form in order to be used in the present analysis. The modified resistance equation has been used to calculate the mean velocity through the channel sections. In addition, a sediment transport equation has been applied for the prediction of transport capacity of the various sections. Results show that the existing drainage sections of Jamuna channel reach under study have adequate carrying capacity under existing bank-full conditions, but these reaches are subject to bed erosion even in low flow situations. Regarding sediment transport rate, it can be estimated that the channel flow has a relatively high range of bed material concentration. Finally, stage­ discharge curves for various sections have been developed. Based on stage-discharge rating data of various sections, water surface profile and sediment-rating curve of Jamuna River have been developed and also the flooding conditions have been analyzed from predicted water surface profile.

Keywords: discharge rating, flow profile, fluvial, sediment rating

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789 Endothelial Progenitor Cells Is a Determinant of Vascular Function and Atherosclerosis in Ankylosing Spondylitis

Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

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Objective: Endothelial progenitor cells (EPCs) have reparative potential in overcoming the endothelial dysfunction and reducing cardiovascular risk. EPC depletion has been demonstrated in the setting of established atherosclerotic diseases. With this background, we evaluated whether reduced EPCs population are associated with endothelial dysfunction, subclinical atherosclerosis and inflammatory markers in ankylosing spondylitis (AS) patients without any known traditional cardiovascular risk factor in AS patients. Methods: Levels of circulating EPCs (CD34+/CD133+), brachial artery flow-mediated dilatation, carotid intima-media thickness (CIMT) and inflammatory markers i.e erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tissue necrosis factor (TNF)–α, interleukin (IL)-6, IL-1 were assessed in 30 AS patients (mean age33.41 ± 10.25; 11 female and 19 male) who fulfilled the modified New York diagnostic criteria with 25 healthy volunteers (mean age 29.36± 8.64; 9 female and 16 male) matched for age and sex. Results: EPCs (CD34+/CD133+) cells were significantly (0.020 ± 0.001% versus 0.040 ± 0.010%, p<0.001) reduced in patients with AS compared to healthy controls. Endothelial function (7.35 ± 2.54 versus 10.27 ±1.73, p=0.002), CIMT (0.63 ± 0.01 versus 0.35 ± 0.02, p < 0.001) and inflammatory markers were also significantly (p < 0.01) altered as compared to healthy controls. Specifically, CD34+CD133+cells were inversely multivariate correlated with CRP and TNF-α and endothelial dysfunction was positively correlated with reduced number of EPC. Conclusion: Depletion of EPCs population is an independent predictor of endothelial dysfunction and early atherosclerosis in AS patients and may provide additional information beyond conventional risk factors and inflammatory markers.

Keywords: endothelial progenitor cells, atherosclerosis, ankylosing spondylitis, cardiovascular

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788 Domain-Specific Deep Neural Network Model for Classification of Abnormalities on Chest Radiographs

Authors: Nkechinyere Joy Olawuyi, Babajide Samuel Afolabi, Bola Ibitoye

Abstract:

This study collected a preprocessed dataset of chest radiographs and formulated a deep neural network model for detecting abnormalities. It also evaluated the performance of the formulated model and implemented a prototype of the formulated model. This was with the view to developing a deep neural network model to automatically classify abnormalities in chest radiographs. In order to achieve the overall purpose of this research, a large set of chest x-ray images were sourced for and collected from the CheXpert dataset, which is an online repository of annotated chest radiographs compiled by the Machine Learning Research Group, Stanford University. The chest radiographs were preprocessed into a format that can be fed into a deep neural network. The preprocessing techniques used were standardization and normalization. The classification problem was formulated as a multi-label binary classification model, which used convolutional neural network architecture to make a decision on whether an abnormality was present or not in the chest radiographs. The classification model was evaluated using specificity, sensitivity, and Area Under Curve (AUC) score as the parameter. A prototype of the classification model was implemented using Keras Open source deep learning framework in Python Programming Language. The AUC ROC curve of the model was able to classify Atelestasis, Support devices, Pleural effusion, Pneumonia, A normal CXR (no finding), Pneumothorax, and Consolidation. However, Lung opacity and Cardiomegaly had a probability of less than 0.5 and thus were classified as absent. Precision, recall, and F1 score values were 0.78; this implies that the number of False Positive and False Negative is the same, revealing some measure of label imbalance in the dataset. The study concluded that the developed model is sufficient to classify abnormalities present in chest radiographs into present or absent.

Keywords: transfer learning, convolutional neural network, radiograph, classification, multi-label

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787 Effect of Cardio-Specific Overexpression of MUL1, a Mitochondrial Protein on Myocardial Function

Authors: Ximena Calle, Plinio Cantero-López, Felipe Muñoz-Córdova, Mayarling-Francisca Troncoso, Sergio Lavandero, Valentina Parra

Abstract:

MUL1, a mitochondrial E3 ubiquitin ligase anchored to the outer mitochondrial membrane, is highly expressed in the heart. MUL1 is involved in multiple biological pathways associated with mitochondrial dynamics. Increased MUL1 affects the balance between fission and fusion, affecting mitochondrial function, which plays a crucial role in myocardial function. Therefore, it is interesting to evaluate the effect of cardiac-specific overexpression of MUL1 on myocardial function. Aim: To determine heart functionality in a mouse model with cardio-specific overexpression MUL1 protein. Methods and Results: Male C57BL/Tg transgenic mice with cardiomyocyte-specific overexpression of MUL1 (n=10) and control (n=4) were evaluated at 12, 27, and 35 weeks of age. Glucose tolerance curve determination was performed after a 6-hours fast to assess metabolic capacity, treadmill test, and systolic, and diastolic pressure was evaluated by the mouse tail-cuff blood pressure system equipment. The result showed no glucose tolerance curve, and the treadmill test demonstrated no significant changes between groups. However, substantial changes in diastolic function were observed by ultrasound and determination of cardiac hypertrophy proteins by western blot. Conclusions: Cardio-specific overexpression of MUL1 in mice without any treatment affects diastolic cardiac function, thus showing the important role contributed by MUL1 in the heart. Future research should evaluate the effect of cardiomyocyte-specific overexpression of MUL1 in pathological conditions such as a high-fat diet is one of the main risk factors for cardiovascular disease.

Keywords: diastolic dysfunction, hypertrophy cardiac, mitochondrial E3 ubiquitin ligase 1, MUL1

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786 Hemodynamics of a Cerebral Aneurysm under Rest and Exercise Conditions

Authors: Shivam Patel, Abdullah Y. Usmani

Abstract:

Physiological flow under rest and exercise conditions in patient-specific cerebral aneurysm models is numerically investigated. A finite-volume based code with BiCGStab as the linear equation solver is used to simulate unsteady three-dimensional flow field through the incompressible Navier-Stokes equations. Flow characteristics are first established in a healthy cerebral artery for both physiological conditions. The effect of saccular aneurysm on cerebral hemodynamics is then explored through a comparative analysis of the velocity distribution, nature of flow patterns, wall pressure and wall shear stress (WSS) against the reference configuration. The efficacy of coil embolization as a potential strategy of surgical intervention is also examined by modelling coil as a homogeneous and isotropic porous medium where the extended Darcy’s law, including Forchheimer and Brinkman terms, is applicable. The Carreau-Yasuda non-Newtonian blood model is incorporated to capture the shear thinning behavior of blood. Rest and exercise conditions correspond to normotensive and hypertensive blood pressures respectively. The results indicate that the fluid impingement on the outer wall of the arterial bend leads to abnormality in the distribution of wall pressure and WSS, which is expected to be the primary cause of the localized aneurysm. Exercise correlates with elevated flow velocity, vortex strength, wall pressure and WSS inside the aneurysm sac. With the insertion of coils in the aneurysm cavity, the flow bypasses the dilatation, leading to a decline in flow velocities and WSS. Particle residence time is observed to be lower under exercise conditions, a factor favorable for arresting plaque deposition and combating atherosclerosis.

Keywords: 3D FVM, Cerebral aneurysm, hypertension, coil embolization, non-Newtonian fluid

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785 Finite Element Modeling and Nonlinear Analysis for Seismic Assessment of Off-Diagonal Steel Braced RC Frame

Authors: Keyvan Ramin

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The geometric nonlinearity of Off-Diagonal Bracing System (ODBS) could be a complementary system to covering and extending the nonlinearity of reinforced concrete material. Finite element modeling is performed for flexural frame, x-braced frame and the ODBS braced frame system at the initial phase. Then the different models are investigated along various analyses. According to the experimental results of flexural and x-braced frame, the verification is done. Analytical assessments are performed in according to three-dimensional finite element modeling. Non-linear static analysis is considered to obtain performance level and seismic behavior, and then the response modification factors calculated from each model’s pushover curve. In the next phase, the evaluation of cracks observed in the finite element models, especially for RC members of all three systems is performed. The finite element assessment is performed on engendered cracks in ODBS braced frame for various time steps. The nonlinear dynamic time history analysis accomplished in different stories models for three records of Elcentro, Naghan, and Tabas earthquake accelerograms. Dynamic analysis is performed after scaling accelerogram on each type of flexural frame, x-braced frame and ODBS braced frame one by one. The base-point on RC frame is considered to investigate proportional displacement under each record. Hysteresis curves are assessed along continuing this study. The equivalent viscous damping for ODBS system is estimated in according to references. Results in each section show the ODBS system has an acceptable seismic behavior and their conclusions have been converged when the ODBS system is utilized in reinforced concrete frame.

Keywords: FEM, seismic behaviour, pushover analysis, geometric nonlinearity, time history analysis, equivalent viscous damping, passive control, crack investigation, hysteresis curve

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784 Canada's "Flattened Curve": A Geospatail Temporal Analysis of Canada's Amelioration of The Sars-Cov-2 Pandemic Through Coordinated Government Intervention

Authors: John Ahluwalia

Abstract:

As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal health care is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, canada, GIS, geospatial analysis

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783 Anal Repair and Diamond Flap in Moderate Anal Stenosis Patient After an Open Hemorrhoidectomy Surgery: A Case Report

Authors: Andriana Purnama, Reno Rudiman, Kezia Christy

Abstract:

Anal stenosis which develops due to anoderm scarring usually caused by secondary to surgical trauma, has become common, causing significant decrease patient’s quality of life. Even though mild anal stenosis was treated with non-surgical treatment, but surgical reconstruction in unavoidable for moderate to severe anal stenosis that cause distressing, severe anal pain and inability to defecate. In our study, we intend to share our result with the use of diamond flap in treatment of anal stenosis. This case report illustrates a 57-year-old male patient who presented with difficulty and discomfort in defecation caused by anal stenosis after 2 years of open hemorrhoidectomy surgery. At physical examination, there was requirement of forceful dilatation when the index finger was inserted or precisely 6mm as measured by hegar dilator (moderate anal stenosis). Blood test result was within normal limits. The patient underwent anal repair and diamond flap where the scar tissue at 6 and 9 o’clock directions was excised and diamond graft was incised carefully while paying attention to the vascular supply. Finally, the graft was fixated without any tension to the anal canal, resulting in diameter of 2 cm after operation. After 2 days post operation, the patient was in stable condition, without any complication, and discharged. There was no abnormality concerning the stool. Ten days after the operation, diamond flap was in normal condition and without any complication. He was scheduled for futher follow up at the Digestive Surgery Department. Anal stenosis due to overzealous hemorrhoidectomy is a complication that is preventable when performed in experienced hands. Diamond flap was one of the options for the anal stenosis treatment with less complication.

Keywords: anal stenosis, diamond flap, post hemorrhoidectomy, anal repair

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782 Parental Drinking and Risky Alcohol Related Behaviors: Predicting Binge Drinking Trajectories and Their Influence on Impaired Driving among College Students

Authors: Shiran Bord, Assaf Oshri, Matthew W. Carlson, Sihong Liu

Abstract:

Background: Alcohol-impaired driving (AID) and binge drinking are major health concerns among college students. Although the link between binge drinking and AID is well established, knowledge regarding binge drinking patterns, the factors influencing binge drinking, and the associations between consumption patterns and alcohol-related risk behaviors is lacking. Aims: To examine heterogeneous trajectories of binge drinking during college and tests factors that might predict class membership as well as class membership outcomes. Methods: Data were obtained from a sample of 1,265 college students (Mage = 18.5, SD = .66) as part of the Longitudinal Study of Violence Against Women (N = 1,265; 59.3% female; 69.2% white). Analyses were completed in three stages. First, a growth curve analysis was conducted to identify trajectories of binge drinking over time. Second, growth curve mixture modeling analyses were pursued to assess unobserved growth trajectories of binge drinking without predictors. Lastly, parental drinking variables were added to the model as predictors of class membership, and AID and being a passenger of a drunk driver were added to the model as outcomes. Results: Three binge drinking trajectories were identified: high-convex, medium concave and low-increasing. Parental drinking was associated with being in high-convex and medium-concave classes. Compared to the low-increasing class, the high convex and medium concave classes reported more AID and being a passenger of a drunk driver more frequently. Conclusions: Parental drinking may affect children’s later engagement in AID. Efforts should focus on parents' education regarding the consequences of parental modeling of alcohol consumption.

Keywords: alcohol impaired driving, alcohol consumption, binge drinking, college students, parental modeling

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781 Bilateral Simultaneous Acute Primary Angle Closure Glaucoma: A Remarkable Case

Authors: Nita Nurlaila Kadarwaty

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Purpose: This study presents a rare case of bilateral Acute Primary Angle Closure Glaucoma (PACG). Method: A case report of a 64-year-old woman with a good outcome Acute PACG in both eyes who underwent phacotrabeculectomy surgery. Result: A 64-year-old woman complained of acute pain in both eyes, accompanied by decreased vision, photophobia, and seeing halos for three weeks. There was no history of trauma, steroid or other systemic drugs used, or intraocular surgery before. Ophthalmologic examination revealed a right eye (RE) visual acuity of 0.1, left eye (LE) 0.2. RE intraocular pressure (IOP) was 12 mmhg and LE: 36.4 mmHg in medication of timolol maleat ED and acetazolamide oral. Both eyes' anterior segments revealed mixed injection, corneal edema, shallow anterior chamber, posterior synechiae, mid-dilatation pupil with negative pupillary reflection, and cloudy lens without intumescent. There was a glaucomatous optic and closed iridocorneal angle on the gonioscopy. Initial treatments included oral acetazolamide and potassium aspartate 250 mg three times a day, timolol maleate ED 0.5% twice a day, and prednisolone acetate ED 1% four times a day. This patient underwent trabeculectomy, phacoemulsification, and implantation of IOL in both eyes. One week after the surgeries, both eyes showed decreased IOP and good visual improvement. Conclusion: Bilateral simultaneous Acute PACG is generally severe and results in a poor outcome. It causes rapidly progressive visual loss and is often irreversible. Phacotrabeculectomy has more benefits compared to only phacoemulsification for the intervention regarding the reduced IOP post-surgical.

Keywords: acute primary angle closure glaucoma, intraocular pressure, phacotrabeculectomy, glaucoma

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780 Effect of Microstructure and Texture of Magnesium Alloy Due to Addition of Pb

Authors: Yebeen Ji, Jimin Yun, Kwonhoo Kim

Abstract:

Magnesium alloys were limited for industrial applications due to having a limited slip system and high plastic anisotropy. It has been known that specific textures were formed during processing (rolling, etc.), and These textures cause poor formability. To solve these problems, many researchers have studied controlling texture by adding rare-earth elements. However, the high cost limits their use; therefore, alternatives are needed to replace them. Although Pb addition doesn’t directly improve magnesium properties, it has been known to suppress the diffusion of other alloying elements and reduce grain boundary energy. These characteristics are similar to the additions of rare-earth elements, and a similar texture behavior is expected as well. However, there is insufficient research on this. Therefore, this study investigates the behavior of texture and microstructure development after adding Pb to magnesium. This study compared and analyzed AZ61 alloy and Mg-15wt%Pb alloy to determine the effect of adding solute elements. The alloy was hot rolled and annealed to form a single phase and initial texture. Afterward, the specimen was set to contraction and elongate parallel to the rolling surface and the rolling direction and then subjected to high-temperature plane strain compression under the conditions of 723K and 0.05/s. Microstructural analysis and texture measurements were performed by SEM-EBSD. The peak stress in the true strain-stress curve after compression was higher in AZ61, but the shape of the flow curve was similar for both alloys. For both alloys, continuous dynamic recrystallization was confirmed to occur during the compression process. The basal texture developed parallel to the compressed surface, and the pole density was lower in the Mg-15wt%Pb alloy. It is confirmed that this change in behavior is because the orientation distribution of recrystallized grains has a more random orientation compared to the parent grains when Pb is added.

Keywords: Mg, texture, Pb, DRX

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779 Active Part of the Burnishing Tool Effect on the Physico-Geometric Aspect of the Superficial Layer of 100C6 and 16NC6 Steels

Authors: Tarek Litim, Ouahiba Taamallah

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Burnishing is a mechanical surface treatment that combines several beneficial effects on the two steel grades studied. The application of burnishing to the ball or to the tip favors a better roughness compared to turning. In addition, it allows the consolidation of the surface layers through work hardening phenomena. The optimal effects are closely related to the treatment parameters and the active part of the device. With an improvement of 78% on the roughness, burnishing can be defined as a finishing operation in the machining range. With a 44% gain in consolidation rate, this treatment is an effective process for material consolidation. These effects are affected by several factors. The factors V, f, P, r, and i have the most significant effects on both roughness and hardness. Ball or tip burnishing leads to the consolidation of the surface layers of both grades 100C6 and 16NC6 steels by work hardening. For each steel grade and its mechanical treatment, the rational tensile curve has been drawn. Lüdwick's law is used to better plot the work hardening curve. For both grades, a material hardening law is established. For 100C6 steel, these results show a work hardening coefficient and a consolidation rate of 0.513 and 44, respectively, compared to the surface layers processed by turning. When 16NC6 steel is processed, the work hardening coefficient is about 0.29. Hardness tests characterize well the burnished depth. The layer affected by work hardening can reach up to 0.4 mm. Simulation of the tests is of great importance to provide the details at the local scale of the material. Conventional tensile curves provide a satisfactory indication of the toughness of 100C6 and 16NC6 materials. A simulation of the tensile curves revealed good agreement between the experimental and simulation results for both steels.

Keywords: 100C6 steel, 16NC6 steel, burnishing, work hardening, roughness, hardness

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778 Transcriptome Analysis Reveals Role of Long Non-Coding RNA NEAT1 in Dengue Patients

Authors: Abhaydeep Pandey, Shweta Shukla, Saptamita Goswami, Bhaswati Bandyopadhyay, Vishnampettai Ramachandran, Sudhanshu Vrati, Arup Banerjee

Abstract:

Background: Long non-coding RNAs (lncRNAs) are the important regulators of gene expression and play important role in viral replication and disease progression. The role of lncRNA genes in the pathogenesis of Dengue virus-mediated pathogenesis is currently unknown. Methods: To gain additional insights, we utilized an unbiased RNA sequencing followed by in silico analysis approach to identify the differentially expressed lncRNA and genes that are associated with dengue disease progression. Further, we focused our study on lncRNAs NEAT1 (Nuclear Paraspeckle Assembly Transcript 1) as it was found to be differentially expressed in PBMC of dengue infected patients. Results: The expression of lncRNAs NEAT1, as compared to dengue infection (DI), was significantly down-regulated as the patients developed the complication. Moreover, pairwise analysis on follow up patients confirmed that suppression of NEAT1 expression was associated with rapid fall in platelet count in dengue infected patients. Severe dengue patients (DS) (n=18; platelet count < 20K) when recovered from infection showing high NEAT1 expression as it observed in healthy donors. By co-expression network analysis and subsequent validation, we revealed that coding gene; IFI27 expression was significantly up-regulated in severe dengue cases and negatively correlated with NEAT1 expression. To discriminate DI from dengue severe, receiver operating characteristic (ROC) curve was calculated. It revealed sensitivity and specificity of 100% (95%CI: 85.69 – 97.22) and area under the curve (AUC) = 0.97 for NEAT1. Conclusions: Altogether, our first observations demonstrate that monitoring NEAT1and IFI27 expression in dengue patients could be useful in understanding dengue virus-induced disease progression and may be involved in pathophysiological processes.

Keywords: dengue, lncRNA, NEAT1, transcriptome

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777 Mathematical Model to Quantify the Phenomenon of Democracy

Authors: Mechlouch Ridha Fethi

Abstract:

This paper presents a recent mathematical model in political sciences concerning democracy. The model is represented by a logarithmic equation linking the Relative Index of Democracy (RID) to Participation Ratio (PR). Firstly the meanings of the different parameters of the model were presented; and the variation curve of the RID according to PR with different critical areas was discussed. Secondly, the model was applied to a virtual group where we show that the model can be applied depending on the gender. Thirdly, it was observed that the model can be extended to different language models of democracy and that little use to assess the state of democracy for some International organizations like UNO.

Keywords: democracy, mathematic, modelization, quantification

Procedia PDF Downloads 328
776 Food Bolus Obstruction: A Rural Hospital’s Experience

Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

Abstract:

Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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775 [Keynote] Implementation of Quality Control Procedures in Radiotherapy CT Simulator

Authors: B. Petrović, L. Rutonjski, M. Baucal, M. Teodorović, O. Čudić, B. Basarić

Abstract:

Purpose/Objective: Radiotherapy treatment planning requires use of CT simulator, in order to acquire CT images. The overall performance of CT simulator determines the quality of radiotherapy treatment plan, and at the end, the outcome of treatment for every single patient. Therefore, it is strongly advised by international recommendations, to set up a quality control procedures for every machine involved in radiotherapy treatment planning process, including the CT scanner/ simulator. The overall process requires number of tests, which are used on daily, weekly, monthly or yearly basis, depending on the feature tested. Materials/Methods: Two phantoms were used: a dedicated phantom CIRS 062QA, and a QA phantom obtained with the CT simulator. The examined CT simulator was Siemens Somatom Definition as Open, dedicated for radiation therapy treatment planning. The CT simulator has a built in software, which enables fast and simple evaluation of CT QA parameters, using the phantom provided with the CT simulator. On the other hand, recommendations contain additional test, which were done with the CIRS phantom. Also, legislation on ionizing radiation protection requires CT testing in defined periods of time. Taking into account the requirements of law, built in tests of a CT simulator, and international recommendations, the intitutional QC programme for CT imulator is defined, and implemented. Results: The CT simulator parameters evaluated through the study were following: CT number accuracy, field uniformity, complete CT to ED conversion curve, spatial and contrast resolution, image noise, slice thickness, and patient table stability.The following limits are established and implemented: CT number accuracy limits are +/- 5 HU of the value at the comissioning. Field uniformity: +/- 10 HU in selected ROIs. Complete CT to ED curve for each tube voltage must comply with the curve obtained at comissioning, with deviations of not more than 5%. Spatial and contrast resultion tests must comply with the tests obtained at comissioning, otherwise machine requires service. Result of image noise test must fall within the limit of 20% difference of the base value. Slice thickness must meet manufacturer specifications, and patient stability with longitudinal transfer of loaded table must not differ of more than 2mm vertical deviation. Conclusion: The implemented QA tests gave overall basic understanding of CT simulator functionality and its clinical effectiveness in radiation treatment planning. The legal requirement to the clinic is to set up it’s own QA programme, with minimum testing, but it remains user’s decision whether additional testing, as recommended by international organizations, will be implemented, so to improve the overall quality of radiation treatment planning procedure, as the CT image quality used for radiation treatment planning, influences the delineation of a tumor and calculation accuracy of treatment planning system, and finally delivery of radiation treatment to a patient.

Keywords: CT simulator, radiotherapy, quality control, QA programme

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774 Reliability Analysis of Geometric Performance of Onboard Satellite Sensors: A Study on Location Accuracy

Authors: Ch. Sridevi, A. Chalapathi Rao, P. Srinivasulu

Abstract:

The location accuracy of data products is a critical parameter in assessing the geometric performance of satellite sensors. This study focuses on reliability analysis of onboard sensors to evaluate their performance in terms of location accuracy performance over time. The analysis utilizes field failure data and employs the weibull distribution to determine the reliability and in turn to understand the improvements or degradations over a period of time. The analysis begins by scrutinizing the location accuracy error which is the root mean square (RMS) error of differences between ground control point coordinates observed on the product and the map and identifying the failure data with reference to time. A significant challenge in this study is to thoroughly analyze the possibility of an infant mortality phase in the data. To address this, the Weibull distribution is utilized to determine if the data exhibits an infant stage or if it has transitioned into the operational phase. The shape parameter beta plays a crucial role in identifying this stage. Additionally, determining the exact start of the operational phase and the end of the infant stage poses another challenge as it is crucial to eliminate residual infant mortality or wear-out from the model, as it can significantly increase the total failure rate. To address this, an approach utilizing the well-established statistical Laplace test is applied to infer the behavior of sensors and to accurately ascertain the duration of different phases in the lifetime and the time required for stabilization. This approach also helps in understanding if the bathtub curve model, which accounts for the different phases in the lifetime of a product, is appropriate for the data and whether the thresholds for the infant period and wear-out phase are accurately estimated by validating the data in individual phases with Weibull distribution curve fitting analysis. Once the operational phase is determined, reliability is assessed using Weibull analysis. This analysis not only provides insights into the reliability of individual sensors with regards to location accuracy over the required period of time, but also establishes a model that can be applied to automate similar analyses for various sensors and parameters using field failure data. Furthermore, the identification of the best-performing sensor through this analysis serves as a benchmark for future missions and designs, ensuring continuous improvement in sensor performance and reliability. Overall, this study provides a methodology to accurately determine the duration of different phases in the life data of individual sensors. It enables an assessment of the time required for stabilization and provides insights into the reliability during the operational phase and the commencement of the wear-out phase. By employing this methodology, designers can make informed decisions regarding sensor performance with regards to location accuracy, contributing to enhanced accuracy in satellite-based applications.

Keywords: bathtub curve, geometric performance, Laplace test, location accuracy, reliability analysis, Weibull analysis

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773 Spontaneous Reformation of Dehiscent Frontal Sinus Wall after Endoscopic Removal of Mucocele

Authors: Tan Dexian Arthur, James Wei Ming Kwek, Ian Loh, Lee Tee Sin

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Statement of the Problem: Mucoceles most commonly affect the frontal sinus, which results from chronic obstruction of the sinus ostium or cystic dilatation of mucous glands with ductal obstruction. They are known to cause bony erosion of the sinus walls, which can lead to large defects. These defects were typically managed by obliteration or cranialization of the frontal sinus. Although short term outcomes of conservative management of significant posterior table defects from fractures are promising, there have been no studies on the long-term outcomes of large dehiscences in the posterior wall of the frontal sinus. Methodology & Findings : Computed Tomography (CT) Paranasal Sinuses images were analyzed and found complete spontaneous osteogenesis of a large dehiscent frontal sinus posterior wall, secondary to a large mucocele, 9 years from functional endoscopic sinus surgery with the defect managed conservatively. Conclusion & Significance: The dura is well known for its osteogenic properties. Prior studies have showed that dura could induce osteogenesis in cutaneous tissue in the absence of other central nervous system structures. It was also demonstrated that osteogenesis and chondrogenesis were possible in zygomatic fractures by transplanting neonatal dura grafts to the bony defects in rats. Extrapolating from these studies, the authors postulate that the presence of dura beneath the bony deformity of the posterior frontal sinus wall had likely initiated the osteogenesis and restored the bony defect in the patient. In our literature review, we did not find any reports of spontaneous osteogenesis of large frontal sinus defects. While our experience is incidental, it reinforces the osteogenetic potential of an intact dura and further highlights that selected large defects of the posterior wall of the frontal sinus can be conservatively managed.

Keywords: paranasal sinus mucocele, mucocele, osteogenesis, dehiscence

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772 Urinary Exosome miR-30c-5p as a Biomarker for Early-Stage Clear Cell Renal Cell Carcinoma

Authors: Shangqing Song, Bin Xu, Yajun Cheng, Zhong Wang

Abstract:

miRNAs derived from exosomes exist in a body fluid such as urine were regarded as potential biomarkers for various human cancers diagnosis and prognosis, as mature miRNAs can be steadily preserved by exosomes. However, its potential value in clear cell renal cell carcinoma (ccRCC) diagnosis and prognosis remains unclear. In the present study, differentially expressed miRNAs from urinal exosomes were identified by next-generation sequencing (NGS) technology. The 16 differentially expressed miRNAs were identified between ccRCC patients and healthy donors. To explore the specific diagnosis biomarker of ccRCC, we validated these urinary exosomes from 70 early-stage renal cancer patients, 30 healthy people and other urinary system cancers, including 30 early-stage prostate cancer patients and 30 early-stage bladder cancer patients by qRT-PCR. The results showed that urinary exosome miR-30c-5p could be stably amplified and meanwhile the expression of miR-30c-5p has no significant difference between other urinary system cancers and healthy control, however, expression level of miR-30c-5p in urinary exosomal of ccRCC patients was lower than healthy people and receiver operation characterization (ROC) curve showed that the area under the curve (AUC) values was 0.8192 (95% confidence interval was 0.7388-0.8996, P= 0.0000). In addition, up-regulating miR-30c-5p expression could inhibit renal cell carcinoma cells growth. Lastly, HSP5A was found as a direct target gene of miR-30c-5p. HSP5A depletion reversed the promoting effect of ccRCC growth casued by miR-30c-5p inhibitor, respectively. In conclusion, this study demonstrated that urinary exosomal miR-30c-5p is readily accessible as diagnosis biomarker of early-stage ccRCC, and miR-30c-5p might modulate the expression of HSPA5, which correlated with the progression of ccRCC.

Keywords: clear cell renal cell carcinoma, exosome, HSP5A, miR-30c-5p

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771 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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770 Young Female’s Heart Was Bitten by Unknown Ghost (Isolated Cardiac Sarcoidosis): A Case Report

Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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769 Biases in Numerically Invariant Joint Signatures

Authors: Reza Aghayan

Abstract:

This paper illustrates that numerically invariant joint signatures suffer biases in the resulting signatures. Next, we classify the arising biases as Bias Type 1 and Bias Type 2 and show how they can be removed.

Keywords: Euclidean and affine geometries, differential invariant signature curves, numerically invariant joint signatures, numerical analysis, numerical bias, curve analysis

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768 Canada's "Flattened Curve": A Geospatial Temporal Analysis of Canada's Amelioration of the Sars-COV-2 Pandemic Through Coordinated Government Intervention

Authors: John Ahluwalia

Abstract:

As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Why is it that Canada has not shared the same fate as the US (and many other nations) that have realized much worse outcomes relative to the COVID-19 pandemic? Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal healthcare is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, Canada, GIS, temporal analysis, ESRI

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