Search results for: lateral neck vascular mass

Authors: Steven Robinson, Adriana Dager, Param Patel

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Wandering spleen is a rare variant where there is abnormal development of the ligamentous peritoneal attachments of the spleen which normally anchor it in the left upper quadrant of the abdomen. Ligamentous abnormalities can be congenital, or acquired through pregnancy, injury, or iatrogenic causes. Absence or laxity of these ligaments allows migration of the spleen into ectopic portions of the abdomen, which is also associated with an elongated vascular pedicle. Incidence of wandering spleen is reported at less than 0.25% with a female to male ratio of approximately 6:1. The most common complication of a wandering spleen is torsion around its vascular pedicle which can lead to thrombosis and infarction. Torsion of a wandering spleen is a rare but important cause of an acute abdomen. Imaging, and specifically CT or ultrasound, is crucial in the diagnosis. We present a case of a torsed wandering spleen which was treated with splenectomy.

Keywords: Wandering Spleen, Torsion, Splenic Torsion, Spleen

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Authors: Gehan Hussein, Hala Agha, Rasha Abdelraof, Marina George, Antoine Fakhri

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Background: β-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients. The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients. 3 D Speckle tracking echocardiography (3D STE) is a novel method for the detection of subclinical myocardial involvement. We aimed to study myocardial affection in SCD and TM using 3D STE, comparing it with conventional echocardiography, correlate it with serum ferritin level and lactate dehydrogenase (LDH). Methodology: Thirty SCD and thirty β TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin, and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography, and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS), and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E’ (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E’ (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.). The potential diagnostic accuracy of LDH in predicting vascular dysfunction as represented by aortic root GCS with a sensitivity 74% and aortic root GCS was predictive of LV dysfunction in SCD patients with sensitivity 100% Conclusion: 3D STE LV and RV systolic dysfunction in spite of their normal values by conventional echocardiography. SCD showed significantly lower right ventricular dysfunction and aortic root GCS than TM and control. LDH can be used to screen patients for cardiac dysfunction in SCD, not in TM

Keywords: thalassemia major, sickle cell disease, 3d speckle tracking echocardiography, LDH

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Authors: Rungpansa Noichan, Bart Julian Dewancker

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Thailand facing the transportation issue because of the rapid economic development. The big issue is the traffic jam, especially in Bangkok. However, recently years Bangkok has operated urban mass transit system for solved transportation problem. The Bangkok Mass Transit System (BTS) skytrain is being operated by the BTS Company Limited under the Bangkok Metropolitan Administration. The passenger satisfaction is a major cause for concern due to the commercial nature. The focus of this paper is to evaluate the passenger satisfaction at the mass transit node by questionnaires survey. The survey was to find out the passenger attitudes. The result shows several important factors that influence the passenger choice of using the BTS as a public transportation mode and the passenger’s opinion.

Keywords: urban transportation, user satisfaction, accessibility, Bangkok mass transit

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Authors: Jiwon Park, Jihae Hur, Kukjae Kim, Hansoo Kim

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In this study, outriggers, which are horizontal structures connecting a building core to distant columns to increase the lateral stiffness of a tall building, are used to reduce differential axial shortening in a tall building. Therefore, the outriggers in tall buildings are used to serve the dual purposes of reducing the lateral displacement and reducing the differential axial shortening. Since the location of the outrigger greatly affects the effectiveness of the outrigger in terms of the lateral displacement at the top of the tall building and the maximum differential axial shortening, the optimum locations of the dual-purpose outriggers can be determined by an optimization method. Because the floors where the outriggers are installed are given as integer numbers, the conventional gradient-based optimization methods cannot be directly used. In this study, a piecewise quadratic interpolation method is used to resolve the integrality requirement posed by the optimum locations of the dual-purpose outriggers. The optimal solutions for the dual-purpose outriggers are searched by linear scalarization which is a popular method for multi-objective optimization problems. It was found that increasing the number of outriggers reduced the maximum lateral displacement and the maximum differential axial shortening. It was also noted that the optimum locations for reducing the lateral displacement and reducing the differential axial shortening were different. Acknowledgment: This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science and ICT (NRF-2017R1A2B4010043) and financially supported by Korea Ministry of Land, Infrastructure and Transport(MOLIT) as U-City Master and Doctor Course Grant Program.

Keywords: concrete structure, optimization, outrigger, tall building

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Authors: Tery Nehemia Nugraha Joseph, J. D. P. Wisnubroto

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Thyroid cancer is a healthcare problem with high morbidity and mortality. Follicular adenoma and follicular carcinoma are thyroid tumors from the thyroid follicular cells differentiation with a microfollicular pattern that consists of follicular cuboidal cells. vascular endothelial growth factor (VEGF) is a potent and powerful mitogen for endothelial cells and increases vascular permeability. Therefore, due to an increase in thyroid-stimulating hormone (TSH), VEGF production is activated in the thyroid that leads to the end of mitogenic TSH stimulation and initiation of angiogenesis. The differences in VEGF levels in the follicular carcinoma of thyroid tissue with follicular adenoma thyroid can be used as a basis in differentiating the two types of neoplasms. This study aims to analyze VEGF in the serum so that it can be used to differentiate the types of thyroid carcinoma before surgery. This study uses a cross-sectional research design. Samples were carried out by taking serum samples, and the VEGF levels were calculated. Data were analyzed using the Mann-Whitney test. The results found a significant difference between VEGF levels in the follicular carcinoma thyroid group and VEGF levels in the follicular adenoma thyroid group with a value of p = 0.007 (p < 0.05). The results obtained are 560,427 ± 160,506 ng/mL in the type of follicular carcinoma thyroid and 320.943 ± 134.573 ng/mL in the type of follicular adenoma thyroid. VEGF levels between follicular adenoma and follicular carcinoma are different. VEGF levels are higher in follicular carcinoma thyroid than follicular adenoma thyroid.

Keywords: follicular adenoma thyroid, follicular carcinoma thyroid, thyroid, VEGF

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Authors: Dara Kutsyk, Olga Bondarenko, Mariya Sorochka

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In 21-century type 2 diabetes (T2D) has become a global health and social problem in the whole world. The goal of treatment for patients with T2D is to prevent complications of diabetes - macrovascular diseases (heart disease, stroke, and peripheral vascular disease) and microvascular diseases (retinopathy, neuropathy and nephropathy). Nitric oxide (NO) plays an important role in maintaining vascular homeostasis. Loss of NO function is one of the earliest indicators of disease and its progression especially in patients with T2D. Aim: To compare NO level between patients with well and bad controlled glycemia in T2D. Methods: The study included 32 patients with T2D. The diagnosis of T2D was confirmed due to International Diabetes Federation (IDF) criteria 2015. Patients were divided into two groups: with well controlled glycaemia (HbA1c < 7%) and bad controlled glycaemia (HbA1c > 7%). The control group consists of 15 healthy subjects. Results: NO level in patients with T2D is significantly higher (27,2 ±3,1 µmol), compared to controls (18,86±0,9 µmol; p < 0,001). A significant difference in NO level was found between patients with bad controlled glycaemia (25,9±2,2 µmol) and well controlled glycaemia (28,7 ± 3,0 µmol; p<0,01). The study showed a moderate negative correlation between NO level and HbA1c (-0,399; р< 0,05). Conclusions: Production of NO is impaired in patients with T2D, especially with badly controlled glycaemia. With the increase in HbAc serum NO decreases. This can be the main target for prevention vascular complication in T2D.

Keywords: type 2 diabetes, glycated hemoglobin, nitric oxide, Diabetes mellitus

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Authors: Ufuk Aydın

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The Coda attenuation and frequency dependency of seismic wave are strongly dependent on the effective stresses structures within the upper crust. In this study, the data of three different stations were used to examine the lateral variation of stress. The tectonic structures of these three areas have been examined comparatively using lateral coda tomography. In the study using the single scatter method, the window length selected to be 20 second. Coda values 80 with 94 and frequency dependency values obtained between 0.69 and 1.21. The 1/QC values for the three regions ranged from 0.0012 to 0.017, highlighting the regional differences in the seismotectonic activity of the crust. The lowest absorption values obtained from Erzurum station when the highest absorption values obtained at the Kemaliye station. The low Qc and high frequency dependency values obtained Kemaliye, which indicates that it has highest tectonic activity than other two regions. The seismo-dynamics data obtained from the study found to be in agreement with the tectonic structure of the region.

Keywords: regional coda attenuation, tectonic stress, crustal deformation

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Authors: Takaaki Nemoto

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Case presentation: A 69-year-old Japanese man presented with a low-grade fever and fatigue that had persisted for one month. The patient had an aortic dissection on the aortic arch 13 years prior, an abdominal aortic aneurysm seven years prior, and an aortic dissection on the distal aortic arch one year prior, which were all treated with artificial blood-vessel replacement surgery. Laboratory tests revealed an inflammatory response (CRP 7.61 mg/dl), high serum creatinine (Cr 1.4 mg/dL), and elevated transaminase (AST 47 IU/L, ALT 45 IU/L). The patient was admitted to our hospital on suspicion of prosthetic vascular graft infection. Following further workups on the inflammatory response, an enhanced chest computed tomography (CT) and a non-enhanced chest DWI (MRI) were performed. The patient was diagnosed with a pulmonary fistula and a prosthetic vascular graft infection on the distal aortic arch. After admission, the patient was administered Ceftriaxion and Vancomycine for 10 days, but his fever and inflammatory response did not improve. On day 13 of hospitalization, a lung fistula repair surgery and an omental filling operation were performed, and Meropenem and Vancomycine were administered. The fever and inflammatory response continued, and therefore we took repeated blood cultures. M. fortuitum was detected in a blood culture on day 16 of hospitalization. As a result, we changed the treatment regimen to Amikacin (400 mg/day), Meropenem (2 g/day), and Cefmetazole (4 g/day), and the fever and inflammatory response began to decrease gradually. We performed a test of sensitivity for Mycobacterium fortuitum, and found that the MIC was low for fluoroquinolone antibacterial agent. The clinical course was good, and the patient was discharged after a total of 8 weeks of intravenous drug administration. At discharge, we changed the treatment regimen to Levofloxacin (500 mg/day) and Clarithromycin (800 mg/day), and prescribed these two drugs as a long life suppressive therapy. Discussion: There are few cases of prosthetic vascular graft infection caused by mycobacteria, and a standard therapy remains to be established. For prosthetic vascular graft infections, it is ideal to provide surgical and medical treatment in parallel, but in this case, surgical treatment was difficult and, therefore, a conservative treatment was chosen. We attempted to increase the treatment success rate of this refractory disease by conducting a susceptibility test for mycobacteria and treating with different combinations of antimicrobial agents, which was ultimately effective. With our treatment approach, a good clinical course was obtained and continues at the present stage. Conclusion: Although prosthetic vascular graft infection resulting from mycobacteria is a refractory infectious disease, it may be curative to administer appropriate antibiotics based on the susceptibility test in addition to surgical treatment.

Keywords: prosthetic vascular graft infection, lung fistula, Mycobacterium fortuitum, conservative treatment

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Authors: Takuya Suzuki, Atsushi Shirai, Takashi Seki

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Acupuncture therapy is one of the treatments in traditional Chinese medicine. Recently, some reports have shown the effectiveness of acupuncture. However, its full acceptance has been hindered by the lack of understanding on mechanism of the therapy. Acupuncture applied to Zusanli (ST-36) enhances blood flow volume in superior mesenteric artery (SMA), yielding peripheral vascular resistance – regulated blood flow of SMA dominated by the parasympathetic system and inhibition of sympathetic system. In this study, a lumped-parameter approximation model of blood flow in the systemic arteries was developed. This model was extremely simple, consisting of the aorta, carotid arteries, arteries of the four limbs and SMA, and their peripheral vascular resistances. Here, the individual artery was simplified to a tapered tube and the resistances were modelled by a linear resistance. We numerically investigated contribution of the peripheral vascular resistance of SMA to the systemic blood distribution using this model. In addition to the upstream end of the model, which correlates with the left ventricle, two types of boundary condition were applied; mean left ventricular pressure which correlates with blood pressure (BP) and mean cardiac output which corresponds to cardiac index (CI). We examined it to reproduce the experimentally obtained hemodynamic change, in terms of the ratio of the aforementioned hemodynamic parameters from their initial values before the acupuncture, by regulating the peripheral vascular resistances and the upstream boundary condition. First, only the peripheral vascular resistance of SMA was changed to show contribution of the resistance to the change in blood flow volume in SMA, expecting reproduction of the experimentally obtained change. It was found, however, this was not enough to reproduce the experimental result. Then, we also changed the resistances of the other arteries together with the value given at upstream boundary. Here, the resistances of the other arteries were changed simultaneously in the same amount. Consequently, we successfully reproduced the hemodynamic change to find that regulation of the upstream boundary condition to the value experimentally obtained after the stimulation is necessary for the reproduction, though statistically significant changes in BP and CI were not observed in the experiment. It is generally known that sympathetic and parasympathetic tones take part in regulation of whole the systemic circulation including the cardiac function. The present result indicates that stimulation to ST-36 could induce vasodilation of peripheral circulation of SMA and vasoconstriction of that of other arteries. In addition, it implies that experimentally obtained small changes in BP and CI induced by the acupuncture may be involved in the therapeutic response.

Keywords: acupuncture, hemodynamics, lumped-parameter approximation, modeling, systemic vascular resistance

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Authors: A. Al-Rifaie, Z. W. Guan, S. W. Jones

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Beam to column connection can be considered as the most important structural part that affects the response of buildings to progressive collapse. However, many studies were conducted to investigate the beam to column connection under accidental loads such as fire, blast and impact load to investigate the connection response. The study is a part of a PhD plan to investigate different types of connections under lateral impact load. The conventional test setups, such as cruciform setup, were designed to apply shear forces and bending moment on the connection, whilst, in the lateral impact case, the connection is subjected to combined tension and moment. Hence, a review is presented to introduce the previous test setup that is used to investigate the connection behaviour. Then, the design and fabrication of the novel test setup is presented. Finally, some trial test results to investigate the efficiency of the proposed setup are discussed. The final results indicate that the setup was efficient in terms of the simplicity and strength.

Keywords: connections, impact load, drop hammer, testing methods

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Authors: Seyed Habib Shojaei, Reza Eivazi, Mir Sajad Shojaei, Alireza Akbari, Pooria Mazloom, Seyede Mitra Sadati, Mir Zeinalabedin Shojaei, Farnaz Farbakhsh

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To study the genetic diversity in rapeseeds and agronomic traits, an experiment was conducted using multivariate statistical methods at Agricultural Research Station of Kashmar in 2012-2013.In this experiment, ten genotypes of rapeseed in a Randomized Complete Block designs with three replications were evaluated. The following traits were studied: seed yield, number of days to the fifty percent of flowering, plant height, number of pods on main stem, length of the pod, seed yield per plant, number of seed in pod, harvest index, weight of 100 seeds, number of pods on lateral branch, number of lateral branches. In analyzing the variance, differences between cultivars were significant. The average comparative revealed that the most valuable variety was Licord regarding to the traits while the least valuable variety was Opera. In stepwise regression, harvest index, grain yield per plant and number of pods per lateral branches were entering to model. Correlation analysis showed that the grain yield with the number of pods per lateral branches and seed yield per plant have positive and significant correlation. In the factor analysis, the first five components explained more than 83% of the variance in the data. In the first factor, seed yield and the number of pods per lateral branches were of the highest importance. The traits, seed yield per plant, and pod per main stem were of a great significance in the second factor. Moreover, in the third factor, plant height and the number of lateral branches were more important. In the fourth factor, plant height and one hundred seeds weight were of the highest variance. Finally, days to fifty percent of flowering and one hundred seeds weight were more important in fifth factor.

Keywords: rapeseed, variance analysis, regression, factor analysis

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Authors: Xinyi Zhao, Furong Tian

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Mycotoxins are secondary metabolic products of fungi. These are poisonous, carcinogens and mutagens in nature and pose a serious health threat to both humans and animals, causing severe illnesses and even deaths. The rapid, simple and cheap detection methods of mycotoxins are of immense importance and in great demand in the food and beverage industry as well as in agriculture and environmental monitoring. Lateral flow immunochromatographic strips (ICSTs) have been widely used in food safety, environment monitoring. Forty-six papers were identified and reviewed on Google Scholar and Scopus for their limit of detection and nanomaterial on Lateral flow immunochromatographic strips on different types of mycotoxins. The papers were dated 2001-2021. Twenty five papers were compared to identify the lowest limit of detection of among different mycotoxins (Aflatoxin B1: 10, Zearalenone:5, Fumonisin B1: 5, Trichothecene-A: 5). Most of these highly sensitive strips are competitive. Sandwich structure are usually used in large scale detection. In conclusion, the mycotoxin receives that most researches is aflatoxin B1 and its limit of detection is the lowest. Gold-nanopaticle based immunochromatographic test strips has the lowest limit of detection. Five papers involve smartphone detection and they all detect aflatoxin B1 with gold nanoparticles. In these papers, quantitative concentration results can be obtained when the user uploads the photograph of test lines using the smartphone application.

Keywords: aflatoxin B1, limit of detection, gold nanoparticle, lateral flow immunochromatographic strips, mycotoxins

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Authors: Mahdi Sadeghian, Mahmoud Hassanlourad, Alireza Ardakani, Reza Dinarvand

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In this research, the behavior of monopiles, under lateral loads, was investigated with vertical and oblique piles by Finite Element Method. In engineering practice when soil-pile interaction comes to the picture some simplifications are applied to reduce the design time. As a simplified replacement of soil and pile interaction analysis, pile could be replaced by a column. The height of the column would be equal to the free length of the pile plus a portion of the embedded length of it. One of the important factors studied in this study was that columns with an equivalent length (free length plus a part of buried depth) could be used instead of soil and pile modeling. The results of the analysis show that the more internal friction angle of the soil increases, the more the bearing capacity of the soil is achieved. This additional length is 6 to 11 times of the pile diameter in dense soil although in loose sandy soil this range might increase.

Keywords: Depth of fixity, Lateral bearing capacity, Oblique pile, Pile group, Soil-structure interaction

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Authors: Jun Hong Lee

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Background: Many dementia patients complain insomnia and depressive mood, and hypnotics and antidepressants are being prescribed. As prevalence of dementia is increasing, insomnia and depressive mood are becoming more important. Objective: We evaluated insomnia and depression in outpatients of dementia center. Patients and Methods/Material and Methods: We reviewed medical records of the patients who visited outpatients clinic of NHIS Ilsan Hospital Dementia Center during 2016. Results: Total 716 patients are included; Subjective Memory Impairment (SMI) : 143 patients (20%), non-amnestic Mild Cognitive Impairment (MCI): single domain 70 (10%), multiple domain 34 (5%), amnestic MCI: single domain 74 (10%), multiple domain 159 (22%), Early onset Alzheimer´s disease (AD): 9 (1%), AD 121 (17%), Vascular dementia: 62 (9%), Mixed dementia 44 (6%). Hypnotics and antidepressants are prescribed as follows; SMI : hypnotics 14 patients (10%), antidepressants 27 (19%), non-amnestic MCI: single domain hypnotics 9 (13%), antidepressants 12 (17%), multiple domain hypnotics 4 (12%), antidepressants 6 (18%), amnestic MCI: single domain hypnotics 10 (14%), antidepressants 16 (22%), multiple domain hypnotics 22 (14%), antidepressants 24 (15%), Early onset Alzheimer´s disease (AD): hypnotics 1 (11%), antidepressants 2 (22%), AD: hypnotics 10 (8%), antidepressants 36 (30%), Vascular dementia: hypnotics 8 (13%), antidepressants 20 (32%), Mixed dementia: hypnotics 4 (9%), antidepressants 17 (39%). Conclusion: Among the outpatients of Dementia Center, MCI and SMI are majorities, and the number of MCI patients are almost half. Depression is more prevalent in AD, and Vascular dementia than MCI and SMI, and about 22% of patients are being prescribed by antidepressants and 11% by hypnotics.

Keywords: insomnia, depression, dementia, antidepressants, hypnotics

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Authors: Mihai-Ionut Firescu, Mark A. P. Carson

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We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

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Authors: Nurzaki Ikhsan, Ahmad Saifizul Abdullah, Rahizar Ramli

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One of the functions of the commercial heavy vehicle is to safely and efficiently transport goods and people. Due to its size and carrying capacity, it is important to study the vehicle dynamic stability during cornering. Study has shown that there are a number of overloaded heavy vehicles or permissible gross vehicle weight (GVW) violations recorded at selected areas in Malaysia assigned by its type and category. Thus, the objective of this study is to investigate the correlation and effect of the GVW on heavy vehicle stability during cornering event using simulation. Various selected heavy vehicle types and category are simulated using IPG/Truck Maker® with different GVW and road condition (coefficient of friction of road surface), while the speed, driver characteristic, center of gravity of load and road geometry are constant. Based on the analysis, the relationship between GVW and lateral acceleration were established. As expected, on the same value of coefficient of friction, the maximum lateral acceleration would be increased as the GVW increases.

Keywords: heavy vehicle, road safety, vehicle stability, lateral acceleration, gross vehicle weight

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Authors: Constantinos Vayenas, Athanasios Fokas, Dimitrios Grigoriou

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We use special relativity to compute the inertial and thus gravitational mass of relativistic electron and muon neutrinos, and we find that, for neutrino kinetic energies above 150 MeV/c2, these masses are in the Planck mass range. Consequently, we develop a simple Bohr-type model using gravitational rather than electrostatic forces between the rotating neutrinos as the centripetal force in order to examine the bound rotational states formed by two or three such relativistic neutrinos. We find that the masses of the composite rotational structures formed, are in the meson and baryon mass ranges, respectively. These models contain no adjustable parameters and by comparing their predictions with the experimental values of the masses of protons and pions, we compute a mass of 0.0437 eV/c2 for the heaviest electron neutrino mass and of 1.1 x10-3 eV/c2 for the heaviest muon neutrino mass.

Keywords: geons, gravitational confinement, neutrino masses, special relativity

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: It is well known that patients with Head and Neck Cancer (HNC) are at increased risk of subsequent head and neck cancers due to various aetiologies. Aim: We sought to determine the factors contributing to an increased risk of subsequent HNC primaries, and also to evaluate whether Aboriginal patients are at increased risk. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. We collected patient data including smoking and alcohol consumption, tumour and treatment data, and data on subsequent HNC primaries. Results: A subsequent HNC primary was seen in 37 patients (11.6%) overall. There was no significant difference in the rate of second primary HNCs between Aboriginal patients (12.5%) and nonAboriginal patients (11.2%) (p=0.408). Subsequent HNCs, were strongly associated with smoking and alcohol consumption however, with 95% of patients with a second primary being ever-smokers, and 54% of patients with a second primary having a history of excessive alcohol consumption. In the 37 patients with multiple HNC primaries, there were a total of 57 HNCs, with 29 patients having two primaries, six patients having 3 HNC primaries, one patient with four, and one with six. 54 out of the 57 cancers were in ever smokers (94.7%). There were only two multiple HNC primaries in a never smoker, non-drinker, and these cases were of unknown etiology with HPV/p16 status unknown in both cases. In the whole study population, there were 32 HPV-positive HNCs, and 67 p16-positive HNCs, with only two 2 nd HNCs in a p16-positive case, giving a rate of 3% in the p16+ population, which is actually much lower than the rate of second primaries seen in the overall population (11.6%), and was highest in the p16-negative population (15.7%). This suggests that p16-positivity is not a strong risk factor for subsequent primaries, and in fact p16-negativity appeared to be associated with increased risk, however this data is limited by the large number of patients without documented p16 status (45.3% overall, 12% for oropharyngeal, and 59.6% for oral cavity primaries had unknown p16 status). Summary: Subsequent HNC primaries were strongly associated with smoking and alcohol excess. Second and later HNC primaries did not appear to occur at increased rates in Aboriginal patients compared with non-Aboriginal patients, and p16-positivity did not predict increased risk, however p16-negativity was associated with an increased risk of subsequent HNCs.

Keywords: head and neck cancer, multiple primaries, aboriginal, p16 status, smoking, alcohol

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Authors: Mohammadreza Saviz, Sina Najafian

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This paper presents an analytical study of vibration moving elevator and shows the elevator 2D dynamic model to evaluate the vertical and lateral motion. Most elevators applied to tall buildings include compensating ropes to satisfy the balanced rope tension between the car and the counterweight. The elasticity of these ropes and springs of sets that connect cabin to ropes make the elevator car to vibrate. A two-dimensional model is derived to calculate vibrations and displacements. The simulation results were validated by the results of similar works.

Keywords: elevator, vibration, simulation, analytical solution, 2D modeling

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: Head and neck cancer and treatments are known for their profound effect on nutrition and tube feeding is a common requirement to maintain nutrition. Aim: We aimed to evaluate the frequency of tube feeding in Aboriginal and non-Aboriginal patients, and to examine the relapse and survival outcomes in patients who require enteral tube feeding. Methods: We performed a retrospective cohort analysis of 320 head and neck cancer patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. Data collected included patient demographics, tumour features, treatment details, and cancer and survival outcomes. Results: Aboriginal and non-Aboriginal patients required feeding tubes at similar rates (42.5% vs 46.2% respectively), however Aboriginal patients were far more likely to fail to return to oral nutrition, with 26.3% requiring long-term tube feeding versus only 15% of non-Aboriginal patients. In the overall study population, 27.5% required short-term tube feeding, 17.8% required long-term enteral tube nutrition, and 45.3% of patients did not have a feeding tube at any point. Relapse was more common in patients who required tube feeding, with relapses in 42.1% of the patients requiring long-term tube feeding, 31.8% in those requiring a short-term tube, versus 18.9% in the ‘no tube’ group. Survival outcomes for patients who required a long-term tube were also significantly poorer when compared to patients who only required a short-term tube, or not at all. Long-term tube-requiring patients were half as likely to survive (29.8%) compared to patients requiring a short-term tube (62.5%) or no tube at all (63.5%). Patients requiring a long-term tube were twice as likely to die with active disease (59.6%) as patients with no tube (28%), or a short term tube (33%). This may suggest an increased relapse risk in patients who require long-term feeding, due to consequences of malnutrition on cancer and treatment outcomes, although may simply reflect that patients with recurrent disease were more likely to have longer-term swallowing dysfunction due to recurrent disease and salvage treatments. Interestingly long-term tube patients were also more likely to die with no active disease (10.5%) (compared with short-term tube requiring patients (4.6%), or patients with no tube (8%)), which is likely reflective of the increased mortality associated with long-term aspiration and malnutrition issues. Conclusions: Requirement for tube feeding was associated with a higher rate of cancer relapse, and in particular, long-term tube feeding was associated with a higher likelihood of dying from head and neck cancer, but also a higher risk of dying from other causes without cancer relapse. This data reflects the complex effect of head and neck cancer and its treatments on swallowing and nutrition, and ultimately, the effects of malnutrition, swallowing dysfunction, and aspiration on overall cancer and survival outcomes. Tube feeding was seen at similar rates in Aboriginal and non-Aboriginal patient, however failure to return to oral intake with a requirement for a long-term feeding tube was seen far more commonly in the Aboriginal population.

Keywords: head and neck cancer, enteral tube feeding, malnutrition, survival, relapse, aboriginal patients

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Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

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Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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Authors: J. Aliyu, A. O. Raji, A. A. Ibrahim

Abstract:

The study was carried out to assess the fertility, early and late embryonic mortalities as well as hatchability by strain, season and hen’s weight in Nigerian indigenous chickens reared on deep litter. Four strains (normal feathered, naked neck, frizzle and dwarf) of hens maintained at a mating ratio of 1 cock to 4 hens, fed breeders mash and water ad libitum were used in a three year experiment. The data generated were subjected to analysis of variance using the SAS package and the means, where significant, were separated using the least significant difference (LSD). There were significant effects (P < 0.05) of strain on all the traits studied. Fertility was generally high (84.29 %) in all the strains. Early embryonic mortality was significantly lowest (P < 0.01) in naked neck which had the highest late embryonic mortality (P < 0.001). Hatchability was significantly highest (P < 0.01) in normal feathered (80.23 %) and slightly depressed in frizzle (74.95 %) and dwarf (72.27 %) while naked neck had the lowest (60.80 %). Season of the year had significant effects on early embryonic mortality. Dry hot season significantly (P < 0.05) depressed fertility while early embryonic mortality was depressed in the wet season (15.33 %). Early and late embryonic mortalities significantly increased (P < 0.05) with increasing weight of hen. Dwarf, frizzle and normal feathered hens could be used to improve hatchability as well as reduce early and late embryonic mortalities in Nigerian indigenous chickens.

Keywords: chicken, fertility, hatchability, indigenous, strain

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Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang

Abstract:

Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).

Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells

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Authors: Mohamed Ali MiladKrem Salem, Sergio F.Breña, Sanjay R. Arwade, Simi T. Hoque

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The location of the main lateral‐load resisting system in high-rise buildings may have positive impacts on sustainability through a reduction in operational energy consumption, and this paper describes an assessment of the accompanying effects on structural performance. It is found that there is a strong influence of design for environmental performance on the structural performance the building, and that systems selected primarily with an eye towards energy use reduction may require substantial additional structural stiffening to meet safety and serviceability limits under lateral load cases. We present a framework for incorporating the environmental costs of meeting structural design requirements through the embodied energy of the core structural materials and also address the issue of economic cost brought on by incorporation of environmental concerns into the selection of the structural system. We address these issues through four case study high-rise buildings with differing structural morphologies (floor plan and core arrangement) and assess each of these building models for cost and embodied energy when the base structural system, which has been suggested by architect Kenneth Yeang based on environmental concerns, is augmented to meet lateral drift requirements under the wind loads prescribed by ASCE 7-10.

Keywords: sustainable, embodied, Outrigger, skyscraper, morphology, efficiency

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Authors: Rene A. Amadore Jr., Ramar John Bangayan, Therese Eileen L. Natividad

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This is a case of a 59-year-old female who presented with a two-year history of heliotrope rash, Gottron's papules, shawl sign, V-neck sign, and muscle weakness. She was previously managed as a case of systemic lupus erythematosus, who initially responded to unrecalled corticosteroids. She was, however, admitted due to a one-month progressively enlarging sacral mass, which eventually turned out to be an abscess. While the abscess was being treated, her autoimmune condition was worked up, and she was then managed as a case of clinically amyopathic dermatomyositis (CADM) with interstitial lung disease (ILD). She received corticosteroids and underwent the first cycle of cyclophosphamide infusion prior to discharge.

Keywords: clinically amyopathic dermatomyositis, interstitial lung disease, corticosteroids, sacral abscess

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Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

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This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

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Authors: Khaled R. Khater

Abstract:

This paper fits in soil-structure interaction division. Its theme is soil retaining structures. Hence, the cantilever secant-pile wall imposed itself, focusing on the capping beam. Four research questions are prompted and beg an answer. How to calculate the forces that control capping beam design? What is the statical system of ‘capping beam-secant pile’ as one unit? Is it possible to design it to satisfy pre-specific lateral deformation? Is it possible to suggest permissible lateral deformation limits? Briefly, pile head displacements induced by Plaxis-2D are converted to forces needed for STAAD-Pro 3D models. Those models are constructed based on the proposed structural system. This is the paper’s idea and methodology. Parametric study performed considered three sand densities, one pile rigidity, and two excavation depths, i.e., 3.0 m and 5.0 m. The research questions are satisfactorily answered. This paper could be a first step towards standardizing analysis, design, and lateral deformations checks.

Keywords: capping beam, secant pile, numerical, design aids, sandy soil

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Authors: Carlos A. Vega-Posada, Jeisson Alejandro Higuita-Villa, Julio C. Saldarriaga-Molina

Abstract:

This paper presents a simplified analytical approach to conduct elastic stability and second-order lateral stiffness analyses of beam-column elements (i.e., piles) with generalized end-boundary conditions embedded on a homogeneous or non-homogeneous Pasternak foundation. The solution is derived using the well-known Differential Transformation Method (DTM), and it consists simply of solving a system of two linear algebraic equations. Using other conventional approaches to solve the governing differential equation of the proposed element can be cumbersome and the solution challenging to implement, especially when the non-homogeneity of the soil is considered. The proposed formulation includes the effects of i) any rotational or lateral transverse spring at the ends of the pile, ii) any external transverse load acting along the pile, iii) soil non-homogeneity, and iv) the second-parameter of the elastic foundation (i.e., shear layer connecting the springs at the top). A parametric study is conducted to investigate the effects of different modulus of subgrade reactions, degrees of non-homogeneities, and intermediate end-boundary conditions on the pile response. The same set of equations can be used to conduct both elastic stability and static analyses. Comprehensive examples are presented to show the simplicity and practicability of the proposed method.

Keywords: elastic stability, second-order lateral stiffness, soil-non-homogeneity, pile analysis

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Authors: Hongfang Ma, Mingchuan Zhou, Haitao Zhang, Weiyong Ying

Abstract:

One dimensional pseudo-homogenous modeling has been performed for methanol steam reforming reactor. The results show that the models can well predict the industrial data. The reactor had minimum temperature along axial because of endothermic reaction. Hydrogen productions and temperature profiles along axial were investigated regarding operation conditions such as inlet mass flow rate and mass fraction of methanol, inlet temperature of external thermal oil. Low inlet mass flow rate of methanol, low inlet temperature, and high mass fraction of methanol decreased minimum temperature along axial. Low inlet mass flow rate of methanol, high mass fraction of methanol, and high inlet temperature of thermal oil made cold point forward. Low mass fraction, high mass flow rate, and high inlet temperature of thermal oil increased hydrogen production. One dimensional models can be a guide for industrial operation.

Keywords: reactor, modeling, methanol, steam reforming

Procedia PDF Downloads 273

Authors: Akbar Nawaz Khan, Abdul Ghaffar, Muhammad Naeem Riaz

Abstract:

The study was conducted to investigate the phenotypic features, morphometry and production potentialities of indigenous naked neck chicken (NN) of Pakistan under intensive management condition. A total of 35 NN chicks were randomly selected, and the experiment was performed at Poultry and wildlife research section NARC Islamabad for a period of 22 weeks. The predominant plumage color was black and golden while skin color was observed white. The average shank length, leg length, thigh length, keel length, chest breadth, head width, wing space, wing length, body length, body girth, body height and pubic bone width in adult males and females were 69.19 ± 3.34mm, 117.93 ± 4.42mm, 117.93 ± 4.42mm, 90.87 ± 6.53mm, 95.03 ± 4.56mm, 49.77 ± 2.53mm, 30.63 ± 1.50cm, 27.24 ± 2.71cm, 18.88 ± 0.65cm, 17.77 ± 1.01cm, 25.96 ± 0.56cm, 47.81 ± 1.41cm and 35.69 ± 4.09mm respectively. The average age and live body weight of NN chicken at sexual maturity were recorded as 165.85 days and 1269.38 g. While hen-day egg production of NN was recorded as 45%. The present study was aimed to investigate the existence of polymorphism at IGF-I gene in indigenous naked neck chicken through PCR based Restriction Fragment Length Polymorphism. Based on restriction analysis using Hinf I restriction enzyme, three genotypes were detected designated as AA, AC, and CC. Restriction analysis of PCR amplified product showed the presence of DNA fragments of 622, 378, 244 and 191, (genotypes). The PCR-RFLP analysis is easy, cost effective method which permits the easy characterization of IGF-I gene. This showed the investigated IGF-I genes can serve as good molecular markers for marker assisted selection (MAS) concerning growth related traits in chicken.

Keywords: Desi chicken, naked neck, morphology, morphometry, production potential, egg traits, egg geometry, IGF-I, growth, PCR- RFLP, chicken

Procedia PDF Downloads 357