Search results for: left truncation

Authors: G. Dadashova, A. Bakhshaliyev

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Aim: Determine gender differences in the etiology and clinical outcomes, as well as in the remodeling of the left ventricle (LV) in patients with chronic heart failure (CHF), suffering from arterial hypertension (AH) and coronary heart disease (CHD). Material and methods: The study included 112 patients of both sexes; aged 45 to 60 years with postinfarction cardiosclerosis had functional class (FC) heart failure II-IV of NYHA which were examined on the basis of Azerbaijan Scientific Research Institute of Cardiology. The patients were divided into 2 groups: 1st c. 60 males, mean age 54,8 ± 3,3 years, and 2nd gr 52 women, mean age 55,8 ± 3,1 years. To assess cardiac hemodynamic all patients underwent echocardiography (B-M-modes) using ‘Vivid 3’. Thus on the basis of indicators such as the index of the relative thickness of the left ventricle wall and the index of left ventricular mass (LVMI) was identified the architectonic model of the left ventricle. Results: According to our research leading cause of heart failure in women is 50.5% of cases of hypertension, ischemic heart disease 23.7% (with 79.5% of the cases developed in patients with chronic heart failure who did not have a history of myocardial infarction). While in men is the undisputed leader of CHD, forming 78.3% of CHF (80.3% in men with CHF occurred after myocardial infarction). According to our research in women more often than men CHF develops a type of diastolic dysfunction (DD, and left ventricular ejection fraction remained unchanged. Since DD occurs in men at 65,8% vs. 76,4% of women when p < 0,05. In the group of women was more common prognostic neblagopryatnye remodeling - eccentric hypertrophy of the left ventricle: 68% vs. 54.5% among men (p < 0,05), concentric left ventricular hypertrophy: 21% in women vs 19,1% (p > 0,05 ). Conclusions: Patients with heart failure are a number of gender-specific: the prevalence of hypertension in women, and coronary heart disease in men. While in women with heart failure often recorded diastolic dysfunction and characterized by the development of prognostically unfavorable remodeling types: eccentric and concentric LV hypertrophy.

Keywords: chronic heart failure, arterial hypertension, remodeling, diastolic dysfunction, men, women, ischemic heart disease

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Authors: Elsayed Fath Khalifa, Samer Mohamed Daghash

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The aim of the current work study to increase the anatomical knowledge about the cattle egret which considered economically important for farmers. The study was carried out on ten adult, apparently healthy cattle egrets of both sexes. Each bird was exsanguinated; the caudal vena cava was cannulated and flushed with warm normal saline solution (0.9%) then injected with blue colored neoprine (60%) latex in order to study the tributaries of the hepatic portal vein. The origin, course and tributaries of the right and left hepatic portal veins were studied. The hepatic portal venous system collected venous blood from the abdominal viscera including; glandular and muscular stomachs, liver, pancreas, spleen, small intestine and large intestine. The hepatic portal vein was formed by the left and the right hepatic portal veins. The smaller left one drained blood from the glandular and muscular stomachs through the ventral and the left proventriculus as well as the left gastric veins. The most tributaries of the right hepatic portal vein drained blood from the rest of the gastrointestinal tract and the spleen by the proventriculosplenic, the gastropancreaticoduodenal and the common mesenteric veins.

Keywords: cattle egret, common mesenteric vein, hepatic portal vein, anatomy

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Authors: Karthikeyan M., Paul M. J.

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This case report discusses a 54-year-old woman from Salem, Tamilnadu, who presented with a rare case of papillary thyroid carcinoma (PTC), manifesting as a hypervascular mass in the left carotid sheath. The patient had a two-and-a-half-month history of non-progressive neck swelling, with symptoms including dysphagia and a choking sensation. Clinical examination and investigations such as FNAC and CECT revealed a large vascular mass in the left neck region, initially perplexing the diagnosis. The patient underwent total thyroidectomy and excision of the left carotid sheath mass. Histopathology confirmed PTC. Postoperatively, the patient received Iodine-131 ablation and showed good recovery with no recurrence. This case highlights the diagnostic challenge and atypical presentation of PTC as a vascular neck mass, emphasizing the importance of a comprehensive approach in evaluating thyroid and neck lesions.

Keywords: lateral neck vascular mass, lateral aberrant thyroid, thyroid vascular swelling, smooth post op recovery

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Authors: Fatma Sümer

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Introduction: This case report aims to report myopic anisometropia with copy-image in monozygotic twins. Methods: In February 2021, a 6-year-old identical twin was seen, who was referred to us with the diagnosis of amblyopia in their left eye from an external center. Both twins had a full ophthalmic examination, which included visual acuity testing, ocular motility testing, cycloplegic refraction, and fundus examination. Results: On examination, “copy image” myopic anisometropia was discovered. Twin 1 had anisometropia with myopic astigmatism in the left eye. His cycloplegic refraction was +1.00 (-0.75x 75) in the right eye and -8.0 (-1.50x175) in the left eye. Similarly, twin 2 had anisometropia with myopic astigmatism in the left eye. His cycloplegic refraction was -7.75 (-1.50x180) in the left eye and +1.25 (-0.75x90 ) in the right eye. The best-corrected visual acuity was 20/60 in the amblyopic eyes and 20/20 in the unaffected eyes. There was no ocular deviation. In either patient, a slit-lamp microscopic examination revealed no abnormalities in the anterior parts of either eye. Fundoscopic examination revealed no abnormalities. No abnormal ocular movements were demonstrated. Conclusion: As far as we have reviewed in the literature, previous studies with twins were mostly concerned with mirror-effect myopic anisometropia and myopic anisometropia, whereas ipsilateral amblyopia and anisometropia were not reported in monozygotic twins. This case underscores the possible genetic basis of myopic anisometropia.

Keywords: amblyopia, anisometropia, myopia, twins

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Authors: Mohammad Alibakhshikenari, Ernesto Limiti, Bal S. Virdee

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The paper presents a miniature wideband antenna using composite right/left-handed transmission-line (CRLH-TL) metamaterial. The proposed planar antenna has a fractional bandwidth of 100% and is designed to operate in several frequency bands from 800MHz to 2.40GHz. The antenna is constructed using just two CRLH-TL unit cells comprising of two T-shaped slots that are inverted. The slots contribute towards generating the series left-handed (LH) capacitance CL. The rectangular patch on which the slots are created is grounded with spiral shaped high impedance stubs that contribute towards LH inductance LL. The antenna has a size of 14×6×1.6mm3 (0.037λ0×0.016λ0× 0.004λ0, where λ0 is free space wavelength at 800MHz). The peak gain and efficiency of the antenna are 1.5 dBi and ~75%, respectively, at 1.6GHz. Proposed antenna is suitable for use in wireless systems working at UHF/L/S-bands, in particular, AMPS, GSM, WCDMA, UMTS, PCS, cellular, DCS, IMT-2000, JCDMA, KPCS, GPS, lower band of WiMAX.

Keywords: miniature antenna, composite right/left-handed transmission line (CRLH-TL), wideband antenna, communication transceiver, metamaterials

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Authors: Jagadish Rao Padubidri, Mehak Bhandary, Sowmya J. Rao

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Introduction: The significance of the human foot and its measurements in identifying an individual has been proved a lot of times by different studies in different geographical areas and its association to the stature and gender of the individual has been justified by many researches. In our study we have used different foot measurements including the length, width, malleol height and navicular height for establishing its association to stature and gender and to find out its accuracy. The purpose of this study is to show the relation of foot measurements with stature and gender, and to derive Multiple and Logistic regression equations for stature and gender estimation in South Indian population. Materials and Methods: The subjects for this study were 200 South Indian students out of which 100 were females and 100 were males, aged between 18 to 24 years. The data for the present study included the stature, foot length, foot breath, foot malleol height, foot navicular height of both right and left foot. Descriptive statistics, T-test and Pearson correlation coefficients were derived between stature, gender and foot measurements. The stature was estimated from right and left foot measurements for both male and female South Indian population using multiple regression analysis and logistic regression analysis for gender estimation. Results: The means, standard deviation, stature, right and left foot measurements and T-test in male population were higher than in females. LFL (Left foot length) is more than RFL (Right Foot length) in male groups, but in female groups the length of both foot are almost equal [RFL=226.6, LFL=227.1]. There is not much of difference in means of RFW (Right foot width) and LFW (Left foot width) in both the genders. Significant difference were seen in mean values of malleol and navicular height of right and left feet in male gender. No such difference was seen in female subjects. Conclusions: The study has successfully demonstrated the correlation of foot length in stature estimation in all the three study groups in both right and left foot. Next in parameters are Foot width and malleol height in estimating stature among male and female groups. Navicular height of both right and left foot showed poor relationship with stature estimation in both male and female groups. Multiple regression equations for both right and left foot measurements to estimate stature were derived with standard error ranging from 11-12 cm in males and 10-11 cm in females. The SEE was 5.8 when both male and female groups were pooled together. The logistic regression model which was derived to determine gender showed 85% accuracy and 92.5% accuracy using right and left foot measurements respectively. We believe that stature and gender can be estimated with foot measurements in South Indian population.

Keywords: foot length, gender, stature, South Indian

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Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

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Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

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Authors: Gulam Anwer Khan, A. Gautam

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Background: The arch of aorta is a large artery that arches over the root of the left lung and connects the ascending aorta and descending aorta. It is situated in the superior mediastinum behind the manubrium sterni. It gives off three major branches i.e. brachiocephalic trunk, left common carotid artery and left subclavian artery arising from the superior surface of arch of aorta from right to left. Material and Methods: This was a descriptive study. It was carried out in 44 cadavers, obtained during dissections for undergraduates of Department of Anatomy, Chitwan Medical College, Bharatpur, Chitwan, between March 2015 to October 2016. Cadavers of both sexes were included in the present study. The arch of aorta was dissected and exposed according to the methods described by Romanes in Cunningham’s manual of practical anatomy. Results: Out of 44 dissected cadavers, 35 (79.54%) were male and 9 (20.46%) were female cadavers. The normal branching pattern of the arch of aorta was encountered in 28 (63.64%) cadavers and the remaining 16 (36.36%) cadavers showed variations in the branching pattern of arch of aorta. Two different types of variations on the branching pattern of arch of aorta were noted in the present study, in which 12 (27.27%) cadavers had common trunk of the Arch of Aorta. In 3 (5.00%) male cadavers, we found the origin of the Thyroid ima artery. This variation was noted in 1(1.66%) female cadaver. Conclusion: The present study carried out on adult human cadavers’ revealed wide variations in the branching pattern of the arch of ao rta. These variations are of clinical significance and also very useful for the anatomists, radiologists, anesthesiologists, surgeons for practice during angiography, instrumentation, supra-aortic thoracic, head and neck surgery.

Keywords: arch of aorta, brachiocephalic trunk, left common carotid artery, left subclavian artery, Thyroidea ima artery

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Authors: Eman A. Embaby, Amira A. A. Abdallah

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Background: Occupational standing is associated with low back pain (LBP) development. Yet, trunk and gluteus-medius muscles’ fatigability has not been extensively studied during occupational standing. This study examined and correlated the rectus abdominus (RA), erector-spinae (ES), external oblique (EO), and gluteus-medius (GM) muscles’ fatigability on both sides while standing in a confined area for 30 min Methods: Median frequency EMG data were collected from 15 female clinical instructors with chronic LBP (group A) and 15 asymptomatic controls (group B) (mean age 29.53±2.4 vs. 29.07±2.4 years, weight 63.6±7 vs. 60±7.8 kg, and height 162.73±4 vs. 162.8±6 cm respectively) using a spectrum analysis program. Data were collected in the first and last 5min of the standing task. Results: Using Mixed three-way ANOVA, group A showed significantly (p<0.05) lower frequencies for the right and left ES, and right GM in the last 5 min and significantly higher frequencies for the left RA in the first and last 5min than group B. In addition, the left ES and right EO, ES and GM in group B showed significantly higher frequencies and the left ES in group A showed significantly lower frequencies in the last 5min compared with the first. Moreover, the right RA showed significantly higher frequencies than the left in the last 5min in group B. Finally, there were significant (p<0.05) correlations among the median frequencies of the tested four muscles on the same side and between both sides in both groups. Discussion/Conclusions: Clinical instructors with LBP are more liable to have higher trunk and gluteus-medius muscle fatigue than asymptomatic individuals. Thus, endurance training for these muscles should be included in the rehabilitation of such patients.

Keywords: EMG, fatigability, gluteus-medius, LBP, standing, trunk

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Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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Authors: Daoudi Abdelaziz, Mahmoudi Saïd, Chikh Mohamed Amine

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This paper presents a fully automatic segmentation method of the left ventricle at End Systolic (ES) and End Diastolic (ED) in the ultrasound images by means of an implicit deformable model (level set) based on Geodesic Active Contour model. A pre-processing Gaussian smoothing stage is applied to the image, which is essential for a good segmentation. Before the segmentation phase, we locate automatically the area of the left ventricle by using a detection approach based on the Hough Transform method. Consequently, the result obtained is used to automate the initialization of the level set model. This initial curve (zero level set) deforms to search the Endocardial border in the image. On the other hand, quantitative evaluation was performed on a data set composed of 15 subjects with a comparison to ground truth (manual segmentation).

Keywords: level set method, transform Hough, Gaussian smoothing, left ventricle, ultrasound images.

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Authors: Rotimi Sunday Ajani, Omowumi Femi-Akinlosotu

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Background: The usually paired human kidneys are retroperitoneal urinary organs with some endocrine functions. Standard text books of anatomy ascribe single value to each of the dimension of length, width and thickness. Research questions: These values do not give consideration to racial and genetic variability in human morphology. They may thus be erroneous to students and clinicians working on Nigerians. Objectives: The study aimed at establishing reference values of the kidney length, width and thickness for Nigerians using the cadaveric model. Methodology: The length, width, thickness and weight of sixty kidneys harvested from cadavers of thirty adult Nigerians (Male: Female; 27: 3) were measured. Respective volume was calculated using the ellipsoid formula. Results: The mean length of the kidney was 9.84±0.89 cm (9.63±0.88 {right}; 10.06±0.86 {left}), width- 5.18±0.70 cm (5.21±0.72 {right}; 5.14±0.70 {left}), thickness-3.45±0.56 cm (3.36±0.58 {right}, 3.53±0.55 {left}), weight-125.06±22.34 g (122.36±21.70 {right}; 127.76 ±24.02 {left}) and volume of 95.45± 24.40 cm3 (91.73± 26.84 {right}; 99.17± 25.75 {left}). Discussion: Though the values of the parameters measured were higher for the left kidney (except for the width), they were not statistically significant. The various parameters obtained by this study differ from those of similar studies from other continents. Conclusion: Stating single value for each of the parameter of length, width and thickness of the kidney as currently obtained in textbooks of anatomy may be incomplete information and hence misleading. Thus, there is the need to emphasize racial differences when stating the normal values of kidney dimensions in textbooks of anatomy. Implication for Research and Innovation: The results of the study showed the dimensions of the kidney (length, width and thickness) have interracial vagaries as they were different from those of similar studies and values stated in standard textbooks of human anatomy. Future direction: This is a preliminary report and the study will continue so that more data will be obtained.

Keywords: kidney dimensions, cadaveric estimation, adult nigerians, racial differences

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Authors: Aditya Sethi, Vaibhav Sethi, Shenouda Girgis

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We present a case of a 31-year-old female who presented with a three week history of left eye blurry vision following a fever. She was diagnosed with Typhoid fever, confirmed by a positive Widal test report. On examination, her best corrected visual acuity in the right eye was 20/20 and in the left eye was 20/60. Fundus examination of the right eye showed a focal area of retinitis with retinal haemorrhages along the superior arcade within the macula. There was also focal area of retinitis with superficial retinal haemorrhages along the superior arcade vessels. There was also presence of multiple yellowish white exudates within the adjacent retinal artery arranged in a beaded pattern, suggestive of Kyrieleis' vasculitis. Optical Coherence Tomography (OCT) of the left eye demonstrated cystoid macula edema with serous foveal detachment.

Keywords: typhoid retinitis, Kyrieleis’ vasculitis, immune-mediated retinitis, post-fever retinitis, typhoid retinopathy, retinitis

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Authors: Yu-Chu Yeh, WeiChin Hsu, Chih-Yen Chang

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Substitution, combination, modification, putting to other uses, elimination, and rearrangement (SCAMPER) has been regarded as an effective technique that provides a structured way to help people to produce creative ideas and solutions. Although some neuroscience studies regarding creativity training have been conducted, no study has focused on SCAMPER. This study therefore aimed at examining whether the learning of SCAMPER through video tutorials would result in alternations of neural activation. Thirty college students were randomly assigned to the experimental group or the control group. The experimental group was requested to watch SCAMPER videos, whereas the control group was asked to watch natural-scene videos which were regarded as neutral stimulating materials. Each participant was brain scanned in a Functional magnetic resonance imaging (fMRI) machine while undertaking a creativity test before and after watching the videos. Furthermore, a two-way ANOVA was used to analyze the interaction between groups (the experimental group; the control group) and tasks (C task; M task; X task). The results revealed that the left precuneus significantly activated in the interaction of groups and tasks, as well as in the main effect of group. Furthermore, compared with the control group, the experimental group had greater activation in the default mode network (left precuneus and left inferior parietal cortex) and the motor network (left postcentral gyrus and left supplementary area). The findings suggest that the SCAMPER training may facilitate creativity through the stimulation of the default mode network and the motor network.

Keywords: creativity, default mode network, neural activation, SCAMPER

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Authors: Ritesh Verma, Manisha Rathi, Chand Singh Dhull, Sumit Sachdeva, Jitender Phogat

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A Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly and ranges in size from 2 to 40mm in diameter. A 38-year-old male presented to the outpatient department with loss of vision in the inferior quadrant of the left eye since 15 days. Visual acuity was 6/6 in the right eye and 6/9 in the left eye. Visual field analysis by HFA-24-2 revealed an inferior field defect extending to the supero-temporal quadrant in the left eye. MRI brain and orbit was advised to the patient and it revealed a well defined cystic pituitary adenoma indenting left optic nerve near optic chiasm consistent with the diagnosis of Rathke’s cleft cyst (RCC). The patient was referred to neurosurgery department for further management. Symptoms vary greatly between individuals having RCCs. RCCs can be non-functioning, functioning, or both. Besides headaches, neurocognitive deficits are almost always present but have a high rate of immediate reversal if the cyst is properly treated or drained.

Keywords: pituitary tumors, rathke’s cleft cyst, visual field defects, vision loss

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Authors: Anton Andreev

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With the collapse of the Soviet Union and the collapse of a large part of the socialist regimes, left-wing parties all over the world entered the space of crisis, of problems with ideology, identity, with the definition of its goals and objectives. First of all, we can say that the communist parties actually lost their foundation. In 1992, despite the victory of left-wing forces, a Broad Front in which was the winner in the struggle against dictatorship plunged into a deep crisis, the nature of which is looking for a new platform, a new foundation, new goals. Thus, in the late 20th century, the party has revised theoretical beliefs and positions. Radical communist ideology was moderated to social reformism. Modern leftist movement in Uruguay is a movement of moderate reform. Left forces suggest going through successive changes. Changes in ideology and ideas have influenced to the understanding of foreign policy. After the collapse of the Soviet Union Broad Front has changed the direction of its diplomacy from the orientation to the Soviet state to support the USA policy. Government formed by Broad Front, supported the integration processes in the South America. Uruguay was developing the cooperation in the framework of MERCOSUR and began to create relationship with the new centers of power in world political space. Uruguay in the early 21st century is a country that starts to play important role in the international arena. Elections of 26 October 2014 should answer the question of support of internal policy of a Broad Front, as well as of the support of the diplomatic work of the "Left" governments of the country.

Keywords: Uruguay, broad front, Vazquez, international dimensions

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Authors: Eleni Peristeri, Georgia Fotiadou, Ianthi-Maria Tsimpli

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The local-global dimension has been studied extensively in healthy controls and preference for globally processed stimuli has been validated in both the visual and auditory modalities. Critically, the local-global dimension has an inherent interference resolution component, a type of cognitive control, and left-prefrontal-cortex-damaged (LPFC) individuals have exhibited inability to override habitual response behaviors in item recognition tasks that involve representational interference. Eight patients with damage in the left PFC (age range: 32;5 to 69;0. Mean age: 54;6 yrs) and twenty age- and education-matched language-unimpaired adults (mean age: 56;7yrs) have participated in the study. Distinct performance patterns were found between the language-unimpaired and the LPFC-damaged group which have mainly stemmed from the latter’s difficulty with inhibiting global stimuli in incongruent trials. Overall, the local-global attentional dimension affects LPFC-damaged individuals with non-fluent aphasia in non-language domains implicating distinct types of inhibitory processes depending on the level of processing.

Keywords: left lateral prefrontal cortex damage (LPFC), local-global non-language attention, representational interference, non-fluent aphasia

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Authors: Inci Kesilmis, Manolya Akin, Mehmet Melih Kesilmis

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The aim of this research was to compare dynamic balance ability (bipedal, right, left foot) and plantar-dorsi flexion range of motion in fencers and swimmers. 43 fencers participated as volunteer with mean age 15.74±1.90year and mean training year 4.97±2.37year. 25 swimmers participated as volunteer with mean age 15.36±1.65 yr. and mean training year 5.98±2.35 yr. Dynamic balance measured while participants were standing in the anatomical position with prokin tecno body for bipedal, right, left foot. Plantar and dorsal flexion range of motion measured while participants in seated position on the examination table and goniometer placed on the lateral malleolus. For statistical analyses; independent samples t test was used. There were significant differences between bipedal (p < 0.05), right foot (p < 0.05), left foot (p < 0.05) dynamic balance ability in favor of fencers. Also there was significant difference between right and left foot dorsal flexion range of motion (p < 0.001) in favor of fencers. There was no significant difference in plantar flexion range of motion between fencers and swimmers. The difference observed in fencers may be due to the use of more dorsal flexion in action moves and that swimming does not impact loading sport and it is performed in pool.

Keywords: fencing, swimming, dynamic balance, flexibility

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Authors: Christine Ysabelle G. Roman, Pauline Torres

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

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

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Authors: Joanna Bielecka-Prus

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In the view of increasing number of labour migrations associated with broadly understood economic crisis, many families experience migration separation. Currently, in the era of globalization, migration movements include an increasing number of families, more and more frequently a new type of family, a transnational family. Accordingly, the functions of the family, family practice of care, and the relationships between members of the group change especially in the case of female migration. Sociologists highlight the emotional aspects of migrants’ family lives: managing emotions, coping with guilt, loneliness and rejection. Not without significance is the fact that today's public discourse often represents migrant women in a negative light. On the one hand, consumption and expanding material resources are assessed positively, on the other hand, deficits emotional and devastation of family life in the transnational families appear. Opinions expressed by different environments: the media, the political environment, etc. do not always take into account the context of mobility and their different effects on family life. The paper will present the analysis of qualitative studies of Polish female migrants’ families left-behind (children, parents, caregivers N = 100) and their coping strategies in different situations in the event of migration separation. The main area of care deficit will be defined and it will be showed who and how help to solve the problems.

Keywords: care, children left behind, female migration, parents left behind

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Authors: Manju Pandey, Nilay Khare, S. C. Shrivastava

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This paper is the final in a series, which has defined two new classes of aggregation operators for triangular and trapezoidal fuzzy numbers based on the geometrical characteristics of their fuzzy membership functions. In the present paper, a new aggregation operator for trapezoidal fuzzy numbers has been defined. The new operator is based on the geometric mean of the membership lines to the left and right of the maximum possibility interval. The operator is defined and the analytical relationships have been derived. Computation of the aggregate is demonstrated with a numerical example. Corresponding arithmetic and geometric aggregates as well as results from the recent work of the authors on TrFN aggregates have also been computed.

Keywords: LR fuzzy number, interval fuzzy number, triangular fuzzy number, trapezoidal fuzzy number, apex angle, left apex angle, right apex angle, aggregation operator, arithmetic and geometric mean

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Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu

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Objective: This study analyzed three criminal judicial cases. We applied the damage analysis of the two vehicles to verify other evidence, such as dashboard camera records of each accident, reconstruct the scenes, and pursue the truth. Methods: Evidence analysis, the method is to collect evidence and the reason for the results in judicial procedures, then analyze the involved damage evidence to verify other evidence. The collision damage analysis method is to inspect the damage to the vehicles and utilize the principles of tool mark analysis, Newtonian physics, and vehicle structure to understand the relevant factors when the vehicles collide. Results: Case 1: Sedan A turned right at the T junction and collided with Scooter B, which was going straight on the left road. The dashboard camera records showed that the left side of Sedan A’s front bumper collided with the body of Scooter B and rider B. After the analysis of the study, the truth was that the front of the left side of Sedan A impacted the right pedal of Scooter B and the right lower limb of rider B. Case 2: Sedan C collided with Scooter D on the left road at the crossroads. The dashboard camera record showed that the left side of the Sedan C’s front bumper collided with the body of Scooter D and rider D. After the analysis of the study, the truth was that the left side of the Sedan C impacted the left side of the car body and the front wheel of Scooter D and rider D. Case 3: Sedan E collided with Scooter F on the right road at the crossroads. The dashboard camera record showed that the right side of the Sedan E’s front bumper collided with the body of Scooter F and rider F. After the analysis of the study, the truth was that the right side of the front bumper and the right side of the Sedan F impacted the Scooter. Conclusion: The application of collision damage analysis in the reconstruction of a sedan-scooter collision could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the road safety policy.

Keywords: evidence analysis, collision damage analysis, accident reconstruction, sedan-scooter collision, dashboard camera records

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Authors: Tianyu Chen

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The No Child Left Behind Act (NCLB) of 2001 was a major federal education policy that aimed to improve academic outcomes for all students in the United States. This study examines whether NCLB improved college readiness, measured by access to higher education, for different demographic groups. Using data from the Integrated Public Use Microdata Series (IPUMS) from 2003-2008, regression analyses explore the relationship between gender, race, family income, and region with occupational education score. The results indicate that NCLB implementation had a positive effect on college access for women and Asian students compared to other groups. Higher family income was also associated with an increased likelihood of pursuing higher education, especially for families in the South. While NCLB intended to close achievement gaps, disparities in college readiness remained five years after implementation. Further research could examine longer-term trends and additional factors influencing the policy's effectiveness across student subgroups. This study provides evidence that simply holding schools accountable for test scores may not sufficiently improve equitable educational outcomes. More targeted support of disadvantaged groups may be needed to fulfill the goal of "no child left behind."

Keywords: no child left behind act, college readiness, achievement gaps, educational equity

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Authors: Anthony S. Machi, Joseph Minardi

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We present a case report of left atrial myxoma diagnosed by bedside transesophageal (TEE) ultrasound. Left atrial myxoma is the most common benign cardiac tumor and can obstruct blood flow and cause valvular insufficiency. Common symptoms consist of dyspnea, pulmonary edema and other features of left heart failure in addition to thrombus release in the form of tumor fragments. The availability of bedside ultrasound equipment is essential for the quick diagnosis and treatment of various emergency conditions including cardiac neoplasms. A 48-year-old Caucasian female with a four-year history of an untreated renal mass and anemia presented to the ED with two months of sharp, intermittent, bilateral flank pain radiating into the abdomen. She also reported intermittent vomiting and constipation along with generalized body aches, night sweats, and 100-pound weight loss over last year. She had a CT in 2013 showing a 3 cm left renal mass and a second CT in April 2016 showing a 3.8 cm left renal mass along with a past medical history of diverticulosis, chronic bronchitis, dyspnea on exertion, uncontrolled hypertension, and hyperlipidemia. Her maternal family history is positive for breast cancer, hypertension, and Type II Diabetes. Her paternal family history is positive for stroke. She was a current everyday smoker with an 11 pack/year history. Alcohol and drug use were denied. Physical exam was notable for a Grade II/IV systolic murmur at the right upper sternal border, dyspnea on exertion without angina, and a tender left lower quadrant. Her vitals and labs were notable for a blood pressure of 144/96, heart rate of 96 beats per minute, pulse oximetry of 96%, hemoglobin of 7.6 g/dL, hypokalemia, hypochloremia, and multiple other abnormalities. Physicians ordered a CT to evaluate her flank pain which revealed a 7.2 x 8.9 x 10.5 cm mixed cystic/solid mass in the lower pole of the left kidney and a filling defect in the left atrium. Bedside TEE was ordered to follow up on the filling defect. TEE reported an ejection fraction of 60-65% and visualized a mobile 6 x 3 cm mass in the left atrium attached to the interatrial septum extending into the mitral valve. Cardiothoracic Surgery and Urology were consulted and confirmed a diagnosis of left atrial myxoma and clear cell renal cell carcinoma. The patient returned a week later due to worsening nausea and vomiting and underwent emergent nephrectomy, lymph node dissection, and colostomy due to a necrotic colon. Her condition declined over the next four months due to lung and brain metastases, infections, and other complications until she passed away.

Keywords: bedside ultrasound, echocardiography, emergency medicine, left atrial myxoma

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Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan

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Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.

Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound

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Authors: Deepti Kohli, Meeta Keswani Mehra

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The paper develops a theoretical model of electoral competition with purely opportunistic candidates and a uni-dimensional policy using the probability voting approach while focusing on the aspect of lobby formation to analyze the inherent complex interactions between centripetal and centrifugal forces and their effects on equilibrium policy platforms. There exist three types of agents, namely, Left-wing, Moderate and Right-wing who comprise of the total voting population. Also, it is assumed that the Left and Right agents are free to initiate a lobby of their choice. If initiated, these lobbies generate donations which in turn can be contributed to one (or both) electoral candidates in order to influence them to implement the lobby’s preferred policy. Four different lobby formation scenarios have been considered: no lobby formation, only Left, only Right and both Left and Right. The equilibrium policy platforms, amount of individual donations by agents to their respective lobbies and the contributions offered to the electoral candidates have been solved for under each of the above four cases. Since it is assumed that the agents cannot coordinate each other’s actions during the lobby formation stage, there exists a probability with which a lobby would be formed, which is also solved for in the model. The results indicate that the policy platforms of the two electoral candidates converge completely under the cases of no lobby and both (extreme) formations but diverge under the cases of only one (Left or Right) lobby formation. This is because in the case of no lobby being formed, only the centripetal forces (emerging from the election-winning aspect) are present while in the case of both extreme (Left-wing and Right-wing) lobbies being formed, centrifugal forces (emerging from the lobby formation aspect) also arise but cancel each other out, again resulting in a pure policy convergence phenomenon. In contrast, in case of only one lobby being formed, both centripetal and centrifugal forces interact strategically, leading the two electoral candidates to choose completely different policy platforms in equilibrium. Additionally, it is found that in equilibrium, while the donation by a specific agent type increases with the formation of both lobbies in comparison to when only one lobby is formed, the probability of implementation of the policy being advocated by that lobby group falls.

Keywords: electoral competition, equilibrium policy platforms, lobby formation, opportunistic candidates

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Authors: Nicholas Pearce, Eun-jin Kim

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Pathologies of the cardiovascular (CV) system remain a serious and deadly health problem for human society. Computational modelling provides a relatively accessible tool for diagnosis, treatment, and research into CV disorders. However, numerical models of the CV system have largely focused on the function of the ventricles, frequently overlooking the behaviour of the atria. Furthermore, in the study of the pressure-volume relationship of the heart, which is a key diagnosis of cardiac vascular pathologies, previous works often evoke popular yet questionable time-varying elastance (TVE) method that imposes the pressure-volume relationship instead of calculating it consistently. Despite the convenience of the TVE method, there have been various indications of its limitations and the need for checking its validity in different scenarios. A model of the combined left ventricle (LV) and left atrium (LA) is presented, which consistently considers various feedback mechanisms in the heart without having to use the TVE method. Specifically, a synergistic model of the left ventricle is extended and modified to include the function of the LA. The synergy of the original model is preserved by modelling the electro-mechanical and chemical functions of the micro-scale myofiber for the LA and integrating it with the microscale and macro-organ-scale heart dynamics of the left ventricle and CV circulation. The atrioventricular node function is included and forms the conduction pathway for electrical signals between the atria and ventricle. The model reproduces the essential features of LA behaviour, such as the two-phase pressure-volume relationship and the classic figure of eight pressure-volume loops. Using this model, disorders in the internal cardiac electrical signalling are investigated by recreating the mechano-electric feedback (MEF), which is impossible where the time-varying elastance method is used. The effects of AV node block and slow conduction are then investigated in the presence of an atrial arrhythmia. It is found that electrical disorders and arrhythmia in the LA degrade the CV system by reducing the cardiac output, power, and heart rate.

Keywords: cardiovascular system, left atrium, numerical model, MEF

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Authors: Liliane Clark

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Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

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Authors: Yaya Gao, Jifeng Liu, Yafeng Liu

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

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

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Authors: Arthi Ganapathy, Rati Tandon, Saroj Kaler

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Introduction: A thorough knowledge of variations in lung anatomy is of prime significance during surgical procedures like lobectomy, pneumonectomy, and segmentectomy of lungs. The arrangement of structures in the lung hilum act as a guide in performing such procedures. The normal pattern of arrangement of hilar structures in the right lung is eparterial bronchus, pulmonary artery, hyparterial bronchus and pulmonary veins from above downwards. In the left lung, it is pulmonary artery, principal bronchus and pulmonary vein from above downwards. The arrangement of hilar structures from anterior to posterior in both the lungs is pulmonary vein, pulmonary artery, and principal bronchus. The bronchial arteries are very small and usually the posterior most structures in the hilum of lungs. Aim: The present study aims at reporting the variations in hilar anatomy (arrangement and number) of lungs. Methodology: 75 adult formalin fixed cadaveric lungs from the department of Anatomy AIIMS New Delhi were observed for variations in the lobar anatomy. Arrangement of pulmonary hilar structures was meticulously observed, and any deviation in the pattern of presentation was recorded. Results: Among the 75 adult lung specimens observed 36 specimens were of right lung and the rest of left lung. Seven right lung specimens showed only 2 lobes with an oblique fissure dividing them and one left lung showed 3 lobes. The normal pattern of arrangement of hilar structures was seen in 22 right lungs and 23 left lungs. Rest of the lung specimens (14 right and 16 left) showed a varied pattern of arrangement of hilar structures. Some of them showed alterations in the sequence of arrangement of pulmonary artery, pulmonary veins, bronchus, and others in the number of these structures. Conclusion: Alterations in the pattern of arrangement of structures in the lung hilum are quite frequent. A compromise in knowledge of such variations will result in inadvertent complications like intraoperative bleeding during surgical procedures.

Keywords: fissures, hilum, lobes, pulmonary

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