Search results for: nerve conduction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 517

Search results for: nerve conduction

457 A Rare Case of Popliteal Artery Aneurysm Presenting with Foot Drop

Authors: John Yahng, Riteesh Bookun

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Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenmosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

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456 Case Report: A Rare Case of Popliteal Artery Aneurysm Presenting with Foot Drop

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by 21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

Procedia PDF Downloads 374
455 Application of Residual Correction Method on Hyperbolic Thermoelastic Response of Hollow Spherical Medium in Rapid Transient Heat Conduction

Authors: Po-Jen Su, Huann-Ming Chou

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In this article we uses the residual correction method to deal with transient thermoelastic problems with a hollow spherical region when the continuum medium possesses spherically isotropic thermoelastic properties. Based on linear thermoelastic theory, the equations of hyperbolic heat conduction and thermoelastic motion were combined to establish the thermoelastic dynamic model with consideration of the deformation acceleration effect and non-Fourier effect under the condition of transient thermal shock. The approximate solutions of temperature and displacement distributions are obtained using the residual correction method based on the maximum principle in combination with the finite difference method, making it easier and faster to obtain upper and lower approximations of exact solutions. The proposed method is found to be an effective numerical method with satisfactory accuracy. Moreover, the result shows that the effect of transient thermal shock induced by deformation acceleration is enhanced by non-Fourier heat conduction with increased peak stress. The influence on the stress increases with the thermal relaxation time.

Keywords: maximum principle, non-Fourier heat conduction, residual correction method, thermo-elastic response

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454 Optimization of Cu (In, Ga)Se₂ Based Thin Film Solar Cells: Simulation

Authors: Razieh Teimouri

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Electrical modelling of Cu (In,Ga)Se₂ thin film solar cells is carried out with compositionally graded absorber and CdS buffer layer. Simulation results are compared with experimental data. Surface defect layers (SDL) are located in CdS/CIGS interface for improving open circuit voltage simulated structure through the analysis of the interface is investigated with or without this layer. When SDL removed, by optimizing the conduction band offset (CBO) position of the buffer/absorber layers with its recombination mechanisms and also shallow donor density in the CdS, the open circuit voltage increased significantly. As a result of simulation, excellent performance can be obtained when the conduction band of window layer positions higher by 0.2 eV than that of CIGS and shallow donor density in the CdS was found about 1×10¹⁸ (cm⁻³).

Keywords: CIGS solar cells, thin film, SCAPS, buffer layer, conduction band offset

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453 Solitary Fibrous Tumor Presumed to Be a Peripheral Nerve Sheath Tumor Involving Right Branchial Plexus

Authors: Daniela Proca, Yuan Rong, Salvatore Luceno, Jalil Nasibli

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Introduction: Solitary Fibrous Tumors (SFT) have many histologic mimickers and the only way to diagnose it, particularly in an unusual location, such as peripheral nerve trunks, is to use a comprehensive immunohistochemical staining panel. Monoclonal STAT6 immunostain is highly sensitive and specific for SFTs and particularly useful in the diagnosis of difficult SFT cases. Methods: We describe a solitary fibrous tumor (SFT) involving the right branchial plexus in a 66 yo female with 4-year history of slowly growing chest wall mass with recent dysesthesias in fingers 4th and 5th. MRI showed a well-circumscribed heterogenous mass measuring 5.4 x 3.8 x 4.0 cm and encircling peripheral nerves of the branchial plexus; no involvement of the bone or muscle was noted. A biopsy showed a bland spindled and epithelioid proliferation with no significant mitotic activity, no necrosis, and no atypia; peripheral nerve fascicles were encircled by the lesion. The main clinical and pathologic differential diagnosis included peripheral nerve sheath tumor, particularly schwannoma; HE microscopy didn’t show the classic Antoni A and B areas but showed focal subtle nuclear palisading, as well as prominent vessels with hyalinization. Immunohistochemical stains showed focal, weak cytoplasmic S100 positivity in the lesion; CD 34 and Vimentin were strongly and diffusely positive; the neoplastic cells were negative with AE1/AE3, EMA, CD31, SMA, Desmin, Calretinin, HMB-45, Melan A, PAX-8, NSE. The immunohistochemical and histologic pattern was not typical of peripheral nerve sheath tumor. On additional stains, the tumor was positive with STAT-6 and bcl-2 and focally positive with CD99. Given this profile, the final diagnosis was that of a solitary fibrous tumor. Results: NA Conclusion: Very few SFTs involving peripheral nerves and mimicking a peripheral nerve sheath tumor are described in the literature. Although histologically benign on this biopsy, long-term follow-up is required because of the risk of recurrence of these tumors and their uncertain biological behavior.

Keywords: solitary fibrous tumor, pathology, diagnosis, immunohistochemistry

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452 Solving Transient Conduction and Radiation using Finite Volume Method

Authors: Ashok K. Satapathy, Prerana Nashine

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Radiative heat transfer in participating medium was anticipated using the finite volume method. The radiative transfer equations are formulated for absorbing and anisotropically scattering and emitting medium. The solution strategy is discussed and the conditions for computational stability are conferred. The equations have been solved for transient radiative medium and transient radiation incorporated with transient conduction. Results have been obtained for irradiation and corresponding heat fluxes for both the cases. The solutions can be used to conclude incident energy and surface heat flux. Transient solutions were obtained for a slab of heat conducting in slab by thermal radiation. The effect of heat conduction during the transient phase is to partially equalize the internal temperature distribution. The solution procedure provides accurate temperature distributions in these regions. A finite volume procedure with variable space and time increments is used to solve the transient energy equation. The medium in the enclosure absorbs, emits, and anisotropically scatters radiative energy. The incident radiations and the radiative heat fluxes are presented in graphical forms. The phase function anisotropy plays a significant role in the radiation heat transfer when the boundary condition is non-symmetric.

Keywords: participating media, finite volume method, radiation coupled with conduction, heat transfer

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451 Text Mining Past Medical History in Electrophysiological Studies

Authors: Roni Ramon-Gonen, Amir Dori, Shahar Shelly

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Background and objectives: Healthcare professionals produce abundant textual information in their daily clinical practice. The extraction of insights from all the gathered information, mainly unstructured and lacking in normalization, is one of the major challenges in computational medicine. In this respect, text mining assembles different techniques to derive valuable insights from unstructured textual data, so it has led to being especially relevant in Medicine. Neurological patient’s history allows the clinician to define the patient’s symptoms and along with the result of the nerve conduction study (NCS) and electromyography (EMG) test, assists in formulating a differential diagnosis. Past medical history (PMH) helps to direct the latter. In this study, we aimed to identify relevant PMH, understand which PMHs are common among patients in the referral cohort and documented by the medical staff, and examine the differences by sex and age in a large cohort based on textual format notes. Methods: We retrospectively identified all patients with abnormal NCS between May 2016 to February 2022. Age, gender, and all NCS attributes reports were recorded, including the summary text. All patients’ histories were extracted from the text report by a query. Basic text cleansing and data preparation were performed, as well as lemmatization. Very popular words (like ‘left’ and ‘right’) were deleted. Several words were replaced with their abbreviations. A bag of words approach was used to perform the analyses. Different visualizations which are common in text analysis, were created to easily grasp the results. Results: We identified 5282 unique patients. Three thousand and five (57%) patients had documented PMH. Of which 60.4% (n=1817) were males. The total median age was 62 years (range 0.12 – 97.2 years), and the majority of patients (83%) presented after the age of forty years. The top two documented medical histories were diabetes mellitus (DM) and surgery. DM was observed in 16.3% of the patients, and surgery at 15.4%. Other frequent patient histories (among the top 20) were fracture, cancer (ca), motor vehicle accident (MVA), leg, lumbar, discopathy, back and carpal tunnel release (CTR). When separating the data by sex, we can see that DM and MVA are more frequent among males, while cancer and CTR are less frequent. On the other hand, the top medical history in females was surgery and, after that, DM. Other frequent histories among females are breast cancer, fractures, and CTR. In the younger population (ages 18 to 26), the frequent PMH were surgery, fractures, trauma, and MVA. Discussion: By applying text mining approaches to unstructured data, we were able to better understand which medical histories are more relevant in these circumstances and, in addition, gain additional insights regarding sex and age differences. These insights might help to collect epidemiological demographical data as well as raise new hypotheses. One limitation of this work is that each clinician might use different words or abbreviations to describe the same condition, and therefore using a coding system can be beneficial.

Keywords: abnormal studies, healthcare analytics, medical history, nerve conduction studies, text mining, textual analysis

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450 Highly Conductive Polycrystalline Metallic Ring in a Magnetic Field

Authors: Isao Tomita

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Electrical conduction in a quasi-one-dimensional polycrystalline metallic ring with a long electron phase coherence length realized at low temperature is investigated. In this situation, the wave nature of electrons is important in the ring, where the electrical current I can be induced by a vector potential that arises from a static magnetic field applied perpendicularly to the ring’s area. It is shown that if the average grain size of the polycrystalline ring becomes large (or comparable to the Fermi wavelength), the electrical current I increases to ~I0, where I0 is a current in a disorder-free ring. The cause of this increasing effect is examined, and this takes place if the electron localization length in the polycrystalline potential increases with increasing grain size, which gives rise to coherent connection of tails of a localized electron wave function in the ring and thus provides highly coherent electrical conduction.

Keywords: electrical conduction, electron phase coherence, polycrystalline metal, magnetic field

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449 Impact of Joule Heating on the Electrical Conduction Behavior of Carbon Composite Laminates under Simulated Lightning Strike

Authors: Hong Yu, Dirk Heider, Suresh Advani

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Increasing demands for high strength and lightweight materials in aircraft industry prompted the wide use of carbon composites in recent decades. Carbon composite laminates used on aircraft structures are subject to lightning strikes. Unlike its metal/alloy counterparts, carbon fiber reinforced composites demonstrate smaller electrical conductivity, yielding more severe damages due to Joule heating. The anisotropic nature of composite laminates makes the electrical and thermal conduction within carbon composite laminates even more complicated. Good understanding of the electrical conduction behavior of carbon composites is the key to effective lightning protection design. The goal of this study is to numerically and experimentally investigate the impact of ultra-high temperature induced by simulated lightning strike on the electrical conduction of carbon composites. A lightning simulator is designed to apply standard lightning current waveform to composite laminates. Multiple carbon composite laminates made from IM7 and AS4 carbon fiber are tested and the transient resistance data is recorded. A microstructure based resistor network model is developed to describe the electrical and thermal conduction behavior, with consideration of temperature dependent material properties. Material degradations such as thermal and electrical breakdown are also modeled to include the effect of high current and high temperature induced by lightning strikes. Good match between the simulation results and experimental data indicates that the developed model captures the major conduction mechanisms. A parametric study is then conducted using the validated model to investigate the effect of system parameters such as fiber volume fraction, inter-ply interface quality, and lightning current waveforms.

Keywords: carbon composite, joule heating, lightning strike, resistor network

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448 The Effect of Action Potential Duration and Conduction Velocity on Cardiac Pumping Efficacy: Simulation Study

Authors: Ana Rahma Yuniarti, Ki Moo Lim

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Slowed myocardial conduction velocity (CV) and shortened action potential duration (APD) due to some reason are associated with an increased risk of re-entrant excitation, predisposing to cardiac arrhythmia. That is because both of CV reduction and APD shortening induces shortening of wavelength. In this study, we investigated quantitatively the cardiac mechanical responses under various CV and APD using multi-scale computational model of the heart. The model consisted of electrical model coupled with the mechanical contraction model together with a lumped model of the circulatory system. The electrical model consisted of 149.344 numbers of nodes and 183.993 numbers of elements of tetrahedral mesh, whereas the mechanical model consisted of 356 numbers of nodes and 172 numbers of elements of hexahedral mesh with hermite basis. We performed the electrical simulation with two scenarios: 1) by varying the CV values with constant APD and 2) by varying the APD values with constant CV. Then, we compared the electrical and mechanical responses for both scenarios. Our simulation showed that faster CV and longer APD induced largest resultants wavelength and generated better cardiac pumping efficacy by increasing the cardiac output and consuming less energy. This is due to the long wave propagation and faster conduction generated more synchronous contraction of whole ventricle.

Keywords: conduction velocity, action potential duration, mechanical contraction model, circulatory model

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447 Stimulation of Nerve Tissue Differentiation and Development Using Scaffold-Based Cell Culture in Bioreactors

Authors: Simon Grossemy, Peggy P. Y. Chan, Pauline M. Doran

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Nerve tissue engineering is the main field of research aimed at finding an alternative to autografts as a treatment for nerve injuries. Scaffolds are used as a support to enhance nerve regeneration. In order to successfully design novel scaffolds and in vitro cell culture systems, a deep understanding of the factors affecting nerve regeneration processes is needed. Physical and biological parameters associated with the culture environment have been identified as potentially influential in nerve cell differentiation, including electrical stimulation, exposure to extracellular-matrix (ECM) proteins, dynamic medium conditions and co-culture with glial cells. The mechanisms involved in driving the cell to differentiation in the presence of these factors are poorly understood; the complexity of each of them raises the possibility that they may strongly influence each other. Some questions that arise in investigating nerve regeneration include: What are the best protein coatings to promote neural cell attachment? Is the scaffold design suitable for providing all the required factors combined? What is the influence of dynamic stimulation on cell viability and differentiation? In order to study these effects, scaffolds adaptable to bioreactor culture conditions were designed to allow electrical stimulation of cells exposed to ECM proteins, all within a dynamic medium environment. Gold coatings were used to make the surface of viscose rayon microfiber scaffolds (VRMS) conductive, and poly-L-lysine (PLL) and laminin (LN) surface coatings were used to mimic the ECM environment and allow the attachment of rat PC12 neural cells. The robustness of the coatings was analyzed by surface resistivity measurements, scanning electron microscope (SEM) observation and immunocytochemistry. Cell attachment to protein coatings of PLL, LN and PLL+LN was studied using DNA quantification with Hoechst. The double coating of PLL+LN was selected based on high levels of PC12 cell attachment and the reported advantages of laminin for neural differentiation. The underlying gold coatings were shown to be biocompatible using cell proliferation and live/dead staining assays. Coatings exhibiting stable properties over time under dynamic fluid conditions were developed; indeed, cell attachment and the conductive power of the scaffolds were maintained over 2 weeks of bioreactor operation. These scaffolds are promising research tools for understanding complex neural cell behavior. They have been used to investigate major factors in the physical culture environment that affect nerve cell viability and differentiation, including electrical stimulation, bioreactor hydrodynamic conditions, and combinations of these parameters. The cell and tissue differentiation response was evaluated using DNA quantification, immunocytochemistry, RT-qPCR and functional analyses.

Keywords: bioreactor, electrical stimulation, nerve differentiation, PC12 cells, scaffold

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446 A Computational Model of the Thermal Grill Illusion: Simulating the Perceived Pain Using Neuronal Activity in Pain-Sensitive Nerve Fibers

Authors: Subhankar Karmakar, Madhan Kumar Vasudevan, Manivannan Muniyandi

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Thermal Grill Illusion (TGI) elicits a strong and often painful sensation of burn when interlacing warm and cold stimuli that are individually non-painful, excites thermoreceptors beneath the skin. Among several theories of TGI, the “disinhibition” theory is the most widely accepted in the literature. According to this theory, TGI is the result of the disinhibition or unmasking of the pain-sensitive HPC (Heat-Pinch-Cold) nerve fibers due to the inhibition of cold-sensitive nerve fibers that are responsible for masking HPC nerve fibers. Although researchers focused on understanding TGI throughexperiments and models, none of them investigated the prediction of TGI pain intensity through a computational model. Furthermore, the comparison of psychophysically perceived TGI intensity with neurophysiological models has not yet been studied. The prediction of pain intensity through a computational model of TGI can help inoptimizing thermal displays and understanding pathological conditions related to temperature perception. The current studyfocuses on developing a computational model to predict the intensity of TGI pain and experimentally observe the perceived TGI pain. The computational model is developed based on the disinhibition theory and by utilizing the existing popular models of warm and cold receptors in the skin. The model aims to predict the neuronal activity of the HPC nerve fibers. With a temperature-controlled thermal grill setup, fifteen participants (ten males and five females) were presented with five temperature differences between warm and cold grills (each repeated three times). All the participants rated the perceived TGI pain sensation on a scale of one to ten. For the range of temperature differences, the experimentally observed perceived intensity of TGI is compared with the neuronal activity of pain-sensitive HPC nerve fibers. The simulation results show a monotonically increasing relationship between the temperature differences and the neuronal activity of the HPC nerve fibers. Moreover, a similar monotonically increasing relationship is experimentally observed between temperature differences and the perceived TGI intensity. This shows the potential comparison of TGI pain intensity observed through the experimental study with the neuronal activity predicted through the model. The proposed model intends to bridge the theoretical understanding of the TGI and the experimental results obtained through psychophysics. Further studies in pain perception are needed to develop a more accurate version of the current model.

Keywords: thermal grill Illusion, computational modelling, simulation, psychophysics, haptics

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445 Central Retinal Venous Occlusion Associated O Bilateral Optic Nerve Infiltration Revealing Relapse Of An Acute Lymphoblastic Leukemia

Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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444 Drastic Improvement in Vision Following Surgical Excision of Juvenile Nasopharyngeal Angiofibroma with Compressive Optic Neuropathy

Authors: Sweta Das

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This case report is a 15-year-old male who presented with painless unilateral vision loss from left optic nerve compression due to juvenile nasopharyngeal angiofibroma. JNA is a rare, benign neoplasm that causes intracranial and intraorbital bone destruction and extends aggressively into surrounding soft tissues. It accounts for <1% of all head and neck tumors, is predominantly found in pediatric males and tends to affect indigenous population disproportionately. The most common presenting symptom for JNA is epistaxis and nasal obstruction. However, it can invade orbit, chiasm and pituitary gland, causing loss of vision and field. Visual acuity and function near normalized following surgical excision. Optometry plays an important role in the diagnosis and co-management of JNA with optic nerve compression by closely monitoring afferent optic nerve function and structure, and extraocular motility. Visual function and acuity in patients with short-term compressive neuropathy may drastically improve following surgical resection as this case demonstrates.

Keywords: orbital mass, painless monocular vision loss, compressive optic neuropathy, pediatric tumor

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443 Effect of Viscous Dissipation and Axial Conduction in Thermally Developing Region of the Channel Partially Filled with a Porous Material Subjected to Constant Wall Heat Flux

Authors: D Bhargavi, J. Sharath Kumar Reddy

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The present investigation has been undertaken to assess the effect of viscous dissipation and axial conduction on forced convection heat transfer in the entrance region of a parallel plate channel with the porous insert attached to both walls of the channel. The flow field is unidirectional. Flow in the porous region corresponds to Darcy-Brinkman model and the clear fluid region to that of plane Poiseuille flow. The effects of the parameters Darcy number, Da, Peclet number, Pe, Brinkman number, Br and a porous fraction γp on the local heat transfer coefficient are analyzed graphically. Effects of viscous dissipation employing the Darcy model and the clear fluid compatible model have been studied.

Keywords: porous material, channel partially filled with a porous material, axial conduction, viscous dissipation

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442 An Accurate Prediction of Surface Temperature History in a Supersonic Flight

Authors: A. M. Tahsini, S. A. Hosseini

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In the present study, the surface temperature history of the adaptor part in a two-stage supersonic launch vehicle is accurately predicted. The full Navier-Stokes equations are used to estimate the aerodynamic heat flux. The one-dimensional heat conduction in solid phase is used to compute the temperature history. The instantaneous surface temperature is used to improve the applied heat flux, to improve the accuracy of the results.

Keywords: aerodynamic heating, heat conduction, numerical simulation, supersonic flight, launch vehicle

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441 Analysis of an Error Estimate for the Asymptotic Solution of the Heat Conduction Problem in a Dilated Pipe

Authors: E. Marušić-Paloka, I. Pažanin, M. Prša

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Subject of this study is the stationary heat conduction problem through a pipe filled with incompressible viscous fluid. In previous work, we observed the existence and uniqueness theorems for the corresponding boundary-value problem and within we have taken into account the effects of the pipe's dilatation due to the temperature of the fluid inside of the pipe. The main difficulty comes from the fact that flow domain changes depending on the solution of the observed heat equation leading to a non-standard coupled governing problem. The goal of this work is to find solution estimate since the exact solution of the studied problem is not possible to determine. We use an asymptotic expansion in order of a small parameter which is presented as a heat expansion coefficient of the pipe's material. Furthermore, an error estimate is provided for the mentioned asymptotic approximation of the solution for inner area of the pipe. Close to the boundary, problem becomes more complex so different approaches are observed, mainly Theory of Perturbations and Separations of Variables. In view of that, error estimate for the whole approximation will be provided with additional software simulations of gotten situation.

Keywords: asymptotic analysis, dilated pipe, error estimate, heat conduction

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440 Heart-Rate Variability Moderates the Relation between Life Threatening Events and Cancer-Development: Making Cancer Less “Vague”

Authors: Yori Gidron, Laura Caton, Irit Ben-Aharon

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Background: Many patients and even certain clinicians attribute cancer development to psychosocial factors. Yet, empirical data supports more the prognostic role, rather than the etiological role, of psychosocial factors in cancer. Part of the inconsistency may result from not considering possible moderating factors in the etiological role of psychosocial factors. One important candidate moderating factor is the vagal nerve, whose activity is indexed by heart-rate variability (HRV). The vagal nerve may prevent cancer since it reduces inflammation on the one hand, and since it increases anti-tumor immunity on the other hand. This study examined the moderating role of the vagus in the relation between life threatening events (LTE) and cancer development. Method: We re-analyzed data from the Lifelines Dutch longitudinal cohort study of over 150,000 people. The present study included 82,751 adults, who initially were cancer-free. We extracted information on background factors (e.g., age, gender, fat consumption), whether they ever experienced LTE, HRV and cancer diagnosis as reported by patients in annual clinic visits. HRV was derived from brief ECGs. Results: Of the full sample, 1011 people developed cancer during a follow-up. In the full sample, LTE significantly predicted cancer development (R.R = 1.063 p < .01) and HRV significantly predicted a reduced risk of cancer development (R.R = .506 p <.001). Importantly, LTE significantly predicted cancer only when HRV was low (R.R = 1.056, 95% CI: 1.007 - 1.108, p < .05) but not when HRV was high (R.R = 1.014; 95% CI: 0.916 - 1.122, p > 0.05), independent of confounders. Conclusions: To the best of our knowledge, this is the first study showing in a large sample that LTE predict cancer development, and that this occurs only when vagal nerve activity (HRV) is relatively low. These results could result from lack of vagal modulation of inflammation and also from lack of vagal modulation of stress responses. Results are in line with the cancer-protective role of the vagus. HRV needs to be routinely monitored in the population and future intervention trials need to examine whether vagal nerve activation can prevent cancer in people with LTE and with other cancer risk factors.

Keywords: cancer development, life-events, moderation, vagal nerve

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439 Relatively High Heart-Rate Variability Predicts Greater Survival Chances in Patients with Covid-19

Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus

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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.

Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve

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438 The Addition of Opioids to Bupivacaine in Bilateral Infraorbital Nerve Block for Postoperative Pain Relief in Paediatric Patients for Cleft Lip Repair-Comparative Effects of Pethidine and Fentanyl: A Prospective Randomized Double Blind Study

Authors: Mrudula Kudtarkar, Rajesh Mane

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Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

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437 Study of Motion of Impurity Ions in Poly(Vinylidene Fluoride) from View Point of Microstructure of Polymer Solid

Authors: Yuichi Anada

Abstract:

Electrical properties of polymer solid is characterized by dielectric relaxation phenomenon. Complex permittivity shows a high dependence on frequency of external stimulation in the broad frequency range from 0.1mHz to 10GHz. The complex-permittivity dispersion gives us a lot of useful information about the molecular motion of polymers and the structure of polymer aggregates. However, the large dispersion of permittivity at low frequencies due to DC conduction of impurity ions often covers the dielectric relaxation in polymer solid. In experimental investigation, many researchers have tried to remove the DC conduction experimentally or analytically for a long time. On the other hand, our laboratory chose another way of research for this problem from the point of view of a reversal in thinking. The way of our research is to use the impurity ions in the DC conduction as a probe to detect the motion of polymer molecules and to investigate the structure of polymer aggregates. In addition to the complex permittivity, the electric modulus and the conductivity relaxation time are strong tools for investigating the ionic motion in DC conduction. In a non-crystalline part of melt-crystallized polymers, free spaces with inhomogeneous size exist between crystallites. As the impurity ions exist in the non-crystalline part and move through these inhomogeneous free spaces, the motion of ions reflects the microstructure of non-crystalline part. The ionic motion of impurity ions in poly(vinylidene fluoride) (PVDF) is investigated in this study. Frequency dependence of the loss permittivity of PVDF shows a characteristic of the direct current (DC) conduction below 1 kHz of frequency at 435 K. The electric modulus-frequency curve shows a characteristic of the dispersion with the single conductivity relaxation time. Namely, it is the Debye-type dispersion. The conductivity relaxation time analyzed from this curve is 0.00003 s at 435 K. From the plot of conductivity relaxation time of PVDF together with the other polymers against permittivity, it was found that there are two group of polymers; one of the group is characterized by small conductivity relaxation time and large permittivity, and another is characterized by large conductivity relaxation time and small permittivity.

Keywords: conductivity relaxation time, electric modulus, ionic motion, permittivity, poly(vinylidene fluoride), DC conduction

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436 Vibration of Nanobeam Subjected to Constant Magnetic Field and Ramp-Type Thermal Loading under Non-Fourier Heat Conduction Law of Lord-Shulman

Authors: Hamdy M. Youssef

Abstract:

In this work, the usual Euler–Bernoulli nanobeam has been modeled in the context of Lord-Shulman thermoelastic theorem, which contains non-Fourier heat conduction law. The nanobeam has been subjected to a constant magnetic field and ramp-type thermal loading. The Laplace transform definition has been applied to the governing equations, and the solutions have been obtained by using a direct approach. The inversions of the Laplace transform have been calculated numerically by using Tzou approximation method. The solutions have been applied to a nanobeam made of silicon nitride. The distributions of the temperature increment, lateral deflection, strain, stress, and strain-energy density have been represented in figures with different values of the magnetic field intensity and ramp-time heat parameter. The value of the magnetic field intensity and ramp-time heat parameter have significant effects on all the studied functions, and they could be used as tuners to control the energy which has been generated through the nanobeam.

Keywords: nanobeam, vibration, constant magnetic field, ramp-type thermal loading, non-Fourier heat conduction law

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435 A Multigrid Approach for Three-Dimensional Inverse Heat Conduction Problems

Authors: Jianhua Zhou, Yuwen Zhang

Abstract:

A two-step multigrid approach is proposed to solve the inverse heat conduction problem in a 3-D object under laser irradiation. In the first step, the location of the laser center is estimated using a coarse and uniform grid system. In the second step, the front-surface temperature is recovered in good accuracy using a multiple grid system in which fine mesh is used at laser spot center to capture the drastic temperature rise in this region but coarse mesh is employed in the peripheral region to reduce the total number of sensors required. The effectiveness of the two-step approach and the multiple grid system are demonstrated by the illustrative inverse solutions. If the measurement data for the temperature and heat flux on the back surface do not contain random error, the proposed multigrid approach can yield more accurate inverse solutions. When the back-surface measurement data contain random noise, accurate inverse solutions cannot be obtained if both temperature and heat flux are measured on the back surface.

Keywords: conduction, inverse problems, conjugated gradient method, laser

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434 Transforaminal Ligaments of the Lumbar Foramina: An Anatomic Study

Authors: Dušica L. Marić, Mirela Erić, Dušan M. Maić, Nebojša T. Milošević, Dragana Radošević, Nikola Vučinić

Abstract:

The anatomical existence of transforaminal ligaments has been studied widely. The crucial anatomic study of these structures describes the transforaminal ligaments as an anomalous structure. The ligaments associated with the intervertebral foramen were classified in the external, intraforaminal and internal foraminal ligaments. The external ligaments are the most frequently reported type of transforaminal ligaments in adult spine. The purpose of this study was to examine the appearance of the ligaments within the external space of the intervertebral foramen in adult cadavers. External transforaminal ligaments branch out forward from the root of the transverse process toward the vertebral body with superior, transverse and inferior directions. The ligament detected in the study was different from the other reported descriptions of L1 foraminal ligaments. This ligament extends from the root of the pedicle to the inferior border of the vertebral body below the level of the disc and forms the compartment through which pass the ventral root of the spinal nerve and a small branch of the spinal artery. The results of this study show that the external ligaments can be clearly macroscopic visualized, and it is very important to have prior knowledge of the cadaveric specimens, to identify these structures. The presence of these ligaments is clinically important. These ligaments could be the cause of nerve root compression and the low back syndrome.

Keywords: anatomy, ligaments, lumbar spine, spinal nerve roots

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433 Nature of Polaronic Hopping Conduction Mechanism in Polycrystalline and Nanocrystalline Gd0.5Sr0.5MnO3 Compounds

Authors: Soma Chatterjee, I. Das

Abstract:

In the present study, we have investigated the structural, electrical and magneto-transport properties of polycrystalline and nanocrystalline Gd0.5Sr0.5MnO3 compounds. The variation of transport properties is modified by tuning the grain size of the material. In the high-temperature semiconducting region, temperature-dependent resistivity data can be well explained by the non-adiabatic small polaron hopping (SPH) mechanism. In addition, the resistivity data for all compounds in the low-temperature paramagnetic region can also be well explained by the variable range hopping (VRH) model. The parameters obtained from SPH and VRH mechanisms are found to be reasonable. In the case of nanocrystalline compounds, there is an overlapping temperature range where both SPH and VRH models are valid simultaneously, and a new conduction mechanism - variable range hopping of small polaron s(VR-SPH) is satisfactorily valid for the whole temperature range of these compounds. However, for the polycrystalline compound, the overlapping temperature region between VRH and SPH models does not exist and the VR-SPH mechanism is not valid here. Thus, polarons play a leading role in selecting different conduction mechanisms in different temperature ranges.

Keywords: electrical resistivity, manganite, small polaron hopping, variable range hopping, variable range of small polaron hopping

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432 Dielectric Spectroscopy Investigation of Hydrophobic Silica Aerogel

Authors: Deniz Bozoglu, Deniz Deger, Kemal Ulutas, Sahin Yakut

Abstract:

In recent years, silica aerogels have attracted great attention due to their outstanding properties, and their wide variety of potential applications such as microelectronics, nuclear and high-energy physics, optics and acoustics, superconductivity, space-physics. Hydrophobic silica aerogels were successfully synthesized in one-step by surface modification at ambient pressure. FT-IR result confirmed that Si-OH groups were successfully converted into hydrophobic and non-polar Si-CH3 groups by surface modification using trimethylchloro silane (TMCS) as co-precursor. Using Alpha-A High-Resolution Dielectric, Conductivity and Impedance Analyzer, AC conductivity of samples were examined at temperature range 293-423 K and measured over frequency range between 1-106 Hz. The characteristic relaxation time decreases with increasing temperature. The AC conductivity follows σ_AC (ω)=σ_t-σ_DC=Aω^s relation at frequencies higher than 10 Hz, and the dominant conduction mechanism is found to obey the Correlated Barrier Hopping (CBH) mechanism. At frequencies lower than 10 Hz, the electrical conduction is found to be in accordance with DC conduction mechanism. The activation energies obtained from AC conductivity results and it was observed two relaxation regions.

Keywords: aerogel, synthesis, dielectric constant, dielectric loss, relaxation time

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431 The Possible Role of the Endoneurial Fibroblast-like Cells in Resolution of the Endoneurial Edema Following Nerve Crush Injury

Authors: Faris M. Altaf, Abdullah M Elkeshy

Abstract:

Forty-two albino male rats aged between 30 and 40 days (weighted 200 g to 250 g) were used in the present study. The left sural nerves of 36 rats were subjected to crush injury at 1 to 6 weeks intervals using 6 animals at each interval. The right and left sural nerves of the rest 6 rats were used as a control. After 2 weeks of the crush injury, the endoneurium showed channel-like spaces that were lined by the fibroblast-like cells and collagen bundles. These channels contained degenerated myelin and were connected with the perivascular and subperineurial spaces. Some of the flattened fibroblast-like cells were arranged in several layers in the subperineurial and perivascular spaces, forming barrier-like cellular sheets localizing the endoneurial edema in these spaces. Fibroblast-like cells also wrapped the regenerating nerve fibers by their branching cytoplasmic processes. At the end of the third week, the flattened fibroblasts formed nearly continuous sheets in the subperineurial and perivascular spaces. Macrophages were frequently noticed between these cellular barrier-like sheets and in the subperineurial and perivascular spaces. Conclusion: it could be concluded that the endoneurial fibroblast-like cells form barrier-like cellular sheets that localized the endoneurial edema in the subperineurial and perivascular spaces and create also the endoneurial channel-like spaces containing degenerated myelin and endoneurial edema helping the resolution of such edema.

Keywords: sural nerve, endoneurial fibroblast-like cells, endoneurial edema, barrier-like and channel-like spaces

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430 Chronic and Sub-Acute Lumbosacral Radiculopathies Behave Differently to Repeated Back Extension Exercises

Authors: Sami Alabdulwahab

Abstract:

Background: Repeated back extension exercises (RBEEs) are among the management options for symptoms associated with lumbosacral radiculopathy (LSR). RBEEs have been reported to cause changes in the distribution and intensity of radicular symptoms caused by possible compression/decompression of the compromised nerve root. Purpose: The purpose of this study was to investigate the effects of the RBEEs on the neurophysiology of the compromised nerve root and on standing mobility and pain intensity in patients with sub-acute and chronic LSR. Methods: A total of 40 patients with unilateral sub-acute/chronic lumbosacral radiculopathy voluntarily participated in the study; the patients performed 3 sets of 10 RBEEs in the prone position with 1 min of rest between the sets. The soleus H-reflex, standing mobility and pain intensity were recorded before and after the RBEEs. Results: The results of the study showed that the RBEEs significantly improved the H-reflex, standing mobility and pain intensity in patients with sub-acute LSR (p<0.01); there was not a significant improvement in the patients with chronic LSR (p<0.61). Conclusion: RBEEs in prone position is recommended for improving the neurophysiological function of the compromised nerve root and standing mobility in patients with sub-acute LSR. Implication: Sub-acute and chronic LSR responded differently to RBEEs. Sub-acute LSR appear to have flexible and movable disc structures, which could be managed with RBEEs.

Keywords: h-reflex, back extension, lumbosacral radiculopathy, pain

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429 Functional Outcome of Speech, Voice and Swallowing Following Excision of Glomus Jugulare Tumor

Authors: B. S. Premalatha, Kausalya Sahani

Abstract:

Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

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428 Resistive Switching in TaN/AlNx/TiN Cell

Authors: Hsin-Ping Huang, Shyankay Jou

Abstract:

Resistive switching of aluminum nitride (AlNx) thin film was demonstrated in a TaN/AlNx/TiN memory cell that was prepared by sputter deposition techniques. The memory cell showed bipolar switching of resistance between +3.5 V and –3.5 V. The resistance ratio of high resistance state (HRS) to low resistance state (HRS), RHRS/RLRS, was about 2 over 100 cycles of endurance test. Both the LRS and HRS of the memory cell exhibited ohmic conduction at low voltages and Poole-Frenkel emission at high voltages. The electrical conduction in the TaN/AlNx/TiN memory cell was possibly attributed to the interactions between charges and defects in the AlNx film.

Keywords: aluminum nitride, nonvolatile memory, resistive switching, thin films

Procedia PDF Downloads 373