Search results for: sudden death

Authors: Abul Kayum Zarzis Alam

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Death is not a terminal; it is just a junction. From Agamas to Vedas, from Buddhism to Judaism, all the major scriptures and religions of the world always do converge to this hypothesis of death. Death is the ultimate catastrophe of life and it is the genesis of every religion on this Earth. Several hundred thousand years ago, the Homo Sapiens in Paleolithic age introduced the notion of religion on this Earth in its most primitive form just to escape from death and natural catastrophes through their belief in supernatural things which created the sense of superstition among the Homo Sapiens which has only increased over time. This sense of superstition and belief in supernatural things are building blocks of religion. Religion is like entropy, a degree of disorder. Entropy for an irreversible system like our own Universe always increases. Same is happening to our human civilization where the disorder had been increasing over time. The degree of this disorder of human civilization is religion divides and conquers over the human civilization of Earth. Religion is the human entropy which had been governing and will govern us. Just like entropy, religion is also an essential intrinsic property of the system which makes the system evolved. We have to optimize this ambivalence of the human entropy to make our civilization an inclusive and sustainable one.

Keywords: death, earth, entropy, Homo sapiens, religion and human entropy

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Authors: Teng lin, Li Yuxing, Han Hui, Zhao Pengfei, Zhang Datong

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With the development of carbon capture and storage (CCS), the flow assurance of CO2 transportation becomes more important, particularly for supercritical CO2 pipelines. The relieving system using the choke valve is applied to control the pressure in CO2 pipeline. However, the temperature of fluid would drop rapidly because of Joule-Thomson cooling (JTC), which may cause solid CO2 form and block the pipe. In this paper, a Computational Fluid Dynamic (CFD) model, using the modified Lagrangian method, Reynold's Stress Transport model (RSM) for turbulence and stochastic tracking model (STM) for particle trajectory, was developed to predict the deposition characteristic of solid carbon dioxide. The model predictions were in good agreement with the experiment data published in the literature. It can be observed that the particle distribution affected the deposition behavior. In the region of the sudden expansion, the smaller particles accumulated tightly on the wall were dominant for pipe blockage. On the contrary, the size of solid CO2 particles deposited near the outlet usually was bigger and the stacked structure was looser. According to the calculation results, the movement of the particles can be regarded as the main four types: turbulent motion close to the sudden expansion structure, balanced motion at sudden expansion-middle region, inertial motion near the outlet and the escape. Furthermore the particle deposits accumulated primarily in the sudden expansion region, reattachment region and outlet region because of the four type of motion. Also the Stokes number had an effect on the deposition ratio and it is recommended for Stokes number to avoid 3-8St.

Keywords: carbon capture and storage, carbon dioxide pipeline, gas-particle flow, deposition

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Authors: Alexandru Dumitrache, Florin Frunzulica, Octavian Preotu

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The flow mitigation detachment problem near solid surfaces, resulting in improved globally aerodynamic performance by exploiting the Coanda effect on surfaces, has been addressed extensively in the literature, since 1940. The research is carried on and further developed, using modern means of calculation and new experimental methods. In this paper, it is shown interest in the detailed behavior of a classical interior ejector assisted by the Coanda effect, used in propulsion systems. For numerical investigations, an implicit formulation of RANS equations for axisymmetric flow with a shear stress transport k- ω (SST model) turbulence model is used. The obtained numerical results emphasize the efficiency of the ejector, depending on the physical parameters of the flow and the geometric configuration. Furthermore, numerical investigations are carried out regarding the evolution of the Reynolds number when the jet is attached to the wall, considering three geometric configurations: sudden expansion, open cavity and sudden expansion with divergent at the inlet. Therefore, further insight into complexities involving issues such as the variety of flow structure and the related bifurcation and flow instabilities are provided. Thus, the conditions and the limits within which one can benefit from the advantages of Coanda-type flows are determined.

Keywords: Coanda effect, Coanda ejector, CFD, stationary bifurcation, sudden expansion

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Authors: Mindaugas Kazlauskas

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In this paper, it is presupposed that the description of the relationship between animal and human should begin with a description of the direct experience of the animal and how, in this experience, the human experiences itself (a self awareness mode). A human is concerned first and foremost with himself as a human through the experience of another as an animal. The questionsare: In the encounter with an animal, how is the animal constituted in the acts of human experience? How does human-animal interaction influence human behavioral patterns, and how does the human identifies itself in this interaction? The paper will present the results of interpretative phenomenological descriptions (IPA) of the relationship between human and animal in the face of death phenomenon through the experience of pet owners who lost their beloved companions and hunters, veterinatians, and farmers who face animal death. The results of IPA analysis reveal different relations such as the identification with an animal, the alienation experience, the experience of resistance, and an experience of detachment. Within these themes, IPA qualitative research results will be presented by highlighting patterns of human behavior, following Friedrich Schlachermacher's hermeneutics methodological principles, and reflecting on changes in value and attitude within society during daily interaction with the animal.

Keywords: animal human interaction, phenomenology, philosophy, death phenomenon

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Authors: Amira M. Othman

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Despite the massive array of literature that engages with the Egyptian legislative system on a theoretical level, very little attention has been dedicated to the comparison between the legislative clauses on the one hand, and the (absence of their) real-world implementation on the other. This paper starts with this discrepancy, focusing on the legal proceedings in some recent cases dubbed ‘political,’ in which defendants received death sentences. Then, it sheds light on the trend of practical disregard of the law on behalf of the criminal justice apparatuses (whether security forces, public prosecution offices, lawyers, judges, prison wardens, and executioners) through the examination of case files and the conduction of interviews with some defense lawyers in the cases in question. It also identifies the resultant state of confusion among prison staff, as manifest in their treatment of defendants even before the death sentences against them is pronounced; in other words, the application of some aspects of the law in certain cases, and their simultaneous disregard of others. Then, the paper explores the effects of such execution of the law on the death row inmates, as it identifies the different strategies through which defendants who are sentenced to death appropriate a number of legal clauses to their benefit, thereby embarrassing - or highly irritating - the judges that pronounce their death sentences. In addition to appropriation, other strategies include the contestation of the law and their presence before the courts in general, as well as the complete disregard and dismissal of the legal system altogether. Finally, the paper investigates the consequent conceptual effect on the first degree families of death row inmates, namely how their daily encounters with the Egyptian legislative system - particularly its emphasis on the absence of the otherwise binding local legislation - continue to shape their conceptions of the ‘law,’ of ‘justice,’ and their trust in the ‘state.’

Keywords: death penalty, Egyptian law absence, justice, political cases

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Authors: Mitra JahangirRad, Sheida Sodagar, Maryam Bahrami Hidaji

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This study was conducted with the aim of comparing anxiety, stress, depression and attitude towards death among patients with breast cancer who have undergone mastectomy or breast-conserving surgery. The study method is causal-comparative. Statistical population was all patients with breast cancer referring to Medical Center of Panjom Azar Hospital in Gorgan or oncologists' offices in this city within eight months. They were selected using purposive sampling. Sample size of this study was 45 patients with breast cancer undergoing mastectomy and 70 patients under breast-conserving surgery. Measurement tools in this study were depression, anxiety, and stress scale (Dass-21) as well as Death Attitude Profile-Revised (DAPR). Results of this study in hypotheses investigation showed that anxiety, stress and depression among patients with breast cancer, undergoing mastectomy or breast-conserving surgery is significantly different. However, their attitudes towards death do not differ. From these findings, it can be concluded that although most patients with breast cancer encounter many psychological problems, patients undergoing mastectomy experience more anxiety, stress and depression relative to patients with breast-conserving surgery and it seems that they need more supportive therapy.

Keywords: anxiety, breast cancer, depression, death, mastectomy

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Authors: Onder Yakut, Oguzhan Timus, Emine Dogru Bolat

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Health diseases have a vital significance affecting human being's life and life quality. Sudden death events can be prevented owing to early diagnosis and treatment methods. Electrical signals, taken from the human being's body using non-invasive methods and showing the heart activity is called Electrocardiogram (ECG). The ECG signal is used for following daily activity of the heart by clinicians. Heart Rate Variability (HRV) is a physiological parameter giving the variation between the heart beats. ECG data taken from MITBIH Arrhythmia Database is used in the model employed in this study. The detection of arrhythmic heart beats is aimed utilizing the features extracted from the HRV time domain parameters. The developed model provides a satisfactory performance with ~89% accuracy, 91.7 % sensitivity and 85% specificity rates for the detection of arrhythmic beats.

Keywords: arrhythmic beat detection, ECG, HRV, kNN classifier

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Authors: Shikha Masand, Sudesh Kumar Yadav

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Certain protein kinases have been shown to be crucial for plant cell signaling pathways associated with plant immune responses. Here we identified a horsegram [Macrotyloma uniflorum (Lam.) Verdc.] malectin-like leucine rich receptor-like protein kinase (RLK) gene MuRLK. The functional MuRLK protein preferentially binds to mannose and N-acetyl glucosamine residues. MuRLK exists in the cytoplasm and also localizes to the plasma membrane of plant cells via its N-terminus. Over-expression of MuRLK in Arabidopsis enhances the basal resistance to infection with Pseudomonas syringae pv. tomato, Alternaria brassicicola and Hyaloperonospora arabidopsidis, are associated with elevated ROS bursts, MAPK activation, thus ultimately leading to hypersensitive cell death. Moreover, salicylic acid-dependent and jasmonic acid-dependent defense responses are also enhanced in the MuRLK-overexpressed plants that lead to HR-induced cell death. Together, these results suggest that MuRLK plays a key role in the regulation of plant cell death, early and late defense responses after the recognition of microbial pathogens.

Keywords: horsegram, Pseudomonas syringae pv. tomato, MuRLK, ROS burst, cell death, plant defense

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Authors: Uliana N. Tumanova, Viacheslav M. Lyapin, Vladimir G. Bychenko, Alexandr I. Shchegolev, Gennady T. Sukhikh

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All cases of stillbirth undoubtedly subject to postmortem examination, since it is necessary to find out the cause of the stillbirths, as well as a forecast of future pregnancies and their outcomes. Determination of the time of death is an important issue which is addressed during the examination of the body of a stillborn. It is mean the period from the time of death until the birth of the fetus. The time for fetal deaths determination is based on the assessment of the severity of the processes of maceration. To study the possibilities of postmortem magnetic resonance imaging (MRI) for determining the time of intrauterine fetal death based on the evaluation of maceration in the kidney. We have conducted MRI morphological comparisons of 7 dead fetuses (18-21 gestational weeks) and 26 stillbirths (22-39 gestational weeks), and 15 bodies of died newborns at the age of 2 hours – 36 days. Postmortem MRI 3T was performed before the autopsy. The signal intensity of the kidney tissue (SIK), pleural fluid (SIF), external air (SIA) was determined on T1-WI and T2-WI. Macroscopic and histological signs of maceration severity and time of death were evaluated in the autopsy. Based on the results of the morphological study, the degree of maceration varied from 0 to 4. In 13 cases, the time of intrauterine death was up to 6 hours, in 2 cases - 6-12 hours, in 4 -12-24 hours, in 9 -2-3 days, in 3 -1 week, in 2 -1,5-2 weeks. At 15 dead newborns, signs of maceration were absent, naturally. Based on the data from SIK, SIF, SIA on MR-tomograms, we calculated the coefficient of MR-maceration (M). The calculation of the time of intrauterine death (MP-t) (hours) was performed by our formula: МR-t = 16,87+95,38×М²-75,32×М. A direct positive correlation of MR-t and autopsy data from the dead at the gestational ages 22-40 weeks, with a dead time, not more than 1 week, was received. The maceration at the antenatal fetal death is characterized by changes in T1-WI and T2-WI signals at postmortem MRI. The calculation of MP-t allows defining accurately the time of intrauterine death within one week at the stillbirths who died on 22-40 gestational weeks. Thus, our study convincingly demonstrates that radiological methods can be used for postmortem study of the bodies, in particular, the bodies of stillborn to determine the time of intrauterine death. Postmortem MRI allows for an objective and sufficiently accurate analysis of pathological processes with the possibility of their documentation, storage, and analysis after the burial of the body.

Keywords: intrauterine death, maceration, postmortem MRI, stillborn

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Authors: Shafait Hussain Ali

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Since its outbreak in China, the Covid_19 19 disease has been caused by the corona virus SARS N coyote 2. Italy was the first Western country to be severely affected, and the first country to take drastic measures to control the disease. In start of December 2019, the sudden outbreaks of the Coronary Virus Disease was caused by a new Corona 2 virus (SARS-CO2) of acute respiratory syndrome in china city Wuhan. The World Health Organization declared the epidemic a public health emergency of international concern on January 30, 2020,. On February 14, 2020, 49,053 laboratory-confirmed deaths and 1481 deaths have been reported worldwide. The threat of the disease has forced most of the governments to implement various control measures. Therefore it becomes necessary to analyze the Italian data very carefully, in particular to investigates and to find out the present condition and the number of infected persons in the form of positive cases, death, hospitalized or some other features of infected persons will clear in simple form. So used such a model that will clearly shows the real facts and figures and also understandable to every readable person which can get some real benefit after reading it. The model used must includes(total positive cases, current positive cases, hospitalized patients, death, recovered peoples frequency rates ) all features that explains and clear the wide range facts in very simple form and helpful to administration of that country.

Keywords: machine learning tools and techniques, rapid miner tool, Naive-Bayes algorithm, predictions

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Authors: Sze Yee Lee

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The death of a sibling in childhood leads to significant impacts on both the personal and family development of the surviving siblings. Yet, the effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. In particular, there is a gap in the literature about the long term impacts on surviving siblings. This paper explores the experience of adult siblings encountering siblings’ death during childhood with the use of in-depth interviews. Through thematic analysis and in-depth interviews, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges, and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in a family atmosphere, family roles, family relationships, family communication, and parenting styles. More importantly, the author identifies (i) existing continuing bonds, (ii) crying, (iii) adequate social support, (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, 'child-centered' and 'family-centered' interventions for families with siblings' death in a Chinese context are discussed. With the use of age-appropriate language and children’s participation in the preparation of death and after-death arrangements, surviving siblings could be assisted in transforming bereavement into opportunities for growth. In addition, the bereaved family could better cope with grief with open communication platforms, adequate social support, and family education resources. Meanwhile, life-and-death education at both school and community levels could enhance the public’s awareness and understanding of the bereaved individuals to prevent creating further harm to them.

Keywords: children and adolescent bereavement, children-centered, family-centered, sibling’s death

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Authors: Satoshi Furukawa, Satomu Morita, Lisa Wingenfeld, Katsuji Nishi, Masahito Hitosugi

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We studied the expression of hypoxia-related antigens (e.g., cold-inducible antigens and apoptotic antigens) in the myocardium and the cerebellumthat were obtained from individuals after death by carbon monoxide or hypothermia. The immunohistochemistry results revealed that expression of cold-inducible RNA binding protein (CIRBP) and RNA-binding protein 3 (RBM3) may be associated with hpyothermic and the hypoxic conditions. The expression of CIRBP and RBM3 in the myocardium was different from their expression in the cerebellum, especially in the Purkinje cells. The results indicate that agonal duration influences antigen expression. In the hypothermic condition, the myocardium uses more ATP since the force of the excitation-contraction coupling of the myocardium increases by more than 400% when the experimental temperature is reduced from 35°C to 25°C. The results obtained in this study indicate that physicians should pay attention to the myocardium when cooling the patient’s body to protect the brain.

Keywords: carbon monoxide death, cerebellum, CIRBP, hypothermic death, myocardium, RBM3

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Authors: M. L. Yeung

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With the surge of divorce rate and male cancer onset/death rates, the phenomenon of divorced wives in the facing cancer death of their ex-husbands is not uncommon in Hong Kong. Yet, there is a dearth of study on the experiences of bereaved-divorced wives in the Hong Kong cultural context. This project fills the knowledge gap by conducting a qualitative study for having interviewed four bereaved ex-wives, who returned to ex-husbands’ end-of-life caregiving and eventually grieved for the ex-spousal’s death. From the perspectives of attachment theory and disenfranchised grief in the Hong Kong cultural context, a ‘double-loss’ experience is found in which interviewees suffer from the first loss of divorce and the second loss of ex-husbands’ death. Traumatic childhood experiences, attachment needs, role ambiguity, unresolved emotions and unrecognized grief are found significant in their lived experiences which alert the ‘double-loss’ is worthy of attention. Extending a family-centered end-of-life and bereavement care services to divorced couples is called for, in which validation on the attachment needs, ex-couple reconciliation, and acknowledgement on the disenfranchised grief are essential for social work practice on this group of clienteles specifically in Hong Kong cultural context.

Keywords: changing family, disenfranchised grief, divorce, ex-spousal death, marriage

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Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

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Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

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Authors: H. Booke, R. Nordmeier

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Sudden cardiac arrest is sometimes eye-witnessed by kids. Mostly, their (grand-)parents are affected by sudden cardiac arrest, putting these kids under enormous psychological pressure: Although they are more than desperate to help, they feel insecure and helpless and are afraid of causing harm rather than realizing their chance to help. Even years later, they may blame themselves for not having helped their beloved ones. However, the absolute majority of school children - at least in Germany - is not educated to provide first aid. Teaching young kids (5th grade) in basic life support thus may help to save lives while washing away the kids' fear from causing harm during cardio-pulmonary resuscitation. A teaching of circulatory and respiratory (patho-)physiology, followed by hands-on training of basic life support for every single child, was offered to each school in our district. The teaching was performed by anesthesiologists, and the program was called 'kids can save lives'. However, before enrollment in this program, the entire class must have had lessons in biology with a special focus on heart and circulation as well as lung and gas exchange. More than 1.000 kids were taught and trained in basic life support, giving them the knowledge and skills to provide basic life support. This may help to reduce the rate of failure to provide first aid. Therefore, educating young kids in basic life support may not only help to save lives, but it also may help to prevent any feelings of guilt because of not having helped in cases of eye-witnessed sudden cardiac arrest.

Keywords: teaching, children, basic life support, cardiac arrest, CPR

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Authors: Mohd Asrul Affendi Bin Abdullah

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Sample size calculation is especially important for zero inflated models because a large sample size is required to detect a significant effect with this model. This paper verify how to present percentage of power approximation for categorical and then extended to zero inflated models. Wald test was chosen to determine power sample size of AIDS death rate because it is frequently used due to its approachability and its natural for several major recent contribution in sample size calculation for this test. Power calculation can be conducted when covariates are used in the modeling ‘excessing zero’ data and assist categorical covariate. Analysis of AIDS death rate study is used for this paper. Aims of this study to determine the power of sample size (N = 945) categorical death rate based on parameter estimate in the simulation of the study.

Keywords: power sample size, Wald test, standardize rate, ZINBDR

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Authors: Sisay Tiroro Salato

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Background: Ethiopia has been implementing the maternal death surveillance and response system to provide real-time actionable information, including causes of death and contributing factors. Analysis of maternal mortality surveillance data was conducted to identify the causes and underlying factors in Addis Ababa, Ethiopia. Methods: We carried out a retrospective surveillance data analysis of 324 maternal deaths reported in Addis Ababa, Ethiopia, from 2017 to 2021. The data were extracted from the national maternal death surveillance and response database, including information from case investigation, verbal autopsy, and facility extraction forms. The data were analyzed by computing frequency and presented in numbers, proportions, and ratios. Results: Of 324 maternal deaths, 92% died in the health facilities, 6.2% in transit, and 1.5% at home. The mean age at death was 28 years, ranging from 17 to 45. The maternal mortality ratio per 100,000 live births was 77for the five years, ranging from 126 in 2017 to 21 in 2021. The direct and indirect causes of death were responsible for 87% and 13%, respectively. The direct causes included obstetric haemorrhage, hypertensive disorders in pregnancy, puerperal sepsis, embolism, obstructed labour, and abortion. The third delay (delay in receiving care after reaching health facilities) accounted for 57% of deaths, while the first delay (delay in deciding to seek health care) and the second delay (delay in reaching health facilities) and accounted for 34% and 24%, respectively. Late arrival to the referral facility, delayed management after admission, andnon-recognition of danger signs were underlying factors. Conclusion: Over 86% of maternal deaths were attributed by avoidable direct causes. The majority of women do try to reach health services when an emergency occurs, but the third delays present a major problem. Improving the quality of care at the healthcare facility level will help to reduce maternal death.

Keywords: maternal death, surveillance, delays, factors

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Authors: SHWETA SRIKUMAR

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Winter stratospheric dynamics is a highly variable and spectacular field of research in middle atmosphere. It is well believed that the interaction of energetic planetary waves with mean flow causes the temperature to increase in the stratosphere and associated circulation reversal. This wave driven sudden disturbances in the polar stratosphere is defined as Sudden Stratospheric Warming. The main objective of the present work is to investigate the mid-winter major stratospheric warming events on equatorial dynamics over Peninsular India. To explore the effect of mid-winter stratospheric warming on Indian region (60oE -100oE), we have selected the winters 2003/04, 2005/06, 2008/09, 2012/13 and 2018/19. This study utilized the data from ERA-Interim Reanalysis, Outgoing Longwave Radiation (OLR) from NOAA and TRMM satellite data from NASA mission. It is observed that a sudden drop in OLR (averaged over Indian Region) occurs during the course of warming for the winters 2005/06, 2008/09 and 2018/19. But in winters 2003/04 and 2012/13, drop in OLR happens prior to the onset of major warming. Significant amplitude of planetary wave activity is observed in equatorial lower stratosphere which indicates the propagation of extra-tropical planetary waves from high latitude to equator. During the course of warming, a strong downward propagation of EP flux convergence is observed from polar to equator region. The polar westward wind reaches upto 20oN and the weak eastward wind dominates the equator during the winters 2003/04, 2005/06 and 2018/19. But in 2012/13 winter, polar westward wind reaches upto equator. The equatorial wind at 2008/09 is dominated by strong westward wind. Further detailed results will be presented in the conference.

Keywords: Equatorial dynamics, Outgoing Longwave Radiation, Sudden Stratospheric Warming, Planetary Waves

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Authors: Guo Yu, Haoming Ma, Peiru Zhou

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BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.

Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality

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Authors: Renukha Devi Anandan

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Charles Forsman’s The End of The Fxxxing World, I Am Not Okay With This, and Slasher invariably deals with existential themes. They reflect the perplexed situation of the characters torn between the search for existence and the constraints of human conditions that impede them from such realization, ensuing a dilemma deeply-rooted in absurdity and alienation. These characters are social misfits who fail to fashion their existence and develop harmoniously. Therefore, the present paper adopts an Existential approach to examine the vignettes of alienation and absurdity vis-à-vis the characters’ speech, actions, and thoughts. Furthermore, this paper explores the role of death either as a self-destructive behavior or the eternal freedom of man in graphic novels. Findings portrayed how the characters’ absurd existence surrounded by the void, would eventually develop into death. Finally, the study revealed that Forsman’s distinctive serial illustration not only unveiled the predicaments of the characters through their hard-boiled smokescreens in the 21st-century social paradigm but also established graphic novels as part and parcel of a literary genre.

Keywords: existentialism, absurdity, alienation, death, self-destruction, eternal freedom

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Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

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Background：Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods：From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results：Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

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Authors: Sumit Roy, A. Uddin

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One of the significant reasons that increase the delay time in the intersections at heterogeneous traffic condition is a sudden reduction of the capacity of the roads. In this study, the delay for this sudden capacity reduction is estimated. Two intersections at Dhaka city were brought in to thestudy, i.e., Kakrail intersection, and SAARC Foara intersection. At Kakrail intersection, the sudden reduction of capacity in the roads is seen at three downstream legs of the intersection, which are because of slowing down or stopping of buses for loading and unloading of passengers. At SAARC Foara intersection, sudden reduction of capacity was seen at two downstream legs. At one leg, it was due to loading and unloading of buses, and at another leg, it was for both loading and unloading of buses and reduction of the number of lanes. With these considerations, the delay due to intentional stoppage or slowing down of buses and reduction of the number of lanes for these two intersections are estimated. Here the delay was calculated by two approaches. The first approach came from the concept of shock waves in traffic streams. Here the delay was calculated by determining the flow, density, and speed before and after the sudden capacity reduction. The second approach came from the deterministic analysis of queues. Here the delay is calculated by determining the volume, capacity and reduced capacity of the road. After determining the delay from these two approaches, the results were compared. For this study, the video of each of the two intersections was recorded for one hour at the evening peak. Necessary geometric data were also taken to determine speed, flow, and density, etc. parameters. The delay was calculated for one hour with one-hour data at both intersections. In case of Kakrail intersection, the per hour delay for Kakrail circle leg was 5.79, and 7.15 minutes, for Shantinagar cross intersection leg they were 13.02 and 15.65 minutes, and for Paltan T intersection leg, they were 3 and 1.3 minutes for 1st and 2nd approaches respectively. In the case of SAARC Foara intersection, the delay at Shahbag leg was only due to intentional stopping or slowing down of busses, which were 3.2 and 3 minutes respectively for both approaches. For the Karwan Bazar leg, the delays for buses by both approaches were 5 and 7.5 minutes respectively, and for reduction of the number of lanes, the delays for both approaches were 2 and 1.78 minutes respectively. Measuring the delay per hour for the Kakrail leg at Kakrail circle, it is seen that, with consideration of the first approach of delay estimation, the intentional stoppage and lowering of speed by buses contribute to 26.24% of total delay at Kakrail circle. If the loading and unloading of buses at intersection is made forbidden near intersection, and any other measures for loading and unloading of passengers are established far enough from the intersections, then the delay at intersections can be reduced at significant scale, and the performance of the intersections can be enhanced.

Keywords: delay, deterministic queue analysis, shock wave, passenger loading-unloading

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Authors: Jinee Gogoi, Som K. Sharma, Kalyan Bhuyan

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The atmospheric layers are coupled to each other with the different dynamical, electrical, radiative and chemical processes. A large scale thermodynamical phenomenon in winter polar regions which affects the middle atmosphere vigorously is Sudden Stratospheric Warming (SSW). Two major SSW events were occurred during 1998-1999; one in December 1998 which is associated with vortex displacement and another in February- March 1999 associated with vortex splitting. Lidar study of these two major events from Mt. Abu (24.36⁰N, 72.45⁰E, ~1670 m amsl) has shown that though SSWs are mostly observed over high and mid latitudes, their effects can also be seen over India. We have studied ionospheric variations (primarily fₒF₂, h’F and hpF₂) over Ahmedabad (23.1⁰N, 72.58⁰E) during these events. Ionospheric disturbances have been found after four-five days of peak temperature. An increase (decrease) in critical frequency (fₒF₂) during morning (afternoon) has been noticed which may be in response to the updrift (down drift). Effects are stronger during displacement event (1998) than during the splitting event (1999). We have also studied some recent events occurred during 2006 (January), 2009 (January) and 2013 (January) using temperature data from Sounding of Atmosphere using Broadband Emission Radiometry (SABER) satellite. Though some modeling work supports the hypothesis that planetary waves are responsible for atmosphere-ionosphere coupling, there is still more significant works to do to understand how exactly the coupling can take place.

Keywords: sudden stratospheric warming (SSW), polar vortex, ionosphere, critical frequency

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Authors: Zhou Shangcheng, Yi Sicen

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Objective: To understand the mortality patterns of Zhangwan District in 2010 and provide the basis for the development of scientific and rational health policy. Methods: Data are collected from the Sixth Census of Zhangwan District and disease surveillance system. The statistical analysis include death difference between age, gender, region and time and the related factors. Methods developed for the Global Burden of Disease (GBD) Study by the World Bank and World Health Organization (WHO) were adapted and applied to Zhangwan District population health data. DALY rate per 1,000 was calculated for varied causes of death. SPSS 16 is used by statistic analysis. Results: From the data of death population of Zhangwan District we know the crude mortality rate was 6.03 ‰. There are significant differences of mortality rate in male and female population which was respectively 7.37 ‰ and 4.68 ‰. 0 age group population life expectancy in Zhangwan District in 2010 was 78.40 years old(Male 75.93, Female 81.03). The five leading causes of YLL in descending order were: cardiovascular diseases(42.63DALY/1000), malignant neoplasm (23.73DALY/1000), unintentional injuries (5.84DALY/1000), Respiratory diseases(5.43 DALY/1000), Respiratory infections (2.44DALY/1000). In addition, there are strong relation between the marital status , educational level and mortality in some to a certain extend. Conclusion Zhangwan District, as city level, is at lower mortality levels. The mortality of the total population of Zhangwan District has a downward trend and life expectancy is rising.

Keywords: sixth census, Zhangwan district, death level differences, influencing factors, cause of death

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Authors: O. S. Adeyemi, C. G. Whiteley

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The present study determined the toxic potential of metal nanoparticles in cell culture system. Silver and gold nanoparticles were synthesized and characterized following established "green" protocols. The synthesized nanoparticles, in varying concentrations ranging from 0.1–100 µM were evaluated for toxicity in metastatic MDA-MB-231 cells. The nanoparticles promoted a generation of reactive oxygen species and reduced cell viability to less than 50% in the demonstration of cellular toxicity. The nanoparticles; gold and the silver-gold mixture had IC50 values of 56.65 and 18.44 µM respectively. The IC50 concentration for silver nanoparticles could not be determined. Furthermore, the probe of the cell death using flow cytometry and confocal microscopy revealed the partial involvement of apoptosis as well as necrosis. Our results revealed cellular toxicity caused by the nanoparticles but the mechanism remains yet undefined.

Keywords: cell death, nanomedicine, nanotoxicology, toxicity

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Authors: Kate L. Yusi

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This paper is an attempt to theoretically reframe the act of self-immolation beyond violence/non-violence discourse, to differentiate it from other paradigmatic examples of necropolitical activism like suicide bombing, in order to highlight its particular ontopolitical statement in relation to life and death and to re-energize its deactivating power. In this paper, the writer seeks to focus on self-immolation by Tibetan monks and other activists against Chinese imperialism, its continuing ethnic cleansing of the Tibetan people, forced assimilation, and territorial occupation. Here, the main driving force is this question: what does self-immolation mean to a people who are forced to live in deathspace? In other words, if one is reduced to nothingness that their deaths (as is their lives) become insignificant, in what ways does the reclamation of death/dying become a “way out” of this state-imposed enclave of death? To answer these questions, the writer engages with and put in conversation the works of Achille Mbembe, Elias Cannetti, and Giorgio Agamben.

Keywords: necropolitics, self immolation, tibetan people, chinese imperialism

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Authors: Ruotian Wang

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Since the birth of the Buddha himself more than 2000 years ago, Buddhism has continued to lead many people’s lives. Scholars and Buddhists have contributed to give detailed explanations to all kinds of issues within the structure of Buddhist philosophy to make Buddhism more complete. Different schools have developed, therefore leading to a lot of different branches within Buddhism. Although they all follow what the Buddha himself taught, they still have various explanations to even fundamental issues. As one of the fundamental problems regarding our lives, death is widely discussed in Buddhism. The controversy regarding death is its seemly incompatibility with the idea of non-self and impermanence, which is what I will discuss in this essay. The idea of rebirth is the basic structure of birth and death, which suggests a connection between this life and the next. Therefore, according to common logic, we should tell that there is something that connects each life, an agent that receives the process of rebirth, which is normally known as a soul. In Buddhism, non-self is also an important concept which speaks to the illusion of a self or soul. The idea of rebirth and non-self seems contradicted. Many different schools of Buddhism attempt to resolve such conflicts, but there are logical flaws within the arguments they made. Thus, I raise a better solution: Different from the annihilationist view, non-self in Buddhism speaks only to the illusion of a self in each moment. There is a self that exists as a sum of all our karmas which we can achieve after Nirvana. However, the nature of such a self is still emptiness. There are no agents needed as one rebirth since the whole cycle of rebirth is the self. Then, the contradiction between rebirth and non-self can be resolved.

Keywords: Buddhism, impermanence, non-self, reincarnation

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Authors: W. Phokhwang-Just, A. Saraketrin, P. Thongpet, J. Udomkitpipat, J. Kaewsakulthong

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The more people get older and live longer, the more health problems they may have. This cross-sectional study aims to study a correlation between death anxiety, quality of life, and self-esteem as well as factors affecting these variables in the elderly living in Surat Thani Province, Thailand. Of 382 elderly people, who were proportionally sampled from 19 districts in Surat Thani Province, 256 (67%) already returned the questionnaires. The Thai version of Templer’s Death Anxiety, Quality of Life (WHO-BREF), and of Rosenberg’s Self-Esteem Questionnaires were employed. The result showed that the samples had a mean age of 72 years old, 53% were female, 62% were married, 61% graduated with primary-school, and 61% had at least one chronic disease Approximately, 19% of them had 3 diseases. The quality of life (QOL), self-esteem (SE), and death anxiety (DA) of samples were in moderate (n= 91, mean = 86.89, SD = 15.47), high (n = 138, mean = 29.33, SD=4.77), and low level (n= 85, mean = 6.23, SD= 3.65), respectively. The QOL was not significantly different between male and female as well as among different marital status. The female elderly had more DA and less SE than male (t= 2.095, df = 83; t =-3.258, df =135, respectively, p < 0.05). The female elderly, who were separated or widow, had a higher level of DA than did the married elderly (LSD: p < 0.05). The married elderly had a higher level of SE than did the separated, widowed (Tukey HSD, LSD: p < 0.05), or single elderly (LSD: p < 0.05). The more diseases the elderly got, the lower level of QOL they had (r = -0.335, p < 0.05). The QOL was significantly correlated with SE (r =0.434, p < 0.05), but not significantly related to DA (r = -0.200, p = 0.069). The lower level of SE the elderly had, the higher level of DA they become (r = -2.71, p < 0.05). In order to promote the QOL, the SE of the elderly should be enhanced. Consequently, the DA can be minimized. Healthcare providers should provide care that promotes QOL, SE, and reduces DA of the elderly, especially those, who are female, single, and separated or widowed as well as those, who have more diseases than the others

Keywords: death anxiety, quality of life, self-esteem, elderly

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Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill

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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.

Keywords: decision making, dying patients, end of life, intensive care unit

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Authors: Paolo Scolari

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Nietzschean thought flows like a current throughout Marcel’s philosophy. Marcel is in constant dialogue with him. He wants to give homage to him, making him one of the most eminent representatives of existential thought. His enthusiasm is triggered by Nietzsche’s phrase: ‘God is dead,’ the fil rouge that ties all of the Nietzschean references scattered through marcelian texts. The death of God is the theme which emphasises both the greatness and simultaneously the tragedy of Nietzsche. Marcel wants to substitute the idea ‘God is dead’ with its original meaning: a tragic existential characteristic that imitators of Nietzsche seemed to have blurred. An interpretation that Marcel achieves aiming at double target. On the one hand he removes the heavy metaphysical suit from Nietzsche’s aphorisms on the death of God, that his interpreters have made them wear – Heidegger especially. On the other hand, he removes a stratus of trivialisation which takes the aphorisms out of context and transforms them into advertising slogans – here Sartre becomes the target. In the lecture: Nietzsche: l'homme devant la mort de dieu, Marcel hurls himself against the metaphysical Heidegger interpretation of the death of God. A hermeneutical proposal definitely original, but also a bit too abstract. An interpretation without bite, that does not grasp the tragic existential weight of the original Nietzschean idea. ‘We are probably on the wrong road,’ announces, ‘when at all costs, like Heidegger, we want to make a metaphysic out of Nietzsche.’ Marcel also criticizes Sartre. He lands in Geneva and reacts to the journalists, by saying: ‘Gentlemen, God is dead’. Marcel only needs this impromptu exclamation to understand how Sartre misinterprets the meaning of the death of God. Sartre mistakes and loses the existential sense of this idea in favour of the sensational and trivialisation of it. Marcel then wipes the slate clean from these two limited interpretations of the declaration of the death of God. This is much more than a metaphysical quarrel and not at all comparable to any advertising slogan. Behind the cry ‘God is dead’ there is the existence of an anguished man who experiences in his solitude the actual death of God. A man who has killed God with his own hands, haunted by the chill that from now on he will have to live in a completely different way. The death of God, however, is not the end. Marcel spots a new beginning at the point in which nihilism is overcome and the Übermensch is born. Dialoguing with Nietzsche he notices to being in the presence of a great spirit that has contributed to the renewal of a spiritual horizon. He descends to the most profound depths of his thought, aware that the way out is really far below, in the remotest areas of existence. The ambivalence of Nietzsche does not scare him. Rather such a thought, characterised by contradiction, will simultaneously be infinitely dangerous and infinitely healthy.

Keywords: Nietzsche's Death of God, Gabriel Marcel, Heidegger, Sartre

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