Current Case Research Articles

Spontaneous anomalous Hall effect in magnetic and non-magnetic systems

Abstract We consider two cases of spontaneous anomalous Hall current. In a non-magnetic system with spin–orbit coupling (SOC), the applied bias results in the appearance of non-equilibrium magnetization and an anomalous Hall current. The latter demonstrates non-linear dependence on the applied bias. In a magnetic system with SOC, an anomalous current appears without applied bias. We perform the calculations in the framework of the free-electron model, whereas the common approach to this type of phenomenon is based on Berry connection. We demonstrate that anomalous currents acquire a measurable magnitude for reasonable model parameters.

Incorporating slow NMDA-type receptors with nonlinear voltage-dependent magnesium block in a next generation neural mass model: derivation and dynamics

We derive a next generation neural mass model of a population of quadratic-integrate-and-fire neurons, with slow adaptation, and conductance-based AMPAR, GABAR and nonlinear NMDAR synapses. We show that the Lorentzian ansatz assumption can be satisfied by introducing a piece-wise polynomial approximation of the nonlinear voltage-dependent magnesium block of NMDAR current. We study the dynamics of the resulting system for two example cases of excitatory cortical neurons and inhibitory striatal neurons. Bifurcation diagrams are presented comparing the different dynamical regimes as compared to the case of linear NMDAR currents, along with sample comparison simulation time series demonstrating different possible oscillatory solutions. The omission of the nonlinearity of NMDAR currents results in a shift in the range (and possible disappearance) of the constant high firing rate regime, along with a modulation in the amplitude and frequency power spectrum of oscillations. Moreover, nonlinear NMDAR action is seen to be state-dependent and can have opposite effects depending on the type of neurons involved and the level of input firing rate received. The presented model can serve as a computationally efficient building block in whole brain network models for investigating the differential modulation of different types of synapses under neuromodulatory influence or receptor specific malfunction.

Casing Collapse and Salt Creeping for an Iraqi Oil Field: Implications for Mitigation

Casing collapse is considered one of the costliest problems that occurs in the oil industry, and it happens when the stresses or loads exceed the casing collapse resistance or due to casing wear and corrosion or salt creeping. For X oil field, located in Iraq's southern east, a casing collapse phenomenon has been exposed in four wells, including well X-1, and the salt creeping may be the main reason because the collapsed casing section is encountered by a salt formation that may be creeping under compression. In this paper, Lower-Fars’s formation had been specified as the high-pressure salt formation that causes this problem according to the analysis of the provided data that included the depths of the collapse, log data and the final geological report. A new suggested casing design had been suggested by using pore pressure, fracture pressure, and horizontal stresses that were estimated by interactive petrophysics software from the well log data. The proposed and current casing designs were Simulated using Landmark-stress check software, and the proposed casing design indicates changing the grade from (L-80, 47 ppf) to (N-80, 53 ppf), which prevents the problem from recurring when drilling new wells in the same field as well as the proposed casing design can be economically considered feasible.

On the effect of pressure coefficient source on the energy demand of an isolated cross-ventilated building

Natural ventilation is a simple and effective measure to both reduce the cooling demand of buildings and improve the indoor air quality. In the prediction of heating and cooling demands by means of building energy simulations (BES), the use of pressure coefficients (Cp) from databases as input for the airflow network model is the common approach. Cp values for the same building typology may differ according to the adopted database and are generally unavailable for buildings with complex geometry. Employed Cp values may lead to differences in BES results. This manuscript presents a comparison, for different wind directions, between the Cp distributions and mean values on the facades of a detached building obtained with full-scale CFD – Reynolds-averaged Navier-Stokes (RANS) and large eddy simulation (LES) – simulations, from a database and from wind-tunnel experiments. The obtained pressure coefficients are used in the BES of a naturally ventilated building and the energy demand difference between the four approaches is quantified. Four climate zones (tropical, dry/desertic, temperate, continental) are considered. Although, in terms of accuracy of Cp prediction, LES outperforms RANS for all the wind directions considered, annual cooling energy demand is found to be relatively insensitive to the source of Cp for the current case study, while predicted peak cooling values differ up to 10.8%. On the other hand, the prediction of annual heating energy demand in cold climates varies up to 3% depending on the Cp source employed for BES simulations.

Estimation of B-inhibin and anti mullerian hormone in functional azoospermia and their correlations with surgical sperm retrieval: A prospective case-control study.

The current study estimated the levels of anti mullerian hormone (AMH) and inhibin-B and reproductive hormones in non obstructive azoospermic (NOA) cases and obstructive azoospermic (OA) cases as well as comparing between them as regards the sensitivity and specificity in determining the sperm retrieval hope in the NOA cases. Finally, we analyzed any potential correlation between all the hormones measured in the current study. The current case control study was conducted at the andrology outpatient clinic from June (2021) to March (2022). The study recruited 135 participants divided equally into three groups NOA cases, OA cases and controls, respectively. The mean inhibin-B was significantly lower in the NOA cases compared to the OA cases and the controls. There was a positive moderate correlation between AMH and Inhibin-B. Also, there was a positive moderate correlation between inhibin-B and free testosterone (FT) and positive weak correlation between beta Inhibin and leutinizing hormone (LH). The current study asserts the observation that inhibin-B is also expressed by Leydig cells as it has demonstrated positive correlations with FT and LH.

(026) Application of Gelatin Sponge as a Hemostatic Agent in Penile Prosthesis Implantation

Abstract Introduction Gelfoam® Sterile Compressed Sponge is a hemostatic that is directly applied to bleeding surfaces. This cost-effective hemostatic agent is prepared from purified porcine skin, Gelatin granules and Water for Injection. It is water insoluble, however is completely absorbed within 4–6 weeks with minimal scar formation. Gelfoam is available sterile for intra-operative use, and is applied in a multitude of surgical specialties. Objective In this work, we demonstrate for the first time the of Gelfoam to minimize the risk of bleeding in penile prosthesis implantation. Methods Eight cases received a three-piece inflatable implant (Rigicon Infla10®) through a peno-scrotal incision. Following cylinder insertion, corporotomies were closed by tying the stay sutures rather than water-tight sewing. Gelfoam was soaked in antibiotic-supplemented saline. Air bubbles were squeezed out followed by soaking. Gelfoam was then applied to the corporotomies, pump space and entry rout to the reservoir space. It was secured over the corporotomies by closing a pre-fashioned layer of Buck’s fascia. A suction drain was inserted. Mummy wrap was not used. Drain output was monitored and complications recorded. Results In two cases, drain output was an average of 80 cc’s in the first 24 hours, then 20 cc’s in the following 24 hours. However, in 6 cases, drain output was an average of 18 cc’s in the first 24 hours, mostly sero-sanguinous, then none in the following 24 hours. No cases of hematoma formation, infection, foreign body reaction, mass formation or hypersensitivity reaction were encountered. Conclusions The initial results of the current small case series demonstrate that Gelfoam is well-tolerated in penile surgeries, with possible value at minimizing post-operative bleeding, encouraging a multi-center larger study. Disclosure No.

КЛИНИЧЕСКИЙ СЛУЧАЙ УСПЕШНОГО 120-ДНЕВНОГО КОМПЛЕКСНОГО ЛЕЧЕНИЯ ИНФЕКЦИОННОГО ЭНДОКАРДИТА МИКСОМАТОЗНО-ИЗМЕНЕННОГО МИТРАЛЬНОГО КЛАПАНА, ОСЛОЖНЕННОГО КАРДИОГЕННЫМ И СЕПТИЧЕСКИМ ШОКОМ С ПОЛИОРГАННОЙ НЕДОСТАТОЧНОСТЬЮ

Annotation. Estimated incidence of infectious endocarditis (IE) is 13.8 cases per 100.000 subjects per year while mortality as high as 0.87 death cases per 100.000 patients demonstrating upstroke trend in majority countries in the world over past 30 years. Imaging positive for IE is among major diagnostic criteria of which transthoracic echocardiography is recommended as the first-line imaging modality in suspected IE. Negative, non-diagnostic or inconclusive results of echocardiography make diagnosis of IE challenging followed by treatment delays and poor outcomes. Within current clinical case we discuss the experience of diagnosis and successful treatment of IE of mitral valve with mixomatous degeneration and rupture of chordae tendineae that challenged vegetations detection and delayed surgical treatment followed by development of complications as cardiogenic and septic shock with multiple organ failure.

The Use of Osteopathic Manipulative Treatment for a Case of Cervical Radiculopathy

Abstract Cervical radiculopathy is a clinical condition related to dysfunction of the cervical spinal nerve roots. Signs and symptoms include unilateral neck, shoulder, or arm pain; paresthesias of the arm, forearm or hand; diminished muscle tendon reflexes, sensory disturbances; and/or muscle weakness. Cervical radiculopathy is primarily a clinical diagnosis with patients reporting a varying degree of pain and/or neurologic dysfunction along a nerve root distribution. In addition to a thorough history, a detailed physical exam including muscle strength testing, deep tendon reflex testing and sensory testing should be performed to determine the nerve root involved and to further help determine a course of action for the patient. The current case report demonstrates the impact of a somatic dysfunction component on underlying pathology of cervical spondylosis, likely driving the symptomatic component of cervical radiculopathy. By eliminating the somatic dysfunction components with the use of osteopathic manipulative treatment, the patient's system was able to function maximally within existing structural limitations and the symptoms resolved.

Navigating the Complexity of Construction Contracts and the value of Blockchain Technology: A Systems Dynamics Perspective - Review Paper

This paper examines the integration of systems thinking and blockchain technology in construction contract management. It addresses the complexities inherent in construction contracts, which are often exacerbated by issues in transparency, efficiency, and stakeholder collaboration. Systems thinking is applied to understand the dynamic interactions within contracts, while blockchain technology is explored as a solution for enhancing contract management, focusing on its capabilities for improving transparency, streamlining execution, and facilitating dispute resolution. The paper critically analyzes the potential benefits and challenges of blockchain implementation in construction, including technological complexities, regulatory uncertainties, and industry adoption barriers. Through a synthesis of current literature and case studies, the paper highlights the transformative potential of combining systems thinking and blockchain in construction contracts, offering insights into future research directions and technological advancements needed for effective integration. This approach promises a more efficient, transparent, and collaborative future in construction contract management, aligning with the industry’s evolving needs in an era of rapid technological change.

Critical Care Service Transformation at the ALERT Comprehensive Specialized Hospital, A Case Study.

BackgroundThe intensive care unit (ICU) is a specialized department within a hospital that provides care for critically ill patients requiring close monitoring, multidisciplinary intervention, and advanced life support. It is a resource-intensive healthcare service, with the patient outcome determined by the adequate utilization of human resources, supplies, technologies, and infrastructure. ALERT Hospital is one of the largest referral hospitals that provides critical care services for both adult and pediatric patients. This case study narrates the establishment and transformation of critical care services at ALERT Hospital over the last five years.ObjectiveTo describe the transformation of critical care services at ALERT Comprehensive Specialized Hospital from the beginning of the service to the current stateMethodsA descriptive case study design was applied to narrate critical care service transformation at ALERT Comprehensive Specialized Hospital. Data was gathered from desk reviews of the emergency department, ICU, quality directorate, hospital data management unit, and the annual audit report.ResultALERT Hospital provides services for about 4.2 million people, encompassing 22 health centers, 8 hospitals, and other private health facilities within its catchment area. The ALERT Trauma Center, established in 2015, had only 3 ICU beds with two functional mechanical ventilators and a few trained nurses, with an annual hospital and emergency patient flow of 328,242 and 13,642, respectively. The critical care service expansion at ALERT Hospital encountered various obstacles concerning infrastructure, personnel, and supplies. Therefore, the hospital administration and clinicians designed and implemented different strategies to transform the service into the current picture. Accordingly, after intensive facilitation of all requiredinputs a general ICU with seven beds and five mechanical ventilators was initially established in 2018. During the second phase of the service expansion in 2022, the hospital has established a large ICU with twelve beds, providing more specialized services for over 349 critical patients annually.

Exploring English Vocabulary Learning of Vietnamese Secondary School Students with VoiceGPT Assistance

With the advent of AI chatbots, many teachers’ teaching practices of English as a foreign language have undergone many changes. Many of them have become accustomed to employing ChatGPT to assist their work, bringing many benefits and potential challenges that, to date, have yet to be fully tested in any aspect. Particularly, two notable research gaps involve how Vietnamese secondary school students use VoiceGPT, the Vietnamese version of ChatGPT, to assist them in learning new English words and how they perceive this support. The current case study aimed to address these gaps by employing a quasi-experimental design at Lam Son Secondary School in Ho Chi Minh City with the participation of ten sixth-grade students in two English-intensive classes. In this investigation, the teacher used the Presentation-Practice-Production teaching method to teach vocabulary to her students, who were randomly assigned into two groups with the same number of members in each group, and the data for analysis was collected from their writing samples and semi-structured interviews. The findings indicate that sixth-grade students had different ways of using VoiceGPT to help them learn English words. The participants with VoiceGPT assistance outperformed those without this A.I. support in terms of lexical performance in the writing productions on five topics surveyed. In addition, they expressed favorable attitudes toward VoiceGPT’s benefits, but some concerns were raised about login difficulties, vocabulary range, and long response time.

Temperature reduction of an HTS transformer under short circuit fault by modifying the cryostat structure: Impact of Perlator and valve location

High Temperature Superconducting (HTS) transformers are one of the potential technologies for power systems connected to offshore wind farms and stand-alone and bulk power grids. In such systems, proper fault performance of any electric device including HTS transformer is a vital factor to ensure a safe, and reliable delivery of electric power as well as power quality in electric grid. Short circuits can increase the risk of developing hot spots in superconducting tapes and as a consequence burning the windings in severe fault current cases. One important way to limit the temperature increase of the superconducting winding during short circuit is to increase the heat transfer of the liquid nitrogen (LN2) during fault. In this paper, the impact of increasing the turbulence of the inlet fluid on the Hot Spot Point (HSP) temperature of superconducting windings of a 120 kVA HTS transformer was investigated during a short circuit fault. To increase turbulence and consequently, heat transfer, a device known as Perlator was used. Then, the impact of the Perlator structure and the location and angle of inlet valves were investigated on the HSP temperature of an HTS transformer, under 65 K and 77 K operating temperatures. The results indicated that by using a Perlator and adjusting valve number and location in the cryostat structure, the HSP temperature of the HTS transformer under the fault current was significantly reduced by about 46.2 K which can be vital to save the transformer from failure.

Foreign body within the upper esophagus of a patient not consenting to surgical treatment – case report and legal proceedings in light of current case law

<b><br>Introduction:</b> Patients intentionally inserting foreign bodies into the lumen of their gastrointestinal tract usually aim at achieving certain benefits, such as postponement or avoidance of punishment.</br> <b><br>Aim:</b> In view of the ever-increasing number of proceedings (including criminal proceedings) against health care professionals, the authors carried out a review of the available literature on: medical actions undertaken in cases of foreign bodies within the esophagus, current legislation and jurisprudence as practiced in the Republic of Poland within the context of model legal proceedings in cases involving patients raising doubts about being fully conscious and not consenting to necessary treatment.</br> <b><br>Case report:</b> The article presents a case of a patient with an esophageal foreign body who had not consented to the proposed surgical treatment. Doubts as raised within the otorhinolaryngological team with regard to the patient’s state of consciousness were not dispelled as the result of psychiatric consultation. Following a meticulous analysis of the current jurisprudence of the Polish judicial system and obtaining a court’s permission to intervene, the procedure (esophagoscopy with removal of esophageal foreign body) was performed. After exclusion of any life-threatening complications, the patient was transferred to the Psychiatric Department.</br> <b><br>Conclusions:</b> In the current state of the law, performing a procedure to remove a foreign body from the esophagus without prior court approval could qualify as a violation of patient’s rights. In such case, legal liability of the physician would arise regardless of the fact that the patient would have received care in accordance with the current medical knowledge and practice.</br>

A CASE STUDY ON THE PRE-GANGRENOUS STAGE FOLLOWED BY LEECH THERAPY AND AYURVEDA INTERVENTION OF KAISHORE GUGGULU

Around the world, a lower leg is amputated every 30 seconds due to gangrene. The mortality rate from diabetic foot gangrene is almost precisely the same as the mortality rate from cancer. When gangrene becomes severe, the only alternative treatments are surgical debridement of the injured tissue (which cannot be reversed) or amputation of the affected limb. The current case study provides an alternative to conventional medical care for chronic wounds & the gangrenous stage that is not healing correctly: Ayurvedic medicine (blood purifier and oxygen-sufficiency enhancer). A 60-year-old woman who had developed a chronic wound which was eventually converting into dry gangrene alongside intense pain was in danger as she was advised to have her left foot amputated below the knee underwent this trial. The patient's gangrenous great toe was extremely painful (80 mm on a 100 mm visual analogue scale) and had necrosed modifications that smelled bad. Aragvadhadi kashaya & Shatdhaut Ghrita were used as wound dressing since it is particularly effective at removing necrotizing areas. Leech Therapy or Hirudotherapy, along with Kishore Guggulu, were used for pain management together to promote healing, oxygen sufficiency & rejuvenation of the skin. Within 25 days, the pain score on a 100 mm visual analogue scale dropped to 0-10 mm, and no more painkillers were needed. Necrotic patches vanished, and the wound healed entirely over almost eight weeks (2 months)

Ejecta behavior during plume-surface interactions under rarefied atmospheric conditions

Plume-surface interactions (PSI) occur during the take-off and landing of interplanetary vehicles, leading to particle ejection and the formation of craters. This can be detrimental to the vehicle and any structures or infrastructure near the landing site. A major challenge in developing a comprehensive understanding of this three-dimensional phenomenon is the need to characterize the ejecta and cratering dynamics simultaneously. Here, experiments are conducted in a vacuum chamber at different nozzle heights and ambient pressure conditions using high-speed stereo-photogrammetry and planar particle tracking velocimetry to quantify the cratering and ejecta dynamics. Predictably, it was observed that the trajectory of ejecta with a large Stokes number was mostly unaffected by the nozzle flow after leaving the crater. Under rarefied conditions, the ejecta kinematics (velocity, ejection angle, range, and height) were significantly different compared to continuum conditions. Finally, the findings demonstrate a dependency between ejecta kinematics and crater topology for the current test cases, providing critical insights into particle ejection’s initial characteristics.

The Implementation Mechanism, Application, And Development Prospects Of Turkey’s Drone Strategy

Drones possess precise intelligence gathering, casualty avoidance, and remote strikes as an emerging strategic technology. With the rapid development of functionality and application modes, drones have become a new focal point in international military competition. In recent years, the operational contributions of Turkish drones in multiple battles have attracted global attention. This article examines the background formation, implementation mechanisms, and further prospects of Turkey’s drone strategy to understand the complex factors behind the particular development patterns. This article adopts the analytic hierarchy process and draws on current literature and case studies, analyzing multiple perspectives of Turkey’s drone strategy from two hierarchical levels: domestic politics and international environments. As a latecomer, Turkey has made significant strategic achievements in the field of drones. The analysis of Turkey’s strategic planning and practices in domestic and international arenas in different periods hold a certain degree of reference for drone development both in China and in the international society.

Fulminant Leptospirosis Presenting with Rapidly Developing Acute Renal Failure and Multiorgan Failure.

Leptospirosis, caused by pathogenic spirochetes of the Leptospira genus, is a common zoonosis in tropical and subtropical regions and can lead to an epidemic following heavy rainfall or flooding. The primary reservoirs of Leptospira include rodents, wild animals, dogs, cats, amphibians, and others, but the brown rat (Rattus norvegicus) remains the main source of human Leptospirosis. Humans are often accidental hosts and they can be infected through cuts, abrasions, mucosa, conjunctiva, or by ingesting contaminated water. The clinical manifestation of leptospirosis can vary from mild, nonspecific symptoms to a fatal outcome involving liver and renal failure, pulmonary hemorrhage, meningitis, and septic shock. The severity of fatal outcomes is likely to be due to virulence factors, host susceptibility, and epidemiological conditions. L. interrogans are associated with high-risk individuals, particularly patients older than 60 years of age in clinical settings. The current case study showed a foreign worker who presented with rapidly deteriorating clinical signs of fever, jaundice, impaired consciousness, and oliguric acute renal failure. Drawing from our experience, it is advisable to consider the possibility of leptospirosis diagnosis in patients who show clinical symptoms such as fever, hepatic failure with jaundice, and acute renal failure. This is particularly important for those individuals with a prior history of pathogen exposure. This case study had a strong suspicion of leptospirosis, which was confirmed by the microscopic agglutination test (MAT) and, later, the patient's recovery following treatment.

The influence of Ohmic noise on the dynamics of three-spin open quantum system

The dynamics of open quantum systems under decoherence effects remain a hotly debated topic in the case of the practical deployment of quantum information processing. In this regard, we examine how the three-qubit mixed state is affected by changes in the cut-off frequency of the Ohmic spectral density in a harmonic reservoir. Specifically, the degree of quantum memory-assisted entropic uncertainty (QMA-EU), along with the entanglement, coherence, and purity of the system, is to be demonstrated. A thorough exercise is done to investigate any underlying relationship between the three-qubit quantum characteristics. We show that a harmonic reservoir controlled by Ohmic noise prevails a monotonic-like decay in the current case where, sooner or later, the state becomes completely disentangled, decoherent, and mixed. The QMA-EU has always been found to have an increasing function causing the quantum resourcefulness to be reduced. Although, there is no pathway to avoid the Ohmic noise consequences and complete decay, however, we provided parameterization which would lead to prolonged preservation of quantum correlations with time. Finally, we provide various settings for the tuning of cut-off frequency regarding the Ohmic type bath and state parameters on the initial as well as final levels of quantum features.

Hearts of stone: Rapidly progressive left ventricular myocardial calcifications in severe sepsis: Case series.

Rapidly progressive left ventricular myocardial calcification (RPLVMC) is a rare phenomenon of severe sepsis which is associated with long-term complications like irreversible cardiomyopathy and arrhythmias. To date, only 19 cases have been reported in literature. We present a case series of two patients with RPLVMC which manifested within a period of days in the setting of severe sepsis. Unique to previous case reports, the patients in the current case series had no pre-existing systemic risk factors such as end-stage kidney disease or endocrinological dysfunction. This case series aims to increase awareness of RPLVMC in severe sepsis, improve its opportunistic detection on routine medical imaging (namely chest x-ray and computed tomography), and spur future research to develop potential prevention strategies.

PAINLESS NEURALGIC AMYOTROPHY (PARSONAGE-TURNER SYNDROME) – A CASE REPORT

Background: Neuralgic amyotrophy (NA) is a rare disorder typically characterized by an abrupt onset of upper extremity pain followed by progressive muscle weakness, atrophy and occasional sensory loss. Although NA has been hypothesized to be an autoimmune-mediated disorder. It is considered a primarily clinical diagnosis, electrodiagnostic evaluation is essential for the diagnosis confirmation and can exclude other etiologies. Electrodiagnostic findings can reveal patchy damage to any nerve within the brachial plexus. Case Description: In the current case report, we are presenting a 43-years-old man admitted to the Neurology Department of “UMHAT Dr. Georgi Stranski” in Pleven, Bulgaria, with decreased muscle strength and limited active movements in the left upper shoulder for approximately 3 weeks. The patient denied feeling any pain during the onset and afterwards. He had no previous infections, vaccinations and history of other diseases. The detailed neurological examination showed the left upper extremity decreased antigravity strength in the deltoid and infraspinatus muscles with marked atrophy of the same. Hyporeflexia of the left biceps and brachioradialis deep‐tendon reflexes was present. Electromyography findings showed denervation of the deltoid and infraspinatus muscles. Initial reinnervation of supraspinatus and cervical paraspinal muscles was present. The diagnosis of NA was confirmed by both the neurological examination and the electrophysiological findings. Conclusion: We are presenting a clinical case of idiopathic neuralgic amyotrophy with atypical painless presentation and discussing the most significant aspects of the disorder with regards to the difficulties in approaching the correct diagnosis. A better understanding of the NA clinical symptoms and signs variability improves the diagnostic and therapeutic approach.