Search results for: open temporomandibular joint surgery

Authors: Luksanaporn Krungkraipetch

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A pterygium is an eye surface lesion that begins in the limbal conjunctiva and progresses to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a distinctive wing-like aspect. Indications for surgery, in decreasing order of significance, are grown over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and aesthetic concerns. Recurrent pterygium results in the loss of time, the expense of therapy, and the potential for vision impairment. The objective of this study is to find out how often the recurrence of pterygium after surgery occurs, what effect the surgery technique has, and what causes them to come back in people with pterygium. Materials and Methods: Observational case control in retrospect: the study involves a retrospective analysis of 164 patient samples. Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium. For factor analysis, the inferential statistics odds ratio (OR) and 95% confidence interval (CI) ANOVA are utilized. A p-value of 0.05 was deemed statistically important. Results: The majority of patients, according to the results, were female (60.4%). Twenty-four of the 164 (14.6%) patients who underwent surgery exhibited recurrent pterygium. The average age is 55.33 years old. Postoperative recurrence was reported in 19 cases (79.3%) of bare sclera techniques and five cases (20.8%) of conjunctival autograft techniques. The recurrence interval is 10.25 months, with the most common (54.17 percent) being 12 months. In 91.67 percent of cases, all follow-ups are successful. The most common recurrence level is 1 (25%). A surgical complication is a subconjunctival hemorrhage (33.33 percent). Comparing the surgeries done on people with recurrent pterygium didn't show anything important (F = 1.13, p = 0.339). Age significantly affected the recurrence of pterygium (95% CI, 6.79-63.56; OR = 20.78, P 0.001). Conclusion: This study discovered a 14.6% rate of pterygium recurrence after pterygium surgery. Across all surgeries and patients, the rate of recurrence was four times higher with the bare sclera method than with conjunctival autograft. The researchers advise selecting a more conventional surgical technique to avoid a recurrence.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Rachelly Ashwall, Ephraim Tabory

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In an attempt to reduce the level of a major identity-based conflict in Israel between Ultra-orthodox and secular Jews, several initiatives in recent years have tried to bring members of the two societies together in facilitated joint discussion forums. Our study analyzes the impact of two types of such programs: joint mediation training classes and confrontation-based learning programs that are designed to facilitate discussions over controversial issues. These issues include claims about an unequal shouldering of national obligations such as military service, laws requiring public observance of the Sabbath, and discrimination against women, among others. The study examines the factors that enabled the two groups to reduce their social distance, and increase their understanding of each other, and develop a recognition and tolerance of the other group's particular social identity. The research conducted over a course of two years involved observations of the activities of the groups, interviews with the participants, and analysis of the social media used by the groups. The findings demonstrate the progression from a mutual initial lack of knowledge about habits, norms, and attitudes of the out-group to an increasing desire to know, understand and more readily accept the identity of a previously rejected outsider. Participants manifested more respect, concern for and even affection for those whose identity initially led them to reject them out of hand. We discuss the implications for seemingly intractable identity-based conflict in fragile societies.

Keywords: identity-based conflict, intergroup relations, joint mediation learning, out-group recognition, social identity

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Authors: Yunzi Chen, James Laybourne, Sarah Steven, Peter Carey, David Steel, Maria Sandinha

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Introduction: Bariatric surgery is popular with the rising incidence of obesity. Its well-known benefits include significant and rapid glycaemic control. However, cases of paradoxical worsening in diabetic retinopathy (DR) despite improved glycaemic control have been reported. Purpose: clarification on the evolution of diabetic retinopathy after bariatric surgery. Method: retrospective study of 40 patients with Type 2 diabetes who underwent bariatric surgery in a UK specialist bariatric unit between 2009 and 2011. Pre-operative and post-operative visual acuity (VA), weight, HbA1c and annual DRSS screening results were analysed. Median follow up was 50 months. Results: No significant change in VA was found during the post-operative period. 85% of patients improved HbA1c post-operatively of which 53% achieved non-diabetic HbA1c of <6.1% - despite this, 2 patients developed new DR. First post-operative screening showed 80% of patients experienced no change, 8% improved but 13% of patients developed new DR (1 case with sight-threatening maculopathy). 80% of these cases persisted up to 24 months. The proportion of patients developing new or worse DR fluctuated over time, peaking at the 3rd annual screening with 26% (15% regressed, 56% stable). The probability of developing new or worse DR postoperatively was significantly associated with a high pre-operative HbA1c (>8%) and male gender. Conclusions: bariatric surgery does not guarantee long-term improvement or prevention of DR. Asymptomatic changes in DR occurred up to 5 years postoperatively. We therefore consider it prudent to continue screening in this cohort of patients.

Keywords: bariatric surgery, diabetic retinopathy, obesity, type 2 diabetes mellitus

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Authors: Majid Moshirfar, Kyle Margulies, Yasmyne C. Ronquillo, Phillip Hoopes

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A total of 66 articles were reviewed to compare glaucoma and its associated surgeries' effect on central corneal endothelium cell density (CECD). The paper reports the average reported central CECD loss at 3-, 6-, 12-, 24-, 36-, 48-, and 60-month post-operation for each glaucoma surgery. ALT, MLT, SLT, CS AGV, VC BGI, Hydrus + phaco, XEN gel + phaco, PRESERFLO, Dual iStent, or Trabectome had no significant impact on postoperative CECD compared to either preoperative CECD or control group CECD. The highest CECD loss was found to be EXPRESS-phaco, AC AGV, CS BGI, CS BGI, AC BGI, and AC BGI at the 3-, 6-, 12-, 24-, 36-, 48-, and 60-month follow-ups, respectively. AC AGV, Trab + MMC, Trab, AC BGI, Trab + MMC, Cypass, and Cypass showed the smallest reduction of CECD at the 3-, 6-, 12-, 24-, 36-, 48-, and 60-month follow-ups.

Keywords: glaucoma, corneal endothelium, cell density, surgery outcome

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Authors: Huijuan Liu, Fukun Li, Hao Yuan

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The bolted spherical node is a common type of joint in space steel structures. The bolt-sphere joint portion almost always controls the bearing capacity of the bolted spherical node. The investigation of the bearing performance and progressive failure in service often requires high-fidelity numerical models. This paper focuses on the constitutive models of bolt steel and sphere steel used in China’s space structure construction. The elastoplastic model is determined by a standard tensile test and calibrated Voce saturated hardening rule. The ductile damage is found dominant based on the fractography analysis. Then Rice-Tracey ductile fracture rule is selected and the model parameters are calibrated based on tensile tests of notched specimens. These calibrated material models can benefit research or engineering work in similar fields.

Keywords: bolt-sphere joint, steel, constitutive model, ductile damage, model calibration

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Authors: Ashok K. Gupta

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Over the past few decades, since the bio-engineering revolution, autologous cell therapy (ACT) has become a rapidly evolving field. Currently, this form of therapy has broad applications in modern medicine and plastic surgery, ranging from the treatment/improvement of wound healing to life-saving operations. A study was conducted on 50 patients having to disfigure, and deform post burn scars and was treated by injection of extracted, refined adipose tissue grafts with their unique stem cell properties. To compare the outcome, a control of 20 such patients was treated with conventional skin or soft-tissue flaps or skin grafting, and a control of 10 was treated with more advanced microsurgical techniques such as Pre-fabricated flaps/pre laminated flaps / free flaps. Assessment of fat volume and survival post- follow up period was done by radiological aid, using MRI and clinically (Survival of the autograft and objective parameters for scar elasticity were evaluated skin elasticity parameters 3 to 9 months postoperatively). Recently, an enzyme that is involved in collagen crosslinking in fibrotic tissue, lysyl hydroxylase (LH2), was identified. This enzyme is normally active in bone and cartilage but hardly in the skin. It has been found that this enzyme is highly expressed in scar tissue and subcutaneous fat; this is in contrast to the dermis, where the enzyme is hardly expressed. Adipose tissue-derived stem cell injections are an effective method in the treatment of various extensive post-burn scar deformities that makes it possible to re-create the lost sub-dermal tissue for improvement in the function of involved joint movements.

Keywords: adipose tissue-derived stem cell injections, treatment of various extensive post-burn scar deformities, re-create the lost sub-dermal tissue, improvement in function of involved joint movements

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Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

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Authors: Tabrej Khan, Tamer A. Sebaey, Balbir Singh, M. A. Umarfarooq

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Spread-tow thin-ply-based technology has resulted in the progress of optimized reinforced composite plies with ultra-low thicknesses. There is wide use of composite bolted joints in the aircraft industry for load-bearing structures, and they are regarded as the primary source of stress concentration. The purpose of this study is to look into the bearing strength and structural performance of single shear bolt joint configurations in composite laminates, which are basically a combination of conventional thin-plies and thick-plies in some specific stacking sequence. The placement effect of thin-ply within the configured stack on bearing strength, as well as the potential damages, were investigated. Mechanical tests were used to understand the disfigurement mechanisms of the plies and their reciprocity, as well as to reflect on the single shear bolt joint properties and its load-bearing capacity. The results showed that changing the configuration of laminates by inserting the thin plies inside improved the bearing strength by up to 19%.

Keywords: hybrid composites, delamination, stress concentrations, mechanical testing, single bolt joint, thin-plies

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Authors: Titap Yazicioglu

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To examine the results of two different surgery in patients with severe ptosis and poor levator function. The records of 10 bilateral congenital ptosis patients, who underwent Whitnall’s sling surgery on one eyelid and frontalis sling surgery on the other were analyzed retrospectively. All patients had severe congenital ptosis(>4mm) and poor levator function (LF<4mm). Data regarding eyelid position, cosmetic outcomes, and postoperative complications were evaluated. All patients were assessed for a minimum of one year with regard to the amount of correction, residual ptosis and lagophthalmos. The study consisted of 10 patients, with an average age of 9.2±2.4 years. Preoperative diagnosis for all patients was noted as, the average LF was 3.4±0.51mm, vertical lid height was 3.5±0.52 mm and margin reflex distance-1 (MRD-1) was 0.4±0.51mm. The mean vertical lid height was measured as 7.1±0.73 mm in the frontalis sling group and 7.2±0.63 mm in the Whitnall’s sling group at the postoperative 1st month control. However, in patients with Whitnall’s sling, revision was performed with frontalis sling surgery due to failure in vertical lid height in the late postoperative period, and an average of 7.5±0.52 mm was achieved. Satisfactory results were obtained in all patients. Although postoperative lagophthalmitis developed in the frontalis sling group, none of them developed exposure keratitis. Granuloma was observed as sling infection in 2(20%) of the patients. Although Whitnall’s sling technique provides a natural look appearance without interfering with the functional result, we did not find it as successful as frontalis sling surgery in severe ptosis.

Keywords: congenital ptosis, frontalis suspension, Whitnall ligament, complications

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Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

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Authors: Long Kim Vu, Ban Dang Nguyen

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In this paper, the finite element method (FEM) is utilized to simulate the comprehensive process including tightening, releasing and self-loosening of a bolt joint under transverse vibration. Following to the accurate geometry of helical threads, an absolutely hexahedral meshing is implemented. The accuracy of simulation process is verified and validated by comparison with the experimental results on clamping force-vibration relationship, which shows the sufficient correlation. Further analysis with different amplitude and frequency of transverse vibration is done to determine the dominant factor inducing the failure.

Keywords: bolt self-loosening, contact state, finite element method, FEM, helical thread modeling

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: J. Martin Leal-Graciano, Juan J. Pérez-Gavilán, A. Reyes-Salazar, J. H. Castorena, J. L. Rivera-Salas

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The experimental results about the global behavior of twelve 1:2 scaled reinforced concrete frame subject to in-plane lateral load are presented. The main objective was to generate experimental evidence about the use of steel bars within mortar bed-joints as shear reinforcement in infill walls. Similar to the Canadian and New Zealand standards, the Mexican code includes specifications for this type of reinforcement. However, these specifications were obtained through experimental studies of load-bearing walls, mainly confined walls. Little information is found in the existing literature about the effects of joint reinforcement on the seismic behavior of infill masonry walls. Consequently, the Mexican code establishes the same equations to estimate the contribution of joint reinforcement for both confined walls and infill walls. A confined masonry construction and a reinforced concrete frame infilled with masonry walls have similar appearances. However, substantial differences exist between these two construction systems, which are mainly related to the sequence of construction and to how these structures support vertical and lateral loads. To achieve the objective established, ten reinforced concrete frames with masonry infill walls were built and tested in pairs, having both specimens in the pair identical characteristics except that one of them included joint reinforcement. The variables between pairs were the type of units, the size of the columns of the frame and the aspect ratio of the wall. All cases included tie-columns and tie-beams on the perimeter of the wall to anchor the joint reinforcement. Also, two bare frame with identical characteristic to the infilled frames were tested. The purpose was to investigate the effects of the infill wall on the behavior of the system to in-plane lateral load. In addition, the experimental results were compared with the prediction of the Mexican code. All the specimens were tested in cantilever under reversible cyclic lateral load. To simulate gravity load, constant vertical load was applied on the top of the columns. The results indicate that the contribution of the joint reinforcement to lateral strength depends on the size of the columns of the frame. Larger size columns produce a failure mode that is predominantly a sliding mode. Sliding inhibits the production of new inclined cracks, which are necessary to activate (deform) the joint reinforcement. Regarding the effects of joint reinforcement in the performance of confined masonry walls, many facts were confirmed for infill walls: this type of reinforcement increases the lateral strength of the wall, produces a more distributed cracking and reduces the width of the cracks. Moreover, it reduces the ductility demand of the system at maximum strength. The prediction of the lateral strength provided by the Mexican code is property in some cases; however, the effect of the size of the columns on the contribution of joint reinforcement needs to be better understood.

Keywords: experimental study, Infill wall, Infilled frame, masonry wall

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Authors: Ruiyang Bi

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Natural rock masses are cut into rock blocks of different shapes and sizes by intersecting joints. These rock blocks often determine the mechanical properties of the rock mass. In this study, fine sandstone cube specimens were produced, and three intersecting joint cracks were cut inside the specimen. Uniaxial compression tests were conducted using mechanical tests and numerical simulation methods to study the mechanical properties and crack propagation mechanism of triangular blocks within the rock. During the test, the mechanical strength, acoustic emission characteristics and strain field evolution of the specimen were analyzed. Discrete element software was used to study the expansion of microcracks during the specimen failure process, and the crack types were divided. The simulation results show that as the inclination angles of the three joints increase simultaneously, the mechanical strength of the specimen first decreases and then increases, and the crack type is mainly shear. As the inclination angle of a single joint increases, the strength of the specimen gradually decreases. When the inclination angles of the two joints increase at the same time, the strength of the specimen gradually decreases. The research results show that the stability of the rock mass is affected by the joint inclination angle and the size of the cut blocks. The greater the joint dip and block size, the more significant the development of micro-cracks in the rock mass, and the worse the stability.

Keywords: rock joints, uniaxial compression, crack extension, discrete element simulation

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Authors: Pawan Kumar Pant, Bhanu Gupta, S. R. Kale, S. V. Veeravalli

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In many countries, buses are the principal means of transport, of which a majority are naturally ventilated with open windows. The design of this ventilation has little scientific basis and to address this problem a study has been undertaken involving both experiments and numerical simulations. The flow pattern inside and around of an open window bus with passengers has been investigated in detail. A full scale three-dimensional numerical simulation has been used for a) a bus with closed windows and b) with open windows. In either simulation, the bus had 58 seated passengers. The bus dimensions used were 2500 mm wide × 2500 mm high (exterior) × 10500 mm long and its speed was set at 40 km/h. In both cases, the flow separates at the top front edge forming a vortex and reattaches close to the mid-length. This attached flow separates once more as it leaves the bus. However, the strength and shape of the vortices at the top front and wake region is different for both cases. The streamline pattern around the bus is also different for the two cases. For the bus with open windows, the dominant airflow inside the bus is from the rear to the front of the bus and air velocity at the face level of the passengers was found to be 1/10th of the free stream velocity. These findings are in good agreement with flow visualization experiments performed in a water channel at 10 m/s, and with smoke/tuft visualizations in a wind tunnel with a free-stream velocity of approximately 40 km/h on a 1:25 scaled Perspex model.

Keywords: air flow, moving bus, open windows, vortex, wind tunnel

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Authors: Faci Youcef, Ahmed Mebtouche, Djillali Allou, Maalem Badredine

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The inclination of the bolt in a fastened joint of composite material during a tensile test can be influenced by several parameters, including material properties, bolt diameter and length, the type of composite material being used, the size and dimensions of the bolt, bolt preload, surface preparation, the design and configuration of the joint, and finally testing conditions. These parameters should be carefully considered and controlled to ensure accurate and reliable results during tensile testing of composite materials with fastened joints. Our work focuses on the effect of the stacking sequence and the geometry of specimens. An experimental test is carried out to obtain the inclination of a bolt during a tensile test of a composite material using acoustic emission and digital image correlation. Several types of damage were obtained during the load. Digital image correlation techniques permit the obtaining of the inclination of bolt angle value during tensile test. We concluded that the inclination of the bolt during a tensile test of a composite material can be related to the damage that occurs in the material. It can cause stress concentrations and localized deformation in the material, leading to damage such as delamination, fiber breakage, matrix cracking, and other forms of failure.

Keywords: damage, inclination, analyzed, carbon

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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: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Kave Moloudi, Heidi Abrahamse, Blassan P. George

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Radiotherapy (RT) and photodynamic therapy (PDT) are both forms of cancer treatment that aim to kill cancer cells while minimizing damage to healthy tissue. The similarity between RT and PDT lies in their mechanism of action. Both treatments use energy to damage cancer cells. RT uses high-energy radiation to damage the DNA of cancer cells, while PDT uses light energy to activate a photosensitizing agent, which produces reactive oxygen species (ROS) that damage the cancer cells. Both treatments require careful planning and monitoring to ensure the correct dose is delivered to the tumor while minimizing damage to surrounding healthy tissue. They are also often used in combination with other treatments, such as surgery or chemotherapy, to improve overall outcomes. However, there are also significant differences between RT and PDT. For example, RT is a non-invasive treatment that can be delivered externally or internally, while PDT requires the injection of a photosensitizing agent and the use of a specialized light source to activate it. Additionally, the side effects and risks associated with each treatment can vary. In this review, we focus on generalizing the 6Rs of radiobiology in PDT, which can open a window for the clinical application of Radio-photodynamic therapy with minimum side effects. Furthermore, this review can open new insight to work on and design new radio-photosensitizer agents in Radio-photodynamic therapy.

Keywords: radiobiology, photodynamic therapy, radiotherapy, 6Rs in radiobiology, ROS, DNA damages, cellular and molecular mechanism, clinical application.

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Authors: Sami Kabir, Sadek Hossain Khoka

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Open Government Data (OGD) refers to all data produced by government which are accessible in reusable way by common people with access to Internet and at free of cost. In line with “Digital Bangladesh” vision of Bangladesh government, the concept of open data has been gaining momentum in the country. Opening all government data in digital and customizable format from single platform can enhance e-governance which will make government more transparent to the people. This paper presents a well-in-progress case study on OGD portal by Bangladesh Government in order to link decentralized data. The initiative is intended to facilitate e-service towards citizens through this one-stop web portal. The paper further discusses ways of collecting data in digital format from relevant agencies with a view to making it publicly available through this single point of access. Further, possible layout of this web portal is presented.

Keywords: e-governance, one-stop web portal, open government data, reusable data, web of data

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Authors: A. Sharma, S. S. Sandhu, A.Shahi, A. Kumar

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In this study, the effects of geometric configurations of butt joints i.e. double V groove, double U groove and UV groove of AISI 304L of thickness 12 mm by using Gas Tungsten Arc Welding (GTAW) are investigated. The magnitude of transverse shrinkage stress and distortion generated during welding under the unrestrained conditions of butt joints is the main objective of the study. The effect of groove design on impact strength and metallurgical properties are also studied. The Finite element analysis for the groove design is done and compared the actual experimentation. The experimental results and the FEM results were compared and reveal a very good correlation for distortion and weld groove design for multipass joint with a standard analogy of 80%. In the case of VV groove design it was found that the transverse stress and cumulative deflection have the lowest value. It was found that the UV groove design had the maximum ultimate and yield tensile strength, VV groove had the highest impact strength. Vicker’s hardness value of all the groove design was measured. Micro structural studies were carried out using conventional microscopic tools which revealed a lot of useful information for correlating the microstructure with mechanical properties.

Keywords: weld groove design, distortion, AISI 304 L, butt joint, FEM, GTAW

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Authors: Yongxu Fu, Shaolong Wan

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We study the band degeneracy, defectiveness, as well as exceptional points of non-Hermitian systems and materials analytically. We elaborate on the energy bands, the band degeneracy, and the defectiveness of eigenstates under open boundary conditions based on developing a general theory of one-dimensional (1D) non-Hermitian systems. We research the presence of the exceptional points in a generalized non-Hermitian Su-Schrieffer-Heeger model under open boundary conditions. Beyond our general theory, there exist infernal points in 1D non-Hermitian systems, where the energy spectra under open boundary conditions converge on some discrete energy values. We study two 1D non-Hermitian models with the existence of infernal points. We generalize the infernal points to the infernal knots in four-dimensional non-Hermitian systems.

Keywords: non-hermitian, degeneracy, defectiveness, exceptional points, infernal points

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Authors: J. Martin Leal-Graciano, Juan J. Pérez-Gavilán, A. Reyes-Salazar, J. H. Castorena, J. L. Rivera-Salas

Abstract:

The experimental results about the global behavior of twelve 1:2 scaled reinforced concrete frames subject to in-plane lateral load are presented. The main objective was to generate experimental evidence about the use of steel bars within mortar bed joints as shear reinforcement in infill walls. Similar to the Canadian and New Zealand standards, the Mexican code includes specifications for this type of reinforcement. However, these specifications were obtained through experimental studies of load-bearing walls, mainly confined walls. Little information is found in the existing literature about the effects of joint reinforcement on the seismic behavior of infill masonry walls. Consequently, the Mexican code establishes the same equations to estimate the contribution of joint reinforcement for both confined walls and infill walls. Confined masonry construction and a reinforced concrete frame infilled with masonry walls have similar appearances. However, substantial differences exist between these two construction systems, which are mainly related to the sequence of construction and to how these structures support vertical and lateral loads. To achieve the objective established, ten reinforced concrete frames with masonry infill walls were built and tested in pairs, having both specimens in the pair identical characteristics except that one of them included joint reinforcement. The variables between pairs were the type of units, the size of the columns of the frame, and the aspect ratio of the wall. All cases included tie columns and tie beams on the perimeter of the wall to anchor the joint reinforcement. Also, two bare frames with identical characteristics to the infilled frames were tested. The purpose was to investigate the effects of the infill wall on the behavior of the system to in-plane lateral load. In addition, the experimental results were compared with the prediction of the Mexican code. All the specimens were tested in a cantilever under reversible cyclic lateral load. To simulate gravity load, constant vertical load was applied on the top of the columns. The results indicate that the contribution of the joint reinforcement to lateral strength depends on the size of the columns of the frame. Larger size columns produce a failure mode that is predominantly a sliding mode. Sliding inhibits the production of new inclined cracks, which are necessary to activate (deform) the joint reinforcement. Regarding the effects of joint reinforcement in the performance of confined masonry walls, many facts were confirmed for infill walls. This type of reinforcement increases the lateral strength of the wall, produces a more distributed cracking, and reduces the width of the cracks. Moreover, it reduces the ductility demand of the system at maximum strength. The prediction of the lateral strength provided by the Mexican code is a property in some cases; however, the effect of the size of the columns on the contribution of joint reinforcement needs to be better understood.

Keywords: experimental study, infill wall, infilled frame, masonry wall

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Authors: Zeynep Ayfer Bozat

Abstract:

As traditional innovation has already taken its place in managers’ to do lists; managers and companies have started to look for new ways to go beyond the traditional innovation. Because of its cost, traditional innovation became a burden for companies since they only use inner sources. Companies have intended to use outer innovation sources to decrease the innovation costs and Open Innovation has become a new solution for companies at this point. Crowdsourcing is a tool of Open Innovation and it consists of two words: Outsourcing and crowd. Crowdsourcing aims to benefit from the efforts and ideas of a virtual crowd via Internet technologies. In addition to that, crowdsourcing can help entrepreneurs to innovate and grow their businesses. They can crowd source anything they can use to grow their businesses: Ideas, investment, new business, new partners, new solutions, new policies, data, insight, marketing or talent. Therefore, the aim of the study is to be able to show some possible ways for entrepreneurs to benefit from crowdsourcing to expand or foster their businesses. In the study, the term crowdsourcing has been given in details and these possible ways have been searched and given.

Keywords: crowdsourcing, entrepreneurship, innovation, open innovation

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Authors: Thammanoon Charmjuree, Yuosre F. Badir, Umar Safdar

Abstract:

There is a consensus among innovation scholars that knowledge is a vital antecedent for firm’s innovation; e.g., process innovation. Recently, there has been an increasing amount of attention to more open approaches to innovation. This open model emphasizes the use of purposive flows of knowledge across the organization boundaries. Firms adopt open innovation strategy to improve their innovation performance by bringing knowledge into the organization (inbound open innovation) to accelerate internal innovation or transferring knowledge outside (outbound open innovation) to expand the markets for external use of innovation. Reviewing open innovation research reveals the following. First, the majority of existing studies have focused on inbound open innovation and less on outbound open innovation. Second, limited research has considered the possible interaction between both and how this interaction may impact the firm’s innovation performance. Third, scholars have focused mainly on the impact of open innovation strategy on product innovation and less on process innovation. Therefore, our knowledge of the relationship between firms’ inbound and outbound open innovation and how these two impact process innovation is still limited. This study focuses on the firm’s external technology acquisition (ETA) and external technology exploitation (ETE) and the firm’s process innovation performance. The ETA represents inbound openness in which firms rely on the acquisition and absorption of external technologies to complement their technology portfolios. The ETE, on the other hand, refers to commercializing technology assets exclusively or in addition to their internal application. This study hypothesized that both ETA and ETE have a positive relationship with process innovation performance and that ETE fully mediates the relationship between ETA and process innovation performance, i.e., ETA has a positive impact on ETE, and turn, ETE has a positive impact on process innovation performance. This study empirically explored these hypotheses in software development firms in Thailand. These firms were randomly selected from a list of Software firms registered with the Department of Business Development, Ministry of Commerce of Thailand. The questionnaires were sent to 1689 firms. After follow-ups and periodic reminders, we obtained 329 (19.48%) completed usable questionnaires. The structure question modeling (SEM) has been used to analyze the data. An analysis of the outcome of 329 firms provides support for our three hypotheses: First, the firm’s ETA has a positive impact on its process innovation performance. Second, the firm’s ETA has a positive impact its ETE. Third, the firm’s ETE fully mediates the relationship between the firm’s ETA and its process innovation performance. This study fills up the gap in open innovation literature by examining the relationship between inbound (ETA) and outbound (ETE) open innovation and suggest that in order to benefits from the promises of openness, firms must engage in both. The study went one step further by explaining the mechanism through which ETA influence process innovation performance.

Keywords: process innovation performance, external technology acquisition, external technology exploitation, open innovation

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Authors: B. Paygozar, S.A. Dizaji, A.C. Kandemir

Abstract:

In this study, the effects of the modified adhesive including different concentrations of Nano-silica are surveyed on the bonding strength of the adhesive scarf joints. The nanoparticles are added in two different concentrations, to an epoxy-based two-component structural adhesive, Araldite 2011, to survey the influences of the nanoparticle weight percentage on the failure load of the joints compared to that of the joints manufactured by the neat adhesive. The effects of being exposure to a moist ambience on the joint strength are also investigated for the joints produced of both neat and modified adhesives. For this purpose, an ageing process was carried out on the joints of both neat and improved kinds with variable immersion periods (20, 40 and 60 days). All the specimens were tested under a quasi-static tensile loading of 2 mm/min speed so as to find the quantities of the failure loads. Outcomes indicate that the failure loads of the joints with modified adhesives are measurably higher than that of the joint with neat adhesive, even while being put for a while under a moist condition. Another result points out that humidity lessens the bonding strength of all the joints of both types as the exposure time increases, which can be attributed to the change in the failure mode.

Keywords: bonding strength, humidity, nano-silica, scarf joint

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Authors: Wasse Uddin Ahmed Saleh, Nawreenbinte Anwar

Abstract:

A well-written operating note is crucial as a teaching tool for providing patients with high-quality medical care and fending off medico-legal claims. In this review article, some adjustments have been advised to the operative note guidelines by the Royal College of Surgeons (RCS) for different methods of ocular anesthesia and ophthalmic procedures like cataract surgeries, kerato-refractive surgeries, glaucoma surgeries, oculoplastic surgeries, etc. Some modifications of the WHO Surgical Safety Checklist have also been mentioned, including pre-operative responsibilities of the nurses, operative assistants and operating ophthalmologists. It has become essential to assemble globally accepted structured operative note guidelines modified for each ocular surgery.

Keywords: ocular surgeries, operation notes, cataract surgery, kerato-refractive surgery, Oculoplastic surgeries, guidelines

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Authors: Kimutai Joan Jepkorir, Moturi Wilkister Nyaora

Abstract:

The practice of open defecation can be devastating for human health as well as the environment, and this practice persistence could be due to ingrained habits that individuals continue to engage in despite having a better alternative. Safe disposal of human excreta is essential for public health protection. This study sought to find if open defecation relates to fecal-oral infections in Burat and Ngaremara Wards in Isiolo County. This was achieved through conducting a cross-sectional study. Simple random sampling technique was used to select 385 households that were used in the study. Data collection was done by use of questionnaires and observation checklists. The result show that 66% of the respondents disposed-off fecal matter in a safe manner, whereas 34% disposed-off fecal matter in unsafe manner through open defecation. The prevalence proportions per 1000 of diarrhea and intestinal worms among children under-5 years of age were 142 and 21, respectively. The prevalence proportions per 1000 of diarrhea and typhoid among children over-5 years of age were 20 and 20, respectively.

Keywords: faecal-oral infections, open defecation, prevalence proportion, sanitation

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Authors: Didem Venus Yildiz, Murat Hocaoglu, Murat Dursun, Taner Akkan

Abstract:

The shoulder joint is a more complex structure than the hip or knee joints. In addition to the overall complexity of the shoulder joint, two different factors influence the insufficient outcome of shoulder replacement: the shoulder prosthesis design is far from fully developed and it is difficult to place these shoulder prosthesis due to shoulder anatomy. The glenohumeral joint is the most complex joint of the human shoulder. There are various treatments for shoulder failures such as total shoulder arthroplasty, reverse total shoulder arthroplasty. Due to its reverse design than normal shoulder anatomy, reverse total shoulder arthroplasty has different physiological and biomechanical properties. Post-operative achievement of this arthroplasty is depend on improved design of reverse total shoulder prosthesis. Designation achievement can be increased by several biomechanical and computational analysis. In this study, data of human both shoulders with right side fracture was collected by 3D Computer Tomography (CT) machine in dicom format. This data transferred to 3D medical image processing software (Mimics Materilise, Leuven, Belgium) to reconstruct patient’s left and right shoulders’ bones geometry. Provided 3D geometry model of the fractured shoulder was used to constitute of reverse total shoulder prosthesis by 3-matic software. Finite element (FE) analysis was conducted for comparison of intact shoulder and prosthetic shoulder in terms of stress distribution and displacements. Body weight physiological reaction force of 800 N loads was applied. Resultant values of FE analysis was compared for both shoulders. The analysis of the performance of the reverse shoulder prosthesis could enhance the knowledge of the prosthetic design.

Keywords: reverse shoulder prosthesis, biomechanics, finite element analysis, 3D printing

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Authors: Hamidreza Torabi, Mohsen Moghtaderi

Abstract:

Introduction: Currently, deep vitrectomy with silicone oil tamponade is the standard treatment method for patients with Rhegmatogenous Retinal Detachment (RRD). After retinal repair, it is necessary to remove silicone oil from the eye, but the appropriate time to remove the oil and complications related to that time has been less studied. The aim of this study was to compare the results of the early removal of silicone oil with the delayed removal of silicone oil in patients with RRD. Method & material: Patients who were referred to the Ophthalmology Clinic of Baqiyatallah Hospital, Tehran, Iran, due to RRD with detached macula in 2021 & 2022 were evaluated. These patients were treated with deep vitrectomy and silicone oil tamponade. Patients whose retinas were attached after the passage of time were candidates for silicone oil removal (SOR) surgery. For patients in the early SOR group, SOR surgery was performed 3-6 months after the initial vitrectomy surgery, and for the late SOR group, SOR was performed after 6 months after the initial vitrectomy surgery. Results: In this study, 60 patients with RRD were evaluated. 23 (38.3%) patients were in the early group, and 37 (61.7%) patients were in the late group. Based on our findings, it was seen that the mean visual acuity of patients based on the Snellen chart in the early group (0.48 ± 0.23 Decimal) was better than the late group (0.33 ± 0.18 Decimal) (P-value=0.009). Retinal re-detachment has happened only in one patient with early SOR. Conclusion: Early removal of silicone oil (less than 6 months) from the eyes of patients undergoing RRD surgery has been associated with better vision results compared to late removal.

Keywords: retinal detachment, vitrectomy, silicone oil, silicone oil removal, visual acuity

Procedia PDF Downloads 58