Search results for: upper limb amputation

Authors: M. A. Ashour

Abstract:

As it is known Egypt is one of the countries having oldest sugarcane industry, which goes back to the year 710 AD. Cane plantations are the main agricultural product in five governorates in Upper Egypt (El-Menia, Sohag, Qena, Luxor, and Aswan), producing not less than 16 million tons a year. Eight factories (Abou-korkas, Gena, Nagaa-Hamadi, Deshna, Kous, Armant, Edfuo, and Komombo), located in such upper Egypt governorates generates huge amount of wastes during the manufacturing stage, the so called bagasse which is the fibrous, and cellulosic materials remaining after the era of the sugarcane and the juice extraction, presents about 30% of such wastes. The amount of bagasse generated yearly through the manufacturing stage of the above mentioned 8 factories is approximately about 2.8 million tons, getting red safely of such huge amount, presents a serious environmental problem. Storage of that material openly in the so hot climate in upper Egypt, may cause its self-ignition under air temperature reaches 50 degrees centigrade in summer, due to the remained residual content of sugar. At the same time preparing places for safely storage for such amount is very expensive with respect to the valueless of it. So the best way for getting rid of bagasse is converting it into an added value environmentally friendly material, especially till now the utilization of it is so limited. Since oil pollution became a serious concern, the issue of environmental cleaning arises. With the structure of sugarcane bagasse, which contains fiber and high content of carbon, it can be an adsorbent to adsorb the oil contamination from the water. The present study is a trail to introduce a new material for the purification of water systems to score two goals at once, the first is getting rid of that harmful waste safely, the second is converting it to a commercial valuable material for cleaning, and purifying the water from oil spills, and petroleum pollution. Introduced the new material proved very good performance, and higher efficiency than other similar materials available in the local market, in both closed and open systems. The introduced modified material can absorb 10 times its weight of oil, while don't absorb any water.

Keywords: environment, water resources, agricultural wastes, oil pollution control, sugarcane

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Authors: Asaad Alhabsi, Alyaqdan Algafri

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Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.

Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty

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Authors: Alireza Javadzadeh

Abstract:

Background: The purpose of this prospective, randomized study was to compare the safety and efficacy of oral versus i.v. midazolam in providing sedation for pediatric upper gastrointestinal (GI) endoscopy. Methods: Sixty-one children (age < 16 years) scheduled for upper GI endoscopy were studied. Patients were randomly assigned to receive oral or i.v. midazolam. Measurements were made and compared for vital signs, level of sedation, pre- and post-procedure comfort, anxiety during endoscopy, ease of separation from parents, ease and duration of procedure, and recovery time. Results: Patients were aged 1–16 years (mean 7.5 ± 3.42 years); 30 patients received oral medication, and 31 received i.v. medication. There were no statistically significant differences in age or gender between groups. There were no significant differences in level of sedation, ease of separation from parents, ease of ability to monitor the patient during the procedure, heart rate, systolic arterial pressure, or respiratory rate. Oxygen saturation was significantly lower in the i.v. group than the oral group 10 and 30 min after removal of the endoscope, and recovery time was longer in the oral than the i.v. group. Conclusions: Oral administration of midazolam is a safe and effective method of sedation that significantly reduces anxiety and improves overall tolerance for children undergoing esophagogastroduodenoscopy.

Keywords: children, endoscopy, midazolam, oral, sedation

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Authors: Mirabbos Mirkamalov, Zavkiddin Mirtoshev

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The M 1.6 class flare occurred on 6^th of September 2012. Our observations correspond to the active region NOAA 11560 with the heliographic coordinates N04W71. The event took place between 04:00 UT and 04:45 UT, and was close to the solar limb at the western region. The flare temperature correlates with flux peak, increases for a short period (between 04:08 UT and 04:12 UT), rises impulsively, attains a maximum value of about 17 MK at 04:12 UT and gradually decreases after peak value. Around the peak we observe significant emissions of X-ray sources. Flux profiles of the X-ray emission exhibit a progressively faster raise and decline as the higher energy channels are considered.

Keywords: magnetic reconnection, solar atmosphere, solar flare, X-ray emission

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Authors: Man Kyu Kim, Hansu Shin

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This study is an analysis on gravel of sand-gravel bar that stretches variously in the Duchon and Naechon stream basins, which are situated on Hong-Cheon River (a well-developed sand-gravel bar in upstream river) basins in Korea. Naechon stream mostly flows through granite zone but Duchon stream mostly flows through gneiss zone. The characteristics of gravel in the sand-gravel bar of these two branches in the upper Hongcheon River were analyzed in this study in order to understand the geomorphic development of streams depending on the differences of bedrock. Through the analysis on the roundness and flatness of gravel, we figured out an irregular trend following the increase in supply of granite gravel and gneiss gravel as we traveled downstream. The result shows that the two basins have uppermost small basin condition reflecting the mountain valley environment although it may be difficult to do an equivalent comparison to other roundness researches in Korea or in Europe. This study conducted an analysis on gravels found in small scale streams unlike the previous studies trend which mostly studies large rivers. The research provides an opportunity to offer basic data for continuous comparison research on various small basins.

Keywords: flatness, geology, roundness, sand-gravel bar

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Authors: Soyeon Kang, Youn-Jee Chung, Jung Namkung

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Objective: This retrospective study investigated the association between uric acid level and bone mineral density (BMD) in the postmenopausal period. Methods: The study included 328 menopausal women (mean age, 57.3 ± 6.5 years; mean serum uric acid level, 4.6 ± 1.0 mg/dL). Patients were divided into three groups by tertile of serum uric acid level. Patients who used hormone treatment (HT), bisphosphonates, or lipid-lowering agents were included. Results: Blood urea nitrogen, serum creatinine, and serum triglyceride levels were significantly higher in the upper uric acid tertiles. No significant difference was found in the mean uric acid levels between medication users and non-users. Distinct HT regimens showed different mean serum uric acid levels. In a cross-sectional analysis, higher serum uric acid levels showed a tendency toward increased BMD in the spine and femoral neck. Longitudinal analysis of 186 women who underwent follow-up examination at a mean interval of 14.6 months revealed a trend toward a smaller reduction in femoral neck BMD in women in the upper serum uric acid tertiles. Conclusion: A positive correlation exists between serum uric acid levels and BMD in menopausal women.

Keywords: menopause, antioxidant, uric acid, bone mineral density

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Authors: M. Haruna, O. O. Onafowokan, G. Holt, K. Anderson, R. G. Middleton

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Background: Requirements for satisfactory outcomes following total hip arthroplasty (THA) include restoration of femoral offset, version, and leg length. Various techniques have been described for restoring these biomechanical parameters, with leg length restoration being the most predominantly described. We describe a “quartered head technique” (QHT) which uses a stepwise series of femoral head osteotomies to identify and preserve the centre of rotation of the femoral head during THA in order to ensure reconstruction of leg length, offset and stem version, such that hip biomechanics are restored as near to normal as possible. This study aims to identify whether using the QHT during hip arthroplasty effectively restores leg length and femoral offset to within acceptable parameters. Methods: A retrospective review of 206 hips was carried out, leaving 124 hips in the final analysis. Power analysis indicated a minimum of 37 patients required. All operations were performed using an anterolateral approach by a single surgeon. All femoral implants were cemented, collarless, polished double taper CPT® stems (Zimmer, Swindon, UK). Both cemented, and uncemented acetabular components were used (Zimmer, Swindon, UK). Leg length, version, and offset were assessed intra-operatively and reproduced using the QHT. Post-operative leg length and femoral offset were determined and compared with the contralateral native hip, and the difference was then calculated. For the determination of leg length discrepancy (LLD), we used the method described by Williamson & Reckling, which has been shown to be reproducible with a measurement error of ±1mm. As a reference, the inferior margin of the acetabular teardrop and the most prominent point of the lesser trochanter were used. A discrepancy of less than 6mm LLD was chosen as acceptable. All peri-operative radiographs were assessed by two independent observers. Results: The mean absolute post-operative difference in leg length from the contralateral leg was +3.58mm. 84% of patients (104/124) had LLD within ±6mm of the contralateral limb. The mean absolute post-operative difference in offset from contralateral leg was +3.88mm (range -15 to +9mm, median 3mm). 90% of patients (112/124) were within ±6mm offset of the contralateral limb. There was no statistical difference noted between observer measurements. Conclusion: The QHT provides a simple, inexpensive yet effective method of maintaining femoral leg length and offset during total hip arthroplasty. Combining this technique with pre-operative templating or other techniques described may enable surgeons to reduce even further the discrepancies between pre-operative state and post-operative outcome.

Keywords: leg length discrepancy, technical tip, total hip arthroplasty, operative technique

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Authors: Leyla Sattarzadeh, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

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Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6) and adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of resistance exercise training on these inflammatory markers, the present study aimed to examine the effect of eight week different patterns of resistance exercise training on CRP, IL-6 and ICAM-1 levels in healthy untrained women. 40 volunteered and healthy untrained female university students (aged: 21+ 3 yr., Body Mass Index: 21.5+ 3.5 kg/m2) were selected purposefully and divided into three groups. At the end of training protocol and after subjects drop during the protocol in upper body exercise training (n=11), lower body (n=12) completed the eight week of training period although the control group (n=7) did anything. Blood samples gathered pre and post experimental period and CRP, IL-6 and ICAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one way Analysis of Variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP and ICAM-1 showed no significant changes due to the exercise training. But there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper and lower body exercise training by involving the different amount of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP and ICAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: C-reactive protein, interleukin-6, intracellular adhesion molecule-1, resistance training

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Authors: Sharon Harel, Rachel Kizony, Yoram Feldman, Gabi Zeilig, Mordechai Shani

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Multiple Sclerosis (MS) is a neurological disease that may cause restriction in participation in daily activities of young adults. Main symptoms include fatigue, weakness and cognitive decline. The appearance of symptoms, their severity and deterioration rate, change between patients. The challenge of health services is to provide long-term rehabilitation services to people with MS. The objective of this presentation is to describe a course of tele-rehabilitation service of a woman with MS. Methods; R is a 48 years-old woman, diagnosed with MS when she was 22. She started to suffer from weakness of her non-dominant left upper extremity about ten years after the diagnosis. She was referred to the tele-rehabilitation service by her rehabilitation team, 16 years after diagnosis. Her goals were to improve ability to use her affected upper extremity in daily activities. On admission her score in the Mini-Mental State Exam was 30/30. Her Fugl-Meyer Assessment (FMA) score of the left upper extremity was 48/60, indicating mild weakness and she had a limitation of her shoulder abduction (90 degrees). In addition, she reported little use of her arm in daily activities as shown in her responses to the Motor Activity Log (MAL) that were equal to 1.25/5 in amount and 1.37 in quality of use. R. received two 30 minutes on-line sessions per week in the tele-rehabilitation service, with the CogniMotion system. These were complemented by self-practice with the system. The CogniMotion system provides a hybrid (synchronous-asynchronous), the home-based tele-rehabilitation program to improve the motor, cognitive and functional status of people with neurological deficits. The system consists of a computer, large monitor, and the Microsoft’s Kinect 3D sensor. This equipment is located in the client’s home and connected to a clinician’s computer setup in a remote clinic via WiFi. The client sits in front of the monitor and uses his body movements to interact with games and tasks presented on the monitor. The system provides feedback in the form of ‘knowledge of results’ (e.g., the success of a game) and ‘knowledge of performance’ (e.g., alerts for compensatory movements) to enhance motor learning. The games and tasks were adapted for R. motor abilities and level of difficulty was gradually increased according to her abilities. The results of her second assessment (after 35 on-line sessions) showed improvement in her FMA score to 52 and shoulder abduction to 140 degrees. Moreover, her responses to the MAL indicated an increased amount (2.4) and quality (2.2) of use of her left upper extremity in daily activities. She reported high level of enjoyment from the treatments (5/5), specifically the combination of cognitive challenges while moving her body. In addition, she found the system easy to use as reflected by her responses to the System Usability Scale (85/100). To-date, R. continues to receive treatments in the tele-rehabilitation service. To conclude, this case report shows the potential of using tele-rehabilitation for people with MS to provide strategies to enhance the use of the upper extremity in daily activities as well as for maintaining motor function.

Keywords: motor function, multiple-sclerosis, tele-rehabilitation, daily activities

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Authors: Hadi Abdollahi, Bijan Iraj, Maryam Mirpourian, Behzad Shariatifar

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Background: The aim of the present study was to determine the relationship between neck circumferences (NC), as an indicator of upper body obesity, with anthropometric and cardio-metabolic factors among the first degree relatives of diabetes patients. Materials and Methods: This cross-sectional study was performed on first degree relatives of diabetes patients (n = 213). Weight, height, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and NC were measured. Laboratory data included oral glucose tolerance test (OGTT) results, high density lipoprotein (HDL), low density lipoprotein, triglyceride (TG) and total cholesterol. Results: There was no difference in NC among different results of OGTT in men or women. Factors including weight, body mass index (BMI), WC and HC were strongly associated with NC in both genders (r = 0.420-0.711). NC was weakly associated with SBP in women (r = 0.195) and moderately with DBP in men (r = 0.314). Regarding lipid profile, HDL and TG were associated with NC only in women (r = −0.268-0.325). Conclusions: NC has a significant correlation with gender and anthropometric variables, including BMI, weight and waist and HCs in both men and women, but it does not differ significantly in patients with different status in OGTT.

Keywords: body mass index, cardiovascular, diabetes, neck circumference, obesity

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Authors: Yu Yoshihara, Chika Tada, Moe Takada, Nyam-Osor Purevdorj, Khorolmaa Chimedtseren, Yutaka Nakai

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Water pollution from animal waste and its influence on grazing animals is a current concern regarding Mongolian grazing lands. We allocated 32 free-grazing lambs to four groups and provided each with water from a different source (upper stream, lower stream, well, and pond) for 49 days. We recorded the amount of water consumed by the lambs, as well as their body weight, behavior, white blood cell count, acute phase (haptoglobin) protein level, and fecal condition. We measured the chemical and biological qualities of the four types of water, and we detected enteropathogenic and enterohemorrhagic Escherichia coli in fecal samples by using a genetic approach. Pond water contained high levels of nitrogen and minerals, and well water contained high levels of bacteria. The odor concentration index decreased in order from pond water to upper stream, lower stream, and well. On day 15 of the experiment, the following parameters were the highest in lambs drinking water from the following sources: water intake (pond or lower stream), body weight gain (pond), WBC count (lower stream), haptoglobin concentration (well), and enteropathogenic E. coli infection rate (lower stream). Lambs that drank well water spent more time lying down and less time grazing than the others, and lambs that drank pond water spent more time standing and less time lying down. Lambs given upper or lower stream water exhibited more severe diarrhea on day 15 of the experiment than before the experiment. Mongolian sheep seemed to adapt to chemically contaminated water: their productivity benefited the most from pond water, likely owing to its rich mineral content. Lambs that drank lower stream water showed increases in enteropathogenic E. coli infection, clinical diarrhea, and WBC count. Lambs that drank well water, which was bacteriologically contaminated, had increased serum acute phase protein levels and poor physical condition; they were thus at increased risk of negative health and production effects.

Keywords: DNA, Escherichia coli, fecal sample, lower stream, well water

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Authors: Mohammed A. Sakr, Tarek M. Khalifa, Walid N. Mansour

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External bonding of fiber reinforced polymer (FRP) plates to reinforced concrete (RC) beams is an effective technique for flexural strengthening. This paper presents an analytical parametric study on the behavior of RC continuous beams flexurally strengthened with externally bonded FRP plates on the upper and lower fibers, conducted using simple uniaxial nonlinear finite element model (UNFEM). UNFEM is able to estimate the load-carrying capacity, different failure modes and the interfacial stresses of RC continuous beams flexurally strengthened with externally bonded FRP plates on the upper and lower fibers. The study investigated the effect of five key parameters on the behavior and moment redistribution of FRP-reinforced continuous beams. The investigated parameters were the length of the FRP plate, the width and the thickness of the FRP plate, the ratio between the area of the FRP plate to the concrete area, the cohesive shear strength of the adhesive layer, and the concrete compressive strength. The investigation resulted in a number of important conclusions reflecting the effects of the studied parameters on the behavior of RC continuous beams flexurally strengthened with externally bonded FRP plates.

Keywords: continuous beams, parametric study, finite element, fiber reinforced polymer

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Authors: Amin Noor, Roslinda Nazar, Norihan Md. Arifin

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In this paper, a numerical and theoretical study has been performed for the stagnation-point boundary layer flow and heat transfer towards a shrinking sheet in a nanofluid. The mathematical nanofluid model in which the effect of the nanoparticle volume fraction is taken into account is considered. The governing nonlinear partial differential equations are transformed into a system of nonlinear ordinary differential equations using a similarity transformation which is then solved numerically using the function bvp4c from Matlab. Numerical results are obtained for the skin friction coefficient, the local Nusselt number as well as the velocity and temperature profiles for some values of the governing parameters, namely the nanoparticle volume fraction Φ, the shrinking parameter λ and the Prandtl number Pr. Three different types of nanoparticles are considered, namely Cu, Al2O3 and TiO2. It is found that solutions do not exist for larger shrinking rates and dual (upper and lower branch) solutions exist when λ < -1.0. A stability analysis has been performed to show which branch solutions are stable and physically realizable. It is also found that the upper branch solutions are stable while the lower branch solutions are unstable.

Keywords: heat transfer, nanofluid, shrinking sheet, stability analysis, stagnation-point flow

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Authors: D. L. David, J. A. Wahedi, Q. T. Zaku

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A study was conducted at River Mayo Ranewo and River Lau, Taraba State Nigeria. The two rivers empty into the Upper Benue Basin. A visual encounter survey was conducted within the two wetlands from June to August, 2014. The fish record was based entirely on landings of fishermen, number of canoes that land fish was counted, types of nets and baits used on each sampling day. Fish were sorted into taxonomic groups, identified to family/species level, counted and weighed in groups. The relative species abundance was determined by dividing the number of species from a site by the total number of species from all tributaries/sites. Fish was preserved in 2% formaldehyde solution and taken to the laboratory, where they were identified. Shannon-Weiner index of species diversity indicated that the diversity was highest at River Mayo Ranewo than River Lau. In the result showed at River Mayo Ranewo, the family Mochokidae recorded the highest (23.15%), followed by Mormyridae (2.64%) and the least was the family Lepidosirenidae (0.04%). While at River Lau the family Mochokidae recorded the highest occurrence of (24.1%), followed by Bagridae (20.20%), and then Mormyridae, which also was the second highest in River Lau, with 18.46% occurrence. There was no occurrence of Malapteruridae and Osteoglossidae (0%) in River Lau, but the least occurrence was the family Gymnarchidae (0.04%). These results indicated that the fish composition were not significantly (p ≤ 0.05) different based on t-test.

Keywords: conservation, diversity index, Lau, Mayo Ranewo, wetlands

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Authors: M. Ghanbari, S. Hossainpour, G. Rezazadeh

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In this paper, longitudinal vibration of a micro-beam in micro-scale fluid media has been investigated. The proposed mathematical model for this study is made up of a micro-beam and a micro-plate at its free end. An AC voltage is applied to the pair of piezoelectric layers on the upper and lower surfaces of the micro-beam in order to actuate it longitudinally. The whole structure is bounded between two fixed plates on its upper and lower surfaces. The micro-gap between the structure and the fixed plates is filled with fluid. Fluids behave differently in micro-scale than macro, so the fluid field in the gap has been modeled based on micro-polar theory. The coupled governing equations of motion of the micro-beam and the micro-scale fluid field have been derived. Due to having non-homogenous boundary conditions, derived equations have been transformed to an enhanced form with homogenous boundary conditions. Using Galerkin-based reduced order model, the enhanced equations have been discretized over the beam and fluid domains and solve simultaneously in order to obtain force response of the micro-beam. Effects of micro-polar parameters of the fluid as characteristic length scale, coupling parameter and surface parameter on the response of the micro-beam have been studied.

Keywords: micro-polar theory, Galerkin method, MEMS, micro-fluid

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Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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Authors: Gao Qin, Hu Liwei, Dong Xiangzhou, Zhu Qifa, Cheng Tingming, Zhao Limei, Yang Mengmeng, Zhai Zhen, Dai Huaxin, Liang Taibo, Zhang Shixiang, Xue Chaoqun

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The functional strain T976 for starch degradation was isolated from Nicotiana tabacum L. Yunyan 97 tobacco leaves, the ratio of starch hydrolysis transparent circle diameter to colony diameter of the strain was 4.14, 16S rDNA sequencing identified these strains as Enterobacter ludwigii. Then Enterobacter ludwigii T976 was fermented and spaying Yunyan 97 plant in vigorous growing stage. The results of once spraying fermentation broth of Enterobacter ludwigii T976 showed that starch content of upper leaves decreased slightly, from 3.77% to 3.1%, the reducing sugar content increased from 4.39% to 5.53%, and the total sugar content increased from 5.82% to 7.39%. The chemical content was also checked after three time spraying. The starch content of middle leaves decreased from 5.63% to 3.74%, while the content of total sugar and reducing sugar decreased slightly. And the starch content of upper leaves decreased from 7.62% to 4.78%, the total sugar and reducing sugar decreased slightly, and starch content of middle leaf decreased from 6.27% to 3.62%, the total sugar and reducing sugar did not change much, and other chemical components were in a suitable range.

Keywords: nicotiana tabacum, yunyan 97, leaf, starch, degradation, enterobacter ludwigii

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Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

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This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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Authors: Abdul Salam Turkmani

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The Lower Cretaceous rocks are exposed only in the mountains regions of Syria, such as the Anti- Lebanon mountain on the western side of Damascus. The lower cretaceous sequences are made up of different rocks. The upper and middle parts of the section are composed mainly of carbonate sediments and, less frequently, gypsum and anhydrite. The lower beds are mainly composed of sandstone, conglomerate and clay. Clay samples were collected from the study area, which is located about 45 km west of the city of Damascus, near the border village of Kfer Yabous and to the left of the Damascus -Beirut International Road, within the lower Cretaceous upper Aptian deposits. The properties of clay were carried out by X-ray diffraction (XRD) and, X-ray fluorescence (XRF) and Thermal Analysis (DTA-TG-DSC) techniques. The studied samples of clay were mainly composed of kaolinite, quartz, illite. Chemical analysis shows the content of SiO₂ varied between 46.06 to 73 % Al₂O₃ 14.55-26.56%, about the staining oxides (Fe₂O₃ + TiO₂), the total content is about 4.3 to 12.5%. The physical properties were determined by studying the behavior of the body before and after firing, showed low bending strength values (22.5 kg/cm²) after drying, and (about 247 kg/cm²) after firing at 1180°C, water absorption value was about 10%. The cubic thermal expansion coefficient at 1140°C is 213.77 x 10-7 /°C. All of the presented results confirm the suitability of this clay for the ceramic industry.

Keywords: anti-Lebanon, Damascus, ceramic, clay, thermal analysis, thermal expansion coefficient

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Authors: Malik D. Halidu, Cathrine F. Moe, Tommy Haugan

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Purpose: The demand for effective school-based interventions in shaping adolescents' unmet mental health needs is growing. Grounding in the functional contextualism approach, this study investigates the role of school satisfaction (SS) in serving as a buffer to school absenteeism (SAB) among adolescents experiencing social anxiety (SA). Methods: A unique and large population-based sample of adolescents (upper secondary school pupils; n= 1864) from the Young-HUNT 3 survey dataset merged with the national educational registry from Norway. Moderation regression analysis was performed using Stata 17. Results: We find a statistically significant moderating role of school satisfaction on the relationship between social anxiety and school absenteeism (β=-0.109,p<0.01) among upper secondary school pupils. Among socially anxious adolescents associated with a higher perceived quality of school life, it functions as a buffer by reducing the positive relationship between SA and SAB. But, there was no statistically significant difference between social anxiety and school absenteeism for adolescents with low school satisfaction. Conclusion: Overall, the study's hypothesis model was statistically supported and contributes to the discourse that school satisfaction as a target of school-based interventions can effectively improve school outcomes (e.g., reduced absenteeism) among socially anxious pupils.

Keywords: social anxiety, school satisfaction, school absenteeism, Norwegian adolescent

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Authors: Nawaf Al Khashram, Graham Arnold, Weijie Wang

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Background—Gait classifying allows clinicians to differentiate gait patterns into clinically important categories that help in clinical decision making. Reliable comparison of gait data between normal and patients requires knowledge of the gait parameters of normal children's specific age group. However, there is still a lack of the gait database for normal children of different ages. Objectives—The aim of this study is to investigate the kinematics of the lower limb joints during gait for normal children in different age groups. Methods—Fifty-three normal children (34 boys, 19 girls) were recruited in this study. All the children were aged between 5 to 16 years old. Age groups were defined as three types: young child aged (5-7), child (8-11), and adolescent (12-16). When a participant agreed to take part in the project, their parents signed a consent form. Vicon® motion capture system was used to collect gait data. Participants were asked to walk at their comfortable speed along a 10-meter walkway. Each participant walked up to 20 trials. Three good trials were analyzed using the Vicon Plug-in-Gait model to obtain parameters of the gait, e.g., walking speed, cadence, stride length, and joint parameters, e.g. joint angle, force, moments, etc. Moreover, each gait cycle was divided into 8 phases. The range of motion (ROM) angle of pelvis, hip, knee, and ankle joints in three planes of both limbs were calculated using an in-house program. Results—The temporal-spatial variables of three age groups of normal children were compared between each other; it was found that there was a significant difference (p < 0.05) between the groups. The step length and walking speed were gradually increasing from young child to adolescent, while cadence was gradually decreasing from young child to adolescent group. The mean and standard deviation (SD) of the step length of young child, child and adolescent groups were 0.502 ± 0.067 m, 0.566 ± 0.061 m and 0.672 ± 0.053 m, respectively. The mean and SD of the cadence of the young child, child and adolescent groups were 140.11±15.79 step/min, 129±11.84 step/min, and a 115.96±6.47 step/min, respectively. Moreover, it was observed that there were significant differences in kinematic parameters, either whole gait cycle or each phase. For example, RoM of knee angle in the sagittal plane in whole cycle of young child group is (65.03±0.52 deg) larger than child group (63.47±0.47 deg). Conclusion—Our result showed that there are significant differences between each age group in the gait phases and thus children walking performance changes with ages. Therefore, it is important for the clinician to consider age group when analyzing the patients with lower limb disorders before any clinical treatment.

Keywords: age group, gait analysis, kinematics, normal children

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Authors: Mekonen G., Sileshi M., Melkamu M.

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Recharge estimation is important for the assessment and management of groundwater resources effectively. This study applied the soil moisture balance and Baseflow separation methods to estimate groundwater recharge in the Fetam Catchment. It is one of the major catchments understudied from the different catchments in the upper Blue Nile River basin. Surface water has been subjected to high seasonal variation; due to this, groundwater is a primary option for drinking water supply to the community. This research has been conducted to estimate groundwater recharge by using fifteen years of River flow data for the Baseflow separation and ten years of daily meteorological data for the daily soil moisture balance recharge estimating method. The recharge rate by the two methods is 170.5 and 244.9mm/year daily soil moisture and baseflow separation method, respectively, and the average recharge is 207.7mm/year. The average value of annual recharge in the catchment is almost equal to the average recharge in the country, which is 200mm/year. So, each method has its own limitations, and taking the average value is preferable rather than taking a single value. Baseflow provides overestimated result compared to the average of the two, and soil moisture balance is the list estimator. The recharge estimation in the area also should be done by other recharge estimation methods.

Keywords: groundwater, recharge, baseflow separation, soil moisture balance, Fetam catchment

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Authors: Christian N. Chibo

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Imo River Basin is located in South Eastern Nigeria comprising of 11 states of Imo, Abia, Anambra, Ebonyi, Enugu, Edo, Rivers, Cross river, AkwaIbom, Bayelsa, Delta, and Bayelsa states. The basin has a fluvial erosional system dominated by powerful rivers coming down from steep slopes in the area. This research investigated various hazards associated with flood, the vulnerable areas, elements at risk of flood and various adaptation strategies adopted by local inhabitants to cope with the hazards. The research aim is to identify, examine and assess flood hazards, vulnerability and adaptations in the Upper Imo River Basin. The study identified the role of elevation in cause of flood, elements at risk of flood as well as examine the effectiveness or otherwise of the adaptation strategies for coping with the hazards. Data for this research is grouped as primary and secondary. Their various methods of generation are field measurement, questionnaire, library websites etc. Other types of data were generated from topographical, geological, and Digital Elevation model (DEM) maps, while the hydro meteorological data was sourced from Nigeria Meteorological Agency (NIMET), Meteorological stations of Geography and Environmental Management Departments of Imo State University and Alvan Ikoku Federal College of Education. 800 copies of questionnaire were distributed using systematic sampling to 8 locations used for the pilot survey. About 96% of the questionnaire were retrieved and used for the study. 13 flood events were identified in the study area. Their causes, years and dates of events were documented in the text, and the damages they caused were evaluated. The study established that for each flood event, there is over 200mm of rain observed on the day of the flood and the day before the flood. The study also observed that the areas that situate at higher elevation (See DEM) are less prone to flood hazards while areas at low elevations are more prone to flood hazards. Elements identified to be at risk of flood are agricultural land, residential dwellings, retail trading and related services, public buildings and community services. The study thereby recommends non settlement at flood plains and flood prone areas and rearrangement of land use activities in the upper Imo River Basin among others

Keywords: flood hazard, flood plain, geomorphology, Imo River Basin

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Authors: Karla Hrbackova, Irena Balaban Cakirpaloglu

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This paper is a report on self-regulation in socially rejected pupils. A certain form of social rejection can be found in almost every class within the school environment. Research shows that due to social rejection mechanisms supporting the individual´s effort of reintegration into the group are not triggered. Paradoxically the opposite tendency arises, i.e., an increase in selfish and defeating behaviour. The link between peer exposure and self-regulation is likely to vary as a function of a type and quality of peer interaction (e.g., rejection or acceptance). The paper aims to clarify the level of self-regulation related to interpersonal cognitive problem-solving within the process of social rejection in a school class. The research was done on a sample of 1,133 upper-primary school pupils using the Means-Ends Problem Solving technique (MEPS) and peer sociometric nomination. The results showed that the level of self-regulated skills is related to the status of social rejection. Socially rejected pupils achieve lower levels of self-regulation than other classmates. We found deficiency in the regulation of behaviour, emotions and the regulation of will in the peer rejected pupils with the exception of cognitive regulation in which no differences were detected between socially rejected pupils and other classmates. The results have implications for early prevention and intervention efforts to foster adaptive self-regulation and reduce the risk of later social rejection.

Keywords: interpersonal cognitive problem-solving, self-regulation, socially rejected pupils, upper-primary school pupils

Procedia PDF Downloads 151

Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite

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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.

Keywords: workplace exercise, paramedic health, strength training, flexibility training

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Authors: Brahmi Brahim, Mohammad Habibur Rahman, Maarouf Saad, Cristóbal Ochoa Luna

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A repetitive training movement is an efficient method to improve the ability and movement performance of stroke survivors and help them to recover their lost motor function and acquire new skills. The ETS-MARSE is seven degrees of freedom (DOF) exoskeleton robot developed to be worn on the lateral side of the right upper-extremity to assist and rehabilitate the patients with upper-extremity dysfunction resulting from stroke. Practically, rehabilitation activities are repetitive tasks, which make the assistive/robotic systems to suffer from repetitive/periodic uncertainties and external perturbations induced by the high-order dynamic model (seven DOF) and interaction with human muscle which impact on the tracking performance and even on the stability of the exoskeleton. To ensure the robustness and the stability of the robot, a new nonlinear backstepping control was implemented with designed tests performed by healthy subjects. In order to limit and to reject the periodic/repetitive disturbances, an iterative estimator was integrated into the control of the system. The estimator does not need the precise dynamic model of the exoskeleton. Experimental results confirm the robustness and accuracy of the controller performance to deal with the external perturbation, and the effectiveness of the iterative estimator to reject the repetitive/periodic disturbances.

Keywords: backstepping control, iterative control, Rehabilitation, ETS-MARSE

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Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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Authors: Munirajulu M, Srikanth Modem

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A large cricket stadium with the capacity to accommodate several thousands of spectators has the seating arena consisting of a two-tier arrangement with an upper and a lower bowl and an intermediate concourse podium level for pedestrian movement to access the bowls. The uniqueness of the stadium is that spectators can have an unobstructed view from all around the podium towards the field of play. Upper and lower bowls are connected by stairs. The stairs landing is a precast slab supported by cantilevered steel beams. These steel beams are fixed to precast columns supporting the stadium structure. The stair slabs are precast concrete supported on a landing slab and cantilevered steel beams. During an event of a fire at podium level between two staircases, fire resistance of steel beams is very critical to life safety. If the steel beam loses its strength due to lack of fire resistance, it will be weak in supporting stair slabs and may lead to a hazard in evacuating occupants from the upper bowl to the lower bowl. In this study, to ascertain fire rating and life safety, a performance-based design using CFD analysis is used to evaluate the steel beams' fire resistance. A fire size of 3.5 MW (convective heat output of fire) with a wind speed of 2.57 m/s is considered for fire and smoke simulation. CFD results show that the smoke temperature near the staircase/ around the staircase does not exceed 1500 C for the fire duration considered. The surface temperature of cantilevered steel beams is found to be less than or equal to 1500 C. Since this temperature is much less than the critical failure temperature of steel (5200 C), it is concluded that the design of structural steel supports on the staircase is adequate and does not need additional fire protection such as fire-resistant coating. CFD analysis provided an engineering basis for the performance-based design of steel structural elements and an opportunity to optimize fire protection requirements. Thus, performance-based design using CFD modeling and simulation of fire and smoke is an innovative way to evaluate fire rating requirements, ascertain life safety and optimize the design with regard to fire protection on structural steel elements.

Keywords: fire resistance, life safety, performance-based design, CFD analysis

Procedia PDF Downloads 173

Authors: Yuri Seu, Hyun Jin Park, Jin Seo Park, Yong-Suk Moon, HongtaeKim, Mi-Sun Hur

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The present case report describes bifid ureters arising directly from the separate calyces and renal pelvis of the kidney. It was a single common ureter leading away from the bladder, which was separated into incompletely duplicated ureters near the level of the anterior superior iliac supine. These two branches then entered the left kidney through their own courses. Each ureter traveled anterior and posterior to the renal vein, respectively. These two ureters formed a Y-shaped pattern. One ureter coursed anterior to the renal vein with shorter length, and it terminated at the renal pelvis that was divided into major calices in approximately lower two thirds of the kidney. The other ureter coursed posterior to the renal vein with longer length, terminating at approximately the upper third of the kidney. The renal calices in the upper third of the kidney were directly connected to the posterior ureter, whereas the other major calices in the lower two thirds of the kidney formed the renal pelvis connecting to the anterior ureter. Thus, convergence of the major calices was separated according to the terminations of two ureters. These anomalous ureters were traced to the calices of the kidney, thereby providing a reference of a rare variation of the ureter. The bifid ureters arising from the separate calyces and renal pelvis should be considered by radiologists when evaluating images and diagnosing possible complications of these anomalies.

Keywords: bifid ureters, kidney, major calices, renal pelvis

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Authors: Amanuel Bekuma, Rebecca Swift, Sarah Jackson, Ben Biddulph

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Economic loss to frost damage is increasing over the past years in the Western Australian Wheatbelt. Agronomic, genetic, and climatic works have still found a weak correlation between temperature and frost damage. One possibility that has not been explored within the Australian cropping system is whether ice nucleation active bacteria (INB) either present in situ on crop residue or introduced by rainfall could be responsible for the increased sensitivity of cereal plants to frost at different stages of development. This study investigated upper and lower leaf canopy, stubble, and soil as a potential site of ice nucleation activity (INA) and tracked the changes in INA during the plant development. We found that older leaves of wheat are the primary sites of ice nucleation (-4.7 to -6.3°C) followed by stubble (-5.7 to -6.7°C) which increases the risk of frost damage during heading and flowering (the most susceptible stages). However, healthy and green upper canopy leaves (flag and flag-2) and the soil have lower INA (< -11°C) during the frost-sensitive stage of wheat. We anticipate the higher INA on the stubble and older leaves to be due to the presence of biologically active ice-nucleating bacteria (INB), known to cause frost injury to sensitive plants at -5°C. Stubble retained or applied during the growing season further exacerbates additional frost risk by potentially increasing the INB load. The implications of the result for stubble and frost risk management in a frost-prone landscape will be discussed.

Keywords: frost, ice-nucleation-activity, stubble, wheat

Procedia PDF Downloads 115