Search results for: pain simulation

Authors: Chau-Kuang Chen, John Hughes, Jr., A. Dexter Samuels

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The prediction models for the United States Medical Licensure Examination (USMLE) Steps 1 and 2 performances were constructed by the Monte Carlo simulation modeling approach via linear regression. The purpose of this study was to build robust simulation models to accurately identify the most important predictors and yield the valid range estimations of the Steps 1 and 2 scores. The application of simulation modeling approach was deemed an effective way in predicting student performances on licensure examinations. Also, sensitivity analysis (a/k/a what-if analysis) in the simulation models was used to predict the magnitudes of Steps 1 and 2 affected by changes in the National Board of Medical Examiners (NBME) Basic Science Subject Board scores. In addition, the study results indicated that the Medical College Admission Test (MCAT) Verbal Reasoning score and Step 1 score were significant predictors of the Step 2 performance. Hence, institutions could screen qualified student applicants for interviews and document the effectiveness of basic science education program based on the simulation results.

Keywords: prediction model, sensitivity analysis, simulation method, USMLE

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Authors: Andrew Hwang

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The average American worker sits for thirteen hours a day, often with poor posture and infrequent breaks, which can lead to health issues and back problems. The Smart Cushion was created to alert individuals of their poor postures, and may potentially alleviate back problems and correct poor posture. The Smart Cushion is a portable, rectangular, foam cushion, with five strategically placed pressure sensors, that utilizes an Arduino Uno circuit board and specifically designed software, allowing it to collect data from the five pressure sensors and store the data on an SD card. The data is then compiled into graphs and compared to controlled postures. Before volunteers sat on the cushion, their levels of back pain were recorded on a scale from 1-10. Data was recorded for an hour during sitting, and then a new, corrected posture was suggested. After using the suggested posture for an hour, the volunteers described their level of discomfort on a scale from 1-10. Different patterns of sitting postures were generated that were able to serve as early warnings of potential back problems. By using the Smart Cushion, the areas where different volunteers were applying the most pressure while sitting could be identified, and the sitting postures could be corrected. Further studies regarding the relationships between posture and specific regions of the body are necessary to better understand the origins of back pain; however, the Smart Cushion is sufficient for correcting sitting posture and preventing the development of additional back pain.

Keywords: Arduino Sketch Algorithm, biomedical technology, pressure sensors, Smart Cushion

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Authors: Noriko Hanakawa, Masaki Obana

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A simulation tool has been proposed for big-scale projection mapping events. The tool has four main functions based on Mapbox and Unity utilities. The first function is building a 3D model of real cities by MapBox. The second function is a movie projection to some buildings in real cities by Unity. The third function is a movie sending function from a PC to a virtual projector. The fourth function is mapping movies with fitting buildings. The simulation tool was adapted to a real projection mapping event that was held in 2019. The event has been finished. The event had a serious problem in the movie projection to the target building. The extra tents were set in front of the target building. The tents became the obstacles to the movie projection. The simulation tool can be reappeared the problems of the event. Therefore, if the simulation tool was developed before the 2019 projection mapping event, the problem of the tents’ obstacles could be avoided with the simulation tool. In addition, we confirmed that the simulation tool is useful to make a plan of future projection mapping events in order to avoid obstacles of various extra equipment such as utility poles, planting trees, monument towers.

Keywords: projection mapping, projector position, real 3D map, avoiding obstacles

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Authors: A. Lubis, S. S. Pasulu, Z. Hikmah, A. Endaryanto, A. Harsono

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Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.

Keywords: arthritis, group a streptococcus, autoantibody, Jones criteria

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Authors: Sara De Pelsmaeker, Catarina Ferreira da Silva, Janne Prawit

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Recent studies show that enzymatically hydrolysed collagen is absorbed and distributed to joint tissues, where it has analgesic and active anti-inflammatory properties. Reviews of the associated relevant literature also support this theory. However, these studies are all using hydrolyzed collagen from animal hide or skin. This study looks into the effect of daily supplementation of hydrolyzed cartilage collagen (HCC), which has a different composition. A consumer study was set up using a double-blind placebo-controlled design with a control group using twice a day 0.5gr of maltodextrin and an experimental group using twice 0.5g of HCC, over a trial period of 12 weeks. A follow-up phase of 4 weeks without supplementation was taken into the experiment to investigate the ‘wash-out’ phase. As this consumer study was conducted during the lockdown periods, a specific app was designed to follow up with the participants. The app had the advantage that in this way, the motivation of the participants was enhanced and the drop-out range of participants was lower than normally seen in consumer studies. Participants were recruited via various sports and health clubs across the UK as we targeted a general population of people that considered themselves in good health. Exclusion criteria were ‘not experiencing any medical conditions’ and ‘not taking any prescribed medication’. A minimum requirement was that they regularly engaged in some level of physical activity. The participants had to log the type of activity that they conducted and the duration of the activity. Weekly, participants were providing feedback on their joint health and subjective pain using the validated pain measuring instrument Visual Analogue Scale (VAS). The weekly repoAbstract Public Health and Wellbeing Conferencerting section in the app was designed with simplicity and based on the accuracy demonstrated in previous similar studies to track subjective pain measures of participants. At the beginning of the trial, each participant indicated their baseline on joint pain. The results of this consumer study indicated that HCC significantly improved joint health and subjective pain scores compared to the placebo group. No significant differences were found between different demographic groups (age or gender). The level of activity, going from high intensive training to regular walking, did not significantly influence the effect of the HCC. The results of the wash-out phase indicated that when the participants stopped the HCC supplementation, their subjective pain scores increased again to the baseline. In conclusion, the results gave a positive indication that the daily supplementation of HCC can contribute to the overall mobility and wellbeing of a general active population

Keywords: VAS-score, food supplement, mobility, joint health

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Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

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Authors: Jatinder Kumar, Ajay Bansal

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Simulation of a photocatalytic reactor helps in understanding the complex behavior of the photocatalytic degradation. Simulation also aids the designing and optimization of the photocatalytic reactor. Lack of simulation strategies is a huge hindrance in the commercialization of the photocatalytic technology. With the increased performance of computational resources, and development of simulation software, computational fluid dynamics (CFD) is becoming an affordable engineering tool to simulate and optimize reactor designs. In the present paper, a CFD (Computational fluid dynamics) model for simulating the performance of an immobilized-titanium dioxide based annular photocatalytic reactor was developed. The computational model integrates hydrodynamics, species mass transport, and chemical reaction kinetics using a commercial CFD code Fluent 6.3.26. The CFD model was based on the intrinsic kinetic parameters determined experimentally in a perfectly mixed batch reactor. Rhodamine B, a complex organic compound, was selected as a test pollutant for photocatalytic degradation. It was observed that CFD could become a valuable tool to understand and improve the photocatalytic systems.

Keywords: simulation, computational fluid dynamics (CFD), annular photocatalytic reactor, titanium dioxide

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Authors: Izani Uzair Zubair, Mohd Ismail Ibrahim, Mohd Nazri Shafei, Hassan Merican Omar Naina Merican, Mohamad Sabri Othman, Mohd Izmi Ahmad Ibrahim, Rasilah Ramli, Rajpal Singh Karam Singh

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Nurses experience a higher prevalence of low back pain (LBP) and musculoskeletal complaints as compared to other hospital workers. Due to no proper policy related to LBP, the job has exposed them to the problem. Thus, the current study aims to look at the intensity of the problem and factors associated with development of LBP. Method and Tools: A cross sectional study was carried out among 1292 nurses from six public hospitals in Penang. They were randomly selected and those who were pregnant and have been diagnosed to have LBP were excluded. A Malay validated BACK Questionnaire was used. The associated factors were determined by using multiple logistic regression from SPSS version 20.0. Result: Most of the respondents were at mean age 30 years old and had mean working experience 86 months. The prevalence of LBP was identified as 76% (95% CI 74, 82). Factors that were associated with LBP among nurses include lifting a heavy object (OR2.626 (95% CI 1.978, 3.486) p =0.001 and the estimation weight of the lifted object (OR1.443 (95% CI 1.056, 1.970) p =0.021. Conclusion: Nurses who practice lifting heavy object and weight of the object lifted give a significant contribution to the development of LBP. The prevalence of the problem is significantly high. Thus, a proper no weight lifting policy should be considered.

Keywords: low back pain, nurses, Penang public hospital, Penang

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Authors: Chariton Christou, David Cornwell

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Production Sharing Contract (PSC) is the type of contract that is being used widely in our time. The financial crisis made the governments tightfisted and they do not have the resources to participate in a development of a field. Therefore, more and more countries introduce the PSC. The companies have the power and the money to develop the field with their own way. The main problem is the transparency of oil and gas companies especially in the PSC and how this can be achieved. Many discussions have been made especially in the U.K. What we are suggesting is a dynamic financial simulation with the help of a flow meter. The flow meter will count the production of each field every day (it will be installed in a pipeline). The production will be the basic input of the simulation. It will count the profit, the costs and more according to the information of the flow meter. In addition it will include the terms of the contract and the costs that have been paid. By all these parameters the simulation will be able to present in real time the information of a field (taxes, employees, R-factor). By this simulation the company will share some information with the government but not all of them. The government will know the taxes that should be paid and what is the sharing percentage of it. All of the other information could be confidential for the company. Furthermore, oil company could control the R-factor by changing the production each day to maximize its sharing percentages and as a result of this the profit. This idea aims to change the way that governments 'control' oil companies and bring a transparency evolution in the industry. With the help of a simulation every country could be next to the company and have a better collaboration.

Keywords: production sharing contracts, transparency, simulation

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Authors: Madina Hamiane

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Modelling and simulation of an analogy function generator is presented based on a polynomial expansion model. The proposed function generator model is based on a 10th order polynomial approximation of any of the required functions. The polynomial approximations of these functions can then be implemented using basic CMOS circuit blocks. In this paper, a circuit model is proposed that can simultaneously generate many different mathematical functions. The circuit model is designed and simulated with HSPICE and its performance is demonstrated through the simulation of a number of non-linear functions.

Keywords: modelling and simulation, analog function generator, polynomial approximation, CMOS transistors

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Authors: Venkatgiri, Ranganath, L. Nagaraja, B. N. Sagar Pandav, S. M. Usturge, D. Dilipkumar, B. V. Shivprakash, B. Bhagwanthappa, D. Jahangir

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A comparative evaluation of Tramadol and Pentazocine as a pre-emptive analgesic in clinical cases of female dogs undergoing ovariohysterectomy was undertaken during this study. During the study, the following parameters were assessed viz., Rectal temperature (ᵒF), Respiratory rate (breaths/min) and Heart rate (beats/min). Hematological and biochemical parameters viz., total erythrocyte count (TEC) (millions/cmm), hemoglobin (g %), otal leucocytes count (TLC) (thousands/cmm), differential leucocytes count (DLC) (%), serum creatinine (mg/dl), plasma protein (mg/dl), blood glucose (mg/dl) was estimated before the surgery and after administration of general anaesthesia and immediate postoperative periods of 0, 12 and 24 hr respectively. Mean Total Pain Score (MTPS) includes measurement of parameters like posture, vocalization, activity level, response to palpation and agitation at different intervals was calculated before surgery and after administration of general anesthesia and post-operative periods of 1, 2, 4, 6, 12hrs and 24 hrs respectively. Mean Total Pain Score (MTPS) was given for each parameter (Posture, Vocalization, Activity Level, Response to Palpation and Agitation) like 0,1,2,3. (maximum score will be given was 4.). Results were revealed in all three groups including control group. There were significant minor alterations in physiological, hematological and biochemical parameters. MTPS (mean total pain score) were revealed and found a significant alteration when compared with control group. In conclusion, Tramadol found to be a better analgesic and had up to 8hrs of analgesic effect and Pentazocine is superior in post-operative pain management when compared to Tramadol because this group of dogs experienced less surgical stress, consumed less anesthetic dose, they recovered early, and they had less MTPS score.

Keywords: dog, pentazocine, tramadol, ovariohysterectomy

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Authors: Razieh Arian, Hadi Adibi-Asl

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This paper investigates an efficient combustion modeling for cycle simulation of internal combustion engine (ICE) studies. The term “efficient model” means that the models must generate desired simulation results while having fast simulation time. In other words, the efficient model is defined based on the application of the model. The objective of this study is to develop math-based models for control applications or shortly control-oriented models. This study compares different modeling approaches used to model the ICEs such as mean-value models, zero dimensional, quasi-dimensional, and multi-dimensional models for control applications. Mean-value models have been widely used for model-based control applications, but recently by developing advanced simulation tools (e.g. Maple/MapleSim) the higher order models (more complex) could be considered as control-oriented models. This paper presents the enhanced zero-dimensional cycle-by-cycle modeling and simulation of a spark ignition engine with a two-zone combustion model. The simulation results are cross-validated against the simulation results from GT-Power package and show a good agreement in terms of trends and values.

Keywords: Two-zone combustion, control-oriented model, wiebe function, internal combustion engine

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Authors: Sean Hall

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Prior to COVID-19, the world was preoccupied with opioids, effectiveness versus risk, and specifically toxicity versus abuse. Historically underpinning opioid use was a concept of safety. As use over time and real-world data evolved, a pursuit for efficacy associated with non-opioid alternatives became mainstream. On January 8, 2021, the US signed back into the opioid problem, with these two fundamental questions still unresolved. The author will share the current progression of a lead non-opioid cancer bone pain candidate, NanaBis™. NanaBis™ represents two innovative factors: The active ingredients are from cannabinoids; these ingredients are in a proprietary sub-micron delivery platform, NanoCelle®. The author will offer an opinion piece, potentiating the future role of delivery platforms in medicine to increase both patient safety and compliance.

Keywords: NanaBis, nanoCelle, opioids, toxicity

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Authors: Siddhant Yadav, Ann Vincent, Sanjeev Nanda, Karen M. Fischer, Jessica A. Wright

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Statement of the Problem: Despite the growing popularity of cannabis in the general population, there are several unknowns regarding its use, specific reasons for use, patient’s choice of products, health benefits, and adverse effects. The aim of our study was to evaluate patient-reported information related to cannabis use that was recorded in the electronic medical records. Methodology & Theoretical Orientation: We manually reviewed the electronic medical records of cannabis users who were part of a large pharmacogenomic study. Data abstracted included demographics, level of education, concurrent alcohol and tobacco use, type of cannabis utilized, formulation, indication, symptomatic improvement, or adverse effects reported. Following this, we did a descriptive statistical analysis. Findings: Our sample of 164 cannabis users were predominantly female (73.2%); 66% of users reported using cannabis for medical indications. Of the 109 patients who recorded information pertaining to alcohol/tobacco use, two-thirds of cannabis users reported concurrent use of alcohol, and about half of them were former or current tobacco users. The mean age of cannabis use was 66 years. Regarding the type of cannabis, 34.1% reported using marijuana, 32.3% reported CBD use, 1.8% reported using THC, and 1.2% reported using Marinol. Oral formulations (capsules, oils, suspensions, brownies, cakes, and tea) were the most common route (44 %). Indications for use included chronic pain (n=76), anxiety (n=9), counteracting side effects of chemotherapy (n=4), and palliative reasons (n=2). Fifty-eight of the 76 users endorsed improvement in chronic pain (80%), 5 users reported improvement in anxiety, and 2 reported improvement in side effects of chemotherapy. Conclusion & Significance: The majority of our cannabis users were Caucasian females, and there was a high likelihood of coinciding use of alcohol/tobacco in patients using cannabis. Most of our patients used the oral formulation for chronic pain. Importantly, a considerable number of patients reported improvements in chronic pain, anxiety, and side effects of chemotherapy.

Keywords: cannabis use, adverse effects, medical practice, indications

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Authors: Mohammed Ali

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In this paper, evaluation of flexible manufacturing system is made under different manufacturing strategies. The objective of this paper is to test the impact of pallets and routing flexibility on system performance operating at different sequencing rules, dispatching rules and at unbalanced load condition. A computer simulation model is developed to evaluate the effects of aforementioned manufacturing strategies on the make-span performance of flexible manufacturing system. The impact of number of pallets is shown with the different levels of routing flexibility. In this paper, the same manufacturing system is modeled under different combination of sequencing and dispatching rules. A series of simulation experiments are conducted and results analyzed. The result of the simulation shows that there is impact of pallets and routing flexibility on the performance of the system.

Keywords: flexibility, flexible manufacturing system, pallets, make-span, simulation

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Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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Authors: Anshu Bahl, Saroj Kaler, Shivani Gupta, S B Ray

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Background: Somatostatin is an endogenous regulatory neuropeptide. Somatostatin and its analogues play an important role in neuropathic and inflammatory pain. Neuropeptide Y is extensively distributed in the mammalian nervous system. NPY has an important role in blood pressure, circadian rhythm, obesity, appetite and memory. The purpose was to investigate somatostatin and NPY expression in dorsal root ganglia during pain. The plantar incision model in rats is similar to postoperative pain in humans. Methods: 24 adult male Sprague dawley rats were distributed randomly into two groups – Control (n=6) and incision (n=18) groups. Using Hargreaves apparatus, thermal hyperalgesia behavioural test for nociception was done under basal condition and after surgical incision in right hind paw at different time periods (day 1, 3 and 5). The plantar incision was performed as per standard protocol. Perfusion was done using 4% paraformaldehyde followed by extraction of dorsal root ganglia at L4 level. The tissue was processed for immunohistochemical localisation for somatostatin and neuropeptide Y. Results: Post incisional groups (day 1, 3 and 5) exhibited significant decrease of paw withdrawal latency as compared to control groups. Somatostatin expression was noted under basal conditions. It decreased on day 1, but again gradually increased on day 3 and further on day five post incision. The expression of Neuropeptide Y was noted in the cytoplasm of dorsal root ganglia under basal conditions. Compared to control group, expression of neuropeptide Y decreased on day one after incision, but again gradually increased on day 3. Maximum expression was noted on day five post incision. Conclusion: Decrease in paw withdrawal latency indicated nociception, particularly on day 1. In comparison to control, somatostatin and NPY expression was decreased on day one post incision. This could be correlated with increased axoplasmic flow towards the spinal cord. Somatostatin and NPY expression was maximum on day five post incision. This could be due to decreased migration from the site of synthesis towards the spinal cord.

Keywords: dorsal root ganglia, neuropeptide y, postoperative pain, somatostatin

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Authors: M. Rahimi, F. Corman

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This paper study the travel behavior of passengers in a public transport disruption under information provision strategies. We develop a within-day approach for multi-agent simulation to evaluate the behavior of the agents, under comprehensive scenarios through various information exposure, equilibrium, and non-equilibrium scenarios. In particular, we quantify the effects of information strategies in disruption situation on passengers’ satisfaction, number of involved agents, and the caused delay. An agent-based micro-simulation model (MATSim) is applied for the city of Zürich, Switzerland, for the purpose of activity-based simulation in a multimodal network. Statistic outcome is analysed for all the agents who may be involved in the disruption. Agents’ movement in the public transport network illustrates agents’ adaptations to available information about the disruption. Agents’ delays and utility reveal that information significantly affects agents’ satisfaction and delay in public transport disruption. Besides, while the earlier availability of the information causes the fewer consequent delay for the involved agents, however, it also leads to more amount of affected agents.

Keywords: agent-based simulation, disruption management, passengers’ behavior simulation, public transport

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Authors: Freda Halim

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Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

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Authors: Khalid Mohammed Idrees

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Endodontic treatment aims to reverse the disease process and thereby eliminate the associated signs of symptoms. When the treatment itself appears to initiate the onset of pain and /or swelling (endodontic flare-up), the result can be distressing to both the patient and the operator. Patient might even consider postoperative symptoms as a bench mark against which the clinician’s skills are measured. Obviously the treatment with the lowest prevalence of postoperative pain is usually the treatment of choice as long as effectiveness and cost are not compromised. Knowledge of the cause and mechanism behind intra appointment flare-up is of utmost importance for the clinician to properly prevent or manage this undesirable condition. This review lecture will discuss the causative factors of flare-up with special attention to the microorganism role, various modalities of preventive measures would be discussed. Those measures are based on scientific evidence combined with the long clinical experience of the lecturer.

Keywords: endodontic flare-up, causative factors, inflammatory mediators, preventive measures

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Authors: Nirav Vaghela, Sanket Parekh

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Objective: Musculoskeletal disorders (MSD) represent one of the most common and important occupational health problems in working populations, being responsible for a substantial impact on quality of life and incurring a major economic burden in compensation cost and lost wages. School teachers represent an occupational group among which there appears to be a high prevalence of MSD. Design: Three hundred and fourteen teachers were enrolled in this study. Teachers were interview with the Modified Nordic Questionnaire. Result: In current study total 314 participants have been recruited in that minimum age of participants is 22 and maximum age is 59 with mean 40.5± 9.88. Total prevalence of the MSD is 71.95% among the teachers. In that Female were more affected with 72% than the males with 28%. Conclusion: The teachers here in reported a high prevalence of musculoskeletal pain in the shoulder, knee and back.

Keywords: repetitive stress injury, pain, occupational hazards, disability, abneetism, physical health, quality of life

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Authors: Arun Prasad

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Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.

Keywords: laparoscopy, hernia, mesh, surgery

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Authors: Won Kyung Ham, Kang Hoon Cho, Sang C. Park

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Presented in this paper is a framework of a software ‘WEMax’. The WEMax is invented for analysis and simulation for manned assembly lines to sustain and improve performance of manufacturing systems. In a manufacturing system, performance, such as productivity, is a key of competitiveness for output products. However, the manned assembly lines are difficult to forecast performance, because human labors are not expectable factors by computer simulation models or mathematical models. Existing approaches to performance forecasting of the manned assembly lines are limited to matters of the human itself, such as ergonomic and workload design, and non-human-factor-relevant simulation. Consequently, an approach for the forecasting and improvement of manned assembly line performance is needed to research. As a solution of the current problem, this study proposes a framework that is for generation and simulation of virtual manned assembly lines, and the framework has been implemented as a software.

Keywords: performance forecasting, simulation, virtual manned assembly line, WEMax

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Authors: Sai Sudarshan, Harsh Vyas, Riddhiman Sherlekar

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The oil and gas industry has been unwilling to adopt stochastic definition of reserves. Nevertheless, Monte Carlo simulation methods have gained acceptance by engineers, geoscientists and other professionals who want to evaluate prospects or otherwise analyze problems that involve uncertainty. One of the common applications of Monte Carlo simulation is the estimation of recoverable hydrocarbon from a reservoir.Monte Carlo Simulation makes use of random samples of parameters or inputs to explore the behavior of a complex system or process. It finds application whenever one needs to make an estimate, forecast or decision where there is significant uncertainty. First, the project focuses on performing Monte-Carlo Simulation on a given data set using U. S Department of Energy’s MonteCarlo Software, which is a freeware e&p tool. Further, an algorithm for simulation has been developed for MATLAB and program performs simulation by prompting user for input distributions and parameters associated with each distribution (i.e. mean, st.dev, min., max., most likely, etc.). It also prompts user for desired probability for which reserves are to be calculated. The algorithm so developed and tested in MATLAB further finds implementation in Python where existing libraries on statistics and graph plotting have been imported to generate better outcome. With PyQt designer, codes for a simple graphical user interface have also been written. The graph so plotted is then validated with already available results from U.S DOE MonteCarlo Software.

Keywords: simulation, probability, confidence interval, sensitivity analysis

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Authors: C. Patrascioiu, M. Jamali

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The paper deals with the simulation of the crude distillation process using the Unisim Design simulator. The necessity of simulating this process is argued both by considerations related to the design of the crude distillation column, but also by considerations related to the design of advanced control systems. In order to use the Unisim Design simulator to simulate the crude distillation process, the identification of the simulators used in Romania and an analysis of the PRO/II, HYSYS, and Aspen HYSYS simulators were carried out. Analysis of the simulators for the crude distillation process has allowed the authors to elaborate the conclusions of the success of the crude modelling. A first aspect developed by the authors is the implementation of specific problems of petroleum liquid-vapors equilibrium using Unisim Design simulator. The second major element of the article is the development of the methodology and the elaboration of the simulation program for the crude distillation process, using Unisim Design resources. The obtained results validate the proposed methodology and will allow dynamic simulation of the process.  

Keywords: crude oil, distillation, simulation, Unisim Design, simulators

Procedia PDF Downloads 234

Authors: Zina Saheb, Ezz El-Masry

Abstract:

As CMOS technology scaling down, Silicon oxide thickness (SiO2) become very thin (few Nano meters). When SiO2 is less than 3nm, gate direct tunneling (DT) leakage current becomes a dormant problem that impacts the transistor performance. Floating gate MOSFET (FGMOSFET) has been used in many low-voltage and low-power applications. Most of the available simulation models of FGMOSFET for analog circuit design does not account for gate DT current and there is no accurate analysis for the gate DT. It is a crucial to use an accurate mode in order to get a realistic simulation result that account for that DT impact on FGMOSFET performance effectively.

Keywords: CMOS transistor, direct-tunneling current, floating-gate, gate-leakage current, simulation model

Procedia PDF Downloads 517

Authors: Rudan Xue, Annika Moscati, Rehel Zeleke Kebede, Peter Johansson

Abstract:

Successful buildings’ simulation and analysis inevitably require information exchange between multiple building information modeling (BIM) software. The BIM infor-mation exchange based on IFC is widely used. However, Industry Foundation Classifi-cation (IFC) files are not always reliable and information can get lost when using dif-ferent software for modeling and simulations. In this research, interviews with lighting simulation experts and a case study provided by a company producing lighting devices have been the research methods used to identify the necessary steps and data for suc-cessful information exchange between lighting simulation tools and authoring design tools. Model creation, information exchange, and model simulation have been identi-fied as key aspects for the success of information exchange. The paper concludes with recommendations for improved information exchange and more reliable simulations that take all the needed parameters into consideration.

Keywords: BIM, data exchange, interoperability issues, lighting simulations

Procedia PDF Downloads 222

Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

Abstract:

Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

Procedia PDF Downloads 109

Authors: Meisam Moghadasi, Hassan Ali Ozgoli, Foad Farhani

Abstract:

In this research, firstly, a commercial gas sweetening unit with methyl-di-ethanol-amine (MDEA) solution is simulated and comprised in an integrated model in accordance with Aspen HYSYS software. For evaluation purposes, in the second step, the results of the simulation are compared with operating data gathered from South Pars Gas Complex (SPGC). According to the simulation results, the considerable energy potential contributed to the pressure difference between absorber and regenerator columns causes this energy driving force to be applied in power recovery turbine (PRT). In the last step, the amount of waste hydraulic energy is calculated, and its recovery methods are investigated.

Keywords: gas sweetening unit, simulation, MDEA, power recovery turbine, waste-to-energy

Procedia PDF Downloads 168

Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

Abstract:

Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

Procedia PDF Downloads 129