Search results for: soft ideals
748 The Prevalence of Intubation Induced Dental Complications among Hospitalized Patients
Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad
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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.Keywords: oral trauma, dental trauma, intubation, anesthesia
Procedia PDF Downloads 149747 Water and Beverage Consumption among Children and Adolescents in Tehran Metropolitan City of Iran
Authors: Mitra Abtahi, Esmat Nasseri, Morteza Abodllahi
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Introduction: Adequate hydration is necessary for proper physical and mental function. The aim of this study is to determine the consumption of water and all other beverages in children (8-13 years) and adolescents (14-17 years) in Tehran metropolitan city of Iran. Materials and Methods: In this cross-sectional study, 455 children (8-13 years) and 334 adolescents (14-17 years) were retrieved from north, center, and south of Tehran (18 schools). Instrument for data collection consisted of a “demographic and general health” questionnaire and a “7-day fluid record”. Data analyses were performed with SPSS 16 software. Results: The mean total consumption of fluids in school children was 1302 ± 500.6 ml/day. The highest mean intakes were observed for water (666 ± 398 ml/day), followed by milk (239 ± 183 ml/day), regular soft beverages (RSB) (188 ± 148 ml/day), and juices (60 ± 74 ml/day). Water, hot drinks (mainly tea) and soft drinks intake was significantly more in boys than girls. A significantly lower intake of milk and a higher intake of RSB and hot beverages (mainly tea) have been seen among adolescents compared to children. Conclusion: The most important finding is that mean fluid intake of children and adolescents does not meet international adequate intake references for water and fluids. This finding may suggest the necessity of development of the local references. To improve fluid intake habits of children and adolescents, relevant policy making and actions are warranted.Keywords: adolescents, beverages, children, water
Procedia PDF Downloads 174746 Technical Realization of Key Aesthetic Principles in Guzheng Performance
Authors: Qiongzi Zheng, Lewis Cornwell, Neal Peres Da Costa
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Drawn on Confucian and Taoist philosophy and long-established tradition of aesthetic ideals, the Art of the Chinese Zither (Xishan Qinkuang), a classic work by Chinese music scholar Xu Shangyin in 1643, distilled twenty-four practicing principles for the Chinese zither. This work has influenced the practice of guzheng to the present day. Whilst the principles were described in detail, how they can actually be achieved on a technical level remains to be explored. This study focuses on three key practicing principles: yuan (roundness), liu (fluidness), and su (swiftness), and examines how the playing techniques developed by Master Zhao Manqin contribute to the implementation of the principles. The study concludes that knowledge of the technicality of fingering positioning before and after plucking motion is critical to the realization of these principles.Keywords: Chinese music aesthetics, practicing principles of the Chinese zither, guzheng playing techniques, Zhao Manqin’s fingering techniques, Xishan Qinkuang
Procedia PDF Downloads 186745 Predicting the Effect of Vibro Stone Column Installation on Performance of Reinforced Foundations
Authors: K. Al Ammari, B. G. Clarke
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Soil improvement using vibro stone column techniques consists of two main parts: (1) the installed load bearing columns of well-compacted, coarse-grained material and (2) the improvements to the surrounding soil due to vibro compaction. Extensive research work has been carried out over the last 20 years to understand the improvement in the composite foundation performance due to the second part mentioned above. Nevertheless, few of these studies have tried to quantify some of the key design parameters, namely the changes in the stiffness and stress state of the treated soil, or have consider these parameters in the design and calculation process. Consequently, empirical and conservative design methods are still being used by ground improvement companies with a significant variety of results in engineering practice. Two-dimensional finite element study to develop an axisymmetric model of a single stone column reinforced foundation was performed using PLAXIS 2D AE to quantify the effect of the vibro installation of this column in soft saturated clay. Settlement and bearing performance were studied as an essential part of the design and calculation of the stone column foundation. Particular attention was paid to the large deformation in the soft clay around the installed column caused by the lateral expansion. So updated mesh advanced option was taken in the analysis. In this analysis, different degrees of stone column lateral expansions were simulated and numerically analyzed, and then the changes in the stress state, stiffness, settlement performance and bearing capacity were quantified. It was found that application of radial expansion will produce a horizontal stress in the soft clay mass that gradually decrease as the distance from the stone column axis increases. The excess pore pressure due to the undrained conditions starts to dissipate immediately after finishing the column installation, allowing the horizontal stress to relax. Changes in the coefficient of the lateral earth pressure K ٭, which is very important in representing the stress state, and the new stiffness distribution in the reinforced clay mass, were estimated. More encouraging results showed that increasing the expansion during column installation has a noticeable effect on improving the bearing capacity and reducing the settlement of reinforced ground, So, a design method should include this significant effect of the applied lateral displacement during the stone column instillation in simulation and numerical analysis design.Keywords: bearing capacity, design, installation, numerical analysis, settlement, stone column
Procedia PDF Downloads 375744 Effect of Sodium Hydroxide on Geotechnical Properties of Soft Soil in Kathmandu Valley
Authors: Bal Deep Sharma, Suresh Ray Yadav
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Local soils are often chosen due to their widespread availability and low cost. However, these soils typically have poor durability, which can lead to significant limitations in their use for construction. To address this issue, various soil stabilization techniques have been developed and used over the years. This study investigates the viability of employing the mineral polymerization (MIP) technique to stabilize black soils, intending to enhance their suitability for construction applications. This technique involves the microstructural transformation of certain clay minerals into solid and stable compounds exhibiting characteristics similar to hydroxy sodalite, feldspathoid, or zeolite. This transformation occurs through the action of an alkaline reactant at atmospheric pressure and low temperature. The soil sample was characterized using grain size distribution, Atterberg limit test, organic content test, and pH-value tests. The unconfined compressive strength of the soil specimens, prepared with varying percentages of sodium hydroxide as an additive and sand as a filler by weight, was determined at the optimum moisture content. The unconfined compressive strength of the specimens was tested under three different conditions: dry, wet, and cycling. The maximum unconfined compressive strengths were 77.568 kg/cm², 38.85 kg/cm², and 56.3 kg/cm² for the dry, wet, and cycling specimens, respectively, while the unconfined compressive strength of the untreated soil was 7.38 kg/cm². The minimum unconfined compressive strength of the wet and cycling specimens was greater than that of the untreated soil. Based on these findings, it can be concluded that these soils can be effectively used as construction material after treatment with sodium hydroxide.Keywords: soil stabilization technique, soft soil treatment, sodium hydroxide, unconfined compressive strength
Procedia PDF Downloads 81743 Antibacterial Hydrogels for Wound Care
Authors: Saba Atefyekta
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Aim: Control of bacterial bioburden in wounds is an important step for minimizing the risk of wound infection. An antimicrobial hydrogel wound dressing is developed out of soft polymeric hydrogels that contain antimicrobial peptides (AMPs). Such wound dressings can bind and kill all types of bacteria, even the resistance types at the wound site. Methods: AMPs are permanently bonded onto a soft nanostructured polymer via covalent attachment and physical entanglement. This improves stability, rapid antibacterial activity, and, most importantly, prevents the leaching of AMPs. Major Findings: Antimicrobial analysis of antimicrobial hydrogels using in-vitro wound models confirmed >99% killing efficiency against multiple bacterial trains, including MRSA, MDR, E. Coli. Furthermore, the hydrogel retained its antibacterial activity for up to 4 days when exposed to human serum. Tests confirmed no release of AMPs, and it was proven non-toxic to mammalian cells. An in-vivo study on human intact skin showed a significant reduction of bacteria for part of the subject’s skin treated with antibacterial hydrogels. A similar result was detected through a qualitative study in veterinary trials on different types of surgery wounds in cats, dogs, and horses. Conclusions: Antimicrobial hydrogels wound dressings developed by permanent attachment of AMPs can effectively and rapidly kill bacteria in contact. Such antibacterial hydrogel wound dressings are non-toxic and do not release any substances into the wound.Keywords: antibacterial wound dressing, antimicrobial peptides, post-surgical wounds, infection
Procedia PDF Downloads 82742 Optimization of Bifurcation Performance on Pneumatic Branched Networks in next Generation Soft Robots
Authors: Van-Thanh Ho, Hyoungsoon Lee, Jaiyoung Ryu
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Efficient pressure distribution within soft robotic systems, specifically to the pneumatic artificial muscle (PAM) regions, is essential to minimize energy consumption. This optimization involves adjusting reservoir pressure, pipe diameter, and branching network layout to reduce flow speed and pressure drop while enhancing flow efficiency. The outcome of this optimization is a lightweight power source and reduced mechanical impedance, enabling extended wear and movement. To achieve this, a branching network system was created by combining pipe components and intricate cross-sectional area variations, employing the principle of minimal work based on a complete virtual human exosuit. The results indicate that modifying the cross-sectional area of the branching network, gradually decreasing it, reduces velocity and enhances momentum compensation, preventing flow disturbances at separation regions. These optimized designs achieve uniform velocity distribution (uniformity index > 94%) prior to entering the connection pipe, with a pressure drop of less than 5%. The design must also consider the length-to-diameter ratio for fluid dynamic performance and production cost. This approach can be utilized to create a comprehensive PAM system, integrating well-designed tube networks and complex pneumatic models.Keywords: pneumatic artificial muscles, pipe networks, pressure drop, compressible turbulent flow, uniformity flow, murray's law
Procedia PDF Downloads 85741 Effects of Family Order and Informal Social Control on Protecting against Child Maltreatment: A Comparative Study of Seoul and Kathmandu
Authors: Thapa Sirjana, Clifton R. Emery
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This paper examines the family order and Informal Social Control (ISC) by the extended families as a protective factor against Child Maltreatment. The findings are discussed using the main effects and the interaction effects of family order and informal social control by the extended families. The findings suggest that IPV mothers are associated with child abuse and child neglect. The children are neglected in the home more and physical abuse occurs in the case, if mothers are abused by their husbands. The mother’s difficulties of being abused may lead them to neglect their children. The findings suggest that ‘family order’ is a significant protective factor against child maltreatment. The results suggest that if the family order is neither too high nor too low than that can play a role as a protective factor. Soft type of ISC is significantly associated with child maltreatment. This study suggests that the soft type of ISC by the extended families is a helpful approach to develop child protection in both the countries. This study is analyzed the data collected from Seoul and Kathmandu families and neighborhood study (SKFNS). Random probability cluster sample of married or partnered women in 20 Kathmandu wards and in Seoul 34 dongs were selected using probability proportional to size (PPS) sampling. Overall, the study is to make a comparative study of Korea and Nepal and examine how the cultural differences and similarities associate with the child maltreatment.Keywords: child maltreatment, intimate partner violence, informal social control and family order Seoul, Kathmandu
Procedia PDF Downloads 248740 Preparation of Fe3Si/Ferrite Micro-and Nano-Powder Composite
Authors: Radovan Bures, Madgalena Streckova, Maria Faberova, Pavel Kurek
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Composite material based on Fe3Si micro-particles and Mn-Zn nano-ferrite was prepared using powder metallurgy technology. The sol-gel followed by autocombustion process was used for synthesis of Mn0.8Zn0.2Fe2O4 ferrite. 3 wt.% of mechanically milled ferrite was mixed with Fe3Si powder alloy. Mixed micro-nano powder system was homogenized by the Resonant Acoustic Mixing using ResodynLabRAM Mixer. This non-invasive homogenization technique was used to preserve spherical morphology of Fe3Si powder particles. Uniaxial cold pressing in the closed die at pressure 600 MPa was applied to obtain a compact sample. Microwave sintering of green compact was realized at 800°C, 20 minutes, in air. Density of the powders and composite was measured by Hepycnometry. Impulse excitation method was used to measure elastic properties of sintered composite. Mechanical properties were evaluated by measurement of transverse rupture strength (TRS) and Vickers hardness (HV). Resistivity was measured by 4 point probe method. Ferrite phase distribution in volume of the composite was documented by metallographic analysis. It has been found that nano-ferrite particle distributed among micro- particles of Fe3Si powder alloy led to high relative density (~93%) and suitable mechanical properties (TRS >100 MPa, HV ~1GPa, E-modulus ~140 GPa) of the composite. High electric resistivity (R~6.7 ohm.cm) of prepared composite indicate their potential application as soft magnetic material at medium and high frequencies.Keywords: micro- and nano-composite, soft magnetic materials, microwave sintering, mechanical and electric properties
Procedia PDF Downloads 364739 Defending Motherhood: Strategic Comparisons and the Management of Moral Self-Worth among Ex-Offender Mothers
Authors: Geniece Mondé
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This article examines how formerly incarcerated mothers deploy strategic comparisons to support their claims of moral self-worth. In depth interviews with 69 ex-offender mothers show that although women occupy a morally ambiguous space, they frame their roles as “good” mothers as independent of past illegal activity. In substantiating the “good” mother narrative women draw comparisons with two groups of women. Some respondents identify individuals perceived as morally disadvantaged and draw comparisons that illustrate their comparative strength in relation to mothers who fail to adequately meet the needs of their children. Women also compared themselves to morally advantaged mothers and expressed a desire to embody the ideals and values of women they viewed as superior mothers. Findings reveal that respondents’ use of strategic comparisons substantiates their framing of personal moral identity, as well as their goals for the future. The paper concludes by examining the theoretical implications of strategic comparisons for the study of morality and identity construction.Keywords: Ex-Offender, Rehabilitation, Incarceration, Motherhood
Procedia PDF Downloads 139738 Law, Regulatory Transformations and Evolving Paradigm: The Case of Corporate Social Responsibility in India
Authors: Shuchi Bharti
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This article intends to analyse the transforming nature of state and corporate sector relationship in the light of evolving regulatory and institutional aspects pertaining to Corporate Social Responsibility (CSR) in India. The focus is on evaluating the accounts of law and decentred discourses, relevant within the changing regulatory and institutional paradigm that substantially goes ahead of formal legal control of state towards corporate actors. At this vantage point, it is important to understand the state’s posture towards a changing scenario particularly as the tone is set by regulatory parameters pertaining to CSR to drive process of engagement with the stakeholders. The tripartite framework of the article intends to focus on finding on the vital interconnected aspects of the CSR provisions (Section 135) of The Companies Act 2013 (The Act), rise of new institutions and the emergence of the decentred regulatory space. Thus is earmarked in a neo-liberal paradigm; state is witnessed to perform a responsive function in engendering enhanced public role for the corporate sector. In this overarching framework the aim is to undertake a causal, exploratory and relational analysis of aspects pertaining law, regulation and institutional transformations. Firstly, focus is drawn on to investigate the relational facets of the advent of law and regulatory framework of CSR. Secondly, in the light of the historical evolution, a causal connection is attempted between globalization, emergence of international soft law framework and the Indian case of CSR. Finally, I look into how the new Companies Act mandates CSR expenditure vis- a -vis multiple parameters and guidelines.Keywords: corporate social responsibility, stakeholders, soft law, decentred regulation
Procedia PDF Downloads 301737 A Rural Journey of Integrating Interprofessional Education to Foster Trust
Authors: Julia Wimmers Klick
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Interprofessional Education (IPE) is widely recognized as a valuable approach in healthcare education, despite the challenges it presents. This study explores IP surface anatomy lab sessions, with a focus on fostering trust and collaboration among healthcare students. The research is conducted within the context of rural healthcare settings in British Columbia (BC), where a medical school and a physical therapy (PT) program operate under the Faculty of Medicine at the University of British Columbia (UBC). While IPE sessions addressing soft skills have been implemented, the integration of hard skills, such as Anatomy, remains limited. To address this gap, a pilot feasibility study was conducted with a positive outcome, a follow-up study involved these IPE sessions aimed at exploring the influence of bonding and trust between medical and PT students. Data were collected through focus groups comprising participating students and faculty members, and a structured SWOC (Strengths, Weaknesses, Opportunities, and Challenges) analysis was conducted. The IPE sessions, 3 in total, consisted of a 2.5-hour lab on surface anatomy, where PT students took on the teaching role, and medical students were newly exposed to surface anatomy. The focus of the study was on the relationship-building process and trust development between the two student groups, rather than assessing the acquisition of surface anatomy skills. Results indicated that the surface anatomy lab served as a suitable tool for the application and learning of soft skills. Faculty members observed positive outcomes, including productive interaction between students, reversed hierarchy with PT students teaching medical students, practicing active listening skills, and using a mutual language of anatomy. Notably, there was no grade assessment or external pressure to perform. The students also reported an overall positive experience; however, the specific impact on the development of soft skill competencies could not be definitively determined. Participants expressed a sense of feeling respected, welcomed, and included, all of which contributed to feeling safe. Within the small group environment, students experienced becoming a part of a community of healthcare providers that bonded over a shared interest in health professions education. They enjoyed sharing diverse experiences related to learning across their varied contexts, without fear of judgment and reprisal that were often intimidating in single professional contexts. During a joint Christmas party for both cohorts, faculty members observed students mingling, laughing, and forming bonds. This emphasized the importance of early bonding and trust development among healthcare colleagues, particularly in rural settings. In conclusion, the findings emphasize the potential of IPE sessions to enhance trust and collaboration among healthcare students, with implications for their future professional lives in rural settings. Early bonding and trust development are crucial in rural settings, where healthcare professionals often rely on each other. Future research should continue to explore the impact of content-concentrated IPE on the development of soft skill competencies.Keywords: interprofessional education, rural healthcare settings, trust, surface anatomy
Procedia PDF Downloads 69736 Study of Phase Separation Behavior in Flexible Polyurethane Foam
Authors: El Hatka Hicham, Hafidi Youssef, Saghiri Khalid, Ittobane Najim
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Flexible polyurethane foam (FPUF) is a low-density cellular material generally used as a cushioning material in many applications such as furniture, bedding, packaging, etc. It is commercially produced during a continuous process, where a reactive mixture of foam chemicals is poured onto a moving conveyor. FPUFs are produced by the catalytic balancing of two reactions involved, the blowing reaction (isocyanate-water) and the gelation reaction (isocyanate-polyol). The microstructure of FPUF is generally composed of soft phases (polyol phases) and rigid domains that separate into two domains of different sizes: the rigid polyurea microdomains and the macrodomains (larger aggregates). The morphological features of FPUF are strongly influenced by the phase separation morphology that plays a key role in determining the global FPUF properties. This phase-separated morphology results from a thermodynamic incompatibility between soft segments derived from aliphatic polyether and hard segments derived from the commonly used aromatic isocyanate. In order to improve the properties of FPUF against the different stresses faced by this material during its use, we report in this work a study of the phase separation phenomenon in FPUF that has been examined using SAXS WAXS and FTIR. Indeed, we have studied with these techniques the effect of water, isocyanates, and alkaline chlorides on the phase separation behavior. SAXS was used to study the morphology of the microphase separated, WAXS to examine the nature of the hard segment packing, and FTIR to investigate the hydrogen bonding characteristics of the materials studied. The prepared foams were shown to have different levels of urea phase connectivity; the increase in water content in the FPUF formulation leads to an increase in the amount of urea formed and consequently the increase of the size of urea aggregates formed. Alkali chlorides (NaCl, KCl, and LiCl) incorporated into FPUF formulations show that is the ability to prevent hydrogen bond formation and subsequently alter the rigid domains. FPUFs prepared by different isocyanate structures showed that urea aggregates are difficult to be formed in foams prepared by asymmetric diisocyanate, while are more easily formed in foams prepared by symmetric and aliphatic diisocyanate.Keywords: flexible polyurethane foam, hard segments, phase separation, soft segments
Procedia PDF Downloads 166735 Tuning of Indirect Exchange Coupling in FePt/Al₂O₃/Fe₃Pt System
Authors: Rajan Goyal, S. Lamba, S. Annapoorni
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The indirect exchange coupled system consists of two ferromagnetic layers separated by non-magnetic spacer layer. The type of exchange coupling may be either ferro or anti-ferro depending on the thickness of the spacer layer. In the present work, the strength of exchange coupling in FePt/Al₂O₃/Fe₃Pt has been investigated by varying the thickness of the spacer layer Al₂O₃. The FePt/Al₂O₃/Fe₃Pt trilayer structure is fabricated on Si <100> single crystal substrate using sputtering technique. The thickness of FePt and Fe₃Pt is fixed at 60 nm and 2 nm respectively. The thickness of spacer layer Al₂O₃ was varied from 0 to 16 nm. The normalized hysteresis loops recorded at room temperature both in the in-plane and out of plane configuration reveals that the orientation of easy axis lies along the plane of the film. It is observed that the hysteresis loop for ts=0 nm does not exhibit any knee around H=0 indicating that the hard FePt layer and soft Fe₃Pt layer are strongly exchange coupled. However, the insertion of Al₂O₃ spacer layer of thickness ts = 0.7 nm results in appearance of a minor knee around H=0 suggesting the weakening of exchange coupling between FePt and Fe₃Pt. The disappearance of knee in hysteresis loop with further increase in thickness of the spacer layer up to 8 nm predicts the co-existence of ferromagnetic (FM) and antiferromagnetic (AFM) exchange interaction between FePt and Fe₃Pt. In addition to this, the out of plane hysteresis loop also shows an asymmetry around H=0. The exchange field Hex = (Hc↑-HC↓)/2, where Hc↑ and Hc↓ are the coercivity estimated from lower and upper branch of hysteresis loop, increases from ~ 150 Oe to ~ 700 Oe respectively. This behavior may be attributed to the uncompensated moments in the hard FePt layer and soft Fe₃Pt layer at the interface. A better insight into the variation in indirect exchange coupling has been investigated using recoil curves. It is observed that the almost closed recoil curves are obtained for ts= 0 nm up to a reverse field of ~ 5 kOe. On the other hand, the appearance of appreciable open recoil curves at lower reverse field ~ 4 kOe for ts = 0.7 nm indicates that uncoupled soft phase undergoes irreversible magnetization reversal at lower reverse field suggesting the weakening of exchange coupling. The openness of recoil curves decreases with increase in thickness of the spacer layer up to 8 nm. This behavior may be attributed to the competition between FM and AFM exchange interactions. The FM exchange coupling between FePt and Fe₃Pt due to porous nature of Al₂O₃ decreases much slower than the weak AFM coupling due to interaction between Fe ions of FePt and Fe₃Pt via O ions of Al₂O₃. The hysteresis loop has been simulated using Monte Carlo based on Metropolis algorithm to investigate the variation in strength of exchange coupling in FePt/Al₂O₃/Fe₃Pt trilayer system.Keywords: indirect exchange coupling, MH loop, Monte Carlo simulation, recoil curve
Procedia PDF Downloads 190734 Integrated Geotechnical and Geophysical Investigation of a Proposed Construction Site at Mowe, Southwestern Nigeria
Authors: Kayode Festus Oyedele, Sunday Oladele, Adaora Chibundu Nduka
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The subsurface of a proposed site for building development in Mowe, Nigeria, using Standard Penetration Test (SPT) and Cone Penetrometer Test (CPT) supplemented with Horizontal Electrical Profiling (HEP) was investigated with the aim of evaluating the suitability of the strata for foundation materials. Four SPT and CPT were implemented using 10 tonnes hammer. HEP utilizing Wenner array were performed with inter-electrode spacing of 10 – 60 m along four traverses coincident with each of the SPT and CPT. The HEP data were processed using DIPRO software and textural filtering of the resulting resistivity sections was implemented to enable delineation of hidden layers. Sandy lateritic clay, silty lateritic clay, clay, clayey sand and sand horizons were delineated. The SPT “N” value defined very soft to soft sandy lateritic (<4), stiff silty lateritic clay (7 – 12), very stiff silty clay (12 - 15), clayey sand (15- 20) and sand (27 – 37). Sandy lateritic clay (5-40 kg/cm2) and silty lateritic clay (25 - 65 kg/cm2) were defined from the CPT response. Sandy lateritic clay (220-750 Ωm), clay (< 50 Ωm) and sand (415-5359 Ωm) were delineated from the resistivity sections with two thin layers of silty lateritic clay and clayey sand defined in the texturally filtered resistivity sections. This study concluded that the presence of incompetent thick clayey materials (18 m) beneath the study area makes it unsuitable for shallow foundation. Deep foundation involving piling through the clayey layers to the competent sand at 20 m depth was recommended.Keywords: cone penetrometer, foundation, lithologic texture, resistivity section, standard penetration test
Procedia PDF Downloads 265733 Comparison of the Curvizigzag Incision with Transverse Stewart Incision in Women Undergoing Modified Radical Mastectomy for Carcinoma Breast
Authors: John Joseph S. Martis, Rohanchandra R. Gatty, Aaron Jose Fernandes, Rahul P. Nambiar
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Introduction: Surgery for breast cancer is either mastectomy or breast conservation surgery. The most commonly used incision for modified radical mastectomy is the transverse Stewart incision. But this incision may have the disadvantage of causing disparity between the closure lines of superior and inferior skin flaps in mastectomy and can cause overhanging of soft tissue below and behind the axilla. The curvizigzag incision, on principle, may help in this regard and can prevent scar migration beyond the anterior axillary line. This study aims to compare the two incisions in this regard. Methods: 100 patients with cancer of breast were included in the study after satisfying inclusion and exclusion criteria. They underwent surgery at Father Muller Medical College, Mangalore, India, between November 2019 to September 2021. The patients were divided into two groups. Group A patients were subjected to modified radical mastectomy with curvizigzag incision and group B patients with transverse Stewart incision. Results: Seroma on postoperative day1, day 2 was 0% in both the groups. Seroma on postoperative day 30 was present in 14% of patients in group B. 60% of patients in group B had sag of soft tissue below and behind the axilla, and none of the patients in group A had this problem. In 64% of the patients in group B, the incision crossed the anterior axillary fold, 64% of the patients in group B had tension in the incision site while approximation of the skin flaps. Conclusion: Curvizigzag incision is statistically better with lesser complications when compared to the transverse Stewart incision for modified radical mastectomy for carcinoma breast.Keywords: breast cancer, curvizigzag incision, transverse Stewart incision, seroma, modified radical mastectomy
Procedia PDF Downloads 96732 Housing Practices of the Young Southern Europeans in Connection with Family Strategies during the Crisis
Authors: Myrto Dagkouli-Kyriakoglou
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Southern European countries tend to have a lot of connections in their culture, customs, ideals and attitude towards everyday aspects. On the contrary, all of them demonstrate a lot of differences in their history, political life and economic situation. Nevertheless, the state welfare and its insufficiency to deal with citizens’ needs, is common for the whole region. As the global financial crisis initiated, all of them gradually were affected and established austerity measures. Consequently, there were crucial budget cuts in state welfare and accordingly limited support to the citizens at a time that is most needed as the economic difficulties of the households are rising rapidly. Crisis in connection with austerity measures brought up a housing problem which was hidden for decades with the assistance of the institution of the Southern European family. New or old copying practices concerning housing are already developed and more will rise in order to survive this new era. Expressly, youth is one of the most vulnerable groups in this situation and therefore there is a special focus on the policies that affect their housing as well as their copying practices in connection with the family/kinship strategies.Keywords: housing, coping practices, Greece, familism
Procedia PDF Downloads 348731 Evaluation of Pile Performance in Different Layers of Soil
Authors: Orod Zarrin, Mohesn Ramezan Shirazi, Hassan Moniri
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The use of pile foundations technique is developed to support structures and buildings on soft soil. The most important dynamic load that can affect the pile structure is earthquake vibrations. Pile foundations during earthquake excitation indicate that piles are subject to damage by affecting the superstructure integrity and serviceability. During an earthquake, two types of stresses can damage the pile head, inertial load that is caused by superstructure and deformation which caused by the surrounding soil. Soil deformation and inertial load are associated with the acceleration developed in an earthquake. The acceleration amplitude at the ground surface depends on the magnitude of earthquakes, soil properties and seismic source distance. According to the investigation, the damage is between the liquefiable and non-liquefiable layers and also soft and stiff layers. This damage crushes the pile head by increasing the inertial load which is applied by the superstructure. On the other hand, the cracks on the piles due to the surrounding soil are directly related to the soil profile and causes cracks from small to large. However, the large cracks reason have been listed such as liquefaction, lateral spreading, and inertial load. In the field of designing, elastic response of piles is always a challenge for designer in liquefaction soil, by allowing deflection at top of piles. Moreover, absence of plastic hinges in piles should be insured, because the damage in the piles is not observed directly. In this study, the performance and behavior of pile foundations during liquefaction and lateral spreading are investigated. In addition, emphasize on the soil behavior in the liquefiable and non-liquefiable layers by different aspect of piles damage such as ranking, location and degree of damage are going to discuss.Keywords: pile, earthquake, liquefaction, non-liquefiable, damage
Procedia PDF Downloads 303730 Barred from Each Other: Why Normative Husbands Remain Married to Incarcerated Wives
Authors: Tomer Einat, Sharon Rabinovitz, Inbal Harel-Aviram
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This study explores men’s motivation and justification to remain married to their criminal, imprisoned wives. Using semi-structured interviews and content-analysis, data were collected and analyzed from eight men who maintain stable marriage relationships with their incarcerated wives. Participants are normative men who describe incarceration as a challenge that enhances mutual responsibility and commitment. They exaggerate the extent to which their partners resemble archetypal romantic ideals. They use motivational accounts to explain the woman’s criminal conduct, which is perceived as non-relevant to her real identity. Physical separation and lack of physical intimacy are perceived as the major difficulties in maintaining their marriage relations. Length of imprisonment and marriage was found to be related to the decision whether to continue or terminate the relationships. Women-inmates’ partners experience difficulties and use coping strategies very similar to those cited by other normative spouses facing lengthy separation.Keywords: female inmates, marriage, normative spouses, romantic accounts
Procedia PDF Downloads 462729 Effects of Polydispersity on the Glass Transition Dynamics of Aqueous Suspensions of Soft Spherical Colloidal Particles
Authors: Sanjay K. Behera, Debasish Saha, Paramesh Gadige, Ranjini Bandyopadhyay
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The zero shear viscosity (η₀) of a suspension of hard sphere colloids characterized by a significant polydispersity (≈10%) increases with increase in volume fraction (ϕ) and shows a dramatic increase at ϕ=ϕg with the system entering a colloidal glassy state. Fragility which is the measure of the rapidity of approach of these suspensions towards the glassy state is sensitive to its size polydispersity and stiffness of the particles. Soft poly(N-isopropylacrylamide) (PNIPAM) particles deform in the presence of neighboring particles at volume fraction above the random close packing volume fraction of undeformed monodisperse spheres. Softness, therefore, enhances the packing efficiency of these particles. In this study PNIPAM particles of a nearly constant swelling ratio and with polydispersities varying over a wide range (7.4%-48.9%) are synthesized to study the effects of polydispersity on the dynamics of suspensions of soft PNIPAM colloidal particles. The size and polydispersity of these particles are characterized using dynamic light scattering (DLS) and scanning electron microscopy (SEM). As these particles are deformable, their packing in aqueous suspensions is quantified in terms of effective volume fraction (ϕeff). The zero shear viscosity (η₀) data of these colloidal suspensions, estimated from rheometric experiments as a function of the effective volume fraction ϕeff of the suspensions, increases with increase in ϕeff and shows a dramatic increase at ϕeff = ϕ₀. The data for η₀ as a function of ϕeff fits well to the Vogel-Fulcher-Tammann equation. It is observed that increasing polydispersity results in increasingly fragile supercooled liquid-like behavior, with the parameter ϕ₀, extracted from the fits to the VFT equation shifting towards higher ϕeff. The observed increase in fragility is attributed to the prevalence of dynamical heterogeneities (DHs) in these polydisperse suspensions, while the simultaneous shift in ϕ₀ is ascribed to the decoupling of the dynamics of the smallest and largest particles. Finally, it is observed that the intrinsic nonlinearity of these suspensions, estimated at the third harmonic near ϕ₀ in Fourier transform oscillatory rheological experiments, increases with increase in polydispersity. These results are in agreement with theoretical predictions and simulation results for polydisperse hard sphere colloidal glasses and clearly demonstrate that jammed suspensions of polydisperse colloidal particles can be effectively fluidized with increasing polydispersity. Suspensions of these particles are therefore excellent candidates for detailed experimental studies of the effects of polydispersity on the dynamics of glass formation.Keywords: dynamical heterogeneity, effective volume fraction, fragility, intrinsic nonlinearity
Procedia PDF Downloads 166728 Experimental-Numerical Inverse Approaches in the Characterization and Damage Detection of Soft Viscoelastic Layers from Vibration Test Data
Authors: Alaa Fezai, Anuj Sharma, Wolfgang Mueller-Hirsch, André Zimmermann
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Viscoelastic materials have been widely used in the automotive industry over the last few decades with different functionalities. Besides their main application as a simple and efficient surface damping treatment, they may ensure optimal operating conditions for on-board electronics as thermal interface or sealing layers. The dynamic behavior of viscoelastic materials is generally dependent on many environmental factors, the most important being temperature and strain rate or frequency. Prior to the reliability analysis of systems including viscoelastic layers, it is, therefore, crucial to accurately predict the dynamic and lifetime behavior of these materials. This includes the identification of the dynamic material parameters under critical temperature and frequency conditions along with a precise damage localization and identification methodology. The goal of this work is twofold. The first part aims at applying an inverse viscoelastic material-characterization approach for a wide frequency range and under different temperature conditions. For this sake, dynamic measurements are carried on a single lap joint specimen using an electrodynamic shaker and an environmental chamber. The specimen consists of aluminum beams assembled to adapter plates through a viscoelastic adhesive layer. The experimental setup is reproduced in finite element (FE) simulations, and frequency response functions (FRF) are calculated. The parameters of both the generalized Maxwell model and the fractional derivatives model are identified through an optimization algorithm minimizing the difference between the simulated and the measured FRFs. The second goal of the current work is to guarantee an on-line detection of the damage, i.e., delamination in the viscoelastic bonding of the described specimen during frequency monitored end-of-life testing. For this purpose, an inverse technique, which determines the damage location and size based on the modal frequency shift and on the change of the mode shapes, is presented. This includes a preliminary FE model-based study correlating the delamination location and size to the change in the modal parameters and a subsequent experimental validation achieved through dynamic measurements of specimen with different, pre-generated crack scenarios and comparing it to the virgin specimen. The main advantage of the inverse characterization approach presented in the first part resides in the ability of adequately identifying the material damping and stiffness behavior of soft viscoelastic materials over a wide frequency range and under critical temperature conditions. Classic forward characterization techniques such as dynamic mechanical analysis are usually linked to limitations under critical temperature and frequency conditions due to the material behavior of soft viscoelastic materials. Furthermore, the inverse damage detection described in the second part guarantees an accurate prediction of not only the damage size but also its location using a simple test setup and outlines; therefore, the significance of inverse numerical-experimental approaches in predicting the dynamic behavior of soft bonding layers applied in automotive electronics.Keywords: damage detection, dynamic characterization, inverse approaches, vibration testing, viscoelastic layers
Procedia PDF Downloads 206727 Streptococcus anginosus Infections; Clinical and Bacteriologic Characteristics: A 6-Year Retrospective Study of Adult Patients in Qatar
Authors: Adila Shaukat, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal
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Background: The aim of this study was to assess clinical presentation and antimicrobial susceptibility of Streptococcus (S.) anginosus group infections in Hamad General Hospital, a tertiary care hospital in the state of Qatar, which is a multinational community. The S. anginosus group is a subgroup of viridans streptococci that consist of 3 different species: S. anginosus, S. constellatus, and S. intermedius. Although a part of the human bacteria flora, they have potential to cause suppurative infections. Method: We studied a total of 101 patients with S. anginosus group infections from January 2006 until March 2012 by reviewing medical records and identification of organisms by VITEK 2 and MALDI-TOF. Results: The most common sites of infection were skin and soft tissue, intra-abdominal, and bacteremia (28.7%, 24.8%, and 22.7%, respectively). Abscess formation was seen in approximately 30% of patients. Streptococcus constellatus was the most common isolated species (40%) followed by S. anginosus(30%) and S. intermedius(7%). In 23% of specimens, the species was unidentified. The most common type of specimen for organism isolation was blood followed by pus and tissue (50%, 22%, and 8%, respectively). Streptococcus constellatus was more frequently associated with abdominal and skin and soft tissue infections than the other 2 species, whereas S. anginosus was isolated more frequently from blood. All isolates were susceptible to penicillin, ceftriaxone, and vancomycin. Susceptibility to erythromycin and clindamycin was also good, reaching 91% and 95%, respectively. Forty percent of patients needed surgical drainage along with antibiotic therapy. Conclusions: Identification of S. anginosus group to species level is helpful in clinical practice because different species exhibit different pathogenic potentials.Keywords: abscess, bacterial infection, bacteremia, Streptococcus anginosus
Procedia PDF Downloads 143726 A Cephalometric Superimposition of a Skeletal Class III Orthognathic Patient on Nasion-Sella Line
Authors: Albert Suryaprawira
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The Nasion-Sella Line (NSL) has been used for several years as a reference line in longitudinal growth study. Therefore this line is considered to be stable not only to evaluate treatment outcome and to predict relapse possibility but also to manage prognosis. This is a radiographic superimposition of an adult male aged 19 years who complained of difficulty in aesthetic, talking and chewing. Patient has a midface hypoplasia profile (concave). He was diagnosed to have a severe Skeletal Class III with Class III malocclusion, increased lower vertical height, and an anterior open bite. A pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. A panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, a pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, a post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition using NSL as a reference line between those radiographs was performed to analyse the outcome. It is important to describe the amount of hard and soft tissue movement and to predict the possibility of relapse after the surgery. The patient also needs to understand all the surgical plan, outcome and relapse prevention. The surgical management included maxillary impaction and advancement of Le Fort I osteotomy. The evaluation using NSL as a reference was a very useful method in determining the outcome and prognosis.Keywords: Nasion-Sella Line, midface hypoplasia, Le Fort 1, maxillary advancement
Procedia PDF Downloads 142725 A Rationale to Describe Ambident Reactivity
Authors: David Ryan, Martin Breugst, Turlough Downes, Peter A. Byrne, Gerard P. McGlacken
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An ambident nucleophile is a nucleophile that possesses two or more distinct nucleophilic sites that are linked through resonance and are effectively “in competition” for reaction with an electrophile. Examples include enolates, pyridone anions, and nitrite anions, among many others. Reactions of ambident nucleophiles and electrophiles are extremely prevalent at all levels of organic synthesis. The principle of hard and soft acids and bases (the “HSAB principle”) is most commonly cited in the explanation of selectivities in such reactions. Although this rationale is pervasive in any discussion on ambident reactivity, the HSAB principle has received considerable criticism. As a result, the principle’s supplantation has become an area of active interest in recent years. This project focuses on developing a model for rationalizing ambident reactivity. Presented here is an approach that incorporates computational calculations and experimental kinetic data to construct Gibbs energy profile diagrams. The preferred site of alkylation of nitrite anion with a range of ‘hard’ and ‘soft’ alkylating agents was established by ¹H NMR spectroscopy. Pseudo-first-order rate constants were measured directly by ¹H NMR reaction monitoring, and the corresponding second-order constants and Gibbs energies of activation were derived. These, in combination with computationally derived standard Gibbs energies of reaction, were sufficient to construct Gibbs energy wells. By representing the ambident system as a series of overlapping Gibbs energy wells, a more intuitive picture of ambident reactivity emerges. Here, previously unexplained switches in reactivity in reactions involving closely related electrophiles are elucidated.Keywords: ambident, Gibbs, nucleophile, rates
Procedia PDF Downloads 86724 New Neuroplasmonic Sensor Based on Soft Nanolithography
Authors: Seyedeh Mehri Hamidi, Nasrin Asgari, Foozieh Sohrabi, Mohammad Ali Ansari
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New neuro plasmonic sensor based on one dimensional plasmonic nano-grating has been prepared. To record neural activity, the sample has been exposed under different infrared laser and then has been calculated by ellipsometry parameters. Our results show that we have efficient sensitivity to different laser excitation.Keywords: neural activity, Plasmonic sensor, Nanograting, Gold thin film
Procedia PDF Downloads 400723 Particle Separation Using Individually-Controlled Magnetic Soft Artificial Cilia
Authors: Yau-Luen Ng, Nathan Banka, Santosh Devasia
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In this paper, a method based on soft artificial cilia is introduced to separate particles based on size and mass. In nature, cilia are used for fluid propulsion in the mammalian circulatory system, as well as for swimming and size-selective particle entrainment for feeding in microorganisms. Inspired by biological cilia, an array of artificial cilia was fabricated using Polydimethylsiloxane (PDMS) to simulate the actual motion. A row of four individually-controlled magnetic artificial cilia in a semi-circular channel are actuated by the magnetic fields from four permanent magnets. Each cilium is a slender rectangular cantilever approximately 13mm long made from a composite of PDMS and carbonyl iron particles. A time-varying magnetic force is achieved by periodically varying the out-of-plane distance from the permanent magnets to the cilia, resulting in large-amplitude deflections of the cilia that can be used to drive fluid motion. Previous results have shown that this system of individually-controlled magnetic cilia can generate effective mixing flows; the purpose of the present work is to apply the individual cilia control to a particle separation task. Based on the observed beating patterns of cilia arrays in nature, the experimental beating patterns were selected as a metachronal wave, in which a fixed phase lead or lag is imposed between adjacent cilia. Additionally, the beating frequency was varied. For each set of experimental parameters, the channel was filled with water and polyethylene microspheres introduced at the center of the cilia array. Two types of particles were used: large red microspheres with density 0.9971 g/cm³ and 850-1000 μm avg. diameter, and small blue microspheres with density 1.06 g/cm³ and diameter 30 μm. At low beating frequencies, all particles were propelled in the mean flow direction. However, the large particles were observed to reverse directions above about 4.8 Hz, whereas reversal of the small particle transport direction did not occur until 6 Hz. Between these two transition frequencies, the large and small particles can be separated as they move in opposite directions. The experimental results show that selecting an appropriate cilia beating pattern can lead to selective transport of neutrally-buoyant particles based on their size. Importantly, the separation threshold can be chosen dynamically by adjusting the actuation frequency. However, further study is required to determine the range of particle sizes that can be effectively separated for a given system geometry.Keywords: magnetic cilia, particle separation, tunable separation, soft actutors
Procedia PDF Downloads 201722 Numerical Simulation of Footing on Reinforced Loose Sand
Authors: M. L. Burnwal, P. Raychowdhury
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Earthquake leads to adverse effects on buildings resting on soft soils. Mitigating the response of shallow foundations on soft soil with different methods reduces settlement and provides foundation stability. Few methods such as the rocking foundation (used in Performance-based design), deep foundation, prefabricated drain, grouting, and Vibro-compaction are used to control the pore pressure and enhance the strength of the loose soils. One of the problems with these methods is that the settlement is uncontrollable, leading to differential settlement of the footings, further leading to the collapse of buildings. The present study investigates the utility of geosynthetics as a potential improvement of the subsoil to reduce the earthquake-induced settlement of structures. A steel moment-resisting frame building resting on loose liquefiable dry soil, subjected to Uttarkashi 1991 and Chamba 1995 earthquakes, is used for the soil-structure interaction (SSI) analysis. The continuum model can simultaneously simulate structure, soil, interfaces, and geogrids in the OpenSees framework. Soil is modeled with PressureDependentMultiYield (PDMY) material models with Quad element that provides stress-strain at gauss points and is calibrated to predict the behavior of Ganga sand. The model analyzed with a tied degree of freedom contact reveals that the system responses align with the shake table experimental results. An attempt is made to study the responses of footing structure and geosynthetics with unreinforced and reinforced bases with varying parameters. The result shows that geogrid reinforces shallow foundation effectively reduces the settlement by 60%.Keywords: settlement, shallow foundation, SSI, continuum FEM
Procedia PDF Downloads 194721 Evaluation of Anti-Pruritus Effect of Melatonin on Hemodialysis Patients with Uremic Pruritus: A Randomized Clinical Trial
Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi
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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus
Procedia PDF Downloads 81720 The Role of the Founding Ideals of a University in Higher Education
Authors: Masanori Kimura
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The “founding spirit” of a Japanese university is similar to the mission statement of a Western university, but the difference between the two is that the former more closely reflects the founder’s inner world because it usually originates from the strong personal beliefs that the founder held when establishing the university. To find how much this ideology actually valued in today’s higher education, this paper surveys 2091 job openings for foreign language full-time faculty positions, posted by Japanese private universities from 2012 to 2016. The results suggest that women’s universities and universities with religious affiliations have a tendency to request that successful candidates observe their founding spirit, or at least demonstrate some understanding of the ideology after being hired. On the other hand, co-ed universities and universities with no religious affiliations do not show such a distinct tendency. A chi-square test revealed that this difference between the two groups was statistically significant (p<.01). Furthermore, the paper argues that it is not always appropriate for universities to evaluate themselves based on a single evaluation scale such as university rankings, and that both faculty and staff members need to be more aware of the founding spirit to improve the quality of the education the university provides.Keywords: founding spirit, higher education, university administrative management, university evaluation
Procedia PDF Downloads 279719 The Use of STIMULAN Resorbable Antibiotic Beads in Conjunction with Autologous Tissue Transfer to Treat Recalcitrant Infections and Osteomyelitis in Diabetic Foot Wounds
Authors: Hayden R Schott, John M Felder III
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Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection
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