Search results for: post traumatic stress

Authors: J. M. Lee, W. R. Noh, C. Y. Kim, M. G. Lee

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Delamination of oxide scale has been often discovered at the interface between Fe carbon steel and oxide scale. Among several mechanisms of this delamination behavior, the normal tensile stress to the substrate-scale interface has been described as one of the main factors. The stress distribution at the interface is also known to be affected by thermal expansion mismatch between substrate and oxide scale, creep behavior during cooling and the geometry of the interface. In this study, stress states near the interface in a Fe carbon steel with oxide scale have been investigated using FE simulations. The thermal and mechanical properties of oxide scales are indicated in literature and Fe carbon steel is measured using tensile testing machine. In particular, the normal and shear stress components developed at the interface during bending are investigated. Preliminary numerical sensitivity analyses are provided to explain the effects of the interface geometry and oxide thickness on the delamination behavior.

Keywords: oxide scale, delamination, Fe analysis, roughness, thickness, stress state

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Authors: Astghik R. Sukiasyan

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Under the drought stress condition, the plants would grow slower. Temperature is one of the most important abiotic factors which suppress the germination processes. However, the processes of transpiration are regulated directly by the cell water, which followed to an increase in volume of vacuoles. During stretching under the influence of water pressure, the cell goes into the state of turgor. In our experiments, lines of the semi-dental sweet maize of Armenian population from various zones of growth under mild and severe drought stress were tested. According to results, the value of the water balance of the plant cells may reflect the ability of plants to adapt to drought stress. It can be assumed that the turgor allows evaluating the number of received dissolved substance in cell.

Keywords: turgor, drought stress, plant growth, Armenian Zea Maize Semidentata

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Authors: Djarot B. Darmadi

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The wider growing Finite Element Method (FEM) application is caused by its benefits of cost saving and environment friendly. Also, by using FEM a deep understanding of certain phenomenon can be achieved. This paper observed the role of material properties and volumetric change when Solid State Phase Transformation (SSPT) takes place in residual stress formation due to a welding process of ferritic steels through coupled Thermo-Metallurgy-Mechanical (TMM) analysis. The correctness of FEM residual stress prediction was validated by experiment. From parametric study of the FEM model, it can be concluded that the material properties change tend to over-predicts residual stress in the weld center whilst volumetric change tend to underestimates it. The best final result is the compromise of both by incorporates them in the model which has a better result compared to a model without SSPT.

Keywords: residual stress, ferritic steels, SSPT, coupled-TMM

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Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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Authors: M. Velana, G. Rinkenauer

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Nowadays, nurses are facing unprecedented amounts of pressure due to the ongoing global health demands. Work-related stress can cause a high physical and psychological workload, which can lead, in turn, to burnout. On the physiological level, stress triggers an initial activation of the sympathetic nervous and adrenomedullary systems resulting in increases in cardiac activity. Furthermore, activation of the hypothalamus-pituitary-adrenal axis provokes endocrine and immune changes leading to the release of cortisol and cytokines in an effort to re-establish body balance. Based on the current state of the literature, it has been identified that resilience and mindfulness exercises among nurses can effectively decrease stress and improve mood. However, it is still unknown what relaxation techniques would be suitable for and to what extent would be effective to decrease psychophysiological arousal deriving from either a physiological or a psychological stressor. Moreover, although cardiac activity and cortisol are promising candidates to examine the effectiveness of relaxation to reduce stress, it still remains to shed light on the role of cytokines in this process so as to thoroughly understand the body’s response to stress and to relaxation. Therefore, the main aim of the present study is to develop a comprehensive experimental paradigm and assess different relaxation techniques, namely progressive muscle relaxation and a mindfulness exercise originating from cognitive therapy by means of biofeedback, under highly controlled laboratory conditions. An experimental between-subject design will be employed, where 120 participants will be randomized either to a physiological or a psychological stress-related experiment. Particularly, the cold pressor test refers to a procedure in which the participants have to immerse their non-dominant hands into ice water (2-3 °C) for 3 min. The participants are requested to keep their hands in the water throughout the whole duration. However, they can immediately terminate the test in case it would be barely tolerable. A pre-test anticipation phase and a post-stress period of 3 min, respectively, are planned. The Trier Social Stress Test will be employed to induce psychological stress. During this laboratory stressor, the participants are instructed to give a 5-min speech in front of a committee of communication specialists. Before the main task, there is a 10-min anticipation period. Subsequently, participants are requested to perform an unexpected arithmetic task. After stress exposure, the participants will perform one of the relaxation exercises (treatment condition) or watch a neutral video (control condition). Electrocardiography, salivary samples, and self-report will be collected at different time points. The preliminary results deriving from the pilot study showed that the aforementioned paradigm could effectively induce stress reactions and that relaxation might decrease the impact of stress exposure. It is of utmost importance to assess how the human body responds under different stressors and relaxation exercises so that an evidence-based intervention could be transferred in a clinical setting to improve nurses’ general health. Based on suggestive future laboratory findings, the research group plans to conduct a pilot-level randomized study to decrease stress and promote well-being among nurses who work in the stress-riddled environment of a hospital located in Northern Germany.

Keywords: nurses, psychophysiology, relaxation, stress

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Authors: Fuchun Li, Hong Xiao

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We propose a new early warning model for predicting financial stress events for a given future time. In this model, we examine whether credit conditions play an important role as a nonlinear propagator of shocks when predicting the likelihood of occurrence of financial stress events for a given future time. This propagation takes the form of a threshold regression in which a regime change occurs if credit conditions cross a critical threshold. Given the new early warning model for financial stress events, we evaluate the performance of this model and currently available alternatives, such as the model from signal extraction approach, and linear regression model. In-sample forecasting results indicate that the three types of models are useful tools for predicting financial stress events while none of them outperforms others across all criteria considered. The out-of-sample forecasting results suggest that the credit-regime switching model performs better than the two others across all criteria and all forecasting horizons considered.

Keywords: cut-off probability, early warning model, financial crisis, financial stress, regime-switching model, forecasting horizons

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Authors: Chia-Ching Tsai

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In service delivery, interpersonal interaction is the key to customer satisfaction, and apparently, the factor of human is critical in service delivery. Besides, customers quite care about the consequences of co-recovery. Thus, this research focuses on service failure caused by other customers and uses a 2x2 factorial design to investigate the impact of consequence and level of service co-recovery on post-recovery satisfaction and repurchase intent. 150 undergraduates were recruited as participants, and assigned to one of the four cells randomly. Every participant was requested to read the scenario and then rated the post-recovery satisfaction and repurchase intent. The results show that under the condition of failed co-recovery, level of co-recovery has no effect on post-recovery satisfaction, while under the condition of successful co-recovery, high-level co-recovery causes significantly higher post-recovery satisfaction than low-level co-recovery. Moreover, post-recovery satisfaction has significantly positive impact on repurchase intent. In the system of service delivery, customers interact with other customers frequently. Therefore, comparing with the literature, this research focuses on the service failure caused by other customers. This research also supplies a better understanding of customers’ view on consequences of different levels of co-recovery, which is helpful for the practitioners to make use of co-recovery.

Keywords: service failure, service co-recovery, consequence of co-recovery, level of co-recovery, post-recovery satisfaction, repurchase intent

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Authors: Jamal A. Hassan, Ali Q. Abdulrazzaq, Sadiq J. Abass

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In this study, both the photoelastic, as well as the finite element methods, are used to study the stress distribution within human vertebra (L4) under forces similar to those that occur during normal life. Two & three dimensional models of vertebra were created by the software AutoCAD. The coordinates obtained were fed into a computer numerical control (CNC) tensile machine to fabricate the models from photoelastic sheets. Completed models were placed in a transmission polariscope and loaded with static force (up to 1500N). Stresses can be quantified and localized by counting the number of fringes. In both methods the Principle stresses were calculated at different regions. The results noticed that the maximum von-mises stress on the area of the extreme superior vertebral body surface and the facet surface with high normal stress (σ) and shear stress (τ). The facets and other posterior elements have a load-bearing function to help support the weight of the upper body and anything that it carries, and are also acted upon by spinal muscle forces. The numerical FE results have been compared with the experimental method using photoelasticity which shows good agreement between experimental and simulation results.

Keywords: photoelasticity, stress, load, finite element

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Authors: Meltem Kürtüncü, Işın Alkan

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Objective: This study was carried out with an experimental design in order to determine whether the lullaby, which was listened from mother’s voice and a stranger’s voice to the babies born at term and hospitalized in neonatal intensive care unit, had an effect on stress and relaxation symptoms of the infants. Method: Data from the study were obtained from 90 newborn babies who were hospitalized in Neonatal Intensive Care Unit of Zonguldak Maternity And Children Hospital between September 2015-January 2016 and who met the eligibility criteria. Lullaby concert was performed by choosing one of the suitable care hours. Stress and relaxation symptoms were recorded by the researcher on “Newborn response follow-up form” at pre-care and post-care. Results: After lullaby concert when stress symptoms compared to infants in the experimental and control groups before the care was not detected statistically significant difference between crying, contraction, facial grimacing, flushing, cyanosis and the rates of increase in temperature. After care, crying, contractions, facial grimacing, flushing, and restlessness revealed a statistically significant difference between the groups, but as the cyanosis and temperature increased stress responses did not result in a significant difference between the groups. In the control group babies the crying, contraction, facial grimacing, flushing, and restlessness behaviors rates were found to be significantly higher than experimental group babies. After lullaby concert when relaxation symptoms compared to infants in the experimental and control groups before the care, eye contact rates who listen to lullaby from mother’s voice was found to be significantly higher than infants who listen to lullaby from stranger’s voice and infants in the control group. After care as eye contact, smiling, sucking/searching, yawning, non-crying and sleep behaviors relaxation symptoms revealed statistically significant results. In the control group, these behaviors were found statistically lower degree than the experimental groups. Conclusion: Lullaby concerts as masking the ambient noise, reducing the stress symptoms and increasing the relaxation symptoms, and also for soothing and stimulant affects, due to ease the transition to the sleep state should be preferred in the neonatal intensive care units.

Keywords: lullaby, mother voice, relaxation, stress

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Authors: Jose Melena, Rosa Santander, Tanya Gonzalez, Richard Duque, Juan Illanes

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Ecuador is one of the countries with the greatest aquatic biodiversity worldwide. In particular, there are at least a dozen native marine species with great aquaculture potential locally. This research concerns one of those species. It has proposed to implement experimental protocols in order to induce spawning and to generate the early larval development of the penshell Atrina maura under controlled conditions. Bioassays were carried out with one adult batch (n= 26) with an average valvar length of 307,6 ± 9,4 mm, which were collected in the Puerto El Morro Mangrove (2° 42' 33'' S, 80° 14' 28'' W), Guayas Province. During a short acclimation stage, five adults of penshell A. maura were sacrificed in order to determine their sexual maturity degree and to estimate their sex ratio. Dissection showed that three were ripe females (60%) and two were ripe males (40%). Later, three groups (n= 7 by each) were tested with two treatments in order to induce the broodstock spawning: thermal stress, osmotic shock, and one control. Spawning induction was achieved by the immersion in water to 0 g L⁻¹ per 1 h and immersion in sea water to 34 g L⁻¹ per 1 h. After the delivery of gametes, it was achieved 1,35 × 10⁶ viable zygotes. As results, fertilized eggs had 60 µm diameter; while first and second cell divisions were observed to 1 h post-fertilization, with individual average length of 65 ± 4 µm and polar body. Latter cell divisions, including gastrula stage, appeared at 9 h post-fertilization, with individual average length of 71 ± 4 µm; and trochophore stage at 16 h post-fertilization with individual average length of 75 ± 5 µm. In addition, veliger stage was registered at 20 h post-fertilization with individual average length of 81 ± 5 µm. Umboned larvae appeared at day 8 post-fertilization, with individual average length of 145 ± 6 µm. These pioneering results in Ecuador can strengthen the local conservation process of the overexploited A. maura and to encourage its production for commercial purposes.

Keywords: Atrina maura, Ecuador, larval development, spawning induction

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Authors: Raheleh Khademian, Roghayeh Aminian

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For the study of salinity stress on Vicia villosa and calcium effect for modulation of that, an experiment was conducted under hydroponic condition, and some important morphological and physiological characteristics were evaluated. This experiment was conducted as a factorial based on randomized complete design with three replications. The treatments include salinity stress in three levels (0, 50, and 100 mM NaCl) and calcium in two levels (content in Hoagland solution and double content). The results showed that all morphological and physiological traits include root and shoot length, root and shoot wet and dry weight, leaf area, leaf chlorophyll content, RWC, CMS, and biological yield was significantly different from the control and is affected by the salinity stress severely. But, calcium effect on them was not significant despite of decreasing salinity effect.

Keywords: Vicia villossa, salinity stress, calcium, hydroponic

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Authors: A. Mohamed, A. El-Hamalawi, M. Frost, A. Connell

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Often design standards do not provide guidance or formulae for the calculation of stresses on buried pipelines caused by external loads. Frequently engineers rely on other methods and published sources of information to calculate such imposed stresses and a variety of methods can be used. This paper reviews three current approaches to soil pipeline interaction modelling to predict stresses on buried pipelines subjected to soil overburden and traffic loading. The traditional approach to use empirical stress formulas to calculate circumferential bending stresses on pipelines. The alternative approaches considered are the use of a finite element package to compute an estimate of circumferential bending stress and a proprietary stress analysis system (SURFLOAD) to estimate the circumferential bending stress. The results from analysis using the methods are presented and compared to experimental results in terms of predicted and measured circumferential stresses. This study shows that the approach used to assess externally generated stress is important and can lead to an over-conservative analysis. Using FE analysis either through SURFLOAD or a general FE package to predict circumferential stress is the most accurate way to undertake stress analysis due to traffic and soil loads. Although conservative, classical empirical methods will continue to be applied to the analysis of buried pipelines, an opportunity exists, therefore, in many circumstances, to use applied numerical techniques, made possible by advances in finite element analysis.

Keywords: buried pipelines, circumferential bending stress, finite element analysis, soil overburden, soil pipeline interaction analysis (SPIA), traffic loadings

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Authors: Şafak Aksoy, Ali Kurşun, Erhan Çetin, Mustafa Reşit Haboğlu

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In this study, thermo elastic stress analysis is performed on a cylinder made of laminated isotropic materials under thermomechanical loads. Laminated cylinders have many applications such as aerospace, automotive and nuclear plant in the industry. These cylinders generally performed under thermomechanical loads. Stress and displacement distribution of the laminated cylinders are determined using by analytical method both thermal and mechanical loads. Based on the results, materials combination plays an important role on the stresses distribution along the radius. Variation of the stresses and displacements along the radius are presented as graphs. Calculations program are prepared using MATLAB® by authors.

Keywords: isotropic materials, laminated cylinders, thermoelastic stress, thermomechanical load

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Authors: Carlos Cuenca, Diego Sarzosa

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Ductile fracture occurs by the mechanism of void nucleation, void growth and coalescence. Potential sites for initiation are second phase particles or non-metallic inclusions. Modelling of ductile damage at the microscopic level is very difficult and complex task for engineers. Therefore, conservative predictions of ductile failure using simple models are necessary during the design and optimization of critical structures like pressure vessels and pipelines. Nowadays, it is well known that the initiation phase is strongly influenced by the stress triaxiality and plastic deformation at the microscopic level. Thus, a simple model used to study the ductile failure under multiaxial stress condition is the Stress Modified Critical Strain (SMCS) approach. Ductile rupture has been study for a structural steel under different stress triaxiality conditions using the SMCS method. Experimental tests are carried out to characterize the relation between stress triaxiality and equivalent plastic strain by notched round bars. After calibration of the plasticity and damage properties, predictions are made for low constraint bending specimens with and without side grooves. Stress/strain fields evolution are compared between the different geometries. Advantages and disadvantages of the SMCS methodology are discussed.

Keywords: damage, SMSC, SEB, steel, failure

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Authors: O. Lasaga

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Defining professional objectives and the search for work are some of the greatest stress factors for final year university students and recent graduates. To manage correctly the stress brought about by the uncertainty, confusion and frustration this process often generates, a course to control stress based on mindfulness has been designed and taught. This course provides tools based on relaxation, mindfulness and meditation that enable students to address personal and professional challenges in the transition to the job market, eliminating or easing the anxiety involved. The course is extremely practical and experiential, combining theory classes and practical classes of relaxation, meditation and mindfulness, group dynamics, reflection, application protocols and session integration. The evaluation of the courses highlighted on the one hand the high degree of satisfaction and, on the other, the usefulness for the students in becoming aware of stressful situations and how these affect them and learning new coping techniques that enable them to reach their goals more easily and with greater satisfaction and well-being.

Keywords: employability, meditation, mindfulness, relaxation techniques, stress

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Authors: Xiao-Yin Liu, Liang-Xue Zhou

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Traumatic brain injury (TBI), as a kind of nerve trauma caused by an external force, affects people all over the world and is a global public health problem. Although there are various clinical treatments for brain injury, including surgery, drug therapy, and rehabilitation therapy, the therapeutic effect is very limited. To improve the therapeutic effect of TBI, scaffolds combined with exosomes are a promising but challenging method for TBI repair. In this study, we examined whether a novel 3D-printed collagen/chitosan scaffold/exosomes derived from neural stem cells (NSCs) pretreated with insulin growth factor-1 (IGF-I) scaffolds (3D-CC-INExos) could be used to improve TBI repair and functional recovery after TBI. Our results showed that composite scaffolds of collagen-, chitosan- and exosomes derived from NSCs pretreated with IGF-I (INExos) could continuously release the exosomes for two weeks. In the rat TBI model, 3D-CC-INExos scaffold transplantation significantly improved motor and cognitive function after TBI, as assessed by the Morris water maze test and modified neurological severity scores. In addition, immunofluorescence staining and transmission electron microscopy showed that the recovery of damaged nerve tissue in the injured area was significantly improved by 3D-CC-INExos implantation. In conclusion, our data suggest that 3D-CC-INExos might provide a potential strategy for the treatment of TBI and lay a solid foundation for clinical translation.

Keywords: traumatic brain injury, exosomes, insulin growth factor-1, neural stem cells, collagen, chitosan, 3D printing, neural regeneration, angiogenesis, functional recovery

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

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

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

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Authors: Lee Seungheon, Kim Ba-Ro

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In this study, the anti-stress effects of the ethanolic extract of Hydrangeae Dulcis Folium (EHDF) were investigated. To determine the effects of EHDF on physical stress, changes in the whole-body cortisol level and behaviour were monitored in zebrafish. To induce physical stress, we used the net handling stress (NHS). Fish were treated with EHDF for 6 min before they were exposed to stress, and the fish were either evaluated via behavioural tests, including a novel tank test and an open field test or sacrificed to collect body fluid from the whole body. The results indicate that increased anxiety-like behaviours in the novel tank test and open field test under stress were recovered by treatment with EHDF at 5, 10 and 20 mg/L (P < 0.05). Moreover, compared with the normal group, which was not treated with NHS, the whole-body cortisol level was significantly increased by treatment with NHS in the control group. Compared with the control group, pre-treatment with EHDF at concentrations of 5, 10 and 20 mg/L for 6 min significantly prevented the increase in the whole-body cortisol level induced by NHS (P < 0.05). In addition, adrenocorticotropin hormone (ACTH) challenge studies showed that EHDF completely blocked the effects of ACTH (0.2 IU/g, IP) on cortisol secretion. These results suggest that EHDF may be a good anti-stress candidate and that its mechanism of action may be related to its positive effects on cortisol release.

Keywords: net handling stress, zebrafish, hydrangeae dulcis folium, whole-body cortisol, novel tank test, open field test

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Authors: I. Made Gatot Karohika, Shigeyuki Haruyama, Ken Kaminishi, Oke Oktavianty, Didik Nurhadiyanto

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Contact width and contact stress are important parameters related to the leakage behavior of corrugated metal gasket. In this study, contact width and contact stress of three-layer corrugated metal gasket are investigated due to the modulus of elasticity and thickness of surface layer for 2 type gasket (0-MPa and 400-MPa mode). A finite element method was employed to develop simulation solution to analysis the effect of each parameter. The result indicated that lowering the modulus of elasticity ratio of surface layer will result in better contact width but the average contact stresses are smaller. When the modulus of elasticity ratio is held constant with thickness ratio increase, its contact width has an increscent trend otherwise the average contact stress has decreased trend.

Keywords: contact width, contact stress, layer, metal gasket, corrugated, simulation

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Authors: Leydi Noemi Peraza Gómez, Jose Álvarez Nemegyei, Damaris Francis Estrella Castillo

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In order to have an epidemiological tool to detect biomechanical stress (ERGO-Mex), which impose physical labor or recreational activities, a questionnaire is constructed in Spanish, validated and culturally adapted to the Mayan indigenous population of Yucatan. Through the seven steps proposed by Guillemin and Beaton the procedure was: initial translation, synthesis of the translations, feed back of the translation. After that review by a committee of experts, pre-test of the preliminary version, and presentation of the results to the committee of experts and members of the community. Finally the evaluation of its internal validity (Cronbach's α coefficient) and external (intraclass correlation coefficient). The results for the validation in Spanish indicated that 45% of the participants have biomechanical stress. The ERGO-Mex correlation was 0.69 (p <0.0001). Subjects with high biomechanical stress had a higher score than subjects with low biomechanical stress (17.4 ± 8.9 vs.9.8 ± 2.8, p = 0.003). The Cronbach's α coefficient was 0.92; and for validation in Cronbach's α maya it was 0.82 and CCI = 0.70 (95% CI: 0.58-0.79; p˂0.0001); ERGO-Mex is suitable for performing early detection of musculoskeletal diseases and helping to prevent disability.

Keywords: biomechanical stress, disability, musculoskeletal disorders, prevention

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Authors: Hossein Agheshlui, Stephan Matthai

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In fractured rock masses open fractures tend to act as the main pathways of fluid flow. The permeability of a rock fracture depends on its aperture. The change of aperture with stress can cause a many-orders-of-magnitude change in the hydraulic conductivity at moderate compressive stress levels. In this study, the change of aperture in fragmented rocks is investigated using finite element analysis. A full 3D mechanical model of a simplified version of an outcrop analog is created and studied. A constant initial aperture value is applied to all fractures. Different far field stresses are applied and the change of aperture is monitored considering the block to block interaction. The fragmented rock layer is assumed to be sandwiched between softer layers. Frictional contact forces are defined at the layer boundaries as well as among contacting rock blocks. For a given in situ stress, the blocks slide and contact each other, resulting in new aperture distributions. A map of changed aperture is produced after applying the in situ stress and compared to the initial apertures. Subsequently, the permeability of the system before and after the stress application is compared.

Keywords: fractured rocks, mechanical model, aperture change due to stress, frictional interface

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Authors: Rachel Ashwell, Sally Millett

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Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

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Authors: Devam Sheth

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Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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Authors: Mohammad Y. Alfaifi

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Anything that poses a challenge or a threat to our well-being is a stress. Understanding the genetic material and cellular response of rats threatened with Repeated swimming stress provides insights that can influence human health. The aim of the present study was to assess the genetical damage and cytological changes caused by exposure of the test organism (Rattus rattus) to forced swimming stress. For this purpose, animals have been submerged in water path 15 minutes daily for 2 weeks. Following that, we performed a micronuclei (MN) test using MNNCE (Micronucleated normocromatic erythrocytes) and MNPCE (Micronucleated polychromatic erythrocytes), NDI (Nuclear division index) and cytological parameters using NDCI (nuclear division cytotoxicity index), necrotic and apoptotic cells in rat's bone marrow samples. Results showed that there was a slightly but not significant increase in the frequency of micronucleated as well as in cytological parameters in bone marrow cells.

Keywords: submergence stress, micronucleus, NDI, NDCI, toxicity, chromosomal aberrations

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Authors: Jiawei Chen, Jia Qu, Dianwei Ju

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316L stainless steel has good mechanical and technological properties, has been widely used in shipbuilding and aerospace manufacturing. In order to understand the effect of strain rate on the yield limit of 316L stainless steel and the constitutive relationship of the materials at different strain rates, this paper used the INSTRON-4505 electronic universal testing machine to study the mechanical properties of the tensile specimen under quasi-static conditions. Meanwhile, the Zwick-Roell RKP450 intelligent oscillometric impact tester was used to test the tensile specimens at different strain rates. Through the above two kinds of experimental researches, the relationship between the true stress-strain and the engineering stress-strain at different strain rates is obtained. The result shows that the tensile yield point of 316L stainless steel increases with the increase of strain rate, and the real stress-strain curve of the 316L stainless steel has a better normalization than that of the engineering stress-strain curve. The real stress-strain curves can be used in the practical engineering of impact stretch to improve its safety.

Keywords: impact stretch, 316L stainless steel, strain rate, real stress-strain, normalization

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Authors: D. Sersab, M. Aberkane

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Residual stresses, in high-density polyethylene (HDPE) pipes, result from a nonhomogeneous cooling rate that occurs between the inner and outer surfaces during the extrusion process in manufacture. Most known methods of measurements to determine the magnitude and profile of the residual stresses in the pipe wall thickness are layer removal and ring slitting method. The combined layer removal and ring slitting methods described in this paper involves measurement of the circumferential residual stresses with minimal local disturbance. The existing methods used for pipe geometry (ring slitting method) gives a single residual stress value at the bore. The layer removal method which is used more in flat plate specimen is implemented with ring slitting method. The method permits stress measurements to be made directly at different depth in the pipe wall and a well-defined residual stress profile was consequently obtained.

Keywords: residual stress, layer removal, ring splitting, HDPE, wall thickness

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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Authors: Amani Waheed, Adel Mishriky, Rasha Farouk, Essam Abdallah, Sarah Hussein

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Background: Occupational stress plays a crucial role in professional drivers' health. They are exposed to high workloads, low physical activity, high demand and low decisions as well as poor lifestyle factors including poor diet, sedentary work, and smoking. Dyslipidemia is a well-established modifiable cardiovascular risk factor. Occupational stress and other forms of chronic stress have been associated with raised levels of atherogenic lipids. Although stress management has some evidence in improving lipid profile, the association between occupational stress and dyslipidemia is not clear. Objectives: To assess the relational between occupational stress and lipid profile among professional drivers. Methodology: A cross-sectional study conducted at a large company in Ismailia City, Egypt, where, 131 professional drivers divided into 44 car drivers, 43 bus drivers, and 44 truck drivers were eligible after applying exclusion criteria. Occupational stress index (OSI), non-occupational risk factors of dyslipidemia were assessed using interview structured questionnaire. Blood pressure, body mass index (BMI) and lipid profile were measured. Results: The mean of total OSI score was 79.98 ± 6.14. The total OSI score is highest among truck drivers (82.16 ± 4.62), then bus drivers (80.26 ± 6.02) and lowest among car drivers (77.55 ± 6.79) with statistically significant. Eighty percent had Dyslipidemia. The duration of driving hours per day, exposure to passive smoking and increased BMI were the risk factors. No statistical significance between Total OSI score and dyslipidemia. Using, logistic regression analysis, occupational stress, duration of driving hours per day, and BMI were positive significant predictors for dyslipidemia. Conclusion: Professional drivers are exposed to occupational stress. A high proportion of drivers have dyslipidemia. Total OSI score doesn't have statistically significant relation with dyslipidemia.

Keywords: body mass index, dyslipidaemia, occupational stress, professional drivers

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Authors: Joe Collins, Matthias Rother

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Background: Oral non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of joint pain during and post-exercise. However, oral NSAIDs increase the risk of systemic side effects, even in healthy individuals, and retard recovery from muscle soreness. TDT 064 (Flexiseq®), a topical formulation containing ultra-deformable drug-free Sequessome™ vesicles, has demonstrated equivalent efficacy to oral celecoxib in reducing osteoarthritis-associated joint pain and stiffness. TDT 064 does not cause NSAID-related adverse effects. We describe clinical study data and a case report on the effectiveness of TDT 064 in reducing joint pain after exercise. Methods: Participants with a pain score ≥3 (10-point scale) 12–16 hours post-exercise were randomized to receive TDT 064 plus oral placebo, TDT 064 plus oral ketoprofen, or ketoprofen in ultra-deformable phospholipid vesicles plus oral placebo. Results: In the 168 study participants, pain scores were significantly higher with oral ketoprofen plus TDT 064 than with TDT 064 plus placebo in the 7 days post-exercise (P = 0.0240) and recovery from muscle soreness was significantly longer (P = 0.0262). There was a low incidence of adverse events. These data are supported by clinical experience. A 24-year-old male professional rugby player suffered a traumatic lisfranc fracture in March 2014 and underwent operative reconstruction. He had no relevant medical history and was not receiving concomitant medications. He had undergone anterior cruciate ligament reconstruction in 2008. The patient reported restricted training due to pain (score 7/10), stiffness (score 9/10) and poor function, as well as pain when changing direction and running on consecutive days. In July 2014 he started using TDT 064 twice daily at the recommended dose. In November 2014 he noted reduced pain on running (score 2-3/10), decreased morning stiffness (score 4/10) and improved joint mobility and was able to return to competitive rugby without restrictions. No side effects of TDT 064 were reported. Conclusions: TDT 064 shows efficacy against exercise- and injury-induced joint pain, as well as that associated with osteoarthritis. It does not retard muscle soreness recovery after exercise compared with an oral NSAID, making it an alternative approach for the treatment of joint pain during and post-exercise.

Keywords: exercise, joint pain, TDT 064, phospholipid vesicles

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Authors: Fatemeh Najafi

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The major stress factor limiting crop growth and development of sesame (Sesamum indicum L.) is drought stress in arid and semiarid regions of the world. For this study the effects of water stress on some qualitative and quantitative traits in sesame germplasm was conducted in the Research Farm of Seed and Plant Improvement Institute, Karaj, in the crop year. Genotypes in a randomized complete block design with three replications in two environments (moisture stress and normal) were studied in regard of the seed weight, capsule weight, grain yield, biomass, plant height, number of capsules per plant, etc. The characteristics were evaluated based on the combined analysis. Irrigation was based on first class evaporation basin. After flowering stage drought stress was applied. The water deficit reduced growth period. Days to reach full ripening decreased so that the reduction was significant at the five percent level. Drought stress reduces yield and plant biomass. Genotypes based on combined analysis of these two traits were significant at the one percent level. Genotypes differ in terms of yield stress in terms of density plots, grain yield, days to first flowering and days to the half of the cap on the confidence level of five percent and traits of days to emergence of the first capsule and days to reach full ripening at the one percent level were significant. Other traits were not significant. The correlation of traits in circumstances of stress the number of seeds per capsule has the greatest impact on performance. The sensitivity and stress tolerance index was calculated. Based on the indicators, (Fars variety) and variety Karaj were identified as the most tolerant genotypes among the studied genotypes to drought stress. The highest sensitivity indicator of stress was related to genotype (FARS).

Keywords: sesamum, drought, stress, germplasm, resistance

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