Search results for: diastolic blood pressure
1655 Oral Versus Iontophoresis Nonsteroidal Anti-Inflammatory Drugs in Tennis Elbow
Authors: Moustafa Ali Elwan, Ibrahim Salem Abdelrafa, Ashraf Moharm
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Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed oral and topical drugs worldwide. Moreover, NSAIDs are responsible for most of all adverse drug reactions. For several decades, there are numerous attempts to use the cutaneous layers as a gate into the body for the local delivery of the therapeutic agent. Transdermal drug delivery is a validated technology contributing significantly to global pharmaceutical care. Transdermal Drug Delivery systems can be improved by using therapeutic agents. Moreover, Transdermal Drug Delivery systems can be improved by using chemical enhancers like ultrasound or iontophoresis. Iontophoresis provides a mechanism to enhance the penetration of hydrophilic and charged molecules across the skin. Objective: to compare the drug administration by ‘iontophoresis’ versus the oral rule. Methods: This study was conducted at the Faculty of Physical Therapy, Modern University for technology and information, Cairo, Egypt, on 20 participants (8 female & 12 male) who complained of tennis elbow. Their mean age was (25.45 ± 3.98) years, and all participants were assessed in many aspects: Pain threshold was assessed by algometer. Range of motion was assessed by electro goniometer, and isometric strength was assessed by a portable hand-held dynamometer. Then Participants were randomly assigned into two groups: group A was treated with oral NSAID (diclofenac) while group B was treated via administration of NSAIDs (diclofenac) via an iontophoresis device. All the participants were subjected to blood samples analysis in both pre-administration of the drug and post-administration of the drug for 24 hours (sample/every 6 hours). Results: The results demonstrated that there was a significant improvement in group b, “iontophoresis NSAIDs group,” more than in group B,” oral NSAIDs group,” in all measurements ‘ pain threshold, strength, and range of motion. Also, the iontophoresis method shows higher maximum plasma concentrations (Cmax) and concentration-time curves than the oral method.Keywords: diclofenac, iontophoresis, NSAIDs, oral, tennis elbow
Procedia PDF Downloads 1111654 Effects of Potassium Sorbate on Some Sexual Maturation Parameters in Immature Female Wistar Rats
Authors: Elisabeth Louise Ndjengue Mindang, Charline Florence Awounfack, Derek Tantoh Ndinteh, Rui W. M. Krause, Dieudonne Njamen
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The evolution of human fertility over the last 50 years has shown considerable problems due to a growing number of couples that find it difficult to procreate without medical assistance. In Africa, this inability to conceive affect 30 to 40% of couples. A number of contaminants in the environment are thought to contribute significantly to the observed infertility epidemic. Methods: On this basis, the impact of 40-days unique oral administration (between 9 and 10 am) of potassium sorbate (at of 12.5, 45, and 78 mg/kg BW doses) was evaluated on sexual maturation and hematologic parameters on immature Wistar rats (21-22 days of age). At the end of the treatment, animals were sacrificed. Vaginal opening was evaluated before the sacrifice. After the sacrifice, relative weight of reproductive organs, pituitary gonadotrophin level (LH and FSH), and sexuals steroids (estrogen and progesterone), cholesterol level in ovaries, folliculogenesis, and some hematological parameters were evaluated. Results: Compared to the control group, no significant variation was observed in the body weight of the animals treated with patassium sorbate. On the other hand, potassium sorbate, a significantly lower percentage (25%) of vaginal-opening in these rats, was observed from day 46 of age (p <0.01); likewise, a significant decrease was observed on the relative weight of the ovaries (p <0.01), number of primary follicles (p <0.01), and a significant increase of follicle number (p <0.001) at 78 mg/kg BW have been obseved. Potassium sorbate always decreased the number of white blood cells (p <0.05). Taken together, these results confirm the disturbing effects on the endocrine system, causing a decrease in fertility by increasing the number of follicles in atresia. A deleterious effect on the immune system was also observed. Overall, these results validate at least in part the global observations on the growing decline in fertility in populationsfeeding increasingly on industrial processed foods.Keywords: potassium sorbate, early puberty, folliculogenesis, endocrine disruptor, immatur wistar rat
Procedia PDF Downloads 1501653 Hematological Malignancies in Children and Parental Occupational Exposure
Authors: H. Kalboussi, A. Aloui, W. Boughattas, M. Maoua, A. Brahem, S. Chatti, O. El Maalel, F. Debbabi, N. Mrizak, Y. Ben Youssef, A. Khlif, I. Bougmiza
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Background: In recent decades, the incidence of children's hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and Methods: Our study is a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012,and which included children with acute leukemia compared to children unharmed by neoplastic disease . Cases and controls were matched by age and gender. Our objective was to: - Describe the socio-occupational characteristics of the parents of children with acute leukemia. - Identify potential occupational factors implicated in the genesis of acute leukemia. Result: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0,009, OR = 3.9; CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5; ICa = [1.09 -11.6]. 25.7 % of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006), OR = 1.46, IC = [1.38 - 1.56]. The parental occupational exposures associated to the occurrence of acute leukemia in children were: - Pesticides with a statistically significant difference (p = 0.03), OR = 2.94, IC = [1.06 - 8.13]. This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75; ICa = [1.27 - 11.03]. - Cement without a statistically non-significant difference (p = 0.2). This difference has become significant after adjustment with the different variables pa = 0.03; ORa = 2.67; ICa = [1.06 - 6.7]. Conclusion: Parental exposure to occupational risk factors may play a role in the pathogenesis of acute leukemia in children.Keywords: hematological malignancies, children, parents, occupational exposure
Procedia PDF Downloads 3151652 The Role of Hypothalamus Mediators in Energy Imbalance
Authors: Maftunakhon Latipova, Feruza Khaydarova
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Obesity is considered a chronic metabolic disease that occurs at any age. Regulation of body weight in the body is carried out through complex interaction of a complex of interrelated systems that control the body's energy system. Energy imbalance is the cause of obesity and overweight, in which the supply of energy from food exceeds the energy needs of the body. Obesity is closely related to impaired appetite regulation, and a hypothalamus is a key place for neural regulation of food consumption. The nucleus of the hypothalamus is connected and interdependent on receiving, integrating and sending hunger signals to regulate appetite. Purpose of the study: to identify markers of food behavior. Materials and methods: The screening was carried out to identify eating disorders in 200 men and women aged 18 to 35 years with overweight and obesity and to check the effects of Orexin A and Neuropeptide Y markers. A questionnaire and questionnaires were conducted with over 200 people aged 18 to 35 years. Questionnaires were for eating disorders and hidden depression (on the Zang scale). Anthropometry is measured by OT, OB, BMI, Weight, and Height. Based on the results of the collected data, 3 groups were divided: People with obesity, People with overweight, Control Group of Healthy People. Results: Of the 200 analysed persons, 86% had eating disorders. Of these, 60% of eating disorders were associated with childhood. According to the Zang test result: Normal condition was about 37%, mild depressive disorder 20%, moderate depressive disorder 25% and 18% of people suffered from severe depressive disorder without knowing it. One group of people with obesity had eating disorders and moderate and severe depressive disorder, and group 2 was overweight with mild depressive disorder. According to laboratory data, the first group had the lowest concentration of Orexin A and Neuropeptide U in blood serum. Conclusions: Being overweight and obese are the first signal of many diseases, and prevention and detection of these disorders will prevent various diseases, including type 2 diabetes. Obesity etiology is associated with eating disorders and signal transmission of the orexinorghetic system of the hypothalamus.Keywords: obesity, endocrinology, hypothalamus, overweight
Procedia PDF Downloads 741651 Reducing Friction Associated with Commercial Use of Biomimetics While Increasing the Potential for Using Eco Materials and Design in Industry
Authors: John P. Ulhøi
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Firms are faced with pressure to stay innovative and entrepreneurial while at the same time leaving lighter ecological footprints. Traditionally inspiration for new product development (NPD) has come from the creative in-house staff and from the marketplace. Often NPD offered by this approach has proven to be (far from) optimal for its purpose or highly (resource and energy) efficient. More recently, a bio-inspired NPD approach has surfaced under the banner of biomimetics. Biomimetics refers to inspiration from and translations of designs, systems, processes, and or specific properties that exist in nature. The principles and structures working in nature have evolved over a long period of time enable them to be optimized for the purpose and resource and energy-efficient. These characteristics reflect the raison d'être behind the field of biomimetics. While biological expertise is required to understand and explain such natural and biological principles and structures, engineers are needed to translate biological design and processes into synthetic applications. It can, therefore, hardly be surprising, biomimetics long has gained a solid foothold in both biology and engineering. The commercial adoption of biomimetic applications in new production development (NDP) in industry, however, does not quite reflect a similar growth. Differently put, this situation suggests that something is missing in the biomimetic-NPD-equation, thus acting as a brake towards the wider commercial application of biomimetics and thus the use of eco-materials and design in the industry. This paper closes some of that gap. Before concluding, avenues for future research and implications for practice will be briefly sketched out.Keywords: biomimetics, eco-materials, NPD, commercialization
Procedia PDF Downloads 1611650 Numerical Investigation of Fluid Flow, Characteristics of Thermal Performance and Enhancement of Heat Transfer of Corrugated Pipes with Various Geometrical Configurations
Authors: Ahmed Ramadhan Al-Obaidi, Jassim Alhamid
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In this investigation, the flow pattern, characteristics of thermal-hydraulic, and improvement of heat transfer performance are evaluated using a numerical technique in three dimensions corrugated pipe heat exchanger. The modification was made under different corrugated pipe geometrical parameters, including corrugated ring angle (CRA), distance between corrugated ring (DBCR), and corrugated diameter (CD), the range of Re number from 2000 to 12000. The numerical results are validated with available experimental data. The numerical outcomes reveal that there is an important change in flow field behaviour and a significant increase in friction factor and improvement in heat transfer performance owing to the use of the corrugated shape in the heat exchanger pipe as compared to the conventional smooth pipe. Using corrugated pipe with different configurations makes the flow more turbulence, flow separation, boundary layer distribution, flow mixing, and that leads to augmenting the performance of heat transfer. Moreover, the value of pressure drop, and the Nusselt number increases as the corrugated pipe geometrical parameters increase. Furthermore, the corrugation configuration shapes have an important influence on the thermal evaluation performance factor, and the maximum value was more than 1.3. Numerical simulation can be performed to predict the various geometrical configurations effects on fluid flow, thermal performance, and heat transfer enhancement.Keywords: corrugated ring angle, corrugated diameter, Nusselt number, heat transfer
Procedia PDF Downloads 1411649 IoT Based Agriculture Monitoring Framework for Sustainable Rice Production
Authors: Armanul Hoque Shaon, Md Baizid Mahmud, Askander Nobi, Md. Raju Ahmed, Md. Jiabul Hoque
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In the Internet of Things (IoT), devices are linked to the internet through a wireless network, allowing them to collect and transmit data without the need for a human operator. Agriculture relies heavily on wireless sensors, which are a vital component of the Internet of Things (IoT). This kind of wireless sensor network monitors physical or environmental variables like temperatures, sound, vibration, pressure, or motion without relying on a central location or sink and collaboratively passes its data across the network to be analyzed. As the primary source of plant nutrients, the soil is critical to the agricultural industry's continued growth. We're excited about the prospect of developing an Internet of Things (IoT) solution. To arrange the network, the sink node collects groundwater levels and sends them to the Gateway, which centralizes the data and forwards it to the sensor nodes. The sink node gathers soil moisture data, transmits the mean to the Gateways, and then forwards it to the website for dissemination. The web server is in charge of storing and presenting the moisture in the soil data to the web application's users. Soil characteristics may be collected using a networked method that we developed to improve rice production. Paddy land is running out as the population of our nation grows. The success of this project will be dependent on the appropriate use of the existing land base.Keywords: IoT based agriculture monitoring, intelligent irrigation, communicating network, rice production
Procedia PDF Downloads 1521648 Full-Field Estimation of Cyclic Threshold Shear Strain
Authors: E. E. S. Uy, T. Noda, K. Nakai, J. R. Dungca
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Cyclic threshold shear strain is the cyclic shear strain amplitude that serves as the indicator of the development of pore water pressure. The parameter can be obtained by performing either cyclic triaxial test, shaking table test, cyclic simple shear or resonant column. In a cyclic triaxial test, other researchers install measuring devices in close proximity of the soil to measure the parameter. In this study, an attempt was made to estimate the cyclic threshold shear strain parameter using full-field measurement technique. The technique uses a camera to monitor and measure the movement of the soil. For this study, the technique was incorporated in a strain-controlled consolidated undrained cyclic triaxial test. Calibration of the camera was first performed to ensure that the camera can properly measure the deformation under cyclic loading. Its capacity to measure deformation was also investigated using a cylindrical rubber dummy. Two-dimensional image processing was implemented. Lucas and Kanade optical flow algorithm was applied to track the movement of the soil particles. Results from the full-field measurement technique were compared with the results from the linear variable displacement transducer. A range of values was determined from the estimation. This was due to the nonhomogeneous deformation of the soil observed during the cyclic loading. The minimum values were in the order of 10-2% in some areas of the specimen.Keywords: cyclic loading, cyclic threshold shear strain, full-field measurement, optical flow
Procedia PDF Downloads 2331647 Electrochemical Biosensor Based on Chitosan-Gold Nanoparticles, Carbon Nanotubes for Detection of Ovarian Cancer Biomarker
Authors: Parvin Samadi Pakchin, Reza Saber, Hossein Ghanbari, Yadollah Omidi
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Ovarian cancer is one of the leading cause of mortality among the gynecological malignancies, and it remains the one of the most prevalent cancer in females worldwide. Tumor markers are biochemical molecules in blood or tissues which can indicates cancers occurrence in the human body. So, the sensitive and specific detection of cancer markers typically recruited for diagnosing and evaluating cancers. Recently extensive research efforts are underway to achieve a simple, inexpensive and accurate device for detection of cancer biomarkers. Compared with conventional immunoassay techniques, electrochemical immunosensors are of great interest, because they are specific, simple, inexpensive, easy to handling and miniaturization. Moreover, in the past decade nanotechnology has played a crucial role in the development of biosensors. In this study, a signal-off electrochemical immunosensor for the detection of CA125 antigen has been developed using chitosan-gold nanoparticles (CS-AuNP) and multi-wall carbon nanotubes (MWCNT) composites. Toluidine blue (TB) is used as redox probe which is immobilized on the electrode surface. CS-AuNP is synthesized by a simple one step method that HAuCl4 is reduced by NH2 groups of chitosan. The CS-AuNP-MWCNT modified electrode has shown excellent electrochemical performance compared with bare Au electrode. MWCNTs and AuNPs increased electrochemical conductivity and accelerate electrons transfer between solution and electrode surface while excessive amine groups on chitosan lead to the effective loading of the biological material (CA125 antibody) and TB on the electrode surface. The electrochemical, immobilization and sensing properties CS-AuNP-MWCNT-TB modified electrodes are characterized by cyclic voltammetry, electrochemical impedance spectroscopy, differential pulse voltammetry and square wave voltammetry with Fe(CN)63−/4−as an electrochemical redox indicator.Keywords: signal-off electrochemical biosensor, CA125, ovarian cancer, chitosan-gold nanoparticles
Procedia PDF Downloads 2861646 Defect Classification of Hydrogen Fuel Pressure Vessels using Deep Learning
Authors: Dongju Kim, Youngjoo Suh, Hyojin Kim, Gyeongyeong Kim
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Acoustic Emission Testing (AET) is widely used to test the structural integrity of an operational hydrogen storage container, and clustering algorithms are frequently used in pattern recognition methods to interpret AET results. However, the interpretation of AET results can vary from user to user as the tuning of the relevant parameters relies on the user's experience and knowledge of AET. Therefore, it is necessary to use a deep learning model to identify patterns in acoustic emission (AE) signal data that can be used to classify defects instead. In this paper, a deep learning-based model for classifying the types of defects in hydrogen storage tanks, using AE sensor waveforms, is proposed. As hydrogen storage tanks are commonly constructed using carbon fiber reinforced polymer composite (CFRP), a defect classification dataset is collected through a tensile test on a specimen of CFRP with an AE sensor attached. The performance of the classification model, using one-dimensional convolutional neural network (1-D CNN) and synthetic minority oversampling technique (SMOTE) data augmentation, achieved 91.09% accuracy for each defect. It is expected that the deep learning classification model in this paper, used with AET, will help in evaluating the operational safety of hydrogen storage containers.Keywords: acoustic emission testing, carbon fiber reinforced polymer composite, one-dimensional convolutional neural network, smote data augmentation
Procedia PDF Downloads 931645 Estimation of Energy Efficiency of Blue Hydrogen Production Onboard of Ships
Authors: Li Chin Law, Epaminondas Mastorakos, Mohd Roslee Othman, Antonis Trakakis
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The paper introduces an alternative concept of carbon capture for shipping by using pre-combustion carbon capture technology (Pre-CCS), which was proven to be less energy intensive than post-combustion carbon capture from the engine exhaust. Energy assessment on amine-based post-combustion CCS on LNG-fuelled ships showed that the energy efficiency of CCS ships reduced from 48% to 36.6%. Then, an energy assessment was carried out to compare the power and heat requirements of the most used hydrogen production methods and carbon capture technologies. Steam methane reformer (SMR) was found to be 20% more energy efficient and achieved a higher methane conversion than auto thermal reaction and methane decomposition. Next, pressure swing adsorber (PSA) has shown a lower energy requirement than membrane separation, cryogenic separation, and amine absorption in pre-combustion carbon capture. Hence, an integrated system combining SMR and PSA (SMR-PSA) with waste heat integration (WHR) was proposed. This optimized SMR-based integrated system has achieved 65% of CO₂ reduction with less than 7-percentage point of energy penalty (41.7% of energy efficiency). Further integration of post-combustion CCS with the SMR-PSA integrated system improved carbon capture rate to 86.3% with 9-percentage points of energy penalty (39% energy efficiency). The proposed system was shown to be able to meet the carbon reduction targets set by International Maritime Organization (IMO) with certain energy penalties.Keywords: shipping, decarbonisation, alternative fuels, low carbon, hydrogen, carbon capture
Procedia PDF Downloads 771644 Development of Mineral Carbonation Process from Ultramafic Tailings, Enhancing the Reactivity of Feedstocks
Authors: Sara Gardideh, Mansoor Barati
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The mineral carbonation approach for reducing global warming has garnered interest on a worldwide scale. Due to the benefits of permanent storage and abundant mineral resources, mineral carbonation (MC) is one of the most effective strategies for sequestering CO₂. The combination of mineral processing for primary metal recovery and mineral carbonation for carbon sequestration is an emerging field of study with the potential to minimize capital costs. A detailed study of low-pressures–solid carbonation of ultramafic tailings in a dry environment has been accomplished. In order to track the changing structure of serpentine minerals and their reactivity as a function of temperature (300-900 ᵒC), CO₂ partial pressure (25-90 mol %), and thermal preconditioning, thermogravimetry has been utilized. The incongruent CO₂ van der Waals molecular diameters with the octahedral-tetrahedral lattice constants of serpentine were used to explain the mild carbonation reactivity. Serpentine requires additional thermal-treatment to remove hydroxyl groups, resulting in the chemical transformation to pseudo-forsterite, which is a mineral composed of isolated SiO₄ tetrahedra linked by octahedrally coordinated magnesium ions. The heating treatment above 850 ᵒC is adequate to remove chemically bound water from the lattice. Particles with a diameter < 34 (μm) are desirable, and thermally treated serpentine at 850 ᵒC for 2.30 hours reached 65% CO₂ storage capacity. The decrease in particle size, increase in temperature, and magnetic separation can dramatically enhance carbonation.Keywords: particle size, thermogravimetry, thermal-treatment, serpentine
Procedia PDF Downloads 881643 Human Activities Damaging the Ecosystem of Isheri Ogun River, South West Nigeria
Authors: N. B. Ikenweiwe, A. A. Alimi, N. A. Bamidele, O. A. Ewumi, K. Fasina, S. O. Otubusin
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A study on the physical, chemical and biological parameters of the lower course of Ogun River, Isheri-Olofin was carried out between January and December 2014 in order to determine the effects of the anthropogenic activities of the Kara abattoir and domestic waste depositions on the quality of the water. Water samples were taken twice each month at three selected stations A, B and C (based on characteristic features or activity levels) along the water course. Samples were analysed using standard methods for chemical and biological parameters the same day in the laboratory while physical parameters were determined in-situ with water parameters kit. Generally, results of Transparency, Dissolved Oxygen, Nitrates, TDS and Alkalinity fall below the permissible limits of WHO and FEPA standards for drinking and fish production. Results of phosphates, lead and cadmium were also low but still within the permissible limit. Only Temperature and pH were within limit. Low plankton community, (phytoplankton, zooplankton), which ranges from 3, 5 to 40, 23 were as a result of low levels of DO, transparency and phosphate. The presence of coliform bacteria of public health importance like Escherichia coli, Proteus vulgaris, Aeromonas sp., Shigella sp, Enterobacter aerogenes as well as gram negative bacteria Proteus morganii are mainly indicators of faecal pollution. Fish and other resources obtained from this water stand the risk of being contaminated with these organisms and man is at the receiving end. The results of the physical, chemical and some biological parameters of Isheri, Ogun River, according to this study showed that the live forms of aquatic and fisheries resources there are dwelling under stress as a result of deposition of bones, horns, faecal components, slurry of suspended solids, fat and blood into the water. Government should therefore establish good monitoring system against illegal waste depositions and create education programmes that will enlighten the community on the social, ecological and economic values of the river.Keywords: damage, ecosystem, human activities, Isheri ogun river
Procedia PDF Downloads 5411642 Pastoralist Transhumance and Conflict along the Nigeria-niger Borderlands: Towards New Perspective for Effective Border Management in Africa
Authors: Abubakar Samaila
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Pastoralism has been an old practice in the Sahel region of west Africa. In recent years, pastoralists in Nigeria have increasingly been migrating on seasonal transhumance southward from the neighboring countries, especially Niger Republic, in search of better grazing conditions due to mainly, climate change. This has increased pressure on farm lands which instigate farmer-herder conflicts. These conflicts occur mainly between farmers and pastoralists but also between pastoralist groups themselves. However, there has been a shift in these conflicts recently to involve traditional institutions and, in some cases, the local authorities along the borderlands. The involvement of local institutions in the conflict has created an incentive to local actors, particularly pastoralcommunity-based groups, in responding to these violent threats. As pastoralists are mobile, these conflicts became difficult to contain and, thus, spill across borders. Consequently, the conflict has now transformed into an urbanized regional conflicts that involve some major cities along the Nigeria-Niger borderlands; Sokoto, Zamfara, and Katsina on the Nigerian side andDosso, Tahoa andMaradi in Niger republic. These areas are now experiencing unprecedented growing wave of violence that have become complex and escalates into a hydra-social conflict. The aim of this research is to investigate how the fluidities of Nigeria-Niger borderland intensified armed conflicts between the local pastoral organizations and sedentary populationspreading to some urban cities along the borderlands. The paper further suggests alternative approaches towards addressing the perennial crisis in African borderlands.Keywords: pastoralism, climate change, conflict, nigeria, niger, borderlands
Procedia PDF Downloads 901641 Wind Energy Loss Phenomenon Over Volumized Building Envelope with Porous Air Portals
Authors: Ying-chang Yu, Yuan-lung Lo
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More and more building envelopes consist of the construction of balconies, canopies, handrails, sun-shading, vertical planters or gardens, maintenance platforms, display devices, lightings, ornaments, and also the most commonly seen double skin system. These components form a uniform but three-dimensional disturbance structure and create a complex surface wind field in front of the actual watertight building interface. The distorted wind behavior would affect the façade performance and building ventilation. Comparing with sole windscreen walls, these three-dimensional structures perform like distributed air portal assembly, and each portal generates air turbulence and consume wind pressure and energy simultaneously. In this study, we attempted to compare the behavior of 2D porous windscreens without internal construction, porous tubular portal windscreens, porous tapered portal windscreens, and porous coned portal windscreens. The wind energy reduction phenomenon is then compared to the different distributed air portals. The experiments are conducted in a physical wind tunnel with 1:25 in scale to simulate the three-dimensional structure of a real building envelope. The experimental airflow was set up to smooth flow. The specimen is designed as a plane with a distributed tubular structure behind, and the control group uses different tubular shapes but the same fluid volume to observe the wind damping phenomenon of various geometries.Keywords: volumized building envelope, porous air portal, wind damping, wind tunnel test, wind energy loss
Procedia PDF Downloads 1321640 Characterization of Aluminosilicates and Verification of Their Impact on Quality of Ceramic Proppants Intended for Shale Gas Output
Authors: Joanna Szymanska, Paulina Wawulska-Marek, Jaroslaw Mizera
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Nowadays, the rapid growth of global energy consumption and uncontrolled depletion of natural resources become a serious problem. Shale rocks are the largest and potential global basins containing hydrocarbons, trapped in closed pores of the shale matrix. Regardless of the shales origin, mining conditions are extremely unfavourable due to high reservoir pressure, great depths, increased clay minerals content and limited permeability (nanoDarcy) of the rocks. Taking into consideration such geomechanical barriers, effective extraction of natural gas from shales with plastic zones demands effective operations. Actually, hydraulic fracturing is the most developed technique based on the injection of pressurized fluid into a wellbore, to initiate fractures propagation. However, a rapid drop of pressure after fluid suction to the ground induces a fracture closure and conductivity reduction. In order to minimize this risk, proppants should be applied. They are solid granules transported with hydraulic fluids to locate inside the rock. Proppants act as a prop for the closing fracture, thus gas migration to a borehole is effective. Quartz sands are commonly applied proppants only at shallow deposits (USA). Whereas, ceramic proppants are designed to meet rigorous downhole conditions to intensify output. Ceramic granules predominate with higher mechanical strength, stability in strong acidic environment, spherical shape and homogeneity as well. Quality of ceramic proppants is conditioned by raw materials selection. Aim of this study was to obtain the proppants from aluminosilicates (the kaolinite subgroup) and mix of minerals with a high alumina content. These loamy minerals contain a tubular and platy morphology that improves mechanical properties and reduces their specific weight. Moreover, they are distinguished by well-developed surface area, high porosity, fine particle size, superb dispersion and nontoxic properties - very crucial for particles consolidation into spherical and crush-resistant granules in mechanical granulation process. The aluminosilicates were mixed with water and natural organic binder to improve liquid-bridges and pores formation between particles. Afterward, the green proppants were subjected to sintering at high temperatures. Evaluation of the minerals utility was based on their particle size distribution (laser diffraction study) and thermal stability (thermogravimetry). Scanning Electron Microscopy was useful for morphology and shape identification combined with specific surface area measurement (BET). Chemical composition was verified by Energy Dispersive Spectroscopy and X-ray Fluorescence. Moreover, bulk density and specific weight were measured. Such comprehensive characterization of loamy materials confirmed their favourable impact on the proppants granulation. The sintered granules were analyzed by SEM to verify the surface topography and phase transitions after sintering. Pores distribution was identified by X-Ray Tomography. This method enabled also the simulation of proppants settlement in a fracture, while measurement of bulk density was essential to predict their amount to fill a well. Roundness coefficient was also evaluated, whereas impact on mining environment was identified by turbidity and solubility in acid - to indicate risk of the material decay in a well. The obtained outcomes confirmed a positive influence of the loamy minerals on ceramic proppants properties with respect to the strict norms. This research is perspective for higher quality proppants production with costs reduction.Keywords: aluminosilicates, ceramic proppants, mechanical granulation, shale gas
Procedia PDF Downloads 1611639 Mauriac Syndrome: A Rare Complicacation With an Easy Solution
Authors: Pablo Cid Galache, Laura Zamorano Bonilla
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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.Keywords: Mauriac, diabetes, complication, developing countries
Procedia PDF Downloads 531638 Thermomechanical Behavior of Asphalt Modified with Thermoplastic Polymer and Nanoclay Dellite 43B
Authors: L. F. Tamele Jr., G. Buonocore, H. F. Muiambo
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Asphalt binders play an essential role in the performance and properties of asphalt mixtures. The increase in heavy loads, greater traffic volume, and high tire pressure, combined with a substantial variation in daily and seasonal pavement temperatures, are the main responsible for the failure of asphalt pavements. To avoid or mitigate these failures, the present research proposes the use of thermoplastic polymers, HDPE and LLDPE, and nanoclay Dellite 43B for modification of asphalt in order to improve its thermomechanical and rheological properties. The nanocomposites were prepared by the solution intercalation method in a high shear mixer for a mixing time of 2 h, at 180℃ and 5000 rpm. The addition of Dellite 43B improved the physical, rheological, and thermal properties of asphalt, either separated or in the form of polymer/bitumen blends. The results of the physical characterization showed a decrease in penetration and an increase in softening point, thermal susceptibility, viscosity, and stiffness. On the other hand, thermal characterization showed that the nanocomposites have greater stability at higher temperatures by exhibiting greater amounts of residues and improved initial and final decomposition temperatures. Thus, the modification of asphalt by polymers and nanoclays seems to be a suitable solution for road pavement in countries which experiment with high temperatures combined with long heavy rain seasons.Keywords: asphalt, nanoclay dellite 43B, polymer modified asphalt, thermal and rheological properties
Procedia PDF Downloads 1451637 Variability of Climatic Elements in Nigeria Over Recent 100 Years
Authors: T. Salami, O. S. Idowu, N. J. Bello
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Climatic variability is an essential issue when dealing with the issue of climate change. Variability of some climate parameter helps to determine how variable the climatic condition of a region will behave. The most important of these climatic variables which help to determine the climatic condition in an area are both the Temperature and Precipitation. This research deals with Longterm climatic variability in Nigeria. Variables examined in this analysis include near-surface temperature, near surface minimum temperature, maximum temperature, relative humidity, vapour pressure, precipitation, wet-day frequency and cloud cover using data ranging between 1901-2010. Analyses were carried out and the following methods were used: - Regression and EOF analysis. Results show that the annual average, minimum and maximum near-surface temperature all gradually increases from 1901 to 2010. And they are in the same case in a wet season and dry season. Minimum near-surface temperature, with its linear trends are significant for annual, wet season and dry season means. However, the diurnal temperature range decreases in the recent 100 years imply that the minimum near-surface temperature has increased more than the maximum. Both precipitation and wet day frequency decline from the analysis, demonstrating that Nigeria has become dryer than before by the way of rainfall. Temperature and precipitation variability has become very high during these periods especially in the Northern areas. Areas which had excessive rainfall were confronted with flooding and other related issues while area that had less precipitation were all confronted with drought. More practical issues will be presented.Keywords: climate, variability, flooding, excessive rainfall
Procedia PDF Downloads 3821636 Preparation and Characterization of Mixed Cu-Ag-Pd Oxide Supported Catalysts for Complete Catalytic Oxidation of Methane
Authors: Ts. Lazarova, V. Tumbalev, S. Atanacova-Vladimirova, G. Ivanov, A. Naydenov, D. Kovacheva
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Methane is a major Greenhouse Gas (GHG) that accounts for 14% of the world’s total amount of GHG emissions, originating mainly from agriculture, Coal mines, land fields, wastewater and oil and gas facilities. Nowadays the problem caused by the methane emissions has been a subject of an increased concern. One of the methods for neutralization of the methane emissions is it's complete catalytic oxidation. The efforts of the researchers are focused on the development of new types of catalysts and optimizing the existing catalytic systems in order to prevent the sintering of the palladium, providing at the same time a sufficient activity at temperatures below 500oC. The aim of the present work is to prepare mixed Cu-Ag-Pd oxide catalysts supported on alumina and to test them for methane complete catalytic oxidation. Cu-Ag-Pd/Al2O3 were prepared on a γ-Al2O3 (BET surface area = 220 m2/g) by the incipient wetness method using the corresponding metal nitrates (Cu:Ag = 90:10, Cu:Pd =97:3, Cu:Ag:Pd= 87:10:3) as precursors. A second set of samples were prepared with addition of urea to the metal nitrate solutions with the above mentioned ratios assuming increased dispersivity of the catalysts. The catalyst samples were dried at 100°C for 3 hours and calcined at 550°C for 30 minutes. Catalysts samples were characterized using X-ray diffraction (XRD), low temperature adsorption of nitrogen (BET) and scanning electron microscopy (SEM). The catalytic activity tests were carried out in a continuous flow type of reactor at atmospheric pressure. The effect of catalyst aging at 500 oC for 120 h on the methane combustion activity was also investigated. The results clearly indicate the synergetic effect of Ag and Pd on the catalytic activity.Keywords: catalysts, XRD, BET, SEM, catalytic oxidation
Procedia PDF Downloads 3811635 Effect of Tai-Chi and Cyclic Meditation on Hemodynamic Responses of the Prefrontal Cortex: A Functional near Infrared Spectroscopy
Authors: Singh Deepeshwar, N. K. Manjunath, M. Avinash
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Meditation is a self-regulated conscious process associated with improved awareness, perception, attention and overall performance. Different traditional origin of meditation technique may have different effects on autonomic activity and brain functions. Based on this quest, the present study evaluated the effect of Tai-Chi Chuan (TCC, a Chines movement based meditation technique) and Cyclic Meditation (CM, an Indian traditional based stimulation and relaxation meditation technique) on the hemodynamic responses of the prefrontal cortex (PFC) and autonomic functions (such as R-R interval of heart rate variability and respiration). These two meditation practices were compared with simple walking. Employing 64 channel near infrared spectroscopy (NIRS), we measured hemoglobin concentration change (i.e., Oxyhemoglobin [ΔHbO], Deoxyhemoglobin [ΔHbR] and Total hemoglobin change [ΔTHC]) in the bilateral PFC before and after TCC, CM and Walking in young college students (n=25; average mean age ± SD; 23.4 ± 3.1 years). We observed the left PFC activity predominantly modulates sympathetic activity effects during the Tai-Chi whereas CM showed changes on right PFC with vagal dominance. However, the changes in oxyhemoglobin and total blood volume change after Tai-Chi was significant higher (p < 0.05, spam t-maps) on the left hemisphere, whereas after CM, there was a significant increase in oxyhemoglobin (p < 0.01) with a decrease in deoxyhemoglobin (p < 0.05) on right PFC. The normal walking showed decrease in Oxyhemoglobin with an increase in deoxyhemoglobin on left PFC. The autonomic functions result showed a significant increase in RR- interval (p < 0.05) along with significant reductions in HR (p < 0.05) in CM, whereas Tai-chi session showed significant increase in HR (p < 0.05) when compared to walking session. Within a group analysis showed a significant reduction in RR-I and significant increase in HR both in Tai-chi and walking sessions. The CM showed there were a significant improvement in the RR - interval of HRV (p < 0.01) with the reduction of heart rate and breath rate (p < 0.05). The result suggested that Tai-Chi and CM both have a positive effect on left and right prefrontal cortex and increase sympathovagal balance (alertful rest) in autonomic nervous system activity.Keywords: brain, hemodynamic responses, yoga, meditation, Tai-Chi Chuan (TCC), walking, heart rate variability (HRV)
Procedia PDF Downloads 3051634 From Connected Family to Disconnection for Teens
Authors: Jocelyn Lachance, Francis Jauréguiberry
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In a few years, the exceptionality of the situation of an individual who could be reached at any time and at any time was replaced by the normality of instantly hearing the voice or immediately seeing the face of the person. This participates in the transformation of our representations of time and space, which gives rise to new expectations. Expectations that parents formulate more or less clearly to their children. The obligation to remain reachable seems to be asserting itself as a general norm which, having imposed itself on adults, now extends to the youngest. In the case of parents and their children, the rationale for this ongoing connection is not always based on actual and imminent dangers. It is the potential for dangerous events that underpins the indisputable argument for the importance of remaining reachable. It is the contingent nature of the risks that imposes itself on these young people as an argument of authority. By entering this connected world, the younger generations also end up adhering in many cases to this reassuring standard of connection. Many teenagers in ours researches nonetheless firmly believe that their freedom of movement is subject to the obligation to carry their smartphone with them. In this way, a connection "pact" is generally established, concluded under pressure, which implies first and foremost that contact be possible at any time, hence the importance of keeping it within reach, and often of '' be attentive to calls and texts sent by parents, at the risk of losing a recently acquired freedom. In this context, if adolescents are growing up in a connected world today, it is also because of the connection the parents are expecting from them. In our conference, by evoking situations reported by teenagers and parents of teenagers during our surveys, we propose to think about the role of the parents in making their child connected and about the desire of the disconnection of the teens.Keywords: connection, disconnection, smartphone, parents, ritual
Procedia PDF Downloads 1881633 Numerical Simulation of Transient 3D Temperature and Kerf Formation in Laser Fusion Cutting
Authors: Karim Kheloufi, El Hachemi Amara
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In the present study, a three-dimensional transient numerical model was developed to study the temperature field and cutting kerf shape during laser fusion cutting. The finite volume model has been constructed, based on the Navier–Stokes equations and energy conservation equation for the description of momentum and heat transport phenomena, and the Volume of Fluid (VOF) method for free surface tracking. The Fresnel absorption model is used to handle the absorption of the incident wave by the surface of the liquid metal and the enthalpy-porosity technique is employed to account for the latent heat during melting and solidification of the material. To model the physical phenomena occurring at the liquid film/gas interface, including momentum/heat transfer, a new approach is proposed which consists of treating friction force, pressure force applied by the gas jet and the heat absorbed by the cutting front surface as source terms incorporated into the governing equations. All these physics are coupled and solved simultaneously in Fluent CFD®. The main objective of using a transient phase change model in the current case is to simulate the dynamics and geometry of a growing laser-cutting generated kerf until it becomes fully developed. The model is used to investigate the effect of some process parameters on temperature fields and the formed kerf geometry.Keywords: laser cutting, numerical simulation, heat transfer, fluid flow
Procedia PDF Downloads 3381632 Evaluation of the Power Generation Effect Obtained by Inserting a Piezoelectric Sheet in the Backlash Clearance of a Circular Arc Helical Gear
Authors: Barenten Suciu, Yuya Nakamoto
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Power generation effect, obtained by inserting a piezo- electric sheet in the backlash clearance of a circular arc helical gear, is evaluated. Such type of screw gear is preferred since, in comparison with the involute tooth profile, the circular arc profile leads to reduced stress-concentration effects, and improved life of the piezoelectric film. Firstly, geometry of the circular arc helical gear, and properties of the piezoelectric sheet are presented. Then, description of the test-rig, consisted of a right-hand thread gear meshing with a left-hand thread gear, and the voltage measurement procedure are given. After creating the tridimensional (3D) model of the meshing gears in SolidWorks, they are 3D-printed in acrylonitrile butadiene styrene (ABS) resin. Variation of the generated voltage versus time, during a meshing cycle of the circular arc helical gear, is measured for various values of the center distance. Then, the change of the maximal, minimal, and peak-to-peak voltage versus the center distance is illustrated. Optimal center distance of the gear, to achieve voltage maximization, is found and its significance is discussed. Such results prove that the contact pressure of the meshing gears can be measured, and also, the electrical power can be generated by employing the proposed technique.Keywords: circular arc helical gear, contact problem, optimal center distance, piezoelectric sheet, power generation
Procedia PDF Downloads 1661631 Fintech Credit and Bank Efficiency Two-way Relationship: A Comparison Study Across Country Groupings
Authors: Tan Swee Liang
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This paper studies the two-way relationship between fintech credit and banking efficiency using the Generalized panel Method of Moment (GMM) estimation in structural equation modeling (SEM). Banking system efficiency, defined as its ability to produce the existing level of outputs with minimal inputs, is measured using input-oriented data envelopment analysis (DEA), where the whole banking system of an economy is treated as a single DMU. Banks are considered an intermediary between depositors and borrowers, utilizing inputs (deposits and overhead costs) to provide outputs (increase credits to the private sector and its earnings). Analysis of the interrelationship between fintech credit and bank efficiency is conducted to determine the impact in different country groupings (ASEAN, Asia and OECD), in particular the banking system response to fintech credit platforms. Our preliminary results show that banks do respond to the greater pressure caused by fintech platforms to enhance their efficiency, but differently across the different groups. The author’s earlier research on ASEAN-5 high bank overhead costs (as a share of total assets) as the determinant of economic growth suggests that expenses may not have been channeled efficiently to income-generating activities. One practical implication of the findings is that policymakers should enable alternative financing, such as fintech credit, as a warning or encouragement for banks to improve their efficiency.Keywords: fintech lending, banking efficiency, data envelopment analysis, structural equation modeling
Procedia PDF Downloads 911630 Large Eddy Simulation Approach for Unsteady Analysis of the Flow Behavior inside a Dual Counter Rotating Axial Swirler
Authors: Foad Vashahi, Shahnaz Rezaei, Jeekeun Lee
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Large Eddy Simulation (LES) was performed on a dual counter rotating axial swirler in a confined rectangular configuration. Grids were constructed based on a primary Reynolds Averaged Navier-Stokes (RANS) simulation and then were refined based on the Kolmogorov length scale. Water as cold flow condition was applied and results were compared via Particle Image Velocimetry (PIV) experimental results. The focus was to investigate the flow behavior within the region before the flare and very close to the exit of the swirler. This region contributes to a highly unsteady flow behavior and requires great attention to enhancing the flame stability in gas turbine combustor and swirl burners. The PVC formation within the central core flow is strongly related to the peaks of pressure or axial velocity spectrum and up to two distinct peaks at the swirler mouth could be observed. Here, spectra analysis in iso-thermal condition inside the swirler where the inner swirler dominates the flow, showed a higher potential of instabilities with three to four distinct peaks where moving forward to the exit of swirler the number of peaks is decreased. In addition to this, the central axis corresponds to no peaks of instabilities while further away in the radial direction, several peaks exist.Keywords: axial counter rotating swirler, large eddy simulation (LES), precessing vortex core (PVC), power spectral density (PSD)
Procedia PDF Downloads 2781629 Segmenting 3D Optical Coherence Tomography Images Using a Kalman Filter
Authors: Deniz Guven, Wil Ward, Jinming Duan, Li Bai
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Over the past two decades or so, Optical Coherence Tomography (OCT) has been used to diagnose retina and optic nerve diseases. The retinal nerve fibre layer, for example, is a powerful diagnostic marker for detecting and staging glaucoma. With the advances in optical imaging hardware, the adoption of OCT is now commonplace in clinics. More and more OCT images are being generated, and for these OCT images to have clinical applicability, accurate automated OCT image segmentation software is needed. Oct image segmentation is still an active research area, as OCT images are inherently noisy, with the multiplicative speckling noise. Simple edge detection algorithms are unsuitable for detecting retinal layer boundaries in OCT images. Intensity fluctuation, motion artefact, and the presence of blood vessels also decrease further OCT image quality. In this paper, we introduce a new method for segmenting three-dimensional (3D) OCT images. This involves the use of a Kalman filter, which is commonly used in computer vision for object tracking. The Kalman filter is applied to the 3D OCT image volume to track the retinal layer boundaries through the slices within the volume and thus segmenting the 3D image. Specifically, after some pre-processing of the OCT images, points on the retinal layer boundaries in the first image are identified, and curve fitting is applied to them such that the layer boundaries can be represented by the coefficients of the curve equations. These coefficients then form the state space for the Kalman Filter. The filter then produces an optimal estimate of the current state of the system by updating its previous state using the measurements available in the form of a feedback control loop. The results show that the algorithm can be used to segment the retinal layers in OCT images. One of the limitations of the current algorithm is that the curve representation of the retinal layer boundary does not work well when the layer boundary is split into two, e.g., at the optic nerve, the layer boundary split into two. This maybe resolved by using a different approach to representing the boundaries, such as b-splines or level sets. The use of a Kalman filter shows promise to developing accurate and effective 3D OCT segmentation methods.Keywords: optical coherence tomography, image segmentation, Kalman filter, object tracking
Procedia PDF Downloads 4811628 Performance of Air Cured Concrete Treated with Waterproofing Admixtures or Surface Treatments
Authors: Sirwan Kamal, Hsein Kew, Hamid Jahromi
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This paper reports results of a study conducted to investigate strength, sorptivity, and permeability under pressure of concrete specimens, cured using a water-based curing compound. The specimens are treated with waterproofing admixtures or surface treatments to enhance performance while exposed to water. Four types of concrete specimens were prepared in the laboratory, Portland cement (CEM I), Portland-fly ash (CEM II/A-V), Blast-furnace cement (CEM III) and Portland-silica fume (CEM II/A-D). Concrete cubes were de-molded three hours after casting, and sprayed with a curing compound. Admixtures were added to the mix during batching, whereas surface treatments were applied on concrete after 28 days. Compressive strength test was carried out to assess the efficiency of curing compound to develop required strength. In addition, sorptivity and permeability tests were conducted to evaluate the performance of treated specimens with respect to water ingress. Results show that strength development in specimens cured with curing compound achieved up to 96% and 90% at 7 and 28 days respectively, compared to cubes cured in water. Moreover, specimens treated with waterproofing admixtures or surface treatments materials characterized by hydrophobic impregnation considerably reduced water penetration compared to untreated control cubes. On the other hand, cubes treated with admixtures or surface treatments materials characterized by crystalline effect were ineffective in reducing water penetration.Keywords: admixtures, concrete, curing compound, surface treatments
Procedia PDF Downloads 1301627 Performance Analysis of High Temperature Heat Pump Cycle for Industrial Process
Authors: Seon Tae Kim, Robert Hegner, Goksel Ozuylasi, Panagiotis Stathopoulos, Eberhard Nicke
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High-temperature heat pumps (HTHP) that can supply heat at temperatures above 200°C can enhance the energy efficiency of industrial processes and reduce the CO₂ emissions connected with the heat supply of these processes. In the current work, the thermodynamic performance of 3 different vapor compression cycles, which use R-718 (water) as a working medium, have been evaluated by using a commercial process simulation tool (EBSILON Professional). All considered cycles use two-stage vapor compression with intercooling between stages. The main aim of the study is to compare different intercooling strategies and study possible heat recovery scenarios within the intercooling process. This comparison has been carried out by computing the coefficient of performance (COP), the heat supply temperature level, and the respective mass flow rate of water for all cycle architectures. With increasing temperature difference between the heat source and heat sink, ∆T, the COP values decreased as expected, and the highest COP value was found for the cycle configurations where both compressors have the same pressure ratio (PR). The investigation on the HTHP capacities with optimized PR and exergy analysis has also been carried out. The internal heat exchanger cycle with the inward direction of secondary flow (IHX-in) showed a higher temperature level and exergy efficiency compared to other cycles. Moreover, the available operating range was estimated by considering mechanical limitations.Keywords: high temperature heat pump, industrial process, vapor compression cycle, R-718 (water), thermodynamic analysis
Procedia PDF Downloads 1471626 New Thromboprophylaxis Regime for Knee Arthroplasties
Authors: H. Noureddine, P. Rao, R. Guru, A. Chandratreya
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The nice guidance for elective total knee replacements states that patients should be given mechanical thrombo-prophylaxis, and if no contraindications chemical thromboprophylaxis in the form of Dabigatran etexilate, Rivaroxiban, UFH, LMWH, or Fondaparinux sodium (CG92, 1.5.14, January 2010). In Practice administering oral agents has been the dominant practice as it reduces the nursing needs, and shortens hospital stay and is generally received better by patients. However, there are well documented associated bleeding risks, and their effects are difficult to reverse in case of major bleeding. Our experience with oral factor 10 inhibitors used for thromboprophylaxis was marked with several patients developing complications necessitating return to the theatre for wound washouts. This has led us to try a different protocol for thromboprophylaxis that we applied on our patients undergoing total and unicondylar knee replacements. We applied mechanical thromboprophylaxis in the form of intermittent pneumatic pressure devices, and chemical thromboprophylaxis in the form of a dose of prophylactic LMWH pre-op, then 150 mg of Aspirin to start 24 hours after the surgery and to continue for 6 weeks, alongside GI cover with PPIs or antihistamines. We also administered local anaesthetics intra-operatively in line with the ERAS protocol thus encouraging early mobilization. We have identified a cohort of 133 patients who underwent one of the aforementioned procedures in the same trust, and by the same surgeon, where this protocol was applied and examined their medical notes retrospectively with a mean follow-up period of 14 months, to identify the rate and percentage of patients who had thrombo-embolic events in the post-operative period.Keywords: aspirin, heparin, knee arthroplasty, thromboprophylaxis
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