Search results for: axial pain

Authors: Dae-Gyun Ahn, Eun-Teak Woo, Yun-Hyun Cho, Seung-Ho Han

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For the sustainable development of wind energy, energy industries have invested in the development of highly efficient wind generators such as the Axial Flux Permanent Magnet (AFPM) generator. The AFPM generator, however, has a history of overheating on the surface of the stator, so that power production decreases significantly. A proper cooling system, therefore, is needed. Although a convective-type cooling system has been developed, the size of the air blower must be increased when the generator’s capacity exceeds 2.5MW. In this study, a newly developed conductive-type cooling system was proposed for the 2.5MW AFPM generator installed on an offshore wind turbine. Through electromagnetic thermal analysis, the efficiency of the heat transfer on the stator surface was investigated. When using the proposed cooling system, the temperatures on the stator surface and on the permanent magnet under conditions of thermal saturation were 76 and 66 C, respectively. (KETEP 20134030200320)

Keywords: heat transfer, thermal analysis, axial flux permanent magnet, conductive-type cooling system

Procedia PDF Downloads 443

Authors: Nouri Sabrina, Benzeghiba Mohamed, Ghezal Abderrahmane

Abstract:

Numerical parametric study is conducted to study the effects of ampoule rotation on the flows and the dopant segregation in vertical Bridgman (VB) crystal growth. Calculations were performed in unsteady state. The extended Darcy model, which includes the time derivative and Coriolis terms, has been employed in the momentum equation. It was found that the convection, and dopant segregation can be affected significantly by ampoule rotation, and the effect is similar to that by an axial magnetic field. Ampoule rotation decreases the intensity of convection and stretches the flow cell axially. When the convection is weak, the flow can be suppressed almost completely by moderate ampoule rotation and the dopant segregation becomes diffusion-controlled. For stronger convection, the elongated flow cell by ampoule rotation may bring dopant mixing into the bulk melt reducing axial segregation at the early stage of the growth. However, if the cellular flow cannot be suppressed completely, ampoule rotation may induce larger radial segregation due to poor mixing.

Keywords: numerical simulation, heat and mass transfer, vertical solidification, chemical segregation

Procedia PDF Downloads 350

Authors: Shang Yee Chong

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Perioperative pain is a complex mechanism activated by various nociceptive, neuropathic, and inflammatory pathways. Opioids have long been a mainstay for analgesia in this period, even as we are continuously moving towards a multimodal model to improve pain control while minimising side effects. Dexmedetomidine, a potent alpha-2 agonist, is a useful sedative and hypnotic agent. Its use in the intensive care unit has been well described, and it is increasingly an adjunct intraoperatively for its opioid sparing effects and to decrease pain scores. We describe a case of a general surgical patient in whom minimal opioids was required with dexmedetomidine use. The patient was a 61-year-old Indian gentleman with a history of hyperlipidaemia and type 2 diabetes mellitus, presenting with rectal adenocarcinoma detected on colonoscopy. He was scheduled for a robotic ultra-low anterior resection. The patient was induced with intravenous fentanyl 75mcg, propofol 160mg and atracurium 40mg. He was intubated conventionally and mechanically ventilated. Anaesthesia was maintained with inhalational desflurane and anaesthetic depth was measured with the Masimo EEG Sedline brain function monitor. An initial intravenous dexmedetomidine dose (bolus) of 1ug/kg for 10 minutes was given prior to anaesthetic induction and thereafter, an infusion of 0.2-0.4ug/kg/hr to the end of surgery. In addition, a bolus dose of intravenous lignocaine 1.5mg/kg followed by an infusion at 1mg/kg/hr throughout the surgery was administered. A total of 10mmol of magnesium sulphate and intravenous paracetamol 1000mg were also given for analgesia. There were no significant episodes of bradycardia or hypotension. A total of intravenous phenylephrine 650mcg was given throughout to maintain the patient’s mean arterial pressure within 10-15mmHg of baseline. The surgical time lasted for 5 hours and 40minutes. Postoperatively the patient was reversed and extubated successfully. He was alert and comfortable and pain scores were minimal in the immediate post op period in the postoperative recovery unit. Time to first analgesia was 4 hours postoperatively – with paracetamol 1g administered. This was given at 6 hourly intervals strictly for 5 days post surgery, along with celecoxib 200mg BD as prescribed by the surgeon regardless of pain scores. Oral oxycodone was prescribed as a rescue analgesic for pain scores > 3/10, but the patient did not require any dose. Neither was there nausea or vomiting. The patient was discharged on postoperative day 5. This case has reinforced the use of dexmedetomidine as an adjunct in general surgery cases, highlighting its excellent opioid-sparing effects. In the entire patient’s hospital stay, the only dose of opioid he received was 75mcg of fentanyl at the time of anaesthetic induction. The patient suffered no opioid adverse effects such as nausea, vomiting or postoperative ileus, and pain scores varied from 0-2/10. However, intravenous lignocaine infusion was also used in this instance, which would have helped improve pain scores. Paracetamol, lignocaine, and dexmedetomidine is thus an effective, opioid-sparing combination of multi-modal analgesia for major abdominal surgery cases.

Keywords: analgesia, dexmedetomidine, general surgery, opioid sparing

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Authors: Nisrine Chlif, Mohammed Diouri, Amar Bentayeb

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Background: The Leaves of Brocchia cinerea (Vis.) (Asteraceae) is used traditionally and ethnomedicinally to alleviate pain, fever, and inflammation conditions. Objective: The current study investigates the anti-inflammatory, analgesic, and antipyretic activities of aqueous extract of the leaves of Brocchia cinerea (LBC). Material and methods: The extract was screened for anti-inflammatory (carrageenan-induced paw edema) and analgesic (acetic acid-induced writhing) activities in Wistar rats. Before acetic acid or carrageenan injection, rats were orally fed LBC (200 and 400 mg/ kg), Indomethacin (10 mg/kg), or Aspirin (100 mg/kg). The antipyretic effect was studied in brewer’s yeast-induced pyrexia model in rats using Paracetamol (100 mg/kg) as a standard drug. Results: The crude extract tested significantly prevented the increase in paw volume as compared to the control at 200 mg/kg and 400 mg/kg. The LBC treatment significantly inhibited pain at 400 mg/kg with a percent inhibition of 55.82%, as well as showing a significant reduction in hyperpyrexia in rats at 400 mg/kg. LBC extract produced a comparable activity to paracetamol at 100 mg/kg (p <0.01). Conclusion: The results of the present study that the leaves of B. cinerea extract exhibited strongly anti-inflammatory, analgesic, and antipyretic properties and justify the traditional use of this plant in inflammation, pain, and fever.

Keywords: analgesic, anti-inflammation, antipyretic, brocchia cinerea

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Authors: Sukrit Ghorai

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Proof of controlling crack width is a basic condition for securing suitable performance in serviceability limit state. The cracking in concrete can occur at any time from the casting of time to the years after the concrete has been set in place. Most codes struggle with offering procedure for crack width calculation. There is lack in availability of design charts for designers to compute crack width with ease. The focus of the study is to utilize design charts and parametric equations in calculating crack width with minimum error. The paper contains a simplified procedure to calculate crack width for reinforced concrete (RC) sections subjected to bending with axial tensile force following the guidelines of Euro code [DS EN-1992-1-1 & DS EN-1992-1-2]. Numerical examples demonstrate the application of the suggested procedure. Comparison with parallel analytical tools support the validity of result and show the percentage deviation of crack width in both the procedures. The technique is simple, user-friendly and ready to evolve for a greater spectrum of section sizes and materials.

Keywords: concrete structures, crack width calculation, serviceability limit state, structural design, bridge engineering

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Authors: Ibrahim M Hassan, Lorna Que, Michael Rutland

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Type I SOD is usually diagnosed by anatomical imaging such as ultrasound, CT and MRCP. However, the types II and III SOD yield negative results despite the presence of significant symptoms. In particular, the type III is difficult to diagnose due to the absence of significant biochemical or anatomical abnormalities. Nuclear Medicine can aid in this diagnostic dilemma by demonstrating functional changes in the bile flow. Low dose Morphine (0.04mg/Kg) stimulates the tone of the sphincter of Oddi (SO) and its usefulness has been shown in diagnosing SOD by causing a delay in bile flow when compared to a non morphine provoked - baseline scan. This work expands on that process by using sublingual GTN at 60 minutes post tracer and morphine injection to relax the SO and induce an improvement in bile outflow, and in some cases show immediate relief of morphine induced abdominal pain. The criteria for positive SOD are as follows: if during the first hour of the morphine provocation showed (1) delayed intrahepatic biliary ducts tracer accumulation; plus (2) delayed appearance but persistent retention of activity in the common bile duct, and (3) delayed bile flow into the duodenum. In addition, patients who required GTN within the first hour to relieve abdominal pain were regarded as highly supportive of the diagnosis. Retrospective analysis of 85 patients (pts) (78F and 6M) referred for suspected SOD (type III) who had been intensively investigated because of recurrent right upper quadrant or abdominal pain post cholecystectomy. 99mTc-HIDA scan with morphine-provocation is performed followed by GTN at 60 minutes post tracer injection and a further thirty minutes of dynamic imaging are acquired. 30 pts were negative. 55 pts were regarded as positive for SOD and 38/55 (60%) of these patients with an abnormal result were further evaluated with a baseline 99mTc-HIDA. As expected, all 38 pts showed better bile flow characteristics than during the morphine provocation. 20/55 (36%) patients were treated by ERCP sphincterotomy and the rest were managed conservatively by medical therapy. In all cases regarded as positive for SOD, the sublingual GTN at 60 minutes showed immediate improvement in bile flow. 11/55(20%) who developed severe post-morphine abdominal pain were relieved by GTN almost instantaneously. We propose that GTN is a useful agent in the diagnosis of SOD when performing 99mTc-HIDA scan and that the satisfactory response to the sublingual GTN could offer additional information in patients who have severe pain at the time the procedure or when presenting to the emergency unit because of biliary pain. And also in determining whether a trial of medical therapy may be used before considering surgery.

Keywords: GTN, HIDA, MORPHINE, SOD

Procedia PDF Downloads 306

Authors: Nouri Sabrina

Abstract:

Numerical parametric study is conducted to study the effects of ampoule rotation on the flows and the dopant segregation in Vertical Bridgman (VB) crystal growth. Calculations were performed in unsteady state. The extended darcy model, whıch includes the time derivative and coriolis terms, has been employed in the momentum equation. It is found that the convection, and dopant segregation can be affected significantly by ampoule rotation, and the effect is similar to that by an axial magnetıc field. Ampoule rotation decreases the intensity of convection and stretches the flow cell axıally. When the convectıon is weak, the flow can be suppressed almost completely by moderate ampoule rotation and the dopant segregation becomes diffusion-controlled. For stronger convection, the elongated flow cell by ampoule rotation may bring dopant mixing into the bulk melt reducing axial segregation at the early stage of the growth. However, if the cellular flow cannot be suppressed completely, ampoule rotation may induce larger radial segregation due to poor mixing.

Keywords: rotating vertical solidification, Finite Volume Method, heat and mass transfer, porous medium, phase change

Procedia PDF Downloads 432

Authors: Sevim Ugur, Cemile Kutmec Yilmaz, Omer Us, Sevdenur Koksaldi

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Aim: This study aims to investigate the effect of digital game playing and Internet addiction on perceived stress levels in university students. Method: The descriptive study was conducted through face-to-face interview method with a total of 364 university students studying at Aksaray University between November 15 and December 30, 2017. The research data were collected using personal information form, a questionnaire to determine the characteristics of playing digital game, the Internet addiction scale and the perceived stress scale. In the evaluation of the data, Mann-Whitney U test was used for two-group comparison of the sample with non-normal distribution, Kruskal-Wallis H-test was used in the comparison of more than two groups, and the Spearman correlation test was used to determine the relationship between Internet addiction and the perceived stress level. Results: It was determined that the mean age of the students participated in the study was 20.13 ± 1.7 years, 67.6% was female, 35.7% was sophomore, and 62.1% had an income 500 TL or less. It was found that 83.5% of the students use the Internet every day and 70.6% uses the Internet for 5 hours or less per day. Of the students, 12.4% prefers digital games instead of spending time outdoors, 8% plays a game as the first activity in leisure time, 12.4% plays all day, 15.7% feels anger when he/she is prevented from playing, 14.8% prefers playing games to get away from his/her problems, 23.4% had his/her school achievement affected negatively because of game playing, and 8% argues with family members due to the time spent for gaming. Students who play games on the computer for a long time were found to feel back pain (30.8%), headache (28.6%), insomnia (26.9%), dryness and pain in the eyes (26.6%), pain in the wrist (21.2%), feeling excessive tension and anger (16.2%), humpback (12.9), vision loss (9.6%) and pain in the wrist and fingers (7.4%). In our study, students' Internet addiction scale mean score was found to be 45.47 ± 16.1 and mean perceived stress scale score was 28.56 ± 2.7. A significant and negative correlation (p=0.037) was found between the total score of the Internet addiction scale and the total score of the perceived stress scale (r=-0.110). Conclusion: It was found in the study that Internet addiction and perceived stress of the students were at a moderate level and that there was a negative correlation between Internet addiction and perceived stress levels. Internet addiction was found to increase with the increasing perceived stress levels of students, and students were found to have health problems such as back pain, dryness in the eyes, pain, insomnia, headache, and humpback. Therefore, it is recommended to inform students about different coping methods other than spending time on the Internet to cope with the stress they perceive.

Keywords: digital game, internet addiction, student, stress level

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Authors: Abuzar Baloach

Abstract:

Spinal cord stimulators (SCS) are increasingly used for managing chronic pain, but their presence requires careful anesthetic planning. This review explores critical anesthetic considerations for patients with SCS, encompassing preoperative, intraoperative, and acute pain management, as well as specific considerations for obstetric and out-of-operating-room procedures. Preoperative Evaluation: Thorough assessment is essential, including a detailed medical history of the SCS device, such as type, manufacturer, and settings. Additionally, a complete pain history and a physical exam are necessary to understand the patient’s baseline neurological function and assess mobility, which can impact anesthesia management. Intraoperative Considerations: Electrocautery poses a risk for patients with SCS due to potential interference. Monopolar electrocautery is discouraged, but if needed, the grounding pad should be positioned away from the device, and the device itself should be turned off. The SCS device can introduce ECG artifacts and potentially interfere with pacemakers and defibrillators (ICD), which may result in inappropriate pacing or shocks. Precautions, including baseline ECG and interrogation, are recommended if both devices are present. Furthermore, lithotripsy, though generally avoided, can be performed under certain conditions with caution. Obstetric Anesthesia: While SCS devices are generally turned off during pregnancy, they have shown no interference with fetal cardiotocography, and epidural placement can be safely achieved with a sterile technique below the SCS leads. Acute Pain Considerations: SCS placement is taken into account in pain management plans, especially with neuraxial anesthesia, as potential risks include infection, limited spread due to fibrous sheaths, and damage to the SCS leads. Out-of-Operating Room Procedures: MRI, previously contraindicated, is now conditionally safe with SCS devices, depending on manufacturer specifications. CT scans are generally safe, though radiation should be minimized to prevent device malfunction. For radiation therapy, specific safety measures are recommended, such as keeping the beam at least 1 cm away from the device and limiting the dose to prevent damage. In conclusion, anesthetic management for SCS patients requires meticulous planning across all stages of care. By understanding the unique interactions and potential risks associated with SCS and other devices, healthcare providers can enhance patient safety and improve outcomes. Further research and the establishment of standardized guidelines are essential to optimize perioperative care for this growing patient population.

Keywords: anesthesia, chronic pain, spinal cord stimulator, SCS

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Authors: Xia Chen, Yulan Wang

Abstract:

purpose: To compare the accuracy of Haigis, SRK/T, T2, Holladay 1, Hoffer Q, Barrett Universal II, Emmetropia Verifying Optical (EVO) and Kane for intraocular lens power calculation in patients with axial length (AL) ≥ 28 mm. Methods: In this retrospective single-center study, 50 eyes of 41 patients with AL ≥ 28 mm that underwent uneventful cataract surgery were enrolled. The actual postoperative refractive results were compared to the predicted refraction calculated with different formulas (Haigis, SRK/T, T2, Holladay 1, Hoffer Q, Barrett Universal II, EVO and Kane). The mean absolute prediction errors (MAE) 1 month postoperatively were compared. Results: The MAE of different formulas were as follows: Haigis (0.509), SRK/T (0.705), T2 (0.999), Holladay 1 (0.714), Hoffer Q (0.583), Barrett Universal II (0.552), EVO (0.463) and Kane (0.441). No significant difference was found among the different formulas (P = .122). The Kane and EVO formulas achieved the lowest level of mean prediction error (PE) and median absolute error (MedAE) (p < 0.05). Conclusion: The Kane and EVO formulas had a better success rate than others in predicting IOL power in high myopic eyes with AL longer than 28 mm in this study.

Keywords: cataract, power calculation formulas, intraocular lens, long axial length

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Authors: Ali Abd El-Aty, Ahmed Tauseef, Ahmad Farooq

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This research aims at analyzing and optimizing the hydroforming process parameters to achieve a sound bulged tube without failure. Theoretical constitutive model is formulated to develop a working diagram including process window, which represents the optimize region to carry out the hydroforming process and predict the type of tube failure during the process accurately. The model is applied into different bulging ratios for low carbon steel (C1010). From this study, it is concluded that the tubes with bulging ratios up to 50% and 70% are successfully formed without defects. The tubes with bulging ratio of 90% are successfully formed by hydroforming with optimized the loading path (axial feed versus internal pressure) within the process window. The working diagram is modified due to different types of formation of wrinkling during the hydroforming process. The formation of wrinkles with increasing axial feed can be useful in terms of the achievement of higher bulging ratio and/or less thinning and this type of wrinkles can be overcome through the internal pressure in the later stage of the hydroforming process. On the other hand, the formation of wrinkles may be harmful, if it cannot be reversed.

Keywords: finite element, hydroforming, process window, wrinkling

Procedia PDF Downloads 280

Authors: Andrew Hwang

Abstract:

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

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

Procedia PDF Downloads 134

Authors: Tejeet Singh, Ishvneet Singh, Vinay Gupta

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The present study focussed on carrying out the creep analysis in an isotropic thick-walled composite cylindrical pressure vessel composed of aluminium matrix reinforced with silicon-carbide in particulate form. The creep behaviour of the composite material has been described by the threshold stress based creep law. The value of stress exponent appearing in the creep law was selected as 3, 5 and 8. The constitutive equations were developed using well known von-Mises yield criteria. Models were developed to find out the distributions of creep stresses and strain rate in thick-walled composite cylindrical pressure vessels under internal pressure. In order to obtain the stress distributions in the cylinder, the equilibrium equation of the continuum mechanics and the constitutive equations are solved together. It was observed that the radial stress, tangential stress and axial stress increases along with the radial distance. The cross-over was also obtained almost at the middle region of cylindrical vessel for tangential and axial stress for different values of stress exponent. The strain rates were also decreasing in nature along the entire radius.

Keywords: creep, composite, cylindrical vessel, internal pressure

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

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

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

Procedia PDF Downloads 236

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

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

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

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

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

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

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Authors: Jin Uk Han, Hye Won Han, Hyo Lim Kang, Tae An Kim, Seung Ho Han

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Direct-drive generators for large-scale wind turbine, which are divided into AFPM(Axial Flux Permanent Magnet) and RFPM(Radial Flux Permanent Magnet) type machine, have attracted interest because of a higher energy density in comparison with gear train type generators. Each type of the machines provides distinguishable geometrical features such as narrow width with a large diameter for the AFPM-type machine and wide width with a certain diameter for the RFPM-type machine. When the AFPM-type machine is applied, an increase of electric power production through a multi-stage arrangement in axial direction is easily achieved. On the other hand, the RFPM-type machine can be applied by using its geometric feature of wide width. In this study, a hybrid two-stage direct-drive generator for 6.2MW class wind turbine was proposed, in which the two-stage AFPM-type machine for 5 MW was composed of two models arranged in axial direction with a hollow shape topology of the rotor with annular disc, the stator and the main shaft mounted on coupled slew bearings. In addition, the RFPM-type machine for 1.2MW was installed at the empty space of the rotor. Analytic results obtained from an electro-magnetic and structural interaction analysis showed that the structural weight of the proposed hybrid two-stage direct-drive generator can be achieved as 155tonf in a condition satisfying the requirements of structural behaviors such as allowable air-gap clearance and strength. Therefore, it was sure that the 6.2MW hybrid two-stage direct-drive generator is competitive than conventional generators. (NRF grant funded by the Korea government MEST, No. 2017R1A2B4005405).

Keywords: AFPM-type machine, direct-drive generator, electro-magnetic analysis, large-scale wind turbine, RFPM-type machine

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

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

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

Procedia PDF Downloads 489

Authors: Mohammad Mojtahedpoor

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In this paper, it has been studied the method of optimal design of the supersonic nozzle. It could make viscous axisymmetric nozzles that the quality of their outlet flow is quite desired. In this method, it is optimized the divergent nozzle, at first. The initial divergent nozzle contour is designed through the method of characteristics and adding a suitable boundary layer to the inviscid contour. After that, it is made a proper grid and then simulated flow by the numerical solution and AUSM+ method by using the operation boundary condition. At the end, solution outputs are investigated and optimized. The numerical method has been validated with experimental results. Also, in order to evaluate the effectiveness of the present method, the nozzles compared with the previous studies. The comparisons show that the nozzles obtained through this method are sufficiently better in some conditions, such as the flow uniformity, size of the boundary layer, and obtained an axial length of the nozzle. Designing the convergent nozzle part affects by flow uniformity through changing its axial length and input diameter. The results show that increasing the length of the convergent part improves the output flow uniformity.

Keywords: nozzle, supersonic, optimization, characteristic method, CFD

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Authors: Luan Trong Nguyen, M. Azizur Rahman, Yusuke Tamenori, Toshihiro Yoshimura, Nozomu Iwasaki, Hiroshi Hasegawa

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This study investigated the distribution of magnesium (Mg), phosphorus (P), sulfur (S) and strontium (Sr) using micro X-ray fluorescence (µ-XRF) along the annual growth rings in the skeleton of Japanese red coral Paracorallium japonicum. The Mg, P and S distribution in µ-XRF mapping images correspond to the dark and light bands along the annual growth rings observed in microscopic images of the coral skeleton. The µ-XRF mapping data showed a positive correlation (r = 0.6) between P and S distribution in the coral skeleton. A contrasting distribution pattern of S and Mg along the axial skeleton of P. japonicum indicates a weak negative correlation (r = -0.2) between these two trace elements. The distribution pattern of S, P and Mg reveals linkage between their distributions and the formation of dark/light bands along the annual growth rings in the axial skeleton of P. japonicum. Sulfur and P were distributed in the organic matrix rich dark bands, while Mg was distributed in the light bands of the annual growth rings.

Keywords: µ-XRF, trace element, precious coral, Paracorallium japonicum

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

Abstract:

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

Keywords: dog, pentazocine, tramadol, ovariohysterectomy

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Authors: Tejeet Singh, Ishavneet Singh

Abstract:

The present study focused on carrying out the creep analysis in an isotropic thick-walled composite cylindrical pressure vessel composed of aluminum matrix reinforced with silicon-carbide in particulate form. The creep behavior of the composite material has been described by the threshold stress based creep law. The values of stress exponent appearing in the creep law were selected as 3, 5 and 8. The constitutive equations were developed using well known von-Mises yield criteria. Models were developed to find out the distributions of creep stress and strain rate in thick-walled composite cylindrical pressure vessels under internal pressure. In order to obtain the stress distributions in the cylinder, the equilibrium equation of the continuum mechanics and the constitutive equations are solved together. It was observed that the radial stress, tangential stress and axial stress increases along with the radial distance. The cross-over was also obtained almost at the middle region of cylindrical vessel for tangential and axial stress for different values of stress exponent. The strain rates were also decreasing in nature along the entire radius.

Keywords: steady state creep, composite, cylinder, pressure

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Authors: Sean Hall

Abstract:

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

Keywords: NanaBis, nanoCelle, opioids, toxicity

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

Abstract:

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

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

Procedia PDF Downloads 93

Authors: Marlin Mubarak

Abstract:

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

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

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

Abstract:

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

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

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Authors: Asal Pournaghshband

Abstract:

This paper presents the development of a finite element model to study the large deflection behavior of restrained stainless steel cellular beams at elevated temperature. Cellular beams are widely used for efficient utilization of raw materials to facilitate long spans with faster construction resulting sustainable design solution that can enhance the performance and merit of any construction project. However, their load carrying capacity is less than the equivalent beams without opening due to developing shear-moment interaction at the openings. In structural frames due to elements continuity, such beams are restrained by their adjoining members which has a substantial effect on beams behavior in fire. Stainless steel has also become integral part of the build environment due to its excellent corrosion resistance, whole life-cycle costs, and sustainability. This paper reports the numerical investigations into the effect of structural continuity on the thermo-mechanical performance of restrained steel beams with circle and elongated circle shapes of web opening in fire. The numerical model is firstly validated using existing numerical results from the literature, and then employed to perform a parametric study. The structural continuity is evaluated through the application of different levels of axial restraints on the response of carbon steel and stainless steel cellular beam in fire. The transit temperature for stainless steel cellular beam is shown to be less affected by the level of axial stiffness than the equivalent carbon steel cellular beam. Overall, it was established that whereas stainless steel cellular beams show similar stages of behavior of carbon steel cellular beams in fire, they are capable of withstanding higher temperatures prior to the onset of catenary action in large deflection, despite the higher thermal expansion of stainless steel material.

Keywords: axial restraint, catenary action, cellular beam, fire, numerical modeling, stainless steel, transit temperature

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Authors: Freda Halim

Abstract:

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

Keywords: acute, bowel obstruction, caecum, endometriosis

Procedia PDF Downloads 151

Authors: Khalid Mohammed Idrees

Abstract:

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

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

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Authors: Nirav Vaghela, Sanket Parekh

Abstract:

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

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

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