Search results for: fracture clinic

Authors: Michael Kassner

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Elevated-temperature creep tests were performed on additively manufactured (AM) Inconel 625 over a relatively wide range of stress. The behavior was compared to conventional wrought alloy. It was found that the steady-state creep rates of the AM alloys were comparable, or even more favorable, than that of the wrought Inconel. However, the ductility of the AM alloy was significantly less than the wrought alloy. The ductility however was recovered with hot isostatic pressing (HIP) of the AM specimens. The basis for the loss and recovery of the ductility will be discussed in terms of the differences in the details of the microstructures. In summary, it appears that HIP AM Inconel 625, over the long-term testing of a year, has very favorable mechanical properties compared to the conventional alloy.

Keywords: Inconel, creep, additive, manufacturing

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Authors: Mousa Saleh Daoud

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Rickets is a condition that affects the development of bones in children. It causes soft bones, which can become bowed or curved, this bending and curvature is evident in the age of Walking. The most common cause of rickets is dietary deficiency of vitamin D or Lack of exposure to sunlight or both together. The link between vitamin D and rickets has been known for many years and is well understood by doctors and scientists. If a child does not get enough of the vitamin D, the bones cannot form hard outer shells. This is why they become soft and weak. This study was conducted on children who reviewed by our medical clinic between the years 2011-2013. The study included 400 children, aged between one and six years. 11 children had clear clinical manifestations of rickets of varying degrees and all of them due to lack of vitamin D except for one case of rickets resistant to vitamin D. 389 cases ranged between natural and deficiency in vitamin D without clinical manifestations of Rickets.

Keywords: rickts, bone metabolic diseases, vitamin D, child

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Authors: Jifeng Zhang , Yongpeng Lei

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Continuous carbon fiber reinforced polyamide 6 (CF/PA6) composites are potential for application in the automotive industry due to their high specific strength and stiffness. However, PA6 resin is sensitive to the moisture in the hydrothermal environment and CF/PA6 composites might undergo several physical and chemical changes, such as plasticization, swelling, and hydrolysis, which induces a reduction of mechanical properties. So far, little research has been reported on the assessment of the effects of hydrothermal aging on the mechanical properties of continuous CF/PA6 composite. This study deals with the effects of hydrothermal aging on moisture absorption and mechanical properties of polyamide 6 (PA6) and polyamide 6 reinforced with continuous carbon fibers composites (CF/PA6) by immersion in distilled water at 30 ℃, 50 ℃, 70 ℃, and 90 ℃. Degradation of mechanical performance has been monitored, depending on the water absorption content and the aging temperature. The experimental results reveal that under the same aging condition, the PA6 resin absorbs more water than the CF/PA6 composite, while the water diffusion coefficient of CF/PA6 composite is higher than that of PA6 resin because of interfacial diffusion channel. In mechanical properties degradation process, an exponential reduction in tensile strength and elastic modulus are observed in PA6 resin as aging temperature and water absorption content increases. The degradation trend of flexural properties of CF/PA6 is the same as that of tensile properties of PA6 resin. Moreover, the water content plays a decisive role in mechanical degradation compared with aging temperature. In contrast, hydrothermal environment has mild effect on the tensile properties of CF/PA6 composites. The elongation at breakage of PA6 resin and CF/PA6 reaches the highest value when their water content reaches 6% and 4%, respectively. Dynamic mechanical analysis (DMA) and scanning electron microscope (SEM) were also used to explain the mechanism of mechanical properties alteration. After exposed to the hydrothermal environment, the Tg (glass transition temperature) of samples decreases dramatically with water content increase. This reduction can be ascribed to the plasticization effect of water. For the unaged specimens, the fibers surface is coated with resin and the main fracture mode is fiber breakage, indicating that a good adhesion between fiber and matrix. However, with absorbed water content increasing, the fracture mode transforms to fiber pullout. Finally, based on Arrhenius methodology, a predictive model with relate to the temperature and water content has been presented to estimate the retention of mechanical properties for PA6 and CF/PA6.

Keywords: continuous carbon fiber reinforced polyamide 6 composite, hydrothermal aging, Arrhenius methodology, interface

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Authors: Alfred Hasanaj , Ardit Gjeta, Miranda Kullolli

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The approach in analyzing defects on different pipe lines is conducted through Failure Assessment Diagram (FAD). These methods of analyses have further extended in recent years. This approach is used to identify and stress out a solution for the defects which randomly occur with gas pipes such are corrosion defects, gauge defects, and combination of defects where gauge and dents are included. Few of the defects are to be analyzed in this paper where our main focus will be the fracture of cast Iron pipes, elastic-plastic failure and plastic collapse of X52 steel pipes for gas transport. We need to conduct a calculation of probability of the defects in order to predict and avoid such costly defects.

Keywords: defects, failure assessment diagrams, steel pipes, safety factor

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Authors: Surjit Angra, Gajanan Rane, Vinod Kumar, Sushma Rani

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This paper presents metallurgical investigation of failed helical gear of diesel engine gear box used in a car. The failure had occurred near the bottomland of the tooth spacing. The failed surface was studied under Scanning Electron Microscope (SEM) and also visually investigated. The images produced through SEM at various magnifications were studied. Detailed metallurgical study indicates that failure was due to foreign material inclusion which is a casting defect. Further study also revealed pitting, spalling and inter-granular fracture as the causes of gear failure.

Keywords: helical gear, scanning electron microscope, casting defect, pitting

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Authors: Parisa Hasanpour, Bahram Borooghani, Vahid Asadi

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In the current research, a catastrophic failure of a 304 stainless steel flange at pipeline transportation of ethylene in a petrochemical refinery was studied. Cracking was found in the flange after about 78840h service. Through the chemical analysis, tensile tests in addition to microstructural analysis such as optical microscopy and Scanning Electron Microscopy (SEM) on the failed part, it found that the fatigue was responsible for the fracture of the flange, which originated from bumps and depressions on the outer surface and propagated by vibration caused by the working condition.

Keywords: failure analysis, 304 stainless steel, fatigue, flange, petrochemical refinery

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Authors: Hee Yong Kang, Hyeon Ho Shin, Jung Cheol Yoo, Il Taek Lee, Sung Mo Yang

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Lightweight technology using composites is being developed for vehicle seat structures, and its design must meet the safety requirements. According to the Federal Motor Vehicle Safety Standard (FMVSS) 207 seating systems test procedure, the back moment load is applied to the seat back frame structure for the safety evaluation of the vehicle seat. The seat back frame using the composites is divided into three parts: upper part frame, and left- and right-side frame parts following the manufacturing process. When a rear moment load is applied to the seat back frame, the side frame receives the bending load and the torsional load at the same time. This results in the largest loaded strength. Therefore, strength test of the component unit is required. In this study, a component test method based on the FMVSS 207 seating systems test procedure was proposed for the strength analysis of bending load and torsional load of the automotive Bulk Molding Compound (BMC) Seat Back Side Frame. Moreover, strength evaluation according to the carbon band reinforcement was performed. The back-side frame parts of the seat that are applied to the test were manufactured through BMC that is composed of vinyl ester Matrix and short carbon fiber. Then, two kinds of reinforced and non-reinforced parts of carbon band were formed through a high-temperature compression molding process. In addition, the structure that is applied to the component test was constructed by referring to the FMVSS 207. Then, the bending load and the torsional load were applied through the displacement control to perform the strength test for four load conditions. The results of each test are shown through the load-displacement curves of the specimen. The failure strength of the parts caused by the reinforcement of the carbon band was analyzed. Additionally, the fracture characteristics of the parts for four strength tests were evaluated, and the weakness structure of the back-side frame of the seat structure was confirmed according to the test conditions. Through the bending and torsional strength test methods, we confirmed the strength and fracture characteristics of BMC Seat Back Side Frame according to the carbon band reinforcement. And we proposed a method of testing the part strength of a seat back frame for vehicles that can meet the FMVSS 207.

Keywords: seat back frame, bending and torsional strength, BMC (Bulk Molding Compound), FMVSS 207 seating systems

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Authors: Mudafara S. Bengleil, Juma M. Orfi, Iman Abdelgader

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Since nickel is a known toxic and carcinogenic metal, the present study was designed to evaluate the level of nickel released into the saliva of orthodontic patients. Non-stimulated saliva was collected from 18 patients attending The Orthodontic Clinic of Dental Faculty of Benghazi University. Patients were divided into two groups and level of nickel was determined by atomic absorption spectrophotometry. Nickel concentration values (mg/L) in first group prior to starting treatment was 0.097± 0.071. An increase in level of nickel was followed by decrease 4 and 8 weeks after applying the arch wire (0.208± 0.112) and (0.077±0.056 mg/L) respectively. Nickel levels in saliva of the second group were showed minimal variation and ranged from 0.061± 0.044mg/L to 0.083±0.054 throughout period of study. It may be concluded that there could be a release of nickel from the appliance used in first group but it doesn't reach toxic level in saliva.

Keywords: atomic absorption spectrophotometry, nickel, orthodontic treatment, saliva, toxicity

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Authors: Razali Bin Abidin

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This paper presents the development of a portable water jet cutter for soft materials such as meat. Twelve geometries of nozzles were simulated using finite element method. Water pressure was set to 1500 lb/in². Through the simulation, highest average water output speed was 133.04 m/s. The nozzle was fabricated from Al - alloy 5052 with the Factor of Safety~ 3. This indicates that the nozzle made of Al-alloy 5052 is capable of performing the cutting process without any fracture. Preliminary design of mobile water jet hand tool is presented at the end of this paper.

Keywords: water jet, finite element, Al-alloy 5052, nozzle geometry

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Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

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Authors: Rasha F. Sharaf

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Administration of local anesthesia for a child is considered a painful procedure, which affects his vital signs, physiological parameters, and his further attitude in the dental clinic. During the extraction of mandibular molars, the nerve block technique is the most commonly used for the administration of local anesthesia; however, this technique requires deep penetration of the needle, which causes pain and discomfort for the child. Therefore, the inferior alveolar nerve block technique can be substituted with an infiltration technique which is not painful if a potent anesthetic solutions will be used. In the current study, the effect of Articaine 4% will be compared to Mepivacaine 2%, and their influence on the vital signs of the child, as well as their ability to control pain during extraction, will be assessed.

Keywords: anesthesia, articaine, pain control, extraction

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Authors: M. K. Manoj, V. Pancholi, S. K. Nath

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Microalloyed dual phase steels have been prepared by intercritical austenitisation (ICA) treatment of normalized steel at different temperature and time. Water quenching wad carried to obtain different martensite volume fraction (MVF) in DP steels. DP steels and normalized steels have been characterized by optical and scanning electron microscopy, Vickers hardness measurements and tensile properties determination. The effect of MVF and martensite morphology on mechanical properties and fracture behavior of microalloyed dual phase steels have been explained in the present work.

Keywords: dual phase steel, martensite morphology, hardness, tensile strength

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Authors: J. Ismail, F. Zaïri, M. Naït-Abdelaziz, Z. Azari

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In this work, a combined approach of continuum damage mechanics (CDM) and fracture mechanics is applied to model a glass plate behavior under static indentation. A spherical indenter is used and a CDM based constitutive model with an anisotropic damage tensor was selected and implemented into a finite element code to study the damage of glass. Various regions with critical damage values were predicted in good agreement with the experimental observations in the literature. In these regions, the directions of crack propagation, including both cracks initiating on the surface as well as in the bulk, were predicted using the strain energy density factor.

Keywords: finite element modeling, continuum damage mechanics, indentation, cracks

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Pırıl Tekin, Rızvan Erol

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Risk management has become very important and popular in developing countries in recent years. Especially making patient and employee health and safety issues compulsory in the hospitals, raised the number of studies in Turkey. Also risk management become more important for hospital senior management from clinics to the laboratories. Because quality is really important to be chosen for both patients to consult and employees to prefer to work. And also risk management studies can lead to hospital management team about future works and methods. By this point of view, this study is the risk assessment carried out in the biggest dental hospital in the south part of Turkey. This study was conducted as a research case study, covering two different health care place; A Clinic and A Laboratory. It shows that the problems in this dental hospital and how it can solve all.

Keywords: risk management, healthcare, dental hospital, quality management

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Authors: Manjinder Singh, Jasvinder Singh

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Existing theories of Titanic/Liberty ship, Sydney bridge accidents and practical experience generated an interest in developing weldments those has high toughness under sub-zero temperature conditions. The purpose was to protect the joint from undergoing DBT (Ductile to brittle transition), when ambient temperature reach sub-zero levels. Metallurgical improvement such as low carbonization or addition of deoxidization elements like Mn and Si was effective to prevent fracture in weldments (crack) at low temperature. In the present research, an attempt has been made to investigate the reason behind ductile to brittle transition of mild steel weldments when subjected to sub-zero temperatures and method of its mitigation. Nickel is added to weldments using manual metal arc welding (MMAW) preventing the DBT, but progressive reduction in charpy impact values as temperature is lowered. The variation in toughness with respect to nickel content being added to the weld pool is analyzed quantitatively to evaluate the rise in toughness value with increasing nickel amount. The impact performance of welded specimens was evaluated by Charpy V-notch impact tests at various temperatures (20 °C, 0 °C, -20 °C, -40 °C, -60 °C). Notch is made in the weldments, as notch sensitive failure is particularly likely to occur at zones of high stress concentration caused by a notch. Then the effect of nickel to weldments is investigated at various temperatures was studied by mechanical and metallurgical tests. It was noted that a large gain in impact toughness could be achieved by adding nickel content. The highest yield strength (462J) in combination with good impact toughness (over 220J at – 60 °C) was achieved with an alloying content of 16 wt. %nickel. Based on metallurgical behavior it was concluded that the weld metals solidify as austenite with increase in nickel. The microstructure was characterized using optical and high resolution SEM (scanning electron microscopy). At inter-dendritic regions mainly martensite was found. In dendrite core regions of the low carbon weld metals a mixture of upper bainite, lower bainite and a novel constituent coalesced bainite formed. Coalesced bainite was characterized by large bainitic ferrite grains with cementite precipitates and is believed to form when the bainite and martensite start temperatures are close to each other. Mechanical properties could be rationalized in terms of micro structural constituents as a function of nickel content.

Keywords: MMAW, Toughness, DBT, Notch, SEM, Coalesced bainite

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Authors: Radek Novotny, Michal Novak, Daniela Marusakova, Monika Sipova, Hugo Fuentes, Peter Borst

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This research has been conducted within the European HORIZON 2020 project ECC-SMART. The main objective is to assess whether it is feasible to design and develop a small modular reactor (SMR) that would be cooled by supercritical water (SCW). One of the main objectives for material research concerns the corrosion of the candidate cladding materials. The experimental part has been conducted in support of the qualification procedure of the future SCW-SMR constructional materials. The last objective was to identify the gaps in current norms and guidelines. Apart from corrosion, resistance testing of candidate materials stresses corrosion cracking susceptibility tests have been performed in supercritical water. This paper describes part of these tests, in particular, those slow strain rate tensile loading applied for tangential ring shape specimens of two candidate materials, Alloy 800H and 310S stainless steel. These ring tensile tests are one the methods used for tensile testing of nuclear cladding. Here full circular heads with dimensions roughly equal to the inner diameter of the sample and the gage sections are placed in the parallel direction to the applied load. Slow strain rate tensile tests have been conducted in 380 or 500oC supercritical water applying two different elongation rates, 1x10-6 and 1x10-7 s-1. The effect of temperature and dissolved oxygen content on the SCC susceptibility of Alloy 800H and 310S stainless steel was investigated when two different temperatures and concentrations of dissolved oxygen were applied in supercritical water. The post-fracture analysis includes fractographic analysis of the fracture surfaces using SEM as well as cross-sectional analysis on the occurrence of secondary cracks. Assessment of the effect of environment and dissolved oxygen content was by comparing to the results of the reference tests performed in air and N2 gas overpressure. The effect of high temperature on creep and its role in the initiation of SCC was assessed as well. It has been concluded that the applied test method could be very useful for the investigation of stress corrosion cracking susceptibility of candidate cladding materials in supercritical water.

Keywords: stress corrosion cracking, ring tensile tests, super-critical water, alloy 800H, 310S stainless steel

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Authors: Gaokai Liu

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The distribution of material grain sizes reflects the strength, fracture, corrosion and other properties, and the grain size can be acquired via the grain boundary. In recent years, the automatic grain boundary detection is widely required instead of complex experimental operations. In this paper, an effective solution is applied to acquire the grain boundary of material images. First, the initial superpixel segmentation result is obtained via a superpixel approach. Then, a region merging method is employed to merge adjacent regions based on certain similarity criterions, the experimental results show that the merging strategy improves the superpixel segmentation result on material datasets.

Keywords: grain boundary detection, image segmentation, material images, region merging

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Authors: Jim S. Meng, Mammo H. Yewondwossen

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As a part of routine oesophageal HDR brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms, and the treatment may need to be aborted. A pre-prepared plan generated before the patient’s sedation may reduce the brachytherapy procedure time by forty minutes. This paper reports the rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirm that all of the pre-prepared plans would be acceptable. The rationality of pre-prepared HDR brachytherapy plans is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. This argument holds also for endobronchial HDR brachytherapy. With the above evidence, pre-prepared plans have been used for all oesophagus and bronchus HDR brachytherapy cases in our clinic.

Keywords: HDR brachytherapy, treatment planning, oesophageal carcinoma, pre-planning

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Authors: G. M. Dominguez Almaraz, J. A. Ruiz Vilchez, M. A. Sanchez Miranda

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Ultrasonic fatigue tests have been carried out in the maraging 300 steel. Experimental results show that fatigue endurance under this modality of testing is closely related to the nature and geometrical properties of inclusions present in this alloy. A model was proposed to correlate the ultrasonic fatigue endurance with the nature and geometrical properties of the crack initiation inclusion. Scanning Electron Microscopy analyses were obtained on the fracture surfaces, in order to assess the crack initiation inclusion and to introduce these parameters in the proposed model, with good agreement for the fatigue life prediction.

Keywords: inclusions, ultrasonic fatigue, maraging 300 steel, crack initiation

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Authors: Adnan Zaid

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Stress corrosion cracking (SCC) may be defined as a degradation of the mechanical properties of a material under the combined action of a tensile stress and corrosive environment of the susceptible material. It is a harmful phenomenon which might cause catastrophic fracture without a sign of prior warning. In this paper, the stress corrosion cracking, SCC, process, the parameters affecting it, and the different damages caused by it are given and discussed. Utilization of shot peening as a mean of enhancing the resistance of materials to SCC is given and discussed. Finally, a method for improving materials resistance to SCC by grain refining its structure by some refining elements prior to usage is suggested.

Keywords: stress corrosion cracking, parameters, damages, treatment methods

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Authors: Seyed M. Zahrai, Saeid Lotfi

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If an infill panel does not have enough ductility against the loading, it breaks and gets damaged before depreciation and load transfer. As steel infill panel has appropriate ductility before fracture, it can be used as an alternative to typical infill panels under blast loading. Concerning enough ductility of out-of-plane behavior the infill panel, the impact force enters the horizontal diaphragm and is distributed among the lateral elements which can be made from steel infill panels. This article investigates the behavior of steel infill panels with different thickness and stiffeners using finite element analysis with geometric and material nonlinearities for optimization of the steel plate thickness and stiffeners arrangement to obtain more efficient design for its out-of-plane behavior.

Keywords: blast loading, ductility, maximum displacement, steel infill panel

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Authors: Aarti M. Shetty, Estela Davoodi, Subrata Gangooly, Anita Rao-Coppisetty

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Background: Testing Patency of Fallopian Tubes is among one of the several protocols for investigating Subfertile Couples. Both, Hysterosalpingogram (HSG) and Laparoscopy and dye test have been used as Tubal patency test for several years, with well-known limitation. Hysterosalpingo Contrast Sonography (HyCoSy) can be used as an alternative tool to HSG, to screen patency of Fallopian tubes, with an advantage of being non-ionising, and also, use of transvaginal scan to diagnose pelvic pathology. Aim: To determine the indication and analyse the performance of transvaginal scan and HyCoSy in Broomfield Hospital. Methods: We retrospectively analysed fertility workup of 282 women, who attended HyCoSy clinic at our institution from January 2015 to June 2016. An Audit proforma was designed, to aid data collection. Data was collected from patient notes and electronic records, which included patient demographics; age, parity, type of subfertility (primary or secondary), duration of subfertility, past medical history and base line investigation (hormone profile and semen analysis). Findings of the transvaginal scan, HyCoSy and Laparoscopy were also noted. Results: The most common indication for referral were as a part of primary fertility workup on couples who had failure to conceive despite intercourse for a year, other indication for referral were recurrent miscarriage, history of ectopic pregnancy, post reversal of sterilization(vasectomy and tuboplasty), Post Gynaecology surgery(Loop excision, cone biopsy) and amenorrhea. Basic Fertility workup showed 34% men had abnormal semen analysis. HyCoSy was successfully completed in 270 (95%) women using ExEm foam and Transvaginal Scan. Of the 270 patients, 535 tubes were examined in total. 495/535 (93%) tubes were reported as patent, 40/535 (7.5%) tubes were reported as blocked. A total of 17 (6.3%) patients required laparoscopy and dye test after HyCoSy. In these 17 patients, 32 tubes were examined under laparoscopy, and 21 tubes had findings similar to HyCoSy, with a concordance rate of 65%. In addition to this, 41 patients had some form of pelvic pathology (endometrial polyp, fibroid, cervical polyp, fibroid, bicornuate uterus) detected during transvaginal scan, who referred to corrective surgeries after attending HyCoSy Clinic. Conclusion: Our audit shows that HyCoSy and Transvaginal scan can be a reliable screening test for low risk women. Furthermore, it has competitive diagnostic accuracy to HSG in identifying tubal patency, with an additional advantage of screening for pelvic pathology. With addition of 3D Scan, pulse Doppler and other non-invasive imaging modality, HyCoSy may potentially replace Laparoscopy and chromopertubation in near future.

Keywords: hysterosalpingo contrast sonography (HyCoSy), transvaginal scan, tubal infertility, tubal patency test

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Authors: Melissa K. Hord, Stephen P. Whiteside

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With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

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Authors: A. Benhamena, L. Aminallah, A. Aid, M. Benguediab, A. Amrouche

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The goal of this work is to analyze the severity of interfacial stress distribution in the single lap adhesive joint under tensile loading. The three-dimensional and non-linear finite element method based on the computation of the peel and shear stresses was used to analyze the fracture behaviour of single lap adhesive joint. The effect of the loading magnitude and the overlap length on the distribution of peel and shear stresses was highlighted. A good correlation was found between the FEM simulations and the analytical results.

Keywords: aluminum 2024-T3 alloy, single-lap adhesive joints, Interface stress distributions, material nonlinear analysis, adhesive, bending moment, finite element method

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Authors: Sahar El Kasmi, Ayoub Aziz, Saadia Lharti, Mohammed El Janati, Boubker Boukili, Nacer El Motawakil, Mayom Chol Luka Awan

Abstract:

Two types of geomaterials (Red Triassic clay from the Maaziz region and Yellow Pliocene clay from the Akrach region) were used to create different mixtures for the fabrication of ceramic bricks. This study investigated the influence of the Pliocene clay on the overall composition and mechanical properties of the Triassic clay. The red Triassic clay, sourced from Maaziz, underwent various mechanical processes and treatments to facilitate its transformation into ceramic bricks for construction. The triassic clay was subjected to a drying chamber and a heating chamber at 100°C to remove moisture. Subsequently, the dried clay samples were processed using a Planetary Babs ll Mill to reduce particle size and improve homogeneity. The resulting clay material was sieved, and the fine particles below 100 mm were collected for further analysis. In parallel, the Miocene marl obtained from the Akrach region was fragmented into finer particles and subjected to similar drying, grinding, and sieving procedures as the triassic clay. The two clay samples are then amalgamated and homogenized in different proportions. Precise measurements were taken using a weighing balance, and mixtures of 90%, 80%, and 70% Triassic clay with 10%, 20%, and 30% yellow clay were prepared, respectively. To evaluate the impact of Pliocene marl on the composition, the prepared clay mixtures were spread evenly and treated with a water modifier to enhance plasticity. The clay was then molded using a brick-making machine, and the initial manipulation process was observed. Additional batches were prepared with incremental amounts of Pliocene marl to further investigate its effect on the fracture behavior of the clay, specifically their resistance. The molded clay bricks were subjected to compression tests to measure their strength and resistance to deformation. Additional tests, such as water absorption tests, were also conducted to assess the overall performance of the ceramic bricks fabricated from the different clay mixtures. The results were analyzed to determine the influence of the Pliocene marl on the strength and durability of the Triassic clay bricks. The results indicated that the incorporation of Pliocene clay reduced the fracture of the triassic clay, with a noticeable reduction observed at 10% addition. No fractures were observed when 20% and 30% of yellow clay are added. These findings suggested that yellow clay can enhance the mechanical properties and structural integrity of red clay-based products.

Keywords: triassic clay, pliocene clay, mineralogical composition, geo-materials, ceramics, akach region, maaziz region, morocco.

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Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

Abstract:

The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

Procedia PDF Downloads 288

Authors: Y. Atilgan Şengül

Abstract:

Health information technologies promise higher quality, safer care and much more for both patients and professionals. Despite their promise, they are costly to develop and difficult to implement. On the other hand, user acceptance and usage determine the success of implemented information technology in healthcare. This study provides a model to understand health professionals’ perception and expectation of health information technology. Extensive literature review has been conducted to determine the main factors to be measured. A questionnaire has been designed as a measurement model and submitted to the personnel of an in vitro fertilization clinic. The respondents’ degree of agreement according to five-point Likert scale was 72% for convenient access to data and 69.4% for the importance of data security. There was a significant difference in acceptance of electronic data storage for female respondents. Also, other significant differences between professions were obtained.

Keywords: healthcare, health informatics, medical record system, questionnaire

Procedia PDF Downloads 152

Authors: Ariyan S. Araghi, Guy C. Jackson, Stephen J. Bonsor

Abstract:

Materials & Methods: A systematic literature search was undertaken using pre-determined inclusion and exclusion criteria. This review followed the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) statement. Several databases were used to search for randomised control trials and longitudinal cohort studies, which were published less than thirty years ago. A total of 54 studies met the predefined inclusion criteria. Four studies reviewed the success, survival, and failure characteristics of zirconia framework resin retained bridges, whilst two reviewed non-precious metal resin retained bridges. Results: The analysis of the studies revealed an overall survival rate of 95.9% for zirconia-based restorations compared to 90.7% for non-precious metal frameworks. Non-precious metal resin retained bridges displayed a higher overall failure rate of 11.9% compared to 4.6% for zirconia-based restorations in the analysed papers. The most frequent complications were wing debonding for the non-precious metal wing group, whereas substructure fracture and veneering ceramic fracture were more prevalent for the zirconia arm of the study. Conclusion: Both types of resin retained bridges provide effective medium to long-term survival. Zirconia-based frameworks will provide marginally increased success and survival and greatly improved aesthetics. However, catastrophic failure is more likely with zirconia-based restorations. Non-precious metal is time tested but performs worse than its zirconia counterpart with regards to longevity; it does not exhibit the same framework fractures as zirconia. Cement choice and attention to the adhesive bonding systems used appear to be paramount to restoration longevity with both restoration subtypes. Furthermore, improved longevity can be seen when air particle abrasion is incorporated into the adhesive protocol. Within the limitations of this study, it has been determined that zirconia-based resin retained bridges can be effectively used in anterior cantilever bridges. Clinical Significance: Zirconia-based resin retained bridges have been demonstrating promising results in terms of improved success and survival characteristics, together with improved aesthetics when compared to non-precious metal winged resin retained bridges. Their popularity is increasing in the age of digital dentistry as many restorations are manufactured using such technology. It is essential that clinicians understand the limitations of each material type and principles of adhesion to ensure restoration longevity.

Keywords: resin retained bridge, fixed partial denture, zirconia bridge, adhesive bridge

Procedia PDF Downloads 67

Authors: Aakriti Lohiya

Abstract:

Sigmund Freud’s clinical theories were deeply influenced by his childhood and his environment before his exile in England. In this article, the author illuminates his different works and the metaphors in them. The clinical relevance of Freud’s theories is much disputed and chatted but rarely has any psychoanalytic writing touched upon the way in which his theories are linked with life experiences. Exploring the metaphors in Freud’s theories will take us into the uncharted paths of how the experience of life events meets experience in the clinic. A sincere and critical reflection of the ideas proposed by Freud would certainly help us to locate its unfamiliar stages. Many of his theories and ideas attempted to create contact with his early childhood experiences. Freud was Jewish by birth but atheist by nature, which was reflected in many of his theories. The ways in which Freud theorizes the psychosexual development of a being and many of his mammoth theories are elucidated in this study. On the other hand, some of his ideas remain a challenge, which requires remembering, restating, and functioning through the clinical and mystical elements in his writing.

Keywords: sigmund freud, exile, psychoanalytic theory, metaphor, psychosexual theory

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