Search results for: guided bone regeneration technique
7879 Transorbital Craniectomy for Treatment of Frontal Lobe and Olfactory Bulb Neoplasia in Two Canids
Authors: Kathryn L. Duncan, Charles A. Kuntz, James O. Simcock
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A surgical approach to the cranium for treatment of frontal lobe and olfactory bulb neoplasia in dogs is described in this report, which provided excellent access for visualisation and removal of gross neoplastic tissue. An 8-year-old spayed female Shih Tzu crossbreed dog (dog 1) and a 13-year-old neutered male Miniature Fox Terrier (dog 2) were evaluated for removal of neoplasms involving both the frontal lobe and olfactory bulb. Both dogs presented with abnormal neurological clinical signs, decreased menace responses, and behavioural changes. Additionally, dog 2 presented with compulsive circling and generalized tonic-clonic seizure activity. Computed tomography was performed in both dogs, and MRI was also performed in dog 1. Imaging was consistent with frontal lobe and olfactory bulb neoplasia. A transorbital frontal bone craniectomy, with orbital ligament desmotomy and ventrolateral retraction of the globe, was performed in both cases without complication. Dog 1 had a focal area of lysis in the frontal bone adjacent to the neoplasm in the frontal lobe. The presence of the bone defect provided part of the impetus for this approach, as it would permit resection of the lytic bone. In addition, the neoplasms would be surgically accessible without encountering interposed brain parenchyma, reducing the risk of iatrogenic injury. Both dogs were discharged from the hospital within 72 hours post-operatively, both with normal mentation. Case 1 had a histopathologic diagnosis of malignant anaplastic neoplasm. The tumour recurred 101d postoperatively, and the patient was euthanized. Case 2 was diagnosed with a meningioma and was neurologically normal at 294d postoperatively. This transorbital surgical approach allowed successful removal of the intracranial frontal lobe and olfactory bulb neoplasms in 2 dogs. This approach should be considered for dogs with lateralized frontal lobe and olfactory bulb neoplasms that are closely associated with the suborbital region of the frontal bone.Keywords: neurosurgery, small animal surgery, surgical oncology, veterinary neurology
Procedia PDF Downloads 1527878 Investigation of Cytotoxic Compounds in Ethyl Acetate and Chloroform Extracts of Nigella sativa Seeds by Sulforhodamine-B Assay-Guided Fractionation
Authors: Harshani Uggallage, Kapila D. Dissanayaka
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A Sulforhodamine-B assay-guided fractionation on Nigella sativa seeds was conducted to determine the presence of cytotoxic compounds against human hepatoma (HepG2) cells. Initially, a freeze-dried sample of Nigella sativa seeds was sequentially extracted into solvents of increasing polarities. Crude extracts from the sequential extraction of Nigella sativa seeds in chloroform and ethyl acetate showed the highest cytotoxicity. The combined mixture of these two extracts was subjected to bioassay guided fractionation using a modified Kupchan method of partitioning, followed by Sephadex® LH-20 chromatography. This chromatographic separation process resulted in a column fraction with a convincing IC50 (half-maximal inhibitory concentration) value of 13.07µg/ml, which is considerable for developing therapeutic drug leads against human hepatoma. Reversed phase High-Performance Liquid Chromatography (HPLC) was finally conducted for the same column fraction, and the result indicates the presence of one or several main cytotoxic compounds against human HepG2 cells.Keywords: cytotoxic compounds, half-maximal inhibitory concentration, high-performance liquid chromatography, human HepG2 cells, nigella sativa seeds, Sulforhodamine-B assay
Procedia PDF Downloads 4037877 Numerical Investigation on Feasibility of Electromagnetic Wave as Water Hardness Detection in Water Cooling System Industrial
Authors: K. H. Teng, A. Shaw, M. Ateeq, A. Al-Shamma'a, S. Wylie, S. N. Kazi, B. T. Chew
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Numerical and experimental of using novel electromagnetic wave technique to detect water hardness concentration has been presented in this paper. Simulation is powerful and efficient engineering methods which allow for a quick and accurate prediction of various engineering problems. The RF module is used in this research to predict and design electromagnetic wave propagation and resonance effect of a guided wave to detect water hardness concentration in term of frequency domain, eigenfrequency, and mode analysis. A cylindrical cavity resonator is simulated and designed in the electric field of fundamental mode (TM010). With the finite volume method, the three-dimensional governing equations were discretized. Boundary conditions for the simulation were the cavity materials like aluminum, two ports which include transmitting and receiving port, and assumption of vacuum inside the cavity. The design model was success to simulate a fundamental mode and extract S21 transmission signal within 2.1 – 2.8 GHz regions. The signal spectrum under effect of port selection technique and dielectric properties of different water concentration were studied. It is observed that the linear increment of magnitude in frequency domain when concentration increase. The numerical results were validated closely by the experimentally available data. Hence, conclusion for the available COMSOL simulation package is capable of providing acceptable data for microwave research.Keywords: electromagnetic wave technique, frequency domain, signal spectrum, water hardness concentration
Procedia PDF Downloads 2727876 Media Literacy Development: A Methodology to Systematically Integrate Post-Contemporary Challenges in Early Childhood Education
Authors: Ana Mouta, Ana Paulino
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The following text presents the ik.model, a theoretical framework that guided the pedagogical implementation of meaningful educational technology-based projects in formal education worldwide. In this paper, we will focus on how this framework has enabled the development of media literacy projects for early childhood education during the last three years. The methodology that guided educators through the challenge of systematically merging analogic and digital means in dialogic high-quality opportunities of world exploration is explained throughout these lines. The effects of this methodology on early age media literacy development are considered. Also considered is the relevance of this skill in terms of post-contemporary challenges posed to learning.Keywords: early learning, ik.model, media literacy, pedagogy
Procedia PDF Downloads 3247875 The Heritagisation of the Titanic Culture for Urban Regeneration Use: A Case Study of the Titanic Belfast
Authors: Yu Liang
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The study of heritage in different contexts has been discussed during the past decades, which the relationship with other fields such as tourism, museum, and urban regeneration has also been interested in scholars. Governmental and policy attention were also fascinated by the use of heritage, which it is a ‘heritagisation’ process, to achieve certain goals because the advantage will appear in both economic development and social inclusion with suitable planning. In the case of Belfast, this city has been through tough ages due to its complicated ideology issues in the past; however, it is obvious to see the transformation through representing their Belfast heritages in tourism. Planners are willing to use this method to attract cultural tourists, investors and also residents to reborn and retrieve their confidence. One of the target topics is the establishment of Titanic Belfast that explores the culture of Titanic and the history of the shipbuilding industry in Belfast. Even though the cultural flagship brought economic and social benefit, not all of the people agreed on the vision of relaunching a sunken ship and felt proud of it. The aim of this research is to clarify the concept of a ‘heritagisation’ that it could achieve certain goals in consolidating areas, increasing local self-identity pride, and promoting tourism activities if well-planned. Moreover, to discuss the preference and the pros and cons of its practice with the Titanic culture in Belfast’s regeneration process, especially the Titanic Belfast flagship project. From the methodological point of view, a mixed incorporating qualitative point of interviews, observation, and secondary sources with different perspectives and approaches are adopted in this case study. The expected result would show that a great majority of outsiders and the planners were pleasured about the concept of Titanic Belfast’s establishment and agreed its attraction traveling to Belfast. Nevertheless, there were still an amount of locals disagree that the Titanic culture and the flagship would be representative of this city and would bring other advantages to them. In other words, some residents doubt or less likely to support the issue since they have been ignored out of the planning process. Hence, opinions are divided among 38 residents, various outsiders, and stakeholders, and their perspectives have drawn an interesting task for sustainable research in the future.Keywords: Belfast, heritagisation, Titanic, Titanic Belfast, urban regeneration
Procedia PDF Downloads 3157874 Lamb Waves Wireless Communication in Healthy Plates Using Coherent Demodulation
Authors: Rudy Bahouth, Farouk Benmeddour, Emmanuel Moulin, Jamal Assaad
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Guided ultrasonic waves are used in Non-Destructive Testing (NDT) and Structural Health Monitoring (SHM) for inspection and damage detection. Recently, wireless data transmission using ultrasonic waves in solid metallic channels has gained popularity in some industrial applications such as nuclear, aerospace and smart vehicles. The idea is to find a good substitute for electromagnetic waves since they are highly attenuated near metallic components due to Faraday shielding. The proposed solution is to use ultrasonic guided waves such as Lamb waves as an information carrier due to their capability of propagation for long distances. In addition to this, valuable information about the health of the structure could be extracted simultaneously. In this work, the reliable frequency bandwidth for communication is extracted experimentally from dispersion curves at first. Then, an experimental platform for wireless communication using Lamb waves is described and built. After this, coherent demodulation algorithm used in telecommunications is tested for Amplitude Shift Keying, On-Off Keying and Binary Phase Shift Keying modulation techniques. Signal processing parameters such as threshold choice, number of cycles per bit and Bit Rate are optimized. Experimental results are compared based on the average Bit Error Rate. Results have shown high sensitivity to threshold selection for Amplitude Shift Keying and On-Off Keying techniques resulting a Bit Rate decrease. Binary Phase Shift Keying technique shows the highest stability and data rate between all tested modulation techniques.Keywords: lamb waves communication, wireless communication, coherent demodulation, bit error rate
Procedia PDF Downloads 2607873 Bone Mineral Density in Type 2 Diabetes Mellitus Postmenopausal Egyptian Female Patients: Correlation with Fetuin-A Level and Metabolic Parameters
Authors: Ahmed A. M. Shoaib, Heba A. Esaily, Mahmoud M. Emara, Eman A. E. Badr, Amany S. Khalifa, Mayada M. M., Abdel-Raizk
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Background: DM is associated with metabolic bone diseases, osteoporosis, low-impact fractures and falls in geriatrics. Fetuin-A, which is a serum protein produced by the liver and promotes bone mineralization, is an independent risk factor for type 2 diabetes. Aim: Evaluation of fetuin-A level and bone mineral density in postmenopausal Egyptian female patients with type 2 diabetes mellitus and their correlation with each other & with other metabolic parameters. Patients and methods: Seventy postmenopausal female patients with type II diabetes and thirty postmenopausal female as control were included in this study. Measurement of Fetuin-A together with metabolic parameters and DXA in wrist, hip and spine, ALP, CBC, FBS, PP2H and HBA1c was done in all participants. Results: - Fetuin-A level was found to be highly significant (p< 0.001) between diabetic and nondiabetic groups and negatively correlated with BMD in spine. No difference in BMD was found between patients and control groups while significant negative correlation was found between FBS and hip BMD (<0.05) and between 2hpp and HBA1c with spine BMD in the diabetic group (<0.05). Osteoporosis represented 12.9% in spine area and 7.2% in hip and wrist areas in diabetic patients, while osteopenia were found in 58.5%, 57.1%, and 37.1% in diabetic patients in spine, wrist, and hip respectively. Conclusion: - type II diabetes cannot be considered as a risk factor for osteoporosis; while glycemic parameters (FBS, 2hpp & HBA1c) and serum Fetuin-A levels were correlated with BMD in diabetics. Good glycemic control can be protective against osteoporosis in diabetic elderly.Keywords: fetuin-A, BMD, postmenopausal, DM type II
Procedia PDF Downloads 2677872 The Role of Homocysteine in Bone and Cartilage Regeneration
Authors: Arif İsmailov, Naila Hasanova, Gunay Orujalieva
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Homocysteine (HCY) is an indicator of prognostic value in monitoring regenerative processes in osteoporosis and osteoporotic fractures. The osteoporosis is known to be a serious health and economic problem, especially for women in the postmenopausal period. The study was carried out on patients 45-83 years old divided into 3 groups: group I – 14 patients with osteoporosis , group II – 15 patients with non-osteoporotic fractures, group III – 25 patients with osteoporotic fractures. The control group consisted of practically healthy 14 people. A blood sample was taken at 3 stages to monitor the dynamics of HCY level: on the 1st day before treatment, on the 10th day of treatment and 1 month after it. Blood levels of Hcy were determined at a wavelength of 450 nm by the ELİSA(Cloud Clone Corp.Elisa kits,USA). The statistical evaluation was performed by using SPSS 26.0 program (IBM SPSS Inc., USA).The results showed that on the 1st day before the treatment HCY concentration was statistically increased 2.7 times(PU = 0.108) in group I, 5.6 times (PU <0.001) in group II and 6.5 times (PU <0.001) in group III compared to the control group. Thus, the average value of HCY in group I was 1.76 ± 0.56 μg/ml; in group II – 3.57 ± 0.62 μg/ml; in group III – 4.2 ± 0.50 μg/ml. HCY level increases more sharply after fractures,especially in osteoporotic patients. In treatment period Vitamin D plays an important role in synthesis of the Cystathionine β‐synthase enzyme, which regulates HCY metabolism. Increased Hcy levels could lead to an increase in the risk of fracture through the interference in collagen cross-linking.Keywords: homocysteine, osteoporosis, osteoporotic fractures, Vitamin D
Procedia PDF Downloads 607871 A Cephalometric Superimposition of a Skeletal Class III Orthognathic Patient on Nasion-Sella Line
Authors: Albert Suryaprawira
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The Nasion-Sella Line (NSL) has been used for several years as a reference line in longitudinal growth study. Therefore this line is considered to be stable not only to evaluate treatment outcome and to predict relapse possibility but also to manage prognosis. This is a radiographic superimposition of an adult male aged 19 years who complained of difficulty in aesthetic, talking and chewing. Patient has a midface hypoplasia profile (concave). He was diagnosed to have a severe Skeletal Class III with Class III malocclusion, increased lower vertical height, and an anterior open bite. A pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. A panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, a pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, a post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition using NSL as a reference line between those radiographs was performed to analyse the outcome. It is important to describe the amount of hard and soft tissue movement and to predict the possibility of relapse after the surgery. The patient also needs to understand all the surgical plan, outcome and relapse prevention. The surgical management included maxillary impaction and advancement of Le Fort I osteotomy. The evaluation using NSL as a reference was a very useful method in determining the outcome and prognosis.Keywords: Nasion-Sella Line, midface hypoplasia, Le Fort 1, maxillary advancement
Procedia PDF Downloads 1427870 Impact of Work Cycles on Autonomous Digital Learning
Authors: Bi̇rsen Tutunis, Zuhal Aydin
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Guided digital learning has attracted many researchers as it leads to autonomous learning.The developments in Guided digital learning have led to changes in teaching and learning in English Language Teaching classes (Jeong-Bae, 2014). This study reports on tasks designed under the principles of learner autonomy in an online learning platform ‘’Webquest’’ with the purpose of teaching English to Turkish tertiary level students at a foundation university in Istanbul. Guided digital learning blog project contents were organized according to work-cycles phases (planning and negotiation phase, decision-making phase, project phase and evaluation phase) which are compatible with the principles of autonomous learning (Legenhausen,2003). The aim of the study was to implement the class blog project to find out its impact on students’ behaviours and beliefs towards autonomous learning. The mixed method research approach was taken. 24 tertiary level students participated in the study on voluntary basis. Data analysis was performed with Statistical Package for the Social Sciences. According to the results, students' attitudes towards digital learning did not differ before and after the training application. The learning styles of the students and their knowledge on digital learning scores differed. It has been observed that the students' learning styles and their digital learning scores increased after the training application. Autonomous beliefs, autonomous behaviors, group cohesion and group norms differed before and after the training application. Students' motivation level, strategies for learning English, perceptions of responsibility and out-of-class activity scores differed before and after the training application. It was seen that work-cycles in online classes create student centered learning that fosters autonomy. This paper will display the work cycles in detail and the researchers will give examples of in and beyond class activities and blog projects.Keywords: guided digital learning, work cycles, english language teaching, autonomous learning
Procedia PDF Downloads 787869 Polymeric Microspheres for Bone Tissue Engineering
Authors: Yamina Boukari, Nashiru Billa, Andrew Morris, Stephen Doughty, Kevin Shakesheff
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Poly (lactic-co-glycolic) acid (PLGA) is a synthetic polymer that can be used in bone tissue engineering with the aim of creating a scaffold in order to support the growth of cells. The formation of microspheres from this polymer is an attractive strategy that would allow for the development of an injectable system, hence avoiding invasive surgical procedures. The aim of this study was to develop a microsphere delivery system for use as an injectable scaffold in bone tissue engineering and evaluate various formulation parameters on its properties. Porous and lysozyme-containing PLGA microspheres were prepared using the double emulsion solvent evaporation method from various molecular weights (MW). Scaffolds were formed by sintering to contain 1 -3mg of lysozyme per gram of scaffold. The mechanical and physical properties of the scaffolds were assessed along with the release of lysozyme, which was used as a model protein. The MW of PLGA was found to have an influence on microsphere size during fabrication, with increased MW leading to an increased microsphere diameter. An inversely proportional relationship was displayed between PLGA MW and mechanical strength of formed scaffolds across loadings for low, intermediate and high MW respectively. Lysozyme release from both microspheres and formed scaffolds showed an initial burst release phase, with both microspheres and scaffolds fabricated using high MW PLGA showing the lowest protein release. Following the initial burst phase, the profiles for each MW followed a similar slow release over 30 days. Overall, the results of this study demonstrate that lysozyme can be successfully incorporated into porous PLGA scaffolds and released over 30 days in vitro, and that varying the MW of the PLGA can be used as a method of altering the physical properties of the resulting scaffolds.Keywords: bone, microspheres, PLGA, tissue engineering
Procedia PDF Downloads 4257868 Dynamic Conformal Arc versus Intensity Modulated Radiotherapy for Image Guided Stereotactic Radiotherapy of Cranial Lesion
Authors: Chor Yi Ng, Christine Kong, Loretta Teo, Stephen Yau, FC Cheung, TL Poon, Francis Lee
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Purpose: Dynamic conformal arc (DCA) and intensity modulated radiotherapy (IMRT) are two treatment techniques commonly used for stereotactic radiosurgery/radiotherapy of cranial lesions. IMRT plans usually give better dose conformity while DCA plans have better dose fall off. Rapid dose fall off is preferred for radiotherapy of cranial lesions, but dose conformity is also important. For certain lesions, DCA plans have good conformity, while for some lesions, the conformity is just unacceptable with DCA plans, and IMRT has to be used. The choice between the two may not be apparent until each plan is prepared and dose indices compared. We described a deviation index (DI) which is a measurement of the deviation of the target shape from a sphere, and test its functionality to choose between the two techniques. Method and Materials: From May 2015 to May 2017, our institute has performed stereotactic radiotherapy for 105 patients treating a total of 115 lesions (64 DCA plans and 51 IMRT plans). Patients were treated with the Varian Clinac iX with HDMLC. Brainlab Exactrac system was used for patient setup. Treatment planning was done with Brainlab iPlan RT Dose (Version 4.5.4). DCA plans were found to give better dose fall off in terms of R50% (R50% (DCA) = 4.75 Vs R50% (IMRT) = 5.242) while IMRT plans have better conformity in terms of treatment volume ratio (TVR) (TVR(DCA) = 1.273 Vs TVR(IMRT) = 1.222). Deviation Index (DI) is proposed to better facilitate the choice between the two techniques. DI is the ratio of the volume of a 1 mm shell of the PTV and the volume of a 1 mm shell of a sphere of identical volume. DI will be close to 1 for a near spherical PTV while a large DI will imply a more irregular PTV. To study the functionality of DI, 23 cases were chosen with PTV volume ranged from 1.149 cc to 29.83 cc, and DI ranged from 1.059 to 3.202. For each case, we did a nine field IMRT plan with one pass optimization and a five arc DCA plan. Then the TVR and R50% of each case were compared and correlated with the DI. Results: For the 23 cases, TVRs and R50% of the DCA and IMRT plans were examined. The conformity for IMRT plans are better than DCA plans, with majority of the TVR(DCA)/TVR(IMRT) ratios > 1, values ranging from 0.877 to1.538. While the dose fall off is better for DCA plans, with majority of the R50%(DCA)/ R50%(IMRT) ratios < 1. Their correlations with DI were also studied. A strong positive correlation was found between the ratio of TVRs and DI (correlation coefficient = 0.839), while the correlation between the ratio of R50%s and DI was insignificant (correlation coefficient = -0.190). Conclusion: The results suggest DI can be used as a guide for choosing the planning technique. For DI greater than a certain value, we can expect the conformity for DCA plans to become unacceptably great, and IMRT will be the technique of choice.Keywords: cranial lesions, dynamic conformal arc, IMRT, image guided radiotherapy, stereotactic radiotherapy
Procedia PDF Downloads 2417867 The Effect of Screw Parameters on Pullout Strength of Screw Fixation in Cervical Spine
Authors: S. Ritddech, P. Aroonjarattham, K. Aroonjarattham
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The pullout strength had an effect on the stability of plate screw fixation when inserted in the cervical spine. Nine different titanium alloy bone screws were used to test the pullout strength through finite element analysis. The result showed that the Moss Miami I can bear the highest pullout force at 1,075 N, which causes the maximum von Mises stress at 858.87 MPa, a value over the yield strength of titanium. The bone screw should have large outer diameter, core diameter and proximal root radius to increase the pullout strength.Keywords: pullout strength, screw parameter, cervical spine, finite element analysis
Procedia PDF Downloads 2947866 Multiparametric Optimization of Water Treatment Process for Thermal Power Plants
Authors: Balgaisha Mukanova, Natalya Glazyrina, Sergey Glazyrin
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The formulated problem of optimization of the technological process of water treatment for thermal power plants is considered in this article. The problem is of multiparametric nature. To optimize the process, namely, reduce the amount of waste water, a new technology was developed to reuse such water. A mathematical model of the technology of wastewater reuse was developed. Optimization parameters were determined. The model consists of a material balance equation, an equation describing the kinetics of ion exchange for the non-equilibrium case and an equation for the ion exchange isotherm. The material balance equation includes a nonlinear term that depends on the kinetics of ion exchange. A direct problem of calculating the impurity concentration at the outlet of the water treatment plant was numerically solved. The direct problem was approximated by an implicit point-to-point computation difference scheme. The inverse problem was formulated as relates to determination of the parameters of the mathematical model of the water treatment plant operating in non-equilibrium conditions. The formulated inverse problem was solved. Following the results of calculation the time of start of the filter regeneration process was determined, as well as the period of regeneration process and the amount of regeneration and wash water. Multi-parameter optimization of water treatment process for thermal power plants allowed decreasing the amount of wastewater by 15%.Keywords: direct problem, multiparametric optimization, optimization parameters, water treatment
Procedia PDF Downloads 3877865 The Development Learning Module Physics based on Guided Inquiry Approach on Model Cooperative Learning Type STAD (Student Team Achievement Division) in the Main Subject of Temperature and Heat
Authors: Fani Firmahandari
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The development learning module physics based on guided inquiry approach on model cooperative learning type STAD (Student Team Achievement Division) in the main subject of temperature and heat. The research development aimed to produce physics learning module based on guided cooperative learning type STAD (Student Team Achievement Division) in the main subject of temperature and heat to the student in X class. The research method used Research and Development approach. The development procedure of this module includes potential problems, data collection to meet the need, product design, and feasibility of this module. The impact of learning can be seen or observed clearly when the learning process takes place, the teachers or the students already implemented measures cooperative learning model type STAD, so that the learning process goes well, the interaction of teachers and students, students with student looks good, besides that students can interact and work together in group.Keywords: cooperative learning type STAD (student team achievement division), development, inquiry, interaction students
Procedia PDF Downloads 3607864 Screening Post-Menopausal Women for Osteoporosis by Complex Impedance Measurements of the Dominant Arm
Authors: Yekta Ülgen, Fırat Matur
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Cole-Cole parameters of 40 post-menopausal women are compared with their DEXA bone mineral density measurements. Impedance characteristics of four extremities are compared; left and right extremities are statistically same, but lower extremities are statistically different than upper ones due to their different fat content. The correlation of Cole-Cole impedance parameters to bone mineral density (BMD) is observed to be higher for a dominant arm. With the post menopausal population, ANOVA tests of the dominant arm characteristic frequency, as a predictor for DEXA classified osteopenic and osteoporotic population around the lumbar spine, is statistically very significant. When used for total lumbar spine osteoporosis diagnosis, the area under the Receiver Operating Curve of the characteristic frequency is 0.875, suggesting that the Cole-Cole plot characteristic frequency could be a useful diagnostic parameter when integrated into standard screening methods for osteoporosis. Moreover, the characteristic frequency can be directly measured by monitoring frequency driven the angular behavior of the dominant arm without performing any complex calculation.Keywords: bioimpedance spectroscopy, bone mineral density, osteoporosis, characteristic frequency, receiver operating curve
Procedia PDF Downloads 5227863 Comparative Study of Analgesic Efficacy of Ultrasound Guided Femoral Nerve Block Versus Intravenous Fentanyl Injection in Fracture Femur Patients at Emergency Department
Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly
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Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.Keywords: femur fracture, nerve block, fentanyl, ultrasound guided
Procedia PDF Downloads 1007862 Epidemiology and Risk Factors of Injury and Stress Fractures in Male and Female Runners
Authors: Balazs Patczai, Katalin Gocze, Gabriella Kiss, Dorottya Szabo, Tibor Mintal
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Introduction: Running has become increasingly popular on a global scale in the past decades. Amateur athletes are taking their sport to a new level in an attempt to surpass their performance goals. The aim of our study was to assess the musculoskeletal condition of amateur runners and the prevalence of injuries with a special focus on stress fracture risk. Methods: The cross sectional analysis included ankle mobility, hamstring and lower back flexibility, the use of Renne’s test for iliotibial band syndrome, functional tests for trunk and rotary stability, and measurements of bone density. Data was collected at 2 major half-marathon events in Hungary. Results: Participants (n=134) mean age was 41.76±8.57 years (males: 40.67±8.83, females: 42.08±8.56). Measures of hamstring and lower back flexibility fell into the category of good for both genders (males: 7.13±6.83cm, females: 10.17±6.67cm). No side asymmetry nor gender differences were characteristic in the case of ankle mobility. Trunk stability was significantly better for males than in females (p=0.004). Markers of bone health were in the low normal range for females and were significantly better for males (T-score: p=0.003, T-ratio: p=0.014, Z-score: p=0.034, Z-ratio: p=0.011). 5.2% of females had a previous stress fracture and 24.1% experienced irregular menstrual cycles during the past year. As for the knowledge on the possible association of energy deficiency, menstrual disturbances and their effect on bone health, Only 8.6% of females have heard of the female athlete triad either during their studies or from a health professional. Discussion: The overall musculoskeletal state was satisfactory for both genders both physically and functionally. More attention and effort should be placed on primary and secondary prevention of amateur runners. Very few active women are well informed about the effects of low energy availability and menstrual dysfunction and the negative impact these have on bone health.Keywords: bone health, flexibility, running, stress fracture
Procedia PDF Downloads 1257861 Biomechanics of Atalantoaxial Complex for Various Posterior Fixation Techniques
Authors: Arun C. O., Shrijith M. B., Thakur Rajesh Singh
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The study aims to analyze and understand the biomechanical stability of the atlantoaxial complex under different posterior fixation techniques using the finite element method in the Indian context. The conventional cadaveric studies performed show heterogeneity in biomechanical properties. The finite element method being a versatile numerical tool, is being wisely used for biomechanics analysis of atlantoaxial complex. However, the biomechanics of posterior fixation techniques for an Indian subject is missing in the literature. It is essential to study in this context as the bone density and geometry of vertebrae vary from region to region, thereby requiring different screw lengths and it can affect the range of motion(ROM), stresses generated. The current study uses CT images for developing a 3D finite element model with C1-C2 geometry without ligaments. Instrumentation is added to this geometry to develop four models for four fixation techniques, namely C1-C2 TA, C1LM-C2PS, C1LM-C2Pars, C1LM-C2TL. To simulate Flexion, extension, lateral bending, axial rotation, 1.5 Nm is applied to C1 while the bottom nodes of C2 are fixed. Then Range of Motion (ROM) is compared with the unstable model(without ligaments). All the fixation techniques showed more than 97 percent reduction in the Range of Motion. The von-mises stresses developed in the screw constructs are obtained. From the studies, it is observed that Transarticular technique is most stable in Lateral Bending, C1LM-C2 Translaminar is found most stable in Flexion/extension. The Von-Mises stresses developed minimum in Trasarticular technique in lateral bending and axial rotation, whereas stress developed in C2 pars construct minimum in Flexion/ Extension. On average, the TA technique is stable in all motions and also stresses in constructs are less in TA. Tarnsarticular technique is found to be the best fixation technique for Indian subjects among the 4 methods.Keywords: biomechanics, cervical spine, finite element model, posterior fixation
Procedia PDF Downloads 1437860 The Effect of Substitution of CaO/MgO and CaO/SrO on in vitro Bioactivity of Sol-Gel Derived Bioactive Glass
Authors: Zeinab Hajifathali, Moghan Amirhosseinian
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This study had two main aims: firstly, to determine how the individual substitution of CaO/MgO and CaO/SrO can affect the in vitro bioactivity of sol-gel derived substituted 58S bioactive glass (BG) and secondly to introduce a composition in the 60SiO2–(36-x)CaO–4P2O5–(x)MgO and 60SiO2–(36-x)CaO–4P2O5–(x)SrO quaternary systems (where x= 0, 5, 10 mol.%) with enhanced biocompatibility, alkaline phosphatase (ALP) activity, and more efficient antibacterial activity against MRSA bacteria. Results showed that both magnesium-substituted bioactive glasses (M-BGs) and strontium- substituted bioactive glasses (S-BGs) retarded the Hydroxyapatite (HA) formation. Meanwhile, magnesium had more pronounced effect. The 3-(4, 5dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and ALP assays revealed that the presence of moderate amount (5 mol%) of Mg and Sr had a stimulating effect on increasing of both proliferation and differentiation of MC3T3-E1 cells. Live dead and Dapi/actin staining revealed both substitution of CaO/MgO and CaO/SrO resulted in more biocompatibility and stimulation potential of the MC3T3 cells compared with control. Taken together, among all of the synthesized magnesium substituted (MBGs) and strontium substituted (SBGs), the sample 58- BG with 5 mol% CaO/MgO substitution (BG-5M) was considered as a multifunctional biomaterial in bone tissue regeneration field with enhanced biocompatibility, ALP activity as well as the highest antibacterial efficiency against methicillin-resistant Staphylococcus aureus (MRSA) bacteria.Keywords: apatite, alkaline earth, bioactivity, biomedical applications, Sol-gel
Procedia PDF Downloads 1787859 Obesity and Bone Mineral Density in Patients with Large Joint Osteoarthritis
Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk
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Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m2. In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.Keywords: bone mineral density, body mass index, obesity, overweight, postmenopausal women, osteoarthritis
Procedia PDF Downloads 1257858 Klotho Level as a Marker of Low Bone Mineral Density in Egyptian Sickle Cell Disease Patients
Authors: Mona Hamdy, Iman Shaheen, Hadeel Seif Eldin, Basma Ali, Omnia Abdeldayem
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Summary: Bone involvement of sickle cell disease (SCD) patients varies from acute clinical manifestations of painful vaso-occlusive crises or osteomyelitis to more chronic affection of bone mineral density (BMD) and debilitating osteonecrosis and osteoporosis. Secreted klotho protein is involved in calcium (Ca) reabsorption in the kidney. This study aimed to measure serum klotho levels in children with SCD to determine the possibility of using it as a marker of low BMD in children with SCD in correlation with a dual-energy radiograph absorptiometry scan. This study included 60 sickle disease patients and 30 age-matched and sex-matched control participants without SCD. A highly statistically significant difference was found between patients with normal BMD and those with low BMD, with serum Ca and klotho levels being lower in the latter group. Klotho serum level correlated positively with both serum Ca and BMD. Serum klotho level showed 94.9% sensitivity and 95.2% specificity in the detection of low BMD. Both serum Ca and klotho serum levels may be useful markers for detection of low BMD related to SCD with high sensitivity and specificity; however, klotho may be a better indicator as it is less affected by the nutritional and endocrinal status of patients or by intake of Ca supplements.Keywords: sickle cell disease, BMD, osteoporosis, DEXA, klotho
Procedia PDF Downloads 1047857 A Learning Effects Research Applied a Mobile Guide System with Augmented Reality for Education Center
Authors: Y. L. Chang, Y. H. Huang
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This study designed a mobile guide system that integrates the design principles of guidance and interpretation with augmented reality (AR) as an auxiliary tool for National Taiwan Science Education Center guidance and explored the learning performance of participants who were divided into two visiting groups: AR-guided mode and non-guided mode (without carrying any auxiliary devices). The study included 96 college students as participants and employed a quasi-experimental research design. This study evaluated the learning performance of education center students aided with different guided modes, including their flow experience, activity involvement, learning effects, as well as their attitude and acceptance of using the guide systems. The results showed that (a) the AR guide promoted visitors’ flow experience; (b) the AR-guidance activity involvement and flow experience having a significant positive effect; (c) most of the visitors of mobile guide system with AR elicited a positive response and acceptance attitude. These results confirm the necessity of human–computer–context interaction. Future research can continue exploring the advantages of enhanced learning effectiveness, activity involvement, and flow experience through application of the results of this study.Keywords: augmented reality, mobile guide system, informal learning, flow experience, activity involvement
Procedia PDF Downloads 2317856 Micro-CT Imaging Of Hard Tissues
Authors: Amir Davood Elmi
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From the earliest light microscope to the most innovative X-ray imaging techniques, all of them have refined and improved our knowledge about the organization and composition of living tissues. The old techniques are time consuming and ultimately destructive to the tissues under the examination. In recent few decades, thanks to the boost of technology, non-destructive visualization techniques, such as X-ray computed tomography (CT), magnetic resonance imaging (MRI), selective plane illumination microscopy (SPIM), and optical projection tomography (OPT), have come to the forefront. Among these techniques, CT is excellent for mineralized tissues such as bone or dentine. In addition, CT it is faster than other aforementioned techniques and the sample remains intact. In this article, applications, advantages, and limitations of micro-CT is discussed, in addition to some information about micro-CT of soft tissue.Keywords: Micro-CT, hard tissue, bone, attenuation coefficient, rapid prototyping
Procedia PDF Downloads 1427855 Reconstruction of Complex Post Oncologic Maxillectomy Defects
Authors: Vinay Kant Shankhdhar
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Purpose: Maxillary defects are three dimensional and require complex bone and soft tissue reconstruction. Maxillary reconstruction using fibula osteocutaneous flaps in situation requiring orbital floor, orbital wall, palatal defects, and external skin, all at the same time require special planning and multiple osteotomies. We tried to improvise our reconstruction using multiple osteotomies and skin paddle designs for fibula and Flexor Hallucis Longus Muscle. This study aims at discussing the planning and outcome in complex maxillary reconstructions using fibula flaps and soft tissue flaps with or without bone grafts. Material and Methods: From 2011 to 2017 a total of 129 Free fibula flaps were done, 67 required two or more struts, 164 Anterolateral Thigh Flaps, 11 Deep Inferior Epigastric Artery perforator flaps and 3 vertical rectus abdominis muscle flaps with iliac crest bone graft. The age range was 2 to 70 years. The reconstruction was evaluated based on the post-operative rehabilitation including orbital support (prevention of diplopia), oral diet, speech and cosmetic appearance. Results: The follow- up is from 5 years to 1 year. In this series, we observed that the common complications were the de-vascularisation of most distal segment of osteotomised fibula and native skin necrosis. Commonest area of breakdown is the medial canthal region. Plate exposure occurs most commonly at the pyriform sinus. There was extrusion of one non-vascularized bone graft. All these complications were noticed post-radiotherapy. Conclusions: The use of free fibula osteocutaneous flap gives very good results when only alveolar reconstruction is required. The reconstruction of orbital floor with extensive skin loss with post operative radiotherapy has maximum complication rate in long term follow up. A soft tissue flap with non vascularized bone graft may be the best option in such cases.Keywords: maxilla reconstruction, fibula maxilla, post cancer maxillary reconstruction
Procedia PDF Downloads 1347854 Non-linear Analysis of Spontaneous EEG After Spinal Cord Injury: An Experimental Study
Authors: Jiangbo Pu, Hanhui Xu, Yazhou Wang, Hongyan Cui, Yong Hu
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Spinal cord injury (SCI) brings great negative influence to the patients and society. Neurological loss in human after SCI is a major challenge in clinical. Instead, neural regeneration could have been seen in animals after SCI, and such regeneration could be retarded by blocking neural plasticity pathways, showing the importance of neural plasticity in functional recovery. Here we used sample entropy as an indicator of nonlinear dynamical in the brain to quantify plasticity changes in spontaneous EEG recordings of rats before and after SCI. The results showed that the entropy values were increased after the injury during the recovery in one week. The increasing tendency of sample entropy values is consistent with that of behavioral evaluation scores. It is indicated the potential application of sample entropy analysis for the evaluation of neural plasticity in spinal cord injury rat model.Keywords: spinal cord injury (SCI), sample entropy, nonlinear, complex system, firing pattern, EEG, spontaneous activity, Basso Beattie Bresnahan (BBB) score
Procedia PDF Downloads 4657853 Comparison of Transforming Growth Factor-β1 Levels in the Human Gingival Sulcus during Canine Retraction Using Elastic Chain and Closed Coil Spring
Authors: Sri Suparwitri
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When an orthodontic force is applied to a tooth, an inflammatory response is initiated then lead to bone remodeling process, and the process accommodates tooth movement. One of cytokine that plays a prominent role in bone remodeling process was transforming growth factor-beta 1 (TGF-β1). The purpose of this study was to identify and compare changes of TGF-β1 in human gingival crevicular fluid during canine retraction using elastic chain and closed coil spring. Ten patients (mean age 20.7 ± 2.9 years) participated. The patients were entering the space closure phase of fixed orthodontic treatment. An upper canine of each patient was retracted using elastic chain, and the contralateral canine was retracted using closed coil spring. Gingival crevicular fluid samples were collected from the canine teeth before and 7 days after the force was applied. Transforming growth factor-beta 1 was determined by enzyme-linked immunosorbent assay (ELISA). The concentrations of TGF-β1 at 7 days were significantly higher compared to before canine retraction in both groups. In the evaluation of between-group difference, before retraction, the difference was insignificant, whereas at 7 days significantly higher values were determined in the closed coil spring group compared to elastic chain group. The result suggests that TGF-β1 is associated with the bone remodeling that occurs during canine distalization movement. Closed coil spring gave higher TGF-β1 concentrations thus more bone remodeling occurred and may be considered the treatment of choice.Keywords: closed coil spring, elastic chain, gingival crevicular fluid, TGF-β1
Procedia PDF Downloads 1707852 Bone Mineralization in Children with Wilson’s Disease
Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam
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Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis
Procedia PDF Downloads 647851 Psychometric Examination of the QUEST-25: An Online Assessment of Intellectual Curiosity and Scientific Epistemology
Authors: Matthew J. Zagumny
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The current study reports an examination of the QUEST-25 (Q-Assessment of Undergraduate Epistemology and Scientific Thinking) online version for assessing the dispositional attitudes toward scientific thinking and intellectual curiosity among undergraduate students. The QUEST-25 consists of scientific thinking (SIQ-25) and intellectual curiosity (ICIQ-25), which were correlated in hypothesized directions with the Religious Commitment Inventory, Curiosity and Exploration Inventory, Belief in Science scale, and measures of academic self-efficacy. Additionally, concurrent validity was established by the resulting significant differences between those identifying the centrality of religious belief in their lives and those who do not self-identify as being guided daily by religious beliefs. This study demonstrates the utility of the QUEST-25 for research, evaluation, and theory development.Keywords: guided-inquiry learning, intellectual curiosity, psychometric assessment, scientific thinking
Procedia PDF Downloads 2627850 Comparative Evaluation of Ultrasound Guided Internal Jugular Vein Cannulation Using Measured Guided Needle and Conventional Size Needle for Success and Complication of Cannulation
Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh
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Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture
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