Search results for: skin laxity
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1031

Search results for: skin laxity

581 Technology in Commercial Law Enforcement: Tanzania, Canada, and Singapore Comparatively

Authors: Katarina Revocati Mteule

Abstract:

The background of this research arises from global demands for fair business opportunities. As one of responses to these demands, nations embarked on reforms in commercial laws. In 1990s Tanzania resorted to economic transformation through liberalization to attract more investments included reform in commercial laws enforcement. This research scrutinizes the effectiveness of reforms in Tanzania in comparison with Canada and Singapore and the role of technology. The methodology to be used is doctrinal legal research mixed with international comparative legal research. It involves comparative analysis of library, online, and internet resources as well as Case Laws and Statutory Laws. Tanzania, Canada and Singapore are sampled comparators basing on their distinct level of economic development. The criteria of analysis includes the nature of reforms, type of technology, technological infrastructure and human resource technical competence in each country. As the world progresses towards reforms in commercial laws, improvements in law, policy, and regulatory frameworks are paramount. Specifically, commercial laws are essential in contract enforcement and dispute resolution and how it copes with modern technologies is a concern. Harnessing the best technology is necessary to cope with the modernity in world businesses. In line with this, Tanzania is improving its business environment, including law enforcement mechanisms that are supportive to investments. Reforms such as specialized commercial law enforcement coupled with alternative dispute resolutions such as arbitration, mediation, and reconciliation are emphasized. Court technology as one of the reform tools given high priority. This research evaluates the progress and the effectiveness of the reforms in Commercial Laws towards friendly business environment in Tanzania in comparison with Canada and Singapore. The experience of Tanzania is compared with Canada and Singapore to see what to improve for each country to enhance quick and fair enforcement of commercial law. The research proposes necessary global standards of procedures and in national laws to offer a business-friendly environment and the use of appropriate technology. Solutions are proposed in tackling the challenges of delays in enforcing Commercial Laws such as case management, funding, legal and procedural hindrances, laxity among staff, and abuse of Court process among litigants, all in line with modern technology. It is the finding of the research that proper use of technology has managed to reduce case backlogs and time taken to resolve a commercial dispute, to increase court integrity by minimizing human contacts in commercial law enforcement which may lead to solicitation of favors and saving of parties’ time due to online service. Among the three countries, each one is facing a distinct challenge due to the level of poverty and remoteness from online service. How solutions are found in one country is a lesson to another. To conclude, this paper is suggesting solutions for improving the commercial law enforcement mechanisms in line with modern technology. The call for technological transformation is essential for the enforcement of commercial laws.

Keywords: commercial law, enforcement, technology

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580 Eccentric Loading of CFDST Columns

Authors: Trevor N. Haas, Alexander Koen

Abstract:

Columns have traditionally been constructed of reinforced concrete or structural steel. Much attention was allocated to estimate the axial capacity of the traditional column sections to the detriment of other forms of construction. Other forms of column construction such as Concrete Filled Double Skin Tubes received little research attention, and almost no attention when subjected to eccentric loading. This paper investigates the axial capacity of columns when subjected to eccentric loading. The experimental axial capacities are compared to other established theoretical formulae on concentric loading to determine a possible relationship. The study found a good correlation between the reduction in axial capacity for different column lengths and hollow section ratios.

Keywords: CSDST, CFST, axial capacity, hollow section ratios

Procedia PDF Downloads 319
579 Virtual Reality Experimental Study on Riding Environment Assessment for Cyclists

Authors: Kaori Nakamura, Shun Su, Yusak Sulio, Daisuke Fukuda

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Active modes of transportation, such as walking and cycling, are crucial in promoting healthy and sustainable urban environments. Encouraging the use of these modes requires a well-designed road environment that ensures safety and comfort. Understanding what constitutes a safe environment for these users is essential. While previous research mainly focuses on subjective safety or the likelihood of collisions, there needs to be more analysis of the real-time experiences of travelers and dynamic transitions of their discomfort perceptions. Post-ride surveys or pre-ride impressions, the typical evaluation methods in past studies, may not accurately capture the immediate reactions and discomforts experienced during their rides. Though past experimental studies may also use physiological and behavioral data to evaluate road designs, they evaluated road design by comparing time-average physiological and behavioral data across different designs. This study aims to investigate the effects of the dynamic riding environmental changes experienced by cyclists during their rides on their dynamic physiological and behavioral responses and then explore how these conditions contribute to cyclists' overall subjective safety and comfort. We conducted an experiment with 24 participants who cycled approximately 500 meters in a virtual reality (VR) environment designed to mimic a typical road environment of Japanese local towns where lanes for cyclists and regular cars are adjacent in limited road spaces. Participants experienced six road designs varying in width, separation type, and bike lane color. We measured their physiological data, such as heart rate and skin conductance, and behavioral data, including steering, acceleration, and coordination of bicycles. Questionnaires for eliciting subjective impressions were conducted before and after each ride. The data analysis results indicate that wider paths (i.e., 1.5m and 2m width) are preferred, enhancing perceived safety and reducing stress, as supported by lower heart rates and skin conductance levels over narrower ones (1m width). Designs with clear divisions from car lanes may enhance perceived safety and reduce stress. The analysis of the physiological data also supports these arguments, showing that lower heart rates and skin conductance levels are found in wider, clearly marked paths. Further, the drift-diffusion decision model was performed to reveal whether different road environment designs may impact dynamic decision-making processes and physiological attributes. Designing a 1.5m wide bike lane with clear divisions from car lanes showed the highest level of clarity and safety in decision-making parameters. In contrast, designs without clear separations from car lanes resulted in less favorable decision-making outcomes. These results coincide with previous primary research indicating a preference for bike lane widths more significant than 1.5m. In conclusion, the analysis using the drift-diffusion decision model showed that decision-making ease slightly differs from subjective safety perceptions, providing a comprehensive understanding of how different road designs impact users. This study offers a solid foundation for assessing the perceptions of active mode users and highlights the importance of considering both real-time physiological and subjective data in designing road environments that encourage active transportation modes.

Keywords: active transport modes, cognitive and decision-making modeling, road environment designs, virtual reality experiment

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578 Preservation and Promotion of Lao Traditional Food as Luangprabang Province Unique Culture and Tradition in Accordance With One District One Product Policy

Authors: Lamphong Volady

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The primary purpose of this study was to explore the traditional cuisine (local food) of Luangprabang Province in line with the Lao PDR’s One District One Product Policy. Another purpose of the study was to examine channels used to present local food, reasons to preserve and promote local food, as well as local food preservation and promotion strategies. It also aimed at testing correlation hypotheses whether there is a statistically significant relationship between enjoyment of having local food and willingness to promote local cuisines becoming international cuisines, attractiveness to consume local food, preservation and promotion of local food problems, and local people’s occupations. The Convergent Parallel Mixed Methods were employed in this study. The results of the study showed that several local cuisines were found to be local food of Luangprabang Province, namely Jeow Bon (Chilli dipping suace), Or Lam or aw lahm (stew buffalo skin, herbs, Mai sakaan), Kai Pan (River Weed Dry), Tam Mak Houng Luangprabang (Papaya Salad), Nang (Yam Buffalo Skin Dry), Sai Oor (Sausage), Laap Sin Koay Sai Mar-Keua Pao (Beef Salad with Roasted Eggplants), Orm Born (Taro leaves Stew), Oor Nor Mai (Bamboo Shoot Sausage), Jeow Nam Poo (Pickled Crab Chillies), Mok Dok Kae (steaming or roasting a Dok Kae Wrapp), Nor Sa Wan, Kao Noom Kee Noo, Kao Noom Ba Bin. It also depicted that YouTube, Facebook, and TikTok were multiple social channels or platforms which were found to be used to introduce traditional food as well as television, smartphone, word of mouth, Lao food fairs and other provincial events. The study also found that local food should be preserved and promoted since traditional food is not only ancestral, ancient, traditional, and local cuisines, but it is also wisdom, unique, and national cuisine. The study also found that people feel attracted to consuming local food because local food is delicious, unique, clean, nutritious, non-contaminated and natural. The study showed that lack of funds to produce local food, inadequate draw materials, lack material to store products, insufficient place to produce and lack of related organizations engagement were found to be problems for preserving and promoting traditional food. Finally, the result of the study revealed that there is a statistically significant weak relationship between enjoyment of having local food and willingness to promote local cuisines becoming international cuisines (R²= 4.5%), (p-value <0.001). There is a statistically significant moderate relationship between enjoyment of having local food and attractiveness to consume local food (R²= 7.8%), (p-value <0.001). However, there is a statistically insignificant relationship between enjoyment of having local food and preservation and promotion of local food problems (R²= 1.8%), (p-value = 0.086). It was found that there is a statistically insignificant relationship between enjoyment of having local food and local people’s occupations (R²= 0.0%), (p-value = 0.929).

Keywords: local food, preservation, promotion, traditional food, cuisines

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577 Investigation of Bremsstrahlung, Braking Radiation from Beta-Emitting Radioactive Sources

Authors: Metin Kömsöken, Ayşe Güneş Tanır, Onur Karaman

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Usage of high energy charged particles for diagnosis and treatment has been widespread in medicine. The main purpose is to investigate that Bremsstrahlung which occurs by tissue interactions with charged particles should not be neglected. Nuclear stopping power (Bremsstrahlung) was calculated for lung, brain, skin, muscle, bone (cortical) and water targets for the energies of electrons obtained from LINAC used in radiotherapy and of β+ sources used in positron emission tomography (PET). These calculations were done by using the four different analytical functions including classical Bethe-Bloch, Tsoulfanidis, modified Bethe-Bloch and modified Tsoulfanidis equations. It was concluded that obtained results were compatible with that of National Institute of Standards and Technology (NIST-ESTAR).

Keywords: β- emitting source, bremsstrahlung, therapeutic radionuclides, LINAC

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576 Evaluation of Antimicrobial and Anti-Inflammatory Activity of Doani Sidr Honey and Madecassoside against Propionibacterium Acnes

Authors: Hana Al-Baghaoi, Kumar Shiva Gubbiyappa, Mayuren Candasamy, Kiruthiga Perumal Vijayaraman

Abstract:

Acne is a chronic inflammatory disease of the sebaceous glands characterized by areas of skin with seborrhea, comedones, papules, pustules, nodules, and possibly scarring. Propionibacterium acnes (P. acnes), plays a key role in the pathogenesis of acne. Their colonization and proliferation trigger the host’s inflammatory response leading to the production of pro-inflammatory cytokines such as interleukin-8 (IL-8) and tumour necrosis factor-α (TNF-α). The usage of honey and natural compounds to treat skin ailments has strong support in the current trend of drug discovery. The present study was carried out evaluate antimicrobial and anti-inflammatory potential of Doani Sidr honey and its fractions against P. acnes and to screen madecassoside alone and in combination with fractions of honey. The broth dilution method was used to assess the antibacterial activity. Also, ultra structural changes in cell morphology were studied before and after exposure to Sidr honey using transmission electron microscopy (TEM). The three non-toxic concentrations of the samples were investigated for suppression of cytokines IL 8 and TNF α by testing the cell supernatants in the co-culture of the human peripheral blood mononuclear cells (hPBMCs) heat killed P. acnes using enzyme immunoassay kits (ELISA). Results obtained was evaluated by statistical analysis using Graph Pad Prism 5 software. The Doani Sidr honey and polysaccharide fractions were able to inhibit the growth of P. acnes with a noteworthy minimum inhibitory concentration (MIC) value of 18% (w/v) and 29% (w/v), respectively. The proximity of MIC and MBC values indicates that Doani Sidr honey had bactericidal effect against P. acnes which is confirmed by TEM analysis. TEM images of P. acnes after treatment with Doani Sidr honey showed completely physical membrane damage and lysis of cells; whereas non honey treated cells (control) did not show any damage. In addition, Doani Sidr honey and its fractions significantly inhibited (> 90%) of secretion of pro-inflammatory cytokines like TNF α and IL 8 by hPBMCs pretreated with heat-killed P. acnes. However, no significant inhibition was detected for madecassoside at its highest concentration tested. Our results suggested that Doani Sidr honey possesses both antimicrobial and anti-inflammatory effects against P. acnes and can possibly be used as therapeutic agents for acne. Furthermore, polysaccharide fraction derived from Doani Sidr honey showed potent inhibitory effect toward P. acnes. Hence, we hypothesize that fraction prepared from Sidr honey might be contributing to the antimicrobial and anti-inflammatory activity. Therefore, this polysaccharide fraction of Doani Sidr honey needs to be further explored and characterized for various phytochemicals which are contributing to antimicrobial and anti-inflammatory properties.

Keywords: Doani sidr honey, Propionibacterium acnes, IL-8, TNF alpha

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575 Kawasaki Disease in a Two Months Kuwaiti Girl: A Case Report ‎and Literature Review.‎

Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

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Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

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574 L. rhamnosus GG Lysate Can Inhibit Cytotoxic Effects of S. aureus on Keratinocytes in vitro

Authors: W. Mohammed Saeed, A. J. Mcbain, S. M. Cruickshank, C. A. O’Neill

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In the gut, probiotics have been shown to protect epithelial cells from pathogenic bacteria through a number of mechanisms: 1-Increasing epithelial barrier function, 2-Modulation of the immune response especially innate immune response, 3-Inhibition of pathogen adherence and down regulation of virulence factors. Since probiotics have positive impacts on the gut, their potential effects on other body tissues, such as skin have begun to be investigated. The purpose of this project is to characterize the potential of probiotic bacteria lysate as therapeutic agent for preventing or reducing the S. aureus infection. Normal human primary keratinocytes (KCs) were exposed to S. aureus (106/ml) in the presence or absence of L. rhamnosus GG lysate (extracted from 108cfu/ml). The viability of the KCs was measured after 24 hours using a trypan blue exclusion assay. When KCs were treated with S aureus alone, only 25% of the KCs remained viable at 24 hours post infection. However, in the presence of L. rhamnosus GG lysate the viability of pathogen infected KCs increased to 58% (p=0.008, n=3). Furthermore, when KCs co-exposed, pre- exposed or post-exposed to L. rhamnosus GG lysate, the viability of the KCs increased to ≈60%, the L. rhamnosus GG lysate was afforded equal protection in different conditions. These data suggests that two possible separate mechanisms are involved in the protective effects of L. rhamnosus GG such as reducing S. aureus growth, or inhibiting of pathogenic adhesion. Interestingly, a lysate of L rhamnosus GG provided significant reduction in S. aureus growth and adhesion of S. aureus that being viable following 24 hours incubation with S aureus. Therefore, a series of Liquid Chromatography (RP-LC) methods were adopted to partially purify the lysate in combination with functional assays to elucidate in which fractions the efficacious molecules were contained. In addition, the Mass Spectrometry-based protein sequencing was used to identify putative proteins in the fractions. The data presented from purification process demonstrated that L. rhamnosus GG lysate has the potential to protect keratinocytes from the toxic effects of the skin pathogen, S. aureus. Three potential mechanisms were identified: inhibition of pathogen growth; competitive exclusion; and displacement of the pathogen from keratinocyte binding sites. In this study, ‘moonlight’ proteins were identified in the current study’s MS/MS data for L. rhamnosus GG lysate, which could elucidate the ability of lysate in the competitive exclusion and displacement of S. aureus from keratinocyte binding sites. Taken together, it can be speculated that L. rhamnosus GG lysate utilizes different mechanisms to protect keratinocytes from S. aureus toxicity. The present study indicates that the proteinaceous substances are involved in anti-adhesion activity. This is achieved by displacing the pathogen and preventing the severity of pathogen infection and the moonlight proteins might be involved in inhibiting the adhesion of pathogens.

Keywords: lysate, fractions, adhesion, L. rhamnosus GG, S. aureus toxicity

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573 Erythema Multiforme Exudativum Major Caused by Isoniazid Hypersensitivity in a Child

Authors: Azwin Lubis, Rika Hapsari, Zahrah Hikmah, Anang Endaryanto, Ariyanto Harsono

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Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.

Keywords: erythema multiforme exudativum major, hypersensitivity, elimination test, provocation test

Procedia PDF Downloads 228
572 Design and Optimization of Soil Nailing Construction

Authors: Fereshteh Akbari, Farrokh Jalali Mosalam, Ali Hedayatifar, Amirreza Aminjavaheri

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The soil nailing is an effective method to stabilize slopes and retaining structures. Consequently, the lateral and vertical displacement of retaining walls are important criteria to evaluate the safety risks of adjacent structures. This paper is devoted to the optimization problems of retaining walls based on ABAQOUS Software. The various parameters such as nail length, orientation, arrangement, horizontal spacing, and bond skin friction, on lateral and vertical displacement of retaining walls are investigated. In order to ensure accuracy, the mobilized shear stress acting around the perimeter of the nail-soil interface is also modeled in ABAQOUS software. The observed trend of results is compared to the previous researches.

Keywords: retaining walls, soil nailing, ABAQOUS software, lateral displacement, vertical displacement

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571 A Therapeutic Approach for Bromhidrosis with Glycopyrrolate 2% Cream: Clinical Study of 20 Patients

Authors: Vasiliki Markantoni, Eftychia Platsidaki, Georgios Chaidemenos, Georgios Kontochristopoulos

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Introduction: Bromhidrosis, also known as osmidrosis, is a common distressing condition with a significant negative effect on patient’s quality of life. Its etiology is multifactorial. It usually affects axilla, genital skin, breasts and soles, areas where apocrine glands are mostly distributed. Therapeutic treatments include topical antibacterial agents, antiperspirants and neuromuscular blocker agents-toxins. In this study, we aimed to evaluate the efficacy and possible complications of topical glycopyrrolate, an anticholinergic agent, for treatment of bromhidrosis. Glycopyrrolate, applied topically as a cream, solution or spray at concentrations between 0,5% and 4%, has been successfully used to treat different forms of focal hyperhidrosis. Materials and Methods: Twenty patients, six males and fourteen females, meeting the criteria for bromhidrosis were treated with topical glycopyrrolate for two months. The average age was 36. Eleven patients had bromhidrosis located to the axillae, four to the soles, four to both axillae and soles and one to the genital folds. Glycopyrrolate was applied topically as a cream at concentration 2%, formulated in Fitalite. During the first month, patients were using the cream every night and thereafter twice daily. The degree of malodor was assessed subjectively by patients and scaled averagely as ‘none’, ‘mild’, ‘moderate’, and ‘severe’ with corresponding scores of 0, 1, 2, and 3, respectively. The modified Dermatology Life Quality Index (DLQI) was used to assess the quality of life. The clinical efficacy was graded by the patient scale of excellent, good, fair and poor. In the end, patients were given the power to evaluate whether they were totally satisfied with, partially satisfied or unsatisfied and possible side effects during the treatment were recorded. Results: All patients were satisfied at the end of the treatment. No patient defined the response as no improvement. The subjectively assessed score level of bromhidrosis was remarkably improved after the first month of treatment and improved slightly more after the second month. DLQI score was also improved to all patients. Adverse effects were reported in 2 patients. In the first case, topical irritation was reported. This was classed as mild (erythema and desquamation), appeared during the second month of treatment and was treated with low-potency topical corticosteroids. In the second case, mydriasis was reported, that recovered without specific treatment, as soon as we insisted to the importance of careful hygiene after cream application so as not to contaminate the periocular skin or ocular surface. Conclusions: Dermatologists often encounter patients with bromhidrosis, therefore should be aware of treatment options. To the best of our knowledge, this is the first study to evaluate the use of topical glycopyrrolate as a therapeutic approach for bromhidrosis. Our findings suggest that topical glycopyrrolate has an excellent safety profile and demonstrate encouraging results for the management of this distressful condition.

Keywords: Bromhidrosis, glycopyrrolate, topical treatment, osmidrosis

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570 Zoonotic Dirofilaria Repens: Geographic Spread and New Avenues for Control

Authors: Francesco La Torre, Angela Di Cesare, Donato Traversa

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The mosquito-transmitted nematode Dirofilaria repens is the causative agent of subcutaneous filariosis in dogs, other animals and humans. Adults and circulating microfilariae may cause different forms of skin conditions, and various allergic reactions. The infection is distributed in several countries and spreading in several areas of Europe. The control of D. repens is pivotal to reduce the transmission in dogs and to minimize the risk of infection in humans, but only few information is available for the chemoprevention of subcutaneous filariosis of dogs. A recent clinical field study showed the efficacy and safety of a monthly administration of an oral formulation containing milbemycin oxime (Milbemax®, Novartis Animal Health) in the chemoprevention of D. repens infection in dogs. Most recent and focused insights into epidemiology and control of zoonotic canine subcutaneous filariosis are here discussed.

Keywords: Dirofilaria repens, epidemiology, zoonosis, control

Procedia PDF Downloads 721
569 Study on Roll Marks of Stainless Steel in Rolling Mill

Authors: Cai-Wan Chang-Jian, Han-Ting Tsai

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In the processing industry of metal forming, rolling is the most used method of processing. In a cold rolling factory of stainless steel, there occurs a product defect on temper rolling process within cold rolling. It is called 'roll marks', which is a phenomenon of undesirable flatness problem. In this research, we performed a series of experimental measurements on the roll marks, and we used optical sensors to measure it and compared the vibration frequency of roll marks with the vibration frequency of key components in the skin pass mill. We found there is less correlation between the above mentioned data. Finally, we took measurement on the motor driver in rolling mill. We found that the undulation frequency of motor could match with the frequency of roll marks, and then we have confirmed that the motor’s undulation caused roll marks.

Keywords: roll mark, plane strain, rolling mill, stainless steel

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568 Arithmetic Operations in Deterministic P Systems Based on the Weak Rule Priority

Authors: Chinedu Peter, Dashrath Singh

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Membrane computing is a computability model which abstracts its structures and functions from the biological cell. The main ingredient of membrane computing is the notion of a membrane structure, which consists of several cell-like membranes recurrently placed inside a unique skin membrane. The emergence of several variants of membrane computing gives rise to the notion of a P system. The paper presents a variant of P systems for arithmetic operations on non-negative integers based on the weak priorities for rule application. Consequently, we obtain deterministic P systems. Two membranes suffice. There are at most four objects for multiplication and five objects for division throughout the computation processes. The model is simple and has a potential for possible extension to non-negative integers and real numbers in general.

Keywords: P system, binary operation, determinism, weak rule priority

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567 Monitoring and Evaluation of the Water Quality of Taal Lake, Talisay, Batangas, Philippines

Authors: Felipe B. Martinez, Imelda C. Galera

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This paper presents an update on the physico-chemical properties of the Taal Lake for local government officials and representatives of non-government organizations by monitoring and evaluating a total of nine (9) water quality parameters. The study further shows that the Taal Lakes surface temperature, pH, total dissolved solids, total suspended solids, color, and dissolved oxygen content conform to the standards set by the Department of Environment and Natural resources (DENR); while phosphate, chlorine, and 5-Day 20°C BOD are below the standard. Likewise, the T-test result shows no significant difference in the overall average of the two sites at the Taal Lake (P > 0.05). Based on the data, the Lake is safe for primary contact recreation such as bathing, swimming and skin diving, and can be used for aqua culture purposes.

Keywords: cool dry season, hot dry season, rainy season, Taal Lake, water quality

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566 Effectivity Analysis of The Decontamination Products for Radioactive 99mTc Used in Nuclear Medicine

Authors: Hayrettin Eroglu, Oguz Aksakal

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In this study, it is analysed that which decontamination products are more effective and how decontamination process should be performed in the case of contamination of radioactive 99mTc which is the most common radioactive element used in nuclear applications dealing with the human body or the environment. Based on the study, it is observed that existing radioactive washers are less effective than expected, alcohol has no effect on the decontamination of 99mTc, and temperature and pH are the most important factors. In the light of the analysis, it is concluded that the most effective decontamination product is DM-D (Decontamination Material-D). When the effect of DM-D on surfaces is analysed, it is observed that decontamination is very fast on scrubs and formica with both DM-D and water, and although DM-D is very effective on skin, it is not effective on f ceramic tiles and plastic floor covering material. Also in this study, the effectiveness of different molecular groups in the decontaminant was investigated. As a result, the acetate group has been observed as the most effective component of the decontaminant.

Keywords: contamination, radioactive, technetium, decontamination

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565 The Influence of Thermal Radiation and Chemical Reaction on MHD Micropolar Fluid in The Presence of Heat Generation/Absorption

Authors: Binyam Teferi

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Numerical and theoretical analysis of mixed convection flow of magneto- hydrodynamics micropolar fluid with stretching capillary in the presence of thermal radiation, chemical reaction, viscous dissipation, and heat generation/ absorption have been studied. The non-linear partial differential equations of momentum, angular velocity, energy, and concentration are converted into ordinary differential equations using similarity transformations which can be solved numerically. The dimensionless governing equations are solved by using Runge Kutta fourth and fifth order along with the shooting method. The effect of physical parameters viz., micropolar parameter, unsteadiness parameter, thermal buoyancy parameter, concentration buoyancy parameter, Hartmann number, spin gradient viscosity parameter, microinertial density parameter, thermal radiation parameter, Prandtl number, Eckert number, heat generation or absorption parameter, Schmidt number and chemical reaction parameter on flow variables viz., the velocity of the micropolar fluid, microrotation, temperature, and concentration has been analyzed and discussed graphically. MATLAB code is used to analyze numerical and theoretical facts. From the simulation study, it can be concluded that an increment of micropolar parameter, Hartmann number, unsteadiness parameter, thermal and concentration buoyancy parameter results in decrement of velocity flow of micropolar fluid; microrotation of micropolar fluid decreases with an increment of micropolar parameter, unsteadiness parameter, microinertial density parameter, and spin gradient viscosity parameter; temperature profile of micropolar fluid decreases with an increment of thermal radiation parameter, Prandtl number, micropolar parameter, unsteadiness parameter, heat absorption, and viscous dissipation parameter; concentration of micropolar fluid decreases as unsteadiness parameter, Schmidt number and chemical reaction parameter increases. Furthermore, computational values of local skin friction coefficient, local wall coupled coefficient, local Nusselt number, and local Sherwood number for different values of parameters have been investigated. In this paper, the following important results are obtained; An increment of micropolar parameter and Hartmann number results in a decrement of velocity flow of micropolar fluid. Microrotation decreases with an increment of the microinertial density parameter. Temperature decreases with an increasing value of the thermal radiation parameter and viscous dissipation parameter. Concentration decreases as the values of Schmidt number and chemical reaction parameter increases. The coefficient of local skin friction is enhanced with an increase in values of both the unsteadiness parameter and micropolar parameter. Increasing values of unsteadiness parameter and micropolar parameter results in an increment of the local couple stress. An increment of values of unsteadiness parameter and thermal radiation parameter results in an increment of the rate of heat transfer. As the values of Schmidt number and unsteadiness parameter increases, Sherwood number decreases.

Keywords: thermal radiation, chemical reaction, viscous dissipation, heat absorption/ generation, similarity transformation

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564 Reduction of Planar Transformer AC Resistance Using a Planar Litz Wire Structure

Authors: Hamed Belloumi, Aymen Ammouri, Ferid Kourda

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A new trend in power converters is to design planar transformer that aim for low profile. However, at high frequency, the planar transformer ac losses become significant due to the proximity and skin effects. In this paper, the design and implementation of a novel planar litz conductor is presented in order to equalize the flux linkage and improving the current distribution. The developed PCB litz wire structure minimizes the losses in a similar way to the conventional multi stranded litz wires. In order to further illustrate the eddy current effect in different arrangements, a finite-element analysis (FEA) tool is used to analyze current distribution inside the conductors. Finally, the proposed planar transformer has been integrated in an electronic stage to test at high signal levels.

Keywords: planar transformer, finite-element analysis (FEA), winding losses, planar litz wire

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563 Comparing Radiographic Detection of Simulated Syndesmosis Instability Using Standard 2D Fluoroscopy Versus 3D Cone-Beam Computed Tomography

Authors: Diane Ghanem, Arjun Gupta, Rohan Vijayan, Ali Uneri, Babar Shafiq

Abstract:

Introduction: Ankle sprains and fractures often result in syndesmosis injuries. Unstable syndesmotic injuries result from relative motion between the distal ends of the tibia and fibula, anatomic juncture which should otherwise be rigid, and warrant operative management. Clinical and radiological evaluations of intraoperative syndesmosis stability remain a challenging task as traditional 2D fluoroscopy is limited to a uniplanar translational displacement. The purpose of this pilot cadaveric study is to compare the 2D fluoroscopy and 3D cone beam computed tomography (CBCT) stress-induced syndesmosis displacements. Methods: Three fresh-frozen lower legs underwent 2D fluoroscopy and 3D CIOS CBCT to measure syndesmosis position before dissection. Syndesmotic injury was simulated by resecting the (1) anterior inferior tibiofibular ligament (AITFL), the (2) posterior inferior tibiofibular ligament (PITFL) and the inferior transverse ligament (ITL) simultaneously, followed by the (3) interosseous membrane (IOM). Manual external rotation and Cotton stress test were performed after each of the three resections and 2D and 3D images were acquired. Relevant 2D and 3D parameters included the tibiofibular overlap (TFO), tibiofibular clear space (TCS), relative rotation of the fibula, and anterior-posterior (AP) and medial-lateral (ML) translations of the fibula relative to the tibia. Parameters were measured by two independent observers. Inter-rater reliability was assessed by intraclass correlation coefficient (ICC) to determine measurement precision. Results: Significant mismatches were found in the trends between the 2D and 3D measurements when assessing for TFO, TCS and AP translation across the different resection states. Using 3D CBCT, TFO was inversely proportional to the number of resected ligaments while TCS was directly proportional to the latter across all cadavers and ‘resection + stress’ states. Using 2D fluoroscopy, this trend was not respected under the Cotton stress test. 3D AP translation did not show a reliable trend whereas 2D AP translation of the fibula was positive under the Cotton stress test and negative under the external rotation. 3D relative rotation of the fibula, assessed using the Tang et al. ratio method and Beisemann et al. angular method, suggested slight overall internal rotation with complete resection of the ligaments, with a change < 2mm - threshold which corresponds to the commonly used buffer to account for physiologic laxity as per clinical judgment of the surgeon. Excellent agreement (>0.90) was found between the two independent observers for each of the parameters in both 2D and 3D (overall ICC 0.9968, 95% CI 0.995 - 0.999). Conclusions: The 3D CIOS CBCT appears to reliably depict the trend in TFO and TCS. This might be due to the additional detection of relevant rotational malpositions of the fibula in comparison to the standard 2D fluoroscopy which is limited to a single plane translation. A better understanding of 3D imaging may help surgeons identify the precise measurements planes needed to achieve better syndesmosis repair.

Keywords: 2D fluoroscopy, 3D computed tomography, image processing, syndesmosis injury

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562 Numerical Simulation of Lightning Strike Direct Effects on Aircraft Skin Composite Laminate

Authors: Muhammad Khalil, Nader Abuelfoutouh, Gasser Abdelal, Adrian Murphy

Abstract:

Nowadays, the direct effects of lightning to aircrafts are of great importance because of the massive use of composite materials. In comparison with metallic materials, composites present several weaknesses for lightning strike direct effects. Especially, their low electrical and thermal conductivities lead to severe lightning strike damage. The lightning strike direct effects are burning, heating, magnetic force, sparking and arcing. As the problem is complex, we investigated it gradually. A magnetohydrodynamics (MHD) model is developed to simulate the lightning strikes in order to estimate the damages on the composite materials. Then, a coupled thermal-electrical finite element analysis is used to study the interaction between the lightning arc and the composite laminate and to investigate the material degradation.

Keywords: composite structures, lightning multiphysics, magnetohydrodynamic (MHD), coupled thermal-electrical analysis, thermal plasmas.

Procedia PDF Downloads 349
561 Mentoring of Health Professionals to Ensure Better Child-Birth and Newborn Care in Bihar, India: An Intervention Study

Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

Abstract:

AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

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560 Effect of Magnetic Field on Mixed Convection Boundary Layer Flow over an Exponentially Shrinking Vertical Sheet with Suction

Authors: S. S. P. M. Isa, N. M. Arifin, R. Nazar, N. Bachok, F. M. Ali, I. Pop

Abstract:

A theoretical study has been presented to describe the boundary layer flow and heat transfer on an exponentially shrinking sheet with a variable wall temperature and suction, in the presence of magnetic field. The governing nonlinear partial differential equations are converted into ordinary differential equations by similarity transformation, which are then solved numerically using the shooting method. Results for the skin friction coefficient, local Nusselt number, velocity profiles as well as temperature profiles are presented through graphs and tables for several sets of values of the parameters. The effects of the governing parameters on the flow and heat transfer characteristics are thoroughly examined.

Keywords: exponentially shrinking sheet, magnetic field, mixed convection, suction

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559 Oil Reservoirs Bifurcation Analysis in the Democratic Republic of Congo: Fractal Characterization Approach of Makelekese MS-25 Field

Authors: Leonard Mike McNelly Longwa, Divine Kusosa Musiku, D. Nahum Kabeya

Abstract:

In this paper the bifurcation analysis of oilfield in Democratic Republic of Congo is presented in order to enhance petroleum production in an intense tectonic evolution characterized by distinct compressive and extensive phases and the digenetic transformation in the reservoirs during burial geological configuration. The use of porous media in Makelekese MS-25 field has been established to simulate the boundaries within 3 sedimentary basins open to exploration including the coastal basin with an area of 5992 km2, a central basin with an area of 800,000 km2, the western branch of the East African Rift in which there are 50,000 km2. The fractal characterization of complex hydro-dynamic fractures in oilfield is developed to facilitate oil production process based on reservoirs bifurcation model.

Keywords: reservoir bifurcation, fractal characterisation, permeability, conductivity, skin effect

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558 Real-Time Nonintrusive Heart Rate Measurement: Comparative Case Study of LED Sensorics' Accuracy and Benefits in Heart Monitoring

Authors: Goran Begović

Abstract:

In recent years, many researchers are focusing on non-intrusive measuring methods when it comes to human biosignals. These methods provide solutions for everyday use, whether it’s health monitoring or finessing the workout routine. One of the biggest issues with these solutions is that the sensors’ accuracy is highly variable due to many factors, such as ambiental light, skin color diversity, etc. That is why we wanted to explore different outcomes under those kinds of circumstances in order to find the most optimal algorithm(s) for extracting heart rate (HR) information. The optimization of such algorithms can benefit the wider, cheaper, and safer application of home health monitoring, without having to visit medical professionals as often when it comes to observing heart irregularities. In this study, we explored the accuracy of infrared (IR), red, and green LED sensorics in a controlled environment and compared the results with a medically accurate ECG monitoring device.

Keywords: data science, ECG, heart rate, holter monitor, LED sensors

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557 Identifying Physiological Markers That Are Sensitive to Cognitive Load in Preschoolers

Authors: Priyashri Kamlesh Sridhar, Suranga Nanayakkara

Abstract:

Current frameworks in assessment follow lesson delivery and rely heavily on test performance or teacher’s observations. This, however, neglects the underlying cognitive load during the learning process. Identifying the pivotal points when the load occurs helps design effective pedagogies and tools that respond to learners’ cognitive state. There has been limited research on quantifying cognitive load in preschoolers, real-time. In this study, we recorded electrodermal activity and heart rate variability (HRV) from 10 kindergarteners performing executive function tasks and Johnson Woodcock test of cognitive abilities. Preliminary findings suggest that there are indeed sensitive task-dependent markers in skin conductance (number of SCRs and average amplitude of SCRs) and HRV (mean heart rate and low frequency component) captured during the learning process.

Keywords: early childhood, learning, methodologies, pedagogies

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556 Subcutan Isosulfan Blue Administration May Interfere with Pulse Oximetry

Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

Abstract:

Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

Procedia PDF Downloads 299
555 Reduction of High-Frequency Planar Transformer Conduction Losses Using a Planar Litz Wire Structure

Authors: Hamed Belloumi, Amira Zouaoui, Ferid kourda

Abstract:

A new trend in power converters is to design planar transformer that aim for low profile. However, at high frequency, the planar transformer ac losses become significant due to the proximity and skin effects. In this paper, the design and implementation of a novel planar Litz conductor is presented in order to equalize the flux linkage and improving the current distribution. The developed PCB litz wire structure minimizes the losses in a similar way to the conventional multi stranded Litz wires. In order to further illustrate the eddy current effect in different arrangements, a Finite-Element Analysis (FEA) tool is used to analyze current distribution inside the conductors. Finally, the proposed planar transformer has been integrated in an electronic stage to test at high signal levels.

Keywords: planar transformer, finite-element analysis, winding losses, planar Litz wire

Procedia PDF Downloads 373
554 Oil Reservoirs Bifurcation Analysis in the Democratic Republic of Congo: Fractal Characterization Approach of Makelekese MS-25 Field

Authors: Leonard Mike McNelly Longwa, Divine Kusosa Musiku, Dieudonne Nahum Kabeya

Abstract:

In this paper, the bifurcation analysis of oilfields in the Democratic Republic of Congo is presented in order to enhance petroleum production in an intense tectonic evolution characterized by distinct compressive and extensive phases and the digenetic transformation in the reservoirs during burial geological configuration. The use of porous media in the Makelekese MS-25 field has been established to simulate the boundaries within 3 sedimentary basins open to exploration including the coastal basin with an area of 5992 km², a central basin with an area of 800,000 km², the western branch of the East African Rift in which there are 50,000 km². The fractal characterization of complex hydro-dynamic fractures in oilfields is developed to facilitate the oil production process based on the reservoirs bifurcation model.

Keywords: reservoir bifurcation, fractal characterization, permeability, conductivity, skin effect

Procedia PDF Downloads 103
553 Chromium-Leaching Study of Cements in Various Environments

Authors: Adriana Estokova, Lenka Palascakova, Martina Kovalcikova

Abstract:

Cement is a basic material used for building construction. Chromium as an indelible non-volatile trace element of raw materials occurs in cement clinker in the trivalent or hexavalent form. Hexavalent form of chromium is harmful and allergenic having very high water solubility and thus can easily come into contact with the human skin. The paper is aimed at analyzing the content of total chromium in Portland cements and leaching rate of hexavalent chromium in various leachants: Deionized water, Britton-Robinson buffer, used to simulate the natural environment, and hydrochloric acid (HCl). The concentration of total chromium in Portland cement samples was in a range from 173.2 to 218.5 mg/kg. The content of dissolved hexavalent chromium ranged 0.23-3.19, 2.0-5.78 and 8.88-16.25 mg/kg in deionized water, Britton-Robinson solution and hydrochloric acid, respectively. The calculated leachable fraction of Cr(VI) from cement samples was observed in the range 0.1--7.58 %.

Keywords: environment, cement, chromium, leaching

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552 Medical Dressing Induced Digital Ischemia in Patient with Congenital Insensitivity to Pain and Anhidrosis

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

Abstract:

First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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