Search results for: mechanical low back pain
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6021

Search results for: mechanical low back pain

981 Early-Age Cracking of Low Carbon Concrete Incorporating Ferronickel Slag as Supplementary Cementitious Material

Authors: Mohammad Khan, Arnaud Castel

Abstract:

Concrete viscoelastic properties such as shrinkage, creep, and associated relaxation are important in assessing the risk of cracking during the first few days after placement. This paper investigates the early-age mechanical and viscoelastic properties, restrained shrinkage-induced cracking and time to cracking of concrete incorporating ferronickel slag (FNS) as supplementary cementitious material. Compressive strength, indirect tensile strength and elastic modulus were measured. Tensile creep and drying shrinkage was measured on dog-bone shaped specimens. Restrained shrinkage induced stresses and concrete cracking age were assessed by using the ring test. Results revealed that early-age strength development of FNS blended concrete is lower than that of the corresponding ordinary Portland cement (OPC) concrete. FNS blended concrete showed significantly higher tensile creep. The risk of early-age cracking for the restrained specimens depends on the development of concrete tensile stress considering both restrained shrinkage and tensile creep and the development of the tensile strength. FNS blended concrete showed only 20% reduction in time to cracking compared to reference OPC concrete, and this reduction is significantly lower compared to fly ash and ground granulated blast furnace slag blended concretes at similar replacement level.

Keywords: ferronickel slag, restraint shrinkage, tensile creep, time to cracking

Procedia PDF Downloads 170
980 Numerical Investigation of Nanofluid Based Thermosyphon System

Authors: Kiran Kumar K., Ramesh Babu Bejjam, Atul Najan

Abstract:

A thermosyphon system is a heat transfer loop which operates on the basis of gravity and buoyancy forces. It guarantees a good reliability and low maintenance cost as it does not involve any mechanical pump. Therefore it can be used in many industrial applications such as refrigeration and air conditioning, electronic cooling, nuclear reactors, geothermal heat extraction, etc. But flow instabilities and loop configuration are the major problems in this system. Several previous researchers studied that stabilities can be suppressed by using nanofluids as loop fluid. In the present study a rectangular thermosyphon loop with end heat exchangers are considered for the study. This configuration is more appropriate for many practical applications such as solar water heater, geothermal heat extraction, etc. In the present work, steady-state analysis is carried out on thermosyphon loop with parallel flow coaxial heat exchangers at heat source and heat sink. In this loop nano fluid is considered as the loop fluid and water is considered as the external fluid in both hot and cold heat exchangers. For this analysis one-dimensional homogeneous model is developed. In this model, conservation equations like conservation of mass, momentum, energy are discretized using finite difference method. A computer code is written in MATLAB to simulate the flow in thermosyphon loop. A comparison in terms of heat transfer is made between water and nano fluid as working fluids in the loop.

Keywords: heat exchanger, heat transfer, nanofluid, thermosyphon loop

Procedia PDF Downloads 461
979 Significance of High Specific Speed in Circulating Water Pump, Which Can Cause Cavitation, Noise and Vibration

Authors: Chandra Gupt Porwal

Abstract:

Excessive vibration means increased wear, increased repair efforts, bad product selection & quality and high energy consumption. This may be sometimes experienced by cavitation or suction/discharge re-circulation which could occur only when net positive suction head available NPSHA drops below the net positive suction head required NPSHR. Cavitation can cause axial surging if it is excessive, will damage mechanical seals, bearings, possibly other pump components frequently and shorten the life of the impeller. Efforts have been made to explain Suction Energy (SE), Specific Speed (Ns), Suction Specific Speed (Nss), NPSHA, NPSHR & their significance, possible reasons of cavitation /internal re-circulation, its diagnostics and remedial measures to arrest and prevent cavitation in this paper. A case study is presented by the author highlighting that the root cause of unwanted noise and vibration is due to cavitation, caused by high specific speeds or inadequate net- positive suction head available which results in damages to material surfaces of impeller & suction bells and degradation of machine performance, its capacity and efficiency too. The author strongly recommends revisiting the technical specifications of CW pumps to provide sufficient NPSH margin ratios > 1.5, for future projects and Nss be limited to 8500 -9000 for cavitation free operation.

Keywords: best efficiency point (BEP), net positive suction head NPSHA, NPSHR, specific speed NS, suction specific speed NSS

Procedia PDF Downloads 243
978 Fabrication and Characterization of Dissolvable Microneedle Patches Using Different Compositions and Ratios of Hyaluronic Acid and Zinc Oxide Nanoparticles

Authors: Dada Kolawole Segun

Abstract:

Transdermal drug delivery has gained popularity as a non-invasive method for controlled drug release compared to traditional delivery routes. Dissolvable transdermal patches have emerged as a promising platform for delivering a variety of drugs due to their ease of use. The objective of this research was to create and characterize dissolvable transdermal patches using various compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. A micromolding technique was utilized to fabricate the patches, which were subsequently characterized using scanning electron microscopy, atomic force microscopy, and tensile strength testing. In vitro drug release studies were conducted to evaluate the drug release kinetics of the patches. The study found that the mechanical strength and dissolution properties of the patches were influenced by the hyaluronic acid and zinc oxide nanoparticle ratios used in the fabrication process. Moreover, the patches demonstrated controlled delivery of model drugs through the skin, highlighting their potential for transdermal drug delivery applications. The results suggest that dissolvable transdermal patches can be tailored to meet specific requirements for drug delivery applications using different compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. This development has the potential to improve treatment outcomes and patient compliance in various therapeutic areas.

Keywords: transdermal drug delivery, characterization, skin permeation, biodegradable materials

Procedia PDF Downloads 66
977 Gradient Index Metalens for WLAN Applications

Authors: Akram Boubakri, Fethi Choubeni, Tan Hoa Vuong, Jacques David

Abstract:

The control of electromagnetic waves is a key aim of several researches over the past decade. In this regard, Metamaterials have shown a strong ability to manipulate the electromagnetic waves on a subwavelength scales thanks to its unconventional properties that are not available in natural materials such as negative refraction index, super imaging and invisibility cloaking. Metalenses were used to avoid some drawbacks presented by conventional lenses since focusing with conventional lenses suffered from the limited resolution because they were only able to focus the propagating wave component. Nevertheless, Metalenses were able to go beyond the diffraction limit and enhance the resolution not only by collecting the propagating waves but also by restoring the amplitude of evanescent waves that decay rapidly when going far from the source and that contains the finest details of the image. Metasurfaces have many mechanical advantages over three-dimensional metamaterial structures especially the ease of fabrication and a smaller required volume. Those structures have been widely used for antenna performance improvement and to build flat metalenses. In this work, we showed that a well-designed metasurface lens operating at the frequency of 5.9GHz, has efficiently enhanced the radiation characteristics of a patch antenna and can be used for WLAN applications (IEEE 802.11 a). The proposed metasurface lens is built with a geometrically modified unit cells which lead to a change in the response of the lens at different position and allow the control of the wavefront beam of the incident wave thanks to the gradient refractive index.

Keywords: focusing, gradient index, metasurface, metalens, WLAN Applications

Procedia PDF Downloads 240
976 Investigation of the Cyclic Response of Mudrock

Authors: Shaymaa Kennedy, Sam Clark, Paul Shaply

Abstract:

With the upcoming construction of high-speed rail HS2 in the UK, a number of issues surrounding the construction technology and track design need to be answered. In this paper performance of subsoil subjected to dynamic loads were studied. The material of study is Mudrock backfill, a weak prevalent rock which response under indicative loading of high-speed rail line is unknown. This paper aims to investigate the use of different track types and the influence they will have on the underlying soil, in order to evaluate the behaviour of it. Ballstless track is a well-established concept in Europe, and the investigation the benefit of the form of construction due to its known savings in maintenance costs. Physical test using a triaxial cyclic loading machine was conducted to assess the expected mechanical behaviour of mudrock under a range of dynamic loads which could be generated beneath different track constructions. Some further parameters are required to frame the problem including determining the stress change with depth and cyclic response are vital to determine the residual plastic strain which is a major concern. In addition, Stress level is discussed in this paper, which are applied to recreate conditions of soil in the laboratory. Results indicate that stress levels are highly influential on the performance of soil at shallower depth and become insignificant with increasing depth.

Keywords: stress level, dynamic load, residual plastic strain, high speed railway

Procedia PDF Downloads 236
975 Study on Brick Aggregate Made Pervious Concrete at Zero Fine Level

Authors: Monjurul Hasan, Golam Kibria, Abdus Salam

Abstract:

Pervious concrete is a form of lightweight porous concrete, obtained by eliminating the fine aggregate from the normal concrete mix. The advantages of this type of concrete are lower density, lower cost due to lower cement content, lower thermal conductivity, relatively low drying shrinkage, no segregation and capillary movement of water. In this paper an investigation is made on the mechanical response of the pervious concrete at zero fine level (zero fine concrete) made with local brick aggregate. Effect of aggregate size variation on the strength, void ratio and permeability of the zero fine concrete is studied. Finally, a comparison is also presented between the stone aggregate made pervious concrete and brick aggregate made pervious concrete. In total 75 concrete cylinder were tested for compressive strength, 15 cylinder were tested for void ratio and 15 cylinder were tested for permeability test. Mix proportion (cement: Coarse aggregate) was kept fixed at 1:6 (by weights), where water cement ratio was valued 0.35 for preparing the sample specimens. The brick aggregate size varied among 25mm, 19mm, 12mm. It has been found that the compressive strength decreased with the increment of aggregate size but permeability increases and concrete made with 19mm maximum aggregate size yields the optimum value. No significant differences on the strength and permeability test are observed between the brick aggregate made zero fine concrete and stone aggregate made zero fine concrete.

Keywords: pervious concrete, brick aggregate concrete, zero fine concrete, permeability, porosity

Procedia PDF Downloads 527
974 Computationally Efficient Stacking Sequence Blending for Composite Structures with a Large Number of Design Regions Using Cellular Automata

Authors: Ellen Van Den Oord, Julien Marie Jan Ferdinand Van Campen

Abstract:

This article introduces a computationally efficient method for stacking sequence blending of composite structures. The computational efficiency makes the presented method especially interesting for composite structures with a large number of design regions. Optimization of composite structures with an unequal load distribution may lead to locally optimized thicknesses and ply orientations that are incompatible with one another. Blending constraints can be enforced to achieve structural continuity. In literature, many methods can be found to implement structural continuity by means of stacking sequence blending in one way or another. The complexity of the problem makes the blending of a structure with a large number of adjacent design regions, and thus stacking sequences, prohibitive. In this work the local stacking sequence optimization is preconditioned using a method found in the literature that couples the mechanical behavior of the laminate, in the form of lamination parameters, to blending constraints, yielding near-optimal easy-to-blend designs. The preconditioned design is then fed to the scheme using cellular automata that have been developed by the authors. The method is applied to the benchmark 18-panel horseshoe blending problem to demonstrate its performance. The computational efficiency of the proposed method makes it especially suited for composite structures with a large number of design regions.

Keywords: composite, blending, optimization, lamination parameters

Procedia PDF Downloads 207
973 Can We Meet the New Challenges of NonIsocyanates Polyurethanes (NIPU) towards NIPU Foams?

Authors: Adrien Cornille, Marine Blain, Bernard Boutevin, Sylvain Caillol

Abstract:

Generally, linear polyurethanes (PUs) are obtained by the reaction between an oligomeric diol, a short diol as chain extender and a diisocyanate. However the use of diisocyanate should be avoided since they are generally very harmful for human health. Therefore the synthesis of NIPUs (non isocyanate PUs) from step growth polymerization of dicyclocarbonates and diamines should be favoured. This method is particularly interesting since no hazardous isocyanates are used. Thus, this reaction, extensively studied by Endo et al. is currently gaining a lot of attention as a substitution route for the synthesis of NIPUs, both from industrial and academic community. However, the reactivity of reaction between amine and cyclic carbonate is a major scientific issue, since cyclic carbonates are poorly reactive. Thus, our team developed several synthetic ways for the synthesis of various di-cyclic carbonates based on C5-, C6- and dithio- cyclic carbonates, from different biobased raw materials (glycerin isosorbide, vegetable oils…). These monomers were used to synthesize NIPUs with various mechanical and thermal properties for various applications. We studied the reactivity of reaction with various catalysts and find optimized conditions for room temperature reaction. We also studied the radical copolymerization of cyclic carbonate monomers in styrene-acrylate copolymers for coating applications. We also succeeded in the elaboration of biobased NIPU flexible foams. To the best of our knowledge, there is no report in literature on the preparation of non-isocyanate polyurethane foams.

Keywords: foam, nonisocyanate polyurethane, cyclic carbonate, blowing agent, scanning electron microscopy

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972 Compact Optical Sensors for Harsh Environments

Authors: Branislav Timotijevic, Yves Petremand, Markus Luetzelschwab, Dara Bayat, Laurent Aebi

Abstract:

Optical miniaturized sensors with remote readout are required devices for the monitoring in harsh electromagnetic environments. As an example, in turbo and hydro generators, excessively high vibrations of the end-windings can lead to dramatic damages, imposing very high, additional service costs. A significant change of the generator temperature can also be an indicator of the system failure. Continuous monitoring of vibrations, temperature, humidity, and gases is therefore mandatory. The high electromagnetic fields in the generators impose the use of non-conductive devices in order to prevent electromagnetic interferences and to electrically isolate the sensing element to the electronic readout. Metal-free sensors are good candidates for such systems since they are immune to very strong electromagnetic fields and given the fact that they are non-conductive. We have realized miniature optical accelerometer and temperature sensors for a remote sensing of the harsh environments using the common, inexpensive silicon Micro Electro-Mechanical System (MEMS) platform. Both devices show highly linear response. The accelerometer has a deviation within 1% from the linear fit when tested in a range 0 – 40 g. The temperature sensor can provide the measurement accuracy better than 1 °C in a range 20 – 150 °C. The design of other type of sensors for the environments with high electromagnetic interferences has also been discussed.

Keywords: optical MEMS, temperature sensor, accelerometer, remote sensing, harsh environment

Procedia PDF Downloads 349
971 The Potential of Tempo-Oxidized Cellulose Nanofibers to Replace Ethylene-Propylene-Diene Monomer Rubber

Authors: S. Dikmen Kucuk, A. Tozluoglu, Y. Guner

Abstract:

In recent years, petroleum-based polymers began to be limited due to effects on human and environmental point of view in many countries. Thus, organic-based biodegradable materials have attracted much interest in the composite industry because of environmental concerns. As a result of this, it has been asked that inorganic and petroleum-based materials should be reduced and altered with biodegradable materials. In this point, in this study, it is aimed to investigate the potential of use of TEMPO (2,2,6,6- tetramethylpiperidine 1-oxyl)-mediated oxidation nano-fibrillated cellulose instead of EPDM (ethylene-propylene-diene monomer) rubber, which is a petroleum-based material. Thus, the exchange of petroleum-based EPDM rubber with organic based cellulose nanofibers, which are environmentally friendly (green) and biodegradable, will be realized. The effect of tempo-oxidized cellulose nanofibers (TCNF) instead of EPDM rubber was analyzed by rheological, mechanical, chemical, thermal and aging analyses. The aged surfaces were visually scrutinized and surface morphological changes were examined via scanning electron microscopy (SEM). The results obtained showed that TEMPO oxidation nano-fibrillated cellulose can be used at an amount of 1.0 and 2.2 phr resulting the values stay within tolerance according to customer standard and without any chemical degradation, crack, colour change or staining.

Keywords: EPDM, cellulose, green materials, nanofibrillated cellulose, TCNF, tempo-oxidized nanofiber

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970 Microstructure and Mechanical Properties of A201 Alloys with Additions of Si

Authors: Suzan Abd El Majid, Menachem Bamberger, Alexander Katsman

Abstract:

Two Al-4 wt. % Cu based alloys, A201 and A201+Si were investigated in the as-cast, solution treated and aged conditions. The addition of Si was used to improve the castability of the basic alloy. The all investigated alloys in the as-cast condition contained a eutectic structure along grain boundaries (GBs) with the composition Al-50at. %Cu that was found by HRSEM EDS. Addition of Si refined the grain structure and changed the amount of the eutectic regions, their size and shape. Additionally, the A201+Si microstructure contained Si rods and small amount of Al6Mn4Cu3Fe2Si-phase. Solution treatment (ST) at 550°C for ~ 20 hours resulted in a slight dissolution of the eutectic structure in the A201 alloy while substantial dissolution and change of the eutectic composition was detected in the A201+Si alloy. After ST, the A201alloy contained θ-Al2Cu, Al5Cu2Mn3 and Al9Cu7Mn3(Fe) phases associated to the GBs, while the ST A201+Si alloy contained θ-Al2Cu, Al6Mn4Cu3(Fe,Si) and Si94Mn3Al2Cu phases. Precipitation hardening during aging at 170°C was investigated for both alloys. The microhardness of the ST A201alloy increased during aging and reached the maximum value ~ 140 HV after 2 h of aging. Initial microhardness of the ST A201+Si alloy was distinctly higher than one of the ST A201 alloy, but it decreased during the first hour of aging, then increased and reached the same maximum value ~ 140 HV after ~ 4 h of aging. It was concluded that the Si addition influenced the precipitation sequence and slowed down the age hardening process. The Si induced grain refining and evolution of the eutectic structure during the heat treatments applied are discussed.

Keywords: A201 alloys, castability, microstructure, micro-hardness

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969 Physical Properties of Crushed Aggregates in Some Selected Quarries in Kwara State, Nigeria

Authors: S. A. Agbalajobi, W. A. Bello

Abstract:

This study examines rock properties of crushed aggregate in some selected quarries in Kwara state, Nigeria. Some physical properties (chemical composition, mineral composition, particle size distribution) of gneiss sample were determined using ISRM standards. The physicomechanical properties (specific gravity, dry density, porosity, water absorption, point load index, tensile, and compressive strength) of the gneiss rock were evaluated. The analysis on the gneiss samples revealed the mean dry density and the unit weight are 2.52 g/m3, 2.63 g/m3, 2.38 g/m3; and 24.1 kN/m3, 25.78 kN/m3, 23.33 kN/m3, respectively (for locations A,B,C). The water absorption level of the gneiss rock sample ranged from 0.38 % – 0.57 % for the three locations. The mean Schmidt hammer rebound value ranged from 51.0 – 52.4 for the three locations and mean point load index values ranged from 9.89 – 10.56 MPa classified as very high strength while the uniaxial compressive strength of the rock samples revealed that its strength ranged from 120 - 139 MPa (for location A, B, and C) classified as strong rock. The aggregate impact value test and aggregate crushing value test conducted on the gneiss aggregates from the three locations in accordance with British Standard. The gneiss sample from the three locations (A, B, and C) is a good material for the production of construction works such as concrete, bricks, pavement, embankment among others, the compressive strength of the material is within the accepted limit.

Keywords: gneiss, aggregate impact, aggregate crushing, physic-mechanical properties, rock hardness

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968 Data Driven Infrastructure Planning for Offshore Wind farms

Authors: Isha Saxena, Behzad Kazemtabrizi, Matthias C. M. Troffaes, Christopher Crabtree

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The calculations done at the beginning of the life of a wind farm are rarely reliable, which makes it important to conduct research and study the failure and repair rates of the wind turbines under various conditions. This miscalculation happens because the current models make a simplifying assumption that the failure/repair rate remains constant over time. This means that the reliability function is exponential in nature. This research aims to create a more accurate model using sensory data and a data-driven approach. The data cleaning and data processing is done by comparing the Power Curve data of the wind turbines with SCADA data. This is then converted to times to repair and times to failure timeseries data. Several different mathematical functions are fitted to the times to failure and times to repair data of the wind turbine components using Maximum Likelihood Estimation and the Posterior expectation method for Bayesian Parameter Estimation. Initial results indicate that two parameter Weibull function and exponential function produce almost identical results. Further analysis is being done using the complex system analysis considering the failures of each electrical and mechanical component of the wind turbine. The aim of this project is to perform a more accurate reliability analysis that can be helpful for the engineers to schedule maintenance and repairs to decrease the downtime of the turbine.

Keywords: reliability, bayesian parameter inference, maximum likelihood estimation, weibull function, SCADA data

Procedia PDF Downloads 61
967 When It Wasn’t There: Understanding the Importance of High School Sports

Authors: Karen Chad, Louise Humbert, Kenzie Friesen, Dave Sandomirsky

Abstract:

Background: The pandemic of COVID-19 presented many historical challenges to the sporting community. For organizations and individuals, sport was put on hold resulting in social, economic, physical, and mental health consequences for all involved. High school sports are seen as an effective and accessible pathway for students to receive health, social, and academic benefits. Studies examining sport cessation due to COVID-19 found substantial negative outcomes on the physical and mental well-being of participants in the high school setting. However, the pandemic afforded an opportunity to examine sport participation and the value people place upon their engagement in high school sport. Study objectives: (1) Examine the experiences of students, parents, administrators, officials, and coaches during a year without high school sports; (2) Understand why participants are involved in high school sports; and (3) Learn what supports are needed for future involvement. Methodology: A mixed method design was used, including semi-structured interviews and a survey (SurveyMonkey software), which was disseminated electronically to high school students, coaches, school administrators, parents, and officials. Results: 1222 respondents completed the survey. Findings showed: (1) 100% of students participate in high school sports to improve their mental health, with >95% said it keeps them active and healthy, helps them make friends and teaches teamwork, builds confidence and positive self-perceptions, teaches resiliency, enhances connectivity to their school, and supports academic learning; (2) Top three reasons teachers coach is their desire to make a difference in the lives of students, enjoyment, and love of the sport, and to give back. Teachers said what they enjoy most is contributing to and watching athletes develop, direct involvement with student sport success, and the competitiveatmosphere; (3) 90% of parents believe playing sports is a valuable experience for their child, 95% said it enriches student academic learning and educational experiences, and 97% encouraged their child to play school sports; (4) Officials participate because of their enjoyment and love of the sport, experience, and expertise, desire to make a difference in the lives of children, the competitive/sporting atmosphere and growing the sport. 4% of officials said it was financially motivated; (5) 100% of administrators said high school sports are important for everyone. 80% believed the pandemic will decrease teachers coaching and increase student mental health and well-being. When there was no sport, many athletes got a part-time job and tried to stay active, with limited success. Coaches, officials, and parents spent more time with family. All participants did little physical activity, were bored; and struggled with mental health and poor physical health. Respondents recommended better communication, promotion, and branding of high school sport benefits, equitable funding for all sports, athlete development, compensation and recognition for coaching, and simple processes to strengthen the high school sport model. Conclusions: High school sport is an effective vehicle for athletes, parents, coaches, administrators, and officials to derive many positive outcomes. When it is taken away, serious consequences prevail. Paying attention to important success factors will be important for the effectiveness of high school sports.

Keywords: physical activity, high school, sports, pandemic

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966 Prevalence of Chronic Diseases and Predictors of Mortality in Home Health Care Service: Data From Saudi Arabia

Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

Abstract:

Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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965 Effects of Surface Roughness on a Unimorph Piezoelectric Micro-Electro-Mechanical Systems Vibrational Energy Harvester Using Finite Element Method Modeling

Authors: Jean Marriz M. Manzano, Marc D. Rosales, Magdaleno R. Vasquez Jr., Maria Theresa G. De Leon

Abstract:

This paper discusses the effects of surface roughness on a cantilever beam vibrational energy harvester. A silicon sample was fabricated using MEMS fabrication processes. When etching silicon using deep reactive ion etching (DRIE) at large etch depths, rougher surfaces are observed as a result of increased response in process pressure, amount of coil power and increased helium backside cooling readings. To account for the effects of surface roughness on the characteristics of the cantilever beam, finite element method (FEM) modeling was performed using actual roughness data from fabricated samples. It was found that when etching about 550um of silicon, root mean square roughness parameter, Sq, varies by 1 to 3 um (at 100um thick) across a 6-inch wafer. Given this Sq variation, FEM simulations predict an 8 to148 Hz shift in the resonant frequency while having no significant effect on the output power. The significant shift in the resonant frequency implies that careful consideration of surface roughness from fabrication processes must be done when designing energy harvesters.

Keywords: deep reactive ion etching, finite element method, microelectromechanical systems, multiphysics analysis, surface roughness, vibrational energy harvester

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964 Mean Nutrient Intake and Nutrient Adequacy Ratio in India: Occurrence of Hidden Hunger in Indians

Authors: Abha Gupta, Deepak K. Mishra

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The focus of food security studies in India has been on the adequacy of calories and its linkage with poverty level. India currently being undergoing a massive demographic and epidemiological transition has demonstrated a decline in average physical activity with improved mechanization and urbanization. Food consumption pattern is also changing with decreasing intake of coarse cereals and a marginal increase in the consumption of fruits, vegetables and meat products resulting into a nutrition transition in the country. However, deficiency of essential micronutrients such as vitamins and minerals is rampant despite their growing importance in fighting back with lifestyle and other modern diseases. The calorie driven studies can hardly tackle the complex problem of malnutrition. This paper fills these research lacuna and analyses mean intake of different major and micro-nutrients among different socio-economic groups and adequacy of these nutrients from recommended dietary allowance. For the purpose, a cross-sectional survey covering 304 households selected through proportional stratified random sampling was conducted in six villages of Aligarh district of the state of Uttar Pradesh, India. Data on quantity consumed of 74 food items grouped into 10 food categories with a recall period of seven days was collected from the households and converted into energy, protein, fat, carbohydrate, calcium, iron, thiamine, riboflavin, niacin and vitamin C using standard guidelines of National Institute of Nutrition. These converted nutrients were compared with recommended norms given by National Nutrition Monitoring Bureau. Per capita nutrient adequacy was calculated by dividing mean nutrient intake by the household size and then by comparing it with recommended norm. Findings demonstrate that source of both macro and micro-nutrients are mainly cereals followed by milk, edible oil and sugar items. Share of meat in providing essential nutrients is very low due to vegetarian diet. Vegetables, pulses, nuts, fruits and dry fruits are a poor source for most of the nutrients. Further analysis evinces that intake of most of the nutrients is higher than the recommended norm. Riboflavin is the only vitamin whose intake is less than the standard norm. Poor group, labour, small farmers, Muslims, scheduled caste demonstrate comparatively lower intake of all nutrients than their counterpart groups, though, they get enough macro and micro-nutrients significantly higher than the norm. One of the major reasons for higher intake of most of the nutrients across all socio-economic groups is higher consumption of monotonous diet based on cereals and milk. Most of the nutrients get their major share from cereals particularly wheat and milk intake. It can be concluded from the analysis that although there is adequate intake of most of the nutrients in the diet of rural population yet their source is mainly cereals and milk products depicting a monotonous diet. Hence, more efforts are needed to diversify the diet by giving more focus to the production of other food items particularly fruits, vegetables and pulse products. Awareness among the population, more accessibility and incorporating food items other than cereals in government social safety programmes are other measures to improve food security in India.

Keywords: hidden hunger, India, nutrients, recommended norm

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963 The Optimization of an Industrial Recycling Line: Improving the Durability of Recycled Polyethyene Blends

Authors: Alae Lamtai, Said Elkoun, Hniya Kharmoudi, Mathieu Robert, Carl Diez

Abstract:

This study applies Taguchi's design of experiment methodology and grey relational analysis (GRA) for multi objective optimization of an industrial recycling line. This last is composed mainly of a mono and twin-screw extruder and a filtration system. Experiments were performed according to L₁₆ standard orthogonal array based on five process parameters, namely: mono screw design, screw speed of the mono and twin-screw extruder, melt pump pressure, and filter mesh size. The objective of this optimization is to improve the durability of the Polyethylene (PE) blend by decreasing the loss of Stress Crack resistance (SCR) using Notched Crack Ligament Stress (NCLS) test and Unnotched Crack Ligament Stress (UCLS) in parallel with increasing the gain of Izod impact strength of the Polyethylene (PE) blend before and after recycling. Based on Grey Relational Analysis (GRA), the optimal setting of process parameters was identified, and the results indicated that the mono-screw design and screw speed of both mono and twin-screw extruder impact significantly the mechanical properties of recycled Polyethylene (PE) blend.

Keywords: Taguchi, recycling line, polyethylene, stress crack resistance, Izod impact strength, grey relational analysis

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962 Nurturing Resilient Families: Strategies for Positive Parenting and Emotional Well-Being

Authors: Xu Qian

Abstract:

This abstract explores the importance of building resilience within families and offers evidence-based strategies for promoting positive parenting and enhancing emotional well-being. It emphasizes the role of effective communication, conflict resolution, and fostering a supportive environment to strengthen family bonds and promote healthy child development. Introduction: The well-being and resilience of families play a crucial role in fostering healthy child development and promoting overall emotional well-being. This abstract highlights the significance of nurturing resilient families and provides evidence-based strategies for positive parenting. By focusing on effective communication, conflict resolution, and creating a supportive environment, families can strengthen their bonds and enhance emotional well-being for both parents and children. Methods: This abstract draws upon a comprehensive review of existing research and literature on resilient families, positive parenting, and emotional well-being. The selected studies employ various methodologies, including surveys, interviews, and longitudinal observations, to investigate the factors contributing to family resilience and the strategies that promote positive parenting practices. The findings from these studies serve as the foundation for the strategies discussed in this abstract. Results: The results of the reviewed studies demonstrate that effective communication within families is a key factor in building resilience and promoting emotional well-being. Open and honest communication allows family members to express their thoughts, feelings, and concerns, fostering trust and understanding. Conflict resolution skills, such as active listening, compromise, and problem-solving, are vital in managing conflicts constructively and preventing negative consequences on family dynamics and children's well-being. Creating a supportive environment that nurtures emotional well-being is another critical aspect of promoting resilient families. This includes providing emotional support, setting clear boundaries, and promoting positive discipline strategies. Research indicates that consistent and responsive parenting approaches contribute to improved self-regulation skills, emotional intelligence, and overall mental health in children. Discussion: The discussion centers on the implications of these findings for promoting positive parenting and emotional well-being. It emphasizes the need for parents to prioritize self-care and seek support when facing challenges. Parental well-being directly influences the quality of parenting and the overall family environment. By attending to their own emotional needs, parents can better meet the needs of their children and create a nurturing atmosphere. Furthermore, the importance of fostering resilience in children is highlighted. Resilient children are better equipped to cope with adversity, adapt to change, and thrive in challenging circumstances. By cultivating resilience through supportive relationships, encouragement of independence, and providing opportunities for growth, parents can foster their children's ability to bounce back from setbacks and develop essential life skills. Conclusion: In conclusion, nurturing resilient families is crucial for positive parenting and enhancing emotional well-being. This abstract presents evidence-based strategies that emphasize effective communication, conflict resolution, and creating a supportive environment. By implementing these strategies, parents can strengthen family bonds, promote healthy child development, and enhance overall family resilience. Investing in resilient families not only benefits individual family members but also contributes to the well-being of the broader community.

Keywords: childrearing families, family education, children's mental health, positive parenting, emotional health

Procedia PDF Downloads 62
961 Reconfigurable Device for 3D Visualization of Three Dimensional Surfaces

Authors: Robson da C. Santos, Carlos Henrique de A. S. P. Coutinho, Lucas Moreira Dias, Gerson Gomes Cunha

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The article refers to the development of an augmented reality 3D display, through the control of servo motors and projection of image with aid of video projector on the model. Augmented Reality is a branch that explores multiple approaches to increase real-world view by viewing additional information along with the real scene. The article presents the broad use of electrical, electronic, mechanical and industrial automation for geospatial visualizations, applications in mathematical models with the visualization of functions and 3D surface graphics and volumetric rendering that are currently seen in 2D layers. Application as a 3D display for representation and visualization of Digital Terrain Model (DTM) and Digital Surface Models (DSM), where it can be applied in the identification of canyons in the marine area of the Campos Basin, Rio de Janeiro, Brazil. The same can execute visualization of regions subject to landslides, as in Serra do Mar - Agra dos Reis and Serranas cities both in the State of Rio de Janeiro. From the foregoing, loss of human life and leakage of oil from pipelines buried in these regions may be anticipated in advance. The physical design consists of a table consisting of a 9 x 16 matrix of servo motors, totalizing 144 servos, a mesh is used on the servo motors for visualization of the models projected by a retro projector. Each model for by an image pre-processing, is sent to a server to be converted and viewed from a software developed in C # Programming Language.

Keywords: visualization, 3D models, servo motors, C# programming language

Procedia PDF Downloads 323
960 Statistical Mechanical Approach in Modeling of Hybrid Solar Cells for Photovoltaic Applications

Authors: A. E. Kobryn

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We present both descriptive and predictive modeling of structural properties of blends of PCBM or organic-inorganic hybrid perovskites of the type CH3NH3PbX3 (X=Cl, Br, I) with P3HT, P3BT or squaraine SQ2 dye sensitizer, including adsorption on TiO2 clusters having rutile (110) surface. In our study, we use a methodology that allows computing the microscopic structure of blends on the nanometer scale and getting insight on miscibility of its components at various thermodynamic conditions. The methodology is based on the integral equation theory of molecular liquids in the reference interaction site representation/model (RISM) and uses the universal force field. Input parameters for RISM, such as optimized molecular geometries and charge distribution of interaction sites, are derived with the use of the density functional theory methods. To compare the diffusivity of the PCBM in binary blends with P3HT and P3BT, respectively, the study is complemented with MD simulation. A very good agreement with experiment and the reports of alternative modeling or simulation is observed for PCBM in P3HT system. The performance of P3BT with perovskites, however, seems as expected. The calculated nanoscale morphologies of blends of P3HT, P3BT or SQ2 with perovskites, including adsorption on TiO2, are all new and serve as an instrument in rational design of organic/hybrid photovoltaics. They are used in collaboration with experts who actually make prototypes or devices for practical applications.

Keywords: multiscale theory and modeling, nanoscale morphology, organic-inorganic halide perovskites, three dimensional distribution

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959 Enhancing Strategic Counter-Terrorism: Understanding How Familial Leadership Influences the Resilience of Terrorist and Insurgent Organizations in Asia

Authors: Andrew D. Henshaw

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The research examines the influence of familial and kinship based leadership on the resilience of politically violent organizations. Organizations of this type frequently fight in the same conflicts though are called 'terrorist' or 'insurgent' depending on political foci of the time, and thus different approaches are used to combat them. The research considers them correlated phenomena with significant overlap and identifies strengths and vulnerabilities in resilience processes. The research employs paired case studies to examine resilience in organizations under significant external pressure, and achieves this by measuring three variables. 1: Organizational robustness in terms of leadership and governance. 2. Bounce-back response efficiency to external pressures and adaptation to endogenous and exogenous shock. 3. Perpetuity of operational and attack capability, and political legitimacy. The research makes three hypotheses. First, familial/kinship leadership groups have a significant effect on organizational resilience in terms of informal operations. Second, non-familial/kinship organizations suffer in terms of heightened security transaction costs and social economics surrounding recruitment, retention, and replacement. Third, resilience in non-familial organizations likely stems from critical external supports like state sponsorship or powerful patrons, rather than organic resilience dynamics. The case studies pair familial organizations with non-familial organizations. Set 1: The Haqqani Network (HQN) - Pair: Lashkar-e-Toiba (LeT). Set 2: Jemaah Islamiyah (JI) - Pair: The Abu Sayyaf Group (ASG). Case studies were selected based on three requirements, being: contrasting governance types, exposure to significant external pressures and, geographical similarity. The case study sets were examined over 24 months following periods of significantly heightened operational activities. This enabled empirical measurement of the variables as substantial external pressures came into force. The rationale for the research is obvious. Nearly all organizations have some nexus of familial interconnectedness. Examining familial leadership networks does not provide further understanding of how terrorism and insurgency originate, however, the central focus of the research does address how they persist. The sparse attention to this in existing literature presents an unexplored yet important area of security studies. Furthermore, social capital in familial systems is largely automatic and organic, given at birth or through kinship. It reduces security vetting cost for recruits, fighters and supporters which lowers liabilities and entry costs, while raising organizational efficiency and exit costs. Better understanding of these process is needed to exploit strengths into weaknesses. Outcomes and implications of the research have critical relevance to future operational policy development. Increased clarity of internal trust dynamics, social capital and power flows are essential to fracturing and manipulating kinship nexus. This is highly valuable to external pressure mechanisms such as counter-terrorism, counterinsurgency, and strategic intelligence methods to penetrate, manipulate, degrade or destroy the resilience of politically violent organizations.

Keywords: Counterinsurgency (COIN), counter-terrorism, familial influence, insurgency, intelligence, kinship, resilience, terrorism

Procedia PDF Downloads 297
958 Sensitivity Analysis of Principal Stresses in Concrete Slab of Rigid Pavement Made From Recycled Materials

Authors: Aleš Florian, Lenka Ševelová

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Complex sensitivity analysis of stresses in a concrete slab of the real type of rigid pavement made from recycled materials is performed. The computational model of the pavement is designed as a spatial (3D) model, is based on a nonlinear variant of the finite element method that respects the structural nonlinearity, enables to model different arrangements of joints, and the entire model can be loaded by the thermal load. Interaction of adjacent slabs in joints and contact of the slab and the subsequent layer are modeled with the help of special contact elements. Four concrete slabs separated by transverse and longitudinal joints and the additional structural layers and soil to the depth of about 3m are modeled. The thickness of individual layers, physical and mechanical properties of materials, characteristics of joints, and the temperature of the upper and lower surface of slabs are supposed to be random variables. The modern simulation technique Updated Latin Hypercube Sampling with 20 simulations is used. For sensitivity analysis the sensitivity coefficient based on the Spearman rank correlation coefficient is utilized. As a result, the estimates of influence of random variability of individual input variables on the random variability of principal stresses s1 and s3 in 53 points on the upper and lower surface of the concrete slabs are obtained.

Keywords: concrete, FEM, pavement, sensitivity, simulation

Procedia PDF Downloads 315
957 Influence of Aluminum Content on the Microstructural, Mechanical and Tribological Properties of TiAlN Coatings for Using in Dental and Surgical Instrumentation

Authors: Hernan D. Mejia, Gilberto B. Gaitan, Mauricio A. Franco

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420 steel is normally used in the manufacture of dental and surgical instrumentation, as well as parts in the chemical, pharmaceutical, and food industries, among others, where they must withstand heavy loads and often be in contact with corrosive environments, which leads to wear and deterioration of these steels in relatively short times. In the case of medical applications, the instruments made of this steel also suffer wear and corrosion during the repetitive sterilization processes due to the relatively low achievable hardness of just 50 HRC and its hardly acceptable resistance to corrosion. In order to improve the wear resistance of 420 steel, TiAlN coatings were deposited, increasing the aluminum content in the alloy by varying the power applied to the aluminum target of 900, 1100, and 1300 W. Evaluations using XRD, Micro Raman, XPS, AFM, SEM, and TEM showed a columnar growth crystal structure with an average thickness of 2 microns and consisting of the TiN and TiAlN phases, whose roughness and grain size decrease with a higher Al content. The AlN phase also appears in the sample deposited at 1300W. The hardness, determined by nanoindentation, initially increases with the aluminum content from 9.7 GPa to 17.1 GPa, but then decreases to 15.4 GPa for the sample with the highest aluminum content due to the appearance of hexagonal AlN and a decrease of harder TiN and TiAlN phases. It was observed that the wear coefficient had a contrary behavior, which took values of 2.7; 1.7 and 6.6x10⁻⁶ mm³/N.m, respectively. All the coated samples significantly improved the wear resistance of the uncoated 420 steel.

Keywords: hard coatings, magnetron sputtering, TiAlN coatings, surgical instruments, wear resistance

Procedia PDF Downloads 107
956 Smart Energy Storage: W₁₈O₄₉ NW/Ti₃C₂Tₓ Composite-Enabled All Solid State Flexible Electrochromic Supercapacitors

Authors: Muhammad Hassan, Kemal Celebi

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Developing a highly efficient electrochromic energy storage device with sufficient color fluctuation and significant electrochemical performance is highly desirable for practical energy-saving applications. Here, to achieve a highly stable material with a large electrochemical storage capacity, a W₁₈O₄₉ NW/Ti₃C₂Tₓ composite has been fabricated and deposited on a pre-assembled Ag and W₁₈O₄₉ NW conductive network by Langmuir-Blodgett technique. The resulting hybrid electrode composed of 15 layers of W₁₈O₄₉ NW/Ti₃C₂Tₓ exhibits an areal capacitance of 125 mF/cm², with a fast and reversible switching response. An optical modulation of 98.2% can be maintained at a current density of 5 mAcm⁻². Using this electrode, we fabricated a bifunctional symmetric electrochromic supercapacitor device having an energy density of 10.26 μWh/cm² and a power density of 0.605 mW/cm², with high capacity retention and full columbic efficiency over 4000 charge-discharge cycles. Meanwhile, the device displays remarkable electrochromic characteristics, including fast switching time (5 s for coloring and 7 s for bleaching) and a significant coloration efficiency of 116 cm²/C with good optical modulation stability. In addition, the device exhibits remarkable mechanical flexibility and fast switching while being stable over 100 bending cycles, which is promising for real-world applications.

Keywords: MXene, nanowires, supercapacitor, ion diffusion, electrochromic, coloration efficiency

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955 Exploring Closed-Loop Business Systems Which Eliminates Solid Waste in the Textile and Fashion Industry: A Systematic Literature Review Covering the Developments Occurred in the Last Decade

Authors: Bukra Kalayci, Geraldine Brennan

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Introduction: Over the last decade, a proliferation of literature related to textile and fashion business in the context of sustainable production and consumption has emerged. However, the economic and environmental benefits of solid waste recovery have not been comprehensively searched. Therefore at the end-of-life or end-of-use textile waste management remains a gap. Solid textile waste reuse and recycling principles of the circular economy need to be developed to close the disposal stage of the textile supply chain. The environmental problems associated with the over-production and –consumption of textile products arise. Together with growing population and fast fashion culture the share of solid textile waste in municipal waste is increasing. Focusing on post-consumer textile waste literature, this research explores the opportunities, obstacles and enablers or success factors associated with closed-loop textile business systems. Methodology: A systematic literature review was conducted in order to identify best practices and gaps from the existing body of knowledge related to closed-loop post-consumer textile waste initiatives over the last decade. Selected keywords namely: ‘cradle-to-cradle ‘, ‘circular* economy* ‘, ‘closed-loop* ‘, ‘end-of-life* ‘, ‘reverse* logistic* ‘, ‘take-back* ‘, ‘remanufacture* ‘, ‘upcycle* ‘ with the combination of (and) ‘fashion* ‘, ‘garment* ‘, ‘textile* ‘, ‘apparel* ‘, clothing* ‘ were used and the time frame of the review was set between 2005 to 2017. In order to obtain a broad coverage, Web of Knowledge and Science Direct databases were used, and peer-reviewed journal articles were chosen. The keyword search identified 299 number of papers which was further refined into 54 relevant papers that form the basis of the in-depth thematic analysis. Preliminary findings: A key finding was that the existing literature is predominantly conceptual rather than applied or empirical work. Moreover, the enablers or success factors, obstacles and opportunities to implement closed-loop systems in the textile industry were not clearly articulated and the following considerations were also largely overlooked in the literature. While the circular economy suggests multiple cycles of discarded products, components or materials, most research has to date tended to focus on a single cycle. Thus the calculations of environmental and economic benefits of closed-loop systems are limited to one cycle which does not adequately explore the feasibility or potential benefits of multiple cycles. Additionally, the time period textile products spend between point of sale, and end-of-use/end-of-life return is a crucial factor. Despite past efforts to study closed-loop textile systems a clear gap in the literature is the lack of a clear evaluation framework which enables manufacturers to clarify the reusability potential of textile products through consideration of indicators related too: quality, design, lifetime, length of time between manufacture and product return, volume of collected disposed products, material properties, and brand segment considerations (e.g. fast fashion versus luxury brands).

Keywords: circular fashion, closed loop business, product service systems, solid textile waste elimination

Procedia PDF Downloads 185
954 The Effect of Arbitrary Support Conditions on the Static Behavior of Curved Beams Using the Finite Element Method

Authors: Hossein Mottaghi T., Amir R. Masoodi

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This study presents a finite curved element for analyzing the static behavior of curved beams within the elastic range. The objective is to enhance accuracy while reducing the number of elements by incorporating first-order shear deformations of Timoshenko beams. Initially, finite element formulations are developed by considering polynomial initial functions for axial, shear, and rotational deformations for a three-node element. Subsequently, nodal interpolation functions for this element are derived, followed by the construction of the element stiffness matrix. To enable the utilization of the stiffness matrix in the static analysis of curved beams, the constructed matrix in the local coordinates of the element is transformed to the global coordinate system using the rotation matrix. A numerical benchmark example is investigated to assess the accuracy and effectiveness of this method. Moreover, the influence of spring stiffness on the rotation of the endpoint of a clamped beam is examined by substituting each support reaction of the beam with a spring. In the parametric study, the effect of the central angle of the beam on the rotation of the beam's endpoint in a cantilever beam under a concentrated load is examined. This research encompasses various mechanical, geometrical, and boundary configurations to evaluate the static characteristics of curved beams, thus providing valuable insights for their analysis and examination.

Keywords: curved beam, finite element method, first-order shear deformation theory, elastic support

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953 Comparative Safety Performance Evaluation of Profiled Deck Composite Slab from the Use of Slope-Intercept and Partial Shear Methods

Authors: Izian Abd. Karim, Kachalla Mohammed, Nora Farah Abd Aznieta Aziz, Law Teik Hua

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The economic use and ease of construction of profiled deck composite slab is marred with the complex and un-economic strength verification required for the serviceability and general safety considerations. Beside these, albeit factors such as shear span length, deck geometries and mechanical frictions greatly influence the longitudinal shear strength, that determines the ultimate strength of profiled deck composite slab, and number of methods available for its determination; partial shear and slope-intercept are the two methods according to Euro-code 4 provision. However, the complexity associated with shear behavior of profiled deck composite slab, the use of these methods in determining the load carrying capacities of such slab yields different and conflicting values. This couple with the time and cost constraint associated with the strength verification is a source of concern that draws more attentions nowadays, the issue is critical. Treating some of these known shear strength influencing factors as random variables, the load carrying capacity violation of profiled deck composite slab from the use of the two-methods defined according to Euro-code 4 are determined using reliability approach, and comparatively studied. The study reveals safety values from the use of m-k method shows good standing compared with that from the partial shear method.

Keywords: composite slab, first order reliability method, longitudinal shear, partial shear connection, slope-intercept

Procedia PDF Downloads 340
952 Clinical Course and Prognosis of Cutaneous Manifestations of COVID-19: A Systematic Review of Reported Cases

Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

Procedia PDF Downloads 167