Search results for: fracture clinic
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1107

Search results for: fracture clinic

627 Stress Intensity Factor for Dynamic Cracking of Composite Material by X-FEM Method

Authors: S. Lecheb, A. Nour, A. Chellil, H. Mechakra, N. Hamad, H. Kebir

Abstract:

The work involves develops attended by a numerical execution of the eXtend Finite Element Method premises a measurement by the fracture process cracked so many cracked plates an application will be processed for the calculation of the stress intensity factor SIF. In the first we give in statically part the distribution of stress, displacement field and strain of composite plate in two cases uncrack/edge crack, also in dynamical part the first six modes shape. Secondly, we calculate Stress Intensity Factor SIF for different orientation angle θ of central crack with length (2a=0.4mm) in plan strain condition, KI and KII are obtained for mode I and mode II respectively using X-FEM method. Finally from crack inclined involving mixed modes results, the comparison we chose dangerous inclination and the best crack angle when K is minimal.

Keywords: stress intensity factor (SIF), crack orientation, glass/epoxy, natural frequencies, X-FEM

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626 Intervention To Prevent Infections And Reinfections With Intestinal Parasites In People Living With Human Immunodeficiency Virus In Some Parts Of Eastern Cape, South Africa

Authors: Ifeoma Anozie, Teka Apalata, Dominic Abaver

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Introduction: Despite use of Anti-retroviral therapy to reduce the incidence of opportunistic infections among HIV/AIDS patients, rapid episodes of re-infection after deworming are still common occurrences because pharmaceutical intervention alone does not prevent reinfection. Unsafe water and inadequate personal hygiene and parasitic infections are widely expected to accelerate the progression of HIV infection. This is because the chronic immunosuppression of HIV infection encourages susceptibility to opportunistic (including parasitic) infections which is linked to CD4+ cell count of <200 cells/μl. Intestinal parasites such as G. intestinalis and Entamoeba spp are ubiquitous protozoa that remain infectious over a long time in an environment and show resistance to standard disinfection. To control re-infection, the social factors that underpin the prevention need to be controlled. This study aims at prevention of intestinal parasites in people living with HIV/AIDS by using a treatment, hygiene education and sanitation (THEdS) bundle approach. Methods: This study was conducted in four clinics (Ngangelizwe health centre, Tsolo gateway clinic, Idutywa health centre and Nqamakwe health centre) across the seven districts in Eastern cape, South Africa. The four clinics were divided in two: experimental and control, for the purpose of intervention. Data was collected from March 2019 to February 2020. Six hundred participants were screened for intestinal parasitic infections. Stool samples were collected and analysed twice: before (Pre-test infection screening) and after (Post-test re-infection) THEdS bundle intervention. The experimental clinics received full intervention package, which include therapeutic treatment, health education on personal hygiene and sanitation training, while the control clinics received only therapeutic treatment for those found with intestinal parasitic infections. Results: Baseline prevalence of Intestinal Parasites isolated shows 12 intestinal parasites with overall frequency of 65, with Ascaris lumbricoides having most frequency (44.6%). The intervention had a cure rate of 60%, with odd ratio of 1.42, which indicates that the intervention group is 1.42 times more likely of parasite clearing as compared to the control group. The relative risk ratio of 1.17 signifies that there is 1.17 times more likelihood to clear intestinal parasite if there no intervention. Discussion and conclusion: Infection with multiple parasites can cause health defects, especially among HIV/AIDS patients. Efficiency of some HIV vaccines in HIV/AIDS patients is affected because treatment of re-infection amplifies drug resistance, affects the efficacy of the front-line drugs, and still permits transmission. In South Africa, treatment of intestinal parasites is usually offered to clinic attending HIV/AIDS patients upon suspicion but not as a mandate for patients being initiated into Antiretroviral (ART) program. The effectiveness of THEdS bundle advocates for inclusiveness of mandatory screening for intestinal parasitic infections among attendees of HIV/Aids clinics on regular basis.

Keywords: cure rate, , HIV/AIDS patients, intestinal parasites, intervention studies, reinfection rate

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625 Identifying Risk Factors for Readmission Using Decision Tree Analysis

Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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624 Theoretical Approach to Kinetics of Transient Plasticity of Metals under Irradiation

Authors: Pavlo Selyshchev, Tetiana Didenko

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Within the framework of the obstacle radiation hardening and the dislocation climb-glide model a theoretical approach is developed to describe peculiarities of transient plasticity of metal under irradiation. It is considered nonlinear dynamics of accumulation of point defects (vacancies and interstitial atoms). We consider metal under such stress and conditions of irradiation at which creep is determined by dislocation motion: dislocations climb obstacles and glide between obstacles. It is shown that the rivalry between vacancy and interstitial fluxes to dislocation leads to fractures of plasticity time dependence. Simulation and analysis of this phenomenon are performed. Qualitatively different regimes of transient plasticity under irradiation are found. The fracture time is obtained. The theoretical results are compared with the experimental ones.

Keywords: climb and glide of dislocations, fractures of transient plasticity, irradiation, non-linear feed-back, point defects

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623 Calculation of Stress Intensity Factors in Rotating Disks Containing 3D Semi-Elliptical Cracks

Authors: Mahdi Fakoor, Seyed Mohammad Navid Ghoreishi

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Initiation and propagation of cracks may cause catastrophic failures in rotating disks, and hence determination of fracture parameter in rotating disks under the different working condition is very important issue. In this paper, a comprehensive study of stress intensity factors in rotating disks containing 3D semi-elliptical cracks under the different working condition is investigated. In this regard, after verification of modeling and analytical procedure, the effects of mechanical properties, rotational velocity, and orientation of cracks on Stress Intensity Factors (SIF) in rotating disks under centrifugal loading are investigated. Also, the effects of using composite patch in reduction of SIF in rotating disks are studied. By that way, the effects of patching design variables like mechanical properties, thickness, and ply angle are investigated individually.

Keywords: stress intensity factor, semi-elliptical crack, rotating disk, finite element analysis (FEA)

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622 Computation of Thermal Stress Intensity Factor for Bonded Composite Repairs in Aircraft Structures

Authors: Fayçal Benyahia, Abdelmohsen Albedah, Bel Abbes Bachir Bouiadjra

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In this study the Finite element method is used to analyse the effect of the thermal residual stresses resulting from adhesive curing on the performances of the bonded composite repair in aircraft structures. The stress intensity factor at the crack tip is chosen as fracture criterion in order to estimate the repair performances. The obtained results show that the presence of the thermal residual stresses reduces considerably the repair performances and consequently decreases the fatigue life of cracked structures. The effects of the curing temperature, the adhesive properties and the adhesive thickness on the Stress Intensity Factor (SIF) variation with thermal stresses are also analysed.

Keywords: bonded composite repair, residual stress, adhesion, stress transfer, finite element analysis

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621 A Large-Strain Thermoviscoplastic Damage Model

Authors: João Paulo Pascon

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A constitutive model accounting for large strains, thermoviscoplasticity, and ductile damage evolution is proposed in the present work. To this end, a fully Lagrangian framework is employed, considering plane stress conditions and multiplicative split of the deformation gradient. The full model includes Gurson’s void growth, nucleation and coalescence, plastic work heating, strain and strain-rate hardening, thermal softening, and heat conductivity. The contribution of the work is the combination of all the above-mentioned features within the finite-strain setting. The model is implemented in a computer code using triangular finite elements and nonlinear analysis. Two mechanical examples involving ductile damage and finite strain levels are analyzed: an inhomogeneous tension specimen and the necking problem. Results demonstrate the capabilities of the developed formulation regarding ductile fracture and large deformations.

Keywords: ductile damage model, finite element method, large strains, thermoviscoplasticity

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620 Visual Improvement with Low Vision Aids in Children with Stargardt’s Disease

Authors: Anum Akhter, Sumaira Altaf

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Purpose: To study the effect of low vision devices i.e. telescope and magnifying glasses on distance visual acuity and near visual acuity of children with Stargardt’s disease. Setting: Low vision department, Alshifa Trust Eye Hospital, Rawalpindi, Pakistan. Methods: 52 children having Stargardt’s disease were included in the study. All children were diagnosed by pediatrics ophthalmologists. Comprehensive low vision assessment was done by me in Low vision clinic. Visual acuity was measured using ETDRS chart. Refraction and other supplementary tests were performed. Children with Stargardt’s disease were provided with different telescopes and magnifying glasses for improving far vision and near vision. Results: Out of 52 children, 17 children were males and 35 children were females. Distance visual acuity and near visual acuity improved significantly with low vision aid trial. All children showed visual acuity better than 6/19 with a telescope of higher magnification. Improvement in near visual acuity was also significant with magnifying glasses trial. Conclusions: Low vision aids are useful for improvement in visual acuity in children. Children with Stargardt’s disease who are having a problem in education and daily life activities can get help from low vision aids.

Keywords: Stargardt, s disease, low vision aids, telescope, magnifiers

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619 Postural Orthostatic Tachycardia Syndrome: A Case Study and Discussion of Its Epidemiology, Pathophysiology, Diagnosis, and Management

Authors: Zayd Parekh, Amish Prasad, Baraa Souman

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Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance due to an exaggerated tachycardia in response to standing upright. This exaggerated orthostatic tachycardia is defined as the heart rate (HR) rising 30 beats above a baseline value while supine or seated within ten minutes. The tachycardia can lead to symptoms of orthostatic intolerance such as palpitations, lightheadedness, exercise intolerance, fatigue, and anxiety. POTS can go undiagnosed for many years due to its similarities with other cardiac and psychiatric conditions and nonspecific presentation, making it crucial to raise awareness for it in the medical field. The following case study discusses a 30-year-old female who was evaluated in the emergency room several times before being referred to the clinic for POTS. An overview of what tests are performed with this patient is also provided, highlighting the diagnostic work-up for POTS and the process of ruling out other differentials being considered. Finally, the epidemiology, the various theories regarding its pathophysiology, the diagnostic process, and pharmacological and non-pharmacological management for POTS are reviewed.

Keywords: orthostatic intolerance, postural orthostatic tachycardia syndrome, syncope, tachycardia

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618 Nondestructive Monitoring of Atomic Reactions to Detect Precursors of Structural Failure

Authors: Volodymyr Rombakh

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This article was written to substantiate the possibility of detecting the precursors of catastrophic destruction of a structure or device and stopping operation before it. Damage to solids results from breaking the bond between atoms, which requires energy. Modern theories of strength and fracture assume that such energy is due to stress. However, in a letter to W. Thomson (Lord Kelvin) dated December 18, 1856, J.C. Maxwell provided evidence that elastic energy cannot destroy solids. He proposed an equation for estimating a deformable body's energy, equal to the sum of two energies. Due to symmetrical compression, the first term does not change, but the second term is distortion without compression. Both types of energy are represented in the equation as a quadratic function of strain, but Maxwell repeatedly wrote that it is not stress but strain. Furthermore, he notes that the nature of the energy causing the distortion is unknown to him. An article devoted to theories of elasticity was published in 1850. Maxwell tried to express mechanical properties with the help of optics, which became possible only after the creation of quantum mechanics. However, Maxwell's work on elasticity is not cited in the theories of strength and fracture. The authors of these theories and their associates are still trying to describe the phenomena they observe based on classical mechanics. The study of Faraday's experiments, Maxwell's and Rutherford's ideas, made it possible to discover a previously unknown area of electromagnetic radiation. The properties of photons emitted in this reaction are fundamentally different from those of photons emitted in nuclear reactions and are caused by the transition of electrons in an atom. The photons released during all processes in the universe, including from plants and organs in natural conditions; their penetrating power in metal is millions of times greater than that of one of the gamma rays. However, they are not non-invasive. This apparent contradiction is because the chaotic motion of protons is accompanied by the chaotic radiation of photons in time and space. Such photons are not coherent. The energy of a solitary photon is insufficient to break the bond between atoms, one of the stages of which is ionization. The photographs registered the rail deformation by 113 cars, while the Gaiger Counter did not. The author's studies show that the cause of damage to a solid is the breakage of bonds between a finite number of atoms due to the stimulated emission of metastable atoms. The guarantee of the reliability of the structure is the ratio of the energy dissipation rate to the energy accumulation rate, but not the strength, which is not a physical parameter since it cannot be measured or calculated. The possibility of continuous control of this ratio is due to the spontaneous emission of photons by metastable atoms. The article presents calculation examples of the destruction of energy and photographs due to the action of photons emitted during the atomic-proton reaction.

Keywords: atomic-proton reaction, precursors of man-made disasters, strain, stress

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617 Determining the Frequency of Pneumonia Emerging in COVID-19 Infection

Authors: Zoirov Amirdin Olimovich, Akbarov Elbek Elmurodovich

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Introduction: Pneumonia that occurs during COVID-19 infection is common among patients. This research was conducted to determine the frequency of symptoms occurring during pneumonia according to the purpose. Objective and Task: The goal of our research is to develop clinical concepts of pneumonia that occur during COVID-19 infection. Our main task is to analyze the results of blood tests and understand the progression of the disease. Research Materials and Methods: The research was conducted among patients admitted to the Tashkent Medical Academy multi-profile clinic in the department of infectious diseases undergoing stationary treatment with a diagnosis of COVID-19. The analyzed patients had an average age of 46, with a total of 48 patients, 23 of whom were female and 25 were male. Research Results: The research results showed the development of pneumonia within three days in 27 patients after COVID-19 infection. During the observation period, 24 patients (88.8%) recovered completely. The X-ray revealed no signs of pneumonia in those who fully recovered. The remaining three patients showed a persistent form of pneumonia. Conclusion: The conclusion of the research indicates that pneumonia during COVID-19 infection develops in many patients, and 88.8% of patients recover completely without any lingering symptoms.

Keywords: COVID-19, pneumonia, the X-ray, blood, TTA

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616 Granule Morphology of Zirconia Powder with Solid Content on Two-Fluid Spray Drying

Authors: Hyeongdo Jeong, Jong Kook Lee

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Granule morphology and microstructure were affected by slurry viscosity, chemical composition, particle size and spray drying process. In this study, we investigated granule morphology of zirconia powder with solid content on two-fluid spray drying. Zirconia granules after spray drying show sphere-like shapes with a diameter of 40-70 μm at low solid contents (30 or 40 wt%) and specific surface area of 5.1-5.6 m²/g. But a donut-like shape with a few cracks were observed on zirconia granules prepared from the slurry of high solid content (50 wt %), green compacts after cold isostatic pressing under the pressure of 200 MPa have the density of 2.1-2.2 g/cm³ and homogeneous fracture surface by complete destruction of granules. After the sintering at 1500 °C for 2 h, all specimens have relative density of 96.2-98.3 %. With increasing a solid content from 30 to 50 wt%, grain size increased from 0.3 to 0.6 μm, but relative density was inversely decreased from 98.3 to 96.2 %.

Keywords: zirconia, solid content, granulation, spray drying

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615 Effect of Welding Parameters on Mechanical and Microstructural Properties of Aluminum Alloys Produced by Friction Stir Welding

Authors: Khalil Aghapouramin

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The aim of the present work is to investigate the mechanical and microstructural properties of dissimilar and similar aluminum alloys welded by Friction Stir Welding (FSW). The specimens investigated by applying different welding speed and rotary speed. Typically, mechanical properties of the joints performed through tensile test fatigue test and microhardness (HV) at room temperature. Fatigue test investigated by using electromechanical testing machine under constant loading control with similar since wave loading. The Maximum stress versus minimum got the range between 0.1 to 0.3 in the research. Based upon welding parameters by optical observation and scanning electron microscopy microstructural properties fulfilled with a cross section of welds, in addition, SEM observations were made of the fracture surfaces

Keywords: friction stir welding, fatigue and tensile test, Al alloys, microstructural behavior

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614 A Robust Optimization Method for Service Quality Improvement in Health Care Systems under Budget Uncertainty

Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh

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With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.

Keywords: allocation, budget uncertainty, healthcare resource, service quality assessment, robust optimization

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613 Quick off the Mark with Achilles Tendon Rupture

Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

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Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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612 Preparation and Characterization of Poly (ε-caprolactone) Loaded with Layered Double Hydroxide Nanohybrid Intercalated with Alendronate for Osteoporosis Treatment

Authors: Seyedeh Faranak Baniahmad, Soroor Yousefi

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Osteoporosis is a bone disease which increases the bone fracture risk, reduces the bone mineral density (BMD) and alters the amount and variety of proteins in bones. Antiresorptive therapy is one the most popular Osteoporosis treatment methods. In this method the bisphosphonates, hormones, calcitonin or the selective estrogen receptor modulators is replaced. In order to reduce undesirable effects and to increase the bioavailability of drug agents, the controlled drug delivery systems have been utilized. In current study, the controlled release of Alendronate from LDH-PCL with (0, 5, 10, 15 % wt. of LDH) was investigated. The results showed that the release of alendronate from the lamellar LDH incorporated into the PCL matrix is much slower than the release of alendronate from the PCL. Therefore such systems are very promising, in which the antiresorptive drug has to remain in the matrix for longer time and can be released in controlled manner.

Keywords: osteoporosis, alendronate, poly (ε–caprolactone), layered double hydroxide

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611 Clinical Characteristics of Children Presenting with History of Child Sexual Abuse to a Tertiary Care Centre in India

Authors: T. S. Sowmya Bhaskaran, Shekhar Seshadri

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This study aims to study the clinical features of with a history of Child Sexual Abuse (CSA). A chart review of 40 children (<16 years) with history of CSA evaluated at the Department of Child and Adolescent Psychiatry of NIMHANS during a two year period was performed. Results:The most common form of abuse was contact penetrative abuse (65%) followed by non-contact penetrative abuse (32.5%). 75% (N=30) had a psychiatric diagnosis at baseline. 50% of these children had one or more psychiatric comorbidities. Anxiety disorder was the most common diagnosis (27.5%) which included PTSD (11%) followed by Depressive disorder (25.2%). Children abused by multiple perpetrators were found to be more likely to have depression, to having a comorbid psychiatric disorder and more prone to exhibit sexualized behaviour. Children who also experienced physical violence at home were more likely to develop psychiatric illness following child sexual abuse. Psychiatric morbidity is high in clinic population of children with history of CSA. It is important to increase the awareness regarding the consequences of CSA in order to increase help seeking.

Keywords: child sexual abuse, India, tertiary care centre, clinical characteristics

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610 Single Stage “Fix and Flap” Orthoplastic Approach to Severe Open Tibial Fractures: A Systematic Review of the Outcomes

Authors: Taylor Harris

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Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

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609 Experimental Characterization of the Shear Behavior of Fiber Reinforced Concrete Beam Elements in Chips

Authors: Djamal Atlaoui, Youcef Bouafia

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This work deals with the experimental study of the mechanical behavior, by shear tests (fracture shear), elements of concrete beams reinforced with fibers in chips. These fibers come from the machining waste of the steel parts. The shear tests are carried out on prismatic specimens of dimensions 10 x 20 x 120 cm3. The fibers are characterized by mechanical resistance and tearing. The optimal composition of the concrete was determined by the workability test. Two fiber contents are selected for this study (W = 0.6% and W = 0.8%) and a BT control concrete (W = 0%) of the same composition as the matrix is developed to serve as a reference with a sand-to-gravel ratio (S/G) of concrete matrix equal to 1. The comparison of the different results obtained shows that the chips fibers confer a significant ductility to the material after cracking of the concrete. Also, the fibers used limit diagonal cracks in shear and improve strength and rigidity.

Keywords: characterization, chips fibers, cracking mode, ductility, undulation, shear

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608 Analysis of Three-Dimensional Cracks in an Isotropic Medium by the Semi-Analytical Method

Authors: Abdoulnabi Tavangari, Nasim Salehzadeh

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We presume a cylindrical medium that is under a uniform loading and there is a penny shaped crack located in the center of cylinder. In the crack growth analysis, the Stress Intensity Factor (SIF) is a fundamental prerequisite. In the present study, according to the RITZ method and by considering a cylindrical coordinate system as the main coordinate and a local polar coordinate, the mode-I SIF of threedimensional penny-shaped crack is obtained. In this method the unknown coefficients will be obtained with minimizing the potential energy that is including the strain energy and the external force work. By using the hook's law, stress fields will be obtained and then by using the Irvine equations, the amount of SIF will be obtained near the edge of the crack. This question has been solved for extreme medium in the Tada handbook and the result of the present research has been compared with that.

Keywords: three-dimensional cracks, penny-shaped crack, stress intensity factor, fracture mechanics, Ritz method

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607 Seismic Behavior of Short Core Buckling Restrained Braces

Authors: Nader Hoveidae

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This paper investigates the seismic behavior of a new type of buckling restrained braces (BRBs) called "Short Core BRBs" in which a shorter core segment is used as an energy dissipating part and an elastic part is serially connected to the core. It seems that a short core BRB is easy to be fabricated, inspected and replaced after a severe earthquake. In addition, the energy dissipating capacity in a short core BRB is higher because of larger core strains. However, higher core strain demands result in high potential of low-cycle fatigue fracture. In this paper, a strategy is proposed to estimate the minimum core length in a short core BRBs. The seismic behavior of short core buckling restrained brace is experimentally examined. The results revealed that the short core buckling restrained brace is able to sustain large inelastic strains without any significant instability or strength degradation.

Keywords: short core, Buckling Restrained Brace, finite element analysis, cyclic test

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606 Numerical Modelling of Dry Stone Masonry Structures Based on Finite-Discrete Element Method

Authors: Ž. Nikolić, H. Smoljanović, N. Živaljić

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This paper presents numerical model based on finite-discrete element method for analysis of the structural response of dry stone masonry structures under static and dynamic loads. More precisely, each discrete stone block is discretized by finite elements. Material non-linearity including fracture and fragmentation of discrete elements as well as cyclic behavior during dynamic load are considered through contact elements which are implemented within a finite element mesh. The application of the model was conducted on several examples of these structures. The performed analysis shows high accuracy of the numerical results in comparison with the experimental ones and demonstrates the potential of the finite-discrete element method for modelling of the response of dry stone masonry structures.

Keywords: dry stone masonry structures, dynamic load, finite-discrete element method, static load

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605 Strengthening and Toughening of Dental Porcelain by the Inclusion of an Yttria-Stabilized Zirconia Reinforcing Phase

Authors: Buno Henriques, Rafaela Santos, Júlio Matias de Souza, Filipe Silva, Rubens Nascimento, Márcio Fredel

Abstract:

Dental porcelain composites reinforced and toughened by 20 wt.% tetragonal zirconia (3Y-TZP) were processed by hot pressing at 1000°C. Two types of particles were tested: yttria-stabilized zirconia (ZrO2–3%Y2O3) agglomerates and pre-sintered yttria-stabilized zirconia (ZrO2–3%Y2O3) particles. The composites as well as the reinforcing particles were analyzed by the means of optical and Scanning Electron Microscopy (SEM), Energy Dispersion Spectroscopy (EDS) and X-Ray Diffraction (XRD). The mechanical properties were obtained by the transverse rupture strength test, Vickers indentations and fracture toughness. Wear tests were also performed on the composites and monolithic porcelain. The best mechanical and wear results were displayed by the porcelain reinforced with the pre-sintered ZrO2–3%Y2O3 particles.

Keywords: dental restoration, zirconia, porcelain, composites, strengthening, toughening, wear

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604 Sustainable Community Participation in Australia

Authors: Virginia Dickson-Swift, Amanda Kenny, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

Abstract:

In this presentation, we will focus on the methods of Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. Using oral health as the focus, we will discuss the ways that RSF can be used to achieve sustainable engagement with stakeholders from various parts of the community. We will describe our findings of using RSF methods to engage with rural communities, including the steps involved and what happened when we asked people about the oral health services that they thought were needed in their community. We found that most community members started by thinking that a public dental clinic was required in every community, which is not a sustainable health service delivery option. Through a series of facilitated workshops, communities were able to discuss and prioritise their needs and develop a costed plan for their community which will ensure sustainable service delivery into the future. Our study highlights the complexities of decision making in rural communities. It is important to ensure that when communities participate in health care planning that the outcomes are practical, feasible and sustainable.

Keywords: community participation, sustainable health planning, Remote Services Futures, rural communities

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603 Analysis of High-Velocity Impacts on Concrete

Authors: Conceição, J. F. M., Rebelo H., Corneliu C., Pereira L.

Abstract:

This research analyses the response of two distinct types of concrete blocks, each possessing an approximate unconfined compressive strength of 30MPa, when exposed to high-velocity impacts produced by an Explosively Formed Penetrator (EFP) traveling at an initial velocity of 1200 m/s. Given the scarcity of studies exploring high-velocity impacts on concrete, the primary aim of this research is to scrutinize how concrete behaves under high-speed impacts, ultimately contributing valuable insights to the development of protective structures. To achieve this objective, a comprehensive numerical analysis was carried out in LS-DYNA to delve into the fracture mechanisms inherent in concrete under such extreme conditions. Subsequently, the obtained numerical outcomes were compared and validated through eight experimental field tests. The methodology employed involved a robust combination of numerical simulations and real-world experiments, ensuring a comprehensive understanding of concrete behavior in scenarios involving rapid, high-energy impacts.

Keywords: high-velocity, impact, numerical analysis, experimental tests, concrete

Procedia PDF Downloads 55
602 Exploring Mechanical Properties of Additive Manufacturing Ceramic Components Across Techniques and Materials

Authors: Venkatesan Sundaramoorthy

Abstract:

The field of ceramics has undergone a remarkable transformation with the advent of additive manufacturing technologies. This comprehensive review explores the mechanical properties of additively manufactured ceramic components, focusing on key materials such as Alumina, Zirconia, and Silicon Carbide. The study delves into various authors' review technology into the various additive manufacturing techniques, including Stereolithography, Powder Bed Fusion, and Binder Jetting, highlighting their advantages and challenges. It provides a detailed analysis of the mechanical properties of these ceramics, offering insights into their hardness, strength, fracture toughness, and thermal conductivity. Factors affecting mechanical properties, such as microstructure and post-processing, are thoroughly examined. Recent advancements and future directions in 3D-printed ceramics are discussed, showcasing the potential for further optimization and innovation. This review underscores the profound implications of additive manufacturing for ceramics in industries such as aerospace, healthcare, and electronics, ushering in a new era of engineering and design possibilities for ceramic components.

Keywords: mechanical properties, additive manufacturing, ceramic materials, PBF

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601 Finite Element Modeling Techniques of Concrete in Steel and Concrete Composite Members

Authors: J. Bartus, J. Odrobinak

Abstract:

The paper presents a nonlinear analysis 3D model of composite steel and concrete beams with web openings using the Finite Element Method (FEM). The core of the study is the introduction of basic modeling techniques comprehending the description of material behavior, appropriate elements selection, and recommendations for overcoming problems with convergence. Results from various finite element models are compared in the study. The main objective is to observe the concrete failure mechanism and its influence on the structural performance of numerical models of the beams at particular load stages. The bearing capacity of beams, corresponding deformations, stresses, strains, and fracture patterns were determined. The results show how load-bearing elements consisting of concrete parts can be analyzed using FEM software with various options to create the most suitable numerical model. The paper demonstrates the versatility of Ansys software usage for structural simulations.

Keywords: Ansys, concrete, modeling, steel

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600 New Stress Instability Workability Criteria for Internal Ductile Failure in Steel Cold Heading

Authors: Amar Sabih, James Nemes

Abstract:

The occurrence of internal ductile failure within the Adiabatic Shear Band (ASB) in cold-headed products presents a significant barrier in the fast-expanding cold-heading (CH) industry. The presence of internal ductile failure in cold-headed products may lead to catastrophic fracture under tensile loads despite the ductile nature of the material causing expensive industrial recalls. Therefore, this paper presents a new workability criterion that uses stress instability as an indicator to accurately reveal the locus of initiation of internal ductile failures. The concept of the instability criterion is to use the stress ratio at failure as a weighting function to indicate the initiation of ductile failure inside the ASBs. This paper presents a comprehensive experimental, metallurgical, and finite element simulation study to calculate the material constants used in this criterion.

Keywords: adiabatic sher band, ductile failure, stress instability, workability criterion

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599 Fracture Crack Monitoring Using Digital Image Correlation Technique

Authors: B. G. Patel, A. K. Desai, S. G. Shah

Abstract:

The main of objective of this paper is to develop new measurement technique without touching the object. DIC is advance measurement technique use to measure displacement of particle with very high accuracy. This powerful innovative technique which is used to correlate two image segments to determine the similarity between them. For this study, nine geometrically similar beam specimens of different sizes with (steel fibers and glass fibers) and without fibers were tested under three-point bending in a closed loop servo-controlled machine with crack mouth opening displacement control with a rate of opening of 0.0005 mm/sec. Digital images were captured before loading (unreformed state) and at different instances of loading and were analyzed using correlation techniques to compute the surface displacements, crack opening and sliding displacements, load-point displacement, crack length and crack tip location. It was seen that the CMOD and vertical load-point displacement computed using DIC analysis matches well with those measured experimentally.

Keywords: Digital Image Correlation, fibres, self compacting concrete, size effect

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598 Improvement in Properties of Ni-Cr-Mo-V Steel through Process Control

Authors: Arnab Majumdar, Sanjoy Sadhukhan

Abstract:

Although gun barrel steels are an important variety from defense view point, available literatures are very limited. In the present work, an IF grade Ni-Cr-Mo-V high strength low alloy steel is produced in Electric Earth Furnace-ESR Route. Ingot was hot forged to desired dimension with a reduction ratio of 70-75% followed by homogenization, hardening and tempering treatment. Sample chemistry, NMIR, macro and micro structural analyses were done. Mechanical properties which include tensile, impact, and fracture toughness were studied. Ultrasonic testing was done to identify internal flaws. The existing high strength low alloy Ni-Cr-Mo-V steel shows improved properties in modified processing route and heat treatment schedule in comparison to properties noted earlier for manufacturing of gun barrels. The improvement in properties seems to withstand higher explosive loads with the same amount of steel in gun barrel application.

Keywords: gun barrel steels, IF grade, chemistry, physical properties, thermal and mechanical processing, mechanical properties, ultrasonic testing

Procedia PDF Downloads 345