Search results for: never pressure injury

Authors: O. W. Lawal, L. O. Ahmed, Y. K. Ali

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The unsteady MHD Poiseuille flow of a third grade fluid between two parallel horizontal nonconducting porous plates is studied with heat transfer. The two plates are fixed but maintained at different constant temperature with the Joule and viscous dissipation taken into consideration. The fluid motion is produced by a sudden uniform exponential decaying pressure gradient and external uniform magnetic field that is perpendicular to the plates. The momentum and energy equations governing the flow are solved numerically using Maple program. The effects of magnetic field and third grade fluid parameters on velocity and temperature profile are examined through several graphs.

Keywords: exponential decaying pressure gradient, MHD flow, Poiseuille flow, third grade fluid

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Authors: Mengqi Zhu, Chang Nyung Kim

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This study numerically investigates three-dimensional liquid-metal (LM) magnetohydrodynamic (MHD) flows in a misaligned duct under a uniform magnetic field. The duct consists of two misaligned horizontal channels (one is inflow channel, the other is outflow channel) and one central vertical channel. Computational fluid dynamics simulations are performed to predict the behavior of the MHD flows, using commercial code CFX. In the current study, a case with Hartmann number 1000 is considered. The electromagnetic features of LM MHD flows are elucidated to examine the interdependency of the flow velocity, current density, electric potential, pressure drop and Lorentz force. The results show that pressure decreases linearly along the main flow direction.

Keywords: CFX, liquid-metal magnetohydrodynamic flows, misaligned duct, pressure drop

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Authors: Azadeh Jafari, Farzin Ghanadi, Matthew J. Emes, Maziar Arjomandi, Benjamin S. Cazzolato

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The turbulence within the atmospheric boundary layer induces highly unsteady aerodynamic loads on structures. These loads, if not accounted for in the design process, will lead to structural failure and are therefore important for the design of the structures. For an accurate prediction of wind loads, understanding the correlation between atmospheric turbulence and the aerodynamic loads is necessary. The aim of this study is to investigate the effect of turbulence within the atmospheric boundary layer on the surface pressure on a flat plate over a wide range of turbulence intensities and integral length scales. The flat plate is chosen as a fundamental geometry which represents structures such as solar panels and billboards. Experiments were conducted at the University of Adelaide large-scale wind tunnel. Two wind tunnel boundary layers with different intensities and length scales of turbulence were generated using two sets of spires with different dimensions and a fetch of roughness elements. Average longitudinal turbulence intensities of 13% and 26% were achieved in each boundary layer, and the longitudinal integral length scale within the three boundary layers was between 0.4 m and 1.22 m. The pressure distributions on a square flat plate at different elevation angles between 30° and 90° were measured within the two boundary layers with different turbulence intensities and integral length scales. It was found that the peak pressure coefficient on the flat plate increased with increasing turbulence intensity and integral length scale. For example, the peak pressure coefficient on a flat plate elevated at 90° increased from 1.2 to 3 with increasing turbulence intensity from 13% to 26%. Furthermore, both the mean and the peak pressure distribution on the flat plates varied with turbulence intensity and length scale. The results of this study can be used to provide a more accurate estimation of the unsteady wind loads on structures such as buildings and solar panels.

Keywords: atmospheric boundary layer, flat plate, pressure coefficient, turbulence

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Authors: Tan G. K. Y., Chew M. S. J., Sajeev S., Vellasamy A.

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Injuries of the extensor hallucis longus (EHL) tendon are a rare phenomenon, with most occurring due to lacerations or penetrating injuries. Closed traumatic ruptures of the EHL are described as “Mallet injuries of the toe”. These can be classified as bony or soft mallet injuries depending on the presence or absence of a fracture at the insertion site of the EHL tendon in the distal phalanx. We present a case of a 33-year-old woman who presented with a hyperflexion injury to the left big toe with an inability to extend the big toe. Ultrasound showed a complete rupture of the EHL tendon with retraction proximal to the hallucal interphalangeal joint of the big toe. The patient was treated through transarticular pinning and repair using the Arthrex Mini Bio-Suture Tak with a 2-0 fibre wire. Six months postoperatively, the patient had symmetrical EHL power and full range of motion of the toe. The lessons to be drawn from this case report are that isolated hallux mallet injuries are rare and can be easily missed in the absence of penetrating wounds. Patients who have such injuries should be investigated early with the appropriate imaging techniques, such as ultrasound or MRI, and treated surgically.

Keywords: hallux mallet, extensor hallucis longus tendon, extensor hallucis longus

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Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

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Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

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Authors: Michalina Aniola, Andrzej Katrusiak

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4,4-Bipyridine is an important compound often used in chemical practice and more recently frequently applied for designing new metal organic framework (MoFs). Here we present a systematic high-pressure study of its hydrobromide salt. 4,4-Bipyridine hydrobromide monohydrate, 44biPyHBrH₂O, at ambient-pressure is orthorhombic, space group P212121 (phase a). Its hydrostatic compression shows that it is stable to 1.32 GPa at least. However, the recrystallization above 0.55 GPa reveals a new hidden b-phase (monoclinic, P21/c). Moreover, when the 44biPyHBrH2O is heated to high temperature the chemical reactions of this compound in methanol solution can be observed. High-pressure experiments were performed using a Merrill-Bassett diamond-anvil cell (DAC), modified by mounting the anvils directly on the steel supports, and X-ray diffraction measurements were carried out on a KUMA and Excalibur diffractometer equipped with an EOS CCD detector. At elevated pressure, the crystal of 44biPyHBrH₂O exhibits several striking and unexpected features. No signs of instability of phase a were detected to 1.32 GPa, while phase b becomes stable at above 0.55 GPa, as evidenced by its recrystallizations. Phases a and b of 44biPyHBrH2O are partly isostructural: their unit-cell dimensions and the arrangement of ions and water molecules are similar. In phase b the HOH-Br- chains double the frequency of their zigzag motifs, compared to phase a, and the 44biPyH+ cations change their conformation. Like in all monosalts of 44biPy determined so far, in phase a the pyridine rings are twisted by about 30 degrees about bond C4-C4 and in phase b they assume energy-unfavorable planar conformation. Another unusual feature of 44biPyHBrH2O is that all unit-cell parameters become longer on the transition from phase a to phase b. Thus the volume drop on the transition to high-pressure phase b totally depends on the shear strain of the lattice. Higher temperature triggers chemical reactions of 44biPyHBrH2O with methanol. When the saturated methanol solution compound precipitated at 0.1 GPa and temperature of 423 K was required to dissolve all the sample, the subsequent slow recrystallization at isochoric conditions resulted in disalt 4,4-bipyridinium dibromide. For the 44biPyHBrH2O sample sealed in the DAC at 0.35 GPa, then dissolved at isochoric conditions at 473 K and recrystallized by slow controlled cooling, a reaction of N,N-dimethylation took place. It is characteristic that in both high-pressure reactions of 44biPyHBrH₂O the unsolvated disalt products were formed and that free base 44biPy and H₂O remained in the solution. The observed reactions indicate that high pressure destabilized ambient-pressure salts and favors new products. Further studies on pressure-induced reactions are carried out in order to better understand the structural preferences induced by pressure.

Keywords: conformation, high-pressure, negative area compressibility, polymorphism

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Authors: Masoumeh Khailghi Sikaroudi, Mohsen Masoodi, Fazad Shidfar, Meghdad Sedaghat

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Background: The hypertonicity of internal anal sphincter resting pressure is one of the main reasons for chronic anal fissures. The aim of this study is to assess the effect of oral administration of L-arginine on anal fissure symptom improvement by relaxation of the internal anal sphincter. Method: Seventy-six chronic anal fissure patients (age: 18-65 years) took part in this randomized, double-blind, placebo-controlled trial study from February 2019 to October 2020 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were allocated into treatment (L-arginine) or placebo groups. They took a 1000 mg capsule three times a day for one month and were followed up at the end of the first and third months after receiving the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. Result: The analysis of data was shown significant improvement in bleeding, fissure size, and pain within each group; however, this effect was more seen in the arginine group compared to the control group at the end of the study (P-values<0.001). Following that, a significant increase in QoL was seen just in patients who were treated with arginine (P-value=0.006). Also, the comparison of anal pressures to baseline and between groups at the end of the study showed a significant reduction in sphincter pressure in treated patients (P-value<0.001, =0.049; respectively). Conclusion: Oral administration of 3000 mg L-arginine can heal chronic anal fissures by reducing anal internal sphincter pressure with fewer side effects. However, a long-term study with more follow-up is recommended.

Keywords: L-arginine, anal fissure, sphincter pressure, clinical symptoms, quality of life

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Authors: Sepideh Beiramipour, Hadi Haghjouei, Kourosh Qaderi, Majid Rahimpour, Mohammad M. Ahmadi, Sameh A. Kantoush

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Reservoir sedimentation is one of the main challenges by which the reservoir behind the dam is filled with sediments transferred through the river flow. Pressure flushing method is an effective way to drain the deposited sediments of the reservoirs through the bottom outlet. So far, several structural methods have been proposed to increase the efficiency of pressure flushing. The aim of this study is to increase the performance of Dendritic Bottomless Extended (DBE) structure on the efficiency of pressurized sediment flushing using submerged vanes. For this purpose, the physical model of the dam reservoir with dimensions of 7.5 m in length, 3.5 m in width, and 1.8 m in height in the hydraulic and water structures research laboratory of Shahid Bahonar University of Kerman was used. In order to investigate the influence of submerged vanes on the performance of DBE structure in pressure flushing, the best arrangement and geometric parameters of the vanes were selected and combined with the DBE structure. The results showed that the submerged vanes significantly increased the performance of the DBE structure so that the volume of the sediment flushing cone with the combination of two structures increased by 3.7 times compared to the DBE structure test.

Keywords: dendritic bottomless extended structure, flushing efficiency, sedimentation, sediment flushing

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Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

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Authors: Osman Turkoglu, Alvin Estilo, Ritu Gupta, Liliam Pineda-Salgado, Rajesh Pandey

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Background: Hepatotoxicity can be linked to a variety of clinical symptoms and histopathological signs, posing a great challenge in the surveillance of suspected drug-induced liver injury (DILI) cases in the safety database. Additionally, the majority of such cases are rare, idiosyncratic, highly unpredictable, and tend to demonstrate unique individual susceptibility; these qualities, in turn, lend to a pharmacovigilance monitoring process that is often tedious and time-consuming. Objective: Develop a multifactorial algorithm to assist pharmacovigilance physicians in identifying high-risk hepatotoxicity cases associated with DILI from the sponsor’s safety database (Argus). Methods: Multifactorial selection criteria were established using Structured Query Language (SQL) and the TIBCO Spotfire® visualization tool, via a combination of word fragments, wildcard strings, and mathematical constructs, based on Hy’s law criteria and pattern of injury (R-value). These criteria excluded non-eligible cases from monthly line listings mined from the Argus safety database. The capabilities and limitations of these criteria were verified by comparing a manual review of all monthly cases with system-generated monthly listings over six months. Results: On an average, over a period of six months, the algorithm accurately identified 92% of DILI cases meeting established criteria. The automated process easily compared liver enzyme elevations with baseline values, reducing the screening time to under 15 minutes as opposed to multiple hours exhausted using a cognitively laborious, manual process. Limitations of the algorithm include its inability to identify cases associated with non-standard laboratory tests, naming conventions, and/or incomplete/incorrectly entered laboratory values. Conclusions: The newly developed multifactorial algorithm proved to be extremely useful in detecting potential DILI cases, while heightening the vigilance of the drug safety department. Additionally, the application of this algorithm may be useful in identifying a potential signal for DILI in drugs not yet known to cause liver injury (e.g., drugs in the initial phases of development). This algorithm also carries the potential for universal application, due to its product-agnostic data and keyword mining features. Plans for the tool include improving it into a fully automated application, thereby completely eliminating a manual screening process.

Keywords: automation, drug-induced liver injury, pharmacovigilance, post-marketing

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Authors: R. Haoui

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The purpose of this work is to simulate the flow at the exit of Vulcan 1 engine of European launcher Ariane 5. The geometry of the propellant nozzle is already determined using the characteristics method. The pressure in the outlet section of the nozzle is less than atmospheric pressure on the ground, causing the existence of oblique and normal shock waves at the exit. During the rise of the launcher, the atmospheric pressure decreases and the shock wave disappears. The code allows the capture of shock wave at exit of nozzle. The numerical technique uses the Flux Vector Splitting method of Van Leer to ensure convergence and avoid the calculation instabilities. The Courant, Friedrichs and Lewy coefficient (CFL) and mesh size level are selected to ensure the numerical convergence. The nonlinear partial derivative equations system which governs this flow is solved by an explicit unsteady numerical scheme by the finite volume method. The accuracy of the solution depends on the size of the mesh and also the step of time used in the discretized equations. We have chosen in this study the mesh that gives us a stationary solution with good accuracy.

Keywords: finite volume, lunchers, nozzles, shock wave

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Authors: Tsun-Hui Huang, Shyue-Cheng Yang, Chiou-Fen Shieha

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In this paper, a nonlinear constitutive law and a curve fitting, two relationships between the stress-strain and the shear stress-strain for sandstone material were used to obtain a second-order polynomial constitutive equation. Based on the established polynomial constitutive equations and Newton’s second law, a mathematical model of the non-homogeneous nonlinear wave equation under an external pressure was derived. The external pressure can be assumed as an impulse function to simulate a real earthquake source. A displacement response under nonlinear two-dimensional wave equation was determined by a numerical method and computer-aided software. The results show that a suit pressure in the sandstone generates the phenomenon of stress solitary waves.

Keywords: polynomial constitutive equation, solitary, stress solitary waves, nonlinear constitutive law

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Authors: Lukasz Grabowski, Konrad Pietrykowski, Michal Bialy

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This paper presents the results of the research to verify the combustion in aircraft piston engine Asz62-IR. This engine was modernized and a type of ignition system was developed. Due to the high costs of experiments of a nine-cylinder 1,000 hp aircraft engine, a simulation technique should be applied. Therefore, computational fluid dynamics to simulate the combustion process is a reasonable solution. Accordingly, the tests for varied ignition advance angles were carried out and the optimal value to be tested on a real engine was specified. The CFD model was created with the AVL Fire software. The engine in the research had two spark plugs for each cylinder and ignition advance angles had to be set up separately for each spark. The results of the simulation were verified by comparing the pressure in the cylinder. The courses of the indicated pressure of the engine mounted on a test stand were compared. The real course of pressure was measured with an optical sensor, mounted in a specially drilled hole between the valves. It was the OPTRAND pressure sensor, which was designed especially to engine combustion process research. The indicated pressure was measured in cylinder no 3. The engine was running at take-off power. The engine was loaded by a propeller at a special test bench. The verification of the CFD simulation results was based on the results of the test bench studies. The course of the simulated pressure obtained is within the measurement error of the optical sensor. This error is 1% and reflects the hysteresis and nonlinearity of the sensor. The real indicated pressure measured in the cylinder and the pressure taken from the simulation were compared. It can be claimed that the verification of CFD simulations based on the pressure is a success. The next step was to research on the impact of changing the ignition advance timing of spark plugs 1 and 2 on a combustion process. Moving ignition timing between 1 and 2 spark plug results in a longer and uneven firing of a mixture. The most optimal point in terms of indicated power occurs when ignition is simultaneous for both spark plugs, but so severely separated ignitions are assured that ignition will occur at all speeds and loads of engine. It should be confirmed by a bench experiment of the engine. However, this simulation research enabled us to determine the optimal ignition advance angle to be implemented into the ignition control system. This knowledge allows us to set up the ignition point with two spark plugs to achieve as large power as possible.

Keywords: CFD model, combustion, engine, simulation

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Authors: Priyakant Vaghela, Jagdish Prajapati

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Bending stress at the root of the gear tooth is the very important criteria in gear design and it should be kept the minimum. Minimization of bending stress at the root of the gear tooth is a recent demand from industry. This paper presents an innovative approach to obtain minimum bending stress at the root of a tooth by optimizing tooth root profile and drive side pressure angle. Circular-filleted at the root of the tooth is widely used in the design. Circular fillet creates discontinuity at the root of the tooth. So, at root stress concentration occurs. In order to minimize stress concentration, an important criterion is a G2 continuity at the blending of the gear tooth. A Bezier curve is used with G2 continuity at the root of asymmetric spur gear tooth. The comparison has been done between normal and modified tooth using ANSYS simulation. Tooth root profile and drive side pressure angle are optimized to minimize bending stress at the root of the tooth of the asymmetric involute spur gear. Von Mises stress of optimized profile is analyzed and compared with normal profile symmetric gear. Von Mises stress is reducing by 31.27% by optimization of drive side pressure angle and root profile. Stress concentration of modified gear was significantly reduced.

Keywords: asymmetric spur gear tooth, G2 continuity, pressure angle, stress concentration at the root of tooth, tooth root stress

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Authors: Seng Sing Tan

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Clamping of the umbilical cord after birth is widely practiced as a part of labor management. Further improvements were proposed to produce a smaller, lighter and more comfortable clamp while still maintaining current standards of clamping. A detachable holder was also developed to facilitate the clamping process. This pilot study on the efficacy of the mini-clamp was conducted to evaluate a tightness of the seal and a firm grip of the clamp on the umbilical cord. The study was carried out at National University Hospital, using 5 sets of placental cord. 18 samples of approximate 10 cm each were harvested. The test results showed that the mini-clamp was able to stop the flow through the cord after clamping without rupturing the cord. All slip tests passed with a load of 0.2 kg. In the pressure testing, 30kPa of saline was exerted into the umbilical veins. Although there was no physical sign of fluid leaking through the end secured by the mini-clamp, the results showed the pressure was not able to sustain the pressure set during the tests. 12 out of the 18 test samples have more than 7% of pressure drop in 30 seconds. During the pressure leak test, it was observed on several samples that when pressurized, small droplets of saline were growing on the outer surface of the cord lining membrane. It was thus hypothesized that the pressure drop was likely caused by the perfusion of the injected saline through the Wharton’s jelly and the cord lining membrane. The average pressure in the umbilical vein is roughly 2.67kPa (20 mmHg), less than 10% of 30kPa (~225mmHg), set for the pressure testing. As such, the pressure set could be over-specified, leading to undesirable outcomes. The development of the mini-clamp was an attempt to increase the comfort of newly born babies while maintaining the usability and efficacy of hospital grade umbilical cord clamp. The pressure leak in this study would be unfair to fully attribute it to the design and efficacy of the mini-clamp. Considering the unexpected leakage of saline through the umbilical membrane due to over-specified pressure exerted on the umbilical veins, improvements can definitely be made to the existing experimental setup to obtain a more accurate and conclusive outcome. If proven conclusive and effective, the mini-clamp with a detachable holder could be a smaller and potentially cheaper alternative to existing umbilical cord clamps. In addition, future clinical trials could be conducted to determine the user-friendliness of the mini-clamp and evaluate its practicality in the clinical setting by labor ward clinicians. A further potential improvement could be proposed on the sustainability factor of the mini-clamp. A biodegradable clamp would revolutionise the industry in this increasingly environmentally sustainability world.

Keywords: leak test, mini-clamp, slip test, umbilical cord

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Authors: Adel Khorramrouz, Monireh Ahmadi Bani, Ehsan Norouzi, Morvarid Lalenoor

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Background: Plantar pressure distribution measurement has been used for a long time to assess foot disorders. Plantar pressure is an important component affecting the foot and ankle function and Changes in plantar pressure distribution could indicate various foot and ankle disorders. Morphologic and mechanical properties of the foot may be important factors affecting the plantar pressure distribution. Accurate and early measurement may help to reduce the prevalence of pes planus. With recent developments in technology, new techniques such as machine learning have been used to assist clinicians in predicting patients with foot disorders. Significance of the study: This study proposes a neural network learning-based flat foot classification methodology using static foot pressure distribution. Methodologies: Data were collected from 895 patients who were referred to a foot clinic due to foot disorders. Patients with pes planus were labeled by an experienced physician based on clinical examination. Then all subjects (with and without pes planus) were evaluated for static plantar pressures distribution. Patients who were diagnosed with the flat foot in both feet were included in the study. In the next step, the leg length was normalized and the network was trained for plantar pressure mapping images. Findings: From a total of 895 image data, 581 were labeled as pes planus. A computational neural network (CNN) ran to evaluate the performance of the proposed model. The prediction accuracy of the basic CNN-based model was performed and the prediction model was derived through the proposed methodology. In the basic CNN model, the training accuracy was 79.14%, and the test accuracy was 72.09%. Conclusion: This model can be easily and simply used by patients with pes planus and doctors to predict the classification of pes planus and prescreen for possible musculoskeletal disorders related to this condition. However, more models need to be considered and compared for higher accuracy.

Keywords: foot disorder, machine learning, neural network, pes planus

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Authors: Merouane Salhi, Toufik Zebbiche

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When the stagnation pressure of perfect gas increases, the specific heat and their ratio do not remain constant anymore and start to vary with this pressure. The gas doesn’t remain perfect. Its state equation change and it becomes for a real gas. In this case, the effects of molecular size and intermolecular attraction forces intervene to correct the state equation. The aim of this work is to show and discuss the effect of stagnation pressure on supersonic thermodynamical, physical and geometrical flow parameters, to find a general case for real gas. With the assumptions that Berthelot’s state equation accounts for the molecular size and intermolecular force effects, expressions are developed for analyzing supersonic flow for thermally and calorically imperfect gas lower than the dissociation molecules threshold. The designs parameters for supersonic nozzle like thrust coefficient depend directly on stagnation parameters of the combustion chamber. The application is for air. A computation of error is made in this case to give a limit of perfect gas model compared to real gas model.

Keywords: supersonic flow, real gas model, Berthelot’s state equation, Simpson’s method, condensation function, stagnation pressure

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Authors: Xu Rumin, Chen Jianyi, Yue Ti, Wang Yaan

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With the rapid development of subsea oil and gas exploitation, the demand for the related underwater process equipment is increasing fast. In order to reduce the energy consuming, people tend to separate the gas and oil phase directly on the seabed. Accordingly, an advanced separator is needed. In this paper, the pressure drop of a new type of separator named Gas Liquid Cylindrical Cyclone (GLCC) which is used in the subsea system is investigated by both experiments and numerical simulation. In the experiments, the single phase flow and gas-liquid two phase flow in GLCC were tested. For the simulation, the performance of GLCC under both laboratory and industrial conditions was calculated. The Eulerian model was implemented to describe the mixture flow field in the GLCC under experimental conditions and industrial oil-natural gas conditions. Furthermore, a relationship among Euler number (Eu), Reynolds number (Re), and Froude number (Fr) is generated according to similarity analysis and simulation data, which can present the GLCC separation performance of pressure drop. These results can give reference to the design and application of GLCC in deep sea.

Keywords: dimensionless analysis, gas-liquid cylindrical cyclone, numerical simulation, pressure drop

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Authors: Tianyi Wang, Hieyong Jeong, An Guo, Yuko Ohno

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Healthcare robot for assisting sit-to-stand (STS) performance had aroused numerous research interests. To author’s best knowledge, knowledge about how evaluating healthcare robot is still unknown. Robot should be labeled as fault if users feel demanding during STS when they are assisted by robot. In this research, we aim to propose a method to evaluate sit-to-stand assist robot through center of pressure (CoP), then classify different STS performance. Experiments were executed five times with ten healthy subjects under four conditions: two self-performed STSs with chair heights of 62 cm and 43 cm, and two robot-assisted STSs with chair heights of 43 cm and robot end-effect speed of 2 s and 5 s. CoP was measured using a Wii Balance Board (WBB). Bayesian classification was utilized to classify STS performance. The results showed that faults occurred when decreased the chair height and slowed robot assist speed. Proposed method for fault classification showed high probability of classifying fault classes form others. It was concluded that faults for STS assist robot could be detected by inspecting center of pressure and be classified through proposed classification algorithm.

Keywords: center of pressure, fault classification, healthcare robot, sit-to-stand movement

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Authors: Mapula Mothomogolo, Anria Clarke

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Ballistic grilles are adopted on military vehicles to mitigate the vulnerability of the radiator. The design of ballistic grilles needs to address conflicting requirements: shielding the surface area of the radiator from incoming projectile threats yet providing sufficient airflow through the radiator to yield adequate heat rejection. These conflicting requirements result in a unique and challenging design problem. In this paper, the airflow through a ballistic grille using a computational modelling approach is investigated. A comparative study was conducted between a standard grille and a ballistic grille of a military vehicle. The results were used as a benchmark study for optimizing the ballistic grille with pressure drop selected as the parameter for optimization. The grilles were modelled as a porous medium to account for the pressure drop in the porous region. The effects of the porous zone were accounted for in the source term of the momentum Navier Stokes equations. The source term defines the pressure drop in the porous region as a function of the velocity. A pressure drop curve approach was used to determine the Darcy coefficient and inertial resistance coefficients of the source terms. The empirically defined coefficients were used as simulation input for a more accurate pressure drop prediction in the porous region. Additionally, the ballistic grille was optimized using an adjoint solver (shape optimization module in Ansys Fluent) to reduce the pressure drop through the ballistic grille by 30%. Based on the simulation results, the optimized ballistic grille geometry needs to be experimentally tested to validate the numerical simulation data.

Keywords: ballistic grille, darcy coefficient, optimization, porous medium

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Authors: Yan Zeng, Li Tao, Liujun Han, Tianye Zhang, Yongan Yu, Kaijun Ma, Long Chen

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Mechanical asphyxia is one of the main cause of death; however, death by mechanical asphyxia may be difficult to prove in court, particularly in cases in which corpses exhibit no obvious signs of asphyxia. To identify a credible biomarker of asphyxia, we first examined the expression levels of all the mRNAs in human cardiac tissue specimens subjected to mechanical asphyxia and compared these expression levels with those of the corresponding mRNAs in specimens subjected to craniocerebral injury. A total of 119 differentially expressed mRNAs were selected and the expression levels of these mRNAs were examined in 44 human cardiac tissue specimens subjected to mechanical asphyxia, craniocerebral injury, hemorrhagic shock and other causes of death. We found that DUSP1 and KCNJ2 were up-regulated in tissue specimens of mechanical asphyxia compared with control tissues, with no significant correlation between age, environmental temperature and PMI, indicating that DUSP1 and KCNJ2 may associate with mechanical asphyxia-induced death and can thus serve as useful biomarkers of death by mechanical asphyxia.

Keywords: mechanical asphyxia, biomarkers, DUSP1, KCNJ2, cardiac tissue

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Authors: Abbas Shafiee, Mohammad Taghi Ahmadian, Maryam Hoviattalab

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The biomechanical behavior of brain tissue is needed for predicting the traumatic brain injury (TBI). Each year over 1.5 million people sustain a TBI in the USA. The appropriate coefficients for injury prediction can be evaluated using experimental data. In this study, an experimental setup on brain soft tissue was developed to perform unconfined compression tests at quasistatic strain rates ∈0.0004 s-1 and 0.008 s-1 and 0.4 stress relaxation test under unconfined uniaxial compression with ∈ 0.67 s-1 ramp rate. The fitted visco-hyperelastic parameters were utilized by using obtained stress-strain curves. The experimental data was validated using finite element analysis (FEA) and previous findings. Also, influence of friction coefficient on unconfined compression and relaxation test and effect of ramp rate in relaxation test is investigated. Results of the findings are implemented on the analysis of a human brain under high acceleration due to impact.

Keywords: brain soft tissue, visco-hyperelastic, finite element analysis (FEA), friction, quasistatic strain rate

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Authors: Hitoshi Minakuchi, Izumi Takei, Shu Wakino, Koichi Hayashi, Hiroshi Itoh

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Objectives: Among type 2 diabetics, patients with CKD(chronic kidney disease), insulin resistance, impaired glyconeogenesis in kidney and reduced degradation of insulin are recognized, and we observed different fluctuational patterns of blood sugar between CKD patients and non-CKD patients. On the other hand, non-dipper type blood pressure change is the risk of organ damage and mortality. We performed cross-sectional study to elucidate the characteristic of the fluctuation of blood glucose and blood pressure at insulin-treated diabetic patients with chronic kidney disease. Methods: From March 2011 to April 2013, at the Ichikawa General Hospital of Tokyo Dental College, we recruited 20 outpatients. All participants are insulin-treated type 2 diabetes with CKD. We collected serum samples, urine samples for several hormone measurements, and performed CGMS(Continuous glucose measurement system), ABPM (ambulatory blood pressure monitoring), brain computed tomography, carotid artery thickness, ankle brachial index, PWV, CVR-R, and analyzed these data statistically. Results: Among all 20 participants, hypoglycemia was decided blood glucose 70mg/dl by CGMS of 9 participants (45.0%). The event of hypoglycemia was recognized lower eGFR (29.8±6.2ml/min：41.3±8.5ml/min, P<0.05), lower HbA1c (6.44±0.57%：7.53±0.49%), higher PWV (1858±97.3cm/s：1665±109.2cm/s), higher serum glucagon (194.2±34.8pg/ml：117.0±37.1pg/ml), higher free cortisol of urine (53.8±12.8μg/day：34.8±7.1μg/day), and higher metanephrin of urine (0.162±0.031mg/day：0.076±0.029mg/day). Non-dipper type blood pressure change in ABPM was detected 8 among 9 participants with hypoglycemia (88.9%), 4 among 11 participants (36.4%) without hypoglycemia. Multiplex logistic-regression analysis revealed that the event of hypoglycemia is the independent factor of non-dipper type blood pressure change. Conclusions: Among insulin-treated type 2 diabetic patients with CKD, the events of hypoglycemia were frequently detected, and can associate with the organ derangements through the medium of non-dipper type blood pressure change.

Keywords: chronic kidney disease, hypoglycemia, non-dipper type blood pressure change, diabetic patients

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Authors: Ahmed Negm, George Aggidis, Xiandong Ma

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With the diverse nature of urban cities, customer demand patterns, landscape topologies or even seasonal weather trends; managing our water distribution networks (WDNs) has proved a complex task. These unpredictable circumstances manifest as pipe failures, intermittent supply and burst events thus adding to water loss, energy waste and increased carbon emissions. Whilst these events are unavoidable, advanced pressure management has proved an effective tool to control and mitigate them. Henceforth, water utilities have struggled with developing a real-time control method that is resilient when confronting the challenges of water distribution. In this paper we use deep reinforcement learning (DRL) algorithms as a novel pressure control strategy to minimise pressure violations and leakage under both burst and background leakage conditions. Agents based on asynchronous actor critic (A2C) and recurrent proximal policy optimisation (Recurrent PPO) were trained and compared to benchmarked optimisation algorithms (differential evolution, particle swarm optimisation. A2C manages to minimise leakage by 32.48% under burst conditions and 67.17% under background conditions which was the highest performance in the DRL algorithms. A2C and Recurrent PPO performed well in comparison to the benchmarks with higher processing speed and lower computational effort.

Keywords: deep reinforcement learning, pressure management, water distribution networks, leakage management

Procedia PDF Downloads 82

Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal

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Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.

Keywords: resistant, hypertension, spironolactone, blood pressure

Procedia PDF Downloads 273

Authors: Abdul Hadi Bin Abdol Rahim, Alhassan Salami Tijani

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Hydrogen produced by means of polymer electrolyte membrane electrolyzer (PEME) is one of the most promising methods due to clean and renewable energy source. In the process, some energy loss due to mass transfer through a PEM is caused by diffusion, electro-osmotic drag, and the pressure difference between the cathode channel and anode channel. In PEME water molecules and ionic particles transferred between the electrodes from anode to cathode, Extensive mixing of the hydrogen and oxygen at anode channel due to gases cross-over must be avoided. In recent times the consciousness of safety issue in high pressure PEME where the oxygen mix with hydrogen at anode channel could create, explosive conditions have generated a lot of concern. In this paper, the steady state and simulation analysis of gases crossover in PEME on the temperature and pressure effect are presented. The simulations have been analysis in MATLAB based on the well-known Fick’s Law of molecular diffusion. The simulation results indicated that as temperature increases, there is a significant decrease in operating voltage.

Keywords: diffusion, gases crosover, steady state, Fick’s law

Procedia PDF Downloads 327

Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Huma Shareef, Ghazala H. Rizwani, Ahsana Dar

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In traditional medicine Cardiospermum halicacabum L. (Sapindeaceae) is used against various ailments. In current investigation searching a new remedy that will available easily, non expensive, able to lower hypertension and standardize blood pressure, made us to develop an herbal medicine. Crude ethanol extract of C. halicacabum and its various fractions ethyl acetate and butanol showed a dose-dependent hypotensive effect in anaesthetized rats. The trachea was exposed and freed from connective tissue and incubated by cannula to facilitate spontaneous respiration. The right carotid artery and left jugular vein were cannulated with polyethylene tubing PE-50 for monitoring blood pressure changes via pressure transducer (Gould P23 ID) connected to a Grass model 79D polygraph and for i.v. injection, respectively. Drugs or the plant extracts were administered at a constant volume of 0.5 ml/kg, followed by injection of 0.2 ml of saline that flushed the cannula. Systolic, diastolic and mean arterial blood pressure (MABP) was measured in mm Hg and heart rate in beats/min. Ethanol extract of C. halicacabum showed a significant activity at 50 mg/kg dose. Ethyl acetate fraction (10, 20, 30, 40, and 50 mg/kg) induced dose dependent fall in systolic and diastolic blood pressure, heart rate of rats. At 10-30 mg/kg the hypotensive effect was non significantly reduced by 10 -15%. However, the extract at 40 mg/kg induced significant hypotensive effect calculated as 30.95±3.2% MABP and this effect persists till 50 mg/kg. The higher polar fraction (butanol) of the whole plant failed to produce any significant response against MABP at all the tested doses (10-50 mg/kg). C. halicacabum lowers blood pressure, exerts a dose-dependent hypotensive effect, can be used as hypotensor.

Keywords: cardiospermum halicacabum, calcium channel blocker, hypotensive, various extracts

Procedia PDF Downloads 500

Authors: N. R. Putra, A. H. Abdul Aziz, A. S. Zaini, Z. Idham, F. Idrus, M. Z. Bin Zullyadini, M. A. Che Yunus

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The content of omega-3 in soybean oil is important in the development of infants and is an alternative for the omega-3 in fish oils. The investigation of extraction of soybean oil is needed to obtain the bioactive compound in the extract. Supercritical carbon dioxide extraction is modern and green technology to extract herbs and plants to obtain high quality extract due to high diffusivity and solubility of the solvent. The aim of this study was to obtain the optimum condition of soybean oil extraction by modified supercritical carbon dioxide. The soybean oil was extracted by using modified supercritical carbon dioxide (SC-CO₂) under the temperatures of 40, 60, 80 °C, pressures of 150, 250, 350 Bar, and constant flow-rate of 10 g/min as the parameters of extraction processes. An experimental design was performed in order to optimize three important parameters of SC-CO₂ extraction which are pressure (X₁), temperature (X₂) to achieve optimum yields of soybean oil. Box Behnken Design was applied for experimental design. From the optimization process, the optimum condition of extraction of soybean oil was obtained at pressure 338 Bar and temperature 80 °C with oil yield of 2.713 g. Effect of pressure is significant on the extraction of soybean oil by modified supercritical carbon dioxide. Increasing of pressure will increase the oil yield of soybean oil.

Keywords: soybean oil, SC-CO₂ extraction, yield, optimization

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Authors: J. DeBoard, R. Dietrich, J. Hughes, K. Yurko, G. Harms

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Alzheimer’s disease (AD) is a predominant type of dementia and is likely a major cause of neural network impairment. The pathogenesis of this neurodegenerative disorder has yet to be fully elucidated. There are currently no known cures for the disease, and the best hope is to be able to detect it early enough to impede its progress. Beyond age and genetics, another prevalent risk factor for AD might be traumatic brain injury (TBI), which has similar neurodegenerative hallmarks. Our research focuses on obtaining information and methods to be able to predict when neurodegenerative effects might occur at a clinical level by observation of events at a cellular and molecular level in model mice. First, we wish to introduce our evidence that brain damage can be observed via brain imaging prior to the noticeable loss of neuromuscular control in model mice of AD. We then show our evidence that some blood biomarkers might be able to be early predictors of AD in the same model mice. Thus, we were interested to see if we might be able to predict which mice might show long-term neurodegenerative effects due to differing degrees of TBI and what level of TBI causes further damage and earlier death to the AD model mice. Upon application of TBIs via an apparatus to effectively induce extremely mild to mild TBIs, wild-type (WT) mice and AD mouse models were tested for cognition, neuromuscular control, olfactory ability, blood biomarkers, and brain imaging. Experiments are currently still in process, and more results are therefore forthcoming. Preliminary data suggest that neuromotor control diminishes as well as olfactory function for both AD and WT mice after the administration of five consecutive mild TBIs. Also, seizure activity increases significantly for both AD and WT after the administration of the five TBI treatment. If future data supports these findings, important implications about the effect of TBI on those at risk for AD might be possible.

Keywords: Alzheimer's disease, blood biomarker, neurodegeneration, neuromuscular control, olfaction, traumatic brain injury

Procedia PDF Downloads 140