Search results for: lower limb muscles
5428 Audit of Intraoperative Ventilation Strategy in Prolonged Abdominal Surgery
Authors: Prabir Patel, Eugene Ming Han Lim
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Introduction: Current literature shows that postoperative pulmonary complications following abdominal surgery may be reduced by using lower than conventional tidal volumes intraoperatively together with moderate levels of positive end expiratory pressure (PEEP). The recent studies demonstrated significant reduction demonstrated significant reduction in major complications in elective abdominal surgery through the use of lower tidal volumes (6-8 ml/kg predicted body weight), PEEP of 5 cmH20 and recruitment manoeuvres compared to higher ‘conventional’ volumes (10-12 mls/kg PBW) without lung recruitment. Our objective was to retrospectively audit current practice for patients undergoing major abdominal surgery in Sir Charles Gairdner Hospital. Methods: Patients over 18 undergoing elective general surgery lasting more than 3 hours and intubated during the duration of procedure were included in this audit. Data was collected over a 6 month period. Patients who had hepatic surgery, procedures necessitating one-lung ventilation, transplant surgery, documented history of pulmonary or intracranial hypertension were excluded. Results: 58 suitable patients were identified and notes were available for 54 patients. Key findings: Average peak airway pressure was 21cmH20 (+4), average peak airway pressure was less than 30 cmH20 in all patients, and less than 25 cmH20 in 80% of the cases. PEEP was used in 81% of the cases. Where PEEP was used, 75% used PEEP more than or equal to 5 cmH20. Average tidal volume per actual body weight was 7.1 ml/kg (+1.6). Average tidal volume per predicted body weight (PBW) was 8.8 ml/kg (+1.5). Average tidal volume was less than 10 ml/kg PBW in 90% of cases; 6-8 ml/kg PBW in 40% of the cases. There was no recorded use of recruitment manoeuvres in any cases. Conclusions: In the vast majority of patients undergoing prolonged abdominal surgery, a lung protective strategy using moderate levels of PEEP, peak airway pressures of less than 30 cmH20 and tidal volumes of less than 10 cmH20/kg PBW was utilised. A recent randomised control trial demonstrated benefit from utilising even lower volumes (6-8 mls/kg) based on findings in critical care patients, but this was compared to volumes of 10-12 ml/kg. Volumes of 6-8 ml/kg PBW were utilised in 40% of cases in this audit. Although theoretically beneficial, clinical benefit of lower volumes than what is currently practiced in this institution remains to be seen. The incidence of pulmonary complications was much lower than in the other cited studies and a larger data set would be required to investigate any benefit from lower tidal volume ventilation. The volumes used are comparable to results from published local and international data but PEEP utilisation was higher in this audit. Strategies that may potentially be implemented to ensure and maintain best practice include pre-operative recording of predicted body weight, adjustment of default ventilator settings and education/updates of current evidence.Keywords: anaesthesia, intraoperative ventilation, PEEP, tidal volume
Procedia PDF Downloads 7575427 Implementation of a Virtual Testbed for Secure IoT Firmware Update Using Blockchain
Authors: Tarun Chand, Michael Jurczyk
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With the increasing need and popularity of IoT devices and how integrated they are becoming in our daily lives and industries, these devices make for a very lucrative target for malicious actors. And since these devices have such limited resources, the implementation of robust security features is a tradeoff to be made for the actual functionality the device was intended for. This makes them an easy target with high returns. Several frameworks for the secure firmware update of these devices have been recently proposed in the literature. They focus on methods such as blockchains and distributed file systems to secure firmware updates, but do not go into the details of the actual implementation of these frameworks and the lower-level interactions among these methods used. This work integrates some of these security measures into one overall framework and details the actual lower-level implementation of this framework in a virtual dockerized testbed running on AWS.Keywords: blockchain, Ethereum, Geth, IPFS, secure IoT-firmware update, virtual testbed development
Procedia PDF Downloads 575426 Short Term Effects of Mobilization with Movement in a Patient with Fibromyalgia: A Case Report
Authors: S. F. Kanaan, Fatima Al-Kadi, H. Khrais
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Background: Fibromyalgia is a chronic condition that is characterized by chronic pain that limits physical and functional activities. To our best knowledge, there is currently no key physiotherapy approach recommended to reduce pain and improve function. In addition, there are scarce studies that investigated the effect of manual therapy in the management of Fibromyalgia, and no study investigated the efficacy of Mulligan´s mobilization with movement (MWM) in particular. Methods: A 51-year-old female diagnosed with Fibromyalgia for more than a year. The patient was complaining of generalized pain including neck, lower back, shoulders, elbows, hips, and knees. In addition, the patient reported severe limitation in activities and inability to complete her work as a lawyer. The Intervention provided for the patient consisted of 4 sessions (in two weeks) of MWM for neck, lower back, shoulders, elbows, sacroiliac joint, hips, and knees. The Visual Analogue Scale of pain (VAS), Range of Motion (ROM), 10-minute walk test, Roland Morris Low Back Pain and Disability Questionnaire (RMQ), Disability of the Arm, Shoulder and Hand Score (DASH) were collected at the baseline and at the end of treatment. Results: Average improvement of ROM in the neck, lower back, shoulder, elbows, hips, and knees was 45%. VAS scale changed from pre-treatment to post-treatment as the following: neck pain (9 to 0), lower back pain (8 to 1), shoulders pain (8 to 2), elbows pain (7 to 1), and knees pain (9 to 0). The patient demonstrated improvement in all functional scale from pre-intervention to post-intervention: 10-meter walk test (9.8 to 4.5 seconds), RMQ (21 to 11/24), and DASH (88.7% to 40.5%). The patient did not report any side effect of using this approach. Conclusion: Fibromyalgia can cause joint 'faulty position' leading to pain and dysfunction, which can be reversed by using MWM. MWM showed to have clinically significant improvement in ROM, pain, and ability to walk and a clinically significant reduction in disability in only 4 sessions. This work can be expanded in a larger sample.Keywords: mobilization, fibromyalgia, dysfunction, manual therapy
Procedia PDF Downloads 1615425 Relation of Black Carbon Aerosols and Atmospheric Boundary Layer Height during Wet Removal Processes over a Semi Urban Location
Authors: M. Ashok Williams, T. V. Lakshmi Kumar
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The life cycle of Black carbon aerosols depends on their physical removal processes from the atmosphere during the precipitation events. Black Carbon (BC) mass concentration has been analysed during rainy and non-rainy days of Northeast (NE) Monsoon months of the years 2015 and 2017 over a semi-urban environment near Chennai (12.81 N, 80.03 E), located on the east coast of India. BC, measured using an Aethalometer (AE-31) has been related to the atmospheric boundary layer height (BLH) obtained from the ERA Interim Reanalysis data during rainy and non-rainy days on monthly mean basis to understand the wet removal of BC over the study location. The study reveals that boundary layer height has a profound effect on the BC concentration on rainy days and non rainy days. It is found that the BC concentration in the night time is lower on rainy days compared to non rainy days owing to wash out on rainy days and the boundary layer height remaining nearly the same on rainy and non rainy days. On the other hand, in the daytime, it is found that the BC concentration remains nearly the same on rainy and non rainy days whereas the boundary layer height is lower on rainy days compared to non rainy days. This reveals that in daytime, lower boundary layer heights compensate for the wet removal effect on BC concentration on rainy days. A quantitative relation is found between the product of BC and BLH during rainy and non-rainy days which indicates the extent of redistribution of BC during non-rainy days when compared to the rainy days. Further work on the wet removal processes of the BC is in progress considering the individual rain events and other related parameters like wind speed.Keywords: black carbon aerosols, atmospheric boundary layer, scavenging processes, tropical coastal location
Procedia PDF Downloads 1475424 Self-Determination Needs, Coping Strategies and Quality of Life Among Chronic Non-Specific Lower Back Pain Patients
Authors: Zubana Afzal, Afsheen Massod
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This quantitative study was carried out in order to explore the role of coping strategies as an explanatory mechanism in the relationship between self-determination needs and quality of life. A cross-sectional survey research design was conducted using scales such as the Basic Psychological Needs Scale (Deci&Ryan, 2000) to measure self-determination-based needs, Pain Coping Strategies Questionnaire (Harland &Georgieff, 2003), and Quality of Life Brief (The WHOQOL Group, 1998), in translated form in addition to a demographic information sheet. The sample comprised 120 (Women=63, Men=57), taken from different hospitals in Lahore, Multan, and Gojra. Descriptive and Inferential analyses were executed through SPSS version 23.00. All self-determination needs were found in result to be significantly and positively correlated with diversion and cognitive pain coping strategies, physical, psychological, social, and environmental quality of life, and significantly negatively correlated with catastrophizing and reinterpreting pain coping strategies. Cognitive and diversion pain coping strategies were found to be significantly and positively associated with all physical, psychological, social, and environmental quality of life. The regression analyses revealed that the strongest predictors were autonomy, cognitive and diversion pain coping strategies in predicting quality of life. All coping strategies except reinterpreting played a mediating role between self-determination needs and quality of life. The findings can lead to a better understanding of the role of self-determination needs and pain coping strategies in determining the quality of life among chronic non-specific lower back pain patients.Keywords: quality of life, chronic lower back pain, coping strategies, self determination needs
Procedia PDF Downloads 925423 Absence of Developmental Change in Epenthetic Vowel Duration in Japanese Speakers’ English
Authors: Takayuki Konishi, Kakeru Yazawa, Mariko Kondo
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This study examines developmental change in the production of epenthetic vowels by Japanese learners of English in relation to acquisition of L2 English speech rhythm. Seventy-two Japanese learners of English in the J-AESOP corpus were divided into lower- and higher-level learners according to their proficiency score and the frequency of vowel epenthesis. Three learners were excluded because no vowel epenthesis was observed in their utterances. The analysis of their read English speech data showed no statistical difference between lower- and higher-level learners, implying the absence of any developmental change in durations of epenthetic vowels. This result, together with the findings of previous studies, will be discussed in relation to the transfer of L1 phonology and manifestation of L2 English rhythm.Keywords: vowel epenthesis, Japanese learners of English, L2 speech corpus, speech rhythm
Procedia PDF Downloads 2595422 Morphological Study of Sesamoid Bones of Thumb in South Indians
Authors: B. V. Murlimanju, R. Abisshek Balaji, Apoorva Aggarwal, Mangala M. Pai
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Background: Since the literature is scarce from the South Indian population about the sesamoid bones of the thumb, the present study was undertaken. The objective of the present study was to figure out the muscle of the thumb which contain these sesamoid bones. Methods: The present study included 25 cadaveric thumbs, which were obtained from the anatomy laboratory of our institution. Thumbs were studied for the prevalence of sesamoid bones at the metacarpophalangeal and interphalangeal joints. The muscle which contain these sesamoid bones were identified. Results: The present study observed that, there were 2 sesamoid bones (92%) at the metacarpophalangeal joint of the thumb each at its medial and lateral aspect. The medial sesamoid bone was found inside the adductor pollicis muscle and lateral one was found either in the flexor pollicis brevis muscle or abductor pollicis brevis muscle. However, among the 25 thumbs being studied, 2 thumbs (8%) had solitary sesamoid bone. The interphalangeal joint of the thumb exhibited only one sesamoid bone at the median plane. Conclusion: The morphological data of the present study from the South Indians can be used as a database, which is enlightening to the operating hand surgeon and radiologist.Keywords: morphology, muscles, sesamoid bones, thumb
Procedia PDF Downloads 1975421 The Effect of Cassava Starch on Compressive Strength and Tear Strength of Alginate Impression Material
Authors: Mirna Febriani
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Statement of problem. Alginate impression material is an imported material and a dentist always used this material to make impression of teeth and oral cavity tissues. Purpose. The aim of this study was to compare about compressive strength and tear strength of alginate impression material and alginate impression material combined with cassava. Material and methods.Property measured included compressive strength and tear strength. Results.The compressive strength and tear strength of the impression materials tested of a comparable ANSI/ADA standard no.18.The compressive strength and tear strength alginate impression material combined with cassava have lower than the compressive strength and tear strength alginate impression material. The alginate impression material combined with cassava has more water and silica content more decrease than alginate impression material. Conclusions.We concluded that compressive strength and tear strength of alginate impression material combined with cassava has lower than alginate impression material without cassava starch.Keywords: compressive strength, tear strength, Cassava starch, alginate
Procedia PDF Downloads 4015420 A Meta-Analysis of the Academic Achievement of Students With Emotional/Behavioral Disorders in Traditional Public Schools in the United States
Authors: Dana Page, Erica McClure, Kate Snider, Jenni Pollard, Tim Landrum, Jeff Valentine
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Extensive research has been conducted on students with emotional and behavioral disorders (EBD) and their rates of challenging behavior. In the past, however, less attention has been given to their academic achievement and outcomes. Recent research examining outcomes for students with EBD has indicated that these students receive lower grades, are less likely to pass classes, and experience higher rates of school dropout than students without disabilities and students with other high incidence disabilities. Given that between 2% and 20% of the school-age population is likely to have EBD (though many may not be identified as such), this is no small problem. Despite the need for increased examination of this population’s academic achievement, research on the actual performance of students with EBD has been minimal. This study reports the results of a meta-analysis of the limited research examining academic achievement of students with EBD, including effect sizes of assessment scores and discussion of moderators potentially impacting academic outcomes. Researchers conducted a thorough literature search to identify potentially relevant documents before screening studies for inclusion in the systematic review. Screening identified 35 studies that reported results of academic assessment scores for students with EBD. These studies were then coded to extract descriptive data across multiple domains, including placement of students, participant demographics, and academic assessment scores. Results indicated possible collinearity between EBD disability status and lower academic assessment scores, despite a lack of association between EBD eligibility and lower cognitive ability. Quantitative analysis of assessment results yielded effect sizes for academic achievement of student participants, indicating lower performance levels and potential moderators (e.g., race, socioeconomic status, and gender) impacting student academic performance. In addition to discussing results of the meta-analysis, implications and areas for future research, policy, and practice are discussed.Keywords: students with emotional behavioral disorders, academic achievement, systematic review, meta-analysis
Procedia PDF Downloads 555419 Perinatal and Postnatal Counseling as Determinants of Early Newborn Sepsis in Rural Bangladesh
Authors: Sajia Islam, T. Tahsina, S. Raihana, M. M. Rahman, Q. S. Rahman, T. M. Huda, S. E. Arifeen, M. J. Dibley
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Early neonatal sepsis accounts for more than two-thirds of all deaths in the first year of life. This study assessed the counseling during antenatal, perinatal, post natal periods and its association with possible sepsis in rural Bangladesh. Method: Data were collected from a large community-based trial in Bangladesh where pregnant women were enrolled from 2013-2015 covering 29,497 newborns. Sepsis was defined using neonatal danger signs reported by 'The Young-Infants Clinical Science Study Group. 'Result: Signs of sepsis was found among 15% of the neonates. Neonatal sepsis was higher among those who did not receive advice on TT vaccinations (15.4% vs. 11%, p < 0.05) and danger signs (14.8% vs. 12.8%, p < 0.05) during pregnancy. Advice on delivering in well-lit place was significantly associated with lower incidence of sepsis (12.7% vs. 14.8% p < 0.05). Sepsis was lower among neonates whose mothers were counseled on immediate newborn care for bathing after 3 days of delivery (13.4% vs. 15.2% p=0), breastfeeding within 1hr of birth (13.82 % vs. 15.28% p=0), apply nothing on the cord (11.54 vs. 15.06 p=0), immediate drying of child (12.62% vs. 14.89%, p=0). Neonatal sepsis was lower among children whose mothers received 2-4 advice [OR=0.91(95% CI: 0.85-0.97)] compared to neonates whose mothers received only 1 or none. Overall, children to mothers who received ≥ 5 advice had lowest incidence of sepsis [OR=0.83 (95% CI: 0.71-0.97)] Conclusion: Advice on antenatal, prenatal and post natal is significantly reduced with early newborn sepsis. Further research is required to identify specific type of counseling messages that translate into practices and reduce pathways towards early-newborn morbidities.Keywords: ante natal care, counseling, neonatal sepsis, post natal care
Procedia PDF Downloads 2645418 The Right to Development as Constitutive and Prescriptive Right: The Lower Omo Valley Case of Ethiopia
Authors: Kebene K. Wodajo
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The right to development (RTD) has gone through different phases of metamorphoses, from the right to economic growth to full human development. Despite the fact that Africa has taken the lead in articulating and recognizing the RTD in a binding multilateral human rights treaty, realization of the right poses a challenge at the operational level. The challenge is worse in Sub-Saharan Africa, mainly because governments often tend to set economic growth as their ultimate goal, with very little consideration to the local peoples’ welfare in their territory. Ethiopia is not an exception to this. While recording a fast economic growth, yet this has been accompanied by increasing severity of multidimensional poverty. This paper explores the place of the ‘people’ in the development trajectory Ethiopia is pursuing and if and how a right-based approach to development could be brought to practice beyond the rhetoric. By inquiring into the place of the ‘people’, the paper attempts to show whether the people are at the center or at the periphery, beneficiary or victims of the ongoing development. In doing so, it divulges the gulf between the rhetoric and the reality of development practice. By asking/discussing if and how a right-based approach to development could bridge the gap, the paper shows how this approach could translate ‘people’s’ need into right, and recognize them as active subjects and stakeholders of the process of development. As an instance of showing the gap, the paper takes the Lower Omo valley sugar plantation project as a case in point. Through analysis the paper demonstrates that the development trajectory being followed by Ethiopia falls short of fitting into the human development discourse of UN Declaration on the Right to Development (DRD), the African Charter on People and Human Rights (the Charter) and the Ethiopian constitution. The paper argues that Ethiopia’s development efforts must take account of both the constitutive and prescriptive nature of the RTD if social equity is to be met.Keywords: development, Ethiopia, lower Omo valley, right-based approach, right to development, people, people’s right
Procedia PDF Downloads 3135417 The Effect of Family SES (Income) On Children’s Socio-Emotional Development
Authors: Xiao Hu
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Children’s social and emotional development is critical for developing their future relationships and behaviors, and poor social skills may result in serious emotional externalizations such as anxiety, distress and aggression. Recent research has emphasized the role of family socio-economic status on children’s emotional development, and this study contributes to this academic discussion by reviewing how socio-economic status affects children at three critical development stages: infancy (0-3months), pre-school (4 months-5 years) and school aged (6-10 years). Results show a consensus in the research literature on a positive relationship between family socio-economic status and children’s emotional development. Socialization, a crucial development milestone, is highly affected by a family’s socio-economic status, as families with higher incomes have access to improved social environments, healthier parenting styles and greater access to social capital and peer support. In contrast, families with lower income and SES (socio-economic status) have lower access to these benefits and are frequently ignored within social environments. This review concludes with a critical discussion on how family income affects children’s social environment, highlighting the important role that “permanent” income plays in children’s development. Consequently, the review suggests that future governments should provide temporary economic support for lower-income families, allowing children to be raised in a healthy social environment with limited economic fluctuation.Keywords: family socio-economic status, parenting style, children’s emotional development, family permanent income
Procedia PDF Downloads 1355416 Implementation of Tissue Engineering Technique to Nursing of Unhealed Diabetic Foot Lesion
Authors: Basuki Supartono
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Introduction: Diabetic wound risks limb amputation, and the healing remains challenging. Chronic Hyperglycemia caused the insufficient inflammatory response and impaired ability of the cells to regenerate. Tissue Engineering Technique is mandatory. Methods: Tissue engineering (TE)-based therapy Utilizing mononuclear cells, plasma rich platelets, and collagen applied on the damaged tissue Results: TE technique resulting in acceptable outcomes. The wound healed completely in 2 months. No adverse effects. No allergic reaction. No morbidity and mortality Discussion: TE-based therapy utilizing mononuclear cells, plasma rich platelets, and collagen are safe and comfortable to fix damaged tissues. These components stop the chronic inflammatory process and increase cells' ability for regeneration and restoration of damaged tissues. Both of these allow the wound to regenerate and heal. Conclusion: TE-based therapy is safe and effectively treats unhealed diabetic lesion.Keywords: diabetic foot lesion, tissue engineering technique, wound healing, stemcells
Procedia PDF Downloads 715415 Hemostasis Poly Vinyl Alcohol Gauze Coated with Chitosan Encapsulated with Polymer and Drug
Authors: Abhishekkumar Ramasamy, Parameshwari
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Chitosan is the deacyelitated derivative of chitin, the second most abundant biopolymer just after cellulose. Without doubt, its biomedical usages have gained more importance among the vast variety of chitosan applications owing to its good biocompatibility and biodegradability. In recent years, particular interest has been devoted to chitosan hydrogels as a promising alternative in competition with conventional sutures or bioadhesives. Different parameters such as acid type and concentration, and degree of deacetylation (DD%) of chitosan, were altered to modify hydrogel properties including viscosity, pH, cohesive strength, and tissue bioadhesiveness. In the current work, we have investigated the effectiveness of chitosan hydrogel encapsulated with tanexamic acid to stop bleeding. Chitosan film was obtained with solubilization of chitosan powder in aqueous acidic media. In vivo experiments have been conducted on rat and rabbit models that provide a convenient way to evaluate the efficacy of prepared samples. The arteries vein was punctured on the hind limb of the rat and the gauze was been applied on the punchered area. Bioadhesive strength as well as irritant effects were discussed. Samples with higher degree of deacetylation, including Chs-16 and Chs-19 that were dissolved in lactic media showed best sealing effect.Keywords: chitosan, biocomaptibility, biodegradability, bioadhersive, deacetylation
Procedia PDF Downloads 3425414 Heat Source Temperature for Centered Heat Source on Isotropic Plate with Lower Surface Forced Cooling Using Neural Network and Three Different Materials
Authors: Fadwa Haraka, Ahmad Elouatouati, Mourad Taha Janan
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In this study, we propose a neural network based method in order to calculate the heat source temperature of isotropic plate with lower surface forced cooling. To validate the proposed model, the heat source temperatures values will be compared to the analytical method -variables separation- and finite element model. The mathematical simulation is done through 3D numerical simulation by COMSOL software considering three different materials: Aluminum, Copper, and Graphite. The proposed method will lead to a formulation of the heat source temperature based on the thermal and geometric properties of the base plate.Keywords: thermal model, thermal resistance, finite element simulation, neural network
Procedia PDF Downloads 3475413 Impact of Lined/Unlined Canal on Groundwater Recharge in the Lower Bhavani Basin, Tamilnadu, India
Authors: K. Mirudhula, R. Saravanan
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Bhavani basin is the fourth largest Sub Basin in the Cauvery basin. The entire command area of all three major canals that takes off from the Bhavani river falls within the Erode District i.e. Lower Bhavani Project (LBP), Kodiveri and Kalingarayan canals. The LBP canal is a major source of irrigation in Erode District. Many of these canals are unlined and leakage takes place from them. Thus the seepage from the canal helps in recharging the wells in the area, enabling to get adequate water supply for the crops when water was not released from Bhavanisagar Dam. In this study, the groundwater recharge is determined by groundwater flow modeling using Visual MODFLOW model. For this purpose, three major natural sources of groundwater recharge are taken into consideration such as rainfall infiltration, canal seepage and return flow of irrigation. The model was run and ZONEBUDGET gives an idea about the amount of recharge from lined/unlined canal to the field. Unlined canal helps to recharge the groundwater about 20% more than the lined canal. The analysis reveals that the annual rainfall also has rapidly changed in this region. In the LBP canal Head reach meets their requirement with available quantity of water from the canal system. Tail end reach does not receive the required quantity of water because of seepage loss and conveyance loss. Hence the lined canal can be provided for full length of the main canal. Branch canals and minor distributaries are suggested to maintain the canals with unlined canal system.Keywords: lower Bhavani basin, erode, groundwater flow modeling, irrigation practice, lined canal system
Procedia PDF Downloads 2925412 Environmental Efficacy on Heracleum persicum Essential Oils
Authors: Rahele Hasani, Iraj Mehregan, Kambiz Larijani, Taher Nejadsattari, Romain Scalone
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Essential oils of Heracleum persicum (Apiaceae) have been widely used from many years ago, but the difference of its properties among different populations have not been identified up to now. Hydrodistilation Clevenger type was used to obtaining the fruit essential oils of four populations of H. persicum from different localities in Iran, then they were characterized by GC-FID and GC-MS analyses. Some ecological factors were also measured. The oils of four populations were compared to determine the similarities and differences and the relationships between these factors and ecological factors. Based on the result, 18-32 different components were identified in four populations, while the percentage of the main components was higher in population with lower number of components. According to the statistical analyses of chemical components and ecological factors, it can be concluded that some ecological factors such as altitude, less humidity, high difference between day and night temperature and salty soil would lead to lower number of components in essential oil, whereas they consist the higher percentage.Keywords: Chemotaxonomy, Persian hogweed, Ecological factors, Apiaceae.
Procedia PDF Downloads 4245411 Implementation of Autologous Adipose Graft from the Abdomen for Complete Fat Pad Loss of the Heel Following a Traumatic Open Fracture Secondary to a Motor Vehicle Accident: A Case Study
Authors: Ahmad Saad, Shuja Abbas, Breanna Marine
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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage
Procedia PDF Downloads 675410 Rheological Study of Wheat-Chickpea Flour Blend Bread for People with Type-2 Diabetes
Authors: Tasleem Zafar, Jiwan Sidhu
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Introduction: Chickpea flour is known to offer many benefits to diabetic persons, especially in maintaining their blood sugar levels in the acceptable range. Under this project we have studied the chemical composition and antioxidant capacity of white flour (WF), whole wheat flour (WWF) and chickpea flour (BF), in addition to the effect of replacement of WF and WWF with BF on the rheological characteristics of these flour blends, with the ultimate objective of producing acceptable quality flat as well as pan-bread for the diabetic consumers. Methods: WF and WWF were replaced with BF ranging from 0 to 40%, to investigate its effect on the rheological properties and functionality of blended flour dough using farinograph, viscoamylograph, mixograph and falling number apparatus as per the AACC standard methods. Texture Profile Analysis (TPA) was carried on the WF, WWF, and their blends with BF using Stable Micro System Texture Analyzer. Effect of certain additives, such as freeze-dried amla fruit powder (Phyllanthus emblica L.), guar gum, and xanthan gum on the dough rheological properties were also studied. Results: Freeze-dried amla fruit powder was found to be very rich in ascorbic acid and other phenolics having higher antioxidant activity. A decreased farinograph water absorption, increased dough development time, higher mixing tolerance index (i.e., weakening of dough), decreased resistance to extension, lower ratio numbers were obtained when the replacement with BF was increased from 0 to 40%. The BF gave lower peak viscosity, lower paste breakdown, and lower setback values when compared with WF. The falling number values were significantly lower in WWF (meaning higher α-amylase activity) than both the WF and BF. Texture Profile Analysis (TPA) carried on the WF, WWF, and their blends with BF showed significant variations in hardness and compressibility values, dough becoming less hard and less compressible when the replacement of WF and WWF with BF was increased from 0 to 40%. Conclusions: To overcome the deleterious effects of adding BF to WF and WWF on the rheological properties will be an interesting challenge when good quality pan bread and Arabic flatbread have to be commercially produced in a bakery. Use of freeze-dried amla fruit powder, guar gum, and xanthan gum did show some promise to improve the mixing characteristics of WF, WWF, and their blends with BF, and these additives are expected to be useful in producing an acceptable quality flat as well as pan-bread on a commercial scale.Keywords: wheat flour, chickpea flour, amla fruit, rheology
Procedia PDF Downloads 1485409 Influence of Counterface and Environmental Conditions on the Lubricity of Multilayer Graphene Coatings Produced on Nickel by Chemical Vapour Deposition
Authors: Iram Zahra
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Friction and wear properties of multilayer graphene coatings (MLG) on nickel substrate were investigated at the macroscale, and different failure mechanisms working at the interface of nickel-graphene coatings were evaluated. Multilayer graphene coatings were produced on a nickel substrate using the atmospheric chemical vapour deposition (CVD) technique. Wear tests were performed on the pin-on-disk tribometer apparatus under dry air conditions, and using the saltwater solution, distilled water, and mineral oil lubricants and counterparts used in these wear tests were fabricated of stainless steel, chromium, and silicon nitride. The wear test parameters such as rotational speed, wear track diameter, temperature, relative humidity, and load were 60 rpm, 6 mm, 22˚C, 45%, and 2N, respectively. To analyse the friction and wear behaviour, coefficient of friction (COF) vs time curves were plotted, and the sliding surfaces of the samples and counterparts were examined using the optical microscope. Results indicated that graphene-coated nickel in mineral oil lubrication and dry conditions gave the minimum average value of COP (0.05) and wear track width ( ̴151 µm) against the three different types of counterparts. In contrast, uncoated nickel samples indicated a maximum wear track width ( ̴411 µm) and COF (0.5). Thorough investigation and analysis concluded that graphene-coated samples have two times lower COF and three times lower wear than the bare nickel samples. Furthermore, mechanical failures were significantly lower in the case of graphene-coated nickel. The overall findings suggested that multilayer graphene coatings have drastically decreased wear and friction on nickel substrate at the macroscale under various lubricating conditions and against different counterparts.Keywords: friction, lubricity, multilayer graphene, sliding, wear
Procedia PDF Downloads 1315408 Concept of a Pseudo-Lower Bound Solution for Reinforced Concrete Slabs
Authors: M. De Filippo, J. S. Kuang
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In construction industry, reinforced concrete (RC) slabs represent fundamental elements of buildings and bridges. Different methods are available for analysing the structural behaviour of slabs. In the early ages of last century, the yield-line method has been proposed to attempt to solve such problem. Simple geometry problems could easily be solved by using traditional hand analyses which include plasticity theories. Nowadays, advanced finite element (FE) analyses have mainly found their way into applications of many engineering fields due to the wide range of geometries to which they can be applied. In such cases, the application of an elastic or a plastic constitutive model would completely change the approach of the analysis itself. Elastic methods are popular due to their easy applicability to automated computations. However, elastic analyses are limited since they do not consider any aspect of the material behaviour beyond its yield limit, which turns to be an essential aspect of RC structural performance. Furthermore, their applicability to non-linear analysis for modeling plastic behaviour gives very reliable results. Per contra, this type of analysis is computationally quite expensive, i.e. not well suited for solving daily engineering problems. In the past years, many researchers have worked on filling this gap between easy-to-implement elastic methods and computationally complex plastic analyses. This paper aims at proposing a numerical procedure, through which a pseudo-lower bound solution, not violating the yield criterion, is achieved. The advantages of moment distribution are taken into account, hence the increase in strength provided by plastic behaviour is considered. The lower bound solution is improved by detecting over-yielded moments, which are used to artificially rule the moment distribution among the rest of the non-yielded elements. The proposed technique obeys Nielsen’s yield criterion. The outcome of this analysis provides a simple, yet accurate, and non-time-consuming tool of predicting the lower-bound solution of the collapse load of RC slabs. By using this method, structural engineers can find the fracture patterns and ultimate load bearing capacity. The collapse triggering mechanism is found by detecting yield-lines. An application to the simple case of a square clamped slab is shown, and a good match was found with the exact values of collapse load.Keywords: computational mechanics, lower bound method, reinforced concrete slabs, yield-line
Procedia PDF Downloads 1715407 Development of a Steam or Microwave-Assisted Sequential Salt-Alkali Pretreatment for Sugarcane Leaf Waste
Authors: Preshanthan Moodley
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This study compares two different pretreatments for sugarcane leaf waste (SLW): steam salt-alkali (SSA) and microwave salt-alkali (MSA). The two pretreatment types were modelled, optimized, and validated with R² > 0.97. Reducing sugar yields of 1.21g/g were obtained with optimized SSA pretreatment using 1.73M ZnCl₂, 1.36M NaOH and 9.69% solid loading, and 1.17g/g with optimized MSA pretreatment using 1.67M ZnCl₂, 1.52M NaOH at 400W for 10min. A lower pretreatment time (10min) was required for the MSA model (83% lower). The structure of pretreated SLW was assessed using scanning electron microscopy (SEM) and Fourier Transform Infrared analysis (FTIR). The optimized SSA and MSA models showed lignin removal of 80.5 and 73% respectively. The MSA pretreatment was further examined on sorghum leaves and Napier grass and showed yield improvements of 1.9- and 2.8-fold compared to recent reports. The developed pretreatment methods demonstrated high efficiency at enhancing enzymatic hydrolysis on various lignocellulosic substrates.Keywords: lignocellulosic biomass, pretreatment, salt, sugarcane leaves
Procedia PDF Downloads 2535406 Development of Industry Sector Specific Factory Standards
Authors: Peter Burggräf, Moritz Krunke, Hanno Voet
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Due to shortening product and technology lifecycles, many companies use standardization approaches in product development and factory planning to reduce costs and time to market. Unlike large companies, where modular systems are already widely used, small and medium-sized companies often show a much lower degree of standardization due to lower scale effects and missing capacities for the development of these standards. To overcome these challenges, the development of industry sector specific standards in cooperations or by third parties is an interesting approach. This paper analyzes which branches that are mainly dominated by small or medium-sized companies might be especially interesting for the development of factory standards using the example of the German industry. For this, a key performance indicator based approach was developed that will be presented in detail with its specific results for the German industry structure.Keywords: factory planning, factory standards, industry sector specific standardization, production planning
Procedia PDF Downloads 3875405 Comparisons of Depressive Symptoms and Cognitive Appraisals in Different Age Groups under Abusive Leadership
Authors: Shao-Ying Wang, Shin-I Shih, Chi-Cheng Wu
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Background: By following to the maturity theory about age, the manifestation of depression in different age groups under occupational stressors still remains unclear. Therefore, the aim of this study was to examine the depression within four main symptoms clusters: cognition, affect, physical complaints and interpersonal difficulty among the different age groups. Additionally, this study also used the stress appraisal theory, through the examination of challenge and hindrance appraisals, the effects of cognitive factors were expected to give therapeutic indication for the future treatment of depression under abusive leadership. Methods (Participants and Procedure): The data were collected in two waves from employees of local companies in Taiwan. The participants (58 males and 167 females) were native Chinese speakers, ranging in age from 20 to 59 years (M= 36.51). Up to 80% educational level of participants were above senior high. The married population was approximately at 43%. Measures; 1. Abusive Leadership: To measure abusive leadership, we used 15-item scale of abusive supervision which anchored on a 7-point Likert-type scale. (α= .96) 2. Depression: We used Taiwanese Depression Scale to measure the 4 clusters (cognition, affect, physical complaints and interpersonal difficulty) of symptoms. Participants responded for depression anchored on a 7-point Likert-type scale (α= .96). 3. Stress Appraisal Scale: To measure challenge and hindrance types of appraisal, participants responded to 33-item measure anchored on a 7-point Likert-type scale. (Challenge appraisal; α= .90; hindrance appraisal α= .87). Results: The results of correlation showed that there was a significant and negative correlation between abusive leadership and age (r = - .21, p < .01). Abusive leadership was positive correlated significantly with hindrance appraisal (r = .52, p < .01) and depression (r = .20, p < .01). The results also showed that hindrance appraisal was correlated to depression positively (r = .36, p < .01). A one-way ANOVA was conducted to compare the effect of lower/middle/order age groups on each cluster of depressive symptoms. The results showed that the effect of age groups on cognition was significant F (2, 157) =3.66, P < .05. Older age group (M=13.43 SD=6.84) reported less cognitive symptoms of depression than the middle (M=16.77 SD=7.49) and lower age (M=16.91 SD=6.97) groups. Besides, the effect of age groups on affect was also significant F (2,157)= 4.09 P < .05. Older age group (M=18.68 SD=8.98) reported less affective symptoms of depression than the middle (M=22.01 SD=7.96) and lower age (M=23.56 SD=7.67) groups. Moreover, the main effect of hindrance appraisal was found F (2, 157) =3.81, P < .05. Older age group (M=9.44 SD=2.89) reported fewer score on hindrance appraisals than the middle (M=11.06 SD=4.02) and lower age (M=9.62 SD=3.17) groups. To conclude, the severity of depression symptoms varies across different age groups. Maturity seems to be the protective factor to depression, accompanying with lower hindrance appraisals.Keywords: abusive leadership, affective commitment, depression symptoms, psychological well-being
Procedia PDF Downloads 1965404 Structural Safety of Biocomposites under Cracking: A Fracture Analytical Approach using the Gғ-Concept
Authors: Brandtner-Hafner Martin
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Biocomposites have established themselves as a sustainable material class in the industry. Their advantages include lower density, lower price, and easier recycling compared to conventional materials. Now there are a variety of ways to measure their technical performance. One possibility is mechanical tests, which are widely used and standardized. However, these provide only very limited insights into damage capacity, which is particularly problematic under cracking conditions. To overcome such shortcomings, experimental tests were performed applying the fracture energetically GF-concept to study the structural safety of the interface under crack opening (mode-I loading). Two different types of biocomposites based on extruded henequen-fibers (NFRP) and wood-particles (WPC) in an HDPE matrix were evaluated. The results show that the fracture energy values obtained are higher than those given in the literature. This suggests that alternatives to previous linear elastic testing methods are needed to perform authentic safety evaluations of green plastics.Keywords: biocomposites, structural safety, Gғ-concept, fracture analysis
Procedia PDF Downloads 1525403 Optimization of Electrical Discharge Machining Parameters in Machining AISI D3 Tool Steel by Grey Relational Analysis
Authors: Othman Mohamed Altheni, Abdurrahman Abusaada
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This study presents optimization of multiple performance characteristics [material removal rate (MRR), surface roughness (Ra), and overcut (OC)] of hardened AISI D3 tool steel in electrical discharge machining (EDM) using Taguchi method and Grey relational analysis. Machining process parameters selected were pulsed current Ip, pulse-on time Ton, pulse-off time Toff and gap voltage Vg. Based on ANOVA, pulse current is found to be the most significant factor affecting EDM process. Optimized process parameters are simultaneously leading to a higher MRR, lower Ra, and lower OC are then verified through a confirmation experiment. Validation experiment shows an improved MRR, Ra and OC when Taguchi method and grey relational analysis were usedKeywords: edm parameters, grey relational analysis, Taguchi method, ANOVA
Procedia PDF Downloads 2855402 Triple Intercell Bar for Electrometallurgical Processes: A Design to Increase PV Energy Utilization
Authors: Eduardo P. Wiechmann, Jorge A. Henríquez, Pablo E. Aqueveque, Luis G. Muñoz
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PV energy prices are declining rapidly. To take advantage of the benefits of those prices and lower the carbon footprint, operational practices must be modified. Undoubtedly, it challenges the electrowinning practice to operate at constant current throughout the day. This work presents a technology that contributes in providing modulation capacity to the electrode current distribution system. This is to raise the day time dc current and lower it at night. The system is a triple intercell bar that operates in current-source mode. The design is a capping board free dogbone type of bar that ensures an operation free of short circuits, hot swapability repairs and improved current balance. This current-source system eliminates the resetting currents circulating in equipotential bars. Twin auxiliary connectors are added to the main connectors providing secure current paths to bypass faulty or impaired contacts. All system conductive elements are positioned over a baseboard offering a large heat sink area to the ventilation of a facility. The system works with lower temperature than a conventional busbar. Of these attributes, the cathode current balance property stands out and is paramount for day/night modulation and the use of photovoltaic energy. A design based on a 3D finite element method model predicting electric and thermal performance under various industrial scenarios is presented. Preliminary results obtained in an electrowinning facility with industrial prototypes are included.Keywords: electrowinning, intercell bars, PV energy, current modulation
Procedia PDF Downloads 1455401 A Physiological Approach for Early Detection of Hemorrhage
Authors: Rabie Fadil, Parshuram Aarotale, Shubha Majumder, Bijay Guargain
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Hemorrhage is the loss of blood from the circulatory system and leading cause of battlefield and postpartum related deaths. Early detection of hemorrhage remains the most effective strategy to reduce mortality rate caused by traumatic injuries. In this study, we investigated the physiological changes via non-invasive cardiac signals at rest and under different hemorrhage conditions simulated through graded lower-body negative pressure (LBNP). Simultaneous electrocardiogram (ECG), photoplethysmogram (PPG), blood pressure (BP), impedance cardiogram (ICG), and phonocardiogram (PCG) were acquired from 10 participants (age:28 ± 6 year, weight:73 ± 11 kg, height:172 ± 8 cm). The LBNP protocol consisted of applying -20, -30, -40, -50, and -60 mmHg pressure to the lower half of the body. Beat-to-beat heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean aerial pressure (MAP) were extracted from ECG and blood pressure. Systolic amplitude (SA), systolic time (ST), diastolic time (DT), and left ventricle Ejection time (LVET) were extracted from PPG during each stage. Preliminary results showed that the application of -40 mmHg i.e. moderate stage simulated hemorrhage resulted significant changes in HR (85±4 bpm vs 68 ± 5bpm, p < 0.01), ST (191 ± 10 ms vs 253 ± 31 ms, p < 0.05), LVET (350 ± 14 ms vs 479 ± 47 ms, p < 0.05) and DT (551 ± 22 ms vs 683 ± 59 ms, p < 0.05) compared to rest, while no change was observed in SA (p > 0.05) as a consequence of LBNP application. These findings demonstrated the potential of cardiac signals in detecting moderate hemorrhage. In future, we will analyze all the LBNP stages and investigate the feasibility of other physiological signals to develop a predictive machine learning model for early detection of hemorrhage.Keywords: blood pressure, hemorrhage, lower-body negative pressure, LBNP, machine learning
Procedia PDF Downloads 1605400 Is the Okun's Law Valid in Tunisia?
Authors: El Andari Chifaa, Bouaziz Rached
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The central focus of this paper was to check whether the Okun’s law in Tunisia is valid or not. For this purpose, we have used quarterly time series data during the period 1990Q1-2014Q1. Firstly, we applied the error correction model instead of the difference version of Okun's Law, the Engle-Granger and Johansen test are employed to find out long run association between unemployment, production, and how error correction mechanism (ECM) is used for short run dynamic. Secondly, we used the gap version of Okun’s law where the estimation is done from three band pass filters which are mathematical tools used in macro-economic and especially in business cycles theory. The finding of the study indicates that the inverse relationship between unemployment and output is verified in the short and long term, and the Okun's law holds for the Tunisian economy, but with an Okun’s coefficient lower than required. Therefore, our empirical results have important implications for structural and cyclical policymakers in Tunisia to promote economic growth in a context of lower unemployment growth.Keywords: Okun’s law, validity, unit root, cointegration, error correction model, bandpass filters
Procedia PDF Downloads 3045399 A Study on the Possibility of Utilizing the Converter Slag as the Cement Admixture
Authors: Choi Woo-Seok, Kim Eun-Sup, Ha Eun-Ryong
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Converter slag is used as a low-value product like a construction fill material and soil stabilizer unlike electric furnace slag and blast furnace slag. This study is fundamental research for utilizing the converter slag as the cement admixture. Magnetic separation was conducted for quality improvement of the converter slag, and it was classified according to into 3 types; SA: pure slag, SB: separated slag, SC: remained slag after separating. In XRF result, SB slag was Fe₂CO₃ ratio was higher, and CaO ratio was lower than SA. SC slag was Fe₂CO₃ ratio was lower, and CaO ratio was higher than SA. In compressive strength test for soil cement using SA, SB, SC as the cement admixture, SC slag was more effective in terms of 28days compressive strength than SA, SB slag. In this result, it is considered that the remained material (SC) after magnetic separation is available as the cement admixture.Keywords: converter slag, magnetic separation, cement admixture, compressive strength
Procedia PDF Downloads 771