Search results for: skin friction

Authors: Roman Khanferyan, Levon Gevorkyan, Ivan Radysh

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Skin barrier dysfunction induces multiple inflammatory skin diseases. Epidemiological studies clearly support the link between most dermatological pathologies, immune disorders and metabolic disorders. Among them most common are psoriasis (PS) and Atopic dermatitis (AD). Psoriasis is a chronic immune-mediated inflammatory skin disease that affects 1.5 to 3.0% of the world's population. Comorbid metabolic disorders play an important role in the progression of PS and AD, as well. It is well known that PS, AD and overweight/obesity are associated with common pathophysiological mechanisms of mild chronic inflammation. The goal of the study was to study the immune disturbances in patients with PS, AD and comorbid metabolic disorders. To study the prevalence of comorbidity of PS and AD (data from 1406 patient’s histories of diseases) were analyzed. The severity of the disease is assessed using the PASI index (Psoriasis Area and Severity Index). 59 patients with psoriasis of different localizations of lesions and severity, as well as with different body mass index (BMI), were examined. The determination of the concentration of pro-inflammatory cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNFa) and chemokines (RANTES, IP-10, MCP-1 and Eotaxin) in sera and supernatants of 48h-cultivated peripheral blood mononuclear cell (PBMC) of psoriasis patients and healthy volunteers (36 adults) have been carried out by multiplex assay (Luminex Corporation, USA). It has been demonstrated that 42% of PS patients had comorbidity with different types of atopies. The most common was bronchial asthma and allergic rhinitis. At the same time, the prevalence of AD in PS patients was determined in 8.7% of patients. It has been shown that serum levels of all studied cytokines (IL-6, IL-8, IFNγ, IL-17, L-18 and TNF) in most of the studied patients were higher in PS patients than in those with AD and healthy controls (p<0.05). An in vitro synthesis of the IL-6 and IFNγ by PBMC demonstrated similar results to those determined in blood sera. There was a high correlation between BMI, immune mediators and the concentrations of adipokines and chemokines (p<0.05). The concentrations of Leptin and Resistin in obese psoriatic patients were greater by 28.6% and 17%, respectively, compared to non-obese psoriatic patients. In obese patients with psoriasis the serum levels of adiponectin were decreased up to 1.3-fold. The mean serum RANTES, IP-10, MCP-1, EOTAXIN levels in obese psoriatic patients were decreased by up to 13.1%, 21.9%, 40.4% and 28.2%, respectively. Similar results have been demonstrated in AD patients with comorbid overweight and obesity. Thus, the study demonstrated the important role of cytokines and chemokines dysregulation in inflammatory skin diseases, especially in patients with comorbid obesity and overweight. Metabolic disorders promote the severity of PS and AD, highly increase immune dysregulation, and synthesis of adipokines, which correlates with the production of proinflammatory immune mediators in comorbid obesity and overweight.

Keywords: psoriasis, atopic dermatitis, pro-inflammatory cytokines, chemokines, comorbid obesity

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Authors: Roghayyeh Motallebzadeh, Shahin Hajizadeh, Mohammad Reza Ghasemi

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Laminar mixed convection heat transfer of a nanofluid with prescribed constant heat flux on the inner wall of horizontal annular tube has been studied numerically based on two-phase mixture model in different Rayleigh numbers and Azimuth angles. Effects of applying of different volume fractions of Al2O3 nanoparticles in water as a base fluid on hydrodynamic and thermal behaviours of the fluid flow such as axial velocity, secondary flow, temperature, heat transfer coefficient and friction coefficient at the inner and outer wall region, has been investigated. Conservation equations in elliptical form has been utilized and solved in three dimensions for a steady flow. It is observed that, there is a good agreement between results in this work and previously published experimental and numerical works on mixed convection in horizontal annulus. These particles cause to increase convection heat transfer coefficient of the fluid, meanwhile there is no considerable effect on friction coefficient.

Keywords: buoyancy force, laminar mixed convection, mixture model, nano-fluid, two-phase

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Authors: Harjot Singh Gill, Neelkanth Grover, Jwala Parshad Singla

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The main aim of this research work is to present the effect of coating on two different grades of grey cast iron using detonation spray method. Ni20Cr and Al2O3-13TiO2 powders were sprayed using detonation gun onto GI250 and GIHC substrates and the results as well as coating surface morphology of the coating is studied by XRD and SEM/EDAX analysis. The wear resistance of Ni20Cr and Al2O3-13TiO2 has been investigated on pin-on-disc tribometer using ASTM G99 standards. Cumulative wear rate and coefficient of friction (µ) were calculated under three normal load of 30N, 40N, 50N at constant sliding velocity of 1m/s. Worn out surfaces were analyzed by SEM/EDAX. The results show significant resistance to wear with Al2O3-13TiO2 coating as compared to Ni20Cr and bare substrates. SEM/EDAX analysis and cumulative wear loss bar charts clearly explain the wear behavior of coated as well as bare sample of GI250 and GIHC.

Keywords: detonation spray, grey cast iron, wear rate, coefficient of friction

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Authors: M. Riaz, Inamur Rehman, Abhishek Sharma

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The present work is the development of an experimental method for determining the thermal diffusivity variations with temperature of selected regular shaped solid fruits and vegetables subjected to forced convection cooling. Experimental investigations were carried on the sample chosen (potato and brinjal), which is approximately of spherical geometry. The variation of temperature within the food product is measured at several locations from centre to skin, under forced convection environment using a deep freezer, maintained at -10°C.This method uses one dimensional Fourier equation applied to regular shapes. For this, the experimental temperature data obtained from cylindrical and spherical shaped products during pre-cooling was utilised. Such temperature and thermal diffusivity profiles can be readily used with other information such as degradation rate, etc. to evaluate thermal treatments based on cold air cooling methods for storage of perishable food products.

Keywords: thermal diffusivity, skin temperature, precooling, forced convection, regular shaped

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Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh

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Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.

Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture

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Authors: Ehsan Mehryaar, Seyed Armin Motahari Tabari

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Coarse-grained soils are known and commonly used in a wide range of geotechnical projects, including high earth dams or embankments for their high shear strength. The most important engineering property of these soils is friction angle which represents the interlocking between soil particles and can be applied widely in designing and constructing these earth structures. Friction angle and dilative behavior of coarse-grained soils can be estimated from empirical correlations with in-situ testing and physical properties of the soil or measured directly in the laboratory performing direct shear or triaxial tests. Unfortunately, large-scale testing is difficult, challenging, and expensive and is not possible in most soil mechanic laboratories. So, it is common to remove the large particles and do the tests, which cannot be counted as an exact estimation of the parameters and behavior of the original soil. This paper describes a new methodology to simulate particles grading distribution of a well-graded gravel sample to a smaller scale sample as it can be tested in an ordinary direct shear apparatus to estimate the stress-strain behavior, friction angle, and dilative behavior of the original coarse-grained soil considering its confining pressure, and relative density using a machine learning method. A total number of 72 direct shear tests are performed in 6 different sizes, 3 different confining pressures, and 4 different relative densities. Multivariate Adaptive Regression Spline (MARS) technique was used to develop an equation in order to predict shear strength and dilative behavior based on the size distribution of coarse-grained soil particles. Also, an uncertainty analysis was performed in order to examine the reliability of the proposed equation.

Keywords: MARS, coarse-grained soil, shear strength, uncertainty analysis

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Authors: Boualem Chetti, Samir Zahaf

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This paper presents the steady-state performance analysis of a four-lobe journal bearing lubricated with a couple stress fluids operating in the turbulent regime, following Constantinescu’s turbulent lubrication theory. The modified Reynolds equation is solved numerically using the finite difference method taking into consideration the effects of the turbulence and the couple stress. In this analysis, the steady-state parameters in terms of the attitude angle, load carrying capacity, side leakage and friction coefficient are determined at various values of eccentricities ratio. The computed results show that the turbulence increases the load carrying capacity, the attitude angle and the friction coefficient for a journal bearing lubricated with a Newtonian or a couple stress fluids. It is found that the turbulence has strongly influence on the steady-state performances of the four-lobe journal bearing lubricated with Newtonian fluids or a couple stress fluids.

Keywords: Four-lobe journal bearings, static characteristics, couple-stress fluids, turbulent flow

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Authors: C. Soffritti, A. Fortini, E. Baroni, M. Merlin, G. L. Garagnani

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Aluminum alloys are widely used in many engineering applications due to their advantages such ashigh electrical and thermal conductivities, low density, high strength to weight ratio, and good corrosion resistance. However, their low hardness and poor tribological properties still limit their use in industrial fields requiring sliding contacts. Hard anodizing is one of the most common solution for overcoming issues concerning the insufficient friction resistance of aluminum alloys. In this work, the tribological behavior ofhard-anodized AW-4006 aluminum alloys in dry and lubricated conditions was evaluated. Three different hard-anodizing treatments were selected: a conventional one (HA) and two innovative golden hard-anodizing treatments (named G and GP, respectively), which involve the sealing of the porosity of anodic aluminum oxides (AAO) with silver ions at different temperatures. Before wear tests, all AAO layers were characterized by scanning electron microscopy (VPSEM/EDS), X-ray diffractometry, roughness (Ra and Rz), microhardness (HV0.01), nanoindentation, and scratch tests. Wear tests were carried out according to the ASTM G99-17 standard using a ball-on-disc tribometer. The tests were performed in triplicate under a 2 Hz constant frequency oscillatory motion, a maximum linear speed of 0.1 m/s, normal loads of 5, 10, and 15 N, and a sliding distance of 200 m. A 100Cr6 steel ball10 mm in diameter was used as counterpart material. All tests were conducted at room temperature, in dry and lubricated conditions. Considering the more recent regulations about the environmental hazard, four bio-lubricants were considered after assessing their chemical composition (in terms of Unsaturation Number, UN) and viscosity: olive, peanut, sunflower, and soybean oils. The friction coefficient was provided by the equipment. The wear rate of anodized surfaces was evaluated by measuring the cross-section area of the wear track with a non-contact 3D profilometer. Each area value, obtained as an average of four measurements of cross-section areas along the track, was used to determine the wear volume. The worn surfaces were analyzed by VPSEM/EDS. Finally, in agreement with DoE methodology, a statistical analysis was carried out to identify the most influencing factors on the friction coefficients and wear rates. In all conditions, results show that the friction coefficient increased with raising the normal load. Considering the wear tests in dry sliding conditions, irrespective of the type of anodizing treatments, metal transfer between the mating materials was observed over the anodic aluminum oxides. During sliding at higher loads, the detachment of the metallic film also caused the delamination of some regions of the wear track. For the wear tests in lubricated conditions, the natural oils with high percentages of oleic acid (i.e., olive and peanut oils) maintained high friction coefficients and low wear rates. Irrespective of the type of oil, smallmicrocraks were visible over the AAO layers. Based on the statistical analysis, the type of anodizing treatment and magnitude of applied load were the main factors of influence on the friction coefficient and wear rate values. Nevertheless, an interaction between bio-lubricants and load magnitude could occur during the tests.

Keywords: hard anodizing treatment, silver ions, bio-lubricants, sliding wear, statistical analysis

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Authors: Awol Mekonnen, Temesgen Sidamo, Epherm Engdawork, Kaleab Asresb

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Ethnopharmacological Relevance: The leaves of Kalanchoe petitiana A. Rich (Crassulaceae) are used in Ethiopian folk medicine for treatment of evil eye, fractured surface for bone setting and several skin disorders including for the treatment of sores, boils, and malignant wounds. Aim of the Study: In order to scientifically prove the claimed utilization of the plant, the effects of the extracts and the fractions were investigated using in vivo excision, incision and dead space wound models. Materials and Method: Mice were used for wound healing study, while rats and rabbit were used for skin irritation test. For studying healing activity, 80% methanolic extract and the fractions were formulated in strength of 5% and 10%, either as ointment (hydroalcoholic extract, aqueous and methanol fractions) or gel (chloroform fraction). Oral administration of the crude extract was used for dead space model. Negative controls were treated either with simple ointment or sodium carboxyl methyl cellulose xerogel, while positive controls were treated with nitrofurazone (0.2 w/v) skin ointment. Negative controls for dead space model were treated with 1% carboxy methyl cellulose. Parameters, including rate of wound contraction, period of complete epithelializtion, hydroxyproline contents and skin breaking strength were evaluated. Results: Significant wound healing activity was observed with ointment formulated from the crude extract at both 5% and 10% concentration (p<0.01) compared to controls in both excision and incision models. In dead space model, 600 mg/kg (p<0.01), but not 300 mg/kg, significantly increased hydroxyproline content. Fractions showed variable effect, with the chloroform fraction lacking any significant effect. Both 5% and 10% formulations of the aqueous and methanolic fractions significantly increased wound contraction, decreased epithelializtion time and increased hydroxyproline content in excision wound model (p<0.05) as compared to controls. These fractions were also endowed with higher skin breaking strength in incision wound model (p<0.01). Conclusions: The present study provided evidence that the leaves of Kalanchoe petitiana A. Rich possess remarkable wound healing activities supporting the folkloric assertion of the plant. Fractionation revealed that polar or semi-polar compound may play vital role, as both aqueous and methanolic fractions were endowed with wound healing activity.

Keywords: wound healing, Kalanchoae petitiana, excision wound, incision wound, dead space model

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Authors: Seongho Jang

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Objective: To investigate an appropriate depth of needle insertion during trigger point injection into the rhomboid major muscle. Methods: Sixty-two patients who visited our department with shoulder or upper back pain participated in this study. The distance between the skin and the rhomboid major muscle (SM) and the distance between the skin and rib (SB) were measured using ultrasonography. The subjects were divided into 3 groups according to BMI: BMI less than 23 kg/m2 (underweight or normal group); 23 kg/m2 or more to less than 25 kg/m2 (overweight group); and 25 kg/m2 or more (obese group). The mean ±standard deviation (SD) of SM and SB of each group were calculated. A range between mean+1 SD of SM and the mean-1 SD of SB was defined as a safe margin. Results: The underweight or normal group’s SM, SB, and the safe margin were 1.2±0.2, 2.1±0.4, and 1.4 to 1.7 cm, respectively. The overweight group’s SM and SB were 1.4±0.2 and 2.4±0.9 cm, respectively. The safe margin could not be calculated for this group. The obese group’s SM, SB, and the safe margin were 1.8±0.3, 2.7±0.5, and 2.1 to 2.2 cm, respectively. Conclusion: This study will help us to set the standard depth of safe needle insertion into the rhomboid major muscle in an effective manner without causing any complications.

Keywords: pneumothorax, rhomboid major muscle, trigger point injection, ultrasound

Procedia PDF Downloads 279

Authors: Ghaem Zamani, Farveh Aghaye Nezhad, Amin Barari

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The installation process of caissons has usually been a challenging step in the design phase, especially in the case of suction-assisted installation. The engineering practice for estimating the caisson penetration resistance is primarily controlled by the resistance governed by inner and outer skirt friction and the tip resistance. Different methods have been proposed in the literature to evaluate the above components, while the CPT-based methodology has attained notable popularity among others. In this method, two empirical coefficients are suggested, k𝒻 and kp, which relate the frictional resistance and tip resistance to the cone penetration resistance (q𝒸), respectively. A series of jacking installation and uninstallation experiments for different soil densities were carried out in the offshore geotechnical laboratory of Aalborg University, Denmark. The main goal of these tests was to find appropriate values for empirical coefficients of the CPT-based method for the buckets with large embedment ratio (i.e., d/D=1, where d is the skirt length and D is the diameter) and increased tip area penetrated into dense sand deposits. The friction resistance effects were isolated during the pullout experiments; hence, the k𝒻 was back-measured from the tests in the absence of tip resistance. The actuator force during jacking installation equals the sum of frictional resistance and tip resistance. Therefore, the tip resistance of the bucket is calculated by subtracting the back-measured frictional resistance from penetration resistance; hence the relevant coefficient kp would be achieved. The cone penetration test was operated at different points before and after each installation attempt to measure the cone penetration resistance (q𝒸), and the average value of q𝒸 is used for calculations. The experimental results of the jacking installation tests indicated that a larger friction area considerably increased the penetration resistance; however, this effect was completely diminished when foundation suction-assisted penetration was used. Finally, the values measured for the empirical coefficient of the CPT-based method are compared with the highest expected and most probable values suggested by DNV(1992) for uniform thickness buckets.

Keywords: suction caisson, offshore geotechnics, cone penetration test, wind turbine foundation

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Authors: A. Achour L. Chekour, A. Mekroud

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Tribology, the science of lubrication, friction and wear, plays an important role in science "crossroads" initiated by the recent developments in the industry. Its multidisciplinary nature reinforces its scientific interest. It covers all the sciences that deal with the contact between two solids loaded and relative motion. It is thus one of the many intersections more clearly established disciplines such as solid mechanics and the fluids, rheological, thermal, materials science and chemistry. As for his experimental approach, it is based on the physical and processing signals and images. The optimization of operating conditions by cutting tool must contribute significantly to the development and productivity of advanced automation of machining techniques because their implementation requires sufficient knowledge of how the process and in particular the evolution of tool wear. In addition, technological advances have developed the use of very hard materials, refractory difficult machinability, requiring highly resistant materials tools. In this study, we present the behavior wear a machining tool during the roughing operation according to the cutting parameters. The interpretation of the experimental results is based mainly on observations and analyzes of sharp edges e tool using the latest techniques: scanning electron microscopy (SEM) and optical rugosimetry laser beam.

Keywords: friction, wear, tool, cutting

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Authors: Alhage Drammeh

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The research is on the occurrence of certain diseases among children in rural and far-flung parts of the Gambia and the extent to which they are caused by lack of access to clean water. A baseline survey was used to discover, describe, and explain the actual processes. The paper explains the purpose of the research, which is majorly to improve the health condition of children, especially those living in rural communities. The paper also gives a brief overview of the socio-economic situation of The Gambia, emphasizing its status as a Least Developed Country (LDC) and the majority of its population living below the poverty line, with women and children hardest hit. The research used as case studies of two rural communities in the Gambia -Basse Dampha Kunda Village and Foni Besse. Data was collected through oral interviews and medical tests conducted among people in both villages, with an emphasis on children. The demographic detail of those tested is tabulated for a clearer understanding. The results were compared, revealing that skin rashes, hepatitis, and certain other diseases are more prevalent in communities lacking access to safe drinking water. These results were also presented in a tabular form. The study established how some policy failures and neglect on the part of the Government of The Gambia are imperiling the health of many rural dwellers in the country, the most glaring being that the research team was unable to test water samples collected from the two communities, as there are no laboratory reagents for testing water anywhere in The Gambia. Many rural communities lack basic amenities, especially clean and potable water, as well as health facilities. The study findings also highlighted the need for healthcare providers and medical NGOs to voice the plight of rural dwellers and collaborate with the government to set up health facilities in rural areas of The Gambia.

Keywords: jaundice, skin rashes, children, rural communities, the Gambia, causes

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Authors: Sohaibullah Zarghoon, Syed Yousaf, Cyril Belavy, Stanislav Duris, Samuel Emebu, Radek Matusu

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Induction heating is extensively employed in industrial furnaces due to its swift response and high energy efficiency. Designing and optimising these furnaces necessitates the use of computer-aided simulations. This study aims to develop an accurate temperature field model for a rectangular steel billet in an induction furnace by leveraging various parameters in COMSOL Multiphysics software. The simulation analysis incorporated temperature dynamics, considering skin depth, temperature-dependent, and constant parameters of the steel billet. The resulting data-driven model was transformed into a state-space model using MATLAB's System Identification Toolbox for the purpose of designing a linear quadratic regulator (LQR). This controller was successfully implemented to regulate the core temperature of the billet from 1000°C to 1200°C, utilizing the distributed parameter system circuit.

Keywords: induction heating, LQR controller, skin depth, temperature field

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Authors: M. A. Hassan, M. H. Sakinah, K. Kadirgama, D. Ramasamy, M. M. Noor, M. M. Rahman

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Tribological properties that include nanoparticles are an alternative to improve the tribological behaviour of lubricating oil, which has been investigated by many researchers for the past few decades. Various nanostructures can be used as additives for tribological improvement. However, this also depends on the characteristics of the nanoparticles. In this study, tribological investigation was performed to examine the effect of CuO nanoparticles on the tribological behaviour of Syntium 800 SL 10W−30. Three parameters used in the analysis using the wear tester (piston ring) were load, revolutions per minute (rpm), and concentration. The specifications of the nanoparticles, such as size, concentration, hardness, and shape, can affect the tribological behaviour of the lubricant. The friction and wear experiment was conducted using a tribo-tester and the Response Surface Methodology method was used to analyse any improvement of the performance. Therefore, two concentrations of 40 nm nanoparticles were used to conduct the experiments, namely, 0.005 wt % and 0.01 wt % and compared with base oil 0 wt % (control). A water bath sonicator was used to disperse the nanoparticles in base oil, while a tribo-tester was used to measure the coefficient of friction and wear rate. In addition, the thermal properties of the nanolubricant were also measured. The results have shown that the thermal conductivity of the nanolubricant was increased when compared with the base oil. Therefore, the results indicated that CuO nanoparticles had improved the tribological behaviour as well as the thermal properties of the nanolubricant oil.

Keywords: concentration, improvement, tribological, copper (II) oxide, nano lubricant

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Authors: Ramy H. Mohammed

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In heat sinks, the flow within the core exhibits separation and hence does not lend itself to simple analytical boundary layer or duct flow analysis of the wall friction. In this paper, I present some findings from an experimental and numerical study aimed to obtain physical insight into the influence of the presence of the shield and its position on the hydraulic and thermal performance of square pin fin heat sink without top by-pass. The variations of the Nusselt number and friction factor are obtained under varied parameters, such as the Reynolds number and the shield position. The numerical code is validated by comparing the numerical results with the available experimental data. It is shown that, there is a good agreement between the temperature predictions based on the model and the experimental data. Results show that, as the presence of the shield, the heat transfer of fin array is enhanced and the flow resistance increased. The surface temperature distribution of the heat sink base is more uniform when the dimensionless shield position equals to 1/3 or 2/3. The comprehensive performance evaluation approach based on identical pumping power criteria is adopted and shows that the optimum shield position is at x/l=0.43 where energy is saved.

Keywords: shield, fin array, performance evaluation, heat transfer, energy

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Authors: Lucas Kurth de Azambuja, Loise Silveira da Silva, Gean Vitor Salmoria, Darlan Dallacosta, Carlos Rodrigo de Mello Roesler

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This work provides a physicochemical and thermal characterization assessment of three different hyaluronic acid (HA)-based injections used for rejuvenation skin treatments. The three products analyzed are manufactured by the same manufacturer and commercialized for application on different skin levels. According to the manufacturer, all three HA-based injections are crosslinked and have a concentration of 23 mg/mL of HA, and 0.3% of lidocaine. Samples were characterized by Fourier-transformed infrared (FTIR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and scanning electron microscope (SEM) techniques. FTIR analysis resulted in a similar spectrum when comparing the different products. DSC analysis demonstrated that the fusion points differ in each product, with a higher fusion temperature observed in specimen A, which is used for subcutaneous applications, when compared with B and C, which are used for the middle dermis and deep dermis, respectively. TGA data demonstrated a considerable mass loss at 100°C, which means that the product has more than 50% of water in its composition. TGA analysis also showed that Specimen A had a lower mass loss at 100°C when compared to Specimen C. A mass loss of around 220°C was observed on all samples, characterizing the presence of hyaluronic acid. SEM images displayed a similar structure on all samples analyzed, with a thicker layer for Specimen A when compared with B and C. This series of analyses demonstrated that, as expected, the physicochemical and thermal properties of the products differ according to their application. Furthermore, to better characterize the crosslinking degree of each product and their mechanical properties, a set of different techniques should be applied in parallel to correlate the results and, thereby, relate injection application with material properties.

Keywords: hyaluronic acid, characterization, soft-tissue fillers, injectable gels

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Authors: Lakhya Jyoti Basumatary, M. J. Davidson

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Tailor Welded Blanks (TWBs) have established themselves to be a revolutionary and foremost integral part of the automotive and aerospace industries. Metals sheets with varied thickness, strength and coatings are welded together to form TWBs through friction stir welding and laser welding prior to stamping operations. The formability of the TWBs completely varies from those of conventional blanks due to the diverse strength levels of individual sheets which are made to deform under the same forming load uniformly throughout causing unequal and unsatisfactory deformation in the blank. Limiting Dome Height(LDH) test helps predicting the formability of each blanks and assists in determining the appropriate TWB. Finite Element Simulation of LDH test for both base material and TWBs was performed and analysed for both before and after the solution heat treatment. The comparison and validation of simulation results are done with the experimental data and correlated accordingly. The formability of solution heat treated TWBs had enhanced than those of blanks made from non-heat treated TWBs.

Keywords: tailor welded blanks, friction stir welding, limiting dome height test, finite element simulation

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Authors: Ginger Egberts, Fred Vermolen, Paul van Zuijlen

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One of the common complications in post-burn scars is contractions. Depending on the extent of contraction and the wound dimensions, the contracture can cause a limited range-of-motion of joints. A one-dimensional morphoelastic continuum hypothesis-based model describing post-burn scar contractions is considered. The beauty of the one-dimensional model is the speed; hence it quickly yields new results and, therefore, insight. This model describes the movement of the skin and the development of the strain present. Besides these mechanical components, the model also contains chemical components that play a major role in the wound healing process. These components are fibroblasts, myofibroblasts, the so-called signaling molecules, and collagen. The dermal layer is modeled as an isotropic morphoelastic solid, and pulling forces are generated by myofibroblasts. The solution to the model equations is approximated by the finite-element method using linear basis functions. One of the major challenges in biomechanical modeling is the estimation of parameter values. Therefore, this study provides a comprehensive description of skin mechanical parameter values and a sensitivity analysis. Further, since skin mechanical properties change with aging, it is important that the model is feasible for predicting the development of contraction in burn patients of different ages, and hence this study provides a feasibility study. The variability in the solutions is caused by varying the values for some parameters simultaneously over the domain of computation, for which the results of the sensitivity analysis are used. The sensitivity analysis shows that the most sensitive parameters are the equilibrium concentration of collagen, the apoptosis rate of fibroblasts and myofibroblasts, and the secretion rate of signaling molecules. This suggests that most of the variability in the evolution of contraction in burns in patients of different ages might be caused mostly by the decreasing equilibrium of collagen concentration. As expected, the feasibility study shows this model can be used to show distinct extents of contractions in burns in patients of different ages. Nevertheless, contraction formation in children differs from contraction formation in adults because of the growth. This factor has not been incorporated in the model yet, and therefore the feasibility results for children differ from what is seen in the clinic.

Keywords: biomechanics, burns, feasibility, fibroblasts, morphoelasticity, sensitivity analysis, skin mechanics, wound contraction

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Authors: Hachul Jung, Ahee Kim, Sanghoon Lee, Dahye Kwon, Songwoo Yoon, Jinhee Moon

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We fabricated a wearable patch device including novel patch type flexible dry electrode based on carbon nanofibers (CNFs) and silicone-based elastomer (MED 6215) for real-time ECG monitoring. There are many methods to make flexible conductive polymer by mixing metal or carbon-based nanoparticles. In this study, CNFs are selected for conductive nanoparticles because carbon nanotubes (CNTs) are difficult to disperse uniformly in elastomer compare with CNFs and silver nanowires are relatively high cost and easily oxidized in the air. Wearable patch is composed of 2 parts that dry electrode parts for recording bio signal and sticky patch parts for mounting on the skin. Dry electrode parts were made by vortexer and baking in prepared mold. To optimize electrical performance and diffusion degree of uniformity, we developed unique mixing and baking process. Secondly, sticky patch parts were made by patterning and detaching from smooth surface substrate after spin-coating soft skin adhesive. In this process, attachable and detachable strengths of sticky patch are measured and optimized for them, using a monitoring system. Assembled patch is flexible, stretchable, easily skin mountable and connectable directly with the system. To evaluate the performance of electrical characteristics and ECG (Electrocardiography) recording, wearable patch was tested by changing concentrations of CNFs and thickness of the dry electrode. In these results, the CNF concentration and thickness of dry electrodes were important variables to obtain high-quality ECG signals without incidental distractions. Cytotoxicity test is conducted to prove biocompatibility, and long-term wearing test showed no skin reactions such as itching or erythema. To minimize noises from motion artifacts and line noise, we make the customized wireless, light-weight data acquisition system. Measured ECG Signals from this system are stable and successfully monitored simultaneously. To sum up, we could fully utilize fabricated wearable patch devices for real-time ECG monitoring easily.

Keywords: carbon nanofibers, ECG monitoring, flexible dry electrode, wearable patch

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Authors: R. Ziaie Moayed, M. Hamidzadeh

Abstract:

The use of waste rubber chips not only can be of great importance in terms of the environment, but also can be used to increase the shear strength of soils. The purpose of this study was to evaluate the variation of the internal friction angle of liquefiable sandy soil using waste rubber chips. For this purpose, the geotechnical properties of unmodified and modified soil samples by waste lining rubber chips have been evaluated and analyzed by performing the triaxial consolidated drained test. In order to prepare the laboratory specimens, the sandy soil in part of Rudsar shores in Gilan province, north of Iran with high liquefaction potential has been replaced by two percent of waste rubber chips. Samples have been compressed until reaching the two levels of density of 15.5 and 16.7 kN/m³. Also, in order to find the optimal length of chips in sandy soil, the rectangular rubber chips with the widths of 0.5 and 1 cm and the lengths of 0.5, 1, and 2 cm were used. The results showed that the addition of rubber chips to liquefiable sandy soil greatly increases the shear resistance of these soils. Also, it can be seen that decreasing the width and increasing the length-to-width ratio of rubber chips has a direct impact on the shear strength of the modified soil samples with rubber chips.

Keywords: improvement, shear strength, internal friction angle, sandy soil, rubber chip

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Authors: Alhaji Modu Bukar, Faez Firdaus Abdullah Jesse, Che Azurahanim Che Abdullah, Mustapha M. Noordin, Mohd-Lila Mohd Azmia

Abstract:

Orf virus (ORFV) is the causative agent of a proliferative skin lesion known as contagious ecthyma in sheep and goats. Currently used live attenuated vaccines against ORFV infection have been reported to cause severe outbreaks in vaccinated animals. In this study, we investigated the immunogenicity of the B2L and F1L proteins of the virus, which are thought to elicit a protective immune response The 6-week-old 50 female mice were divided into 8 groups: seven experimental groups and one control group. Each animal in the experimental group received an initial immunisation with the nanoparticles or proteins coated with the nanoparticles, followed by two booster immunizations with the same products 14 days apart. Ten days after the last booster inoculation, the mice were either humanely killed or lethally challenged with UPM /HSN-2-ORFV at a dose of 106 TCID50/mL in a volume of 50 μl. The spleen was examined for histopathological changes and quantification of T cells by flow cytometry. On the other hand, the degree of protection of mice from the lethal virus was evaluated by lesion size, weight loss, and histopathological examination of skin and liver. The results showed that mice immunised with rB2L alone, rB2L-Al₂O₃-NPs, rB2L/rF1L, and rB2L/rF1L-Al₂O₃-NPs elicited statistically higher levels of anti-rB2L and/or rF1L-specific IgA/IgG and CD4/CD8 cell immune responses than mice in the control groups (p < 0.01). The vaccine candidate did not exhibit severe skin damage after monitoring histopathology, morbidity, and mortality. Overall, the results suggest that recombinant rB2L and rF1L antigens may be useful universal vaccine candidates against ORFV infections.

Keywords: orf virus, antigen nanoparticles, virus, nanoparticles

Procedia PDF Downloads 46

Authors: S. Talebnezhad, S. Pourmahdian, D. Soudbar, M. Khosravani, J. Merasi

Abstract:

Adding toughened polypropylene and plastomer in FFS 3 layered blown film formulation resulted in superior dart impact and MD tear resistance along with acceptable tensile properties in TD and MD. The optimum loading of toughened polypropylene and plastomer in each layer depends on miscibility of polypropylene in polyethylene medium, mechanical properties, welding characteristics in bags top and bottoms and friction coefficient of film surfaces. Film property tests and efficiency of FFS machinery during processing in industrial scale showed that about 4% loading of plastomer and 16% of toughened polypropylene (reactor grade) in middle layer and loading of 0-1% plastomer and 5-19% of toughened polypropylene in other layers results optimum characteristics in the formulation based on 1-butene LLDPE grade with MFR of 0.9 and LDPE grade with MFI of 0.3. Both the plastomer and toughened polypropylene had the MFI of blow 1 and the TiO2 and processing aid masterbatches loading was 2%. The friction coefficient test results also represented the anti-block masterbatch could be omitted from formulation with adding toughened polypropylene due to partial miscibility of PP in PE which makes the surface of films somewhat bristly.

Keywords: FFS 3 layered blown film, toughened polypropylene, plastomer, dart impact, tear resistance

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Authors: Pavana Basavakumar, Devadas Bhat

Abstract:

Diabetes is a disease which often goes undiagnosed until its secondary effects are noticed. Early detection of the disease is necessary to avoid serious consequences which could lead to the death of the patient. Conventional invasive tests for screening of diabetes are mostly painful, time consuming and expensive. There’s also a risk of infection involved, therefore it is very essential to develop non-invasive methods to screen and estimate the level of blood glucose. Extensive research is going on with this perspective, involving various techniques that explore optical, electrical, chemical and thermal properties of the human body that directly or indirectly depend on the blood glucose concentration. Thus, non-invasive blood glucose monitoring has grown into a vast field of research. In this project, an attempt was made to device a prototype for screening of diabetes by measuring electrical impedance of the skin and building a model to predict a patient’s condition based on the measured impedance. The prototype developed, passes a negligible amount of constant current (0.5mA) across a subject’s index finger through tetra polar silver electrodes and measures output voltage across a wide range of frequencies (10 KHz – 4 MHz). The measured voltage is proportional to the impedance of the skin. The impedance was acquired in real-time for further analysis. Study was conducted on over 75 subjects with permission from the institutional ethics committee, along with impedance, subject’s blood glucose values were also noted, using conventional method. Nonlinear regression analysis was performed on the features extracted from the impedance data to obtain a model that predicts blood glucose values for a given set of features. When the predicted data was depicted on Clarke’s Error Grid, only 58% of the values predicted were clinically acceptable. Since the objective of the project was to screen diabetes and not actual estimation of blood glucose, the data was classified into three classes ‘NORMAL FASTING’,’NORMAL POSTPRANDIAL’ and ‘HIGH’ using linear Support Vector Machine (SVM). Classification accuracy obtained was 91.4%. The developed prototype was economical, fast and pain free. Thus, it can be used for mass screening of diabetes.

Keywords: Clarke’s error grid, electrical impedance of skin, linear SVM, nonlinear regression, non-invasive blood glucose monitoring, screening device for diabetes

Procedia PDF Downloads 317

Authors: Lesly Y Carmona-Sarabia, Luisa Barraza-Vergara, Vilmalí López-Mejías, Wandaliz Torres-García, Maribella Domenech-Garcia, Madeline Torres-Lugo

Abstract:

Biosensors are used in many applications providing real-time monitoring to treat long-term conditions. Thus, understanding the physicochemical properties and biological side effects on the skin of polymers (e. g., poly(methyl methacrylate), PMMA) employed in the fabrication of wearable biosensors is crucial for the selection of manufacturing materials within this field. The PMMA (hydrophobic and thermoplastic polymer) is commonly employed as a coating material or substrate in the fabrication of wearable devices. The cytotoxicityof PMMA (including residual monomers or degradation products) on the skin, in terms of cells and tissue, is required to prevent possible adverse effects (cell death, skin reactions, sensitization) on human health. Within this work, accelerated aging of PMMA (Mw ~ 15000) through thermal and photochemical degradation was under-taken. The accelerated aging of PMMA was carried out by thermal (200°C, 1h) and photochemical degradation (UV-Vis, 8-15d) adapted employing ISO protocols (ISO-10993-12, ISO-4892-1:2016, ISO-877-1:2009, ISO-188: 2011). In addition, in vitro cytotoxicity evaluation of PMMA degradation products was performed using NIH3T3 fibroblast cells to assess the response of skin tissues (in terms of cell viability) exposed with polymers utilized to manufacture wearable biosensors, such as PMMA. The PMMA (Mw ~ 15000) before and after accelerated aging experiments was characterized by thermal gravimetric analysis (TGA), differential scanning calorimetric (DSC), powder X-ray diffractogram (PXRD), and scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) to determine and verify the successful degradation of this polymer under the specific conditions previously mention. The degradation products were characterized through nuclear magnetic resonance (NMR) to identify possible byproducts generated after the accelerated aging. Results demonstrated a percentage (%) weight loss between 1.5-2.2% (TGA thermographs) for PMMA after accelerated aging. The EDS elemental analysis reveals a 1.32 wt.% loss of carbon for PMMA after thermal degradation. These results might be associated with the amount (%) of PMMA degrade after the accelerated aging experiments. Furthermore, from the thermal degradation products was detected the presence of the monomer and methyl formate (low concentrations) and a low molecular weight radical (·COOCH3) in higher concentrations by NMR. In the photodegradation products, methyl formate was detected in higher concentrations. These results agree with the proposed thermal or photochemical degradation mechanisms found in the literature.1,2 Finally, significant cytotoxicity on the NIH3T3 cells was obtained for the thermal and photochemical degradation products. A decrease in cell viability by > 90% (stock solutions) was observed. It is proposed that the presence of byproducts (e.g. methyl formate or radicals such as ·COOCH₃) from the PMMA degradation might be responsible for the cytotoxicity observed in the NIH3T3 fibroblast cells. Additionally, experiments using skin models will be employed to compare with the NIH3T3 fibroblast cells model.

Keywords: biosensors, polymer, skin irritation, degradation products, cell viability

Procedia PDF Downloads 130

Authors: Rafid Mueen, Konstantin Konstantinov, Micheal Lerch, Zhenxiang Cheng

Abstract:

In the past two decades, the concern for skin protection from ultraviolet (UV) radiation has attracted considerable attention due to the increased intensity of UV rays that can reach the Earth’s surface as a result of the breakdown of ozone layer. Recently, UVA has also attracted attention, since, in comparison to UVB, it can penetrate deeply into the skin, which can result in significant health concerns. Sunscreen agents are one of the significant tools to protect the skin from UV irradiation, and it is either organic or in organic. Developing of inorganic UV blockers is essential, which provide efficient UV protection over a wide spectrum rather than organic filters. Furthermore inorganic UV blockers are good comfort, and high safety when applied on human skin. Inorganic materials can absorb, reflect, or scatter the ultraviolet radiation, depending on their particle size, unlike the organic blockers, which absorb the UV irradiation. Nowadays, most inorganic UV-blocking filters are based on (TiO2) and ZnO). ZnO can provide protection in the UVA range. Indeed, ZnO is attractive for in sunscreen formulization, and this relates to many advantages, such as its modest refractive index (2.0), absorption of a small fraction of solar radiation in the UV range which is equal to or less than 385 nm, its high probable recombination of photogenerated carriers (electrons and holes), large direct band gap, high exciton binding energy, non-risky nature, and high tendency towards chemical and physical stability which make it transparent in the visible region with UV protective activity. A significant issue for ZnO use in sunscreens is that it can generate ROS in the presence of UV light because of its photocatalytic activity. Therefore it is essential to make a non-photocatalytic material through modification by other metals. Several efforts have been made to deactivate the photocatalytic activity of ZnO by using inorganic surface modifiers. The doping of ZnO by different metals is another way to modify its photocatalytic activity. Recently, successful doping of ZnO with different metals such as Ce, La, Co, Mn, Al, Li, Na, K, and Cr by various procedures, such as a simple and facile one pot water bath, co-precipitation, hydrothermal, solvothermal, combustion, and sol gel methods has been reported. These materials exhibit greater performance than undoped ZnO towards increasing the photocatalytic activity of ZnO in visible light. Therefore, metal doping can be an effective technique to modify the ZnO photocatalytic activity. However, in the current work, we successfully reduce the photocatalytic activity of ZnO through Na doped ZnO fabricated via sol-gel and hydrothermal methods.

Keywords: photocatalytic, ROS, UVA, ZnO

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Authors: Choupani Andisheh, Temucin Elif Sevval, Bediz Bekir

Abstract:

Due to their various advantages compared to many other drug delivery systems such as hypodermic injections and oral medications, microneedle arrays (MNAs) are a promising drug delivery system. To achieve enhanced performance of the MN, it is crucial to develop numerical models, optimization methods, and simulations. Accordingly, in this work, the optimized design of dissolvable MNAs, as well as their manufacturing, is investigated. For this purpose, a mechanical model of a single MN, having the geometry of an obelisk, is developed using commercial finite element software. The model considers the condition in which the MN is under pressure at the tip caused by the reaction force when penetrating the skin. Then, a multi-objective optimization based on non-dominated sorting genetic algorithm II (NSGA-II) is performed to obtain geometrical properties such as needle width, tip (apex) angle, and base fillet radius. The objective of the optimization study is to reach a painless and effortless penetration into the skin along with minimizing its mechanical failures caused by the maximum stress occurring throughout the structure. Based on the obtained optimal design parameters, master (male) molds are then fabricated from PMMA using a mechanical micromachining process. This fabrication method is selected mainly due to the geometry capability, production speed, production cost, and the variety of materials that can be used. Then to remove any chip residues, the master molds are cleaned using ultrasonic cleaning. These fabricated master molds can then be used repeatedly to fabricate Polydimethylsiloxane (PDMS) production (female) molds through a micro-molding approach. Finally, Polyvinylpyrrolidone (PVP) as a dissolvable polymer is cast into the production molds under vacuum to produce the dissolvable MNAs. This fabrication methodology can also be used to fabricate MNAs that include bioactive cargo. To characterize and demonstrate the performance of the fabricated needles, (i) scanning electron microscope images are taken to show the accuracy of the fabricated geometries, and (ii) in-vitro piercing tests are performed on artificial skin. It is shown that optimized MN geometries can be precisely fabricated using the presented fabrication methodology and the fabricated MNAs effectively pierce the skin without failure.

Keywords: microneedle, microneedle array fabrication, micro-manufacturing structural optimization, finite element analysis

Procedia PDF Downloads 102

Authors: N. S. Risqina, G. Edijanti, P. S. Nurita, L. Endang, R. A. Siti, R. Tri

Abstract:

Skin is an important and vital organs and also as a mirror of health and life. Facial skin care is one of the main emphasis to get the beautiful, healthy, and fresh skin. Potentially antioxidant phenolic compounds shows, antimutagen, antitumor, anti-inflammatory, and anti-cancer. Flavonoids are a group of polyphenolic compounds that have the nature of free radicals, inhibiting the oxidative and hydrolytic enzymes as well as anti-inflammatory. Bitter melon (Momordica charantia Linn) is a plant that contains flavonoids, and phenolic antioxidant activity. Bitter melon has strong antioxidant activity that can counteract the free radicals.These compounds can prevent free radicals that cause premature aging. Gel masks including depth cleansing is the cosmetics which work in depth and could raise the dead skin cells. Measurement of antioxidant activity of the extract and gel mask is done by using the immersion method of DPPH. IC50 value of ethanol extract of bitter melon fruit of 287.932 ppm. The preparation of gel mask bitter melon fruit extract, necessary to test the effectiveness of antioxidants using DPPH method is done by measuring the inhibition of DPPH and using UV spectrophotometer at the wavelength of maximum DPPH solution. Tests conducted at the beginning and end of the evaluation (day 0 and day 28). The purpose of this study is to determine the antioxidant activity of the bitter melon's extract and to determine the antioxidant activity of ethanol extract gel mask pare in varying concentrations, ie 1xIC100 (0.295%), 2xIC100 (0.590%) and 4xIC100 (1.180%). Evaluation of physical properties of the preparation on (Day-0,7,14,21, and 28) and evaluation of antioxidant activity (day 0 and 28). Data were analyzed using One Way ANOVA to determine differences in the physical properties of each formula. The statistical results showed that differences in the formula and storage time affects the adhesion, dispersive power, dry time and pH it is shown on a significant value of p <0.05, but longer storage does not affect the pH because the significance value p> 0,05. The antioxidant test showed that there are differences in antioxidant activity in all formulas. Measurement of antioxidant activity of bitter melon fruit extract gel mask on day 0 with a concentration of 0.295%, 0.590%, and 1.180%, respectively, are 124,209.277 ppm, ppm 83819.223 and 47323.592 ppm, whereas day 28 consecutive 130 411, 495 ppm, and 53239.806 95561.645 ppm ppm. The Conclusions drawn that there are antioxidant activity in preparation gel mask of bitter melon fruit extract. The antioxidant activity of bitter melon fruit extract gel mask on the day 0 with a concentration of 0.295%, 0.590%, and 1.180%, respectively, are 124,209.277 ppm, ppm 83819.223 and 47323.592 ppm, whereas on day 28 of antioxidant activity gel mask bitter melon fruit extract with a concentration of 0.295%, 0.590%, and 1.180% in succession, namely: 130,411.495 ppm, ppm 95561.645 and 53239.806 ppm.

Keywords: antioxdant, bitter melon, gel mask, IC50

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Authors: Kakali Roy, Sahana P. Raju, Subhra Dhar, Sandipan Dhar

Abstract:

Introduction: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR) induced DNA damage in the nucleotide excision repair pathway. Which results in increased photosensitivity, UVR induced damage to skin and eye, increased susceptibility of skin and ocular cancer, and progressive neurodegeneration in some patients. XP is present worldwide, with higher incidence in areas having frequent consanguinity. Being extremely rare, there is limited literature on XP and associated complications. Here, the clinico-pathological experience (spectrum of clinical presentation, histopathological findings of malignant skin lesions, and progression) of managing 8 cases of XP is presented. Methodology: A retrospective study was conducted in a pediatric tertiary care hospital in eastern India during a ten-year period from 2013 to 2022. A clinical diagnosis was made based on severe sun burn or premature photo-aging and/or onset of cutaneous malignancies at early age (1st decade) in background of consanguinity and autosomal recessive inheritance pattern in family. Results: The mean age of presentation was 1.2 years (range of 7month-3years), while three children presented during their infancy. Male to female ratio was 5:3, and all were born of consanguineous marriage. They presented with dermatological manifestations (100%) followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme sensitivity to UVR in the form of exaggerated sun tanning, burning, and blistering on minimal sun exposure, followed by abnormal skin pigmentation like freckles and lentiginosis. Subsequently, over time there was progressive xerosis, atrophy, wrinkling, and poikiloderma. Six patients had varied degree of ocular involvement, while three of them had severe manifestation, including madarosis, tylosis, ectropion, Lagopthalmos, Pthysis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. 50% (n=4) cases had skin and ocular pre-malignant (actinic keratosis) and malignant lesions, including melanoma and non melanoma skin cancer (NMSC) like squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Subnormal intelligence was noticed as neurological feature, and none had sensory neural hearing loss, microcephaly, neuroregression, or neurdeficit. All the patients had been being managed by a multidisciplinary team of pediatricians, dermatologists, ophthalmologists, neurologists and psychiatrists. Conclusion: Although till date there is no complete cure for XP and the disease is ultimately fatal. But increased awareness, early diagnosis followed by persistent vigorous protection from UVR, and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Keywords: childhood malignancies, dermato-pathological findings, eastern India, Xeroderma pigmentosa

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Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

Abstract:

Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

Procedia PDF Downloads 159