Search results for: fracture clinic

Authors: Hoo Cheol Lee, Dae Seung Kim, Sang Myung Jung, Gwang Heum Yoon, Hwa Sung Shin

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Loss of bone tissue can occur due to a bone tissue disease and aging or fracture. Renewable formation of bone is mainly made by its differentiation and metabolism. For this reason, osteoblasts have been studied for regeneration of bone tissue. So, tissue engineering has attracted attention as a recovery means. In tissue engineering, a particularly important factor is a scaffold that supports cell growth. For osteoblast scaffold, we used the cellulose nanowhisker (CNW) extracted from marine organism. CNW is one of an abundant material obtained from a number of plants and animals. CNW is polymer consisting of monomer cellulose and this composition offers biodegradability and biocompatibility to CNW. Mechanical strength of CNW is superior to the existing natural polymers. In addition, substances of marine origin have a low risk of secondary infection by bacteria and pathogen in contrast with those of land-derived. For evaluating its suitability as an osteoblast scaffold, we fabricate CNW film for osteoblast culture and performed the MTT assay and ALP assay to confirm its cytotoxicity and effect on differentiation. Taking together these results, we assessed CNW is a potential candidate of a material for bone tissue regeneration.

Keywords: bone regeneration, cellulose nanowhisker, marine derived material, osteoblast

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Authors: Vaso K. Kapnopoulou, Piero Caridis

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The fatigue of ship structural details is of major concern in the maritime industry as it can generate fracture issues that may compromise structural integrity. In the present study, a fatigue analysis of the lower hopper knuckle connection of a bulk carrier was conducted using the Finite Element Method by means of ABAQUS/CAE software. The fatigue life was calculated using Miner’s Rule and the long-term distribution of stress range by the use of the two-parameter Weibull distribution. The cumulative damage ratio was estimated using the fatigue damage resulting from the stress range occurring at each load condition. For this purpose, a cargo hold model was first generated, which extends over the length of two holds (the mid-hold and half of each of the adjacent holds) and transversely over the full breadth of the hull girder. Following that, a submodel of the area of interest was extracted in order to calculate the hot spot stress of the connection and to estimate the fatigue life of the structural detail. Two hot spot locations were identified; one at the top layer of the inner bottom plate and one at the top layer of the hopper plate. The IACS Common Structural Rules (CSR) require that specific dynamic load cases for each loading condition are assessed. Following this, the dynamic load case that causes the highest stress range at each loading condition should be used in the fatigue analysis for the calculation of the cumulative fatigue damage ratio. Each load case has a different effect on ship hull response. Of main concern, when assessing the fatigue strength of the lower hopper knuckle connection, was the determination of the maximum, i.e. the critical value of the stress range, which acts in a direction normal to the weld toe line. This acts in the transverse direction, that is, perpendicularly to the ship's centerline axis. The load cases were explored both theoretically and numerically in order to establish the one that causes the highest damage to the location examined. The most severe one was identified to be the load case induced by beam sea condition where the encountered wave comes from the starboard. At the level of the cargo hold model, the model was assumed to be simply supported at its ends. A coarse mesh was generated in order to represent the overall stiffness of the structure. The elements employed were quadrilateral shell elements, each having four integration points. A linear elastic analysis was performed because linear elastic material behavior can be presumed, since only localized yielding is allowed by most design codes. At the submodel level, the displacements of the analysis of the cargo hold model to the outer region nodes of the submodel acted as boundary conditions and applied loading for the submodel. In order to calculate the hot spot stress at the hot spot locations, a very fine mesh zone was generated and used. The fatigue life of the detail was found to be 16.4 years which is lower than the design fatigue life of the structure (25 years), making this location vulnerable to fatigue fracture issues. Moreover, the loading conditions that induce the most damage to the location were found to be the various ballasting conditions.

Keywords: dynamic load cases, finite element method, high cycle fatigue, lower hopper knuckle

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Authors: Nawal A. Abu-Shady, Ibrahim M. I. Hamoda, Ahmed R. Z. Baghdadi, Mohammed K. Mohamed

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Background: The aim of this work was to investigate the efficacy of Transcranial Magnetic Therapy (TMT) on balance in hemiparetic stroke patients. It was conducted in outpatient clinic and in BIODEX balance system lab in Faculty of Physical Therapy, Cairo University. Subjects and Methods: Thirty hemiparetic stroke patients from both sexes represent the sample of this study. The patients' ages ranged from 45 to 55 years. They were assigned randomly into two equal groups; the study group (GA) and the control group (GB). control group treated by selected therapeutic physical therapy program. GA treated by the same program of treatment as the GB in addition to TMT. The duration of treatment was six weeks, three times weekly.day after day. The different aspects of dynamic balance (overall stability, anteroposterior stability and mediolateral stability indices) were assessed pre and post treatment objectively by Biodex balance system and clinically by Short Form of Berg Balance Scale (SFBBS) in both groups. Results: Comparison of each variable pre and post treatment in each group revealed a significant improvement in all different parameters in both groups ( p < 0.01), however comparison between post results revealed that the GA showed a high significant improvement higher than the GB in all different variables.

Keywords: stroke, TMT, SFBBS, biodex balance system

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Authors: D. Kari Basavaraja, M. G. Skanda, C. Soumya, V. Ramesh

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This paper discusses the effects of sodium hypophosphite concentration, pH, and temperature on deposition rate. This paper also discusses the evaluation of coating strength, surface, and subsurface by varying the bath parameters, percentage of phosphate, plating temperature, and pH of the plating solution. Taguchi technique has been used for the analysis. In the experiment, nickel chloride which is a source of nickel when mixed with sodium hypophosphite has been used as the reducing agent and the source of phosphate and sodium hydroxide has been used to vary the pH of the coating bath. The coated samples are tested for impact energy by conducting impact test. Finally, the effects of coating bath parameters on the impact energy absorbed have been plotted, and analysis has been carried out. Further, percentage contribution of coating bath parameters using Design of Experiments approach (DOE) has been analysed. Finally, it can be concluded that the bath parameters of the Ni-P coating will certainly influence on the strength of the specimen.

Keywords: bath parameters, coatings, design of experiment, fracture toughness, impact strength

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Authors: Eliska Smidova, Petr Kabele

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This paper describes non-linear finite element simulation of laminated veneer lumber (LVL) under tensile and shear loads that induce cracking along fibers. For this purpose, we use 2D homogeneous orthotropic constitutive model of tensile and shear fracture in timber that has been recently developed and implemented into ATENA® finite element software by the authors. The model captures (i) material orthotropy for small deformations in both linear and non-linear range, (ii) elastic behavior until anisotropic failure criterion is fulfilled, (iii) inelastic behavior after failure criterion is satisfied, (iv) different post-failure response for cracks along and across the grain, (v) unloading/reloading behavior. The post-cracking response is treated by fixed smeared crack model where Reinhardt-Hordijk function is used. The model requires in total 14 input parameters that can be obtained from standard tests, off-axis test results and iterative numerical simulation of compact tension (CT) or compact tension-shear (CTS) test. New engineered timber composites, such as laminated veneer lumber (LVL), offer improved structural parameters compared to sawn timber. LVL is manufactured by laminating 3 mm thick wood veneers aligned in one direction using water-resistant adhesives (e.g. polyurethane). Thus, 3 main grain directions, namely longitudinal (L), tangential (T), and radial (R), are observed within the layered LVL product. The core of this work consists in 3 numerical simulations of experiments where Radiata Pine LVL and Yellow Poplar LVL were involved. The first analysis deals with calibration and validation of the proposed model through off-axis tensile test (at a load-grain angle of 0°, 10°, 45°, and 90°) and CTS test (at a load-grain angle of 30°, 60°, and 90°), both of which were conducted for Radiata Pine LVL. The second finite element simulation reproduces load-CMOD curve of compact tension (CT) test of Yellow Poplar with the aim of obtaining cohesive law parameters to be used as an input in the third finite element analysis. That is four point bending test of small-size arch of 780 mm span that is made of Yellow Poplar LVL. The arch is designed with a through crack between two middle layers in the crown. Curved laminated beams are exposed to high radial tensile stress compared to timber strength in radial tension in the crown area. Let us note that in this case the latter parameter stands for tensile strength in perpendicular direction with respect to the grain. Standard tests deliver most of the relevant input data whereas traction-separation law for crack along the grain can be obtained partly by inverse analysis of compact tension (CT) test or compact tension-shear test (CTS). The initial crack was modeled as a narrow gap separating two layers in the middle the arch crown. Calculated load-deflection curve is in good agreement with the experimental ones. Furthermore, crack pattern given by numerical simulation coincides with the most important observed crack paths.

Keywords: compact tension (CT) test, compact tension shear (CTS) test, fixed smeared crack model, four point bending test, laminated arch, laminated veneer lumber LVL, off-axis test, orthotropic elasticity, orthotropic fracture criterion, Radiata Pine LVL, traction-separation law, yellow poplar LVL, 2D constitutive model

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Authors: Na Li, Yunwei Zhang, Yuhong Niu

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The study discussed the patent protections of health system and enterprises in Shanghai. The comparisons of technical distribution and scopes of patent protections between Shanghai health system and enterprises were used by the methods of IPC classification, co-words analysis and visual social network. Results reflected a decreasing order within IPC A61 area, namely A61B, A61K, A61M, and A61F. A61B required to be further investigated. The highest authorized patents A61B17 of A61B of IPC A61 area was found. Within A61B17, fracture fixation, ligament reconstruction, cardiac surgery, and biopsy detection were regarded as common concerned fields by Shanghai health system and enterprises. However, compared with cardiac closure which Shanghai enterprises paid attention to, Shanghai health system was more inclined to blockages and hemostatic tools. The results also revealed that the scopes of patent protections of Shanghai enterprises were relatively centralized. Shanghai enterprises had a series of comprehensive strategies for protecting core patents. In contrast, Shanghai health system was considered to be lack of strategic patent protections for core patents.

Keywords: co-words analysis, IPC classification, patent protection, technical distribution

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Authors: Sanaa Mekdad, Leenah Alsayed

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Pharmacists play an important role in the CDTM in the care of patients with heart failure (HF). CDTM allows specialized, dedicated clinical pharmacists in a formal agreement in collaborative practice with physicians. Thus, the aim of this study is to investigate the role of cardiology clinical pharmacists in CDTM in decreasing hospitalization and cost. We studied patients with left ventricular systolic dysfunction in a cluster-randomized selection in a tertiary care center. We allocated 296 patients to pharmacist intervention from 1480 patients. Results: With an acceptance rate of 86%, we documented 696 interventions carried out by clinical pharmacists in cardiology. The average intervention was 2.4 patients, and the admission after interventions decreased from 0.79 to. 0.24 (p value = 0.001). Conclusions: In HF CDTM, clinical pharmacists play a crucial role in enhancing medication management, patient education, and lifestyle modification of patients with chronic heart failure. These efforts improve patients' outcomes and lower costs by reducing hospitalization and other associated expenses.

Keywords: cardiology, medication management, heart failure, outpatient therapy, pharmacist-based services, chronic heart failure, heart failure recommendations, CDTM, Middle East, pharmacist-based services, quality of life, pharmacist

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Authors: B. S. So, Y. H. Yoon, J. O. Jung, K. S. Bae

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Metal Injection Molding (MIM) is a technology that combines powder metallurgy and injection molding. Particularly, it is widely applied to the manufacture of precision mobile parts and automobile turbocharger parts because compact precision parts with complicated three-dimensional shapes that are difficult to machining are formed into a large number of finished products. The swing valve is a valve that adjusts the boost pressure of the turbocharger. Since the head portion is exposed to the harsh temperature condition of about 900 degrees in the gasoline GDI engine, it is necessary to use Inconel material with excellent heat resistance and abrasion resistance, resulting in high manufacturing cost. In this study, we developed a swing valve using a metal powder injection molding based hybrid material (Inconel 713C material with heat resistance is applied to the head part, and HK30 material with low price is applied to the rest of the body part). For this purpose, the process conditions of the metal injection molding were optimized to minimize the internal defects, and the effectiveness was confirmed by the fracture strength and fatigue test.

Keywords: hybrid metal injection molding, swing valve, turbocharger, double injection

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background: The TP53 mutation is frequently detected in acute myeloid leukemia (AML) patients with complex karyotype (CK), but the stability of this mutation during the clinical course remains unclear. Material and Methods: In this study, TP53 mutations were identified in 7% of 500 patients with de novo AML and 58.8% of patients with CK in Tabriz, Iran. TP53 mutations were closely associated with older age, lower white blood cell (WBC) and platelet counts, FAB M6 subtype, unfavorable-risk cytogenetics, and CK, but negatively associated with NPM1 mutation, FLT3/ITD and DNMT3A mutation. Result: Multivariate analysis demonstrated that TP53 mutation was an independent poor prognostic factor for overall survival and disease-free survival among the total cohort and the subgroup of patients with CK. A scoring system incorporating TP53 mutation and nine other prognostic factors, including age, WBC counts, cytogenetics, and gene mutations, into survival analysis proved to be very useful to stratify AML patients. Sequential study of 420 samples showed that TP53 mutations were stable during AML evolution, whereas the mutation was acquired only in 1 of the 126 TP53 wild-type patients when therapy-related AML originated from different clone emerged. Conclusion: In conclusion, TP53 mutations are associated with distinct clinic-biological features and poor prognosis in de novo AML patients and are rather stable during disease progression.

Keywords: acute myloblastic leukemia, TP53, FLT3/ITD, Iran

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Authors: Temitope Olumide Olugbade

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Low resistance and delayed fracture to corrosion, especially in harsh environmental conditions, often limit the wide application of high-manganese (high-Mn) steels. To address this issue, the present work investigates the influence of microalloying on the corrosion properties of high-Mn steels. Microalloyed and base high-Mn steels were synthesized through an arc melting process under an argon atmosphere. To generate different microstructures, the temperature and duration were varied via thermal homogenization treatments. The electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization techniques were used to determine the corrosion properties in 0.6 M NaCl aqueous solution at room temperature. The relationship between the microstructures and corrosion properties was investigated via Scanning Kelvin Probe Microscopy (SKPFM), energy dispersive X-ray spectroscopy (EDX), and Scanning electron microscopy (SEM) techniques. The local corrosion properties were investigated via in situ atomic force spectroscopy (AFM), considering the homogenization treatments. The results indicate that microalloying is a successful technique for enhancing the corrosion behavior of high-Mn steels. Compared to other alloying elements, Vanadium has shown improvement in corrosion properties for both general and local corrosion in chloride environments.

Keywords: corrosion, high-manganese steel, homogenization, microalloying, vanadium

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Authors: Jun Hong Lee

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Background: Many dementia patients complain insomnia and depressive mood, and hypnotics and antidepressants are being prescribed. As prevalence of dementia is increasing, insomnia and depressive mood are becoming more important. Objective: We evaluated insomnia and depression in outpatients of dementia center. Patients and Methods/Material and Methods: We reviewed medical records of the patients who visited outpatients clinic of NHIS Ilsan Hospital Dementia Center during 2016. Results: Total 716 patients are included; Subjective Memory Impairment (SMI) : 143 patients (20%), non-amnestic Mild Cognitive Impairment (MCI): single domain 70 (10%), multiple domain 34 (5%), amnestic MCI: single domain 74 (10%), multiple domain 159 (22%), Early onset Alzheimer´s disease (AD): 9 (1%), AD 121 (17%), Vascular dementia: 62 (9%), Mixed dementia 44 (6%). Hypnotics and antidepressants are prescribed as follows; SMI : hypnotics 14 patients (10%), antidepressants 27 (19%), non-amnestic MCI: single domain hypnotics 9 (13%), antidepressants 12 (17%), multiple domain hypnotics 4 (12%), antidepressants 6 (18%), amnestic MCI: single domain hypnotics 10 (14%), antidepressants 16 (22%), multiple domain hypnotics 22 (14%), antidepressants 24 (15%), Early onset Alzheimer´s disease (AD): hypnotics 1 (11%), antidepressants 2 (22%), AD: hypnotics 10 (8%), antidepressants 36 (30%), Vascular dementia: hypnotics 8 (13%), antidepressants 20 (32%), Mixed dementia: hypnotics 4 (9%), antidepressants 17 (39%). Conclusion: Among the outpatients of Dementia Center, MCI and SMI are majorities, and the number of MCI patients are almost half. Depression is more prevalent in AD, and Vascular dementia than MCI and SMI, and about 22% of patients are being prescribed by antidepressants and 11% by hypnotics.

Keywords: insomnia, depression, dementia, antidepressants, hypnotics

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Authors: S. H. Atef, N. H. Mahmoud, S. Abdrahman, A. Fattoh

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Background: The aim of the study is to assess the diagnostic value of fibrotest and hyaluronic acid in discriminate between insignificant and significant fibrosis. Also, to find out if these parameters could replace liver biopsy which is currently used for selection of chronic hepatitis C patients eligible for antiviral therapy. Study design: This study was conducted on 52 patients with HCV RNA detected by polymerase chain reaction (PCR) who had undergone liver biopsy and attending the internal medicine clinic at Ain Shams University Hospital. Liver fibrosis was evaluated according to the METAVIR scoring system on a scale of F0 to F4. Biochemical markers assessed were: alpha-2 macroglobulin (α2-MG), apolipoprotein A1 (Apo-A1), haptoglobin, gamma-glutamyl transferase (GGT), total bilirubin (TB) and hyaluronic acid (HA). The fibrotest score was computed after adjusting for age and gender. Predictive values and ROC curves were used to assess the accuracy of fibrotest and HA results. Results: For fibrotest, the observed area under curve for the discrimination between minimal or no fibrosis (F0-F1) and significant fibrosis (F2-F4) was 0.6736 for cutoff value 0.19 with sensitivity of 84.2% and specificity of 85.7%. For HA, the sensitivity was 89.5% and specificity was 85.7% and area under curve was 0.540 at the best cutoff value 71 mg/dL. Multi-use of both parameters, HA at 71 mg/dL with fibrotest score at 0.22 give a sensitivity 89.5%, specificity 100 and efficacy 92.3% (AUC 0.895). Conclusion: The use of both fibrotest score and HA could be as alternative to biopsy in most patients with chronic hepaitis C putting in consideration some limitations of the proposed markers in evaluating liver fibrosis.

Keywords: fibrotest, liver fibrosis, HCV RNA, biochemical markers

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Authors: Prashant Dhiman, Viranshu Kumar, Pradeep Joshi

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Lot of research is going on to study the effect of cryogenic treatment on materials. Cryogenic treatment is a heat treatment process which is used widely to enhance the mechanical and metallurgical properties of various materials whether the material is ferrous or non ferrous. In almost all ferrous metals, it is found that retained austenite is converted into martensite. Generally deep cryogenic treatment is done using liquid nitrogen having temperature of -195 ℃. The austenite is unstable at this stage and converts into martensite. In non ferrous materials there presents a microcavity and under the action of stress it becomes crack. When this crack propagates, fracture takes place. As the metal contract under low temperature, by doing cryogenic treatment these microcavities will be filled hence increases the soundness of the material. Properties which are enhanced by cryogenic treatment of both ferrous and non ferrous materials are hardness, tensile strength, wear rate, electrical and thermal conductivity, and others. Also there is decrease in residual stress. A large number of manufacturing process (EDM, CNC etc.) are using cryogenic treatment on different tools or workpiece to reduce their wear. In this Review paper the use of cryogenic heat treatment in different manufacturing has been shown along with their advantages.

Keywords: cyrogenic treatment, EDM (Electrical Discharge Machining), CNC (Computer Numeric Control), Mechanical and Metallurgical Properties

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Authors: Terence Tumolva, Johannes Kristoff Vito, Joanna Crystelle Ragasa, Renz Marion Dela Cruz

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Natural fiber reinforced polymer (NFRP) composites have been the focus of various research projects due to their advantages over synthetic fiber-reinforced composites. For this study, ana haw is used as the fiber source due to its abundance throughout the Philippines. A problem addressed in this study is the need for an environment-friendly method of fiber treatment. The use of sodium alginate to treat fibers was thus investigated. The fibers were immersed in a sodium alginate solution and then in a calcium chloride solution afterwards. The treated fibers were used to reinforce orthophthalic unsaturated polyester (ortho-UP) resin. The mechanical properties were tested using a universal testing machine (UTM), and the fracture surfaces were characterized using scanning electron microscope (SEM). Results showed that the sodium alginate treatment had increased the tensile and flexural strength of the composite. The increase in fiber load had also been found to increase the stiffness of the composite. However, sodium alginate treatment did not provide any significant improvement in the wet mechanical properties of the NFRP. The composite is comparable to some commercially available polymeric materials.

Keywords: NFRP, composite, alginate, anahaw, polymer

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Authors: Byeong-Sam Kim, Kyoungwoo Park

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This research analyzes structure of flat panel display (FPD) such as LCD as quantitative through CFD analysis and modeling change to minimize the badness rate and rate of production decrease by damage of large scale plater at wafer heating chamber at semi-conductor manufacturing process. This glass panel and wafer device with atmospheric pressure or chemical vapor deposition equipment for transporting and transferring wafers, robot hands carry these longer and wider wafers can also be easily handled. As a contact handling system composed of several problems in increased potential for fracture or warping. A non-contact handling system is required to solve this problem. The panel and wafer warping makes it difficult to carry out conventional contact to analysis. We propose a new non-contact transportation system with combining air suction and blowout. The numerical analysis and experimental is, therefore, should be performed to obtain compared to results achieved with non-contact solutions. This wafer panel noncontact handler shows its strength in maintaining high cleanliness levels for semiconductor production processes.

Keywords: flat panel display, non contact transportation, heat treatment process, CFD analysis

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Authors: Hamood Al Kiyumi, Salim Al Huseini, Khalid Al Risi, Hassan Mirza, Amira Al Hosni, Sanjay Jaju, Asaad Al Habsi

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Objectives: The aim of this study was to assess the proportion of depressive symptoms along with demographic data in children diagnosed with epilepsy in a tertiary care institution in Oman. Methods: This cross-sectional study was conducted between June 2016 and August 2018. We have included 75 children with age group from five to 12 years old, attending epilepsy clinic at Sultan Qaboos University Hospital who were diagnosed with epilepsy and already on treatment. Patients were excluded if they have mental retardation. Validated Depression Scale for Children (CES-DC) questionnaire was utilized to assess the level of depressive symptoms among children. In addition, we have looked at associated factors including seizure status in the last three months, compliance with antiepileptic medications, type of epilepsy, and number of antiepileptic medications. Results: In this study, we found that depressive symptoms were present in 39 (52%) of patients. We also found that 96% of the patients were compliant to medications. In addition, seizure was present in the last three months in 48% of the sample studies. There was no statistically significant association between any of the studied variables and depression. Conclusions: Although depression is highly prevalent in children with epilepsy, this study did not find any significant association between the CES-DC scores and the studied factors.

Keywords: depression, children, epilepsy, Oman

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Authors: Erhan Ayas, Buse Katipoğlu, Eda Metin, Rifat Yılmaz

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The search for new materials has begun to be used even higher than the service temperature (~1150ᵒC) where nickel-based superalloys are currently used. This search should also meet the increasing demands for energy efficiency improvements. The materials studied for aerospace applications are expected to have good oxidation resistance. Mo-Si-B alloys, which have higher operating temperatures than nickel-based superalloys, are candidates for ultra-high temperature materials used in gas turbine and jet engines. Because the Moss and Mo₅SiB₂ (T2) phases exhibit high melting temperature, excellent high-temperature creep strength and oxidation resistance properties, however, low fracture toughness value at room temperature is a disadvantage for these materials, but this feature can be improved with optimum Moss phase and microstructure control. High-density value is also a problem for structural parts. For example, in turbine rotors, the higher the weight, the higher the centrifugal force, which reduces the creep life of the material. The density value of the nickel-based superalloys and the T2 phase, which is the Mo-Si-B alloy phase, is in the range of 8.6 - 9.2 g/cm³. But under these conditions, T2 phase Moss (density value 10.2 g/cm³), this value is above the density value of nickel-based superalloys. So, with some ceramic-based contributions, this value is enhanced by optimum values.

Keywords: molybdenum, composites, in-situ, mmc

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Authors: Jatziri Y. Moreno-Martinez, Arturo Galvan, Xavier Chavez Cardenas, Hiram Arroyo

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Several methods have been utilized to study the prediction of cracking of concrete structural under loading. The finite element analysis is an alternative that shows good results. The aim of this work was the numerical study of the width crack in reinforced concrete beams with dapped ends, these are frequently found in bridge girders and precast concrete construction. Properly restricting cracking is an important aspect of the design in dapped ends, it has been observed that the cracks that exceed the allowable widths are unacceptable in an aggressive environment for reinforcing steel. For simulating the crack width, the discrete crack approach was considered by means of a Cohesive Zone (CZM) Model using a function to represent the crack opening. Two cases of dapped-end were constructed and tested in the laboratory of Structures and Materials of Engineering Institute of UNAM. The first case considers a reinforcement based on hangers as well as on vertical and horizontal ring, the second case considers 50% of the vertical stirrups in the dapped end to the main part of the beam were replaced by an equivalent area (vertically projected) of diagonal bars under. The loading protocol consisted on applying symmetrical loading to reach the service load. The models were performed using the software package ANSYS v. 16.2. The concrete structure was modeled using three-dimensional solid elements SOLID65 capable of cracking in tension and crushing in compression. Drucker-Prager yield surface was used to include the plastic deformations. The reinforcement was introduced with smeared approach. Interface delamination was modeled by traditional fracture mechanics methods such as the nodal release technique adopting softening relationships between tractions and the separations, which in turn introduce a critical fracture energy that is also the energy required to break apart the interface surfaces. This technique is called CZM. The interface surfaces of the materials are represented by a contact elements Surface-to-Surface (CONTA173) with bonded (initial contact). The Mode I dominated bilinear CZM model assumes that the separation of the material interface is dominated by the displacement jump normal to the interface. Furthermore, the opening crack was taken into consideration according to the maximum normal contact stress, the contact gap at the completion of debonding, and the maximum equivalent tangential contact stress. The contact elements were placed in the crack re-entrant corner. To validate the proposed approach, the results obtained with the previous procedure are compared with experimental test. A good correlation between the experimental and numerical Load-Displacement curves was presented, the numerical models also allowed to obtain the load-crack width curves. In these two cases, the proposed model confirms the capability of predicting the maximum crack width, with an error of ± 30 %. Finally, the orientation of the crack is a fundamental for the prediction of crack width. The results regarding the crack width can be considered as good from the practical point view. Load-Displacement curve of the test and the location of the crack were able to obtain favorable results.

Keywords: cohesive zone model, dapped-end beams, discrete crack approach, finite element analysis

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Authors: Enkelejda Shkurti, Diamant Shtiza

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Background: Health-related quality of life (HRQoL) is a significant consequence in health care. The objective of our study was to recognize features related to lower HRQoL scores in children with anorectal malformation (ARM) and Hirschsprung disease (HD). Methods: Children younger than 18 years, with HD or ARM, that were assessed at our private clinic in Tirana, Albania, from December 2018 to October 2019, were acknowledged. The outcomes of broad questionnaires concerning diagnosis, symptoms, and preceding health/surgical history and authenticated tools to measure urinary status, stooling grade, and HRQoL were appraised. Results: In patients aged 0-6 years, vomiting and abdominal enlargement were allied with a substantial decrease in total HRQoL scores. In children > 6 years of age, vomiting, abdominal swelling, and abdominal discomfort were also linked to a considerably lower HRQoL. The main indicator of lower HRQoL scores on regression tree analysis in all age clusters was the occurrence of psychosomatic, behavioral, or progressive comorbidity. Conclusion: Children with both HD or ARM that have a psychosomatic, behavioral, or growing problem experience considerably lower HRQoL than patients deprived of such problems, proposing that establishment of behavioral/growing sustenance as part of the care of these patients may have a considerable influence on their HRQoL.

Keywords: anorectal malformation, Hirsch Sprung disease, quality of life, Albania

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Authors: R. H. Bustos, L. Martinez, J. García, F. Suárez

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MRP1 (Multi-drug resistance associated protein 1) and MRP2 (Multi-drug resistance associated protein 2) are two proteins belonging to the transporters of ABC (ATP-Binding Cassette). These transporter proteins are involved in the efflux of several biological drugs and xenobiotic and also in multiple physiological, pathological and pharmacological processes. Evidence has been found that there is a correlation among different polymorphisms found and their clinical implication in the resistance to antiepileptic, chemotherapy and anti-infectious drugs. In our study, exonic regions of MRP1/ABCC1 y MRP2/ABCC2 were studied in the Colombian population, specifically in the region of the central Savannah (Cundinamarca) to determinate SNP (Single Nucleotide Polymorphisms) and determinate its allele frequency and its genomics frequency. Results showed that for our population, SNP are found that have been previously reported for MRP1/ABCC1 (rs200647436, rs200624910, rs150214567) as well as for MRP2/ABCC2 (rs2273697, rs3740066, rs142573385, rs17216212). In addition, 13 new SNP were identified. Evidences show an important clinic correlation for polymorphisms rs3740066 and rs2273697. The study object population displays genetic variability as compared to the one reported in other populations.

Keywords: ATP-binding cassette (ABCC), Colombian population, multidrug-resistance protein (MRP), pharmacogenetic, single nucleotide polymorphism (SNP)

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Authors: Javaid Butt, Habtom Mebrahtu, Hassan Shirvani

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The paper presents a new additive manufacturing process for the production of metal and composite parts. It is termed as composite metal foil manufacturing and is a combination of laminated object manufacturing and brazing techniques. The process has been described in detail and is being used to produce dissimilar aluminum to copper foil single lap joints. A three dimensional finite element model has been developed to study the thermo-mechanical characteristics of the dissimilar Al/Cu single lap joint. The effects of thermal stress and strain have been analyzed by carrying out transient thermal analysis on the heated plates used to join the two 0.1mm thin metal foils. Tensile test has been carried out on the foils before joining and after the single Al/Cu lap joints are made, they are subjected to tensile lap-shear test to analyze the effect of heat on the foils. The analyses are designed to assess the mechanical integrity of the foils after the brazing process and understand whether or not the heat treatment has an effect on the fracture modes of the produced specimens.

Keywords: brazing, laminated object manufacturing, tensile lap-shear test, thermo-mechanical analysis

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Authors: Alia Ali, Azeem Taj, Muhammed Joher Amin, Farrukh Iqbal, Zafar Iqbal

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Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients were screened for microalbuminuria and raised blood pressure, attending the diabetic clinic of Shaikh Zayed Hospital, Lahore, Pakistan. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end-stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Keywords: hypertension, microalbuminuria, diabetic kidney disease, type 2 Diabetes mellitus

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Authors: Joaquim de Almeida Dultra, Daiana Cristina Pereira Santana, Fátima Karoline Alves Araújo Dultra, Liliane Akemi Kawano Shibasaki, Mariana Machado Mendes de Carvalho, Ieda Margarida Crusoé Rocha Rebello

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Defects originating from mandibular resections can cause significant functional impairment and facial disharmony, and they have complex rehabilitation. The aim of this report is to demonstrate the authors' experience facing challenging rehabilitation after mandibular resection in a patient with ameloblastoma. Clinical and surgical steps are described simultaneously, highlighting the adaptation of the final fixed prosthesis, reported in an unprecedented way in the literature. A 37-year-old male patient was seen after a sports accident, where a pathological fracture in the symphysis and left mandibular body was identified, where a large radiolucent lesion was found. The patient underwent resection, bone graft, distraction osteogenesis, rehabilitation with dental implants, prosthesis, and finally, orofacial harmonization, in an interval of six years. Rehabilitation should consider the patient's needs individually and should have as the main objective to provide similar aesthetics and function to that present before the disease. We also emphasize the importance of interdisciplinary work during the course of rehabilitation.

Keywords: ameloblastoma, mandibular reconstruction, distraction osteogenesis, dental implants. dental prosthesis, implant-supported, treatment outcome

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Authors: Wenting Ye

Abstract:

The biological materials evolved in nature generally exhibit interpenetrating network structures, which may offer useful inspiration for the architectural design of wear-resistant composites. Here, a strategy for designing self-lubricating medium entropy alloy (MEA) composites with high strength and excellent anti-wear performance was proposed through quasi-continuously networked in-situ carbides and graphene nanosheets. The discontinuous coating of graphene on the MEA powder surface inhibits continuous metallurgy bonding of the MEA powders during sintering, generating the typical quasi-continuously networked architecture. A good combination of mechanical properties with high fracture strength over 2 GPa and large compressive plasticity over 30% benefits from metallurgy bonding that prevents crack initiation and extension. The wear rate of an order of 10-6 m3N-1m-1 ascribing to an amorphous-crystalline nanocomposite surface, tribo-film induced by graphene, as well as the gradient worn subsurface during friction was achieved by the MEA composite, which is an order of magnitude lower than the unreinforced MEA matrix.

Keywords: in-situ carbide, tribological behavior, medium entropy alloy matrix composite, graphene

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Authors: Osama Shakeel

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The objective of the paper is to study the clinic-pathological factors, survival analyses, recurrence rate, metastatic rate, risk factors and the management of cutaneous malignant melanoma at Shaukat Khanum Memorial Cancer Hospital and Research Center. Methodology: From 2014 to 2017, all patients with a diagnosis of cutaneous malignant melanoma (CMM) were included in the study. Demographic variables were collected. Short and long term oncological outcomes were recorded. All data were entered and analyzed in SPSS version 21. Results: A total of 28 patients were included in the study. Median age was 46.5 +/-15.9 years. There were 16 male and 12 female patients. The family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43+/- 9.09 months. Lower limb was the commonest site among all which constitutes 46.4%(n=13). On histopathological analyses, ulceration was seen in 53.6% (n=15) patients. Unclassified tumor type was present in 75%(n=21) of the patients followed by nodular 21.4% (n=6) and superficial spreading 3.5%(n=1). Clark level IV was the commonest presentation constituting 46.4%(n=13). Metastases were seen in 50%(n=14) of the patients. Local recurrence was observed in 60.7%(n=17). 64.3%(n=18) lived after one year of treatment. Conclusion: CMM is a fatal disease. Although its disease of fair skin individuals, however, the incidence of CMM is also rising in this part of the world. Management includes early diagnoses and prompt management. However, mortality associated with this disease is still not favorable.

Keywords: malignant cancer of skin, cutaneous malignant melanoma, skin cancer, survival analyses

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Authors: Mustafa Ali Abugila, Basma Nuri Kajruba, Hanan Elhadi, Rehab Ramadan Wali

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Iron deficiency anemia is characterized by a decrease of Hb (hemoglobin), serum iron, ferritin, and RBC (red blood cells) (shape and size). Also, it is characterized by an increase in total iron binding capacity (TIBC). Red blood cells become microctytic and hypochromic due to a decrease in iron content. This study was conducted in the north west of Libya and included 210 women in childbearing age (18-45 years) who were visiting women clinic. After filling the questionnaire, blood samples were taken and analyzed for hematological and biochemical profiles. Biochemical tests included measurement of serum iron, ferritin, and total iron binding capacity (TIBC). Among the total sample (210 women), there were 87 (41.42%) pregnant and 123 (58.57%) non-pregnant women (includes married and single). Pregnant women (87) were classified according to the gestational age into first, second, and third trimesters. The means of biochemical and hematological parameters in the studied samples were: Hb = 10.37± 2.02 g/dl, RBC = 3.78± 1.037 m/m3, serum iron 61.86± 40.28 µg/dl, and TIBC = 386.01 ± 94.91 µg/dl. In this study, we considered that any women have hemoglobin below 11.5 g/dl is anemic. 89.1%, 69.5%, and 47.8% of pregnant women who belong to third trimester had low (below normal value) Hb, serum iron, and ferritin, i.e. iron deficiency anemia was more common in third trimester among the first and the second trimesters. Third trimester pregnant women also had high TIBC more than first and second trimesters.

Keywords: red blood cells, hemoglobin, total iron binding capacity, ferritin

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Authors: Arif İsmailov, Naila Hasanova, Gunay Orujalieva

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Homocysteine (HCY) is an indicator of prognostic value in monitoring regenerative processes in osteoporosis and osteoporotic fractures. The osteoporosis is known to be a serious health and economic problem, especially for women in the postmenopausal period. The study was carried out on patients 45-83 years old divided into 3 groups: group I – 14 patients with osteoporosis , group II – 15 patients with non-osteoporotic fractures, group III – 25 patients with osteoporotic fractures. The control group consisted of practically healthy 14 people. A blood sample was taken at 3 stages to monitor the dynamics of HCY level: on the 1st day before treatment, on the 10th day of treatment and 1 month after it. Blood levels of Hcy were determined at a wavelength of 450 nm by the ELİSA(Cloud Clone Corp.Elisa kits,USA). The statistical evaluation was performed by using SPSS 26.0 program (IBM SPSS Inc., USA).The results showed that on the 1st day before the treatment HCY concentration was statistically increased 2.7 times(PU = 0.108) in group I, 5.6 times (PU <0.001) in group II and 6.5 times (PU <0.001) in group III compared to the control group. Thus, the average value of HCY in group I was 1.76 ± 0.56 μg/ml; in group II – 3.57 ± 0.62 μg/ml; in group III – 4.2 ± 0.50 μg/ml. HCY level increases more sharply after fractures,especially in osteoporotic patients. In treatment period Vitamin D plays an important role in synthesis of the Cystathionine β‐synthase enzyme, which regulates HCY metabolism. Increased Hcy levels could lead to an increase in the risk of fracture through the interference in collagen cross-linking.

Keywords: homocysteine, osteoporosis, osteoporotic fractures, Vitamin D

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Authors: Bhumika Wadhwa, Fayaz Malik

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The serine/threonine protein kinase B (PKB) also known as Akt, is one of the multifaceted kinase in human kinome, existing in three isoforms. Akt plays a vital role in phosphoinositide 3-kinase (PI3K) mediated oncogenesis in various malignancies and is one of the attractive targets for cancer drug discovery. The functional significance of an individual isoform of Akt is not redundant in cancer cell proliferation and metastasis instead Akt isoforms play distinct roles during metastasis; thereby regulating EMT. This study aims to determine isoform specific functions of Akt in cancer. The results obtained suggest that Akt1 restrict tumor invasion, whereas Akt2 promotes cell migration and invasion by various techniques like MTT, wound healing and invasion assay. Similarly, qRT-PCR also revealed that Akt3 has shown promising results in promoting cancer cell migration. Contrary to pro-oncogenic properties attributed to Akt, it is to be understood how various isoforms of Akt compensates each other in the regulation of common pathways during cancer progression and drug resistance. In conclusion, this study aims to target selective isoforms which is essential to inhibit cancer. However, the question now is whether, and how much, Akt inhibition will be tolerated in the clinic remains to be answered and the experiments will have to address the question of which combinations of newly devised Akt isoform specific inhibitors exert a favourable therapeutic effect in in vivo models of cancer to provide the therapeutic window with minimal toxicity.

Keywords: Akt isoforms, cancer, drug resistance, epithelial mesenchymal transition

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Authors: Siti Hasnah Kamarudin, Luqman Chuah Abdullah, Min Min Aung, Chantara Thevy Ratnam

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The primary objective of this work was to develop fully nanocomposite material based on poly(lactic acid), epoxidized jatropha oil (EJO) and nanocrystalline cellulose. EJO was investigated as a sustainable alternative to petrochemical-based plasticizers to reinforce the ductility and toughness of plastics, in this case, nanocellulose/poly(lactic acid) (PLA). The EJO was melt blended into nanocellulose/PLA at concentrations from 1 wt% to 5 wt%. The blends were then hot-pressed into sheets to characterize their mechanical and physical properties. Microcrystalline cellulose had been converted to nanocrystalline cellulose by acid mercerisation technique and the effects thereof on the composites’ tensile, flexural, and impact properties, as well as their water absorption and density, were studied. The impact strengths of the nanocomposites were improved with the addition of NCC up to 0.5 wt%, with a maximum over 10 times that of the neat PLA. The flexural strength and modulus increased 4% and 50%, respectively, for NCC/PLA plasticized with EJO. This increase demonstrated the nanocrystalline cellulose addition gave notable improvements to the composites’ properties. Furthermore, analysis by scanning electron microscopy (SEM) of the nanocomposites’ tensile fracture surfaces indicated better interaction adhesion of the NCC/PLA plasticized with EJO compared with the PLA/EJO composites.

Keywords: nanocrystalline cellulose, nanocomposite, poly (lactic acid), epoxidised jatropha oil

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Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

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Background: We aimed to compare clinical and survival differences between B-cell (B-NHL) and NKT-cell non-Hodgkin lymphomas (NKT-NHL) located in the nasal cavity, nasopharynx and paranasal sinuses, which are always categorized as one sinonasal type. Methods: Patients diagnosed with primary B-NHL and NKT-NHL in the nasal cavity, nasopharynx, and paranasal sinuses from the SEER database were included. We identified these patients based on histological types and anatomical sites and subsequently conducted univariate and multivariate Cox regression and Kaplan–Meier analyses to examine cancer-special survival (CSS) outcomes. Results: Overall, most B-NHL cases originated from the nasopharynx, while the majority of NKT-NHL cases occurred in the nasal cavity. Notably, the CSS outcomes improved significantly in all sinonasal B-NHL cases over time, whereas no such improvement trend was observed in each sinonasal NKT-NHL type. Additionally, increasing age was linked with an elevated risk of death in B-NHL, particularly in the nasal cavity (HR:3.37), rather than in NKT-NHL. Compared with B-NHL, the adverse effect of the higher stage on CSS was more evident in NKT-NHL, particularly in its nasopharynx site (HR: 5.12). Furthermore, radiotherapy was beneficial for survival in patients with sinonasal B-NHL and NKT-NHL, except in those with NKT-NHL in the nasopharynx site. However, chemotherapy has only been beneficial for CSS in patients with B-NHL in paranasal sinuses (HR: 0.42) since 2010, rather than in other types of B-NHL or NKT-NHL. Conclusions: Although B-NHL and NKT-NHL in the nasal cavity, nasopharynx and paranasal sinuses have similar anatomical locations, their clinic demographics and prognoses are largely different and should be treated and studied as distinct diseases.

Keywords: B-cell non-Hodgkin lymphomas, NKT-cell non-Hodgkin lymphomas, nasal cavity lymphomas, nasal sinuses lymphomas, nasopharynx lymphomas

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