Search results for: lateral ankle sprain
223 Photophysics and Rotational Relaxation Dynamics of 6-Methoxyquinoline Fluorophore in Cationic Alkyltrimethylammonium Bromide Micelles
Authors: Tej Varma Y, Debi D. Pant
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Photophysics and rotational dynamics of the fluorescent probe, 6-methoxyquinoline (6MQ) with cationic surfactant, alkyltrimethylammonium bromide (nTAB) micelle solutions have been investigated (n = 12, 14 and 16). Absorption and emission peaks of the dye have been observed to shift at concentrations around critical micellar concentration (cmc) of nTAB compared to that of bulk solutions suggesting probe is in a lower polar environment. The probe senses changes in polarity (ET (30)) brought about by variation of surfactant chain length concentration and is invariably solubilized in the aqueous interface or palisade layer. The order of change in polarity observed was DTAB > CTAB > TTAB. The binding constant study shows that the probe binds strongest with TTAB (is of the order TTAB > CTAB > DTAB) due to deeper penetration into the micelle. The anisotropy decay for the probe in all the nTAB micelles studied have been rationalized based on a two-step model consisting of fast-restricted rotation of the probe and slow lateral diffusion of the probe in the micelle that is coupled to the overall rotation of the micelle. Fluorescence lifetime measurements of probe in the cationic micelles demonstrate the close proximity of the 6MQ to the Br - counterions. The fluorescence lifetimes of TTAB and DTAB are much shorter than in CTAB. These results indicate that 6MQ resides to a substantial degree in the head group region of the micelles. All the changes observed in the steady state fluorescence, microenvironment, fluorescence lifetimes, fluorescence anisotropy, and other calculations are in agreement with each other suggesting binding of the cationic surfactant with the neutral dye molecule.Keywords: photophysics, chain length, ntaB, micelles
Procedia PDF Downloads 637222 An Investigation into Why Liquefaction Charts Work: A Necessary Step toward Integrating the States of Art and Practice
Authors: Tarek Abdoun, Ricardo Dobry
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This paper is a systematic effort to clarify why field liquefaction charts based on Seed and Idriss’ Simplified Procedure work so well. This is a necessary step toward integrating the states of the art (SOA) and practice (SOP) for evaluating liquefaction and its effects. The SOA relies mostly on laboratory measurements and correlations with void ratio and relative density of the sand. The SOP is based on field measurements of penetration resistance and shear wave velocity coupled with empirical or semi-empirical correlations. This gap slows down further progress in both SOP and SOA. The paper accomplishes its objective through: a literature review of relevant aspects of the SOA including factors influencing threshold shear strain and pore pressure buildup during cyclic strain-controlled tests; a discussion of factors influencing field penetration resistance and shear wave velocity; and a discussion of the meaning of the curves in the liquefaction charts separating liquefaction from no liquefaction, helped by recent full-scale and centrifuge results. It is concluded that the charts are curves of constant cyclic strain at the lower end (Vs1 < 160 m/s), with this strain being about 0.03 to 0.05% for earthquake magnitude, Mw ≈ 7. It is also concluded, in a more speculative way, that the curves at the upper end probably correspond to a variable increasing cyclic strain and Ko, with this upper end controlled by over consolidated and preshaken sands, and with cyclic strains needed to cause liquefaction being as high as 0.1 to 0.3%. These conclusions are validated by application to case histories corresponding to Mw ≈ 7, mostly in the San Francisco Bay Area of California during the 1989 Loma Prieta earthquake.Keywords: permeability, lateral spreading, liquefaction, centrifuge modeling, shear wave velocity charts
Procedia PDF Downloads 297221 High Performance Wood Shear Walls and Dissipative Anchors for Damage Limitation
Authors: Vera Wilden, Benno Hoffmeister, Georgios Balaskas, Lukas Rauber, Burkhard Walter
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Light-weight timber frame elements represent an efficient structural solution for wooden multistory buildings. The wall elements of such buildings – which act as shear diaphragms- provide lateral stiffness and resistance to wind and seismic loads. The tendency towards multi-story structures leads to challenges regarding the prediction of stiffness, strength and ductility of the buildings. Lightweight timber frame elements are built up of several structural parts (sheeting, fasteners, frame, support and anchorages); each of them contributing to the dynamic response of the structure. This contribution describes the experimental and numerical investigation and development of enhanced lightweight timber frame buildings. These developments comprise high-performance timber frame walls with the variable arrangements of sheathing planes and dissipative anchors at the base of the timber buildings, which reduce damages to the timber structure and can be exchanged after significant earthquakes. In order to prove the performance of the developed elements in the context of a real building a full-scale two-story building core was designed and erected in the laboratory and tested experimentally for its seismic performance. The results of the tests and a comparison of the test results to the predicted behavior are presented. Observation during the test also reveals some aspects of the design and details which need to consider in the application of the timber walls in the context of the complete building.Keywords: dissipative anchoring, full scale test, push-over-test, wood shear walls
Procedia PDF Downloads 247220 Design and Construction of a Device to Facilitate the Stretching of a Plantiflexors Muscles in the Therapy of Rehabilitation for Patients with Spastic Hemiplegia
Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez
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Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching
Procedia PDF Downloads 166219 The application of Gel Dosimeters and Comparison with other Dosimeters in Radiotherapy: A Literature Review
Authors: Sujan Mahamud
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Purpose: A major challenge in radiotherapy treatment is to deliver precise dose of radiation to the tumor with minimum dose to the healthy normal tissues. Recently, gel dosimetry has emerged as a powerful tool to measure three-dimensional (3D) dose distribution for complex delivery verification and quality assurance. These dosimeters act both as a phantom and detector, thus confirming the versatility of dosimetry technique. The aim of the study is to know the application of Gel Dosimeters in Radiotherapy and find out the comparison with 1D and 2D dimensional dosimeters. Methods and Materials: The study is carried out from Gel Dosimeter literatures. Secondary data and images have been collected from different sources such as different guidelines, books, and internet, etc. Result: Analyzing, verifying, and comparing data from treatment planning system (TPS) is determined that gel dosimeter is a very excellent powerful tool to measure three-dimensional (3D) dose distribution. The TPS calculated data were in very good agreement with the dose distribution measured by the ferrous gel. The overall uncertainty in the ferrous-gel dose determination was considerably reduced using an optimized MRI acquisition protocol and a new MRI scanner. The method developed for comparing measuring gel data with calculated treatment plans, the gel dosimetry method, was proven to be a useful for radiation treatment planning verification. In 1D and 2D Film, the depth dose and lateral for RMSD are 1.8% and 2%, and max (Di-Dj) are 2.5% and 8%. Other side 2D+ ( 3D) Film Gel and Plan Gel for RMSDstruct and RMSDstoch are 2.3% & 3.6% and 1% & 1% and system deviation are -0.6% and 2.5%. The study is investigated that the result fined 2D+ (3D) Film Dosimeter is better than the 1D and 2D Dosimeter. Discussion: Gel Dosimeters is quality control and quality assurance tool which will used the future clinical application.Keywords: gel dosimeters, phantom, rmsd, QC, detector
Procedia PDF Downloads 152218 The Design of Safe Spaces in Healthcare Facilities Vulnerable to Tornado Impact in Central US
Authors: Lucy Ampaw-Asiedu, Terri R. Norton
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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.Keywords: disaster management, safe spaces, structural design, tornado, vulnerability
Procedia PDF Downloads 215217 Intensity-Enhanced Super-Resolution Amplitude Apodization Effect on the Non-Spherical Near-Field Particle-Lenses
Authors: Liyang Yue, Bing Yan, James N. Monks, Rakesh Dhama, Zengbo Wang, Oleg V. Minin, Igor V. Minin
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A particle can function as a refractive lens to focus a plane wave, generating a narrow, high intensive, weak-diverging beam within a sub-wavelength volume, known as the ‘photonic jet’. Refractive index contrast (particle to background media) and scaling effect of the dielectric particle (relative-to-wavelength size) play key roles in photonic jet formation, rather than the shape of particle-lens. Waist (full width of half maximum, FWHM) of a photonic jet could be beyond the diffraction limit and smaller than the Airy disk, which defines the minimum distance between two objects to be imaged as two instead of one. Many important applications for imaging and sensing have been afforded based upon the super-resolution characteristic of the photonic jet. It is known that apodization method, in the form of an amplitude pupil-mask centrally situated on a particle-lens, can further reduce the waist of a photonic nanojet, however, usually lower its intensity at the focus due to blocking of the incident light. In this paper, the anomalously intensity-enhanced apodization effect was discovered in the near-field via numerical simulation. It was also experimentally verified by a scale model using a copper-masked Teflon cuboid solid immersion lens (SIL) with 22 mm side length under radiation of a plane wave with 8 mm wavelength. Peak intensity enhancement and the lateral resolution of the produced photonic jet increased by about 36.0 % and 36.4 % in this approach, respectively. This phenomenon may possess the scale effect and would be valid in multiple frequency bands.Keywords: apodization, particle-lens, scattering, near-field optics
Procedia PDF Downloads 192216 Maternal Awareness of Sudden Infant Death Syndrome: A Jordanian Study
Authors: Nemeh Ahmad Al-Akour, Ibrahem Alfaouri
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Objective: To examine the level of maternal awareness of SIDS and its prevention amongst Jordanian mothers in the north of Jordan, as well as to determine their SIDS-related infant care practices. Design: A cross-sectional design. Setting: The study was conducted in maternal out-patients clinics of two teaching hospitals and three maternal and child health clinic in three major health care centers in Northern Jordan. Participants: A total of 356 mothers of infants attending the maternal and child health clinics were included in this study. Measurements and findings: A self-administered questionnaire was used for collecting data study. In this study, 64%of mothers didn’t hear about SIDS, while only 7% of mothers were able to identify factors risk-reducing recommendations. Avoidance of prone sleeping was the most frequently identified recommendation (5%). There were 67.7% of mothers who put their infant in a lateral position to sleep, 61% used soft mattress surface for their babies sleep and 25.8% who shared a bed with their babies. Employed mother, mothers of higher age, and mothers living within a nuclear family were the only factors associated with maternal awareness of SIDS. Friends were the highest a source of knowledge of SIDS for mothers (44.7%). Key conclusions: There was a low level of awareness of SIDS and its associated risk factor among the mothers in Jordan. The mothers' misconception about smoking and sleeping position for their infants requires further efforts. Implications for practice: To ensure raising awareness of infant care practice regarding SIDS, a national educational intervention on SIDS risk reduction strategies and recommendations is necessary for maintaining a low rate of SIDS in the population.Keywords: bed sharing, infant care, Jordan, sleep position, sudden infant death
Procedia PDF Downloads 317215 Gross Anatomical and Ultra Structural Microscopic Studies on the Nose of the Dromedary Camel (Camelus Dromederius)
Authors: Mahmoud S Gewaily, Atif Hasan, Mohamed Kassab, Ali A. Mansour
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The current study was carried out on the nose of seventeenth healthy adult camels. Specimens were collected from slaughter houses then fixed, dissected and photographed. For ultra structural studies, fresh samples were fixed in different fixatives and prepared for examination by light, scanning and electron microscopes. Grossly, nose of the camel had narrow nostrils, slit like in outline. In the nasal cavity, the nasal vestibule was narrow and has scanty dorsal and lateral cartilaginous support. The Nasal conchae (dorsal, middle and ventral) enclosed the dorsal, middle conchal sinuses and no ventral conchal sinus; instead there was recess and bull a. The ethmoidal conchae (8 in number) were noticeably fewer than in the other domestic animals like ox and horse. The olfactory mucosa was restricted to a small area covering the caudal parts of the ethmoidal conchae. The lining epithelium of the nasal cavity changes gradually from stratified squamous epithelium in the nasal vestibule to pseudo stratified columnar ciliated in the respiratory region and finally, olfactory epithelium covering the caudal parts of the ethmoidal conchae. In the dromedary camel, a special feature was the presence of dense and relatively long hair covering the nostrils and the rostral part of the nasal vestibule. In conclusion, the anatomical features of the nose of the dromedary camel, especially in its rostral parts enable this animal to breathe properly in the sandy dry weather.Keywords: camel nose, anatomy, dromedary camel, nasal vestibule
Procedia PDF Downloads 439214 Numerical Analysis for Soil Compaction and Plastic Points Extension in Pile Drivability
Authors: Omid Tavasoli, Mahmoud Ghazavi
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A numerical analysis of drivability of piles in different geometry is presented. In this paper, a three-dimensional finite difference analysis for plastic point extension and soil compaction in the effect of pile driving is analyzed. Four pile configurations such as cylindrical pile, fully tapered pile, T-C pile consists of a top tapered segment and a lower cylindrical segment and C-T pile has a top cylindrical part followed by a tapered part are investigated. All piles which driven up to a total penetration depth of 16 m have the same length with equivalent surface area and approximately with identical material volumes. An idealization for pile-soil system in pile driving is considered for this approach. A linear elastic material is assumed to model the vertical pile behaviors and the soil obeys the elasto-plastic constitutive low and its failure is controlled by the Mohr-Coulomb failure criterion. A slip which occurred at the pile-soil contact surfaces along the shaft and the toe in pile driving procedures is simulated with interface elements. All initial and boundary conditions are the same in all analyses. Quiet boundaries are used to prevent wave reflection in the lateral and vertical directions for the soil. The results obtained from numerical analyses were compared with available other numerical data and laboratory tests, indicating a satisfactory agreement. It will be shown that with increasing the angle of taper, the permanent piles toe settlement increase and therefore, the extension of plastic points increase. These are interesting phenomena in pile driving and are on the safe side for driven piles.Keywords: pile driving, finite difference method, non-uniform piles, pile geometry, pile set, plastic points, soil compaction
Procedia PDF Downloads 484213 Finite Element Analysis of the Lumbar Spine after Unilateral and Bilateral Laminotomies and Laminectomy
Authors: Chih-Hsien Chen, Yi-Hung Ho, Chih-Wei Wang, Chih-Wei Chang, Yen-Nien Chen, Chih-Han Chang, Chun-Ting Li
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Laminotomy is a spinal decompression surgery compatible with a minimally invasive approach. However, the unilateral laminotomy for bilateral side decompression leads to more perioperative complications than the bilateral laminotomy. Although the unilateral laminotomy removes the least bone tissue among the spinal decompression surgeries, the difference of spinal stability between unilateral and bilateral laminotomy and laminectomy is rarely investigated. This study aims to compare the biomechanical effects of unilateral and bilateral laminotomy and laminectomy on the lumbar spine by finite element (FE) simulation. A three-dimensional FE model of the lumbar spine (L1–L5) was constructed with the vertebral body, discs, and ligaments, as well as the sacrum was constructed. Three different surgical methods, namely unilateral laminotomy, bilateral laminotomy and laminectomy, at L3–L4 and L4–L5 were considered. Partial pedicle and entire ligamentum flavum were removed to simulate bilateral decompression in laminotomy. The entire lamina and spinal processes from the lower L3 to upper L5 were detached in the laminectomy model. Then, four kinds of loadings, namely flexion, extension, lateral bending and rotation, were applied on the lumbar with various decompression conditions. The results indicated that the bilateral and unilateral laminotomy both increased the range of motion (ROM) compared with intact lumbar, while the laminectomy increased more ROM than both laminotomy did. The difference of ROM between the bilateral and unilateral laminotomy was very minor. Furthermore, bilateral laminotomy demonstrated similar poster element stress with unilateral laminotomy. Unilateral and bilateral laminotomy are equally suggested to bilateral decompression of lumbar spine with minimally invasive technique because limited effect was aroused due to more bone remove in the bilateral laminotomy on the lumbar stability. Furthermore, laminectomy is the last option for lumbar decompression.Keywords: minimally invasive technique, lumbar decompression, laminotomy, laminectomy, finite element method
Procedia PDF Downloads 188212 Through-Bolt Moment Connection in HSS Column
Authors: Bardia Khafaf, Mehrdad Ghaffari, Amir Hussein Samakar
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It is currently desirable to use Hollow Square Sections (HSS) in moment resistant structures in construction of building because they offer fewer restrictions for designing and more useful space while adhering to build design codes. This paper present a through bolt connection in HSS column. This connection meets building code standards that require the moment resistant connections to deflect and absorb energy resulting from gravity and seismic loads. Connection through bolts is installed and pretension to provide the connection strength needed to make a beam–column moment rigid zone. A rigid joint is typically used to resist lateral forces by holding columns and beams fixed in relation to one another. With bolted moment frames using HSS columns, a through–bolt connection could be used to secure the beam and end plate to the column. However, when multiple columns and beams are used to span a length of building, the use of through-bolts would necessities aligning multiple beams simultaneously to the columns. In the case of a linear span, the assembly process requires the holes of a first beam end plate to be aligned with through bolt holes in a column and aligning the holes of a second, opposing beam plate with the column through bolt, then inserting the through bolts in each hole for tightening with nuts and washers. In moment resistant building, a problem arises when assembling beams to columns where multiple beams and columns are required. Through bolt, moment connections are among the economical, practical and not difficult rigid steel connection for HSS column building. In this paper, the results of numerous analytical studies performed for moment structures with HSS columns with through bolt based on AISC standard codes are shown.Keywords: through bolt, moment resistant connection, HSS columns section, construction engineering
Procedia PDF Downloads 469211 Direct-Displacement Based Design for Buildings with Non-Linear Viscous Dampers
Authors: Kelly F. Delgado-De Agrela, Sonia E. Ruiz, Marco A. Santos-Santiago
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An approach is proposed for the design of regular buildings equipped with non-linear viscous dissipating devices. The approach is based on a direct-displacement seismic design method which satisfies seismic performance objectives. The global system involved is formed by structural regular moment frames capable of supporting gravity and lateral loads with elastic response behavior plus a set of non-linear viscous dissipating devices which reduce the structural seismic response. The dampers are characterized by two design parameters: (1) a positive real exponent α which represents the non-linearity of the damper, and (2) the damping coefficient C of the device, whose constitutive force-velocity law is given by F=Cvᵃ, where v is the velocity between the ends of the damper. The procedure is carried out using a substitute structure. Two limits states are verified: serviceability and near collapse. The reduction of the spectral ordinates by the additional damping assumed in the design process and introduced to the structure by the viscous non-linear dampers is performed according to a damping reduction factor. For the design of the non-linear damper system, the real velocity is considered instead of the pseudo-velocity. The proposed design methodology is applied to an 8-story steel moment frame building equipped with non-linear viscous dampers, located in intermediate soil zone of Mexico City, with a dominant period Tₛ = 1s. In order to validate the approach, nonlinear static analyses and nonlinear time history analyses are performed.Keywords: based design, direct-displacement based design, non-linear viscous dampers, performance design
Procedia PDF Downloads 193210 Vibration Absorption Strategy for Multi-Frequency Excitation
Authors: Der Chyan Lin
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Since the early introduction by Ormondroyd and Den Hartog, vibration absorber (VA) has become one of the most commonly used vibration mitigation strategies. The strategy is most effective for a primary plant subjected to a single frequency excitation. For continuous systems, notable advances in vibration absorption in the multi-frequency system were made. However, the efficacy of the VA strategy for systems under multi-frequency excitation is not well understood. For example, for an N degrees-of-freedom (DOF) primary-absorber system, there are N 'peak' frequencies of large amplitude vibration per every new excitation frequency. In general, the usable range for vibration absorption can be greatly reduced as a result. Frequency modulated harmonic excitation is a commonly seen multi-frequency excitation example: f(t) = cos(ϖ(t)t) where ϖ(t)=ω(1+α sin(δt)). It is known that f(t) has a series expansion given by the Bessel function of the first kind, which implies an infinity of forcing frequencies in the frequency modulated harmonic excitation. For an SDOF system of natural frequency ωₙ subjected to f(t), it can be shown that amplitude peaks emerge at ω₍ₚ,ₖ₎=(ωₙ ± 2kδ)/(α ∓ 1),k∈Z; i.e., there is an infinity of resonant frequencies ω₍ₚ,ₖ₎, k∈Z, making the use of VA strategy ineffective. In this work, we propose an absorber frequency placement strategy for SDOF vibration systems subjected to frequency-modulated excitation. An SDOF linear mass-spring system coupled to lateral absorber systems is used to demonstrate the ideas. Although the mechanical components are linear, the governing equations for the coupled system are nonlinear. We show using N identical absorbers, for N ≫ 1, that (a) there is a cluster of N+1 natural frequencies around every natural absorber frequency, and (b) the absorber frequencies can be moved away from the plant's resonance frequency (ω₀) as N increases. Moreover, we also show the bandwidth of the VA performance increases with N. The derivations of the clustering and bandwidth widening effect will be given, and the superiority of the proposed strategy will be demonstrated via numerical experiments.Keywords: Bessel function, bandwidth, frequency modulated excitation, vibration absorber
Procedia PDF Downloads 157209 Effect of Palatal Lift Prosthesis on Speech Clarity in Flaccid Dysarthria
Authors: Firas Alfwaress, Abdelraheem Bebers Abdelhadi Hamasha, Maha Abu Awaad
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Objectives: The aim of the present study was to investigate the effect of Palatal Lift Prosthesis (PLP) on speech clarity in patients with Flaccid Dysarthria. Five speech measures were investigated including Nasalance Scores, Diadchokinetic (DDK), Vowel Duration, airflow, and Sound Intensity. Participants: Twelve (7 Males and 5 females) native speakers of Jordanian Arabic with Flaccid Dysarthria following stroke, traumatic brain injury, and amyotrophic lateral sclerosis were included. The age of the participants ranged from 8–65 years with an average of 31.75 years. Design: Nasalance Scores, Diadchokinetic rate, Vowel Duration, and Sound Intensity were obtained using the Nasometer II, Model 6450 in three conditions. The first condition included obtaining the five measures without wearing the customized Palatal Lift Prosthesis. The second and third conditions included obtaining the five measures immediately after wearing the Palatal Lift Prosthesis and three months later. Results: Palatal lift prosthesis was found to be effective in individuals with flaccid dysarthria. Results showed decrease in the Nasalance Scores for the syllable repetition tasks and vowel prolongation tasks when comparing the means in the pre PLP with the post PLP at p≤0.001 except for the /m/ prolongation task. Results showed increased DDK repetition task, airflow amount, and sound intensity, and a decrease in vowel length at p≤0.001. Conclusions: The use of palatal lift prosthesis is effective in improving the speech of patients with flaccid dysarthria.Keywords: palatal lift prosthesis, flaccid dysarthria, hypernasality, speech clarity, diadchokinetic rate
Procedia PDF Downloads 386208 Identification and Characterization of Groundwater Recharge Sites in Kuwait
Authors: Dalal Sadeqi
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Groundwater is an important component of Kuwait’s water resources. Although limited in quantity and often poor in quality, the significance of this natural source of water cannot be overemphasized. Recharge of groundwater in Kuwait occurs during periodical storm events, especially in open desert areas. Runoff water dissolves accumulated surficial meteoric salts and subsequently leaches them into the groundwater following a period of evaporative enrichment at or near the soil surface. Geochemical processes governing groundwater recharge vary in time and space. Stable isotope (18O and 2H) and geochemical signatures are commonly used to gain some insight into recharge processes and groundwater salinization mechanisms, particularly in arid and semiarid regions. This article addresses the mechanism used in identifying and characterizing the main water shed areas in Kuwait using stable isotopes in an attempt to determine favorable groundwater recharge sites in the country. Stable isotopes of both rainwater and groundwater were targeted in different hydrogeological settings. Additionally, data and information obtained from subsurface logs in the study area were collected and analyzed to develop a better understanding of the lateral and vertical extent of the groundwater aquifers. Geographic Information System (GIS) and RockWorks 3D modelling software were used to map out the hydrogeomorphology of the study area and the subsurface lithology of the investigated aquifers. The collected data and information, including major ion chemistry, isotopes, subsurface characteristics, and hydrogeomorphology, were integrated in a GIS platform to identify and map out suitable natural recharge areas as part of an integrated water resources management scheme that addresses the challenges of the sustainability of the groundwater reserves in the country.Keywords: scarcity, integrated, recharge, isotope
Procedia PDF Downloads 115207 Variation In Gastrocnemius and Hamstring Muscle Activity During Peak Knee Flexor Torque After Anterior Cruciate Ligament Reconstruction with Hamstring Graft
Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas
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The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy
Procedia PDF Downloads 241206 Construction and Validation of a Hybrid Lumbar Spine Model for the Fast Evaluation of Intradiscal Pressure and Mobility
Authors: Dicko Ali Hamadi, Tong-Yette Nicolas, Gilles Benjamin, Faure Francois, Palombi Olivier
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A novel hybrid model of the lumbar spine, allowing fast static and dynamic simulations of the disc pressure and the spine mobility, is introduced in this work. Our contribution is to combine rigid bodies, deformable finite elements, articular constraints, and springs into a unique model of the spine. Each vertebra is represented by a rigid body controlling a surface mesh to model contacts on the facet joints and the spinous process. The discs are modeled using a heterogeneous tetrahedral finite element model. The facet joints are represented as elastic joints with six degrees of freedom, while the ligaments are modeled using non-linear one-dimensional elastic elements. The challenge we tackle is to make these different models efficiently interact while respecting the principles of Anatomy and Mechanics. The mobility, the intradiscal pressure, the facet joint force and the instantaneous center of rotation of the lumbar spine are validated against the experimental and theoretical results of the literature on flexion, extension, lateral bending as well as axial rotation. Our hybrid model greatly simplifies the modeling task and dramatically accelerates the simulation of pressure within the discs, as well as the evaluation of the range of motion and the instantaneous centers of rotation, without penalizing precision. These results suggest that for some types of biomechanical simulations, simplified models allow far easier modeling and faster simulations compared to usual full-FEM approaches without any loss of accuracy.Keywords: hybrid, modeling, fast simulation, lumbar spine
Procedia PDF Downloads 306205 Use of Geosynthetics as Reinforcement Elements in Unpaved Tertiary Roads
Authors: Vivian A. Galindo, Maria C. Galvis, Jaime R. Obando, Alvaro Guarin
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In Colombia, most of the roads of the national tertiary road network are unpaved roads with granular rolling surface. These are very important ways of guaranteeing the mobility of people, products, and inputs from the agricultural sector from the most remote areas to urban centers; however, it has not paid much attention to the search for alternatives to avoid the occurrence of deteriorations that occur shortly after its commissioning. In recent years, geosynthetics have been used satisfactorily to reinforce unpaved roads on soft soils, with geotextiles and geogrids being the most widely used. The interaction of the geogrid and the aggregate minimizes the lateral movement of the aggregate particles and increases the load capacity of the material, which leads to a better distribution of the vertical stresses, consequently reducing the vertical deformations in the subgrade. Taking into account the above, the research aimed at the mechanical behavior of the granular material, used in unpaved roads with and without the presence of geogrids, from the development of laboratory tests through the loaded wheel tester (LWT). For comparison purposes, the reinforced conditions and traffic conditions to which this type of material can be accessed in practice were simulated. In total four types of geogrids, were tested with granular material; this means that five test sets, the reinforced material and the non-reinforced control sample were evaluated. The results of the numbers of load cycles and depth rutting supported by each test body showed the influence of the properties of the reinforcement on the mechanical behavior of the assembly and the significant increases in the number of load cycles of the reinforced specimens in relation to those without reinforcement.Keywords: geosynthetics, load wheel tester LWT, tertiary roads, unpaved road, vertical deformation
Procedia PDF Downloads 250204 Evaluation of Internal Friction Angle in Overconsolidated Granular Soil Deposits Using P- and S-Wave Seismic Velocities
Authors: Ehsan Pegah, Huabei Liu
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Determination of the internal friction angle (φ) in natural soil deposits is an important issue in geotechnical engineering. The main objective of this study was to examine the evaluation of this parameter in overconsolidated granular soil deposits by using the P-wave velocity and the anisotropic components of S-wave velocity (i.e., both the vertical component (SV) and the horizontal component (SH) of S-wave). To this end, seventeen pairs of P-wave and S-wave seismic refraction profiles were carried out at three different granular sites in Iran using non-invasive seismic wave methods. The acquired shot gathers were processed, from which the P-wave, SV-wave and SH-wave velocities were derived. The reference values of φ and overconsolidation ratio (OCR) in the soil deposits were measured through laboratory tests. By assuming cross-anisotropy of the soils, the P-wave and S-wave velocities were utilized to develop an equation for calculating the coefficient of lateral earth pressure at-rest (K₀) based on the theory of elasticity for a cross-anisotropic medium. In addition, to develop an equation for OCR estimation in granular geomaterials in terms of SH/SV velocity ratios, a general regression analysis was performed on the resulting information from this research incorporated with the respective data published in the literature. The calculated K₀ values coupled with the estimated OCR values were finally employed in the Mayne and Kulhawy formula to evaluate φ in granular soil deposits. The results showed that reliable values of φ could be estimated based on the seismic wave velocities. The findings of this study may be used as the appropriate approaches for economic and non-invasive determination of in-situ φ in granular soil deposits using the surface seismic surveys.Keywords: angle of internal friction, overconsolidation ratio, granular soils, P-wave velocity, SV-wave velocity, SH-wave velocity
Procedia PDF Downloads 159203 Molecular Evolutionary Relationships Between O-Antigens of Enteric Bacteria
Authors: Yuriy A. Knirel
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Enteric bacteria Escherichia coli is the predominant facultative anaerobe of the colonic flora, and some specific serotypes are associated with enteritis, hemorrhagic colitis, and hemolytic uremic syndrome. Shigella spp. are human pathogens that cause diarrhea and bacillary dysentery (shigellosis). They are in effect E. coli with a specific mode of pathogenicity. Strains of Salmonella enterica are responsible for a food-borne infection (salmonellosis), and specific serotypes cause typhoid fever and paratyphoid fever. All these bacteria are closely related in respect to structure and genetics of the lipopolysaccharide, including the O-polysaccharide part (O‑antigen). Being exposed to the bacterial cell surface, the O antigen is subject to intense selection by the host immune system and bacteriophages giving rise to diverse O‑antigen forms and providing the basis for typing of bacteria. The O-antigen forms of many bacteria are unique, but some are structurally and genetically related to others. The sequenced O-antigen gene clusters between conserved galF and gnd genes were analyzed taking into account the O-antigen structures established by us and others for all S. enterica and Shigella and most E. coli O-serogroups. Multiple genetic mechanisms of diversification of the O-antigen forms, such as lateral gene transfer and mutations, were elucidated and are summarized in the present paper. They include acquisition or inactivation of genes for sugar synthesis or transfer or recombination of O-antigen gene clusters or their parts. The data obtained contribute to our understanding of the origins of the O‑antigen diversity, shed light on molecular evolutionary relationships between the O-antigens of enteric bacteria, and open a way for studies of the role of gene polymorphism in pathogenicity.Keywords: enteric bacteria, O-antigen gene cluster, polysaccharide biosynthesis, polysaccharide structure
Procedia PDF Downloads 142202 In Situ Volume Imaging of Cleared Mice Seminiferous Tubules Opens New Window to Study Spermatogenic Process in 3D
Authors: Lukas Ded
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Studying the tissue structure and histogenesis in the natural, 3D context is challenging but highly beneficial process. Contrary to classical approach of the physical tissue sectioning and subsequent imaging, it enables to study the relationships of individual cellular and histological structures in their native context. Recent developments in the tissue clearing approaches and microscopic volume imaging/data processing enable the application of these methods also in the areas of developmental and reproductive biology. Here, using the CLARITY tissue procedure and 3D confocal volume imaging we optimized the protocol for clearing, staining and imaging of the mice seminiferous tubules isolated from the testes without cardiac perfusion procedure. Our approach enables the high magnification and fine resolution axial imaging of the whole diameter of the seminiferous tubules with possible unlimited lateral length imaging. Hence, the large continuous pieces of the seminiferous tubule can be scanned and digitally reconstructed for the study of the single tubule seminiferous stages using nuclear dyes. Furthermore, the application of the antibodies and various molecular dyes can be used for molecular labeling of individual cellular and subcellular structures and resulting 3D images can highly increase our understanding of the spatiotemporal aspects of the seminiferous tubules development and sperm ultrastructure formation. Finally, our newly developed algorithms for 3D data processing enable the massive parallel processing of the large amount of individual cell and tissue fluorescent signatures and building the robust spermatogenic models under physiological and pathological conditions.Keywords: CLARITY, spermatogenesis, testis, tissue clearing, volume imaging
Procedia PDF Downloads 136201 Trajectory Optimization of Re-Entry Vehicle Using Evolutionary Algorithm
Authors: Muhammad Umar Kiani, Muhammad Shahbaz
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Performance of any vehicle can be predicted by its design/modeling and optimization. Design optimization leads to efficient performance. Followed by horizontal launch, the air launch re-entry vehicle undergoes a launch maneuver by introducing a carefully selected angle of attack profile. This angle of attack profile is the basic element to complete a specified mission. Flight program of said vehicle is optimized under the constraints of the maximum allowed angle of attack, lateral and axial loads and with the objective of reaching maximum altitude. The main focus of this study is the endo-atmospheric phase of the ascent trajectory. A three degrees of freedom trajectory model is simulated in MATLAB. The optimization process uses evolutionary algorithm, because of its robustness and efficient capacity to explore the design space in search of the global optimum. Evolutionary Algorithm based trajectory optimization also offers the added benefit of being a generalized method that may work with continuous, discontinuous, linear, and non-linear performance matrix. It also eliminates the requirement of a starting solution. Optimization is particularly beneficial to achieve maximum advantage without increasing the computational cost and affecting the output of the system. For the case of launch vehicles we are immensely anxious to achieve maximum performance and efficiency under different constraints. In a launch vehicle, flight program means the prescribed variation of vehicle pitching angle during the flight which has substantial influence reachable altitude and accuracy of orbit insertion and aerodynamic loading. Results reveal that the angle of attack profile significantly affects the performance of the vehicle.Keywords: endo-atmospheric, evolutionary algorithm, efficient performance, optimization process
Procedia PDF Downloads 405200 Clay Hydrogel Nanocomposite for Controlled Small Molecule Release
Authors: Xiaolin Li, Terence Turney, John Forsythe, Bryce Feltis, Paul Wright, Vinh Truong, Will Gates
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Clay-hydrogel nanocomposites have attracted great attention recently, mainly because of their enhanced mechanical properties and ease of fabrication. Moreover, the unique platelet structure of clay nanoparticles enables the incorporation of bioactive molecules, such as proteins or drugs, through ion exchange, adsorption or intercalation. This study seeks to improve the mechanical and rheological properties of a novel hydrogel system, copolymerized from a tetrapodal polyethylene glycol (PEG) thiol and a linear, triblock PEG-PPG-PEG (PPG: polypropylene glycol) α,ω-bispropynoate polymer, with the simultaneous incorporation of various amounts of Na-saturated, montmorillonite clay (MMT) platelets (av. lateral dimension = 200 nm), to form a bioactive three-dimensional network. Although the parent hydrogel has controlled swelling ability and its PEG groups have good affinity for the clay platelets, it suffers from poor mechanical stability and is currently unsuitable for potential applications. Nanocomposite hydrogels containing 4wt% MMT showed a twelve-fold enhancement in compressive strength, reaching 0.75MPa, and also a three-fold acceleration in gelation time, when compared with the parent hydrogel. Interestingly, clay nanoplatelet incorporation into the hydrogel slowed down the rate of its dehydration in air. Preliminary results showed that protein binding by the MMT varied with the nature of the protein, as horseradish peroxidase (HRP) was more strongly bound than bovine serum albumin. The HRP was no longer active when bound, presumably as a result of extensive structural refolding. Further work is being undertaken to assess protein binding behaviour within the nanocomposite hydrogel for potential diabetic wound healing applications.Keywords: hydrogel, nanocomposite, small molecule, wound healing
Procedia PDF Downloads 269199 Cephalometric Changes of Patient with Class II Division 1 [Malocclusion] Post Orthodontic Treatment with Growth Stimulation: A Case Report
Authors: Pricillia Priska Sianita
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An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.Keywords: cephalometric evaluation, class II division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems
Procedia PDF Downloads 249198 Dynamic Analysis of Mono-Pile: Spectral Element Method
Authors: Rishab Das, Arnab Banerjee, Bappaditya Manna
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Mono-pile foundations are often used in soft soils in order to support heavy mega-structures, whereby often these deep footings may undergo dynamic excitation due to many causes like earthquake, wind or wave loads acting on the superstructure, blasting, and unbalanced machines, etc. A comprehensive analytical study is performed to study the dynamics of the mono-pile system embedded in cohesion-less soil. The soil is considered homogeneous and visco-elastic in nature and is analytically modeled using complex springs. Considering the N number of the elements of the pile, the final global stiffness matrix is obtained by using the theories of the spectral element matrix method. Further, statically condensing the intermediate internal nodes of the global stiffness matrix results to a smaller sub matrix containing the nodes experiencing the external translation and rotation, and the stiffness and damping functions (impedance functions) of the embedded piles are determined. Proper plots showing the variation of the real and imaginary parts of these impedance functions with the dimensionless frequency parameter are obtained. The plots obtained from this study are validated by that provided by Novak,1974. Further, the dynamic analysis of the resonator impregnated pile is proposed within this study. Moreover, with the aid of Wood's 1g laboratory scaling law, a proper scaled-down resonator-pile model is 3D printed using PLA material. Dynamic analysis of the scaled model is carried out in the time domain, whereby the lateral loads are imposed on the pile head. The response obtained from the sensors through the LabView software is compared with the proposed theoretical data.Keywords: mono-pile, visco-elastic, impedance, LabView
Procedia PDF Downloads 118197 Abnormal Branching Pattern of Lumbar Plexus in an Adult Male Cadaver: A Case Report
Authors: Deepthinath Reghunathan, Satheesha Nayak, Sudarshan S., Prasad Alathady Maloor, Prakash Shetty
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Lumbar plexus is formed by the union of ventral rami of T12, L1, L2, L3 spinal nerves and the larger upper division of L4 lumbar spinal nerves. Variations in the normal anatomy of the lumbar and sacral plexus might be seen in some cases and are reported in the literature, but finding such an unusual case comprising of multiple variations which is normally not expected in a clinical setup, proves to be a vital piece of information for clinicians and medical practitioners. During the dissection of the abdomen and pelvis of an approximately 70 year old cadaver, we observed the following variations in the formation of the lumbar and sacral nerves. 1. The genitofemoral nerve bifurcated at a higher level; genital branch of genitofemoral nerve gave branches to the anterior abdominal wall muscles, 2. A communicating branch was given from the lateral cutaneous nerve of thigh to the medial cutaneous nerve of thigh, 3. A muscular branch was given from femoral nerve to psoas major, 4. There was absence of contribution of L4 spinal nerve in the formation of the lumbosacral trunk and 5. Lumbosacral trunk gave communicating branches to the femoral and obturator nerves. Most of the variations found were rare and finding all the above said variations in a single cadaver is even rare. Documentation of such rare cases with multiple variations in the formation of nerves from the lumbar plexus provides vital information on such occurrences. This information would in turn improve the knowledge of clinicians and surgeons dealing with this region. Emphasizing such knowledge of this region would prevent accidental damage to the structures with a variant anatomy.Keywords: femoral nerve, genitofemoral nerve, lumbar plexus, lumbosacral trunk
Procedia PDF Downloads 288196 Design of Hybrid Auxetic Metamaterials for Enhanced Energy Absorption under Compression
Authors: Ercan Karadogan, Fatih Usta
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Auxetic materials have a negative Poisson’s ratio (NPR), which is not often found in nature. They are metamaterials that have potential applications in many engineering fields. Mechanical metamaterials are synthetically designed structures with unusual mechanical properties. These mechanical properties are dependent on the properties of the matrix structure. They have the following special characteristics, i.e., improved shear modulus, increased energy absorption, and intensive fracture toughness. Non-auxetic materials compress transversely when they are stretched. The system naturally is inclined to keep its density constant. The transversal compression increases the density to balance the loss in the longitudinal direction. This study proposes to improve the crushing performance of hybrid auxetic materials. The re-entrant honeycomb structure has been combined with a star honeycomb, an S-shaped unit cell, a double arrowhead, and a structurally hexagonal re-entrant honeycomb by 9 X 9 cells, i.e., the number of cells is 9 in the lateral direction and 9 in the vertical direction. The Finite Element (FE) and experimental methods have been used to determine the compression behavior of the developed hybrid auxetic structures. The FE models have been developed by using Abaqus software. The specimens made of polymer plastic materials have been 3D printed and subjected to compression loading. The results are compared in terms of specific energy absorption and strength. This paper describes the quasi-static crushing behavior of two types of hybrid lattice structures (auxetic + auxetic and auxetic + non-auxetic). The results show that the developed hybrid structures can be useful to control collapse mechanisms and present larger energy absorption compared to conventional re-entrant auxetic structures.Keywords: auxetic materials, compressive behavior, metamaterials, negative Poisson’s ratio
Procedia PDF Downloads 97195 Numerical Tools for Designing Multilayer Viscoelastic Damping Devices
Authors: Mohammed Saleh Rezk, Reza Kashani
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Auxiliary damping has gained popularity in recent years, especially in structures such as mid- and high-rise buildings. Distributed damping systems (typically viscous and viscoelastic) or reactive damping systems (such as tuned mass dampers) are the two types of damping choices for such structures. Distributed VE dampers are normally configured as braces or damping panels, which are engaged through relatively small movements between the structural members when the structure sways under wind or earthquake loading. In addition to being used as stand-alone dampers in distributed damping applications, VE dampers can also be incorporated into the suspension element of tuned mass dampers (TMDs). In this study, analytical and numerical tools for modeling and design of multilayer viscoelastic damping devices to be used in dampening the vibration of large structures are developed. Considering the limitations of analytical models for the synthesis and analysis of realistic, large, multilayer VE dampers, the emphasis of the study has been on numerical modeling using the finite element method. To verify the finite element models, a two-layer VE damper using ½ inch synthetic viscoelastic urethane polymer was built, tested, and the measured parameters were compared with the numerically predicted ones. The numerical model prediction and experimentally evaluated damping and stiffness of the test VE damper were in very good agreement. The effectiveness of VE dampers in adding auxiliary damping to larger structures is numerically demonstrated by chevron bracing one such damper numerically into the model of a massive frame subject to an abrupt lateral load. A comparison of the responses of the frame to the aforementioned load, without and with the VE damper, clearly shows the efficacy of the damper in lowering the extent of frame vibration.Keywords: viscoelastic, damper, distributed damping, tuned mass damper
Procedia PDF Downloads 107194 Parasagittal Approach to Lumbar Epidural Steroid Injections: A Cost-Effectiveness Analysis
Authors: K. D. Candido, A. Lissounov, I. Knezevic, N. Knezevic
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Background: The most commonly performed pain procedures in the USA is Lumbar Epidural Steroid Injections (LESI). There are three main types of these procedures: transforaminal (TF), interlaminar (IL) and caudal injections. It is expected for TF injections to have better outcomes than IL injections, based on the recently published systematic review. The studies presented in that review used a midline IL approach, but those with parasagittal IL approach were not taken into consideration. Our aim is to emphasize the efficacy of the lateral parasagittal (paramedian) IL approach in this review. Methods: We included five studies in this systematic review, which compared Parasagittal-IL (PIL) with either Midline-IL (MIL) or TF LESI. Total of 296 patients who had undergone different types of LESI were observed across the five studies, and the average pain and functional improvements were calculated and compared among groups. Results: Pain and function improvements with PIL approach is superior on 12 months follow up to MIL approach (53.4% vs. 14.7%) and (55% vs. 27.7%), respectively. A 12 months follow-up results between PIL and TF shows a near equivalent effectiveness for pain (58.9% vs. 63.2%) and function improvement (47.3% vs. 48.1%). An average follow-up of 17.1 days have shown better short-term pain relief for PIL than TF approach (45.8% vs. 19.2%), respectively. Number of repeated injections is lower for PIL injections than MIL. Number of weeks between 1st and 2nd injections: PIL averaged 15.8 weeks and MIL averaged 9.7 weeks. Third LESI injection is more common in TF group (30%) than PIL group (18.8%). Conclusion: Higher complication rates are associated with TF injections for which FDA7 issued an official warning. We have recorded better outcomes in pain and function improvement of Parasagittal-IL LESI as compared to midline-IL injection, in the presented systematic review. Parasagittal and TF injections have equivalent efficacy in Pain and Function improvements thus we advocate for Parasagittal-IL approach consideration as an alternative for TF injections.Keywords: parasagital approach, lumbar, back pain, epidural steroid injection
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