Search results for: open temporomandibular joint surgery

Authors: A. S. Bouchikhi, A. Megueni, S. Habibi

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One major problem when using bonded Fiber Reinforced Polymer is the presence of high inter facial stresses near the end of the composite laminate which might govern the failure of the strengthening schedule. It is known that the decrease of FRP plate thickness and the fitness of adhesive reduce the stress concentration at plate ends. Another way is to use a plate with a non uniform section or tapered ends and softer adhesive at the edges. In this paper, a comprehensive finite element (FE) study has been conducted to investigate the effect of mixed adhesive joints (MAJ) and tapering plate on the inter facial stress distribution in the adhesive layer, this paper presents the results of a study of application of two adhesives with different stiffnesses (bi-adhesive) along the joint strength length between the CFRP-strengthened steel beam for tapered and untapered plate on the distribution of inter facial stresses. A stiff adhesive was applied in the middle portion of the joint strength, while a low modulus adhesive was applied towards the edges prone to stress concentrations.

Keywords: FRP, mixed adhesive joints, stresses, tapered plate, retrofitted beams bonded

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Authors: Naila Naseer

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Emotional Intelligence (EI) concept is not new yet unique and interesting. EI is a person’s ability to be aware of his/her own emotions and to manage, handle and communicate emotions with others effectively. The present study was conducted to assess the relationship between emotional intelligence and age of graduate level students at Allama Iqbal Open University (AIOU). Population consisted of Allama Iqbal Open University students (B.Ed 3rd Semester, Autumn 2007) from Rawalpindi and Islamabad regions. Total number of sample consisted of 469 participants was randomly drawn out by using table of random numbers. Bar-On EQ-i was administered on the participants through personal contact. The instrument was also validated through pilot study on a random sample of 50 participants (B.Ed students Spring 2006), who had completed their B.Ed degree successfully. Data was analyzed and tabulated in percentages, frequencies, mean, standard deviation, correlation, and scatter gram in SPSS (version 16.0 for windows). The results revealed that students with higher age group had scored low on the scale (Bar-On EQ-i). Moreover, the students in low age groups exhibited higher levels of EI as compared with old age students.

Keywords: emotional intelligence, age level, learning, emotion-related feelings

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Authors: M. A. Akulov, V. O. Zaharov, A. A. Tomskij

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Introduction: Scapulohumeral periarthrosis, resulting as a reaction to mechanical injury of shoulder tendons and muscles, is associated with high incidence of temporal and permanent disability. There is a strong need for investigation of treatment of that patient group. Severe pain leads to limitation of movements range, which result in secondary alterations of joint capsule and ligamentous apparatus. Muscle tension and edema, swelling of fascial and fibrous structures result in nerve and vascular compression in intramuscular and osseo-muscular-fibrous spaces. Botulinum toxin injection leads to decrease of muscle tone, increase of movements range and associated pain alleviation. Study aim: Optimization of rehabilitation process in scapolohumeral periarthrosis using Xeomin. Patients and methods: 40 patients aged 37-56 years with scapulohumeral periarthrosis were evaluated. Patients were divided into two groups according to treatment regimen. The first (main) group included 21 patients, receiving intramuscular Xeomin 150-200 U in the area of brachio-scapular joint and trigger points (inducing motion range limitation and pain). Treatment procedures were combined with physical therapy and osteopathic procedures. The second (control) group included 19 patients, receiving conventional physical therapy and osteopathic procedures. The evaluation and efficacy comparison was carried out using McGill pain questionnaire, Clinical Global Impression scale (CGI), and patient-reported increase of brachio-scapular joint movement range and pain decrease at 1, 3 and 6 months of treatment. Results. The study demonstrated a significant improvement in the main group after one month of treatment, which persisted during months of treatment. At baseline, rank pain index on McGill pain questionnaire was 18,4±4,9 and 17,8±5,1 in the main and control group, respectively (p > 0,05). At 1 month of treatment we observed a significant decrease of pain syndrome (no pain or modest pain) and increase of movement range in angular degrees in the main group (р < 0,05). In the control group significant improvements were observed only on the 3 month of treatment (р < 0,05), but at 6 months of treatment the improvement in pain syndrome and motion range in brachio-scapular joint was significantly smaller, than in the main group. Rank pain index on McGill pain scale was 5,2±1,8 in the main group compared to 12,0±2,6 in the control group (р < 0,05). At 6 months of treatment patients in the first group reported a significant/highly significant improvement of general health on CGI, whereas in the second group most patients reported a minimal improvement. We observed a sustained and persistent improvement of motion range in brachio-scapular joint in the main group. Conclusion: Xeomin injections as a part of rehabilitation process in scapulohumeral periarthrosis lead to reduced time and increased quality of rehabilitation.

Keywords: botulinum toxin, rehabilitation, scapulohumeral periarthrosis

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Authors: Mahesh S. Harne, Sunil V. Deshmukh

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A continuous passive motion machine improves and helps the patient to restore range of motion in various physiotherapy activities. The paper presents a concept for portable CPM. The device is used for various joint for upper and lower body extremities. The device is designed so that the active and passive motion is incorporated. During development, the physiotherapist and patient need is integrated with designer aspects. Various tools such as Analytical Higher Hierarchy process (AHP) and Quality Function Deployment (QFD) is used to integrate the need at the design stage. With market survey of various commercial CPM the gaps are identified, and efforts are made to fill the gaps with ergonomic need. Indian anthropomorphic dimension is referred. The device is modular to best suit for all the anthropomorphic need of different human. Experimentation is carried under the observation of physiotherapist and doctor on volunteer patient. We reported better results are compare to conventional CPM with comfort and less pain. We concluded that the concept will be helpful to reduces therapy cost and wide utility of device for various joint and physiotherapy exercise.

Keywords: continuous passive motion machine, ergonomics, physiotherapy, quality function deployment

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Authors: Yassine Mehros, Jean-Michel Degeorge, Abdelaziz Elabjani

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Innovation has long been considered the key to the survival, development, and growth of companies. It is a process in which start-ups play a key role, but they suffer from a structural lack of resources, which hinders the development of new innovations and their commercialization. The use of alternative channels to access resources is therefore becoming a necessity to overcome this constraint and identify opportunities. This is why they can be part of large communities of interdependent actors, namely innovation ecosystems that are part of a logic of sharing and open innovation. This research aims to explore and better understand OI in start-ups within an innovation ecosystem. We offer an exploratory qualitative study with start-ups and other actors in the Saint-Étienne innovation ecosystem. Our paper explored the characteristics and main actors of the Saint-Etienne innovation ecosystem, focusing on start-ups. We have identified the motivations of start-up’s adopting OI, its difficulties, its risks, and its impact on their growth. Also, our results show the existence of strong links between the different actors in the ecosystem. In addition, a strong trust has been established between these actors thanks to the geographical proximity; the start-ups manage to get in touch with the different actors of their innovation ecosystem by practicing OI. The actors collaborate on projects involving companies and, in particular, start-ups.

Keywords: open innovation, start-ups, Innovation ecosystem, actors

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

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Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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Authors: Morteza Aien, Masoud Rashidinejad, Mahmud Fotuhi-Firuzabad

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As energetic and environmental issues are getting more and more attention all around the world, the penetration of distributed energy resources (DERs) mainly those harvesting renewable energies (REs) ascends with an unprecedented rate. This matter causes more uncertainties to appear in the power system context; ergo, the uncertainty analysis of the system performance is an obligation. The uncertainties of any system can be represented probabilistically or possibilistically. Since sufficient historical data about all the system variables is not available, therefore, they do not have a probability density function (PDF) and must be represented possibilistiacally. When some of system uncertain variables are probabilistic and some are possibilistic, neither the conventional pure probabilistic nor pure possibilistic methods can be implemented. Hence, a combined solution is appealed. The first of this two-paper series formulates a new possibilistic-probabilistic tool for the load flow uncertainty assessment. The proposed methodology is based on the evidence theory and joint propagation of possibilistic and probabilistic uncertainties. This possibilistic- probabilistic formulation is solved in the second companion paper in an uncertain load flow (ULF) study problem.

Keywords: probabilistic uncertainty modeling, possibilistic uncertainty modeling, uncertain load flow, wind turbine generator

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Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong

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For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.

Keywords: wrong side surgery, never events, checklist, workload, communication

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Authors: Polina Pekker

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This work analyzes the role of lecturers in e-learning in Russia. It is based on qualitative research of lecturers who conduct courses on Russian national platforms of open education. The platform is based on edx software (provider of massive open online courses). The interviews with e-learning lecturers were conducted: from December 2015 till January 2016 and from April 2016 till May 2016. The results of interviews (face-to-face, telephone, skype) show, firstly, the difference between the role of lecturers in e-learning and in traditional education and, secondly, that the competition between lecturers is high in Russia. The results of interviews in Russia show that e-learning lecturer should have several special professional competences: the ability to keep attention of audiences without real contact, the ability to work on camera and competences related with e-learning course support (test, forum, communication on forum and etc.) It is concluded that lecturers need special course on acting and speech skills and on conducting and organizing of e-learning course in Russia. It is planned to conduct French study. When results from French research will be totally ready, they will be compared to Russian. As well French platform, France Universite Numerique, was launched earlier, in January 2014, so Russian lecturers should get best practice from the French colleagues.

Keywords: e-courses lecturer, e-learning, professional competences of lecturers, national Russian and French platforms of open education

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Authors: Nazim Mir-Nasiri, Hudyjaya Siswoyo Jo

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The paper describes conceptual design, control strategies, and partial simulation for a new fully autonomous lower limb wearable exoskeleton system for human motion enhancement that can support its weight and increase strength and endurance. Various problems still remain to be solved where the most important is the creation of a power and cost efficient system that will allow an exoskeleton to operate for extended period without batteries being frequently recharged. The designed exoskeleton is enabling to decouple the weight/mass carrying function of the system from the forward motion function which reduces the power and size of propulsion motors and thus the overall weight, cost of the system. The decoupling takes place by blocking the motion at knee joint by placing passive air cylinder across the joint. The cylinder is actuated when the knee angle has reached the minimum allowed value to bend. The value of the minimum bending angle depends on usual walk style of the subject. The mechanism of the exoskeleton features a seat to rest the subject’s body weight at the moment of blocking the knee joint motion. The mechanical structure of each leg has six degrees of freedom: four at the hip, one at the knee, and one at the ankle. Exoskeleton legs are attached to subject legs by using flexible cuffs. The operation of all actuators depends on the amount of pressure felt by the feet pressure sensors and knee angle sensor. The sensor readings depend on actual posture of the subject and can be classified in three distinct cases: subject stands on one leg, subject stands still on both legs and subject stands on both legs but transit its weight from one leg to other. This exoskeleton is power efficient because electrical motors are smaller in size and did not participate in supporting the weight like in all other existing exoskeleton designs.

Keywords: energy efficient system, exoskeleton, motion enhancement, robotics

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Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani

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Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.

Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients

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Authors: Faci Youcef

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In the present work, an experimental study is carried out using the digital image correlation (DIC) technique to analyze the damage and behavior of woven composite carbon/epoxy under tensile loading. The tension mechanisms associated with failure modes of bolted joints in advanced composites are studied, as well as displacement distribution and strain distribution. The evolution value of bolt angle inclination during tensile tests was studied. In order to compare the distribution of displacements and strains along the surface, figures of image mapping are made. Several factors that are responsible for the failure of fiber-reinforced polymer composite materials are observed. It was found that strain concentrations observed in the specimens can be used to identify full-field damage onset and to monitor damage progression during loading. Moreover, there is an interaction between laminate pattern, laminate thickness, fastener size and type, surface strain concentrations, and out-of-plane displacement. Conclusions include a failure analysis associated with bolt angle inclinations and supported by microscopic visualizations of the composite specimen. The DIC results can be used to develop and accurately validate numerical models.

Keywords: Carbone, woven, damage, digital image, bolted joint, the inclination of angle

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Authors: Rakibul Islam Sagor, Sadia Ibnat Raisa

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Many nations across the globe, including Dhaka, are facing challenges in meeting the needs for a satisfactory quality of life due to the combination of a growing population and limited land resources. As a result, maximum spaces in modern cities are engulfed by concrete infrastructure, and there are hardly any open spaces in the urban neighborhoods. Although vertical movement has predominantly been employed for residential and commercial applications, the notion of vertical recreational and sports facilities remains unsettled. The primary objective of this study is to explore the feasibility of implementing vertical adaptations in urban recreational spaces, drawing upon the principles of high-rise theory. This article presents an analysis of the open spaces in Gulshan, Dhaka, focusing on the evaluation of the demand for open recreational and sports facilities that adequately cater to the existing population of the region. Initially, the study tried to identify and examine all potential open spaces within the designated area. Following that, an acceptable place is selected utilizing space syntax analysis, which takes into account the most conveniently accessible space for social interactions in the neighborhood. In addition, socioeconomic conditions of the area have been studied in order to determine the feasibility of the area. Finally, the study presented viable options for vertical urban sports facilities in the context of Dhaka, Bangladesh. Additionally, it seeks to develop strategies for maximizing the use of vertical expansions, thereby promoting a healthier and more active lifestyle among the city's residents. This approach aims to effectively handle the issue of limited land availability and enhance the efficiency of recreational areas around the globe.

Keywords: vertical sports, urban open spaces, social interaction, recreational activities

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Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

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The aim of the presented investigation is to recognize the possible mechanical issues of mini-plate connection used to treat mandible fractures and to check the impact of different factors for the stresses and displacements within the bone-stabilizer system. The mini-plate osteosynthesis technique is a common type of internal fixation using metal plates connected to the fractured bone parts by a set of screws. The selected two types of plate application methodology used by maxillofacial surgeons were investigated in the work. Those patterns differ in location and number of plates. The bone geometry was modeled on the base of computed tomography scans of hospitalized patient done just after mini-plate application. The solid volume geometry consisting of cortical and cancellous bone was created based on gained cloud of points. Temporomandibular joint and muscle system were simulated to imitate the real masticatory system behavior. Finite elements mesh and analysis were performed by ANSYS software. To simulate realistic connection behavior nonlinear contact conditions were used between the connecting elements and bones. The influence of the initial compression of the connected bone parts or the gap between them was analyzed. Nonlinear material properties of the bone tissues and elastic-plastic model of titanium alloy were used. The three cases of loading assuming the force of magnitude of 100N acting on the left molars, the right molars and the incisors were investigated. Stress distribution within connecting plate shows that the compression of the bone parts in the connection results in high stress concentration in the plate and the screws, however the maximum stress levels do not exceed material (titanium) yield limit. There are no significant differences between negative offset (gap) and no-offset conditions. The location of the external force influences the magnitude of stresses around both the plate and bone parts. Two-plate system gives generally lower von Misses stress under the same loading than the one-plating approach. Von Mises stress distribution within the cortical bone shows reduction of high stress field for the cases without the compression (neutral initial contact). For the initial prestressing there is a visible significant stress increase around the fixing holes at the bottom mini-plate due to the assembly stress. The local stress concentration may be the reason of bone destruction in those regions. The performed calculations prove that the bone-mini-plate system is able to properly stabilize the fractured mandible bone. There is visible strong dependency between the mini-plate location and stress distribution within the stabilizer structure and the surrounding bone tissue. The results (stresses within the bone tissues and within the devices, relative displacements of the bone parts at the interface) corresponding to different models of the connection provide a basis for the mechanical optimization of the mini-plate connections. The results of the performed numerical simulations were compared to clinical observation. They provide information helpful for better understanding of the load transfer in the mandible with the stabilizer and for improving stabilization techniques.

Keywords: finite element modeling, mandible fracture, mini-plate connection, osteosynthesis

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Authors: B. V. Murlimanju, R. Abisshek Balaji, Apoorva Aggarwal, Mangala M. Pai

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Background: Since the literature is scarce from the South Indian population about the sesamoid bones of the thumb, the present study was undertaken. The objective of the present study was to figure out the muscle of the thumb which contain these sesamoid bones. Methods: The present study included 25 cadaveric thumbs, which were obtained from the anatomy laboratory of our institution. Thumbs were studied for the prevalence of sesamoid bones at the metacarpophalangeal and interphalangeal joints. The muscle which contain these sesamoid bones were identified. Results: The present study observed that, there were 2 sesamoid bones (92%) at the metacarpophalangeal joint of the thumb each at its medial and lateral aspect. The medial sesamoid bone was found inside the adductor pollicis muscle and lateral one was found either in the flexor pollicis brevis muscle or abductor pollicis brevis muscle. However, among the 25 thumbs being studied, 2 thumbs (8%) had solitary sesamoid bone. The interphalangeal joint of the thumb exhibited only one sesamoid bone at the median plane. Conclusion: The morphological data of the present study from the South Indians can be used as a database, which is enlightening to the operating hand surgeon and radiologist.

Keywords: morphology, muscles, sesamoid bones, thumb

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Authors: Ian Jones, Jonathan Griffiths

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Laser welding offers the potential for making very precise joints in plastics products, both in terms of the joint location and the amount of heating applied. These methods have allowed the production of complex products such as microfluidic devices where channels and structure resolution below 100 µm is regularly used. However, to date, the dimension of welds made using lasers has been limited by the focus spot size that is achievable from the laser source. Theoretically, the minimum spot size possible from a laser is comparable to the wavelength of the radiation emitted. Practically, with reasonable focal length optics the spot size achievable is a few factors larger than this, and the melt zone in a plastics weld is larger again than this. The narrowest welds feasible to date have therefore been 10-20 µm wide using a near-infrared laser source. The aim of this work was to prepare laser absorber tracks and channels less than 10 µm wide in PMMA thermoplastic using EB lithography followed by sealing of channels using laser welding to carry out welds with widths of the order of 1 µm, below the resolution limit of the near-infrared laser used. Welded joints with a width of 1 µm have been achieved as well as channels with a width of 5 µm. The procedure was based on the principle of transmission laser welding using a thin coating of infrared absorbent material at the joint interface. The coating was patterned using electron-beam lithography to obtain the required resolution in a reproducible manner and that resolution was retained after the transmission laser welding process. The joint strength was ratified using larger scale samples. The results demonstrate that plastics products could be made with a high density of structure with resolution below 1 um, and that welding can be applied without excessively heating regions beyond the weld lines. This may be applied to smaller scale sensor and analysis chips, micro-bio and chemical reactors and to microelectronic packaging.

Keywords: microchannels, polymer, EB lithography, laser welding

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Authors: Yusri Yusof, Kamran Latif

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Computer Numeric Control (CNC) machine has been widely used in the industries since its inception. Currently, in CNC technology has been used for various operations like milling, drilling, packing and welding etc. with the rapid growth in the manufacturing world the demand of flexibility in the CNC machines has rapidly increased. Previously, the commercial CNC failed to provide flexibility because its structure was of closed nature that does not provide access to the inner features of CNC. Also CNC’s operating ISO data interface model was found to be limited. Therefore, to overcome that problem, Open Architecture Control (OAC) technology and STEP-NC data interface model are introduced. At present the Personal Computer (PC) has been the best platform for the development of open-CNC systems. In this paper, both ISO data interface model interpretation, its verification and execution has been highlighted with the introduction of the new techniques. The proposed is composed of ISO data interpretation, 3D simulation and machine motion control modules. The system is tested on an old 3 axis CNC milling machine. The results are found to be satisfactory in performance. This implementation has successfully enabled sustainable manufacturing environment.

Keywords: CNC, ISO 6983, ISO 14649, LabVIEW, open architecture control, reconfigurable manufacturing systems, sustainable manufacturing, Soft-CNC

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Authors: Nosratollah Hedayatpour, Hamid Reza Taheri, Mehrdad Fathi

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Introduction: Quadriceps femoris muscle is frequently involved in various movements e.g., jumping, landing) during sport and/or daily activities. During ballistic movement when individuals are faced with unexpected knee perturbation, fast twitch muscle fibers contribute to force production to stabilize knee joint. Fast twitch muscle fiber is more susceptible to fatigue and therefor may reduce the ability of the quadriceps muscle to stabilize knee joint during fast perturbation. Aim: The aim of this study was to investigate the effect of fatigue on postural response of the knee extensor muscles to fast and slow perturbations. Methods: Fatigue was induced to the quadriceps muscle using a KinCom Isokinetic Dynamometer (Chattanooga, TN). Bipolar surface electromyography (EMG) signals were simultaneously recorded from quadriceps components (vastus medialis, rectus femoris, and vastus lateralis) during pre- and post-fatigue postural perturbation performed at two different velocities of 120 ms and 250 mes. Results: One-way ANOVA showed that maximal voluntary knee extension force and time to task failure, and associated EMG activities were significantly reduced after fatiguing knee exercise (P< 0.05). Two-ways ANOVA also showed that ARV of EMG during backward direction was significantly larger than forward direction (P< 0.05), and during fast-perturbation it was significantly higher than slow-perturbation (P< 0.05). Moreover, ARV of EMG was significantly reduced during post fatigue perturbation, with the largest reduction identified for fast-perturbation compared with slow perturbation (P< 0.05). Conclusion: A larger reduction in muscle activity of the quadriceps muscle was observed during post fatigue fast-perturbation to stabilize knee joint, most likely due to preferential recruitment of fast twitch muscle fiber which are more susceptible to fatigue. This may partly explain that why knee injuries is common after fast ballistic movement.

Keywords: electromyography, fast-slow perturbations, fatigue, quadriceps femoris muscle

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Authors: Palaniraj Rama Raj, Himeesh Kumar, Paul Adler

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Purpose: To investigate the effect of ultrasound energy, expressed as cumulative dissipated energy (CDE), on short and long-term outcomes after uncomplicated cataract surgery by phacoemulsification. Methods: In this single-surgeon, two-center retrospective study, non-glaucomatous participants who underwent uncomplicated cataract surgery were investigated. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured at 3 separate time points: pre-operative, Day 1 and ≥1 month. Anterior chamber (AC) inflammation and corneal odema (CO) were assessed at 2 separate time points: Pre-operative and Day 1. Short-term changes (Day 1) in BCVA, IOP, AC and CO and long-term changes (≥1 month) in BCVA and IOP were evaluated as a function of CDE using a multivariate multiple linear regression model, adjusting for age, gender, cataract type and grade, preoperative IOP, preoperative BCVA and duration of long-term follow-up. Results: 110 eyes from 97 non-glaucomatous participants were analysed. 60 (54.55%) were female and 50 (45.45%) were male. The mean (±SD) age was 73.40 (±10.96) years. Higher CDE counts were strongly associated with higher grades of sclerotic nuclear cataracts (p <0.001) and posterior subcapsular cataracts (p <0.036). There was no significant association between CDE counts and cortical cataracts. CDE counts also had a positive correlation with Day 1 CO (p <0.001). There was no correlation between CDE counts and Day 1 AC inflammation. Short-term and long-term changes in post-operative IOP did not demonstrate significant associations with CDE counts (all p >0.05). Though there was no significant correlation between CDE counts and short-term changes in BCVA, higher CDE counts were strongly associated with greater improvements in long-term BCVA (p = 0.011). Conclusion: Though higher CDE counts were strongly associated with higher grades of Day 1 postoperative CO, there appeared to be no detriment to long-term BCVA. Correspondingly, the strong positive correlation between CDE counts and long-term BCVA was likely reflective of the greater severity of underlying cataract type and grade. CDE counts were not associated with short-term or long-term postoperative changes in IOP.

Keywords: cataract surgery, phacoemulsification, cumulative dissipated energy, CDE, surgical outcomes

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Authors: Saima Ali, Liaqat Ali, Nasir Orakzai

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Background: Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with Ultrasonography. The prenatal hydronephrosis is a diagnostic dilemma in differentiating between obstructive variant versus physiologic hydronephrosis. The assessment and prompt diagnosis of prenatal hydronephrosis is important because of the fact that untreated obstructive hydronephrosis usually leads to recurrent UTI, Urosepsis, deterioration of renal functions, non-functioning kidneys, and even end-stage renal disease. Objectives: To determine the etiology and outcome of postnatal treatment of children with prenatal hydronephrosis in two teaching hospitals of Khyber Pakhtunkhwa (KPK) Methods: It is a multicentric descriptive study that was conducted in department of Paediatrics in Kuwait teaching hospital Peshawar and Department of Urology in Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from January 2008 till December 2010. Total numbers of 64 neonates were included in the study with the mean follow-up of 14.5 months. All the diagnostic data in prenatal, postnatal data, and operative and non-operative data were collected on structured Proforma and was analyzed on SPSS version 17. Results: Out of 64 patients, 39 (60.9 %) were male while 25 were female. 52 patients had unilateral while 12 patients had bilateral hydronephrosis. Based upon prenatal USG in term of AP diameter, 37 (57 %) patients had mild hydronephrosis (5-10 mm AP diameter), 14 patients had moderate hydronephrosis (10-15 mm AP diameter) while 13 patients had gross hydronephrosis (More than 15mm). Regarding etiology, 44(76 %) patients were labeled as physiologic hydronephrosis, 11 patients (9.3%) with PUJ obstruction, 5 patients with Vesicoureteric reflux (VUR) and 4 patients with posterior urethral valves. Surgery was performed in total of 15 (23.4%) patients that included open Pyeloplasty in 11 patients, Vesicostomy followed by posterior valve fulguration in 4 patients. All the patients of VUR treated medically. The severity in the grade of prenatal hydronephrosis is significantly associated with the need for definitive urological surgery p < 0.005. Ancillary procedures like percutaneous nephrostomy (PCN) were inserted 7 patients. Conclusions: Prenatal hydronephrosis is a common ailment associated with significant morbidity. Physiological Hydronephrosis and VUR can be successfully treated with medical treatment. However obstructive PUJ obstructions and posterior urethral valves require surgical correction with a good success rate.

Keywords: prenatal hydronephrosis, Pelviureteric Junction (PUJ) Obstruction, vesicoureteric reflux, posterior urethral valve, renography

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Authors: Nuzhat Sharmin

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Human being is the most integral part of the nature and responsible for maintaining ecological balance both in rural and urban areas. But unfortunately, we are not doing our job with a holistic approach. The rapid growth of urbanization is making human life more isolated from greenery. Nowadays modern urban living involves sensory deprivation and overloaded stress. In many cities and towns of the world are expanding unabated in the name of urbanization and industrialization and in fact becoming jungles of concrete. Dhaka is one of the examples of such cities where open and green spaces are decreasing because of accommodating the overflow of population. This review paper has been prepared based on interviewing 30 teenagers, both male and female in Dhaka city. There were 12 open-ended questions in the questionnaire. For the literature review information had been gathered from scholarly papers published in various peer-reviewed journals. Some information was collected from the newspapers and some from fellow colleagues working around the world. Ideally about 25% of an urban area should be kept open or with parks, fields and/or plants and vegetation. But currently Dhaka has only about 10-12% open space and these also are being filled up rapidly. Old Dhaka has only about 5% open space while the new Dhaka has about 12%. Dhaka is now one of the most populated cities in the world. Accommodating this huge influx of people Dhaka is continuously losing its open space. As a result, children and teenagers are losing their interest in playing games and making friends, rather they are mostly occupied by television, gadgets and social media. It has been known from the interview that only 28% of teenagers regularly play. But the majority of them have to play on the street and rooftop for the lack of open space. On an average they are occupied with electronic devices for 8.3 hours/day. 64% of them has chronic diseases and often visit doctors. Most shockingly 35% of them claimed for not having any friends. Green space offers relief from stress. Areas of natural environment in towns and cities are theoretically seen providing setting for recovery and recuperation from anxiety and strains of the urban environment. Good quality green spaces encourage people to walk, run, cycle and play. Green spaces improve air quality and reduce noise, while trees and shrubbery help to filter out dust and pollutants. Relaxation, contemplation and passive recreation are essential to stress management. All city governments that are losing its open spaces should immediately pay attention to this aesthetic issue for the benefit of urban people. All kinds of development must be sustainable both for human being and nature.

Keywords: greenery, health, human, urban

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Authors: Bintao Wu, Xiangfang Xu, Yugang Miao，Duanfeng Han

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Joining of 1 mm thick aluminum 6061 to titanium TC4 was conducted using Bypass-current MIG welding-brazed, and stable welding process and good bead appearance were obtained. The Joint profile and microstructure of Ti/Al joints were observed by optical microscopy and SEM and then the structure of the interfacial reaction layers were analyzed in details. It was found that the intermetallic compound layer at the interfacial top is in the form of columnar crystal, which is in short and dense state. A mount of AlTi were observed at the interfacial layer near the Ti base metal while intermetallic compound like Al3Ti、TiSi3 were formed near the Al base metal, and the Al11Ti5 transition phase was found in the center of the interface layer due to the uneven distribution inside the weld pool during the welding process. Tensile test results show that the average tensile strength of joints is up to 182.6 MPa, which reaches about 97.6% of aluminum base metal. Fracture is prone to occur in the base metal with a certain amount of necking.

Keywords: bypass-current MIG welding-brazed, Al alloy, Ti alloy, joint characteristics, mechanical properties

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Authors: J. R. Ashrapov, G. A. Alihodzhaeva, D. E. Abdullaev, N. R. Kadirbekov

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Diagnosis of brain tumors is one of the challenges, as several central nervous system diseases run the same symptoms. Modern diagnostic techniques such as CT, MRI helps to significantly improve the surgery in the operating period, after surgery, after allowing time to identify postoperative complications in neurosurgery. Purpose: To study the MRI characteristics and localization of brain tumors in children and to detect the postoperative complications in the postoperative period. Materials and methods: A retrospective study of treatment of 62 children with brain tumors in age from 2 to 5 years was performed. Results of the review: MRI scan of the brain of the 62 patients 52 (83.8%) case revealed a brain tumor. Distribution on MRI of brain tumors found in 15 (24.1%) - glioblastomas, 21 (33.8%) - astrocytomas, 7 (11.2%) - medulloblastomas, 9 (14.5%) - a tumor origin (craniopharyngiomas, chordoma of the skull base). MRI revealed the following characteristic features: an additional sign of the heterogeneous MRI signal of hyper and hypointensive T1 and T2 modes with a different perifocal swelling degree with involvement in the process of brain vessels. The main objectives of postoperative MRI study are the identification of early or late postoperative complications, evaluation of radical surgery, the identification of the extended-growing tumor that (in terms of 3-4 weeks). MRI performed in the following cases: 1. Suspicion of a hematoma (3 days or more) 2. Suspicion continued tumor growth (in terms of 3-4 weeks). Conclusions: Magnetic resonance tomography is a highly informative method of diagnostics of brain tumors in children. MRI also helps to determine the effectiveness and tactics of treatment and the follow up in the postoperative period.

Keywords: brain tumors, children, MRI, treatment

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Authors: Hsiao-Yung Wang

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This essay aims to examine how the discursive formation of the 'transing-nationalism' (which is extended and slightly modified from 'homonationalism') had been constructed in the Taiwanese news media before the legalization of 'sex reassignment surgery (SRS)' in 1988. Samples for rhetorical analysis were selected from two mainstream newspapers, including China Times, and United Daily. The time frame for sample selection is from August 1953 (when the first transgender case was reported) to 1988, while the SRS was legalized in Taiwan. To enhance understanding of media representation as contextualized-based, the author refers to the representative of spatial rhetoric Mikhail Bakhtin for his late study on 'emergence' and 'visualization of time' in Bildungsroman; thereby categorizing the media discourse of transgender into two critical period: (1) transgender as 'misrecognized' and 'included' into the rhetoric of modern medical space; (2) transgender as 'institutionalized' into discourse of protection and salvation by the reified sympathy of nation-state. These two periods and relevant spatial rhetoric were of no immediate concern on the vital interest of transgender individuals; therefore constructed the imagery of transgender for the service of nationalism rather than gender consciousness or human right rhetoric. Based on the research findings, this essay concludes that 'queer multiplicity' should be regarded as not only the guideline for the amendment of the gendered policies and laws but the rhetorical resources for the mobilization of transgender movement in Taiwan from now on.

Keywords: Bakhtin, legalization, rhetoric, sex reassignment surgery, transgender, transing-nationalism

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Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

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We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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Authors: Flora Tajiki

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Undoubtedly, the desire to experience the beauty of motherhood is a dream for every woman, and delays in achieving this can have significant psychological consequences. Endometriosis, which is the presence of endometrial tissue in organs other than the uterus, can cause infertility through adhesion and inflammation. The fallopian tubes play a crucial role in transferring the egg to the uterus; if adhesions are present, the chances of natural pregnancy decrease, while the likelihood of ectopic pregnancy and miscarriage increases. In cases of mild adhesions observed during hysterosalpingography or laparoscopy, the tubes may open, but in severe adhesions, this is usually not possible. The aim of this study is to assess the effectiveness of a healthy lifestyle combined with massage of the uterine and ovarian areas in relieving adhesions in the fallopian tubes and treating the complications of endometriosis. This case study focuses on a 33-year-old woman, who married at 20, and experienced a miscarriage five years ago that required curettage. Following this, a hysterosalpingography revealed blockages in both fallopian tubes. A laparoscopic examination also indicated endometriosis and specialists in infertility ruled out the possibility of natural pregnancy. Three years ago, she underwent an unsuccessful IVF procedure. Two years ago, she began a lifestyle modification program that included improving sleep patterns, eliminating sugar and preservatives, avoiding red meat and gluten, eating a balanced diet, walking, exercising, and incorporating beneficial foods like olive oil, almonds, and nutritious vegetables, along with abdominal massage using chamomile oil. She also took vitamin C and vitamin D supplements. After approximately twenty weeks of these methods, and given that infertility centers had indicated that surgery and repeated IVF were the only options for her to conceive, she became pregnant naturally and had a successful pregnancy and delivery. Endometriosis is one of the significant factors contributing to infertility and adhesions in the fallopian tubes and uterus, and unfortunately, it has no definitive cure and can recur even after surgery. The treatment of similar cases emphasizes lifestyle modifications, and this approach has proven to be both cost-effective and harmless. Therefore, it seems essential to focus on this treatment strategy.

Keywords: infertility, endometriosis, adhesions, fallopian tubes, healthy lifestyle, lifestyle modifications, abdominal massage, case study, natural pregnancy, ivf, psychological consequences, uterine health, complementary treatments, nutrition, women's health.

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Authors: Huy Hieu Pham, Houssam Salmane, Louahdi Khoudour, Alain Crouzil, Pablo Zegers, Sergio Velastin

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We present a deep learning-based multitask framework for joint 3D human pose estimation and action recognition from color video sequences. Our approach proceeds along two stages. In the first, we run a real-time 2D pose detector to determine the precise pixel location of important key points of the body. A two-stream neural network is then designed and trained to map detected 2D keypoints into 3D poses. In the second, we deploy the Efficient Neural Architecture Search (ENAS) algorithm to find an optimal network architecture that is used for modeling the Spatio-temporal evolution of the estimated 3D poses via an image-based intermediate representation and performing action recognition. Experiments on Human3.6M, Microsoft Research Redmond (MSR) Action3D, and Stony Brook University (SBU) Kinect Interaction datasets verify the effectiveness of the proposed method on the targeted tasks. Moreover, we show that our method requires a low computational budget for training and inference.

Keywords: human action recognition, pose estimation, D-CNN, deep learning

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Authors: Maja Jokić, Andrea Mervar, Stjepan Mateljan

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Peer review journals, as the main communication channel among researchers, fully achieve their objective if they are available to the global research community, which is accomplished through open access. In the EU countries, the idea of open access has spread over the years through various projects, initiatives, and strategic documents. Consequently, in this paper we want to analyze, using various bibliometric indicators, visibility, and significance of open access peer review journals compared to the conventional (non-open access) ones. We examine the sample of open access (OA) journals in 28 EU countries in addition to open access journals in three EU candidate countries (Bosnia and Herzegovina, FYR Macedonia and Serbia), all indexed by Scopus (N=1,522). These journals comprise 42% of the total number of OA journals indexed by Scopus. The distribution of OA journals in our sample according to the subject fields indicates that the largest share has OA journals in Health Sciences, 29% followed by Social Sciences and Physical Sciences with 25%, and 21% in Life Sciences. At the same time, the distribution according to countries (N=31) shows the dominance of EU15 countries with the share of 68.3% (N=1041) while post-socialist European countries (EU11 plus three candidate EU countries) have the share of 31.6% (N=481). Bibliometric indicators are derived from the SCImago Journal Ranking database. The analysis of OA journals according to their quartile scores (that reflect the relation between number of articles and their citations) shows that the largest number of OA journals from our sample was in the third quartile in 2015. For comparison, the majority of all academic journals indexed in Scopus from the countries in our sample were in the same year in the first quartile. The median of SJR indicator (SCImago Journal Rankings) for 2015 that measures the journal's prestige, amounted 0.297 for OA journals from the sample, while it was modestly lower for all OA journals, 0.284. The value of the same indicator for all journals indexed by Scopus (N=11,086) from our group of countries was 0.358, which is significantly different from the one for OA journals. Apart from the number of OA journals we also confirm significant differences between EU15 and post-socialist countries in bibliometric status of OA journals. The median SJR indicator for 2015 for EU15 countries was 0.394, while for post-socialist countries it amounted to 0.226. The changes in bibliometric indicators: quartile score, SJR (SCImago Journal Rankings), SNIP (Sources Normalised Impact by Paper) and IPP (Impact per Publication) of OA journals during 2012-2015 period, as well as H-index for the main four subject fields (Life Sciences, Physical Sciences, Social Sciences and Health Sciences) in the whole sample as well as in two main groups of European countries, show increasing trend of acceptance and visibility of OA journals within the academic community. More comprehensive insights into the visibility of OA journals could be reached by using additional qualitative research methods such as for example, interviews with researchers.

Keywords: bibliometric analysis, European countries, journal evaluation, open access journals

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