Search results for: knee joint injury

Authors: Sanjaya N. Munasinghe, R. Gnanasekeram, Dimuthu Tennakoon

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During the last few years there has been a dramatic increase in the number of motorcyclists in Sri Lankan roads and thus an increase of motorcycle accidents (MCAs) with a heavy death and casualty toll. Extremity injuries due to MCAs cause a heavy burden on government hospitals. However, data on MCA injuries are limited. This study tries to determine the relationship between extremity injuries with protective gears and clothing motorcycle riders were wearing at the time of the accident. Data were collected from 410 motorcycle riders and passengers involved with MCAs and admitted to orthopedic and emergency observation wards in Teaching Hospital Kurunegala with extremity injuries between 1st February 2015 and 31st July 2015 using an interviewer administered questioner. Data were analyzed using SPSS version 17.0. Distal radial fracture is the most common upper extremity injury (12%), and Tibial fracture is the most common and severe lower extremity injury (23%). Very few participants were wearing safety gloves (2%) and jackets (10%). Most of the participants were wearing slippers (66%), short sleeved upper clothing (96%) and light cloth trousers (49%). According to Chi-square test associations were found between footwear and foot injuries (p-value - 0.001, Cramer's v-value - 0.203) and safety jacket and upper extremity injuries (p-value - 0.002, Cramer's v-value - 0.177). The results indicate that using safety gear can minimize the number of injuries in MCA victims. Thus it is necessary to ensure that motorcycle riders and pillion riders use proper safety gear.

Keywords: extremity injuries, fractures, motorcycle accidents, safety gear

Procedia PDF Downloads 294

Authors: B. Paygozar, S.A. Dizaji

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Adhesive bonding is a highly valued type of fastening mechanical parts in complex structures, where joining some simple components is always needed. This method is of several merits, such as uniform stress distribution, appropriate bonding strength, and fatigue performance, and lightness, thereby outweighing other sorts of bonding methods. This study is to investigate the failure load of adhesive single-strap joints, including adherends of different sizes and materials. This kind of adhesive joint is very practical in different industries, especially when repairing the existing joints or attaching substrates of dissimilar materials. In this research, experimentally validated numerical analyses carried out in a commercial finite element package, ABAQUS, are utilized to extract the failure loads of the joints, based on the cohesive zone model. In addition, the stress analyses of the substrates are performed in order to acquire the effects of lowering the thickness of the substrates on the stress distribution inside them to avoid designs suffering from the necking or failure of the adherends. It was found out that this method of bonding is really feasible in joining dissimilar materials which can be utilized in a variety of applications. Moreover, the stress analyses indicated the minimum thickness for the adherends so as to avoid the failure of them.

Keywords: cohesive zone model, dissimilar materials, failure load, single strap joint

Procedia PDF Downloads 123

Authors: Yuko Ishiwaka, Tomohiro Yoshida, Tadateru Itoh

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Human makes preparation called readiness potential unconsciously (RP) before awareness of their own decision. For example, when recognizing a button and pressing the button, the RP peaks are observed 200 ms before the initiation of the movement. It has been known that the preparatory movements are acquired before actual movements, but it has not been still well understood how humans can obtain the RP during their growth. On the proposition of why the brain must respond earlier, we assume that humans have to adopt the dangerous environment to survive and then obtain the behavior to cover the various time lags distributed in the body. Without RP, humans cannot take action quickly to avoid dangerous situations. In taking action, the brain makes decisions, and signals are transmitted through the Spinal Cord to the muscles to the body moves according to the laws of physics. Our research focuses on the time lag of the neuron signal transmitting from a brain to muscle via a spinal cord. This time lag is one of the essential factors for readiness potential. We propose a firing pattern controller model of a motor nerve system considered innervation and jitter, which produces time lag. In our simulation, we adopt innervation and jitter in our proposed muscle-skeleton model, because these two factors can create infinitesimal time lag. Q10 Hodgkin Huxley model to calculate action potentials is also adopted because the refractory period produces a more significant time lag for continuous firing. Keeping constant power of muscle requires cooperation firing of motor neurons because a refractory period stifles the continuous firing of a neuron. One more factor in producing time lag is slow or fast-twitch. The Expanded Hill Type model is adopted to calculate power and time lag. We will simulate our model of muscle skeleton model by controlling the firing pattern and discuss the relationship between the time lag of physics and neurons. For our discussion, we analyze the time lag with our simulation for knee bending. The law of inertia caused the most influential time lag. The next most crucial time lag was the time to generate the action potential induced by innervation and jitter. In our simulation, the time lag at the beginning of the knee movement is 202ms to 203.5ms. It means that readiness potential should be prepared more than 200ms before decision making.

Keywords: firing patterns, innervation, jitter, motor nerve system, readiness potential

Procedia PDF Downloads 829

Authors: Ahmeda Ali, Mary Codd, Susan Brundage

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Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

Procedia PDF Downloads 243

Authors: Aastha Arora, Vikas Bhuria, Saurabh Singh, Uma Pathak, Shweta Mathur, Puja P. Hazari, Rajat Sandhir, Ravi Soni, Anant N. Bhatt, Bilikere S. Dwarakanath

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Radiotherapy is an effective curative and palliative option for patients with thoracic malignancies. However, lung injury, comprising of pneumonitis and fibrosis, remains a significant clin¬ical complication of thoracic radiation, thus making it a dose-limiting factor. Also, injury to the lung is often reported as part of multi-organ failure in victims of accidental radiation exposures. Radiation induced inflammatory response in the lung, characterized by leukocyte infiltration and vascular changes, is an important contributing factor for the injury. Therefore, countermeasure agents to attenuate radiation induced inflammatory response are considered as an important approach to prevent chronic lung damage. Although Amifostine, the widely used, FDA approved radio-protector, has been found to reduce the radiation induced pneumonitis during radiation therapy of non-small cell lung carcinoma, its application during mass and field exposure is limited due to associated toxicity and ineffectiveness with the oral administration. The amifostine analogue (DRDE-30) overcomes this limitation as it is orally effective in reducing the mortality of whole body irradiated mice. The current study was undertaken to investigate the potential of DRDE-30 to ameliorate radiation induced lung damage. DRDE-30 was administered intra-peritoneally, 30 minutes prior to 13.5 Gy thoracic (60Co-gamma) radiation in C57BL/6 mice. Broncheo- alveolar lavage fluid (BALF) and lung tissues were harvested at 12 and 24 weeks post irradiation for studying inflammatory and fibrotic markers. Lactate dehydrogenase (LDH) leakage, leukocyte count and protein content in BALF were used as parameters to evaluate lung vascular permeability. Inflammatory cell signaling (p38 phosphorylation) and anti-oxidant status (MnSOD and Catalase level) was assessed by Western blot, while X-ray CT scan, H & E staining and trichrome staining were done to study the lung architecture and collagen deposition. Irradiation of the lung increased the total protein content, LDH leakage and total leukocyte count in the BALF, reflecting endothelial barrier dysfunction. These disruptive effects were significantly abolished by DRDE-30, which appear to be linked to the DRDE-30 mediated abrogation of activation of the redox-sensitive pro- inflammatory signaling cascade, the MAPK pathway. Concurrent administration of DRDE-30 with radiation inhibited radiation-induced oxidative stress by strengthening the anti-oxidant defense system and abrogated p38 mitogen-activated protein kinase activation, which was associated with reduced vascular leak and macrophage recruitment to the lungs. Histopathological examination (by H & E staining) of the lung showed radiation-induced inflammation of the lungs, characterized by cellular infiltration, interstitial oedema, alveolar wall thickening, perivascular fibrosis and obstruction of alveolar spaces, which were all reduced by pre-administration of DRDE-30. Structural analysis with X-ray CT indicated lung architecture (linked to the degree of opacity) comparable to un-irradiated mice that correlated well with the lung morphology and reduced collagen deposition. Reduction in the radiation-induced inflammation and fibrosis brought about by DRDE-30 resulted in a profound increase in animal survival (72 % in the combination vs 24% with radiation) observed at the end of 24 weeks following irradiation. These findings establish the potential of the Amifostine analogue, DRDE-30, in reducing radiation induced pulmonary injury by attenuating the inflammatory and fibrotic responses.

Keywords: amifostine, fibrosis, inflammation, lung injury radiation

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Authors: Szymon Kowieski, Zygmunt Mikno

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The study involved the optimization of process parameters during resistance spot welding of Al-coated martensitic boron steel 22MnB5, applied in hot stamping, performed using a programme with a multiple current impulse mode and a programme with variable pressure force. The aim of this research work was to determine the possibilities of a growth in welded joint strength and to identify the expansion of a welding lobe. The process parameters were adjusted on the basis of welding process simulation and confronted with experimental data. 22MnB5 steel is known for its tendency to obtain high hardness values in weld nuggets, often leading to interfacial failures (observed in the study-related tests). In addition, during resistance spot welding, many production-related factors can affect process stability, e.g. welding lobe narrowing, and lead to the deterioration of quality. Resistance spot welding performed using the above-named welding programme featuring 3 levels of force made it possible to achieve 82% of welding lobe extension. Joints made using the multiple current impulse program, where the total welding time was below 1.4s, revealed a change in a peeling mode (to full plug) and an increase in weld tensile shear strength of 10%.

Keywords: 22MnB5, hot stamping, interfacial fracture, resistance spot welding, simulation, single lap joint, welding lobe

Procedia PDF Downloads 387

Authors: Alireza Pishgahi, Mohammad Rahbar, Javad Shokri, Shahla Dareshiri, Yaghoub Salekzamani, Fariba Eslamian

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Background and Objectives: Hypertrophic scars are one of the complications following a burn injury. Intralesional corticosteroid injection is an invasive method for treatment of this complication. We had design a single blinded randomized control trial to deliver dexamethasone by phonophoresis and evaluate its efficacy on hypertrophic burn scars characteristics. Material and Methods: 56 cases of hypertrophic burn scar due to burn injury allocated randomly to dexamethasone and control group. Individuals in case group received 10 sessions of dexamethasone 0.4% phonophoresis. Patients in control group had placebo phonophoresis (ultrasound with normal routine aquatic gel without any dexamethasone) with the same protocol. At the beginning of study and one week after last session, hypertrophic scar characteristics and pruritus were measured by ‘Vancouver Scar Scale’, and ‘5-D Pruritus Scale’ respectively in both groups. Results: Despite mild improvement in Vancouver Scar Scale score one week after intervention in dexamethasone phonophoresis group in comparison to control subjects, but this difference was not significant (p=0.08). Pruritus score perceived subjectively were significantly lower one week after intervention in dexamethasone groups in comparison to control subjects (p=0.00). Conclusion: Dexamethasone phonophoresis is a safe and effective treatment method for burn hypertrophic scar pruritus, but its efficacy for scar characteristics improvement needs to be evaluated by larger studies with long-term follow-up period.

Keywords: dexamethasone, hypertrophic scar, phonophoresis, pruritus

Procedia PDF Downloads 173

Authors: M. H. Ahmadi, A. Mortazavi, H. Zarei

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Several authors have described the main mechanism of formation of cracks in the segment lining during the construction of tunnels with tunnel boring machines. A comprehensive analysis of segmental lining joints may help to guarantee a safe construction during Tunneling and serviceable stages. The most frequent types of segment damage are caused by a condition of uneven segment matching due to contact deficiencies. This paper investigated the interaction mechanism of precast concrete lining joints in tunnels. The Discrete Element Method (DEM) was used to analyze a typical segmental lining model consisting of six segment rings. In the analyses, typical segmental lining design parameters of the Ghomrood water conveyance tunnel, Iran were employed in the study. In the conducted analysis, the worst-case scenario of loading faced during the boring of Ghomrood tunnel was considered. This was associated with the existence of a crushed zone dipping at 75 degree at the location of the key segment. In the analysis, moreover, the effect of changes in horizontal stress ratio on the loads on the segment was assessed. The boundary condition associated with K (ratio of the horizontal to the vertical stress) values of 0.5, 1, 1.5 and 2 were applied to the model and separate analysis was conducted for each case. Important parameters such as stress, moments, and displacements were measured at joint locations and the surrounding rock. Accordingly, the segment joint interactions were assessed and analyzed. Moreover, rock mass properties of the Ghomrood in Ghom were adopted. In this study, the load acting on segments joints are included a crushed zone stratum force that intersect tunnel with 75 slopes in the location of the key segment, gravity force of segments and earth pressures. A numerical investigation was used for different coefficients of stress concentration of 0.5, 1, 1.5, 2 and different geological conditions of saturated crushed zone under the critical scenario. The numerical results also demonstrate that maximum bending moments in longitudinal joints occurred for crushed zone with the weaken strengths (Sandstone). Besides that, increasing the load in segment-stratum interfaces affected radial stress in longitudinal joints and finally the opening of joints occurred.

Keywords: joint, interface, segment, contact

Procedia PDF Downloads 258

Authors: Claudia Norambuena, Myissa Weiss, Maria Ruiz Maya, Matthew Straley, Elijah Hammond, Benjamin Chesebrough, David Grow

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The purpose of this project is to develop a low-cost, portable sensor device that can be used at home for long-term analysis of gait and balance abnormalities. One area of particular concern involves the asymmetries in movement and balance that can accompany certain types of injuries and/or the associated devices used in the repair and rehabilitation process (e.g. the use of splints and casts) which can often increase chances of falls and additional injuries. This device has the capacity to monitor a patient during the rehabilitation process after injury or operation, increasing the patient’s access to healthcare while decreasing the number of visits to the patient’s clinician. The sensor device may thereby improve the quality of the patient’s care, particularly in rural areas where access to the clinician could be limited, while simultaneously decreasing the overall cost associated with the patient’s care. The device consists of nine interconnected accelerometer/ gyroscope/compass chips (9-DOF IMU, Adafruit, New York, NY). The sensors attach to and are used to determine the orientation and acceleration of the patient’s lower abdomen, C7 vertebra (lower neck), L1 vertebra (middle back), anterior side of each thigh and tibia, and dorsal side of each foot. In addition, pressure sensors are embedded in shoe inserts with one sensor (ESS301, Tekscan, Boston, MA) beneath the heel and three sensors (Interlink 402, Interlink Electronics, Westlake Village, CA) beneath the metatarsal bones of each foot. These sensors measure the distribution of the weight applied to each foot as well as stride duration. A small microntroller (Arduino Mega, Arduino, Ivrea, Italy) is used to collect data from these sensors in a CSV file. MATLAB is then used to analyze the data and output the hip, knee, ankle, and trunk angles projected on the sagittal plane. An open-source program Processing is then used to generate an animation of the patient’s gait. The accuracy of the sensors was validated through comparison to goniometric measurements (±2° error). The sensor device was also shown to have sufficient sensitivity to observe various gait abnormalities. Several patients used the sensor device, and the data collected from each represented the patient’s movements. Further, the sensors were found to have the ability to observe gait abnormalities caused by the addition of a small amount of weight (4.5 - 9.1 kg) to one side of the patient. The user-friendly interface and portability of the sensor device will help to construct a bridge between patients and their clinicians with fewer necessary inpatient visits.

Keywords: biomedical sensing, gait analysis, outpatient, rehabilitation

Procedia PDF Downloads 289

Authors: Isabel Moscol, Carlos J. Díaz, Ciro Rodríguez

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Hip replacement becomes necessary when a person suffers severe pain or considerable functional limitations and the best option to enhance their quality of life is through the replacement of the damaged joint. One of the main components in femoral prostheses is the stem which distributes the loads from the joint to the proximal femur. To preserve more bone stock and avoid weakening of the diaphysis, a short starting stem was selected, generated from the intramedullary morphology of the patient's femur. It ensures the implantability of the design and leads to geometric delimitation for personalized optimization with machine learning (ML) and metaheuristic algorithms. The present study attempts to design a cementless short stem to make the strain deviation before and after implantation close to zero, promoting its fixation and durability. Regression models developed to estimate the percentage change of maximum principal stresses were used as objective optimization functions by the metaheuristic algorithm. The latter evaluated different geometries of the short stem with the modification of certain parameters in oblique sections from the osteotomy plane. The optimized geometry reached a global stress shielding (SS) of 18.37% with a determination factor (R²) of 0.667. The predicted results favour implantability integration in the short stem optimization to effectively reduce SS in the proximal femur.

Keywords: machine learning techniques, metaheuristic algorithms, short-stem design, stress shielding, hip replacement

Procedia PDF Downloads 196

Authors: Chien-Kuo Chang, Yu-Hsiang Lin, Yi-Yun Tang, Min-Chiu Wu

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With the trend of technological advancement, the harm caused by power outages is substantial, mostly due to problems in the power grid. This highlights the necessity for further improvement in the reliability of the power system. In the power system, gas-insulated switches (GIS) and power cables play a crucial role. Long-term operation under high voltage can cause insulation materials in the equipment to crack, potentially leading to partial discharges. If these partial discharges (PD) can be analyzed, preventative maintenance and replacement of equipment can be carried out, there by improving the reliability of the power grid. This research will diagnose defects by identifying three different defects in GIS and three different defects in straight cable joints, for a total of six types of defects. The partial discharge data measured will be converted through phase analysis diagrams and pulse sequence analysis. Discharge features will be extracted using convolutional image processing, and three different deep learning models, CNN, ResNet18, and MobileNet, will be used for training and evaluation. Class Activation Mapping will be utilized to interpret the black-box problem of deep learning models, with each model achieving an accuracy rate of over 95%. Lastly, the overall model performance will be enhanced through an ensemble learning voting method.

Keywords: partial discharge, gas-insulated switches, straight cable joint, defect identification, deep learning, ensemble learning

Procedia PDF Downloads 78

Authors: Mohammad Tahir Yousafzai, Nighat Nisar, Rehana Khalil

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The aim of this study is to assess the practices of sharp injuries and factors leading to it among medical practitioners in slum areas of Karachi, Pakistan. A cross sectional study was conducted in slum areas of Landhi Town Karachi. All medical practitioners (317) running the private clinics in the areas were asked to participate in the study. Data was collected on self administered pre-tested structured questionnaires. The frequency with percentage and 95% confidence interval was calculated for at least one sharp injury (SI) in the last one year. The factors leading to sharp injuries were assessed using multiple logistic regressions. About 80% of private medical practitioners consented to participate. Among these 87% were males and 13% were female. The mean age was 38±11 years and mean work experience was 12±9 years. The frequency of at least one sharp injury in the last one year was 27%(95% CI: 22.2-32). Almost 47% of Sharp Injuries were caused by needle recapping, less work experience, less than 14 years of schooling, more than 20 patients per day, administering more than 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharp injuries. Injection practices were found inadequate among private medical practitioners in slum areas of Karachi, and the frequency of Sharp Injuries was found high in these areas. There is a risk of occupational transmission of blood borne infections among medical practitioners warranting an urgent need for launching awareness and training on standard precautions for private medical practitioners in the slum areas of Karachi.

Keywords: injection practices, private practitioners, sharp injuries, blood borne infections

Procedia PDF Downloads 421

Authors: Hossein Barri Ghazani

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Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

Procedia PDF Downloads 163

Authors: Olurankinse Felix

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Local governments in Ondo State Nigeria are the third tier of government saddled with the responsibility of providing governance and economic services at the grassroots. To be able to do this, the Constitution of the Federal Republic of Nigeria provided that a proportion of Federation Account be allocated to them in addition to their internally generated revenue. From the allocation and other incidental sources of revenue, the local governments are expected to provide basic infrastructures and other social amenities to better the lots of the rural dwellers. Nevertheless, local governments’ performances in terms of provision of social amenities are without questioning and quite not encouraging. Assessing the performance of local governments in this period of dearth and scarcity of resources is highly indispensable more so that the activities of local governments’ staff are bedeviled and characterized with fraud, corruption and mismanagement. Considering the direct impact of the consequences of their action on the living standard of the rural dwellers therefore calls for the need to evaluate their level of performances using capital budgeting approach. The paper being a time series study adopts the survey design. Data were obtained through secondary source mainly from the Annual financial statements and publication of approved budgets estimates covering the period of study (2008-2012). The use of ratio analysis was employed in analyzing the comparative level of performances of the local governments under study. The result of the study shows that less than 30% of the local governments were able to harness the budgetary allocation to provide amenities to the beneficiaries while majority of the local governments were involved in unethical conduct ranging from theft of fund, corruption, diversion of funds and extra-budgetary activities. Also, there is poor internally generated revenue to complement the statutory allocation and besides, the monthly withholding of larger portions of local government share by the state in the name of joint account were also seen as contributory factors. The study recommends the need for transparency and accountability in public fund management through the oversight function of the state house of assembly. Also local government should be made to be autonomous and independent of the state by jettisoning the idea of joint account.

Keywords: performance, transparency and accountability, capital budgeting, joint account, local government autonomy

Procedia PDF Downloads 331

Authors: Nikitha Francis, Anjana Hoode, Vinitha George, Jayashree S. Bhat

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The interaction between cognition and language, referred as cognitive-communication, is very intricate, involving several mental processes such as perception, memory, attention, lexical retrieval, decision making, motor planning, self-monitoring and knowledge. Cognitive-communication disorders are difficulties in communicative competencies that result from underlying cognitive impairments of attention, memory, organization, information processing, problem solving, and executive functions. Traumatic brain injury (TBI) is an acquired, non - progressive condition, resulting in distinct deficits of cognitive communication abilities such as naming, word-finding, self-monitoring, auditory recognition, attention, perception and memory. Cognitive-communication intervention in TBI is individualized, in order to enhance the person’s ability to process and interpret information for better functioning in their family and community life. The present case report illustrates the cognitive-communicative behaviors and the intervention outcomes of an adult with TBI, who was brought to the Department of Audiology and Speech Language Pathology, with cognitive and communicative disturbances, consequent to road traffic accident. On a detailed assessment, she showed naming deficits along with perseverations and had severe difficulty in recalling the details of the accident, her house address, places she had visited earlier, names of people known to her, as well as the activities she did each day, leading to severe breakdowns in her communicative abilities. She had difficulty in initiating, maintaining and following a conversation. She also lacked orientation to time and place. On administration of the Manipal Manual of Cognitive Linguistic Abilities (MMCLA), she exhibited poor performance on tasks related to visual and auditory perception, short term memory, working memory and executive functions. She attended 20 sessions of cognitive-communication intervention which followed a domain-general, adaptive training paradigm, with tasks relevant to everyday cognitive-communication skills. Compensatory strategies such as maintaining a dairy with reminders of her daily routine, names of people, date, time and place was also recommended. MMCLA was re-administered and her performance in the tasks showed significant improvements. Occurrence of perseverations and word retrieval difficulties reduced. She developed interests to initiate her day-to-day activities at home independently, as well as involve herself in conversations with her family members. Though she lacked awareness about her deficits, she actively involved herself in all the therapy activities. Rehabilitation of moderate to severe head injury patients can be done effectively through a holistic cognitive retraining with a focus on different cognitive-linguistic domains. Selection of goals and activities should have relevance to the functional needs of each individual with TBI, as highlighted in the present case report.

Keywords: cognitive-communication, executive functions, memory, traumatic brain injury

Procedia PDF Downloads 347

Authors: Teja Joshi

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Laterality has shown to play a role in performance as well as injuries especially in unilateral sports disciplines. Uniquely, Artistic Gymnastics involves combination of unilateral, bilateral and complex multi-planer elements as well as gymnastics specific rotational preference. Therefore, this study was conducted to explore if any such preferences are associated with number of injuries in artistic gymnasts. To explore the association between lateral preferences, rotational preferences and injuries incidence in artistic gymnastics. Artistic gymnasts above 16 years of age, were invited to participate in an online survey. The survey included consent, lateral preference inventory, injury data collection according to anatomical locations and rotational preference for selected gymnastics elements performed on the floor exercise. SPSS version 24 was used to analyse Non-parametric data using Kruskal-Wallis (K- independent test) test. Multiple regression was performed to identify the predictor for injuries and their side in gymnasts. Total number of injuries per gymnast was associated with handedness (p value-0.049) and no significant association was noted for footdness (p value-0.207), eyedness (p value-0.491) and eardness (p value-0.798). Additionally, rotational preferences did not influence number of injuries (p value-0.521). In multiple regression, eyedness was identified as a predicting factor to determine the number of injuries. Rotational preferences were neither determined as a national strategy nor a product of lateral preference. Dominant hand had higher number of injuries in artistic gymnasts. Rotational preference is independent of laterality, number of injuries and nationality.

Keywords: sports injury, rotational preference, gymnastics, handedness

Procedia PDF Downloads 119

Authors: Nadia Zahra Karimi Khiavi, Amir Ghiami Rad

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Due to the high likelihood of injuries in karate, karatekas' injuries warrant special treatment. This study explores the prevalence of karate injuries in East Azerbaijan, Iran and provides a model for karatekas to use in the prevention of such injuries. This study employs a descriptive approach. Male and female participants with a brown belt or above in either control or non-control styles in East Azerbaijan province are included in the study's statistical population. A statistical sample size of 100 people was computed using the tools employed (smartpls), and the samples were drawn at random from all clubs in the province with the assistance of the Karate Board in order to give a model for the prevention of karate injuries. Information was gathered by means of a survey that made use of the Standard Questionnaire for Australian Sports Medicine Injury Reports. The information is presented in the form of tables and samples, and descriptive statistics were used to organise and summarise the data. Control and non-control independent t-tests were conducted using SPSS version 20, and structural equation modelling (pls) was utilised for injury prevention modelling at a 0.05 level of significance. The results showed that the most common areas of injury among the control groups were the upper limbs (46.15%), lower limbs (34.61%), trunk (15.38%), and head and neck (3.84%). The most common types of injuries were broken bones (34.61%), sprain or strain (23.13%), bruising and contusions (23.13%), trauma to the face and mouth (11.53%), and damage to the nerves (69.69%). Uncontrolled committees are most likely to sustain injuries to the head and neck (33.33%), trunk (25.92%), upper limbs (22.22%), and lower limbs (18.51%). The most common injuries were to the mouth and face (33.33%), dislocations and fractures (22.22%), aspirin and strain (22.22%), bruises and contusions (18.51%), and nerves (70%), in that order. Among those who practice control kata, injuries to the upper limb account for 45.83%, the lower limb for 41.666%, the trunk for 8.33%, and the head and neck for 4.166%. The most common types of injuries are dislocations and fractures (41.66 per cent), aspirin and strain (29.16 per cent), bruising and bruises (16.66 per cent), and nerves (12.5%). Injuries to the face and mouth were not reported among those practising the control kata. By far, the most common sites of injury for those practising uncontrolled kata were the lower limb (43.74%), upper limb (39.13%), trunk (13.14%), and head and neck (4.34%). The most common types of injuries were dislocations and fractures (34.82%), aspirin and strain (26.08%), bruises and contusions (21.73%), mouth and face (13.14%), and nerves. Teaching the concepts of cooling and warming (0.591) and enhancing the degree of safety in the sports environment (0.413) were shown to play the most essential roles in reducing sports injuries among karate practitioners of controlling and uncontrolled styles, respectively. Use of common sports gear (0.390), Modification of training programme principles (0.341), Formulation of an effective diet plan for athletes (0.284), Evaluation of athletes' physical anatomy, physiology, chemistry, and physics (0.247).

Keywords: sports injuries, karate, prevention, cooling and warming

Procedia PDF Downloads 101

Authors: Matthew J. I. Woolley, Gemma J. M. Read, Paul M. Salmon, Natassia Goode

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The significance of high consequence, workplace failures within construction continues to resonate with a combined average of 12 fatal incidents occurring daily throughout Australia, the United Kingdom, and the United States. Within the Australian construction domain, more than 35 serious, compensable injury incidents are reported daily. These alarming figures, in conjunction with the continued occurrence of fatal and serious, occupational injury incidents globally suggest existing approaches to incident analysis may not be achieving required injury prevention outcomes. One reason may be that, incident analysis methods used in construction have not kept pace with advances in the field of safety science and are not uncovering the full range system-wide contributory factors that are required to achieve optimal levels of construction safety performance. Another reason underpinning this global issue may also be the absence of information surrounding the construction operating and project delivery system. For example, it is not clear who shares the responsibility for construction safety in different contexts. To respond to this issue, to the author’s best knowledge, a first of its kind, control structure model of the construction industry is presented and then used to analyse a fatal construction incident. The model was developed by applying and extending the Systems Theoretic and Incident Model and Process method to hierarchically represent the actors, constraints, feedback mechanisms, and relationships that are involved in managing construction safety performance. The Causal Analysis based on Systems Theory (CAST) method was then used to identify the control and feedback failures involved in the fatal incident. The conclusions from the Coronial investigation into the event are compared with the findings stemming from the CAST analysis. The CAST analysis highlighted additional issues across the construction system that were not identified in the coroner’s recommendations, suggested there is a potential benefit in applying a systems theory approach to incident analysis in construction. The findings demonstrate the utility applying systems theory-based methods to the analysis of construction incidents. Specifically, this study shows the utility of the construction control structure and the potential benefits for project leaders, construction entities, regulators, and construction clients in controlling construction performance.

Keywords: construction project management, construction performance, incident analysis, systems thinking

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Authors: Shiva Rezaei, Seyed Jalal Hosseinimehr, Abbasali Karimpour Malekshah, Mansooreh Mirzaei, Fereshteh Talebpour Amiri, Mehryar Zargari

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Objective(s): Cyclophosphamide (CP), as an antineoplastic drug, is widely used in cancer patients, and liver toxicity is one of its complications. Sinapic acid (SA), as a natural phenylpropanoid, has antioxidant, anti-inflammatory, and anti-cancer properties. Materials and Methods: The purpose of the current study was to determine the protective effect of SA versus CP-induced liver toxicity. In this research, BALB/c mice were treated with SA (5 and 10 mg/kg) orally for one week, and CP (200 mg/kg) was injected on day 3 of the study. Oxidative stress markers, serum liver-specific enzymes, histopathological features, caspase-3, and nuclear factor kappa-B cells were then checked. Results: CP induced hepatotoxicity in mice and showed structural changes in liver tissue. CP significantly increased liver enzymes and lipid peroxidation and decreased glutathione. The immunoreactivity of caspase-3 and nuclear factor kappa-B cells was significantly increased. Administration of SA significantly maintained histochemical parameters and liver function enzymes in mice treated with CP. Immunohistochemical examination showed SA reduced apoptosis and inflammation. Conclusion: The data confirmed that SA with anti-apoptotic, anti-oxidative, and anti-inflammatory activities was able to preserve CP-induced liver injury in mice.

Keywords: apoptosis, cyclophosphamide, liver injury, inflammation, oxidative stress, sinapic acid

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Authors: Saleh N. Maodaa

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Background: Lead (Pb) is an environmental pollutant causing serious health problems, including impairment of reproduction. Visnagin (VIS) is a furanochromone with promising antioxidant and anti-inflammatory effects; however, its protective efficacy against Pb toxicity has not been investigated. Objective: This study evaluated the protective effect of VIS on Pb reproductive toxicity, impaired steroidogenesis and spermatogenesis, oxidative stress and inflammation. Methods: Rats received VIS (30 or 60 mg/kg) and 50 mg/kg lead acetate for 3 weeks, and blood and testes samples were collected. Results: Pb intoxication impaired the pituitary-testicular axis (PTA), manifested by the decreased serum levels of gonadotropins and testosterone. Pb decreased sperm count, motility and viability, increased sperm abnormalities, and downregulated the steroidogenesis markers StAR, CYP17A1, 3β-HSD and 17β-HSD in the testis of rats. VIS significantly increased serum gonadotropins and testosterone, alleviated sperm parameters and upregulated steroidogenesis. In addition, VIS decreased pro-inflammatory cytokines, testicular lipid peroxidation and DNA fragmentation, downregulated Bax, and enhanced antioxidants and Bcl-2 Conclusion: These results demonstrate the protective effect of VIS against Pb reproductive toxicity in rats. VIS improved serum gonadotropins and testosterone, enhanced steroidogenesis and spermatogenesis, and attenuated oxidative injury, inflammation and apoptosis. Therefore, VIS is a promising candidate for the protection against Pb-induced reproduction impairment.

Keywords: pituitary-gonadal axis, cytokines, DNA damage, apoptosis

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Authors: Joana PaScoa Pinheiro, David Goncalves Ferreira, Filipe Ramos, Joaquim Soares Do Brito, Samuel Martins, Marco Sarmento

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Introduction: The SARS-CoV-2 (COVID-19) pandemic was identified in January 2020 in China, in the city of Wuhan. The increase in the number of cases over the following months was responsible for the restructuring of hospitals and departments in order to accommodate admissions related to COVID-19. Essential services, such as trauma, had to readapt to maintain their functionality and thus guarantee quick and safe access in case of an emergency. Objectives: This study describes the impact of COVID-19 on a Level III Trauma Center and particularly on the clinical management of hospitalized patients with spine injuries. Study Design & Methods: This is a retrospective cohort study whose results were obtained through the medical records of patients with spine injuries who underwent surgical intervention in the years 2019 and 2020 (period from March 1st to December 31st). A comparison between the two groups was made. In the study patients with injuries in the context of trauma were included who underwent surgery in the periods previously described. Patients hospitalized with a spine injury in a non-traumatic context and/or were not surgically treated were excluded. Results: In total, 137 patients underwent trauma spine surgery of which 71 in 2019 (51.8%) were without significant differences in intergroup comparisons. The most frequent injury mechanism in 2019 was motor vehicle crash (47.9%) compared to 2020 which was of a person falling from a height between 2-4 meters (37.9%). Cervical trauma was reported to be the most frequent spine injury in both years. There was a significant decrease in the need for intensive care in 2020, 51.4% vs 30.3%, p = .015 and the number of complications was also lower in 2020 (1.35% vs 0.98%), including the number of deaths, being the difference marginally significant. There were no significant differences regarding time for presentation to surgery or in the total days of hospitalization. Conclusions: The restructuring made in the trauma unit at a Level III Trauma Center in the context of the current COVID-19 pandemic was effective, with no significant differences between the years of 2019 vs 2020 when compared with the time for presentation to surgery or the number of days of hospitalization. It was also found that lockdown rules in 2020 were probably responsible for the decrease in the number of road traffic accidents, which justifies a significant decrease in the need for intensive care as well as in the number of complications in patients hospitalized in the context of spine trauma.

Keywords: trauma, spine, impact, covid-19

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Authors: R. C. Law, Shirley Kang, T. Y. Hin, M. Z. Abdullah

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LED technology has been evolving aggressively in recent years from incandescent bulb during older days to as small as chip scale package. It will continue to stay bright in future. As such, there is tremendous pressure to stay competitive in the market by optimizing products to next level of performance and reliability with the shortest time to market. This changes the conventional way of product design and development to virtual prototyping by means of Computer Aided Engineering (CAE). It comprises of the deployment of Finite Element Method (FEM) and Computational Fluid Dynamic (CFD). FEM accelerates the investigation for early detection of failures such as crack, improve the thermal performance of system and enhance solder joint reliability. CFD helps to simulate the flow pattern of molding material as a function of different temperature, molding parameters settings to evaluate failures like voids and displacement. This paper will briefly discuss the procedures and applications of FEM in thermal stress, solder joint reliability and CFD of compression molding in LED CSP. Integration of virtual prototyping in product development had greatly reduced the time to market. Many successful achievements with minimized number of evaluation iterations required in the scope of material, process setting, and package architecture variant have been materialized with this approach.

Keywords: LED, chip scale packaging (CSP), computational fluid dynamic (CFD), virtual prototyping

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Authors: Akash Verma, Sujit Kumar Samanta

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This study examines a discrete-time Geo/G/1 queueing-inventory system attached with (s, Q) inventory policy. Assume that the customers follow the Bernoulli process on arrival. Each customer demands a single item with arbitrarily distributed service time. The inventory is replenished by an outside supplier, and the lead time for the replenishment is determined by a geometric distribution. There is a single server and infinite waiting space in this facility. Demands must wait in the specified waiting area during a stock-out period. The customers are served on a first-come-first-served basis. With the help of the embedded Markov chain technique, we determine the joint probability distributions of the number of customers in the system and the number of items in stock at the post-departure epoch using the Matrix Analytic approach. We relate the system length distribution at post-departure and outside observer's epochs to determine the joint probability distribution at the outside observer's epoch. We use probability distributions at random epochs to determine the waiting time distribution. We obtain the performance measures to construct the cost function. The optimum values of the order quantity and reordering point are found numerically for the variety of model parameters.

Keywords: discrete-time queueing inventory model, matrix analytic method, waiting-time analysis, cost optimization

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Authors: Linyu Wang, Mingjun Zhu, Jianhong Xiang, Hanyu Jiang

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Aiming at the problem that the spectral efficiency of hybrid precoding (HP) is too low in the current millimeter wave (mmWave) massive multiple input multiple output (MIMO) system, this paper proposes a digital joint equivalent channel hybrid precoding algorithm, which is based on the introduction of digital encoding matrix iteration. First, the objective function is expanded to obtain the relation equation, and the pseudo-inverse iterative function of the analog encoder is derived by using the pseudo-inverse method, which solves the problem of greatly increasing the amount of computation caused by the lack of rank of the digital encoding matrix and reduces the overall complexity of hybrid precoding. Secondly, the analog coding matrix and the millimeter-wave sparse channel matrix are combined into an equivalent channel, and then the equivalent channel is subjected to Singular Value Decomposition (SVD) to obtain a digital coding matrix, and then the derived pseudo-inverse iterative function is used to iteratively regenerate the simulated encoding matrix. The simulation results show that the proposed algorithm improves the system spectral efficiency by 10~20%compared with other algorithms and the stability is also improved.

Keywords: mmWave, massive MIMO, hybrid precoding, singular value decompositing, equivalent channel

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Authors: Gabriel P. Fife, Saeyong Lee, David M. O'Sullivan

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Introduction: Although investigations into injury characteristics are represented well in the literature, few have investigated the biomechanical characteristics associated with head impacts in Taekwondo. Therefore, the purpose of this study was to identify the kinematic characteristics of head impacts due to taekwondo kicks among non-elite practitioners. Participants: Male participants (n= 11, 175 + 5.3 cm, 71 + 8.3 kg) with 7.5 + 3.6 years of taekwondo training volunteered for this study. Methods: Participants were asked to perform five repetitions of each technique (i.e., turning kick, spinning hook kick, spinning back kick, front axe kick, and clench axe kick) aimed at the Hybrid III head with their dominant kicking leg. All participants wore a protective foot pad (thickness = 12 mm) that is commonly used in competition and training. To simulate head impact in taekwondo, the target consisted of a Hybrid III 50th Percentile Crash Test Dummy (Hybrid III) head (mass = 5.1 kg) and neck (fitted with taekwondo headgear) secured to an aluminum support frame and positioned to each athlete’s standing height. The Hybrid III head form was instrumented with a 500 g tri-axial accelerometer (PCB Piezotronics) mounted to the head center of gravity to obtain resultant linear accelerations (RLA). Rotational accelerations were collected using three angular rate sensors mounted orthogonally to each other (Diversified Technical Systems ARS-12 K Angular Rate Sensor). The accelerometers were interfaced via a 3-channel, battery-powered integrated circuit piezoelectric sensor signal conditioner (PCB Piezotronics) and connected to a desktop computer for analysis. Acceleration data were captured using LABVIEW Signal Express and processed in accordance with SAE J211-1 channel frequency class 1000. Head injury criteria values (HIC) were calculated using the VSRSoftware. A one-way analysis of variance was used to determine differences between kicks, while the Tukey HSD test was employed for pairwise comparisons. The level of significance was set to an effect size of 0.20. All statistical analyses were done using R 3.1.0. Results: A statistically significant difference was observed in RLA (p = 0.00075); however, these differences were not clinically meaningful (η² = 0.04, 95% CI: -0.94 to 1.03). No differences were identified with ROTA (p = 0.734, η² = 0.0004, 95% CI: -0.98 to 0.98). A statistically significant difference (p < 0.001) between kicks in HIC was observed, with a medium effect (η2= 0.08, 95% CI: -0.98 to 1.07). However, the confidence interval of this difference indicates uncertainty. Tukey HSD test identified differences (p < 0.001) between kicking techniques in RLA and HIC. Conclusion: This study observed head impact levels that were comparable to previous studies of similar objectives and methodology. These data are important as impact measures from this study may be more representative of impact levels experienced by non-elite competitors. Although the clench axe kick elicited a lower RLA, the ROTA of this technique was higher than levels from other techniques (although not large differences in reference to effect sizes). As the axe kick has been reported to cause severe head injury, future studies may consider further study of this kick important.

Keywords: Taekwondo, head injury, biomechanics, kicking

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Authors: Sait Ozsoy, Hacer Yasar Teke, Mustafa Dalgic, Cetin Ketenci, Ertugrul Gok, Kenan Karbeyaz, Azem Irez, Mesut Akyol

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Self-mutilating behavior or self-injury behavior (SIB) is defined as: intentional harm to one’s body without intends to commit suicide”. SIB cases are commonly seen in psychiatry and forensic medicine practices. Despite variety of SIB methods, cuts in the skin is the most common (70-97%) injury in this group of patients. Subjects with SIB have one or more other comorbidities which include depression, anxiety, depersonalization, and feeling of worthlessness, borderline personality disorder, antisocial behaviors, and histrionic personality. These individuals feel a high level of hostility towards themselves and their surroundings. Researches have also revealed a strong relationship between antisocial personality disorder, criminal behavior, and SIB. This study has retrospectively evaluated 6,599 autopsy cases performed at forensic medicine institutes of six major cities (Ankara, Izmir, Diyarbakir, Erzurum, Trabzon, Eskisehir) of Turkey in 2013. The study group consisted of all cases with SIB findings (psychopathic cuts, cigarette burns, scars, and etc.). The relationship between causes of death in the study group (SIB subjects) and the control group was investigated. The control group was created from subjects without signs of SIB. Mann-Whitney U test was used for age variables and Chi-square test for categorical variables. Multinomial logistic regression analysis was used in order to analyze group differences in respect to manner of death (natural, accident, homicide, suicide) and analysis of risk factors associated with each group was determined by the Binomial logistic regression analysis. This study used SPSS statistics 15.0 for all its statistical and calculation needs. The statistical significance was p <0.05. There was no significant difference between accidental and natural death among the groups (p=0.737). Also there was a unit increase in number of cuts in psychopathic group while number of accidental death decreased (95% CI: 0.941-0.993) by 0.967 times (p=0.015). In contrast, there was a significant difference between suicidal and natural death (p<0.001), and also between homicidal and natural death (p=0.025). SIB is often seen with borderline and antisocial personality disorder but may be associated with many psychiatric illnesses. Studies have shown a relationship between antisocial personality disorders with criminal behavior and SIB with suicidal behavior. In our study, rate of suicide, murder and intoxication was higher compared to the control group. It could be concluded that SIB can be used as a predictor of possibility of one’s harm to him/herself and other people.

Keywords: autopsy, cause of death, forensic science, self-injury behaviour

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Authors: M. Saard, A. Kolk, K. Sepp, L. Pertens, L. Reinart, C. Kööp

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Introduction: Social competence is often impaired in children with acquired brain injury (ABI), but evidence-based rehabilitation for social skills has remained undeveloped. Modern technology-based methods create effective and safe learning environments for pediatric social skills remediation. The aim of the study was to implement our structured model of neuro rehab for socio-cognitive deficit using multitouch-multiuser tabletop (MMT) computer-based platforms and virtual reality (VR) technology. Methods: 40 children aged 8-13 years (yrs) have participated in the pilot study: 30 with ABI -epilepsy, traumatic brain injury and/or tic disorder- and 10 healthy age-matched controls. From the patients, 12 have completed the training (M = 11.10 yrs, SD = 1.543) and 20 are still in training or in the waiting-list group (M = 10.69 yrs, SD = 1.704). All children performed the first individual and paired assessments. For patients, second evaluations were performed after the intervention period. Two interactive applications were implemented into rehabilitation design: Snowflake software on MMT tabletop and NoProblem on DiamondTouch Table (DTT), which allowed paired training (2 children at once). Also, in individual training sessions, HTC Vive VR device was used with VR metaphors of difficult social situations to treat social anxiety and train social skills. Results: At baseline (B) evaluations, patients had higher deficits in executive functions on the BRIEF parents’ questionnaire (M = 117, SD = 23.594) compared to healthy controls (M = 22, SD = 18.385). The most impaired components of social competence were emotion recognition, Theory of Mind skills (ToM), cooperation, verbal/non-verbal communication, and pragmatics (Friendship Observation Scale scores only 25-50% out of 100% for patients). In Sentence Completion Task and Spence Anxiety Scale, the patients reported a lack of friends, behavioral problems, bullying in school, and social anxiety. Outcome evaluations: Snowflake on MMT improved executive and cooperation skills and DTT developed communication skills, metacognitive skills, and coping. VR, video modelling and role-plays improved social attention, emotional attitude, gestural behaviors, and decreased social anxiety. NEPSY-II showed improvement in Affect Recognition [B = 7, SD = 5.01 vs outcome (O) = 10, SD = 5.85], Verbal ToM (B = 8, SD = 3.06 vs O = 10, SD = 4.08), Contextual ToM (B = 8, SD = 3.15 vs O = 11, SD = 2.87). ToM Stories test showed an improved understanding of Intentional Lying (B = 7, SD = 2.20 vs O = 10, SD = 0.50), and Sarcasm (B=6, SD = 2.20 vs O = 7, SD = 2.50). Conclusion: Neurorehabilitation based on the Structured Model of Neurorehab for Socio-Cognitive Deficit in children with ABI were effective in social skills remediation. The model helps to understand theoretical connections between components of social competence and modern interactive computerized platforms. We encourage therapists to implement these next-generation devices into the rehabilitation process as MMT and VR interfaces are motivating for children, thus ensuring good compliance. Improving children’s social skills is important for their and their families’ quality of life and social capital.

Keywords: acquired brain injury, children, social skills deficit, technology-based neurorehabilitation

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Authors: Nikita Pasricha, Karen Smith, Simone Marshall, Vincent DePaul, Jessica Trier

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Understanding that physical activity in rehabilitation programs shapes outcomes in acquired brain injury (ABI) populations is not a new concept. However, there is a void in understanding the physical activity patterns of inpatients in ABI rehabilitation, the trajectory of physical activity recovery, and factors that contribute to the recovery of physical activity over the initial months post-ABI. The purpose of this study was to determine if physical activity patterns vary in people with recent ABI in inpatient rehabilitation. The study also investigated differences in physical activity patterns in ABI patients compared to age-related healthy participants. Results revealed that ABI patients spent approximately 6.7 times longer per day in sedentary postures than in active positions. In comparison, the control group spent only 2.8 times longer in sedentary postures compared to active positions. Patients with ABI took significantly fewer steps than age-matched health control participants. Within the ABI population, patients took 0.78 times fewer steps on weekends compared to weekdays. Participants with greater mobility limitations had a greater difference in WD to WE steps taken. Potential reasons could be from no structured weekend rehabilitation programs, lower availability of staff, or varying schedules. Given that the rehabilitation program is only structured on weekdays, further research to investigate the benefits of structured physical activities like group walking programs on weekends for ABI patients in inpatient rehabilitation programs is warranted.

Keywords: brain, ABI, TBI, rehabilitation

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Authors: Maryam Ghoreishi, Christian Larsen

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In this paper, we investigate the effect of stochastic inputs on problem of joint optimal pricing and lot-sizing decisions where the inventory cycle is divided into advance and spot sales periods. During the advance sales period, customer can make reservations while customer with reservations can cancel their order. However, during the spot sales period customers receive the order as soon as the order is placed, but they cannot make any reservation or cancellation during that period. We assume that the inter arrival times during the advance sales and spot sales period are exponentially distributed where the arrival rate is decreasing function of price. Moreover, we assume that the number of cancelled reservations is binomially distributed. In addition, we assume that deterioration process follows an exponential distribution. We investigate two cases. First, we consider two-state case where we find the optimal price during the spot sales period and the optimal price during the advance sales period. Next, we develop a generalized case where we extend two-state case also to allow dynamic prices during the spot sales period. We apply the Markov decision theory in order to find the optimal solutions. In addition, for the generalized case, we apply the policy iteration algorithm in order to find the optimal prices, the optimal lot-size and maximum advance sales amount.

Keywords: inventory control, pricing, Markov decision theory, advance sales system

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Authors: A. M. Halahla, M. H. Baluch, M. K. Rahman, A. H. Al-Gadhib, M. N. Akhtar

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In the present study, 3D simulation of a typical exterior (RC) beam–column joint (BCJ) strengthened with carbon fiber-reinforced plastic (CFRP) sheet are carried out. Numerical investigations are performed using a nonlinear finite element ( FE) analysis by incorporating damage plasticity model (CDP), for material behaviour the concrete response in compression, tension softening were used, linear plastic with isotropic hardening for reinforcing steel, and linear elastic lamina material model for CFRP sheets using the commercial FE software ABAQUS. The numerical models developed in the present study are validated with the results obtained from the experiment under monotonic loading using the hydraulic Jack in displacement control mode. The experimental program includes casting of deficient BCJ loaded to failure load for both un-strengthened and strengthened BCJ. The failure mode, and deformation response of CFRP strengthened and un-strengthened joints and propagation of damage in the components of BCJ are discussed. Finite element simulations are compared with the experimental result and are noted to yield reasonable comparisons. The damage plasticity model was able to capture with good accuracy of the ultimate load and the mode of failure in the beam column joint.

Keywords: reinforced concrete, exterior beam-column joints, concrete damage plasticity model, computational simulation, 3-D finite element model

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