Search results for: analysis of joint wrist injury
Commenced in January 2007
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Edition: International
Paper Count: 29144

Search results for: analysis of joint wrist injury

28334 Work-Related Musculoskeletal Disorders Among Malaysian Office Workers in Klang Valley

Authors: Mohd Fadzly Yahya, Matthew Teo Yong Chang

Abstract:

Globally, the increasing life expectancy of human beings has brought more issues with non-communicable diseases, especially work-related musculoskeletal disorders (WMDs). WMSD also is one of the leading causes of health-related absence from work restricted work time in Malaysia. WMDs are cumulative disorders, resulting from repeated exposure to high or low-intensity loads over a long period. Evidence from a previous study showed that office workers in government and private sectors were showing high WRMDs prevalence in Malaysia. The objectives of this study were to determine the prevalence of MSDs among Malaysian office workers in Klang Valley and to identify the association between MSDs pain and working experience among office workers. This is a cross-sectional study focusing on officer workers in the Klang Valley area. The questionnaires consisted of the subject’s demographics, Nordic Musculoskeletal Questionnaire, and The Numeric Pain Rating Scale were distributed online via google forms to all consenting participants. The data were analyzed for descriptive analysis, parametric test, and student T-test using IBM SPSS Statistics Version 27. From a total of 244 participants, 95 (38.9%) were male and 149 (61.1%) were female. 57.8% of the total samples were government staff while private-sector workers were 42.2%. The highest MSDs prevalence was neck pain during the last 12 months which contributed to 69.3% (n=169) of total participants, which is male 38.5% (n=65) and female 61.5% (n=104). Our study revealed that female office workers have a higher prevalence of WMDs and there is a significant difference in elbow pain, wrist, and hands pain, and lower back pain across four different working experience groups. Office workers in this study were highly exposed to MSDs due to poor ergonomics implementation at the workplace. It is crucial to advocate preventative measures to employers such as workplace ergonomics and changes to work practices to reduce the incidence of MSDs cases in office settings.

Keywords: musculoskeletal disorders, pain, prevalence rate, office workers, risks

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28333 Aging and Falls Profile from Hospital Databases

Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

Abstract:

Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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28332 Coupled Analysis with Fluid and Flexible Multibody Dynamics of 6-DOF Platform with Liquid Sloshing Tank

Authors: Sung-Pill Kim, Dae-Gyu Sung, Hee-Sung Shin, Jong-Chun Park

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When a sloshing tank filled partially with liquid is excited with the motion of platform, it can be observed that the center of mass inside the tank is changed and impact loads is instantaneously applied to the wall, which causes dynamic loads additionally to the supporting links of platform. In this case, therefore, the dynamic behavior of platform associated with fluid motion should be considered in the early stage of design for safety and economics of the system. In this paper, the dynamic loads due to liquid sloshing motion in a rectangular tank which is loaded up on the upper deck of a Stewart platform are simulated using a coupled analysis of Moving Particle Simulation (MPS) and Flexible Multi-Body Dynamics (FMBD). The co-simulation is performed using two commercial softwares, Recurdyn for solving FMBD and Particleworks for analyzing fluid motion based on MPS method. For validating the present coupled system, a rectangular sloshing tank being enforced with inline sway motion by 1-DOF motion platform is assumed, and time-varied free-surface elevation and reaction force at a fixed joint are compared with experiments.

Keywords: dynamic loads, liquid sloshing tank, Stewart platform, moving particle semi-implicit (MPS) method, flexible multi-body dynamics (FMBD)

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28331 Biomechanical Evaluation of the Chronic Stroke with 3D-Printed Hand Device

Authors: Chen-Sheng Chen, Tsung-Yi Huang, Pi-Chang Sun

Abstract:

Chronic stroke patients often have complaints about hand dysfunction due to flexor hypertonia and extensor weakness, which makes it difficult to open their affected hand for functional grasp. Hand rehabilitation after stroke is essential for restoring functional independence. Constraint-induced movement therapy has shown to be a successful treatment for patients who have acquired certain level of wrist and finger extension. The goal of this study was to investigate the feasibility of task-oriented approach incorporating 3D-printed dynamic hand device by evaluating hand functional performance. This study manufactured a hand device using 3d printer for chronic stroke. The experimental group engaged task-oriented approach with dynamic hand device, but the control group only received task-oriented approach. Outcome measurements include palmar pinch force (PPF), lateral pinch force (LPF), grip force (GF), and Box and Blocks Test (BBT). The results of study revealed the improvement of PPF in experimental group but not in control group. Meanwhile, improvement in LPF, GF and BBT can be found in both groups. This study demonstrates that the 3D-printed dynamic hand device is an effective therapeutic assistive device to improve pinch force, grasp force, and dexterity and facilitate motivation during home program in individuals with chronic stroke.

Keywords: 3D printing, biomechanics, hand orthosis, stroke

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28330 Cricket Shot Recognition using Conditional Directed Spatial-Temporal Graph Networks

Authors: Tanu Aneja, Harsha Malaviya

Abstract:

Capturing pose information in cricket shots poses several challenges, such as low-resolution videos, noisy data, and joint occlusions caused by the nature of the shots. In response to these challenges, we propose a CondDGConv-based framework specifically for cricket shot prediction. By analyzing the spatial-temporal relationships in batsman shot sequences from an annotated 2D cricket dataset, our model achieves a 97% accuracy in predicting shot types. This performance is made possible by conditioning the graph network on batsman 2D poses, allowing for precise prediction of shot outcomes based on pose dynamics. Our approach highlights the potential for enhancing shot prediction in cricket analytics, offering a robust solution for overcoming pose-related challenges in sports analysis.

Keywords: action recognition, cricket. sports video analytics, computer vision, graph convolutional networks

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28329 Turkey-Syria Relations between 2002-2011 from the Perspective of Social Construction

Authors: Didem Aslantaş

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In this study, the reforms carried out by the Justice and Development Party, which came to power in 2002, and how the foreign policy understanding it transformed reflected on the relations with Syria will be analyzed from the social constructivist theory. Contrary to the increasing security concerns of the states after the September 11 attacks, the main problem of the research is how the relations between Syria and Turkey developed and how they progressed in non-security dimensions. In order to find an answer to this question, the basic assumptions of the constructivist theory will be used. Since there is a limited number of studies in the literature, a comparative analysis of the Adana Consensus and the Cooperation Agreement between the Republic of Turkey and the Syrian Arab Republic, and the Joint Cooperation Agreement Against Terrorism and Terrorist Organizations will be included. In order to answer the main problem of the research and to support the arguments, document and archive scanning methods from qualitative research methods will be used. In the first part of the study, what the social constructivist theory is and its basic assumptions are explained, while in the second part, Turkey-Syria relations between 2002-2011 are included. In the third and last part, the relations between the two countries will be tried to be read through social constructivism by referring to the foreign policy features of the Ak Party period.

Keywords: Social Constructivist Theory, foreign policy analysis, Justice and Development Party, Syria

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28328 The Relationship between Fight-Flight-Freeze System, Level of Expressed Emotion in Family, and Emotion Regulation Difficulties of University Students: Comparison Experienced to Inexperienced Non-Suicidal Self-Injury Students (NSSI)

Authors: Hyojung Shin, Munhee Kweon

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Non-suicide Self Injuri (NSSI) can be defined as the act of an individual who does not intend to die directly and intentionally damaging his or her body tissues. According to a study conducted by the Korean Ministry of Education in 2018, the NSSI is widely spreading among teenagers, with 7.9 percent of all middle school students and 6.4 percent of high school students reporting experience in NSSI. As such, it is understood that the first time of the NSSI is in adolescence. However, the NSSI may not start and stop at a certain time, but may last longer. However, despite the widespread prevalence of NSSI among teenagers, little is known about the process and maintenance of NSSI college students on a continuous development basis. Korea's NSSI research trends are mainly focused on individual internal vulnerabilities (high levels of painful emotions/awareness, lack of pain tolerance) and interpersonal vulnerabilities (poor communication skills and social problem solving), and little studies have been done on individuals' unique characteristics and environmental factors such as substrate or environmental vulnerability factors. In particular, environmental factors are associated with the occurrence of NSSI by acting as a vulnerability factor that can interfere with the emotional control of individuals, whereas individual factors play a more direct role by contributing to the maintenance of NSSI, so it is more important to consider this for personal environmental involvement in NSSI. This study focused on the Fight-Flight-Freeze System as a factor in the defensive avoidance system of Reward Sensitivity in individual factors. Also, Environmental factors include the level of expressed emotion in family. Wedig and Nock (2007) said that if parents with a self-critical cognitive style take the form of criticizing their children, the experience of NSSI increases. The high level of parental criticism is related to the increasing frequency of NSSI acts as well as to serious levels of NSSI. If the normal coping mechanism fails to control emotions, people want to overcome emotional difficulties even through NSSI, and emotional disturbances experienced by individuals within an unsupported social relationship increase vulnerability to NSSI. Based on these theories, this study is to find ways to prevent NSSI and intervene in counseling effectively by verifying the differences between the characteristics experienced NSSI persons and non-experienced NSSI persons. Therefore, the purpose of this research was to examine the relationship of Fight-Flight-Freeze System (FFFS), level of expressed emotion in family and emotion regulation difficulties, comparing those who experienced Non-Suicidal Self-Injury (NSSI) with those who did not experienced Non-Suicidal Self-Injury (NSSI). The data were collected from university students in Seoul Korea and Gyeonggi-do province. 99 subjects were experienced student of NSSI, while 375 were non- experienced student of NSSI. The results of this study are as follows. First, the result of t-test indicated that NSSI attempters showed a significant difference in fight-flight-freeze system, level of expressed emotion and emotion regulation difficulties, compared with non-attempters. Second, fight-flight-freeze system, level of expressed emotion in family and emotion regulation difficulties of NSSI attempters showed a significant difference in correlation. The correlation was significant only freeze system of fight-flight-freeze system, Level of expressed emotion in family and emotion regulation difficulties. Third, freeze system and level of expressed emotion in family predicted emotion regulation difficulties of NSSI attempters. Fight-freeze system and level of expressed emotion in family predicted emotion regulation difficulties of non-NSSI attempters. Lastly, Practical implications for counselors and limitations of this study are discussed.

Keywords: fight-flight-freeze system, level of expressed emotion in family, emotion regulation difficulty, non-suicidal self injury

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28327 The Influence of Fiber Fillers on the Bonding Safety of Structural Adhesives: A Fracture Analytical Evaluation

Authors: Brandtner-Hafner Martin

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Adhesives have established themselves as an innovative joining technology in the industry. Their strengths lie in joining different materials, avoiding structural weakening as in welding or screwing, and enabling lightweight construction methods. Now there are a variety of ways to improve the efficiency and effectiveness of bonded joints. One way is to add fiber fillers. This leads to an improvement in adhesion and cohesion (structural integrity). In this study, the effectiveness of fiber-modified adhesives for bonding different construction materials is reviewed. A series of experimental tests were performed using the fracture analytical GF principle to study the adhesive bonding safety and performance of the joint. Three different structural adhesive systems based on epoxy, CA/A hybrid, and PUR were modified with different fiber materials on different substrates. The results show that significant performance improvements can be achieved and that bonding reliability can be sustainably increased.

Keywords: fiber-modified adhesives, bonding safety, GF-principle, fracture analysis

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28326 Partnerships between Public Administration and Private Social Investment for Territorial Development: Lessons after 15 Brazilian Cases

Authors: Graziela D. de Azevedo, Livia M. Pagotto, Mario P. Monzoni, Neto

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This article aims to discuss partnerships between public administration and private social investment aimed at territorial development. There has been some approximation in Brazil from private social investors with initiatives aiming at territorial development policies in highly vulnerable territories or in places where the business sector operates. This represents this paper’s major justification: on the advance of academic debate about how businesses, institutes, and foundations have been working alongside local governments, taking the territory as the reference for joint action. The research was based on the literature on governance and territorial development and adopted a mixed iterative approach (inductive and deductive) through an interpretative lens so as to develop an analysis structure that complements and expands knowledge about the contribution of public policies and private social investments for territorial development in Brazil. The analysis of 15 cases based on three distinct blocks (territorial development plans, articulation for education, and thematic approaches) has made it possible to identify common elements regarding the motivations of partnerships, the specific needs of the actors involved, and the priority drivers for stimulating development. Findings include discussion on the leading role of territories in their development paths, on the institutionalization and strengthening of capacities, and on long-term perspectives in development strategies.

Keywords: private social investment, public administration, territorial governance, territorial development

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28325 Macroscopic Anatomy of the Nutrient Foramina of Human Scaphoid Bone

Authors: B. V. Murlimanju

Abstract:

Background: Scaphoid bone is commonly fractured among all the bones of the wrist. The fracture can damage the arteries and would cause avascular necrosis of the scaphoid. In this present study, the goal was to study the topography and number of nutrient foramina in the scaphoid bones of South Indian population. Methods: We studied 46 human scaphoid bones, among them 20 were left sided and 26 belonged to the right side. The scaphoid bones were available at the department of anatomy of our institution. The scaphoid bones were macroscopically observed for the topography and number of nutrient foramina. The data was collected, tabulated and analyzed. Results: The nutrient foramina were observed in all the scaphoid bones (100%). The locations of the foramina were over the non-articular surfaces in all these scaphoids. They were distributed over the palmar and dorsal surfaces. The foramina were found proximal as well as distal to the mid waist of the scaphoid bone. Their number ranged between 9 and 54 in each scaphoid bone. The number ranged between 2-24 over the palmar surface and 7-36 over the dorsal surface. They ranged between 2-24 proximal to the waist and 3-39 distal to the waist. Conclusion: The knowledge of arterial supply, topography of nutrient foramen and their number is essential to understand the concepts of avascular necrosis of scaphoid bone. It will be enlightening to understand the non-union of the fracture of waist of the scaphoid. The morphological data is required to the operating hand surgeon. We do believe that the present study has provided additional information about the topography and number of nutrient foramina of the human scaphoid bones.

Keywords: avascular necrosis, nutrient foramen, scaphoid, vascular

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28324 Barrier to Implementing Public-Private Mix Approach for Tuberculosis Case Management in Nepal

Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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28323 New Technologies in Corporate Finance Management in the Digital Economy: Case of Kyrgyzstan

Authors: Marat Kozhomberdiev

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The research will investigate the modern corporate finance management technologies currently used in the era of digitalization of the global economy and the degree to which financial institutions are utilizing these new technologies in the field of corporate finance management in Kyrgyzstan. The main purpose of the research is to reveal the role of financial management technologies as joint service centers, intercompany banks, specialized payment centers in the third-world country. Particularly, the analysis of the implacability of automated corporate finance management systems such as enterprise resource planning system (ERP) and treasury management system (TMS) will be carried out. Moreover, the research will investigate the role of cloud accounting systems in corporate finance management in Kyrgyz banks and whether it has any impact on the field of improving corporate finance management. The study will utilize a data collection process via surveying 3 banks in Kyrgyzstan, namely Mol-Bulak, RSK, and KICB. The banks were chosen based on their ownerships, such as state banks, private banks with local authorized capital, and private bank with international capital. The regression analysis will be utilized to reveal the correlation between the ownership of the bank and the use of new financial management technologies. The research will provide policy recommendations to both private and state banks on developing strategies for switching and utilizing modern corporate finance management technologies in their daily operations.

Keywords: digital economy, corporate finance, digital environment, digital technologies, cloud technologies, financial management

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28322 Design, Analysis and Obstacle Avoidance Control of an Electric Wheelchair with Sit-Sleep-Seat Elevation Functions

Authors: Waleed Ahmed, Huang Xiaohua, Wilayat Ali

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The wheelchair users are generally exposed to physical and psychological health problems, e.g., pressure sores and pain in the hip joint, associated with seating posture or being inactive in a wheelchair for a long time. Reclining Wheelchair with back, thigh, and leg adjustment helps in daily life activities and health preservation. The seat elevating function of an electric wheelchair allows the user (lower limb amputation) to reach different heights. An electric wheelchair is expected to ease the lives of the elderly and disable people by giving them mobility support and decreasing the percentage of accidents caused by users’ narrow sight or joystick operation errors. Thus, this paper proposed the design, analysis and obstacle avoidance control of an electric wheelchair with sit-sleep-seat elevation functions. A 3D model of a wheelchair is designed in SolidWorks that was later used for multi-body dynamic (MBD) analysis and to verify driving control system. The control system uses the fuzzy algorithm to avoid the obstacle by getting information in the form of distance from the ultrasonic sensor and user-specified direction from the joystick’s operation. The proposed fuzzy driving control system focuses on the direction and velocity of the wheelchair. The wheelchair model has been examined and proven in MSC Adams (Automated Dynamic Analysis of Mechanical Systems). The designed fuzzy control algorithm is implemented on Gazebo robotic 3D simulator using Robotic Operating System (ROS) middleware. The proposed wheelchair design enhanced mobility and quality of life by improving the user’s functional capabilities. Simulation results verify the non-accidental behavior of the electric wheelchair.

Keywords: fuzzy logic control, joystick, multi body dynamics, obstacle avoidance, scissor mechanism, sensor

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28321 Effect of Welding Current on Mechanical Properties and Microstructure of Tungsten Inert Gas Welding of Type-304 Austenite Stainless Steel

Authors: Emmanuel Ogundimu, Esther Akinlabi, Mutiu Erinosho

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The aim of this paper is to study the effect of welding current on the microstructure and the mechanical properties. Material characterizations were conducted on a 6 mm thick plates of type-304 austenite stainless steel, welded by TIG welding process at two different welding currents of 150 A (Sample F3) and 170 A (Sample F4). The tensile strength and the elongation obtained from sample F4 weld were approximately 584 MPa and 19.3 %; which were higher than sample F3 weld. The average microhardness value of sample F4 weld was found to be 235.7 HV, while that of sample F3 weld was 233.4 HV respectively. Homogenous distribution of iron (Fe), chromium (Cr) and nickel (Ni) were observed at the welded joint of the two samples. The energy dispersive spectroscopy (EDS) analysis revealed that Fe, Cr, and Ni made up the composition formed in the weld zone. The optimum welding current of 170 A for TIG welding of type-304 austenite stainless steel can be recommended for high-tech industrial applications.

Keywords: microhardness, microstructure, tensile, MIG welding, process, tensile, shear stress TIG welding, TIG-MIG welding

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28320 Effect of Hydroxy Propyl Methyl Cellulose (HPMC) Coating in Combination with MGSO4 on Some Guava Cultivars

Authors: Muhammad Randhawa, Muhammad Nadeem

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Guava (Psidium guajava L.) is a vital source of minerals, vitamins, dietary fiber and antioxidants. Owing to highly perishable nature and proning towards chilling injury, diseases, insect-pests and physical damage the main drawbacks of guava after harvesting, present study was designed. Due to its delicacy in physiology, economic importance, effects of pre and postharvest factors and maturity indices, guava fruits should be given prime importance for good quality attributes. In this study guava fruits were stored at 10°C with 80% relative humidity after treating with different levels of sulphate salt of magnesium followed by dipping in cellulose based edible coating hydroxy propyl methyl cellulose (HPMC). The main objective of this coating was to enhance the shelf life of guava by inhibiting the respiration and also by binding the dissolved solids with salt application. Characterization for quality attributes including physical, physiological and bio chemical analysis was performed after every 7 days interval till the fruit remains edible during the storage period of 4 weeks. Finally, data obtained was subjected to statistical analysis. It was concluded on statistical basis that Surahi variety (treated with 5% MgSO4) showed best storage stability and kept its original quality up to almost 23 days during storage.

Keywords: edible coating, guava cultivars, physicochemical attributes, storage

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28319 Seismic Behavior of Self-Balancing Post-Tensioned Reinforced Concrete Spatial Structure

Authors: Mircea Pastrav, Horia Constantinescu

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The construction industry is currently trying to develop sustainable reinforced concrete structures. In trying to aid in the effort, the research presented in this paper aims to prove the efficiency of modified special hybrid moment frames composed of discretely jointed precast and post-tensioned concrete members. This aim is due to the fact that current design standards do not cover the spatial design of moment frame structures assembled by post-tensioning with special hybrid joints. This lack of standardization is coupled with the fact that previous experimental programs, available in scientific literature, deal mainly with plane structures and offer little information regarding spatial behavior. A spatial model of a modified hybrid moment frame is experimentally analyzed. The experimental results of a natural scale model test of a corner column-beams sub-structure, cut from an actual multilevel building tested to seismic type loading are presented in order to highlight the behavior of this type of structure. The test is performed under alternative cycles of imposed lateral displacements, up to a storey drift ratio of 0.035. Seismic response of the spatial model is discussed considering the acceptance criteria for reinforced concrete frame structures designed based on experimental tests, as well as some of its major sustainability features. The results obtained show an overall excellent behavior of the system. The joint detailing allows for quick and cheap repairs after an accidental event and a self-balancing behavior of the system that ensures it can be used almost immediately after an accidental event it.

Keywords: modified hybrid joint, seismic type loading response, self-balancing structure, acceptance criteria

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28318 Arthroscopic Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon (LHBT)

Authors: Ho Sy Nam, Tang Ha Nam Anh

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Background: Rotator cuff tears are a common problem in the aging population. The prevalence of massive rotator cuff tears varies in some studies from 10% to 40%. Of irreparable rotator cuff tears (IRCTs), which are mostly associated with massive tear size, 79% are estimated to have recurrent tears after surgical repair. Recent studies have shown that superior capsule reconstruction (SCR) in massive rotator cuff tears can be an efficient technique with optimistic clinical scores and preservation of stable glenohumeral stability. Superior capsule reconstruction techniques most commonly use either fascia lata autograft or dermal allograft, both of which have their own benefits and drawbacks (such as the potential for donor site issues, allergic reactions, and high cost). We propose a simple technique for superior capsule reconstruction that involves using the long head of the biceps tendon as a local autograft; therefore, the comorbidities related to graft harvesting are eliminated. The long head of the biceps tendon proximal portion is relocated to the footprint and secured as the SCR, serving to both stabilize the glenohumeral joint and maintain vascular supply to aid healing. Objective: The purpose of this study is to assess the clinical outcomes of patients with large to massive RCTs treated by SCR using LHBT. Materials and methods: A study was performed of consecutive patients with large to massive RCTs who were treated by SCR using LHBT between January 2022 and December 2022. We use one double-loaded suture anchor to secure the long head of the biceps to the middle of the footprint. Two more anchors are used to repair the rotator cuff using a single-row technique, which is placed anteriorly and posteriorly on the lateral side of the previously transposed LHBT. Results: The 3 men and 5 women had an average age of 61.25 years (range 48 to 76 years) at the time of surgery. The average follow-up was 8.2 months (6 to 10 months) after surgery. The average preoperative ASES was 45.8, and the average postoperative ASES was 85.83. The average postoperative UCLA score was 29.12. VAS score was improved from 5.9 to 1.12. The mean preoperative ROM of forward flexion and external rotation of the shoulder was 720 ± 160 and 280 ± 80, respectively. The mean postoperative ROM of forward flexion and external rotation were 1310 ± 220 and 630 ± 60, respectively. There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Conclusion: SCR using LHBT is considered a treatment option for patients with large or massive RC tears. It can restore superior glenohumeral stability and function of the shoulder joint and can be an effective procedure for selected patients, helping to avoid progression to cuff tear arthropathy.

Keywords: superior capsule reconstruction, large or massive rotator cuff tears, the long head of the biceps, stabilize the glenohumeral joint

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28317 Predictors of Post-marketing Regulatory Actions Concerning Hepatotoxicity

Authors: Salwa M. Almomen, Mona A. Almaghrabi, Saja M. Alhabardi, Adel A. Alrwisan

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Background: Hepatotoxicity is a major reason for medication withdrawal from the markets. Unfortunately, serious adverse hepatic effects can occur after marketing with limited indicators during clinical development. Therefore, finding possible predictors for hepatotoxicity might guide the monitoring program of various stakeholders. Methods: We examined the clinical review documents for drugs approved in the US from 2011 to 2016 to evaluate their hepatic safety profile. Predictors: we assessed whether these medications meet Hy’s Law with hepatotoxicity grade ≥ 3, labeled hepatic adverse effects at approval, or accelerated approval status. Outcome: post-marketing regulatory action related to hepatotoxicity, including product withdrawal or updates to warning, precaution, or adverse effects sections. Statistical analysis: drugs were included in the analysis from the time of approval until the end of 2019 or the first post-marketing regulatory action related to hepatotoxicity, whichever occurred first. The hazard ratio (HR) was estimated using Cox-regression analysis. Results: We included 192 medications in the study. We classified 48 drugs as having grade ≥ 3 hepatotoxicities, 43 had accelerated approval status, and 74 had labeled information about hepatotoxicity prior to marketing. The adjusted HRs for post-marketing regulatory action for products with grade ≥ 3 hepatotoxicity was 0.61 (95% confidence interval [CI], 0.17-2.23), 0.92 (95%CI, 0.29-2.93) for a drug approved via accelerated approval program, and was 0.91 (95%CI, 0.33-2.56) for drugs with labeled hepatotoxicity information at approval time. Conclusion: This study does not provide conclusive evidence on the association between post-marketing regulatory action and grade ≥ 3 hepatotoxicity, accelerated approval status, or availability of labeled information at approval due to sampling size and channeling bias.

Keywords: accelerated approvals, hepatic adverse effects, drug-induced liver injury, hepatotoxicity predictors, post-marketing withdrawal

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28316 Curcumin Derivatives as Potent Inhibitors of Inducible Nitric Oxide Synthase in Osteoarthritis: A Molecular Docking Study

Authors: F. Ambreen, A.Naheed

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Osteoarthritis (OA) is a degenerative disorder affecting millions of people worldwide. Nitric oxide (NO) was found to play a catabolic role in the development of osteoarthritis. It is a toxic free radical gas generated during the metabolism of L-arginine by the enzyme Nitric oxide synthase (NOS). Inducible Nitric Oxide Synthase (iNOS) is one of the isoform of NOS, and its overexpression leads to the excessive formation of NO that results in pathophysiological joint conditions. Several synthetic anti-inflammatory drugs and inhibitors are present to date, but all showed side effects and complications. Therefore, the pursuit of natural disease-modifying drugs remains a top priority. Curcumin is an active component of turmeric, and the past few decades have witnessed intense research devoted to the antioxidant and anti-inflammatory properties of curcumin. The present study focused on curcumin and its derivatives in the search for new iNOS inhibitors for the treatment of osteoarthritis. We conducted a molecular docking study on curcumin and its four derivatives; cyclocurcumin, tetrahydrocurcumin, demethoxycurcumin and curcumin monoglucoside with iNOS using CLC Drug discovery work bench 3.02. We selected two co-crystallized ligands for this study; tetrahydrobiopterin and N-omega-propyl-L-arginine present in complex with the enzyme iNOS. Results showed the best binding affinity of N-omega-propyl-L-arginine with cyclocurcumin and curcumin monoglucoside that exhibit binding energies of -65.2 kcal/mol and -68 kcal/mol respectively. Whereas with tetrahydrobiopterin, best binding scores of -64.7 kcal/mol and -62.2 kcal/mol were found with tetrahydrocurcumin and demethoxycurcumin respectively. This information could open doors of research for the designing of novel drugs using herbs such as curcumin for the treatment of inflammatory joint diseases.

Keywords: curcumin, iNOS, molecular docking, osteoarthritis

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28315 Knowledge, Attitudes, and Practices of Army Soldiers on Prehospital Trauma Care in Matara District

Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

Abstract:

Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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28314 Analysis of Nonlinear Dynamic Systems Excited by Combined Colored and White Noise Excitations

Authors: Siu-Siu Guo, Qingxuan Shi

Abstract:

In this paper, single-degree-of-freedom (SDOF) systems to white noise and colored noise excitations are investigated. By expressing colored noise excitation as a second-order filtered white noise process and introducing colored noise as an additional state variable, the equation of motion for SDOF system under colored noise is then transferred artificially to multi-degree-of-freedom (MDOF) system under white noise excitations. As a consequence, corresponding Fokker-Planck-Kolmogorov (FPK) equation governing the joint probabilistic density function (PDF) of state variables increases to 4-dimension (4-D). Solution procedure and computer programme become much more sophisticated. The exponential-polynomial closure (EPC) method, widely applied for cases of SDOF systems under white noise excitations, is developed and improved for cases of systems under colored noise excitations and for solving the complex 4-D FPK equation. On the other hand, Monte Carlo simulation (MCS) method is performed to test the approximate EPC solutions. Two examples associated with Gaussian and non-Gaussian colored noise excitations are considered. Corresponding band-limited power spectral densities (PSDs) for colored noise excitations are separately given. Numerical studies show that the developed EPC method provides relatively accurate estimates of the stationary probabilistic solutions. Moreover, statistical parameter of mean-up crossing rate (MCR) is taken into account, which is important for reliability and failure analysis.

Keywords: filtered noise, narrow-banded noise, nonlinear dynamic, random vibration

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28313 The Effect of Low Power Laser on CK and Some of Markers Delayed Onset Muscle Soreness (DOMS)

Authors: Bahareh Yazdanparast Chaharmahali

Abstract:

The study showed effect of low power laser therapy on knee range of motion (flexion and extension), resting angle of knee joint, knee circumference and rating of delayed onset muscle soreness induced pain, 24 and 48 hours after eccentric training of knee flexor muscle (hamstring muscle). We investigate the effects of pulsed ultrasound on swelling, relaxed, flexion and extension knee angle and pain. 20 volunteers among girl students of college voluntary participated in this research. After eccentric training, subjects were randomly divided into two groups, control and laser therapy. In day 1 and in order to induce delayed onset muscle soreness, subjects eccentrically trained their knee flexor muscles. In day 2, subjects were randomly divided into two groups: control and low power laser therapy. 24 and 48 hours after eccentric training. Variables (knee flexion and extension, srang of motion, resting knee joint angle and knee circumferences) were measured and analyzed. Data are reported as means ± standard error (SE) and repeated measured was used to assess differences within groups. Methods of treatment (low power laser therapy) have significant effects on delayed onset muscle soreness markers. 24 and 48 hours after training a significant difference was observed between mean pains of 2 groups. This difference was significant between low power laser therapy and C groups. The Bonferroni post hock is significant. Low power laser therapy trophy as used in this study did significantly diminish the effects of delayed – onset muscle soreness on swelling, relaxed – knee extension and flexion angle.

Keywords: creatine kinase, DOMS, eccentric training, low power laser

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28312 Human Dental Pulp Stem Cells Attenuate Streptozotocin-Induced Parotid Gland Injury in Rats

Authors: Gehan ElAkabawy

Abstract:

Background: Diabetes mellitus causes severe deteriorations of almost all the organs and systems of the body, as well as significant damage to the oral cavity. The oral changes are mainly related to salivary glands dysfunction characterized by hyposalivation and xerostomia, which significantly reduce diabetic patients’ quality of life. Human dental pulp stem cells represent a promising source for cell-based therapies, owing to their easy, minimally invasive surgical access, and high proliferative capacity. It was reported that the trophic support mediated by dental pulp stem cells can rescue the functional and structural alterations of damaged salivary glands. However, potential differentiation and paracrine effects of human dental pulp stem cells in diabetic-induced parotid gland damage have not been previously investigated. Our study aimed to investigate the therapeutic effects of intravenous transplantation of human dental pulp stem cells (hDPSCs) on parotid gland injury in a rat model of streptozotocin (STZ)-induced type 1 diabetes. Methods: Thirty Sprague-Dawley male rats were randomly categorised into three groups: control, diabetic (STZ), and transplanted (STZ+hDPSCs). hDPSCs or vehicle was injected into the tail vein 7 days after STZ injection. The fasting blood glucose levels were monitored weekly. A glucose tolerance test was performed, and the parotid gland weight, salivary flow rate, oxidative stress indices, parotid gland histology, and caspase-3, vascular endothelial growth factor (VEGF), and proliferating cell nuclear antigen (PCNA) expression in parotid tissues were assessed 28 days post-transplantation. Results: Transplantation of hDPSCs downregulated blood glucose, improved the salivary flow rate, and reduced oxidative stress. The cells migrated to, survived, and differentiated into acinar, ductal, and myoepithelial cells in the STZ-injured parotid gland. Moreover, they downregulated the expression of caspase-3 and upregulated the expression of VEGF and PCNA, likely exerting pro-angiogenetic and antiapoptotic effects and promoting endogenous regeneration. In addition, the transplanted cells enhanced the parotid nitric oxide (NO) -tetrahydrobiopterin (BH4) pathway. Conclusions: Our results show that hDPSCs can migrate to and survive within the STZ-injured parotid gland, where they prevent its functional and morphological damage by restoring normal glucose levels, differentiating into parotid cell populations, and stimulating paracrine-mediated regeneration. Thus, hDPSCs may have therapeutic potential in the treatment of diabetes-induced parotid gland injury.

Keywords: dental pulp stem cells, diabetes, streptozotocin, parotid gland

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28311 The Antecedents of Internet Addiction toward Smartphone Usage

Authors: Pui-Lai To, Chechen Liao, Hen-Yi Huang

Abstract:

Twenty years after Internet development, scholars have started to identify the negative impacts brought by the Internet. Overuse of Internet could develop Internet dependency and in turn cause addiction behavior. Therefore understanding the phenomenon of Internet addiction is important. With the joint efforts of experts and scholars, Internet addiction has been officially listed as a symptom that affects public health, and the diagnosis, causes and treatment of the symptom have also been explored. On the other hand, in the area of smartphone Internet usage, most studies are still focusing on the motivation factors of smartphone usage. Not much research has been done on smartphone Internet addiction. In view of the increasing adoption of smartphones, this paper is intended to find out whether smartphone Internet addiction exists in modern society or not. This study adopted the research methodology of online survey targeting users with smartphone Internet experience. A total of 434 effective samples were recovered. In terms of data analysis, Partial Least Square (PLS) in Structural Equation Modeling (SEM) is used for sample analysis and research model testing. Software chosen for statistical analysis is SPSS 20.0 for windows and SmartPLS 2.0. The research result successfully proved that smartphone users who access Internet service via smartphone could also develop smartphone Internet addiction. Factors including flow experience, depression, virtual social support, smartphone Internet affinity and maladaptive cognition all have significant and positive influence on smartphone Internet addiction. In the scenario of smartphone Internet use, descriptive norm has a positive and significant influence on perceived playfulness, while perceived playfulness also has a significant and positive influence on flow experience. Depression, on the other hand, is negatively influenced by actual social support and positive influenced by the virtual social support.

Keywords: internet addiction, smartphone usage, social support, perceived playfulness

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28310 Groundwater Contamination and Fluorosis: A Comprehensive Analysis

Authors: Rajkumar Ghosh, Bhabani Prasad Mukhopadhay

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Groundwater contamination with fluoride has emerged as a global concern affecting millions of people, leading to the widespread occurrence of fluorosis. It affects bones and teeth, leading to dental and skeletal fluorosis. This study presents a comprehensive analysis of the relationship between groundwater contamination and fluorosis. It delves into the causes of fluoride contamination in groundwater, its spatial distribution, and adverse health impacts of fluorosis on affected communities. Fluoride contamination in groundwater can be attributed to both natural and anthropogenic sources. Geogenic sources involve the dissolution of fluoride-rich minerals present in the aquifer materials. On the other hand, anthropogenic activities such as industrial discharges, agricultural practices, and improper disposal of fluoride-containing waste contribute to the contamination of groundwater. The spatial distribution of fluoride contamination varies widely across different regions and geological formations. High fluoride levels are commonly observed in areas with fluorine-rich geological deposits. Additionally, agricultural and industrial centres often exhibit elevated fluoride concentrations due to anthropogenic contributions. Excessive fluoride ingestion during tooth development leads to dental fluorosis, characterized by enamel defects, discoloration, and dental caries. The severity of dental fluorosis varies based on fluoride exposure levels during tooth development. Long-term consumption of fluoride-contaminated water causes skeletal fluorosis, resulting in bone and joint pain, decreased joint mobility, and skeletal deformities. In severe cases, skeletal fluorosis can lead to disability and reduced quality of life. Various defluoridation techniques such as activated alumina, bone char, and reverse osmosis have been employed to reduce fluoride concentrations in drinking water. These methods effectively remove fluoride, but their implementation requires careful consideration of cost, maintenance, and sustainability. Diversifying water sources, such as rainwater harvesting and surface water supply, can reduce the reliance on fluoride-contaminated groundwater, especially in regions with high fluoride concentrations. Groundwater contamination with fluoride remains a significant public health challenge, leading to the widespread occurrence of fluorosis globally. This scientific report emphasizes the importance of understanding the relationship between groundwater contamination and fluorosis. Implementing effective mitigation strategies and preventive measures is crucial to combat fluorosis and ensure sustainable access to safe drinking water for communities worldwide. Collaborative efforts between government agencies, local communities, and scientific researchers are essential to address this issue and safeguard the health of vulnerable populations. Additionally, the report explores various mitigation strategies and preventive measures to address the issue and offers recommendations for sustainable management of groundwater resources to combat fluorosis effectively.

Keywords: fluorosis, fluoride contamination, groundwater contamination, groundwater resources

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28309 Prospective Study of the Evaluation of Autologous Blood Injection in the Treatment of Lateral Epicondylitis

Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

Abstract:

This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

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28308 Hot Spot Stress Analysis and Parametric Study on Rib-To-Deck Welded Connections in Orthotropic Steel Bridge Decks

Authors: Dibu Dave Mbako, Bin Cheng

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This paper study the stress variation of the welded joints in the rib-to-deck connection structure, the influence stress of the deck plate and u-rib thickness at different positions. A Finite-element model of orthotropic steel deck structure using solid element and shell element was established in ABAQUS. Under a single wheel load, the static response was analyzed to understand the structural behaviors and examine stress distribution. A parametric study showed that the geometric parameters have a significant effect on the hot spot stress at the weld toe, but has little impact on the stress concentration factor. The increase of the thickness of the deck plate will lead to the decrease of the hot spot stress at the weld toe and the maximum deflection of the deck plate. The surface stresses of the deck plate are significantly larger than those of the rib near the joint in the 80% weld penetration into the u-rib.

Keywords: orthotropic steel bridge deck, rib-to-deck connection, hot spot stress, finite element method, stress distribution

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28307 Case Study of Human Factors and Ergonomics in the Design and Use of Harness-Embedded Costumes in the Entertainment Industry

Authors: Marielle Hanley, Brandon Takahashi, Gerry Hanley, Gabriella Hancock

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Safety harnesses and their protocols are very common within the construction industry, and the Occupational Safety and Health Administration has provided extensive guidelines with protocols being constantly updated to ensure the highest level of safety within construction sites. There is also extensive research on harnesses that are meant to keep people in place in moving vehicles, such as seatbelts. Though this research is comprehensive in these areas, the findings and recommendations are not generally applicable to other industry sectors where harnesses are used, such as the entertainment industry. The focus of this case study is on the design and use of harnesses used by theme park employees wearing elaborate costumes in parades and performances. The key factors of posture, kinesthetic factors, and harness engineering interact in significantly different ways when the user is performing repetitive choreography with 20 to 40 lbs. of apparatus connected to harnesses that need to be hidden from the audience’s view. Human factors and ergonomic analysis take into account the required performers’ behaviors, the physical and mental preparation and posture of the performer, the design of the harness-embedded costume, and the environmental conditions during the performance (e.g., wind) that can determine the physical stresses placed on the harness and performer. The uniqueness and expense of elaborate costumes frequently result in one or two costumes created for production, and a variety of different performers need to fit into the same costume. Consequently, the harnesses should be adjustable if they are to minimize the physical and cognitive loads on the performer, but they are frequently more a “one-size fits all”. The complexity of human and technology interactions produces a range of detrimental outcomes, from muscle strains to nerve damage, mental and physical fatigue, and reduced motivation to perform at peak levels. Based on observations conducted over four years for this case study, a number of recommendations to institutionalize the human factors and ergonomic analyses can significantly improve the safety, reliability, and quality of performances with harness-embedded costumes in the entertainment industry. Human factors and ergonomic analyses can be integrated into the engineering design of the performance costumes with embedded harnesses, the conditioning and training of the performers using the costumes, the choreography of the performances within the staged setting and the maintenance of the harness-embedded costumes. By applying human factors and ergonomic methodologies in the entertainment industry, the industry management and support staff can significantly reduce the risks of injury, improve the longevity of unique performers, increase the longevity of the harness-embedded costumes, and produce the desired entertainment value for audiences.

Keywords: ergonomics in entertainment industry, harness-embedded costumes, performer safety, injury prevention

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28306 Factors Contributing to the Risk and Vulnerability to HIV Infection among Individuals with Spinal Cord Injuries (SCI) in South Africa

Authors: J. J. Lloyd, J. S. Phillips

Abstract:

Background: HIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (SCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. Objectives: Thus, the overall objective of this study was to assess the factors that exacerbate the risk and vulnerability of individuals with spinal cord injuries to HIV infection in order to develop a more effective HIV intervention. Methodology: This paper reports on the cross-sectional data gathered from individuals with a traumatic spinal cord injury in 4 conveniently selected provinces in South Africa. Data was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; sexual communication, and negotiation skills and Self-efficacy to refuse sex. Results: The majority of the study sample was males (72.7%) with a mean age of 34.6 years. The majority reported lifetime sexual intercourse (92.4%) but only 31.8% reported condom use with last sexual intercourse. Low level of HIV knowledge, and being male were the strongest predictor of risky sexual behaviours in this sample. Conclusion: Significant numbers of individuals with spinal cord injuries are thus engaging in risky sexual behaviours pointing to a need to strengthen comprehensive sexual health education to increase access to HIV testing, promote safe sex and condom use among this group.

Keywords: Human Immunodeficiency Virus (HIV), individuals with spinal cord injuries, risky sexual behaviours, HIV risk factors, sub-saharan Africa

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28305 Development of a Finite Element Model of the Upper Cervical Spine to Evaluate the Atlantoaxial Fixation Techniques

Authors: Iman Zafarparandeh, Muzammil Mumtaz, Paniz Taherzadeh, Deniz Erbulut

Abstract:

The instability in the atlantoaxial joint may occur due to cervical surgery, congenital anomalies, and trauma. There are different types of fixation techniques proposed for restoring the stability and preventing harmful neurological deterioration. Application of the screw constructs has become a popular alternative to the older techniques for stabilizing the joint. The main difference between the various screw constructs is the type of the screw which can be lateral mass screw, pedicle screw, transarticular screw, and translaminar screw. The aim of this paper is to study the effect of three popular screw constructs fixation techniques on the biomechanics of the atlantoaxial joint using the finite element (FE) method. A three-dimensional FE model of the upper cervical spine including the skull, C1 and C2 vertebrae, and groups of the existing ligaments were developed. The accurate geometry of the model was obtained from the CT data of a 35-year old male. Three screw constructs were designed to compare; Magerl transarticular screw (TA-Screw), Goel-Harms lateral mass screw and pedicle screw (LM-Screw and Pedicle-Screw), and Wright lateral mass screw and translaminar screw (LM-Screw and TL-Screw). Pure moments were applied to the model in the three main planes; flexion (Flex), extension (Ext), axial rotation (AR) and lateral bending (LB). The range of motion (ROM) of C0-C1 and C1-C2 segments for the implanted FE models are compared to the intact FE model and the in vitro study of Panjabi (1988). The Magerl technique showed less effect on the ROM of C0-C1 than the other two techniques in sagittal plane. In lateral bending and axial rotation, the Goel-Harms and Wright techniques showed less effect on the ROM of C0-C1 than the Magerl technique. The Magerl technique has the highest fusion rate as 99% in all loading directions for the C1-C2 segment. The Wright technique has the lowest fusion rate in LB as 79%. The three techniques resulted in the same fusion rate in extension loading as 99%. The maximum stress for the Magerl technique is the lowest in all load direction compared to other two techniques. The maximum stress in all direction was 234 Mpa and occurred in flexion with the Wright technique. The maximum stress for the Goel-Harms and Wright techniques occurred in lateral mass screw. The ROM obtained from the FE results support this idea that the fusion rate of the Magerl is more than 99%. Moreover, the maximum stress occurred in each screw constructs proves the less failure possibility for the Magerl technique. Another advantage of the Magerl technique is the less number of components compared to other techniques using screw constructs. Despite the benefits of the Magerl technique, there are drawbacks to using this method such as reduction of the C1 and C2 before screw placement. Therefore, other fixation methods such as Goel-Harms and Wright techniques find the solution for the drawbacks of the Magerl technique by adding screws separately to C1 and C2. The FE model implanted with the Wright technique showed the highest maximum stress almost in all load direction.

Keywords: cervical spine, finite element model, atlantoaxial, fixation technique

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