Search results for: combined surgery
2868 Estimation of Biomedical Waste Generated in a Tertiary Care Hospital in New Delhi
Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur
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Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi
Procedia PDF Downloads 2442867 Adaptive Training Methods Designed to Improve a Shorter Resident Curriculum in Obstetrics and Gynecology
Authors: Philippe Judlin, Olivier Morel
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Background: In France, the resident curriculum (RC) in Obstetrics and Gynecology (OBGYN) takes five years. In the course of the last 15 years, this RC has undergone major changes, characterized mainly by successive reductions of work hours. The program used to comprise long and frequent shifts, huge workload, poor supervision and erratic theoretical teaching. A decade ago, the French Ministry of Heath recommended a limitation of shift duration up to 24 hours and a minimum of 11 hours off duty between shifts. Last year, in order to comply with European Union directives, new recommendations have further limited residents’ work hours to 48 hours per week. Methods: Assessment of the residency program adjustments recently made to accommodate the recommendations while improving the training quality in resorting to new methods. Results: The challenge facing program directors was to provide an all-encompassing curriculum to OBGYN residents despite fewer work hours. Program has been dramatically redesigned, and several measures have been put in place: -The resident rotation system has been redesigned. Residents used to make 6-month rotations between 10-12 Departments of OBGYN or Surgery. Fewer Departments, those providing the best teaching, have been kept in the new RC. -Extensive inhouse supervision has been implemented for all kinds of clinical activities. Effectual supervision of residents has proved to be an effective tool to improve the quality of training. -The tutorship system, with academic members individually overseeing residents during their curriculum, has been perfected. It allows a better follow-up of residents’ progresses during the 5-year program. -The set up of an extensive program of lectures encompassing all maters in Obstetrics & Gynecology. These mandatory lectures are available online in a dedicated website. Therefore, face-to-face lectures have been limited in order to fit in the 48-hour limit. -The use of simulation has been significantly increased in obstetrics, materno-fetal medicine and surgery (stressing especially laparoscopic training). -Residents’ feedback has been taken into account in the setup of the new RC. Conclusion: This extensive overhaul of the Obstetrics and Gynecology RC has been in place since last year only. Nevertheless, the new program seems to adequately take into account the new recommendations while providing a better and more consistent teaching to the OBGYN residents.Keywords: education, laparoscopy, residency, simulation
Procedia PDF Downloads 1852866 Effect of Volcanic Ash and Recycled Aggregates in Concrete
Authors: Viviana Letelier, Ester Tarela, Giacomo Moriconi
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The cement industry is responsible for around a 5% of the CO2 emissions worldwide and considering that concrete is one of the most used materials in construction its total effect is important. An alternative to reduce the environmental impact of concrete production is to incorporate certain amount of residuals in the dosing, limiting the replacement percentages to avoid significant losses in the mechanical properties of the final material. This study analyses the variation in the mechanical properties of structural concretes with recycled aggregates and volcanic ash as cement replacement to test the effect of the simultaneous use of different residuals in the same material. Analyzed concretes are dosed for a compressive strength of 30MPa. The recycled aggregates are obtained from prefabricated pipe debris with a compressive strength of 20MPa. The volcanic ash was obtained from the Ensenada (Chile) area after the Calbuco eruption in April 2015. The percentages of natural course aggregates that are replaced by recycled aggregates are of 0% and 30% and the percentages of cement replaced by volcanic ash are of 0%, 5%, 10% and 15%. The combined effect of both residuals in the mechanical properties of the concrete is evaluated through compressive strength tests after, 28 curing days, flexural strength tests after 28 days, and the elasticity modulus after 28 curing days. Results show that increasing the amount of volcanic ash used increases the losses in compressive strength. However, the use of up to a 5% of volcanic ash allows obtaining concretes with similar compressive strength to the control concrete, whether recycled aggregates are used or not. Furthermore, the pozzolanic reaction that occurs between the amorphous silica and the calcium hydroxide (Ca(OH)2) provokes an increase of a 10% in the compressive strength when a 5% of volcanic ash is combined with a 30% of recycled aggregates. Flexural strength does not show significant changes with neither of the residues. On the other hand, decreases between a 14% and a 25% in the elasticity modulus have been found. Concretes with up to a 30% of recycled aggregates and a 5% of volcanic ash as cement replacement can be produced without significant losses in their mechanical properties, reducing considerably the environmental impact of the final material.Keywords: compressive strength of recycled concrete, mechanical properties of recycled concrete, recycled aggregates, volcanic ash as cement replacement
Procedia PDF Downloads 2992865 Control Strategy for a Solar Vehicle Race
Authors: Francois Defay, Martim Calao, Jean Francois Dassieu, Laurent Salvetat
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Electrical vehicles are a solution for reducing the pollution using green energy. The shell Eco-Marathon provides rules in order to minimize the battery use for the race. The use of solar panel combined with efficient motor control and race strategy allow driving a 60kg vehicle with one pilot using only the solar energy in the best case. This paper presents a complete modelization of a solar vehicle used for the shell eco-marathon. This project called Helios is cooperation between non-graduated students, academic institutes, and industrials. The prototype is an ultra-energy-efficient vehicle based on one-meter square solar panel and an own-made brushless controller to optimize the electrical part. The vehicle is equipped with sensors and embedded system to provide all the data in real time in order to evaluate the best strategy for the course. A complete modelization with Matlab/Simulink is used to test the optimal strategy to increase the global endurance. Experimental results are presented to validate the different parts of the model: mechanical, aerodynamics, electrical, solar panel. The major finding of this study is to provide solutions to identify the model parameters (Rolling Resistance Coefficient, drag coefficient, motor torque coefficient, etc.) by means of experimental results combined with identification techniques. One time the coefficients are validated, the strategy to optimize the consumption and the average speed can be tested first in simulation before to be implanted for the race. The paper describes all the simulation and experimental parts and provides results in order to optimize the global efficiency of the vehicle. This works have been started four years ago and evolved many students for the experimental and theoretical parts and allow to increase the knowledge on electrical self-efficient vehicle.Keywords: electrical vehicle, endurance, optimization, shell eco-marathon
Procedia PDF Downloads 2642864 Boundary Feedback Stabilization of an Overhead Crane Model
Authors: Abdelhadi Elharfi
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A problem of boundary feedback (exponential) stabilization of an overhead crane model represented by a PDE is considered. For any $r>0$, the exponential stability at the desired decay rate $r$ is solved in semi group setting by a collocated-type stabiliser of a target system combined with a term involving the solution of an appropriate PDE.Keywords: feedback stabilization, semi group and generator, overhead crane system
Procedia PDF Downloads 4042863 Application of Combined Cluster and Discriminant Analysis to Make the Operation of Monitoring Networks More Economical
Authors: Norbert Magyar, Jozsef Kovacs, Peter Tanos, Balazs Trasy, Tamas Garamhegyi, Istvan Gabor Hatvani
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Water is one of the most important common resources, and as a result of urbanization, agriculture, and industry it is becoming more and more exposed to potential pollutants. The prevention of the deterioration of water quality is a crucial role for environmental scientist. To achieve this aim, the operation of monitoring networks is necessary. In general, these networks have to meet many important requirements, such as representativeness and cost efficiency. However, existing monitoring networks often include sampling sites which are unnecessary. With the elimination of these sites the monitoring network can be optimized, and it can operate more economically. The aim of this study is to illustrate the applicability of the CCDA (Combined Cluster and Discriminant Analysis) to the field of water quality monitoring and optimize the monitoring networks of a river (the Danube), a wetland-lake system (Kis-Balaton & Lake Balaton), and two surface-subsurface water systems on the watershed of Lake Neusiedl/Lake Fertő and on the Szigetköz area over a period of approximately two decades. CCDA combines two multivariate data analysis methods: hierarchical cluster analysis and linear discriminant analysis. Its goal is to determine homogeneous groups of observations, in our case sampling sites, by comparing the goodness of preconceived classifications obtained from hierarchical cluster analysis with random classifications. The main idea behind CCDA is that if the ratio of correctly classified cases for a grouping is higher than at least 95% of the ratios for the random classifications, then at the level of significance (α=0.05) the given sampling sites don’t form a homogeneous group. Due to the fact that the sampling on the Lake Neusiedl/Lake Fertő was conducted at the same time at all sampling sites, it was possible to visualize the differences between the sampling sites belonging to the same or different groups on scatterplots. Based on the results, the monitoring network of the Danube yields redundant information over certain sections, so that of 12 sampling sites, 3 could be eliminated without loss of information. In the case of the wetland (Kis-Balaton) one pair of sampling sites out of 12, and in the case of Lake Balaton, 5 out of 10 could be discarded. For the groundwater system of the catchment area of Lake Neusiedl/Lake Fertő all 50 monitoring wells are necessary, there is no redundant information in the system. The number of the sampling sites on the Lake Neusiedl/Lake Fertő can decrease to approximately the half of the original number of the sites. Furthermore, neighbouring sampling sites were compared pairwise using CCDA and the results were plotted on diagrams or isoline maps showing the location of the greatest differences. These results can help researchers decide where to place new sampling sites. The application of CCDA proved to be a useful tool in the optimization of the monitoring networks regarding different types of water bodies. Based on the results obtained, the monitoring networks can be operated more economically.Keywords: combined cluster and discriminant analysis, cost efficiency, monitoring network optimization, water quality
Procedia PDF Downloads 3482862 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017
Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly
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Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)
Procedia PDF Downloads 1672861 Self-Inflating Soft Tissue Expander Outcome for Alveolar Ridge Augmentation a Randomized Controlled Clinical and Histological Study
Authors: Alaa T. Ali, Nevine H. Kheir El Din, Ehab S. Abdelhamid, Ahmed E. Amr
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Objective: Severe alveolar bone resorption is usually associated with a deficient amount of soft tissues. soft tissue expansion is introduced to provide an adequate amount of soft tissue over the grafted area. This study aimed to assess the efficacy of sub-periosteal self-inflating osmotic tissue expanders used as preparatory surgery before horizontal alveolar ridge augmentation using autogenous onlay block bone graft. Methods: A prospective randomized controlled clinical trial was performed. Sixteen partially edentulous patients demanding horizontal bone augmentation in the anterior maxilla were randomly assigned to horizontal ridge augmentation with autogenous bone block grafts harvested from the mandibular symphysis. For the test group, soft tissue expanders were placed sub-periosteally before horizontal ridge augmentation. Impressions were taken before and after STE, and the cast models were optically scanned and superimposed to be used for volumetric analysis. Horizontal ridge augmentation was carried out after STE completion. For the control group, a periosteal releasing incision was performed during bone augmentation procedures. Implants were placed in both groups at re-entry surgery after six months period. A core biopsy was taken. Histomorphometric assessment for newly formed bone surface area, mature collagen area fraction, the osteoblasts count, and blood vessel count were performed. The change in alveolar ridge width was evaluated through bone caliper and CBCT. Results: Soft tissue expander successfully provides a Surplus amount of soft tissues in 5 out of 8 patients in the test group. Complications during the expansion period were perforation through oral mucosa occurred in two patients. Infection occurred in one patient. The mean soft tissue volume gain was 393.9 ± 322mm. After 6 months. The mean horizontal bone gains for the test and control groups were 3.14 mm and 3.69 mm, respectively. Conclusion: STE with a sub-periosteal approach is an applicable method to achieve an additional soft tissue and to reduce bone block graft exposure and wound dehiscence.Keywords: soft tissue expander, ridge augmentation, block graft, symphysis bone block
Procedia PDF Downloads 1232860 Comparing the Contribution of General Vocabulary Knowledge and Academic Vocabulary Knowledge to Learners' Academic Achievement
Authors: Reem Alsager, James Milton
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Coxhead’s (2000) Academic Word List (AWL) believed to be essential for students pursuing higher education and helps differentiate English for Academic Purposes (EAP) from General English as a course of study, and it is thought to be important for comprehending English academic texts. It has been described that AWL is an infrequent, discrete set of vocabulary items unreachable from general language. On the other hand, it has been known for a period of time that general vocabulary knowledge is a good predictor of academic achievement. This study, however, is an attempt to measure and compare the contribution of academic knowledge and general vocabulary knowledge to learners’ GPA and examine what knowledge is a better predictor of academic achievement and investigate whether AWL as a specialised list of infrequent words relates to the frequency effect. The participants were comprised of 44 international postgraduate students in Swansea University, all from the School of Management, following the taught MSc (Master of Science). The study employed the Academic Vocabulary Size Test (AVST) and the XK_Lex vocabulary size test. The findings indicate that AWL is a list based on word frequency rather than a discrete and unique word list and that the AWL performs the same function as general vocabulary, with tests of each found to measure largely the same quality of knowledge. The findings also suggest that the contribution that AWL knowledge provides for academic success is not sufficient and that general vocabulary knowledge is better in predicting academic achievement. Furthermore, the contribution that academic knowledge added above the contribution of general vocabulary knowledge when combined is really small and noteworthy. This study’s results are in line with the argument and suggest that it is the development of general vocabulary size is an essential quality for academic success and acquiring the words of the AWL will form part of this process. The AWL by itself does not provide sufficient coverage, and is probably not specialised enough, for knowledge of this list to influence this general process. It can be concluded that AWL as an academic word list epitomizes only a fraction of words that are actually needed for academic success in English and that knowledge of academic vocabulary combined with general vocabulary knowledge above the most frequent 3000 words is what matters most to ultimate academic success.Keywords: academic achievement, academic vocabulary, general vocabulary, vocabulary size
Procedia PDF Downloads 2182859 The Biomechanical Consequences of Pes Planus
Authors: Mariette Swanepoel, Terry Ellapen, Henriette Hammil, Juandre Williams, Timothy Qumbu
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The biomechanical consequence of pes planus is a topic seldom reviewed in regards to energy expenditure and predisposition to injury. However its comprehension in the field of foot rehabilitation, pre-and post-surgery is fundamental to successful patient management. This short communication unites the present literature to provide the reader with better insight on the consequence of pes planus, foot mechanics and its predisposition to injury at the foot and tibiofemoral joint. Further, the consideration of synergistic dominance of the foot invertors to compensate for the ineffective torque production of the fibularis longus due pes planus is presented.Keywords: pes planus, fibularis longus, synergistic dominance, injury
Procedia PDF Downloads 2852858 Impact of Combined Heat and Power (CHP) Generation Technology on Distribution Network Development
Authors: Sreto Boljevic
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In the absence of considerable investment in electricity generation, transmission and distribution network (DN) capacity, the demand for electrical energy will quickly strain the capacity of the existing electrical power network. With anticipated growth and proliferation of Electric vehicles (EVs) and Heat pump (HPs) identified the likelihood that the additional load from EV changing and the HPs operation will require capital investment in the DN. While an area-wide implementation of EVs and HPs will contribute to the decarbonization of the energy system, they represent new challenges for the existing low-voltage (LV) network. Distributed energy resources (DER), operating both as part of the DN and in the off-network mode, have been offered as a means to meet growing electricity demand while maintaining and ever-improving DN reliability, resiliency and power quality. DN planning has traditionally been done by forecasting future growth in demand and estimating peak load that the network should meet. However, new problems are arising. These problems are associated with a high degree of proliferation of EVs and HPs as load imposes on DN. In addition to that, the promotion of electricity generation from renewable energy sources (RES). High distributed generation (DG) penetration and a large increase in load proliferation at low-voltage DNs may have numerous impacts on DNs that create issues that include energy losses, voltage control, fault levels, reliability, resiliency and power quality. To mitigate negative impacts and at a same time enhance positive impacts regarding the new operational state of DN, CHP system integration can be seen as best action to postpone/reduce capital investment needed to facilitate promotion and maximize benefits of EVs, HPs and RES integration in low-voltage DN. The aim of this paper is to generate an algorithm by using an analytical approach. Algorithm implementation will provide a way for optimal placement of the CHP system in the DN in order to maximize the integration of RES and increase in proliferation of EVs and HPs.Keywords: combined heat & power (CHP), distribution networks, EVs, HPs, RES
Procedia PDF Downloads 2022857 Effect of Nitrogen and/or Bio-Fertilizer on the Yield, Total Flavonoids, Carbohydrate Contents, Essential Oil Quantity and Constituents of Dill Plants
Authors: Mohammed S. Aly, Abou-Zeid N. El-Shahat, Nabila Y. Naguib, Huussie A. Said-Al Ahl, Atef M. Zakaria, Mohamed A. Abou Dahab
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This study was conducted during two successive seasons of 2000/2001 and 2001/2002 to evaluate the response of Anethum graveolens L. plants to nitrogen fertilizer with or without bio-fertilizer on fruits yield, total flavonoids and carbohydrates content, essential oil yield and constituents. Results cleared that the treatment of 60 Kg N/feddan without and with bio-fertilizer gave the highest umbels number per plant through the two seasons and these increments were significant in comparison with control plants. Meanwhile, fruits weight (g/plant) showed significant increase with the treatments of nitrogen fertilizers alone and combined with bio-fertilizers compared with control plants in the first and second season. Maximum increments were resulted with the previous treatment (60 Kg N/fed). Fruits yield (Kg/fed) revealed the same trend of fruits weight (g/plant). Total flavonoids contents were significantly increased with all of used treatments. Maximum increase was noticed with bio-fertilizers combined with 60 Kg N/fed during two seasons. Total carbohydrate contents showed significant increase with applied nitrogen fertilizers treatments as alone, meanwhile total carbohydrate contents were increased non-significantly with the other used treatments during the two seasons in comparison with control plants content. The treatment of bio-fertilizer and in most of nitrogen fertilizer levels significantly increased essential oil percentage, content and yield. The treatment of 60 Kg N/fed with or without bio-fertilizer gave the best values. All identified compounds were observed in the essential oil of all treatments. The major compounds were limonene, carvone and dillapiole. The most effective fertilization on limonene content was 40 Kg N/fed and/or bio-fertilizers. Meanwhile 20 Kg N/fed with or without bio-fertilizers increased carvone, but most of fertilization treatments except those of bio-fertlizers and 40 Kg N/fed increased dillapiole content.Keywords: carbohydrates, dill, essential oil, fertilizer, flavonoids
Procedia PDF Downloads 4172856 Diagnostic Value of CT Scan in Acute Appendicitis
Authors: Maria Medeiros, Suren Surenthiran, Abitha Muralithar, Soushma Seeburuth, Mohammed Mohammed
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Introduction: Appendicitis is the most common surgical emergency globally and can have devastating consequences. Diagnostic imaging in acute appendicitis has become increasingly common in aiding the diagnosis of acute appendicitis. Computerized tomography (CT) and ultrasound (US) are the most commonly used imaging modalities for diagnosing acute appendicitis. Pre-operative imaging has contributed to a reduction of negative appendicectomy rates from between 10-29% to 5%. Literature report CT scan has a diagnostic sensitivity of 94% in acute appendicitis. This clinical audit was conducted to establish if the CT scan's diagnostic yield for acute appendicitis matches the literature. CT scan has a high sensitivity and specificity for diagnosing acute appendicitis and its use can result in a lower negative appendicectomy rate. The aim of this study is to compare the pre-operative imaging findings from CT scans to the histopathology results post-operatively and establish the accuracy of CT scans in aiding the diagnosis of acute appendicitis. Methods: This was a retrospective study focusing on adult presentations to the general surgery department in a district general hospital in central London with an impression of acute appendicitis. We analyzed all patients from July 2022 to December 2022 who underwent a CT scan preceding appendicectomy. Pre-operative CT findings and post-operative histopathology findings were compared to establish the efficacy of CT scans in diagnosing acute appendicitis. Our results were also cross-referenced with pre-existing literature. Data was collected and anonymized using CERNER and analyzed in Microsoft Excel. Exclusion criteria: Children, age <16. Results: 65 patients had CT scans in which the report stated acute appendicitis. Of those 65 patients, 62 patients underwent diagnostic laparoscopies. 100% of patients who underwent an appendicectomy with a pre-operative CT scan showing acute appendicitis had acute appendicitis in histopathology analysis. 3 of the 65 patients who had a CT scan showing appendicitis received conservative treatment. Conclusion: CT scans positive for acute appendicitis had 100% sensitivity and a positive predictive value, which matches published research studies (sensitivity of 94%). The use of CT scans in the diagnostic work-up for acute appendicitis can be extremely helpful in a) confirming the diagnosis and b) reducing the rates of negative appendicectomies and consequently reducing unnecessary operative-associated risks for patients, reducing costs and reducing pressure on emergency theatre lists.Keywords: acute apendicitis, CT scan, general surgery, imaging
Procedia PDF Downloads 912855 Biomechanical Analysis on Skin and Jejunum of Chemically Prepared Cat Cadavers Used in Surgery Training
Authors: Raphael C. Zero, Thiago A. S. S. Rocha, Marita V. Cardozo, Caio C. C. Santos, Alisson D. S. Fechis, Antonio C. Shimano, FabríCio S. Oliveira
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Biomechanical analysis is an important factor in tissue studies. The objective of this study was to determine the feasibility of a new anatomical technique and quantify the changes in skin and the jejunum resistance of cats’ corpses throughout the process. Eight adult cat cadavers were used. For every kilogram of weight, 120ml of fixative solution (95% 96GL ethyl alcohol and 5% pure glycerin) was applied via the external common carotid artery. Next, the carcasses were placed in a container with 96 GL ethyl alcohol for 60 days. After fixing, all carcasses were preserved in a 30% sodium chloride solution for 60 days. Before fixation, control samples were collected from fresh cadavers and after fixation, three skin and jejunum fragments from each cadaver were tested monthly for strength and displacement until complete rupture in a universal testing machine. All results were analyzed by F-test (P <0.05). In the jejunum, the force required to rupture the fresh samples and the samples fixed in alcohol for 60 days was 31.27±19.14N and 29.25±11.69N, respectively. For the samples preserved in the sodium chloride solution for 30 and 60 days, the strength was 26.17±16.18N and 30.57±13.77N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days was 2.79±0.73mm and 2.80±1.13mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 2.53±1.03mm and 2.83±1.27mm, respectively. There was no statistical difference between the samples (P=0.68 with respect to strength, and P=0.75 with respect to displacement). In the skin, the force needed to rupture the fresh samples and the samples fixed for 60 days in alcohol was 223.86±131.5N and 211.86±137.53N respectively. For the samples preserved in sodium chloride solution for 30 and 60 days, the force was 227.73±129.06 and 224.78±143.83N, respectively. In relation to the displacement required for the rupture of the samples, the values of fresh specimens and those fixed in alcohol for 60 days were 3.67±1.03mm and 4.11±0.87mm, respectively. For the samples preserved for 30 and 60 days with sodium chloride solution, the displacement was 4.21±0.93mm and 3.93±0.71mm, respectively. There was no statistical difference between the samples (P=0.65 with respect to strength, and P=0.98 with respect to displacement). The resistance of the skin and intestines of the cat carcasses suffered little change when subjected to alcohol fixation and preservation in sodium chloride solution, each for 60 days, which is promising for use in surgery training. All experimental procedures were approved by the Municipal Legal Department (protocol 02.2014.000027-1). The project was funded by FAPESP (protocol 2015-08259-9).Keywords: anatomy, conservation, fixation, small animal
Procedia PDF Downloads 2912854 Video Processing of a Football Game: Detecting Features of a Football Match for Automated Calculation of Statistics
Authors: Rishabh Beri, Sahil Shah
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We have applied a range of filters and processing in order to extract out the various features of the football game, like the field lines of a football field. Another important aspect was the detection of the players in the field and tagging them according to their teams distinguished by their jersey colours. This extracted information combined about the players and field helped us to create a virtual field that consists of the playing field and the players mapped to their locations in it.Keywords: Detect, Football, Players, Virtual
Procedia PDF Downloads 3282853 The Georgians’ Discourses of National Identity in the Context of Europeanisation
Authors: Lia Tsuladze
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The paper discusses the Georgians’ online discourses of national identity in the context of Europeanisation focusing on two periods - initialing of the EU-Georgia Association Agreement in November 2013 and signing it in June 2014. Discussing how the Georgians’ aspiration to integrate with the EU is combined with their perception of Europeanisation as a threat to the national identity, the author explores how the national sentiment is expressed in the above discourses while performed for the local vs. international audiences.Keywords: Europeanisation, frontstage, backstage discourses, Georgia, national identity
Procedia PDF Downloads 5052852 Postoperative Wound Infections Following Caesarean Section in Obese Patients
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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.Keywords: pregnancy, obesity, caesarean, infection
Procedia PDF Downloads 802851 Climate Change Results in Increased Accessibility of Offshore Wind Farms for Installation and Maintenance
Authors: Victoria Bessonova, Robert Dorrell, Nina Dethlefs, Evdokia Tapoglou, Katharine York
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As the global pursuit of renewable energy intensifies, offshore wind farms have emerged as a promising solution to combat climate change. The global offshore wind installed capacity is projected to increase 56-fold by 2055. However, the impacts of climate change, particularly changes in wave climate, are not widely understood. Offshore wind installation and maintenance activities often require specific weather windows, characterized by calm seas and low wave heights, to ensure safe and efficient operations. However, climate change-induced alterations in wave characteristics can reduce the availability of suitable weather windows, leading to delays and disruptions in project timelines. it applied the operational limits of installation and maintenance vessels to past and future climate wave projections. This revealed changes in the annual and monthly accessibility of offshore wind farms at key global development locations. When accessibility is only defined by significant wave height, spatial patterns in the annual accessibility roughly follow changes in significant wave height, with increased availability where significant wave height is decreasing. This resulted in a 1-6% increase in Europe and North America and a similar decrease in South America, Australia and Asia. Monthly changes suggest unchanged or slightly decreased (1-2%) accessibility in summer months and increased (2-6%) in winter. Further assessment includes assessing the sensitivity of accessibility to operational limits defined by wave height combined with wave period and wave height combined with wind speed. Results of this assessment will be included in the presentation. These findings will help stakeholders inform climate change adaptations in installation and maintenance planning practices.Keywords: climate change, offshore wind, offshore wind installation, operations and maintenance, wave climate, wind farm accessibility
Procedia PDF Downloads 812850 An Index to Measure Transportation Sustainable Performance in Construction Projects
Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry
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The continuous increase in the world population, resource shortage and the warning of climate change cause various environmental and social issues to the world. Thus, sustainability concept is much needed nowadays. Organizations are progressively falling under strong worldwide pressure to integrate sustainability practices into their project decision-making development. Construction projects in the industry are amongst the most significant, since it is one of the biggest divisions and of main significance for the national economy and hence has a massive effect on the environment and society. So, it is important to discover approaches to incorporate sustainability into the management of those projects. This study presents a combined sustainability index of projects with sustainable transportation which has been formed as per a comprehensive literature review and survey study. Transportation systems enable the movement of goods and services worldwide, and it is leading to economic growth and creating jobs while creating negative impacts on the environment and society. This research is study to quantify the sustainability indicators, through 1) identifying the importance of sustainable transportation indicators that are based on the sustainable practices used for the construction projects and 2) measure the effectiveness of practices through these indicators on the three sustainable pillars. A total 26 sustainability indicators have been selected and grouped under each related sustainability pillars. A survey was used to collect the opinion about the sustainability indicators by a scoring system. A combined sustainability index considering three sustainable pillars can be helpful in evaluating the transportation sustainable practices of a project and making decisions regarding project selection. In addition to focus on the issue of financial resource allocation in a project selection, the decision-maker could take into account the sustainability as an important key in addition to the project’s return and risk. The purpose of this study is to measure the performance of transportation sustainability which allow companies to assess multiple projects selection. This is useful to decision makers to rank and focus more on future sustainable projects.Keywords: sustainable transportation, transportation performances, sustainable indicators, sustainable construction practice, sustainability
Procedia PDF Downloads 1412849 Combining Ability for Maize Grain Yield and Yield Component for Resistant to Striga hermmonthica (Del) Benth in Southern Guinea Savannah of Nigeria
Authors: Terkimbi Vange, Obed Abimiku, Lateef Lekan Bello, Lucky Omoigui
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In 2014 and 2015, eight maize inbred lines resistant to Striga hermonthica (Del) Benth were crossed in 8 x 8 half diallel (Griffing method 11, model 1). The eight parent inbred lines were planted out in a Randomized Complete Block Design (RCBD) with three replications at two different Striga infested environments (Lafia and Makurdi) during the late cropping season. The objectives were to determine the combining ability of Striga resistant maize inbred lines and identify suitable inbreds for hybrids development. The lines were used to estimate general combining ability (GCA), and specific combining ability (SCA) effects for Striga related parameters such as Striga shoot counts, Striga damage rating (SDR), plant height and grain yield and other agronomic traits. The result of combined ANOVA revealed that mean squares were highly significant for all traits except Striga damage rating (SDR1) at 8WAS and Striga emergence count (STECOI) at 8WAS. Mean squares for SCA were significantly low for all traits. TZSTR190 was the highest yielding parent, and TZSTR166xTZST190 was the highest yielding hybrid (cross). Parent TZSTR166, TZEI188, TZSTR190 and TZSTR193 shows significant (p < 0.05) positive GCA effects for grain yield while the rest had negative GCA effects for grain yield. Parent TZSTR166, TZEI188, TZSTR190, and TZSTR193 could be used for initiating hybrid development. Also, TZSTR166xTZSTR190 cross was the best specific combiner followed by TZEI188xTZSTR193, TZEI80xTZSTR193, and TZSTR190xTZSTR193. TZSTR166xTZSTR190 and TZSTR190xTZSTR193 had the highest SCA effects. However, TZEI80 and TZSTR190 manifested a high positive SCA effect with TZSTR166 indicating that these two inbreds combined better with TZSTR166.Keywords: combining ability, Striga hermonthica, resistance, grain yield
Procedia PDF Downloads 2402848 Etiology and Postnatal Management of Prenatal Hydronephrosis: A Study of Two Teaching Hospitals of Khyber Pakhtunkhwa
Authors: Saima Ali, Liaqat Ali, Nasir Orakzai
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Background: Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with Ultrasonography. The prenatal hydronephrosis is a diagnostic dilemma in differentiating between obstructive variant versus physiologic hydronephrosis. The assessment and prompt diagnosis of prenatal hydronephrosis is important because of the fact that untreated obstructive hydronephrosis usually leads to recurrent UTI, Urosepsis, deterioration of renal functions, non-functioning kidneys, and even end-stage renal disease. Objectives: To determine the etiology and outcome of postnatal treatment of children with prenatal hydronephrosis in two teaching hospitals of Khyber Pakhtunkhwa (KPK) Methods: It is a multicentric descriptive study that was conducted in department of Paediatrics in Kuwait teaching hospital Peshawar and Department of Urology in Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from January 2008 till December 2010. Total numbers of 64 neonates were included in the study with the mean follow-up of 14.5 months. All the diagnostic data in prenatal, postnatal data, and operative and non-operative data were collected on structured Proforma and was analyzed on SPSS version 17. Results: Out of 64 patients, 39 (60.9 %) were male while 25 were female. 52 patients had unilateral while 12 patients had bilateral hydronephrosis. Based upon prenatal USG in term of AP diameter, 37 (57 %) patients had mild hydronephrosis (5-10 mm AP diameter), 14 patients had moderate hydronephrosis (10-15 mm AP diameter) while 13 patients had gross hydronephrosis (More than 15mm). Regarding etiology, 44(76 %) patients were labeled as physiologic hydronephrosis, 11 patients (9.3%) with PUJ obstruction, 5 patients with Vesicoureteric reflux (VUR) and 4 patients with posterior urethral valves. Surgery was performed in total of 15 (23.4%) patients that included open Pyeloplasty in 11 patients, Vesicostomy followed by posterior valve fulguration in 4 patients. All the patients of VUR treated medically. The severity in the grade of prenatal hydronephrosis is significantly associated with the need for definitive urological surgery p < 0.005. Ancillary procedures like percutaneous nephrostomy (PCN) were inserted 7 patients. Conclusions: Prenatal hydronephrosis is a common ailment associated with significant morbidity. Physiological Hydronephrosis and VUR can be successfully treated with medical treatment. However obstructive PUJ obstructions and posterior urethral valves require surgical correction with a good success rate.Keywords: prenatal hydronephrosis, Pelviureteric Junction (PUJ) Obstruction, vesicoureteric reflux, posterior urethral valve, renography
Procedia PDF Downloads 2442847 A Hybrid-Evolutionary Optimizer for Modeling the Process of Obtaining Bricks
Authors: Marius Gavrilescu, Sabina-Adriana Floria, Florin Leon, Silvia Curteanu, Costel Anton
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Natural sciences provide a wide range of experimental data whose related problems require study and modeling beyond the capabilities of conventional methodologies. Such problems have solution spaces whose complexity and high dimensionality require correspondingly complex regression methods for proper characterization. In this context, we propose an optimization method which consists in a hybrid dual optimizer setup: a global optimizer based on a modified variant of the popular Imperialist Competitive Algorithm (ICA), and a local optimizer based on a gradient descent approach. The ICA is modified such that intermediate solution populations are more quickly and efficiently pruned of low-fitness individuals by appropriately altering the assimilation, revolution and competition phases, which, combined with an initialization strategy based on low-discrepancy sampling, allows for a more effective exploration of the corresponding solution space. Subsequently, gradient-based optimization is used locally to seek the optimal solution in the neighborhoods of the solutions found through the modified ICA. We use this combined approach to find the optimal configuration and weights of a fully-connected neural network, resulting in regression models used to characterize the process of obtained bricks using silicon-based materials. Installations in the raw ceramics industry, i.e., bricks, are characterized by significant energy consumption and large quantities of emissions. Thus, the purpose of our approach is to determine by simulation the working conditions, including the manufacturing mix recipe with the addition of different materials, to minimize the emissions represented by CO and CH4. Our approach determines regression models which perform significantly better than those found using the traditional ICA for the aforementioned problem, resulting in better convergence and a substantially lower error.Keywords: optimization, biologically inspired algorithm, regression models, bricks, emissions
Procedia PDF Downloads 802846 Enhancement of Radiosensitization by Aptamer 5TR1-Functionalized AgNCs for Triple-Negative Breast Cancer
Authors: Xuechun Kan, Dongdong Li, Fan Li, Peidang Liu
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Triple-negative breast cancer (TNBC) is the most malignant subtype of breast cancer with a poor prognosis, and radiotherapy is one of the main treatment methods. However, due to the obvious resistance of tumor cells to radiotherapy, high dose of ionizing radiation is required during radiotherapy, which causes serious damage to normal tissues near the tumor. Therefore, how to improve radiotherapy resistance and enhance the specific killing of tumor cells by radiation is a hot issue that needs to be solved in clinic. Recent studies have shown that silver-based nanoparticles have strong radiosensitization, and silver nanoclusters (AgNCs) also provide a broad prospect for tumor targeted radiosensitization therapy due to their ultra-small size, low toxicity or non-toxicity, self-fluorescence and strong photostability. Aptamer 5TR1 is a 25-base oligonucleotide aptamer that can specifically bind to mucin-1 highly expressed on the membrane surface of TNBC 4T1 cells, and can be used as a highly efficient tumor targeting molecule. In this study, AgNCs were synthesized by DNA template based on 5TR1 aptamer (NC-T5-5TR1), and its role as a targeted radiosensitizer in TNBC radiotherapy was investigated. The optimal DNA template was first screened by fluorescence emission spectroscopy, and NC-T5-5TR1 was prepared. NC-T5-5TR1 was characterized by transmission electron microscopy, ultraviolet-visible spectroscopy and dynamic light scattering. The inhibitory effect of NC-T5-5TR1 on cell activity was evaluated using the MTT method. Laser confocal microscopy was employed to observe NC-T5-5TR1 targeting 4T1 cells and verify its self-fluorescence characteristics. The uptake of NC-T5-5TR1 by 4T1 cells was observed by dark-field imaging, and the uptake peak was evaluated by inductively coupled plasma mass spectrometry. The radiation sensitization effect of NC-T5-5TR1 was evaluated through cell cloning and in vivo anti-tumor experiments. Annexin V-FITC/PI double staining flow cytometry was utilized to detect the impact of nanomaterials combined with radiotherapy on apoptosis. The results demonstrated that the particle size of NC-T5-5TR1 is about 2 nm, and the UV-visible absorption spectrum detection verifies the successful construction of NC-T5-5TR1, and it shows good dispersion. NC-T5-5TR1 significantly inhibited the activity of 4T1 cells and effectively targeted and fluoresced within 4T1 cells. The uptake of NC-T5-5TR1 reached its peak at 3 h in the tumor area. Compared with AgNCs without aptamer modification, NC-T5-5TR1 exhibited superior radiation sensitization, and combined radiotherapy significantly inhibited the activity of 4T1 cells and tumor growth in 4T1-bearing mice. The apoptosis level of NC-T5-5TR1 combined with radiation was significantly increased. These findings provide important theoretical and experimental support for NC-T5-5TR1 as a radiation sensitizer for TNBC.Keywords: 5TR1 aptamer, silver nanoclusters, radio sensitization, triple-negative breast cancer
Procedia PDF Downloads 572845 Application of IoTs Based Multi-Level Air Quality Sensing for Advancing Environmental Monitoring in Pingtung County
Authors: Men An Pan, Hong Ren Chen, Chih Heng Shih, Hsing Yuan Yen
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Pingtung County is located in the southernmost region of Taiwan. During the winter season, pollutants due to insufficient dispersion caused by the downwash of the northeast monsoon lead to the poor air quality of the County. Through the implementation of various control methods, including the application of permits of air pollution, fee collection of air pollution, control oil fume of catering sectors, smoke detection of diesel vehicles, regular inspection of locomotives, and subsidies for low-polluting vehicles. Moreover, to further mitigate the air pollution, additional alternative controlling strategies are also carried out, such as construction site control, prohibition of open-air agricultural waste burning, improvement of river dust, and strengthening of road cleaning operations. The combined efforts have significantly reduced air pollutants in the County. However, in order to effectively and promptly monitor the ambient air quality, the County has subsequently deployed micro-sensors, with a total of 400 IoTs (Internet of Things) micro-sensors for PM2.5 and VOC detection and 3 air quality monitoring stations of the Environmental Protection Agency (EPA), covering 33 townships of the County. The covered area has more than 1,300 listed factories and 5 major industrial parks; thus forming an Internet of Things (IoTs) based multi-level air quality monitoring system. The results demonstrate that the IoTs multi-level air quality sensors combined with other strategies such as “sand and gravel dredging area technology monitoring”, “banning open burning”, “intelligent management of construction sites”, “real-time notification of activation response”, “nighthawk early bird plan with micro-sensors”, “unmanned aircraft (UAV) combined with land and air to monitor abnormal emissions”, and “animal husbandry odour detection service” etc. The satisfaction improvement rate of air control, through a 2021 public survey, reached a high percentage of 81%, an increase of 46% as compared to 2018. For the air pollution complaints for the whole year of 2021, the total number was 4213 in contrast to 7088 in 2020, a reduction rate reached almost 41%. Because of the spatial-temporal features of the air quality monitoring IoTs system by the application of microsensors, the system does assist and strengthen the effectiveness of the existing air quality monitoring network of the EPA and can provide real-time control of the air quality. Therefore, the hot spots and potential pollution locations can be timely determined for law enforcement. Hence, remarkable results were obtained for the two years. That is, both reduction of public complaints and better air quality are successfully achieved through the implementation of the present IoTs system for real-time air quality monitoring throughout Pingtung County.Keywords: IoT, PM, air quality sensor, air pollution, environmental monitoring
Procedia PDF Downloads 732844 The Outcome of Early Balance Exercises and Agility Training in Sports Rehabilitation for Patients Post Anterior Cruciate Ligament (ACL) Reconstruction
Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun
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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance
Procedia PDF Downloads 2532843 Fresh Amnion Membrane Grafting for the Regeneration of Skin in Full Thickness Burn in Newborn - Case Report
Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar
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The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin
Procedia PDF Downloads 1602842 Combined Effect of Roughness and Suction on Heat Transfer in a Laminar Channel Flow
Authors: Marzieh Khezerloo, Lyazid Djenidi
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Owing to wide range of the micro-device applications, the problems of mixing at small scales is of significant interest. Also, because most of the processes produce heat, it is needed to develop and implement strategies for heat removal in these devices. There are many studies which focus on the effect of roughness or suction on heat transfer performance, separately, although it would be useful to take advantage of these two methods to improve heat transfer performance. Unfortunately, there is a gap in this area. The present numerical study is carried to investigate the combined effects of roughness and wall suction on heat transfer performance of a laminar channel flow; suction is applied on the top and back faces of the roughness element, respectively. The study is carried out for different Reynolds numbers, different suction rates, and various locations of suction area on the roughness. The flow is assumed two dimensional, incompressible, laminar, and steady state. The governing Navier-Stokes equations are solved using ANSYS-Fluent 18.2 software. The present results are tested against previous theoretical results. The results show that by adding suction, the local Nusselt number is enhanced in the channel. In addition, it is shown that by applying suction on the bottom section of the roughness back face, one can reduce the thickness of thermal boundary layer, which leads to an increase in local Nusselt number. This indicates that suction is an effective means for improving the heat transfer rate (suction by controls the thickness of thermal boundary layer). It is also shown that the size and intensity of vortical motion behind the roughness element, decreased with an increasing suction rate, which leads to higher local Nusselt number. So, it can be concluded that by using suction, strategically located on the roughness element, one can control both the recirculation region and the heat transfer rate. Further results will be presented at the conference for coefficient of drag and the effect of adding more roughness elements.Keywords: heat transfer, laminar flow, numerical simulation, roughness, suction
Procedia PDF Downloads 1122841 Investigation of Drought Resistance in Iranian Sesamum Germpelasm
Authors: Fatemeh Najafi
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The major stress factor limiting crop growth and development of sesame (Sesamum indicum L.) is drought stress in arid and semiarid regions of the world. For this study the effects of water stress on some qualitative and quantitative traits in sesame germplasm was conducted in the Research Farm of Seed and Plant Improvement Institute, Karaj, in the crop year. Genotypes in a randomized complete block design with three replications in two environments (moisture stress and normal) were studied in regard of the seed weight, capsule weight, grain yield, biomass, plant height, number of capsules per plant, etc. The characteristics were evaluated based on the combined analysis. Irrigation was based on first class evaporation basin. After flowering stage drought stress was applied. The water deficit reduced growth period. Days to reach full ripening decreased so that the reduction was significant at the five percent level. Drought stress reduces yield and plant biomass. Genotypes based on combined analysis of these two traits were significant at the one percent level. Genotypes differ in terms of yield stress in terms of density plots, grain yield, days to first flowering and days to the half of the cap on the confidence level of five percent and traits of days to emergence of the first capsule and days to reach full ripening at the one percent level were significant. Other traits were not significant. The correlation of traits in circumstances of stress the number of seeds per capsule has the greatest impact on performance. The sensitivity and stress tolerance index was calculated. Based on the indicators, (Fars variety) and variety Karaj were identified as the most tolerant genotypes among the studied genotypes to drought stress. The highest sensitivity indicator of stress was related to genotype (FARS).Keywords: sesamum, drought, stress, germplasm, resistance
Procedia PDF Downloads 702840 The Association Between Different Body Mass Index Levels And Midterm Surgical Revascularization Outcomes
Authors: Farzad Masoud Kabir, Jamshid Bagheri, Khosro Barkhordari
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This historical cohort study included 17,751 patients patients who underwent isolated CABG at our center between 2007 and 2016. The endpoints of this study were all-cause mortality and major adverse cardio-cerebrovascular events (MACCEs), comprising acute coronary syndromes, cerebrovascular accidents, and all-cause mortality at five years. Our findings suggest that preoperative obesity (BMI>30 kg/m2) in patients who survive early after CABG is associated with an increased risk of 5-year all-cause mortality and 5-year MACCEs.Keywords: body mass index, surgical outcomes, midterm, cardiac surgery patients
Procedia PDF Downloads 752839 Single and Combined Effects of Diclofenac and Ibuprofen on Daphnia Magna and Some Phytoplankton Species
Authors: Ramatu I. Sha’aba, Mathias A. Chia, Abdullahi B. Alhassan, Yisa A. Gana, Ibrahim M. Gadzama
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Globally, Diclofenac (DLC) and Ibuprofen (IBU) are the most prescribed drugs due to their antipyretic and analgesic properties. They are, however, highly toxic at elevated doses, with the involvement of an already described oxidative stress pathway. As a result, there is rising concern about the ecological fate of analgesics on non-target organisms such as Daphnia magna and Phytoplankton species. Phytoplankton is a crucial component of the aquatic ecosystem that serves as the primary producer at the base of the food chain. However, the increasing presence and levels of micropollutants such as these analgesics can disrupt their community structure, dynamics, and ecosystem functions. This study presents a comprehensive series of the physiology, antioxidant response, immobilization, and risk assessment of Diclofenac and Ibuprofen’s effects on Daphnia magna and the Phytoplankton community using a laboratory approach. The effect of DLC and IBU at 27.16 µg/L and 20.89 µg/L, respectively, for a single exposure and 22.39 µg/L for combined exposure of DLC and IBU for the experimental setup. The antioxidant response increased with increasing levels of stress. The highest stressor to the organism was 1000 µg/L of DLC and 10,000 µg/L of IBU. Peroxidase and glutathione -S-transferase activity was higher for Diclofenac + Ibuprofen. The study showed 60% and 70% immobilization of the organism at 1000 g L-1 of DLC and IBU. The two drugs and their combinations adversely impacted Phytoplankton biomass with increased exposure time. However, combining the drugs resulted in more significant adverse effects on physiological and pigment content parameters. The risk assessment calculation for the risk quotient and toxic unit of the analgesic reveals from this study was RQ Diclofenac = 8.41, TU Diclofenac = 3.68, and RQ Ibuprofen = 718.05 and TU Ibuprofen = 487.70. Hence, these findings demonstrate that the current exposure concentrations of Diclofenac and Ibuprofen can immobilize D. magna. This study shows the dangers of multiple drugs in the aquatic environment because their combinations could have additive effects on the structure and functions of Phytoplankton and are capable of immobilizing D. magna.Keywords: algae, analgesic drug, daphnia magna, toxicity
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