Search results for: abdominal compression
332 Comparative Analysis of Residual Shear Depiction and Grain Distribution Characteristics of Slide Soil Profile Sections
Authors: Ephrem Getahun, Shengwen Qi, Songfeng Guo, Yu Zou, Melesse Alemayehu
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Residual shear characteristics of slide soil profile sections (SSPS) were examined using ring shear tests to know the relative residual shear behaviors among the sections of slide soil. The multistage-multiphase shearing techniques were employed to perform the experiment for each soil specimen continuously towards large displacements. The grain distribution analysis of SSPS samples was characterized by coarsening upward from bottom slip to the top sections; however, the slip surface was considered as a sheared zone that endorses their low shear resistance for failure. There is an average range of 1-2.5 mm axial displacement on each stage of loadings and phases of shearing that depicts the significant effect of dilation and compression of soil specimen. The middle section has the largest consolidation percentage (10-29%), and vertical displacement compared to other sections and showed high shear strengthening behavior having maximum shear stress of 189kPa at 240kPa loading compared to basal and top sections. It is found that the middle section of SSPS has relatively high shear resistance behavior for large displacement shearing. The residual shear assessment indicates that there is a significant influence of large displacement and rate on the friction coefficient behaviors; it resulted in shear weakening effect to attain their residual condition.Keywords: comparison, displacements, residual shear stress, shear behavior, slide soils
Procedia PDF Downloads 149331 Recovery of Physical Performance in Postpartum Women: An Effective Physical Education Program
Authors: Julia A. Ermakova
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This study aimed to investigate the efficacy of a physical rehabilitation program for postpartum women. The program was developed with the purpose of restoring physical performance in women during the postpartum period. The research employed a variety of methods, including an analysis of scientific literature, pedagogical testing and experimentation, mathematical processing of study results, and physical performance assessment using a range of tests. The program recommends refraining from abdominal exercises during the first 6-8 months following a cesarean section and avoiding exercises with weights. Instead, a feasible training regimen that gradually increases in intensity several times a week is recommended, along with moderate cardio exercises such as walking, bodyweight training, and a separate workout component that targets posture improvement. Stretching after strength training is also encouraged. The necessary equipment includes comfortable sports attire with a chest support top, mat, push-ups, resistance band, timer, and clock. The motivational aspect of the program is paramount, and the mentee's positive experience with the workout regimen includes feelings of lightness in the body, increased energy, and positive emotions. The gradual reduction of body size and weight loss due to an improved metabolism also serves as positive reinforcement. The mentee's progress can be measured through various means, including an external assessment of her form, body measurements, weight, BMI, and the presence or absence of slouching in everyday life. The findings of this study reveal that the program is effective in restoring physical performance in postpartum women. The mentee achieved weight loss and almost regained her pre-pregnancy shape while her self-esteem improved. Her waist, shoulder, and hip measurements decreased, and she displayed less slouching in her daily life. In conclusion, the developed physical rehabilitation program for postpartum women is an effective means of restoring physical performance. It is crucial to follow the recommended training regimen and equipment to avoid limitations and ensure safety during the postpartum period. The motivational component of the program is also fundamental in encouraging positive reinforcement and improving self-esteem.Keywords: physical rehabilitation, postpartum, methodology, postpartum recovery, rehabilitation
Procedia PDF Downloads 75330 Experimental Investigation on Cold-Formed Steel Foamed Concrete Composite Wall under Compression
Authors: Zhifeng Xu, Zhongfan Chen
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A series of tests on cold-formed steel foamed concrete (CSFC) composite walls subjected to axial load were proposed. The primary purpose of the experiments was to study the mechanical behavior and identify the failure modes of CSFC composite walls. Two main factors were considered in this study: 1) specimen with pouring foamed concrete or without and 2) different foamed concrete density ranks (corresponding to different foamed concrete strength). The interior space between two pieces of straw board of the specimen W-2 and W-3 were poured foamed concrete, and the specimen W-1 does not have foamed concrete core. The foamed concrete density rank of the specimen W-2 was A05 grade, and that of the specimen W-3 was A07 grade. Results showed that the failure mode of CSFC composite wall without foamed concrete was distortional buckling of cold-formed steel (CFS) column, and that poured foamed concrete includes the local crushing of foamed concrete and local buckling of CFS column, but the former prior to the later. Compared with CSFC composite wall without foamed concrete, the ultimate bearing capacity of spec imens poured A05 grade and A07 grade foamed concrete increased 1.6 times and 2.2 times respectively, and specimen poured foamed concrete had a low vertical deformation. According to these results, the simplified calculation formula for the CSFC wall subjected to axial load was proposed, and the calculated results from this formula are in very good agreement with the test results.Keywords: cold-formed steel, composite wall, foamed concrete, axial behavior test
Procedia PDF Downloads 337329 Finite Element Simulation of RC Exterior Beam-Column Joints Using Damage Plasticity Model
Authors: A. M. Halahla, M. H. Baluch, M. K. Rahman, A. H. Al-Gadhib, M. N. Akhtar
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In the present study, 3D simulation of a typical exterior (RC) beam–column joint (BCJ) strengthened with carbon fiber-reinforced plastic (CFRP) sheet are carried out. Numerical investigations are performed using a nonlinear finite element ( FE) analysis by incorporating damage plasticity model (CDP), for material behaviour the concrete response in compression, tension softening were used, linear plastic with isotropic hardening for reinforcing steel, and linear elastic lamina material model for CFRP sheets using the commercial FE software ABAQUS. The numerical models developed in the present study are validated with the results obtained from the experiment under monotonic loading using the hydraulic Jack in displacement control mode. The experimental program includes casting of deficient BCJ loaded to failure load for both un-strengthened and strengthened BCJ. The failure mode, and deformation response of CFRP strengthened and un-strengthened joints and propagation of damage in the components of BCJ are discussed. Finite element simulations are compared with the experimental result and are noted to yield reasonable comparisons. The damage plasticity model was able to capture with good accuracy of the ultimate load and the mode of failure in the beam column joint.Keywords: reinforced concrete, exterior beam-column joints, concrete damage plasticity model, computational simulation, 3-D finite element model
Procedia PDF Downloads 383328 Strength of Soft Clay Reinforced with Polypropylene Column
Authors: Muzamir Hasan, Anas Bazirgan
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Granular columns is a technique that has the properties of improving bearing capacity, accelerating the dissipation of excess pore water pressure and reducing settlement in a weak soft soil. This research aims to investigate the role of Polypropylene column in improving the shear strength and compressibility of soft reconstituted kaolin clay by determining the effects of area replacement ratio, height penetrating ratio and volume replacement ratio of a singular Polypropylene column on the strength characteristics. Reinforced kaolin samples were subjected to Unconfined Compression (UCT) and Unconsolidated Undrained (UU) triaxial tests. The kaolin samples were 50 mm in diameter and 100 mm in height. Using the PP column reinforcement, with an area replacement ratio of 0.8, 0.5 and 0.3, shear strength increased approximately 5.27%, 26.22% and 64.28%, and 37.14%, 42.33% and 51.17%, for area replacement ratios of 25% and 10.24%. Meanwhile, UU testing showed an increase in shear strength of 24.01%, 23.17% and 23.49% and 28.79%, 27.29 and 30.81% for the same ratios. Based on the UCT results, the undrained shear strength generally increased with the decrease in height penetration ratio. However, based on the UU test results Mohr-Coulomb failure criteria, the installation of Polypropylene columns did not show any significant difference in effective friction angle. However, there was an increase in the apparent cohesion and undrained shear strength of the kaolin clay. In conclusion, Polypropylene column greatly improved the shear strength; and could therefore be implemented in reducing the cost of soil improvement as a replacement for non-renewable materials.Keywords: polypropylene, UCT, UU test, Kaolin S300, ground improvement
Procedia PDF Downloads 329327 Anisotropic Behavior of Sand Stabilized with Colloidal Silica
Authors: Eleni Maria Pavlopoulou, Vasiliki N. Georgiannou, Filippos C. Chortis
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The response of M31 sand stabilized with colloidal silica (CS) aqueous gel is investigated in the laboratory. CS is introduced in the water regime, forming a hydrosol. The low viscosity hydrosol thickens in a controllable manner to form a stable, non-toxic gel; the gel fills the pore space, retains the pore water, and supports the grain structure. The role of colloidal silica on subsequent sand behavior is examined with the aid of direct shear, triaxial, and normal compression tests. Under the examined loading modes, while the strength of the treated sand is enhanced, its stiffness may reduce, and its compressibility increase. However, in most geotechnical problems, the loading conditions are complex, involving changes in both stress magnitude and direction. Rotation of principal stresses (σ1, σ2, σ3) in varying amounts expressed as angle α, (from α=0° to 90°) in concurrence with increasing shear stress loading is commonly encountered in soil structures such as foundations, embankments, underwater slopes. To assess the influence of anisotropy on the response of sands before and after their stabilization, hollow cylinder tests were performed. The behavior of stabilized sand is compared with the characteristic sand behavior, i.e., a reduction in peak stress ratio associated with a softer stress-strain response with the increasing angle a. The influence of the magnitude of the intermediate principal stress (σ2) on the mechanical response of treated and untreated sand is also examined.Keywords: anisotropy, colloidal silica, laboratory tests, sands, soil stabilization
Procedia PDF Downloads 135326 A Double-Blind, Randomized, Controlled Trial on N-Acetylcysteine for the Prevention of Acute Kidney Injury in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Sara Ataei, Molouk Hadjibabaie, Amirhossein Moslehi, Maryam Taghizadeh-Ghehi, Asieh Ashouri, Elham Amini, Kheirollah Gholami, Alireza Hayatshahi, Mohammad Vaezi, Ardeshir Ghavamzadeh
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Acute kidney injury (AKI) is one of the complications of hematopoietic stem cell transplantation and is associated with increased mortality. N-acetylcysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties that has been investigated for the prevention of AKI in several clinical settings. In the present study, we evaluated the effects of intravenous NAC on the prevention of AKI in allogeneic hematopoietic stem cell transplantation patients. A double-blind randomized placebo-controlled trial was conducted, and 80 patients were recruited to receive 100 mg/kg/day NAC or placebo as intermittent intravenous infusion from day -6 to day +15. AKI was determined on the basis of the Risk-Injury-Failure-Loss-Endstage renal disease and AKI Network criteria as the primary outcome. We assessed urine neutrophil gelatinase-associated lipocalin (uNGAL) on days -6, -3, +3, +9, and +15 as the secondary outcome. Moreover, transplant-related outcomes and NAC adverse reactions were evaluated during the study period. Statistical analysis was performed using appropriate parametric and non-parametric methods including Kaplan–Meier for AKI and generalized estimating equation for uNGAL. At the end of the trial, data from 72 patients were analyzed (NAC: 33 patients and placebo: 39 patients). Participants of each group were not different considering baseline characteristics. AKI was observed in 18% of NAC recipients and 15% of placebo group patients, and the occurrence pattern was not significantly different (p = 0.73). Moreover, no significant difference was observed between groups for uNGAL measures (p = 0.10). Transplant-related outcomes were similar for both groups, and all patients had successful engraftment. Three patients did not tolerate NAC because of abdominal pain, shortness of breath and rash with pruritus and were dropped from the intervention group before transplantation. However, the frequency of adverse reactions was not significantly different between groups. In conclusion, our findings could not show any clinical benefits from high-dose NAC particularly for AKI prevention in allogeneic hematopoietic stem cell transplantation patients.Keywords: acute kidney injury, N-acetylcysteine, hematopoietic stem cell transplantation, urine neutrophil gelatinase-associated lipocalin, randomized controlled trial
Procedia PDF Downloads 433325 Mixed Mode Fracture Analyses Using Finite Element Method of Edge Cracked Heavy Spinning Annulus Pulley
Authors: Bijit Kalita, K. V. N. Surendra
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Rotating disk is one of the most indispensable parts of a rotating machine. Rotating disk has found many applications in the diverging field of science and technology. In this paper, we have taken into consideration the problem of a heavy spinning disk mounted on a rotor system acted upon by boundary traction. Finite element modelling is used at various loading condition to determine the mixed mode stress intensity factors. The effect of combined shear and normal traction on the boundary is incorporated in the analysis under the action of gravity. The variation near the crack tip is characterized in terms of the stress intensity factor (SIF) with an aim to find the SIF for a wide range of parameters. The results of the finite element analyses carried out on the compressed disk of a belt pulley arrangement using fracture mechanics concepts are shown. A total of hundred cases of the problem are solved for each of the variations in loading arc parameter and crack orientation using finite element models of the disc under compression. All models were prepared and analyzed for the uncracked disk, disk with a single crack at different orientation emanating from shaft hole as well as for a disc with pair of cracks emerging from the same center hole. Curves are plotted for various loading conditions. Finally, crack propagation paths are determined using kink angle concepts.Keywords: crack-tip deformations, static loading, stress concentration, stress intensity factor
Procedia PDF Downloads 143324 Recycled Aggregates from Construction and Demolition Waste in the Production of Concrete Blocks
Authors: Juan A. Ferriz-Papi, Simon Thomas
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The construction industry generates large amounts of waste, usually mixed, which can be composed of different origin materials, most of them catalogued as non-hazardous. The European Union targets for this waste for 2020 have been already achieved by the UK, but it is mainly developed in downcycling processes (backfilling) whereas upcycling (such as recycle in new concrete batches) still keeps at a low percentage. The aim of this paper is to explore further in the use of recycled aggregates from construction and demolition waste (CDW) in concrete mixes so as to improve upcycling. A review of most recent research and legislation applied in the UK is developed regarding the production of concrete blocks. As a case study, initial tests were developed with a CDW recycled aggregate sample from a CDW plant in Swansea. Composition by visual inspection and sieving tests of two samples were developed and compared to original aggregates. More than 70% was formed by soil waste from excavation, and the rest was a mix of waste from mortar, concrete, and ceramics with small traces of plaster, glass and organic matter. Two concrete mixes were made with 80% replacement of recycled aggregates and different water/cement ratio. Tests were carried out for slump, absorption, density and compression strength. The results were compared to a reference sample and showed a substantial reduction of quality in both mixes. Despite that, the discussion brings to identify different aspects to solve, such as heterogeneity or composition, and analyze them for the successful use of these recycled aggregates in the production of concrete blocks. The conclusions obtained can help increase upcycling processes ratio with mixed CDW as recycled aggregates in concrete mixes.Keywords: aggregates, concrete, concrete block, construction and demolition waste, recycling
Procedia PDF Downloads 299323 Effects of Hierarchy on Poisson’s Ratio and Phononic Bandgaps of Two-Dimensional Honeycomb Structures
Authors: Davood Mousanezhad, Ashkan Vaziri
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As a traditional cellular structure, hexagonal honeycombs are known for their high strength-to-weight ratio. Here, we introduce a class of fractal-appearing hierarchical metamaterials by replacing the vertices of the original non-hierarchical hexagonal grid with smaller hexagons and iterating this process to achieve higher levels of hierarchy. It has been recently shown that the isotropic in-plane Young's modulus of this hierarchical structure at small deformations becomes 25 times greater than its regular counterpart with the same mass. At large deformations, we find that hierarchy-dependent elastic buckling introduced at relatively early stages of deformation decreases the value of Poisson's ratio as the structure is compressed uniaxially leading to auxeticity (i.e., negative Poisson's ratio) in subsequent stages of deformation. We also show that the topological hierarchical architecture and instability-induced pattern transformations of the structure under compression can be effectively used to tune the propagation of elastic waves within the structure. We find that the hierarchy tends to shift the existing phononic bandgaps (defined as frequency ranges of strong wave attenuation) to lower frequencies while opening up new bandgaps. Deformation is also demonstrated as another mechanism for opening more bandgaps in hierarchical structures. The results provide new insights into the role of structural organization and hierarchy in regulating mechanical properties of materials at both the static and dynamic regimes.Keywords: cellular structures, honeycombs, hierarchical structures, metamaterials, multifunctional structures, phononic crystals, auxetic structures
Procedia PDF Downloads 349322 Mesenteric Ischemia Presenting as Acalculous Cholecystitis: A Case Review of a Rare Complication and Aberrant Anatomy
Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa
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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia
Procedia PDF Downloads 191321 Rare Internal Organ Trauma in Adolescent Athletes: Insights from a Pancreatic Injury Case Study
Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka
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Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman
Procedia PDF Downloads 73320 Heat Forging Analysis Method on Blank Consist of Two Metals
Authors: Takashi Ueda, Shinichi Enoki
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Forging parts is used to automobiles. Because they have high strength and it is possible to press them into complicated shape. When it is possible to manufacture hollow forging parts, it leads to reduce weight of the automobiles. But, hollow forging parts are confined to axisymmetrical shape. Hollow forging parts that were pressed to complicated shape are expected. Therefore, we forge a blank that aluminum alloy was inserted in stainless steel. After that, we can provide complex forging parts that are reduced weight, if it is possible to be melted the aluminum alloy away by using different of melting points. It is necessary to establish heat forging analysis method on blank consist of stainless steel and aluminum alloy. Because, this forging is different from conventional forging and this technology is not confirmed. In this study, we compared forging experiment with numerical analysis on the view point of forming load and shape after forming and establish how to set the material temperatures of two metals and material property of stainless steel on the analysis method. Consequently, temperature difference of stainless steel and aluminum alloy was obtained by experiment. We got material property of stainless steel on forging experimental by compression tests. We had compared numerical analysis that was used the temperature difference of two metals and the material property of stainless steel on forging experimental with forging experiment. Forging analysis method on blank consist of two metals was established by result of numerical analysis having agreed with result of forging experiment.Keywords: forging, lightweight, analysis, hollow
Procedia PDF Downloads 415319 Comparative Study on Structural Behaviour of Circular Hollow Steel Tubular, Concrete Filled Steel Tubular, and Reinforced Cement Concrete Stub Columns under Pure Axial Compression
Authors: Niladri Roy, M. Longshithung Patton
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This paper is aimed at studying the structural response of circular hollow steel tubular (HST), concrete filled steel tubular (CFST), and reinforced cement concrete (RCC) stub columns when subjected to only axial compressive forces and also examining their comparative nature using finite element (FE) models. These results are further compared with the respective experimental results. FE software package ABAQUS 6.14 has been used for further parametric studies where a total of 108 FE models were modelled. The diameters of the HST, CFST, and RCC stub columns are kept as 100, 140, 180, and 220, with length to diameter ratio fixed at 3 to avoid end effects and flexural failure. To keep the same percentage of steel (by volume), the thicknesses of steel tubes in HST and CFST columns were varied in response to the change in diameter of the main reinforcement bar in RCC columns. M25 grade of concrete was used throughout. The objective is to compare the structural behaviour of HST, CFST, and RCC stub columns on the basis of their axial compressive load carrying capacity and failure modes. The studies show that filling the circular HST columns with concrete increases the Pu of the CCFST columns by 2.97 times. It was also observed that the Pu (HST) is about 0.72 times Pu (RCC) on average, and the Pu (CFST) is about 2.08 times Pu (RCC) on average. After the analysis and comparison, it has been proved that CFST has much more load carrying capacity than HST and RCC and also provides the same strength at a very less sectional size.Keywords: HST columns, stub columns, CFST columns, RCC columns, finite element modeling, ABAQUS
Procedia PDF Downloads 100318 Development of an Auxetic Tissue Implant
Authors: Sukhwinder K. Bhullar, M. B. G. Jun
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The developments in biomedical industry have demanded the development of biocompatible, high performance materials to meet higher engineering specifications. The general requirements of such materials are to provide a combination of high stiffness and strength with significant weight savings, resistance to corrosion, chemical resistance, low maintenance, and reduced costs. Auxetic materials which come under the category of smart materials offer huge potential through measured enhancements in mechanical properties. Unique deformation mechanism, providing cushioning on indentation, automatically adjustable with its strength and thickness in response to forces and having memory returns to its neutral state on dissipation of stresses make them good candidate in biomedical industry. As simple extension and compression of tissues is of fundamental importance in biomechanics, therefore, to study the elastic behaviour of auxetic soft tissues implant is targeted in this paper. Therefore development and characterization of auxetic soft tissue implant is studied in this paper. This represents a real life configuration where soft tissue such as meniscus in knee replacement, ligaments and tendons often are taken as transversely isotropic. Further, as composition of alternating polydisperse blocks of soft and stiff segments combined with excellent biocompatibility make polyurethanes one of the most promising synthetic biomaterials. Hence selecting auxetic polyurathylene foam functional characterization is performed and compared with conventional polyurathylene foam.Keywords: auxetic materials, deformation mechanism, enhanced mechanical properties, soft tissues
Procedia PDF Downloads 459317 Risk of Fatal and Non-Fatal Coronary Heart Disease and Stroke Events among Adult Patients with Hypertension: Basic Markov Model Inputs for Evaluating Cost-Effectiveness of Hypertension Treatment: Systematic Review of Cohort Studies
Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi
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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events
Procedia PDF Downloads 71316 In vitro Susceptibility of Isolated Shigella flexneri and Shigella dysenteriae to the Ethanolic Extracts of Trachyspermum ammi and Peganum harmala
Authors: Ibrahim Siddig Hamid, Ikram Mohamed Eltayeb
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Trachyspermum ammi belongs to the family Apiaceae, is used traditionally for the treatment of gastrointestinal ailments, lack of appetite and bronchial problems as well used as antiseptic, antimicrobial, antipyretic, febrifugal and in the treatment of typhoid fever. Peganum harmala belongs to the family Zygophyllaceae it has been reported to have an antibacterial activity and used to treat depression and recurring fevers. It also used to kill algae, bacteria, intestinal parasites and molds. In Sudan, the combination of two plants are traditionally used for the treatment of bacillary dysentery. Bacillary dysentery is caused by one or more types of Shigella species bacteria mainly Shigella dysenteri and shigella flexneri. Bacillary dysentery is mainly found in hot countries like Sudan with poor hygiene and sanitation. Bacillary dysentery causes sudden onset of high fever and chills, abdominal pain, cramps and bloating, urgency to pass stool, weight loss, and dehydration and if left untreated it can lead to serious complications including delirium, convulsions and coma. A serious infection like this can be fatal within 24 hours. The objective of this study is to investigate the in vitro susceptibility of Sh. flexneri and Sh. dysenteriae to the T. ammi and P. harmala. T. ammi and P. harmala were extracted by 96% ethanol using Soxhlet apparatus. The antimicrobial activity of the extracts was investigated according to the disc diffusion method. The discs were prepared by soaking sterilized filter paper discs in 20 microliter of serially diluted solutions of each plant extract with the concentrations (100, 50, 25, 12.5, 6.25mg/dl) then placing them on Muller Hinton Agar plates that were inoculated with bacterial suspension separately, the plates were incubated for 24 hours at 37c and the minimum inhibitory concentration of the extract which was the least concentration of the extract to inhibit fungal growth was determined. The results showed the high antimicrobial activity of T. ammi extract with an average diameter zone ranging from 18-20 mm and its minimum inhibitory concentration was found to be 25 mg/ml against the two shigella species. P. harmala extract was found to have slight antibacterial effect against the two bacteria. This result justified the Sudanese traditional use of Trachyspermum ammi plant for the treatment of bacillary dysentery.Keywords: harmala, peganum, shigella, trachyspermum
Procedia PDF Downloads 244315 Study of the Hydraulic Concrete Physical-Mechanical Properties by Using Admixtures
Authors: Natia Tabatadze
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The research aim is to study the physical - mechanical characteristics of structural materials, in particular, hydraulic concrete in the surface active environment and receiving of high strength concrete, low-deformable, resistant to aggressive environment concrete due application of nano technologies. The obtained concrete with additives will by possible to apply in hydraulic structures. We used cement (compressive strength R28=39,42 mPa), sand (0- 5 mm), gravel (5-10 mm, 10-20 mm), admixture CHRYSO® Fuge B 1,5% dosage of cement. CHRYSO® Fuge B renders mortar and concrete highly resistant to capillary action and reduces, or even eliminates infiltration of water under pressure. The fine particles that CHRYSO® Fuge B contains combine with the lime in the cement to form water repellent particles. These obstruct the capillary action within concrete. CHRYSO® Fuge B does not significantly modify the characteristics of the fresh concrete and mortar, nor the compressive strength. As result of research, the alkali-silica reaction was improved (relative elongation 0,122 % of admixture instead of 0,126 % of basic concrete after 14 days). The aggressive environment impact on the strength of heavy concrete, fabricated on the basis of the hydraulic admixture with the penetrating waterproof additives also was improved (strength on compression R28=47,5 mPa of admixture instead of R28=35,8 mPa), as well as the mass water absorption (W=3,37 % of admixture instead of W=1,41 %), volume water absorption (W=1,41 % of admixture instead of W=0,59 %), water tightness (R14=37,9 mPa instead R14=28,7 mPa) and water-resistance (B=18 instead B=12). The basic parameters of concrete with admixture was improved in comparison with basic concrete.Keywords: structural materials, hydraulic concrete, low-deformable, water absorption for mass, water absorption for volume
Procedia PDF Downloads 320314 Influence of Alkali Aggregate Reaction Induced Expansion Level on Confinement Efficiency of Carbon Fiber Reinforcement Polymer Wrapping Applied to Damaged Concrete Columns
Authors: Thamer Kubat, Riadh Al-Mahaidi, Ahmad Shayan
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The alkali-aggregate reaction (AAR) in concrete has a negative influence on the mechanical properties and durability of concrete. Confinement by carbon fibre-reinforced polymer (CFRP) is an effective method of treatment for some AAR-affected elements. Eighteen reinforced columns affected by different levels of expansion due to AAR were confined using CFRP to evaluate the effect of expansion level on confinement efficiency. Strength and strain capacities (axial and circumferential) were measured using photogrammetry under uniaxial compressive loading to evaluate the efficiency of CFRP wrapping for the rehabilitation of affected columns. In relation to uniaxial compression capacity, the results indicated that the confinement of AAR-affected columns by one layer of CFRP is sufficient to reach and exceed the load capacity of unaffected sound columns. Parallel to the experimental study, finite element (FE) modeling using ATENA software was employed to predict the behavior of CFRP-confined damaged concrete and determine the possibility of using the model in a parametric study by simulating the number of CFRP layers. A comparison of the experimental results with the results of the theoretical models showed that FE modeling could be used for the prediction of the behavior of confined AAR-damaged concrete.Keywords: carbon fiber reinforced polymer (CFRP), finite element (FE), ATENA, confinement efficiency
Procedia PDF Downloads 78313 Virtual Prototyping of Ventilated Corrugated Fibreboard Carton of Fresh Fruit for Improved Containerized Transportation
Authors: Alemayehu Ambaw, Matia Mukama, Umezuruike Linus Opara
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This study introduces a comprehensive method for designing ventilated corrugated fiberboard carton for fresh fruit packaging utilising virtual prototyping. The technique efficiently assesses and analyses the mechanical and thermal capabilities of fresh fruit packing boxes prior to making production investments. Comprehensive structural, aerodynamic, and thermodynamic data from designs were collected and evaluated in comparison to real-world packaging needs. Physical prototypes of potential designs were created and evaluated afterward. The virtual prototype is created with computer-aided graphics, computational structural dynamics, and computational fluid dynamics technologies. The virtual prototyping quickly generated data on carton compression strength, airflow resistance, produce cooling rate, spatiotemporal temperature, and product quality map in the cold chain within a few hours. Six distinct designs were analysed. All the various carton designs showed similar effectiveness in preserving the quality of the goods. The innovative packaging box design is more compact, resulting in a higher freight density of 1720 kg more fruit per reefer compared to the commercial counterpart. The precooling process was improved, resulting in a 17% increase in throughput and a 30% reduction in power usage.Keywords: postharvest, container logistics, space/volume usage, computational method, packaging technology
Procedia PDF Downloads 59312 Congenital Malformations in Neonate Dogs in the Sao Paulo State University Veterinary Hospital, Botucatu, Sao Paulo, Brazil
Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado
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Congenital malformations are organ defects due to genetic or teratogenic causes, which can lead to high mortality in dog litters. This study assessed and described the congenital malformations in newborn dogs. The study included litters attend in the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil. One hundred seventy-eight litters and 803 newborns were evaluated. The occurrence of litters with malformations was 24.7%, and of newborns was 6.7%. Twenty-seven different malformations were registered: anasarca, anal atresia, cleft lip, cleft palate, duplicated right ribcage, equinovarus, exencephaly, gastroschisis, hydrocephaly, lissencephaly, macroglossia, microphthalmia, mitral valve dysplasia, omphalocele, eyelid agenesis, persistent urachus, polydactyly, pulmonary hypoplasia, pulmonary valve stenosis, rectovaginal fistula, agenesis of abdominal muscles, rib hypoplasia, scoliosis, segmental aplasia of the intestines, tricuspid valve dysplasia, unilateral kidney agenesis, and vaginal atresia. 68.7% of newborns died as a result of malformations. The pure breeds with the highest chances of manifesting malformations in contrast with mixed breeds were French Bulldog, Pug, English Bulldog, Rottweiler, German Spitz, Pinscher, Pitbull, Yorkshire Terrier, and Shih-Tzu. Significant values (P<0.05) occurred in races French Bulldogs and Pugs. The causes of congenital disabilities are possibly related to hereditary genetic factors considering that the highest incidence of malformations was observed among purebreds. There as one case of exposure to a teratogenic agent, but no other mothers were exposed to such agents during pregnancy. Two cases of consanguineal breeding between siblings were reported. The mortality rate was high. Genetic breeding programs for reproduction, avoiding consanguineous mating, care in choosing parents, and avoiding maternal exposure to teratogenic agents are of utmost importance in reducing dog malformations and consequent mortality.Keywords: congenital defects, teratogenesis, canine neonatology, newborn puppy
Procedia PDF Downloads 142311 Preventive Effect of Locoregional Analgesia Techniques on Chronic Post-Surgical Neuropathic Pain: A Prospective Randomized Study
Authors: Beloulou Mohamed Lamine, Bouhouf Attef, Meliani Walid, Sellami Dalila, Lamara Abdelhak
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Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with post-surgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariate analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature or component, particularly in surgeries that are more prone to chronicization.Keywords: chronic postsurgical pain, postsurgical chronic neuropathic pain, regional anesthesia and analgesia techniques (RAAT), neuropathic pain score dn2, preventive impact
Procedia PDF Downloads 27310 The Effect of Surface Modified Nano-Hydroxyapatite Incorporation into Polymethylmethacrylate Cement on Biocompatibility and Mechanical Properties
Authors: Yu-Shan Wu, Po-Liang Lai, I-Ming Chu
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Poly(methylmethacrylate)(PMMA) is the most frequently used bone void filler for vertebral augmentation in osteoporotic fracture. PMMA bone cement not only exhibits strong mechanical properties but also can fabricate according to the shape of bone defect. However, the adhesion between the PMMA-based cement and the adjacent bone is usually weak and as PMMA bone cement is inherently bioinert. The combination of bioceramics and polymers as composites may increase cell adhesion and improve biocompatibility. The nano-hydroxyapatite(HAP) not only plays a significant role in maintaining the properties of the natural bone but also offers a favorable environment for osteoconduction, protein adhesion, and osteoblast proliferation. However, defects and cracks can form at the polymer/ceramics interface, resulting in uneven distribution of stress and subsequent inferior mechanical strength. Surface-modified HAP nano-crystals were prepared by chemically grafting poly(ε-caprolactone)(PCL) on surface-modified nano-HAP surface to increase the affinity of polymer/ceramic phases .Thus, incorporation of surface-modified nano-hydroxyapatite (EC-HAP) may not only improve the interfacial adhesion between cement and bone and between nanoparticles and cement, but also increase biocompatibility. In this research, PMMA mixing with 0, 5, 10, 15, 20, 25 and 30 wt% EC-HAP were examined. MC3T3-E1 cells were used for the biological evaluation of the response to the cements in vitro. Morphology was observed using scanning electron microscopy (SEM). Mechanical properties of HAP/PMMA and EC-HAP/PMMA cement were investigated by compression test. Surface wettability of the cements was measured by contact angles.Keywords: bone cement, biocompatibility, nano-hydroxyapatite, polycaprolactone, PMMA, surface grafting
Procedia PDF Downloads 395309 Structural Performance Evaluation of Concrete Beams Reinforced with Recycled and Virgin Plastic Fibres
Authors: Vighnesh Daas, David B. Tann, Mahmood Datoo
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The incorporation of recycled plastic fibres in concrete as reinforcement is a potential sustainable alternative for replacement of ordinary steel bars. It provides a scope for waste reduction and re-use of plastics in the construction industry on a large scale. Structural use of fibre reinforced concrete is limited to short span members and low reliability classes. In this study, recycled carpet fibres made of 95% polypropylene with length of 45mm were used for experimental investigations. The performance of recycled polypropylene fibres under structural loading has been compared with commercially available virgin fibres at low volume fractions of less than 1%. A series of 100 mm cubes and 125x200x2000 mm beams were used to conduct strength tests in bending and compression to measure the influence of type and volume of fibres on the structural behaviour of fibre reinforced concrete beams. The workability of the concrete mix decreased as a function of fibre content and resulted in a modification of the mix design. The beams failed in a pseudo-ductile manner with an enhanced bending capacity. The specimens showed significant improvement in the post-cracking behaviour and load carrying ability as compared to conventional reinforced concrete members. This was associated to the binding properties of the fibres in the concrete matrix. With the inclusion of fibres at low volumes of 0-0.5%, there was reduction in crack sizes and deflection. This study indicates that the inclusion of recycled polypropylene fibres at low volumes augments the structural behaviour of concrete as compared to conventional reinforced concrete as well as virgin fibre reinforced concrete.Keywords: fibre reinforced concrete, polypropylene, recycled, strength
Procedia PDF Downloads 247308 Rapid Fetal MRI Using SSFSE, FIESTA and FSPGR Techniques
Authors: Chen-Chang Lee, Po-Chou Chen, Jo-Chi Jao, Chun-Chung Lui, Leung-Chit Tsang, Lain-Chyr Hwang
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Fetal Magnetic Resonance Imaging (MRI) is a challenge task because the fetal movements could cause motion artifact in MR images. The remedy to overcome this problem is to use fast scanning pulse sequences. The Single-Shot Fast Spin-Echo (SSFSE) T2-weighted imaging technique is routinely performed and often used as a gold standard in clinical examinations. Fast spoiled gradient-echo (FSPGR) T1-Weighted Imaging (T1WI) is often used to identify fat, calcification and hemorrhage. Fast Imaging Employing Steady-State Acquisition (FIESTA) is commonly used to identify fetal structures as well as the heart and vessels. The contrast of FIESTA image is related to T1/T2 and is different from that of SSFSE. The advantages and disadvantages of these two scanning sequences for fetal imaging have not been clearly demonstrated yet. This study aimed to compare these three rapid MRI techniques (SSFSE, FIESTA, and FSPGR) for fetal MRI examinations. The image qualities and influencing factors among these three techniques were explored. A 1.5T GE Discovery 450 clinical MR scanner with an eight-channel high-resolution abdominal coil was used in this study. Twenty-five pregnant women were recruited to enroll fetal MRI examination with SSFSE, FIESTA and FSPGR scanning. Multi-oriented and multi-slice images were acquired. Afterwards, MR images were interpreted and scored by two senior radiologists. The results showed that both SSFSE and T2W-FIESTA can provide good image quality among these three rapid imaging techniques. Vessel signals on FIESTA images are higher than those on SSFSE images. The Specific Absorption Rate (SAR) of FIESTA is lower than that of the others two techniques, but it is prone to cause banding artifacts. FSPGR-T1WI renders lower Signal-to-Noise Ratio (SNR) because it severely suffers from the impact of maternal and fetal movements. The scan times for these three scanning sequences were 25 sec (T2W-SSFSE), 20 sec (FIESTA) and 18 sec (FSPGR). In conclusion, all these three rapid MR scanning sequences can produce high contrast and high spatial resolution images. The scan time can be shortened by incorporating parallel imaging techniques so that the motion artifacts caused by fetal movements can be reduced. Having good understanding of the characteristics of these three rapid MRI techniques is helpful for technologists to obtain reproducible fetal anatomy images with high quality for prenatal diagnosis.Keywords: fetal MRI, FIESTA, FSPGR, motion artifact, SSFSE
Procedia PDF Downloads 530307 Effective Slab Width for Beam-End Flexural Strength of Composite Frames with Circular-Section Columns
Authors: Jizhi Zhao, Qiliang Zhou, Muxuan Tao
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The calculation of the ultimate loading capacity of composite frame beams is an important step in the design of composite frame structural systems. Currently, the plastic limit theory is mainly used for this calculation in the codes adopted by many countries; however, the effective slab width recommended in most codes is based on the elastic theory, which does not accurately reflect the complex stress mechanism at the beam-column joints in the ultimate loading state. Therefore, the authors’ research group put forward the Compression-on-Column-Face mechanism and Tension-on-Transverse-Beam mechanism to explain the mechanism in the ultimate loading state. Formulae are derived for calculating the effective slab width in composite frames with rectangular/square-section columns under ultimate lateral loading. Moreover, this paper discusses the calculation method of the effective slab width for the beam-end flexural strength of composite frames with circular-section columns. The proposed design formula is suitable for exterior and interior joints. Finally, this paper compares the proposed formulae with available formulae in other literature, current design codes, and experimental results, providing the most accurate results to predict the effective slab width and ultimate loading capacity.Keywords: composite frame structure, effective slab width, circular-section column, design formulae, ultimate loading capacity
Procedia PDF Downloads 128306 Effects of Particle Size Distribution on Mechanical Strength and Physical Properties in Engineered Quartz Stone
Authors: Esra Arici, Duygu Olmez, Murat Ozkan, Nurcan Topcu, Furkan Capraz, Gokhan Deniz, Arman Altinyay
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Engineered quartz stone is a composite material comprising approximately 90 wt.% fine quartz aggregate with a variety of particle size ranges and `10 wt.% unsaturated polyester resin (UPR). In this study, the objective is to investigate the influence of particle size distribution on mechanical strength and physical properties of the engineered stone slabs. For this purpose, granular quartz with two particle size ranges of 63-200 µm and 100-300 µm were used individually and mixed with a difference in ratios of mixing. The void volume of each granular packing was measured in order to define the amount of filler; quartz powder with the size of less than 38 µm, and UPR required filling inter-particle spaces. Test slabs were prepared using vibration-compression under vacuum. The study reports that both impact strength and flexural strength of samples increased as the mix ratio of the particle size range of 63-200 µm increased. On the other hand, the values of water absorption rate, apparent density and abrasion resistance were not affected by the particle size distribution owing to vacuum compaction. It is found that increasing the mix ratio of the particle size range of 63-200 µm caused the higher porosity. This led to increasing in the amount of the binder paste needed. It is also observed that homogeneity in the slabs was improved with the particle size range of 63-200 µm.Keywords: engineered quartz stone, fine quartz aggregate, granular packing, mechanical strength, particle size distribution, physical properties.
Procedia PDF Downloads 147305 Effect of Fines on Liquefaction Susceptibility of Sandy Soil
Authors: Ayad Salih Sabbar, Amin Chegenizadeh, Hamid Nikraz
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Investigation of liquefaction susceptibility of materials that have been used in embankments, slopes, dams, and foundations is very essential. Many catastrophic geo-hazards such as flow slides, declination of foundations, and damage to earth structure are associated with static liquefaction that may occur during abrupt shearing of these materials. Many artificial backfill materials are mixtures of sand with fines and other composition. In order to provide some clarifications and evaluations on the role of fines in static liquefaction behaviour of sand sandy soils, the effect of fines on the liquefaction susceptibility of sand was experimentally examined in the present work over a range of fines content, relative density, and initial confining pressure. The results of an experimental study on various sand-fines mixtures are presented. Undrained static triaxial compression tests were conducted on saturated Perth sand containing 5% bentonite at three different relative densities (10, 50, and 90%), and saturated Perth sand containing both 5% bentonite and slag (2%, 4%, and 6%) at single relative density 10%. Undrained static triaxial tests were performed at three different initial confining pressures (100, 150, and 200 kPa). The brittleness index was used to quantify the liquefaction potential of sand-bentonite-slag mixtures. The results demonstrated that the liquefaction susceptibility of sand-5% bentonite mixture was more than liquefaction susceptibility of clean sandy soil. However, liquefaction potential decreased when both of two fines (bentonite and slag) were used. Liquefaction susceptibility of all mixtures decreased with increasing relative density and initial confining pressure.Keywords: liquefaction, bentonite, slag, brittleness index
Procedia PDF Downloads 221304 Buildings Founded on Thermal Insulation Layer Subjected to Earthquake Load
Authors: David Koren, Vojko Kilar
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The modern energy-efficient houses are often founded on a thermal insulation (TI) layer placed under the building’s RC foundation slab. The purpose of the paper is to identify the potential problems of the buildings founded on TI layer from the seismic point of view. The two main goals of the study were to assess the seismic behavior of such buildings, and to search for the critical structural parameters affecting the response of the superstructure as well as of the extruded polystyrene (XPS) layer. As a test building a multi-storeyed RC frame structure with and without the XPS layer under the foundation slab has been investigated utilizing nonlinear dynamic (time-history) and static (pushover) analyses. The structural response has been investigated with reference to the following performance parameters: i) Building’s lateral roof displacements, ii) Edge compressive and shear strains of the XPS, iii) Horizontal accelerations of the superstructure, iv) Plastic hinge patterns of the superstructure, v) Part of the foundation in compression, and vi) Deformations of the underlying soil and vertical displacements of the foundation slab (i.e. identifying the potential uplift). The results have shown that in the case of higher and stiff structures lying on firm soil the use of XPS under the foundation slab might induce amplified structural peak responses compared to the building models without XPS under the foundation slab. The analysis has revealed that the superstructure as well as the XPS response is substantially affected by the stiffness of the foundation slab.Keywords: extruded polystyrene (XPS), foundation on thermal insulation, energy-efficient buildings, nonlinear seismic analysis, seismic response, soil–structure interaction
Procedia PDF Downloads 301303 A Randomised Controlled Study to Compare Efficacy and Safety of Bupivacaine plus Dexamethasone Versus Bupivacaine plus Fentanyl for Caudal Block in Children
Authors: Ashwini Patil
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Caudal block is one of the most commonly used regional anesthetic techniques in children. Currently, fentanyl is used as an adjuvant to bupivacaine to prolong analgesia but fentanyl is a narcotic. Dexamethasone, a glucocorticoid with strong anti-inflammatory effects provides improvement in post-operative analgesia and post-operative side effects. However, its analgesic efficacy and safety in comparison with fentanyl has not been extensively studied. So the objective of this randomized controlled study is to compare dexamethasone with fentanyl as an adjuvant to bupivacaine for caudal block in children in relation to the duration of caudal analgesia, post-operative analgesic requirement and incidence of post-operative nausea and vomiting. This study included 100 children, aged 1–6 years, undergoing lower abdominal surgeries. Patients were randomized into two groups, 50 each to receive a combination of dexamethasone 0.2 mg/kg along with 1 ml/kg bupivacaine 0.25% (group A) or combination of fentanyl (1 ug/kg) along with 1ml/kg bupivacaine 0.25% (group B). In the post-operative period, pain was assessed using a Modified Objective Pain Scale (MOPS) until 12 hr after surgery and rescue analgesia is administered when MOPS score 4 or more is recorded. Residual motor block, number of analgesic doses required within 24 hr after surgery, sedation scores, intra-operative and post-operative hemodynamic variables, post-operative nausea and vomiting (PONV), and other adverse effects were recorded. Data is analysed using unpaired t test and Significance level of P< 0.05 is considered statistically significant. Group A showed a significantly longer time to first analgesic requirement than group B (p<0.05). The number of rescue analgesic doses required in the first 24 h was significantly less in group A (p<0.05). Group A showed significantly lower MOPS scores than group B(p<0.05). Intra-operative and post-operative hemodynamic variables, Modified Bromage Scale scores, and sedation scores were comparable in both the groups. Group A showed significantly fewer incidences of PONV compared with group B(p<0.05). This study reveals that adding dexamethasone to bupivacaine prolongs the duration of postoperative analgesia and decreases the incidence of PONV as compared to combination of fentanyl to bupivacaine after a caudal block in pediatric patients.Keywords: bupivacaine, caudal analgesia, dexamethasone, pediatric
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