Search results for: hip fracture surgery

Authors: J. Sagouis, A. Chamel, E. Carre, C. Casasreales, G. Rudnik, M. Cerdan

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Robotics provides answers to amputees. The most expensive solutions surgically connect the prosthesis to nerve endings. There are also several types of non-invasive technologies that recover nerve messages passing through the muscles. After analyzing these messages, myoelectric prostheses perform the desired movement. The main goal is to avoid all surgeries, which can be heavy and offer cheaper alternatives. For an amputee, we use valid muscles to recover the electrical signal involved in a muscle movement. EMG sensors placed on the muscle allows us to measure a potential difference, which our program transforms into control for a robotic arm with two degrees of freedom. We have shown the feasibility of non-invasive prostheses with two degrees of freedom. Signal analysis and an increase in degrees of freedom is still being improved.

Keywords: prosthesis, electromyography (EMG), robotic arm, nerve message

Procedia PDF Downloads 249

Authors: T. Kuchukhidze, N. Jalagonia, T. Korkia, V. Gabunia, N. Jalabadze, R. Chedia

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In this work, obtaining methods of ultrafine alumina powdery composites and high temperature pressing technology of matrix ceramic composites with different compositions have been discussed. Alumina was obtained by solution combustion synthesis and sol-gel methods. Metal carbides containing powdery composites were obtained by homogenization of finishing powders in nanomills, as well as by their single-step high temperature synthesis .Different types of matrix ceramics composites (α-Al2O3-ZrO2-Y2O3, α-Al2O3- Y2O3-MgO, α-Al2O3-SiC-Y2O3, α-Al2O3-WC-Co-Y2O3, α-Al2O3- B4C-Y2O3, α-Al2O3- B4C-TiB2 etc.) were obtained by using OXYGON furnace. Consolidation of powders were carried out at 1550- 1750°C (hold time - 1 h, pressure - 50 MPa). Corundum ceramics samples have been obtained and characterized by high hardness and fracture toughness, absence of open porosity, high corrosion resistance. Their density reaches 99.5-99.6% TD. During the work, the following devices have been used: High temperature vacuum furnace OXY-GON Industries Inc (USA), Electronic Scanning Microscopes Nikon Eclipse LV 150, Optical Microscope NMM- 800TRF, Planetary mill Pulverisette 7 premium line, Shimadzu Dynamic Ultra Micro Hardness Tester DUH-211S, Analysette 12 Dynasizer.

Keywords: α-alumina, consolidation, phase transformation, powdery composites

Procedia PDF Downloads 348

Authors: M. Al-Farttoosi, M. Y. Rafiq, J. Summerscales, C. Williams

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Structures can be subjected to impact loading from various sources like earthquake, tsunami, missiles and explosions. The impact loading can cause different degrees of damage to concrete structures. The demand for strengthening and rehabilitation of damaged structures is increasing. In recent years, Car0bon Fibre Reinforced Polymer (CFRP) matrix composites has gain more attention for strengthening and repairing these structures. To study the impact behaviour of the reinforced concrete (RC) beams strengthened or repaired using CFRP, a heavy impact test machine was designed and manufactured .The machine included a newly designed support system for beams together with various instrumentation. This paper describes the support design configuration of the impact test machine, instrumentation and dynamic analysis of the concrete beams. To evaluate the efficiency of the new impact test machine, experimental impact tests were conducted on simple supported reinforced concrete beam. Different methods were used to determine the impact force and impact response of the RC beams in terms of inertia force, maximum deflection, reaction force and fracture energy. The manufactured impact test machine was successfully used in testing RC beams under impact loading and used successfully to test the reinforced concrete beams strengthened or repaired using CFRP under impact loading.

Keywords: beam, concrete, impact, machine

Procedia PDF Downloads 423

Authors: Jay N. Vyas, Sachin Daxini

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Numerical simulation techniques are widely used now in product development and testing instead of expensive, time-consuming and sometimes dangerous laboratory experiments. Numerous numerical methods are available for performing simulation of physical problems of different engineering fields. Grid based methods, like Finite Element Method, are extensively used in performing various kinds of static, dynamic, structural and non-structural analysis during product development phase. Drawbacks of grid based methods in terms of discontinuous secondary field variable, dealing fracture mechanics and large deformation problems led to development of a relatively a new class of numerical simulation techniques in last few years, which are popular as Meshless methods or Meshfree Methods. Meshless Methods are expected to be more adaptive and flexible than Finite Element Method because domain descretization in Meshless Method requires only nodes. Present paper introduces Meshless Methods and differentiates it with Finite Element Method in terms of following aspects: Shape functions used, role of weight function, techniques to impose essential boundary conditions, integration techniques for discrete system equations, convergence rate, accuracy of solution and computational effort. Capabilities, benefits and limitations of Meshless Methods are discussed and concluded at the end of paper.

Keywords: numerical simulation, Grid-based methods, Finite Element Method, Meshless Methods

Procedia PDF Downloads 389

Authors: N. Akhavan, Sh. Tavousi Tafreshi, A. Ghasemi

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Seismic behavior of irregular structures through the past decades indicate that the stated buildings do not have appropriate performance. Among these subjects, the current paper has investigated the behavior of special steel moment frame with different configuration of soft storey vertically. The analyzing procedure has been evaluated with respect to incremental dynamic analysis (IDA), and numeric process was carried out by OpenSees finite element analysis package. To this end, nine 2D steel frames, with different numbers of stories and irregularity positions, which were subjected to seven pairs of ground motion records orthogonally with respect to Ibarra-Krawinkler deterioration model, have been investigated. This paper aims at evaluating the response of two-dimensional buildings incorporating soft storey which subjected to bi-directional seismic excitation. The IDAs were implemented for different stages of PGA with various ground motion records, in order to determine maximum inter-storey drift ratio. According to statistical elements and fracture range (standard deviation), the vulnerability or exceedance from above-mentioned cases has been examined. For this reason, fragility curves for different placement of soft storey in the first, middle and the last floor for 4, 8, and 16 storey buildings have been generated and compared properly.

Keywords: special steel moment frame, soft storey, incremental dynamic analysis, fragility curve

Procedia PDF Downloads 349

Authors: Shengping Zhong, Qimin Shi, Yaling Deng, Shoufeng Yang

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Additive manufacturing has exerted a tremendous fascination on the development of the manufacturing and materials industry in the past three decades. Zirconia-based advanced ceramic has been poured substantial attention in the interest of structural and functional ceramics. As a novel material jetting process for selectively depositing nanoparticles, NanoParticle Jetting™ is capable of fabricating dense zirconia components with a high-detail surface, precisely controllable shrinkage, and remarkable mechanical properties. The presence of NPJ™ gave rise to a higher elevation regarding the printing process and printing accuracy. Emphasis is placed on the performance evaluation of NPJ™ printed ceramic components by which the physical, chemical, and mechanical properties are evaluated. The experimental results suggest the Y₂O₃-stabilized ZrO₂ boxes exhibit a high relative density of 99.5%, glossy surface of minimum 0.33 µm, general linear shrinkage factor of 17.47%, outstanding hardness and fracture toughness of 12.43±0.09 GPa and 7.52±0.34 MPa·m¹/², comparable flexural strength of 699±104 MPa, and dense and homogeneous grain distribution of microstructure. This innovative NanoParticle Jetting system manifests an overwhelming potential in dental, medical, and electronic applications.

Keywords: nanoparticle jetting, ZrO₂ ceramic, materials jetting, performance evaluation

Procedia PDF Downloads 177

Authors: Dins Sumerags, Mara Pilmane, Vita Konopecka, Gunta Sumeraga

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Reinke’s oedema is a specific type of chronic laryngitis evolving only in smokers. Our study aimed to identify the presence and interaction of the immunohistochemical markers for inflammation [IL-1α] and [IL-10], proliferation [Ki-67] and immunoreactive innervation [PGP 9.5] in the laryngeal mucosa using biotin-streptavidin immunochemical staining method. The laryngeal tissue samples were taken from the vocal cord during the surgery of the Reinke’s oedema and compared to the control group from the tissue samples of the cadavers without any visual laryngeal disease. The study results confirm increased cellular proliferation and elevation of the inflammation markers in the laryngeal mucosa in the case of Reinke’s oedema by comparing with the control.

Keywords: reinke`s oedema, immunohistochemical markers, laryngeal mucosa, biotin-streptavidin

Procedia PDF Downloads 134

Authors: Shota Nagata, Kazuya Okubo, Toru Fujii

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The purpose of this study is to investigate the proper condition in extracting carbon fibers as the reinforcement of composite molded by injection method. Recycled carbon fibers were extracted from wasted CFRP by pyrolyzing epoxy matrix of CFRP under air atmosphere at different temperature conditions 400, 600 and 800°C in this study. Recycled carbon fiber reinforced polypropylene (RCF/PP) pellets were prepared using twin screw extruder. The RCF/PP specimens were molded into dumbbell shaped specimens using injection molding machine. The tensile strength of recycled carbon fiber was decreased with rising pyrolysis temperature from 400 to 800°C. However, superior mechanical properties of tensile strength, tensile modulus and fracture strain of RCF/PP specimen were obtained when the extracting temperature was 600°C. Almost fibers in RCF/PP specimens were aligned in the mold filling direction in this study when the extracting temperature was 600°C. To discuss the results, the failure mechanisms of RCF/PP specimens was shown schematically. Finally, it was concluded that the temperature condition at 600°C should be selected in extracting carbon fibers as the reinforcement of RCF/PP composite molded by injection method.

Keywords: CFRP, recycled carbon fiber, injection molding, mechanical properties, fiber orientation, failure mechanism

Procedia PDF Downloads 445

Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

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Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

Procedia PDF Downloads 455

Authors: Y. Teterin, S. Suleymanova, I. Dmitriev, P. Yartcev

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Introduction: One of the most common complications after pancreas transplantation are pancreatic fluid collections (PFCs), which are often complicated not only by infection and subsequent disfunction of the pancreatoduodenal graft (PDG), but also with a rather high mortality rate of recipients. Drainage is not always effective and often requires repeated open surgical interventions, which worsens the outcome of the surgery. Percutaneous drainage of PFCs combined with endoscopic stenting of the main pancreatic duct of the pancreatoduodenal graft (MPDPDG) showed high efficiency in the treatment of PFCs. Aims & Methods: From 01.01.2012 to 31.12.2021 at the Sklifosovsky Research Institute for Emergency Medicine were performed 64 transplantations of PDG. In 11 cases (17.2%), the early postoperative period was complicated by the formation of PFCs. Of these, 7 patients underwent percutaneous drainage of pancreonecrosis with high efficiency and did not required additional methods of treatment. In the remaining 4 patients, drainage was ineffective and was an indication for endoscopic stenting of the MPDPDG. They were the ones who made up the study group. Among them were 3 men and 1 woman. The mean age of the patients was 36,4 years.PFCs in these patients formed on days 1, 12, 18, and 47 after PDG transplantation. We used a gastroscope to stent the MPDPDG, due to anatomical features of the location of the duodenoduodenal anastomosis after PDG transplantation. Through the endoscope channel was performed selective catheterization of the MPDPDG, using a catheter and a guidewire, followed by its contrasting with a water-soluble contrast agent. Due to the extravasation of the contrast, was determined the localization of the defect in the PDG duct system. After that, a plastic pancreatic stent with a diameter of 7 Fr. and a length of 7 cm. was installed along guidewire. The stent was installed in such a way that its proximal edge completely covered the defect zone, and the distal one was determined in the intestinal lumen. Results: In all patients PDG pancreaticography revealed extravasation of a contrast in the area of the isthmus and body of the pancreas, which required stenting of the MPDPDG. In 1 (25%) case, the patient had a dislocation of the stent into the intestinal lumen (III degree according to Clavien-Dindo (2009)). This patient underwent repeated endoscopic stenting of the MPDPDG. On average 23 days after endoscopic stenting of the MPDPDG, the drainage tubes were removed and after approximately 40 days all patients were discharged in a satisfactory condition with follow-up endocrinologist and surgeon consultation. Pancreatic stents were removed after 6 months ± 7 days. Conclusion: Endoscopic stenting of the main pancreatic duct of the donor pancreas is by far the most highly effective and minimally invasive method in the treatment of PFCs after transplantation of the pancreatoduodenal complex.

Keywords: pancreas transplantation, endoscopy surgery, diabetes, stenting, main pancreatic duct

Procedia PDF Downloads 86

Authors: Liam Martin, Martha Watson

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Patients with learning disabilities (LD) are at increased risk of physical and mental illness due to health inequality. To address this, NICE recommends that people from the age of 14 with a learning disability should have an annual LD health check. This consultation should include a holistic review of the patient’s physical, mental and social health needs with a view of creating an action plan to support the patient’s care. The expected standard set by the Quality and Outcomes Framework (QOF) is that each general practice should review at least 75% of their LD patients annually. During COVID-19, there have been barriers to primary care, including health anxiety, the shift to online general practice and the increase in GP workloads. A surgery in North London wanted to assess whether they were falling short of the expected standard for LD patient annual reviews in order to optimize care post Covid-19. A baseline audit was completed to assess how many LD patients were receiving their annual reviews over the period of 29th September 2020 to 29th September 2021. This information was accessed using EMIS Web Health Care System (EMIS). Patients included were aged 14 and over as per QOF standards. Doctors were not notified of this audit taking place. Following the results of this audit, the creation of learning disability clinics was recommended. These clinics were recommended to be on the ground floor and should be a dedicated time for LD reviews. A re-audit was performed via the same process 6 months later in March 2022. At the time of the baseline audit, there were 71 patients aged 14 and over that were on the LD register. 54% of these LD patients were found to have documentation of an annual LD review within the last 12 months. None of the LD patients between the ages of 14-18 years old had received their annual review. The results were discussed with the practice, and dedicated clinics were set up to review their LD patients. A second pass of the audit was completed 6 months later. This showed an improvement, with 84% of the LD patients registered at the surgery now having a documented annual review within the last 12 months. 78% of the patients between the ages of 14-18 years old had now been reviewed. The baseline audit revealed that the practice was not meeting the expected standard for LD patient’s annual health checks as outlined by QOF, with the most neglected patients being between the ages of 14-18. Identification and awareness of this vulnerable cohort is important to ensure measures can be put into place to support their physical, mental and social wellbeing. Other practices could consider an audit of their annual LD health checks to make sure they are practicing within QOF standards, and if there is a shortfall, they could consider implementing similar actions as used here; dedicated clinics for LD patient reviews.

Keywords: COVID-19, learning disability, learning disability health review, quality and outcomes framework

Procedia PDF Downloads 85

Authors: Ralph Gruber, Martina Hafner, Theresia Greunz, Christian Reisecker, David Stifter

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The application of dry lubricant on aluminium for automotive industry is indispensable for a high-quality forming behaviour. To provide a short production time those forming aids will not be removed during the joining step. The aim of this study was the characterization of the influence of dry lubricants on the bond strength and the corrosion resistance of an 6xxx aluminium alloy for automotive applications. For this purpose, samples with a well-defined surface were lubricated with 1 g/m² dry lubricant and joined with a commercial thermosetting 1K-epoxy structural adhesive. The bond strength was characterized by means of lap shear test. To evaluate the corrosion resistance of the adhered aluminium samples an immersion test in 5 w% NaCl-solution was used. Based on fracture pattern analysis, the corrosion behaviour could be described. Dissolved corrosion products were examined using ICP-MS and NMR. By means of SEM/EDX the elementary composition of precipitated solids was determined. The results showed a dry lubricant independent bond strength for standard testing conditions. However, a significant effect of the forming aid, regarding the corrosion resistance of adhered aluminium samples against corrosive infiltration of the metal-adhesive-interface, was observed

Keywords: aluminium alloys, dry film lubricants, automotive industry, adhesive bonding, corrosion

Procedia PDF Downloads 102

Authors: G. H. Li, M. Liu, H. J. Qi, Q. Zhu, W. Z. He

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The drilling and riveting processes are widely used in the assembly of carrier rocket, which makes the efficiency and quality of drilling become the important factor affecting the assembly process. According to the problem existing in the drilling of thick stacked plate (thickness larger than 10mm) of carrier rocket, such as drill break, large noise and burr etc., experimental study of the influence of tool material on the drilling was carried out. The cutting force was measured by a piezoelectric dynamometer, the aperture was measured with an outline projector, and the burr is observed and measured by a digital stereo microscope. Through the measurement, the effects of tool material on the drilling were analyzed from the aspects of drilling force, diameter, and burr. The results show that, compared with carbide drill and coated carbide one, the drilling force of high speed steel is larger. But, the application of high speed steel also has some advantages, e.g. a higher number of hole can be obtained, the height of burr is small, the exit is smooth and the slim burr is less, and the tool experiences wear but not fracture. Therefore, the high speed steel tool is suitable for the drilling of thick stacked plate of 2219 Aluminum alloy.

Keywords: 2219 aluminum alloy, thick stacked plate, drilling, tool material

Procedia PDF Downloads 235

Authors: Sandeep Mohindra

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Since 2013, the authors have operated on 568 cases of pituitary tumors through the trans-sphenoidal route, using the binostril approach. The distribution included 486 cases of non-functioning pituitary tumors, 24 cases of Growth hormone(GH) secreting tumors(acromegaly), and 28 cases of adrenocorticotrophic(ACTH) secreting tumors(Cushing's Disease). The authors utilized neuro-navigation for 18 cases, and all belonged to the functional tumor category. Complications included ICA injury in 2 cases, fatal meningitis in 5 cases, while CSF leak required repair in 28 cases. Satisfactory excision was noted in 512 cases, while recurrence/residual required repeat surgery in 32 cases. Authors conclude that trans sphenoidal route remains the best and optimal way of managing sellar tumors, especially pituitary adenomas.

Keywords: pituitary, adenoma, trans-sphenoidal, endonasal, neuronavigation

Procedia PDF Downloads 63

Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Frazer Kirk, Rohen Skiba, Pankaj Saxena

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The natural history of the QAV is poorly understood due to the exceeding rarity of the condition. Incidence rates vary between 0.00028-1%. Classically patients present with Aortic Regurgitation (AR) between 40-60 years of age experiencing palpitations, chest pain, or heart failure. (1, 2) Echocardiography is the mainstay of diagnosis for this condition; however, given the rarity of this condition, it can easily be overlooked, as demonstrated here. The case report that follows serves as a reminder of the condition to reduce the innate cognitive bias to overlook the diagnosis due to the availability heuristic. Intraoperative photography, echocardiographic and magnetic resonance imaging from this case for reference to demonstrate that while the diagnosis of Aortic regurgitation was recognized early, the valve morphology was underappreciated.

Keywords: quadricuspid aortic valve, cardiac surgery, echocardiography, congenital

Procedia PDF Downloads 162

Authors: Daniel N. L. Alves, Marcelo C. Rodrigues, Jose G. de Almeida

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The search for structural efficiency in mechanical systems has been strongly exerted with aim of economic optimization and structural safety. As soon, to understand the response of materials when submitted to adverse conditions is essential to design a safety project. This work investigates the presence of cracks in dissimilar welded joints (DWJ). Its fracture toughness responses depend upon the heterogeneity present in these joints. Thus, this work aim analyzing the behavior of the crack tip zone located in a buttery dissimilar welded joint (ASTM A-36, Inconel, and AISI 8630 M) used in the union of pipes present in the offshore oil production lines. The crack was placed 1 mm from fusion line (FL) Inconel-AISI 8630 M toward the AISI 8630 M. Finite Element Method (FEM) was used to analyze stress and strain fields generated during the loading imposed on the specimen. It was possible observing critical stress area by the numerical tool as well as a preferential plastic flow was also observed in the sample of dissimilar welded joint, which can be considered a harbinger of the crack growth path. The results obtained through numerical analysis showed a convergent behavior in relation to the plastic flow, qualitatively and quantitatively, in agreement with previous performed.

Keywords: crack, dissimilar welded joint, numerical analysis, strain field, the stress field

Procedia PDF Downloads 171

Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

Procedia PDF Downloads 215

Authors: Abhishek Pandey

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Capping and lamination are the most common tablet defects with poorly compressible drugs the common example of that Ibuprofen and Acetaminophen. Generally both these drugs are compressed by wet granulation method which is very time consuming process Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis Acetaminophen used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression technique and their evaluation. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimize formulation nine different formulations were generated among them batch F5, F6, F7 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of evaluation parameters.

Keywords: capping, lamination, tablet defects, direct compression

Procedia PDF Downloads 438

Authors: Muhammad Faisal Khilji, Rana Shoaib Hamid

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Subdural hematoma (SDH) is an extremely rare complication of immune thrombocytopenic purpura (ITP). We present a case of a 34 years old female who presented to the Emergency department of a tertiary care hospital with complaints of headache, on and off gums bleeding and upper respiratory tract symptoms for the last two weeks. Examination was unremarkable except some purpura over limbs. Investigations revealed zero platelets and peripheral film suggestive of ITP. Computerized tomography (CT) brain revealed bilateral SDH in the frontal areas extending into Falx cerebri. Impression of ITP with SDH was made. Patient was treated with intravenous immunoglobulin (IVIg), methyl prednisolone and initial Platelets transfusion. Patient recovered uneventfully with platelets reaching normal levels within a few days and resolution of SDH without surgery.

Keywords: headache, immune thrombocytopenia, purpura, subdural hematoma

Procedia PDF Downloads 398

Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

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Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

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Authors: Bin Wang, Yong Xu, Honggang Qu, Rongmei Liu, Zhenji Gao

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Based on the geodynamic environment, basic geological characteristics of minerals and so on, gold deposits in China are divided into 11 categories, of which tectonic fracture altered rock, mid-intrudes and contact zone, micro-fine disseminated and continental volcanic types are the main prospecting kinds. The metallogenic age of gold deposits in China is dominated by the Mesozoic and Cenozoic. According to the geotectonic units, geological evolution, geological conditions, spatial distribution, gold deposits types, metallogenic factors etc., 42 gold concentration areas are initially determined and have a concentrated distribution feature. On the basis of the gold exploration density, gold concentration areas are divided into high, medium and low level areas. High ones are mainly distributed in the central and eastern regions. 93.04% of the gold exploration drillings are within 500 meters, but there are some problems, such as less and shallower of drilling verification etc.. The paper discusses the resource potentials of gold deposits and proposes the future prospecting directions and suggestions. The deep and periphery of old mines in the central and eastern regions and western area, especially in Xinjiang and Qinghai, will be the future key prospecting one and have huge potential gold reserves. If the exploration depth is extended to 2,000 meters shallow, the gold resources will double.

Keywords: gold deposits, gold deposits types, gold concentration areas, prospecting, resource potentiality

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Authors: Nima Dastanboo, Xiao-Qing Li, Hamed Gharibdoost

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The purpose of this study is to investigate about the geological properties ahead of a tunnel face with using Electrical Resistivity Tomography ERT and Tunnel Seismic Prediction TSP303 methods. In deep tunnels with hydro-geological conditions, it is important to study the geological structures of the region before excavating tunnels. Otherwise, it would lead to unexpected accidents that impose serious damage to the project. For constructing Nosoud tunnel in west of Iran, the ERT and TSP303 methods are employed to predict the geological conditions dynamically during the excavation. In this paper, based on the engineering background of Nosoud tunnel, the important results of applying these methods are discussed. This work demonstrates seismic method and electrical tomography as two geophysical techniques that are able to detect a tunnel. The results of these two methods were being in agreement with each other but the results of TSP303 are more accurate and quality. In this case, the TSP 303 method was a useful tool for predicting unstable geological structures ahead of the tunnel face during excavation. Thus, using another geophysical method together with TSP303 could be helpful as a decision support in excavating, especially in complicated geological conditions.

Keywords: tunnel seismic prediction (TSP303), electrical resistivity tomography (ERT), seismic wave, velocity analysis, low-velocity zones

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Authors: Amirul Adlan, Robert A McCulloch, Neil Jenkins, MIchael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The current antibiotic prophylaxis for oncological patients is based upon evidence from primary arthroplasty despite significant differences in both patient group and procedure. The aim of this study was to compare the microbiology organisms responsible for PJI in patients who underwent two-stage revision for infected primary knee replacement with those of infected oncological endoprostheses of the lower limb in a single institution. This will subsequently guide decision making regarding antibiotic prophylaxis at primary implantation for oncological procedures and empirical antibiotics for infected revision procedures (where the infecting organism(s) are unknown). Patient and Methods: 118 patients were treated with two-stage revision surgery for infected knee arthroplasty and lower limb endoprostheses between 1999 and 2019. 74 patients had two-stage revision for PJI of knee arthroplasty, and 44 had two-stage revision of lower limb endoprostheses. There were 68 males and 50 females. The mean age for the knee arthroplasty cohort and lower limb endoprostheses cohort were 70.2 years (50-89) and 36.1 years (12-78), respectively (p<0.01). Patient host and extremity criteria were categorised according to the MSIS Host and Extremity Staging System. Patient microbiological culture, the incidence of polymicrobial infection and multi-drug resistance (MDR) were analysed and recorded. Results: Polymicrobial infection was reported in 16% (12 patients) from knee arthroplasty PJI and 14.5% (8 patients) in endoprostheses PJI (p=0.783). There was a significantly higher incidence of MDR in endoprostheses PJI, isolated in 36.4% of cultures, compared to knee arthroplasty PJI (17.2%) (p=0.01). Gram-positive organisms were isolated in more than 80% of cultures from both cohorts. Coagulase-negative Staphylococcus (CoNS) was the commonest gram-positive organism, and Escherichia coli was the commonest Gram-negative organism in both groups. According to the MSIS staging system, the host and extremity grade of knee arthroplasty PJI cohort were significantly better than endoprostheses PJI(p<0.05). Conclusion: Empirical antibiotic management of PJI in orthopaedic oncology is based upon PJI in arthroplasty despite differences in both host and microbiology. Our results show a significant increase in MDR pathogens within the oncological group despite CoNS being the most common infective organism in both groups. Endoprosthetic patients presented with poorer host and extremity criteria. These factors should be considered when managing this complex patient group, emphasising the importance of broad-spectrum antibiotic prophylaxis and preoperative sampling to ensure appropriate perioperative antibiotic cover.

Keywords: microbiology, periprosthetic Joint infection, knee arthroplasty, endoprostheses

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Authors: Meriem Senani, Noureedine Ferhoune

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This paper presents the axial bearing capacity of thin welded rectangular steel stubs filled with concrete sand. A series of tests was conducted to study the behavior of short composite columns under axial compressive load, the cross section dimensions were: 100x70x2 mm. A total of 16 stubs have been tested, as follows: 4 filled with ordinary concrete appointed by BO columns, 6 filled with concrete witch natural sand was completely substitute a crystallized sand slag designated in this paper by BSI, and 6 others were tucked in concrete whose natural sand was partially replace by a crystallized sand slag called by BSII. The main objectives of these tests were to clarify the steel specimen's performance filled by concrete sand compared to those filled with ordinary concrete. The main parameters studied are: The height of the specimen (300mm-500mm), eccentricity of load and type of filling concrete. Based on test results obtained, it is confirmed that the length of the tubes, has a considerable effect on the bearing capacity and the failure mode. In all test tubes, fracture occurred by the convex warping of the largest, followed by the smallest due to the outward thrust of the concrete, it was observed that the sand concrete improves the bearing capacity of tubes compounds compared to those filled with ordinary concrete.

Keywords: concrete sand, crystallized slag, failure mode, buckling

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Authors: Jain Jyoti, Jain Shorab, Sinha Shishir

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In the current scenario, development of new biodegradable composites with the reinforcement of some plant derived natural fibers are in major research concern. Abundant quantity of these natural plant derived fibers including sisal, ramp, jute, wheat straw, pine, pineapple, bagasse, etc. can be used exclusively or in combination with other natural or synthetic fibers to augment their specific properties like chemical, mechanical or thermal properties. Among all natural fibers, wheat straw, bagasse, kenaf, pineapple leaf, banana, coir, ramie, flax, etc. pineapple leaf fibers have very good mechanical properties. Being hydrophilic in nature, pineapple leaf fibers have very less affinity towards all types of polymer matrixes. Not much work has been carried out in this area. Surface treatments like alkaline treatment in different concentrations were conducted to improve its compatibility towards hydrophobic polymer matrix. Pineapple leaf fiber epoxy composites have been prepared using hand layup method. Effect of variation in fiber loading up to 20% in epoxy composites has been studied for mechanical properties like tensile strength and flexural strength. Analysis of fiber morphology has also been studied using FTIR, XRD. SEM micrographs have also been studied for fracture surface.

Keywords: composite, mechanical, natural fiber, pineapple leaf fiber

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Authors: Carlos Escobar-del Pozo, César Ahumada-Monroy, Azael García-Rebolledo, Alberto Brambila-Solórzano, Gregorio Martínez-Sánchez, Luis Ortiz-Rincón

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Numerical simulations of flow in complex biological structures have gained considerable attention in the last years. However, the major issue is the validation of the results. The present work shows a Particle Image Velocimetry PIV flow visualization technique in complex biological structures, particularly in intracranial aneurysms. A methodology to reconstruct and generate a transparent model has been developed, as well as visualization and particle tracking techniques. The generated transparent models allow visualizing the flow patterns with a regular camera using the visualization techniques. The final goal is to use visualization as a tool to provide more information on the treatment and surgery decisions in aneurysms.

Keywords: aneurysms, PIV, flow visualization, particle tracking

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Authors: Rajendra Kanojia

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Femoral components with inbuilt rotation require thicker flexion resection of the lateral femoral condyle and could potential risk to damage the popliteus tendon especially in the smaller Asian knees. We prospectively evaluated 10 patients with bilateral varus osteoarthritis knee to size the cuts and their location in relation to the popliteus tendon. Two different types of implant were used on either side, one side requires resection in 3° external rotation (group A) and other side femoral component with inbuilt external roation (group B). We had popliteus tendon injury in 3 knees all from group B. Risk of damaging the popliteus tendon was found higher in group B.

Keywords: popliteaus tendon injury, TKA, orthopaedic surgery, biomechanics and clinical applications

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Authors: A. Mohamed, A. El-Aziz

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The pH of the body plays a great role in the degradation kinetics of biodegradable Mg-Ca orthopedic implants. At the location of fracture, the pH of the body becomes no longer neutral which draws the attention towards studying a range of different pH values of the body fluid. In this study, the pH of Hank’s balanced salt solution (HBSS) was modified by phosphate buffers into an aggressive acidic pH 1.8, a slightly acidic pH 5.3 and an alkaline pH 8.1. The biodegradation of Mg-0.8Ca implant was tested in those three different media using immersion test and electrochemical polarization means. It was proposed that the degradation rate has increased with decreasing the pH of HBSS. The immersion test revealed weight gain for all the samples followed by weight loss as the immersion time increased. The highest weight gain was pronounced for the acidic pH 1.8 and the least weight gain was observed for the alkaline pH 8.1. This was in agreement with the electrochemical polarization test results where the degradation rate was found to be high (7.29 ± 2.2 mm/year) in the aggressive acidic solution of pH 1.8 and relatively minimum (0.31 ± 0.06 mm/year) in the alkaline medium of pH 8.1. Furthermore, it was confirmed that the pH of HBSS has reached a steady state of an alkaline pH (~pH 11) at the end of the two-month immersion period regardless of the initial pH of the solution. Finally, the corrosion products formed on the samples’ surface were investigated by SEM, EDX and XRD analyses that revealed the formation of magnesium and calcium phosphates with different morphologies according to the pH.

Keywords: biodegradable, electrochemical polarization means, orthopedics, immersion test, simulated body fluid

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Authors: Musa D. Aliyu, Ouahid Harireche, Colin D. Hills

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The incapability of supercritical C02 to transport and dissolve mineral species from the geothermal reservoir to the fracture apertures and other important parameters in heat mining makes it an attractive substance for Heat extraction from hot dry rock. In other words, the thermodynamic efficiency of hot dry rock (HDR) reservoirs also increases if supercritical C02 is circulated at excess temperatures of 3740C without the drawbacks connected with silica dissolution. Studies have shown that circulation of supercritical C02 in homogenous geothermal reservoirs is quite encouraging; in comparison to that of the water. This paper aims at investigating the aforementioned processes in the case of the heterogeneous geothermal reservoir located at the Soultz site (France). The MultiPhysics finite element package COMSOL with an interface of coupling different processes encountered in the geothermal reservoir stimulation is used. A fully coupled numerical model is developed to study the thermal and hydraulic processes in order to predict the long-term operation of the basic reservoir parameters that give optimum energy production. The results reveal that the temperature of the SCC02 at the production outlet is higher than that of water in long-term stimulation; as the temperature is an essential ingredient in rating the energy production. It is also observed that the mass flow rate of the SCC02 is far more favourable compared to that of water.

Keywords: FEM, HDR, heterogeneous reservoir, stimulation, supercritical C02

Procedia PDF Downloads 385