Search results for: plastic 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 237

Authors: Nilgun Becenen

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In this study, the structural properties of composite materials with the plastic matrix, which are used in body parts of urban furniture were investigated. Surfaces of the specimens were observed by scanning electron microscopy (SEM: JSM-5200, JEOL) and Climatic environmental test analyses in laboratory conditions were used to analyze the performance of the composite samples. Climate conditions were determined as follow; 3 hour working under the conditions of -10 ºC heat and 20 % moisture, Heating until 45 ºC for 4 hours, 3 hour work at 45 ºC, 3 hour work under the conditions of 45 ºC heat and 80 % moisture, Cooling at -10 ºC for 4 hours. In this cycle, the atmospheric conditions that urban furniture would be exposed to in the open air were taken into consideration. Particularly, sudden heat changes and humidity effect were investigated. The climate conditions show that performance in Low Temperatures: The endurance isn’t affected, hardness does not change, tensile, bending and impact resistance does not change, the view isn’t affected. It has a high environmental performance.

Keywords: fibre-reinforced material, glass fiber, textile science, polymer composites

Procedia PDF Downloads 233

Authors: W. J. Kim

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The behaviors of the recovery stress and strain of an ultrafine-grained Ni-50.2 at.% Ti alloy prepared by high-ratio differential speed rolling (HRDSR) were examined by a specially designed tensile-testing set up, and the factors that influence the recovery stress and strain were studied. After HRDSR, both the recovery stress and strain were enhanced compared to the initial condition. The constitutive equation showing that the maximum recovery stress is a sole function of the recovery strain was developed based on the experimental data. The recovery strain increased as the yield stress increased. The maximum recovery stress increased with an increase in yield stress. The residual recovery stress was affected by the yield stress as well as the austenite-to-martensite transformation temperature. As the yield stress increased and as the martensitic transformation temperature decreased, the residual recovery stress increased.

Keywords: high-ratio differential speed rolling, tensile testing, severe plastic deformation, shape memory alloys

Procedia PDF Downloads 349

Authors: Giulio Rosati, Luciano Sappia, Rossana Madrid, Noemi Rozlòsnik

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The addition of PEG of different molecular weights has important effects on the physical, electrical and electrochemical properties of iron(III)-tosylate doped PEDOT. This particular polymer can be easily spin coated over plastic discs, optimizing thickness and uniformity of the PEDOT-PEG films. The conductivity and morphological analysis of the hybrid PEDOT-PEG polymer by 4-point probe (4PP), 12-point probe (12PP), and conductive AFM (C-AFM) show strong effects of the PEG doping. Moreover, the conductive films kinetics at the nanoscale, in response to different bias voltages, change radically depending on the PEG molecular weight. The hybrid conductive films show also interesting electrochemical properties, making the PEDOT PEG doping appealing for biosensing applications both for EIS-based and amperometric affinity/catalytic biosensors.

Keywords: atomic force microscopy, biosensors, four-point probe, nano-films, PEDOT

Procedia PDF Downloads 327

Authors: F. Onyango, Salim R. Wanjala, M. Ndege, L. Masu

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Asphalt concrete pavements have a short life cycle, failing mainly due to temperature changes, traffic loading and ageing. Modified asphalt mixtures provide the technology to produce a bituminous binder with improved viscoelastic properties which remain in balance over a wider temperature range and loading conditions. In this research, 60/70 penetration grade asphalt binder was modified by adding 2, 4, 6, 8, and 10 percent by weight of asphalt binder following the wet process and the mineral aggregate was modified by adding 1, 2, 3, 4, and 5 percent crumb rubber by volume of the mineral aggregate following the dry process. The LDPE modified asphalt binder Rheological properties were evaluated. The laboratory results showed an increase in viscosity, softening point and stiffness of the binder. The modified asphalt was then used in preparing asphalt mixtures by Marshall Mix design procedure. The Marshall stability values for mixes containing 2% crumb rubber and 4% LDPE were found to be 30% higher than the conventional asphalt concrete mix.

Keywords: crumb rubber, dry process, hot mix asphalt, wet process

Procedia PDF Downloads 356

Authors: Xiaoxin Ye, Guoyi Tang

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The effect of electropulsing ultrasonic shock (EUS) on the surface hardening and microstructure of Ti6Al4V alloy was studied. It was found that electropulsing improved the microhardness dramatically both in the influential depth and maximum value, compared with the only ultrasonic-shocked sample. It’s indicated that refined surface layer with nanocrystalline and improved microhardness were obtained on account of surface severe plastic deformation, dynamic recrystallization (DRX) and phase change, which was implemented at relative low temperature and high strain rate/capacity due to the coupling of the thermal and athermal effects of EUS. It’s different from conventional experiments and theory. It’s discussed that the positive contributions of EPT in the thermodynamics and kinetics of microstructure and properties change were attributed to the reduction of nucleation energy barrier and acceleration of atomic diffusion. Therefore, it’s supposed that EUS is an energy-saving and high-efficiency method of surface treatment technique with the help of high-energy electropulses, which is promising in cost reduction of the surface engineering and energy management.

Keywords: titanium alloys, electropulsing, ultrasonic shock, microhardness, nanocrystalline

Procedia PDF Downloads 277

Authors: Mohammad M. Khan, Pankaj Agarwal

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The present investigation deals with the microstructures, mechanical and detailed wear characteristics of in situ TiC particles reinforced zinc aluminum-based metal matrix composites. The composites have been synthesized by liquid metallurgy route using vortex technique. The composite was found to be harder than the matrix alloy due to high hardness of the dispersoid particles therein. The former was also lower in ultimate tensile strength and ductility as compared to the matrix alloy. This could be explained to be due to the use of coarser size dispersoid and larger interparticle spacing. Reasonably uniform distribution of the dispersoid phase in the alloy matrix and good interfacial bonding between the dispersoid and matrix was observed. The composite exhibited predominantly brittle mode of fracture with microcracking in the dispersoid phase indicating effective easy transfer of load from matrix to the dispersoid particles. To study the wear behavior of the samples three different types of tests were performed namely: (i) sliding wear tests using a pin on disc machine under dry condition, (ii) high stress (two-body) abrasive wear tests using different combinations of abrasive media and specimen surfaces under the conditions of varying abrasive size, traversal distance and load, and (iii) low-stress (three-body) abrasion tests using a rubber wheel abrasion tester at various loads and traversal distances using different abrasive media. In sliding wear test, significantly lower wear rates were observed in the case of base alloy over that of the composites. This has been attributed to the poor room temperature strength as a result of increased microcracking tendency of the composite over the matrix alloy. Wear surfaces of the composite revealed the presence of fragmented dispersoid particles and microcracking whereas the wear surface of matrix alloy was observed to be smooth with shallow grooves. During high-stress abrasion, the presence of the reinforcement offered increased resistance to the destructive action of the abrasive particles. Microcracking tendency was also enhanced because of the reinforcement in the matrix. The negative effect of the microcracking tendency was predominant by the abrasion resistance of the dispersoid. As a result, the composite attained improved wear resistance than the matrix alloy. The wear rate increased with load and abrasive size due to a larger depth of cut made by the abrasive medium. The wear surfaces revealed fine grooves, and damaged reinforcement particles while subsurface regions revealed limited plastic deformation and microcracking and fracturing of the dispersoid phase. During low-stress abrasion, the composite experienced significantly less wear rate than the matrix alloy irrespective of the test conditions. This could be explained to be due to wear resistance offered by the hard dispersoid phase thereby protecting the softer matrix against the destructive action of the abrasive medium. Abraded surfaces of the composite showed protrusion of dispersoid phase. The subsurface regions of the composites exhibited decohesion of the dispersoid phase along with its microcracking and limited plastic deformation in the vicinity of the abraded surfaces.

Keywords: abrasive wear, liquid metallurgy, metal martix composite, SEM

Procedia PDF Downloads 137

Authors: Adnan I. O. Zaid, Safwan M. A. Alqawabah

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Review of the available literature on grain refinement of aluminum and its alloys reveals that little work is published on the effect of refiners on mechanical characteristics and wear resistance. In this paper, the effect of addition of Zr to Al grain refined by Ti+B on its metallurgical, mechanical characteristics and wear resistance both in the as cast and after extrusion condition are presented and discussed. It was found that Addition of Zr to Al resulted in deterioration of its mechanical strength and hardness, whereas it resulted in improvement of both of them when added to Al grain refined by Ti+B. Furthermore it was found that the direct extrusion process resulted in further increase of the mechanical strength and hardness of Al and its micro-alloys. Also it resulted in increase of their work hardening index, n, i.e. improved their formability, hence it reduces the number of stages required for forming at large strains in excess of the plastic instability before Zr addition.

Keywords: aluminum, grain refinement, titanium + boron, zirconium, mechanical characteristics, wear resistance, direct extrusion

Procedia PDF Downloads 433

Authors: Dalila Hammiche, Lisa Klaai, Sonia Imzi, Amar Boukerrou

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The fight against plastic pollution implies the development of polymers as alternatives to synthetic polymers. Starch is a natural polymer that can easily be plasticized by means of additives. The objective of this work is to develop and characterize biodegradable biofilms based on starch, plasticized by glycerol (20 and 30%). The elaboration of the biofilms was carried out by the casting method under simple conditions. The samples were characterized by infrared spectroscopy analysis with Fourier transform (FTIR), thermogravimetric analysis, and biodegradability test. Infrared spectral analysis showed that the 30% and 20% glycerol films have the same chemical structure and no functional group changes occurred. Thermogravimetric analysis showed that a 30% glycerol film has higher thermal stability than a 20% glycerol film. Biodegradability test showed that the lower the percentage of glycerol, the more easily the biofilm degrades.

Keywords: starch, natural sources, FTIR, thermogravimetric analysis, biodegradability test

Procedia PDF Downloads 85

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 116

Authors: Andres Nieto-Leal, Victor N. Kaliakin, Tania P. Molina

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The nature of most engineering materials is quite complex. It is, therefore, difficult to devise a general mathematical model that will cover all possible ranges and types of excitation and behavior of a given material. As a result, the development of mathematical models is based upon simplifying assumptions regarding material behavior. Such simplifications result in some material idealization; for example, one of the simplest material idealization is to assume that the material behavior obeys the elasticity. However, soils are nonhomogeneous, anisotropic, path-dependent materials that exhibit nonlinear stress-strain relationships, changes in volume under shear, dilatancy, as well as time-, rate- and temperature-dependent behavior. Over the years, many constitutive models, possessing different levels of sophistication, have been developed to simulate the behavior geomaterials, particularly cohesive soils. Early in the development of constitutive models, it became evident that elastic or standard elastoplastic formulations, employing purely isotropic hardening and predicated in the existence of a yield surface surrounding a purely elastic domain, were incapable of realistically simulating the behavior of geomaterials. Accordingly, more sophisticated constitutive models have been developed; for example, the bounding surface elastoplasticity. The essence of the bounding surface concept is the hypothesis that plastic deformations can occur for stress states either within or on the bounding surface. Thus, unlike classical yield surface elastoplasticity, the plastic states are not restricted only to those lying on a surface. Elastoplastic bounding surface models have been improved; however, there is still need to improve their capabilities in simulating the response of anisotropically consolidated cohesive soils, especially the response in extension tests. Thus, in this work an improved constitutive model that can more accurately predict diverse stress-strain phenomena exhibited by cohesive soils was developed. Particularly, an improved rotational hardening rule that better simulate the response of cohesive soils in extension. The generalized definition of the bounding surface model provides a convenient and elegant framework for unifying various previous versions of the model for anisotropically consolidated cohesive soils. The Generalized Bounding Surface Model for cohesive soils is a fully three-dimensional, time-dependent model that accounts for both inherent and stress induced anisotropy employing a non-associative flow rule. The model numerical implementation in a computer code followed an adaptive multistep integration scheme in conjunction with local iteration and radial return. The one-step trapezoidal rule was used to get the stiffness matrix that defines the relationship between the stress increment and the strain increment. After testing the model in simulating the response of cohesive soils through extensive comparisons of model simulations to experimental data, it has been shown to give quite good simulations. The new model successfully simulates the response of different cohesive soils; for example, Cardiff Kaolin, Spestone Kaolin, and Lower Cromer Till. The simulated undrained stress paths, stress-strain response, and excess pore pressures are in very good agreement with the experimental values, especially in extension.

Keywords: bounding surface elastoplasticity, cohesive soils, constitutive model, modeling of geomaterials

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Authors: Saeed Talamkhani, Seyed Abolhassan Naeini

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In recent years, the occurrence of several liquefactions in sandy soils containing various values of clay content has shown that in addition to silty sands, clayey sands are also susceptible to liquefaction. Therefore, it is necessary to investigate the properties of these soil compositions and their behavioral characteristics. This paper presents the effect of clay fines on the undrained shear strength of sands at various confining pressures. For this purpose, a series of unconsolidated undrained triaxial shear tests were carried out on clean sand and sand mixed with 5, 10, 15, 20, and 30 percent of clay fines. It was found that the presence of clay particle in sandy specimens change the dilative behavior to contraction. The result also showed that increasing the clay fines up to 10 percent causes to increase the potential for liquefaction, and decreases it at higher values fine content. These results reveal the important role of clay particles in changing the undrained strength of the sandy soil.

Keywords: clayey sand, liquefaction, triaxial test, undrained shear strength

Procedia PDF Downloads 174

Authors: Nurul-Akidah M. Yusak, Rahmah Mohamed, Noor Zuhaira Abd Aziz

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The introduction of degradable plastic materials into agricultural sectors has represented a promising alternative to promote green agriculture and environmental friendly of modern farming practices. Major challenges of developing degradable agricultural films are to identify the most feasible types of degradation mechanisms, composition of degradable polymers and related processing techniques. The incorrect choice of degradable mechanisms to be applied during the degradation process will cause premature losses of mechanical performance and strength. In order to achieve controlled process of agricultural film degradation, the compositions of degradable agricultural film also important in order to stimulate degradation reaction at required interval of time and to achieve sustainability of the modern agricultural practices. A set of photodegradable polyethylene based agricultural film was developed and produced, following the selective optimization of processing parameters of the agricultural film manufacturing system. Example of agricultural films application for oil palm seedlings cultivation is presented.

Keywords: photodegradable polyethylene, plasticulture, processing schemes

Procedia PDF Downloads 497

Authors: A. Kouadri-Henni, L. Barrallier

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The objective of the study was to characterize the properties of a magnesium alloy welded by friction stir welding (FSW). The results led to a better understanding of the relationship between this process, the microstructure and anisotropic properties of alloy materials. Welding principally leads to a large reduction in grain size in welded zones due to the phenomenon of dynamic recrystallization. The most remarkable observation was that crystallographic textures changed from a base metal with one texture in two zones: the thermo-mechanically affected and stir welded zones. The latter zone has the peculiarity of possessing a marked texture with two components on the basal plane and the pyramidal plane. These characteristics disappeared in the TMAZ, which had only one component following the basal plane. These modifications have been explained by the nature of the plastic deformation in these zones, which occurs at a moderate temperature in the TMAZ and high temperature in the SWZ. In the same time, we compared this evolution with the nature and the level of the residual stresses obtained by X-ray diffraction.

Keywords: texture christallography, residual stresses, FSW process

Procedia PDF Downloads 353

Authors: Supriady R. P. Siregar, Rizki Barkah Aulia, Dhiya Fadilla Dewi

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Polybag is a plastic that is used to seed plants. The common type that used for polybag is a synthetic that made from petroleum such as polyethylene. Beside the character of the raw material that are non-renewable and limited, synthetic polybag ability to disintegrate in the environment is very low. According to that situation, we need a solution to overcome these problems by creating an environmentally friendly polybag. In this research, using the water hyacinth plant fibers (Eichornia crassipes) as a major component in manufacturing the environmentally friendly polybag, the water hyacinth (Eichornia crassipes) contains approximately 60% cellulose. The research method used is an experiment by testing the mechanical characters and biodegradability bio-polybag water hyacinth fibers (Eichornia crassipes) on three medium that is dissolved in water, river water and buried in soil. The research shows bio-polybag of hyacinth fibers can rapidly degraded. This study is expected to be the beginning of the creation bio-polybag of water hyacinth fiber (Eichornia crassipes) and can be applied in agriculture.

Keywords: revolution, biopolybag, renewable, environment

Procedia PDF Downloads 226

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 438

Authors: Marzie Shahini, Alireza Bagheri Sabbagh, Rasoul Mirghaderi, Paul C. Davidson

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The focus of this paper is to incorporating the slotted bolted connection into the cold-formed steel (CFS) beams with aim of increasing inelastic bending capacity through bolt slip. An extensive finite element analysis was conducted on the through plate CFS bolted connections which are equipped with the slotted hole. The studied parameters in this paper included the following: CFS beam section geometry, the value of slip force, CFS beam thickness. The numerical results indicate that CFS slotted bolted connection exhibit higher inelastic capacity in terms of ductility compare to connection with standards holes. Moreover, the effect of slip force was analysed by comparing the moment-rotation curves of different models with different slip force value. As a result, as the slip force became lower, there was a tendency for the plastic strain to extend from the CFS member to the connection region.

Keywords: slip-critical bolted connection, inelastic capacity, slotted holes, cold-formed steel, bolt slippage, slip force

Procedia PDF Downloads 416

Authors: Mokhlisur Rahman

Abstract:

Ocean inhibits one of the most complex ecosystems on the planet that regulates the earth's climate and weather by providing us with compatible weather to live. Ocean provides food by extending various ways of lifestyles that are dependent on it, transportation by accommodating the world's biggest carriers, recreation by offering its beauty in many moods, and home to countless species. At the essence of receiving various forms of entertainment, consumers choose to be close to the ocean while performing many fun activities. Which, at some point, upsets the stomach of the ocean by threatening marine life and the environment. Consumers throw the waste into the ocean after using it. Most of them are plastics that float over the ocean and turn into thousands of micro pieces that are hard to observe with the naked eye but easily eaten by the sea species. Eventually, that conflicts with the natural consumption process of any living species, making them sick. This information is not known by most consumers who go to the sea or seashores occasionally to spend time, nor is it widely discussed, which creates an information gap among consumers. However, advertising is a powerful tool to educate people about ocean pollution. This abstract analyzes three major ocean-saving advertisement campaigns that use innovative and advanced technology to get maximum exposure. The study collects data from the selected campaigns' websites and retrieves all available content related to messages, videos, and images. First, the SeaLegacy campaign uses stunning images to create awareness among the people; they use social media content, videos, and other educational content. They create content and strategies to build an emotional connection among the consumers that encourage them to move on an action. All the messages in their campaign empower consumers by using powerful words. Second, Ocean Conservancy Campaign uses social media marketing, events, and educational content to protect the ocean from various pollutants, including plastics, climate change, and overfishing. They use powerful images and videos of marine life. Their mission is to create evidence-based solutions toward a healthy ocean. Their message includes the message regarding the local communities along with the sea species. Third, ocean clean-up is a campaign that applies strategies using innovative technologies to remove plastic waste from the ocean. They use social media, digital, and email marketing to reach people and raise awareness. They also use images and videos to evoke an emotional response to take action. These tree advertisements use realistic images, powerful words, and the presence of living species in the imagery presentation, which are eye-catching and can grow emotional connection among the consumers. Identifying the effectiveness of the messages these advertisements carry and their strategies highlights the knowledge gap of mass people between real pollution and its consequences, making the message more accessible to the mass of people. This study aims to provide insights into the effectiveness of ocean-saving advertisement campaigns and their impact on the public's awareness of ocean conservation. The findings from this study help shape future campaigns.

Keywords: advertising-campaign, content-creation, images ocean-saving technology, videos

Procedia PDF Downloads 62

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 70

Authors: John Tolentino, Yong Seok Park

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There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D Printing, Cycling, Prosthetic design, Synthetic design.

Procedia PDF Downloads 126

Authors: Mohammad Befkin, Alireza Momtaz

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Structural design is the challenging aspect of every project due to limitations in dimensions, functionality of the structure, and more importantly, the allocated budget for construction. This research study aims to investigate the optimized design for three steel moment frame buildings with different number of stories using genetic algorithm code. The number and length of spans, and height of each floor were constant in all three buildings. The design of structures are carried out according to AISC code within the provisions of plastic design with allowable stress values. Genetic code for optimization is produced using MATLAB program, while buildings modeled in Opensees program and connected to the MATLAB code to perform iterations in optimization steps. In the end designs resulted from genetic algorithm code were compared with the analysis of buildings in ETABS program. The results demonstrated that suggested structural elements by the code utilize their full capacity, indicating the desirable efficiency of produced code.

Keywords: genetic algorithm, structural analysis, steel moment frame, structural design

Procedia PDF Downloads 96

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 46

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

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Authors: Anusha Chanda, Reenu Singh

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Packaging is one of the major contributors to global waste. While efforts are being made to switch to more sustainable types of packaging, such as switching from single use plastics to paper, not all polluting materials, have been rethought in terms of recycling. Minimalism in packaging design can help reduce the amount of waste produced greatly. While online companies have shifted to using cardboard boxes for packages, a large amount of waste in still generated from other materials affiliated with cardboard packaging, such as tape, bubble wrap, plastic wrap, among others. Minimalism also works by reducing extra packaging and increasing the reusability of the material. This paper looks at research related to minimalism in packaging design, minimalism, and sustainability. A survey was conducted in order to find out the different ways in which minimalism can be implemented in packaging design. Information gathered from the research and responses from the survey was used to ideate product design alternatives for sustainable substitutes for bubble wrap in packaging. This would help greatly reduce the amount of packaging waste and improve environmental quality.

Keywords: environment, minimalism, packaging, product design, sustainable

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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

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Authors: J. H. O. Nascimento, F. R. Oliveira, K. K. O. S. Silva, J. Neves, V. Teixeira, J. Carneiro

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These the aliphatic polyesters such as Polylactic Acid (PLA) in the form of fibers, nanofibers or plastic films, generally possess chemically inert surfaces, free porosity, and surface free energy (ΔG) lesser than 32 mN/m. It is therefore considered a low surface energy material, consequently has a low work of adhesion. For this reason, the products manufactured using these polymers are often subjected to surface treatments in order to change its physic-chemical surface, improving their wettability and the Work of Adhesion (WA). Plasma Radio Frequency low pressure (RF) treatment was performed in order to improve the Work of Adhesion (WA) on PLA fibers. Different parameters, such as, power, ratio of working gas (Argon/Oxygen) and treatment time were used to optimize the plasma conditions to modify the PLA surface properties. With plasma treatment, a significant increase in the work of adhesion on PLA fiber surface was observed. The analysis performed by XPS showed an increase in polar functional groups and the SEM and AFM image revealed a considerable increase in roughness.

Keywords: RF plasma, surface modification, PLA fabric, atomic force macroscopic, Nanotechnology

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Authors: Renzo Palomino, Alessandra Trujillo, Lidia Pacheco

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The document presents a study based on the incremental bearing capacity of silty clay soil with the incorporation of crushed PET fibers. For a better understanding of the behavior of soil, it is necessary to know its origin. The analyzed samples came from the subgrade layer of a highway that connects the cities of Muniches and Yurimaguas in Loreto, Peru. The material in this area usually has properties such as low support index, medium to high plasticity, and other characteristics that make it considered a ‘problematic’ soil due to factors such as climate, humidity, and geographical location. In addition, PET fibers are obtained from the decomposition of plastic bottles that are polluting agents with a high production rate in our country; in that sense, their use in a construction process represents a considerable reduction in environmental impact. Moreover, to perform a precise analysis of the behavior of this soil mixed with PET, tests such as the hydrometer test, Proctor and CBR with 15%, 10%, 5%, 4%, 3%, and 1% of PET with respect to the mass of the sample of natural soil were carried out. The results show that when a low percentage of PET is used, the support index increases.

Keywords: environmental impact, geotechnics, PET, silty clay soil

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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

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Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

Abstract:

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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