Search results for: active medical implants

Authors: Farnaz Dehkhoda

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This study was conducted to compare the effectiveness of active and receptive music-therapy on anxiety in cancer patients undergoing chemotherapy or radiotherapy. 184 young adult patients, who were diagnosed with early stage cancer and were undergoing treatment, were divided into three groups. Two groups received music therapy as a parallel treatment and the third group was control group. In active music-therapy, a music specialist helped the patients to play guitar and sing. In the receptive music-therapy, patients preferred pre-recorded music played by MP3 player. The level of anxiety was measured by the Beck Anxiety Inventory as pre-test and post-test. ANCOVA revealed that both types of music-therapy reduced anxiety level of patients and the active music-therapy intervention found to be more effective. The results suggest that music-therapy can be applied as an intervention method contemporary with cancer medical treatment, for improving quality of life in cancer patients by reducing their anxiety.

Keywords: Anxiety, Cancer, Chemotherapy, Music-therapy

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Authors: R. Chakib, A. Essadki, M. Cherkaoui

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This paper proposes the study of a robust control of the doubly fed induction generator (DFIG) used in a wind energy production. The proposed control is based on the linear active disturbance rejection control (ADRC) and it is applied to the control currents rotor of the DFIG, the DC bus voltage and active and reactive power exchanged between the DFIG and the network. The system under study and the proposed control are simulated using MATLAB/SIMULINK.

Keywords: doubly fed induction generator (DFIG), active disturbance rejection control (ADRC), vector control, MPPT, extended state observer, back-to-back converter, wind turbine

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Authors: Serkan Yağlı, Selçuk Dal

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Cyber-attacks pose a serious threat to all states. Therefore, states constantly seek for various methods to encounter those threats. In addition, recent changes in the nature of cyber-attacks and their more complicated methods have created a new concept: active cyber defence (ACD). This article tries to answer firstly why ACD is important to NATO and find out the viewpoint of NATO towards ACD. Secondly, infrastructure protection is essential to cyber defence. Critical infrastructure protection with ACD means is even more important. It is assumed that by implementing active cyber defence, NATO may not only be able to repel the attacks but also be deterrent. Hence, the use of ACD has a direct positive effect in all international organizations’ future including NATO.

Keywords: active cyber defence, advanced persistent treat, critical infrastructure, NATO

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Authors: R. B. Mishra, Sudhakar Tripathi

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In this paper, the cable model of dendrites have been considered. The dendrites are cylindrical cables of various segments having variable length and reducing radius from start point at synapse and end points. For a particular event signal being received by a neuron in response only some dendrite are active at a particular instance. Initial current signals with different current flows in dendrite are assumed. Due to overlapping and coupling of active dendrite, they induce currents in the dendrite segments of each other at a particular instance. But how these currents are induced in the various segments of active dendrites due to coupling between these dendrites, It is not presented in the literature. Here the paper presents a model for induced currents in active dendrite segments due to mutual coupling at the starting instance of an activity in dendrite. The model is as discussed further.

Keywords: currents, dendrites, induction, simulation

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Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

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Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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Authors: Javad Yarmahmoudi, Alireza Mirzaee

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Many active and passive structural health monitoring (SHM) techniques have been developed for detection of the defects of plates. Generally, riveted joints hold the plates together and their failure may create accidents. In this study, well known active and passive methods were modified for the evaluation of the health of the riveted joints between the plates. The active method generated Lamb waves and monitored their propagation by using lead zirconate titanate (PZT) disks. The signal was analyzed by using the wavelet transformations. The passive method used the Fiber Bragg Grating (FBG) sensors and evaluated the spectral characteristics of the signals by using Fast Fourier Transformation (FFT). The results indicated that the existing methods designed for the evaluation of the health of individual plates may be used for inspection of riveted joints with software modifications.

Keywords: structural health monitoring, SHM, active SHM, passive SHM, fiber bragg grating sensor, lead zirconate titanate, PZT

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Authors: Roxana Maria Angelescu, Doina Răducanu, Mariana Lucia Angelescu, Ion Cincă, Vasile Dănuţ Cojocaru, Cosmin Cotruț, Şerban Nicolae

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Titanium alloys are often used for biomedical applications as hard tissue replacements, such as: orthopedic implants, spinal fixation devices and dental implants. Their advantages are well known and demonstrated: excellent mechanical properties, biocompatibility and good corrosion resistance, but it is also known that the main disadvantage of the metallic materials is their tendency of corrosion in in-vivo environments. In 1987, titanium was found to be the only metallic biomaterial that osseointegrates. The aim of this study was to investigate the microstructure and the corrosion behavior of the Ti-20Nb-5Ta wt% alloy. In this case Nb stabilizes the β-Ti structure and Ta is a highly passivating metal. The as studied alloy was melt under argon protective atmosphere in a levitation induction melting furnace, type FIVE CELES - MP25, with a nominal power of 25 kW and a melting capacity of 30 cm3. The microstructure of the as studied alloy was analyzed by using the electronic microscope Tescan Vega II-XMU. The phase structure of the as studied alloy was determined, as well as the crystalline grain size (100-200µ). To determine the corrosion behavior of the as studied alloy, the technique used was the linear polarization, with the PARSTAT 4000 potentiostat, produced by Princeton Applied Research; potentiodynamic curves were obtained with the VeraStudio v.2.4.2 software.

Keywords: corrosion resistance, microstructure, titanium alloys

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Authors: Nouby M. Ghazaly, Ahmed O. Moaaz, Mostafa Makrahy

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The main purpose of a car suspension system is to reduce the vibrations resulting from road roughness. The main objective of this research paper is to decrease vibration and improve passenger comfort through controlling car suspension system using sliding mode control techniques. The mathematical model for passive and active suspensions systems for quarter car model which subject to excitation from different road profiles is obtained. The active suspension system is synthesized based on sliding mode control for a quarter car model. The performance of the sliding mode control is determined through computer simulations using MATLAB and SIMULINK toolbox. The simulated results plotted in time domain, and root mean square values. It is found that active suspension system using sliding mode control improves the ride comfort and decrease vibration.

Keywords: quarter car model, active suspension system, sliding mode control, road profile

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Authors: Jagriti Mishra, Vasundhara Chaudhary

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Introduction: The case highlights various issues and challenges faced by Khanna Enterprises while conceptualizing and execution of launching Active Leisure wear in the domestic market, where different steps involved in the range planning and production have been elaborated. Although Khanna Enterprises was an established company which dealt in the production of knitted and woven garments, they took the risk of launching a new concept- Active Leisure wear for Millennials. Methodology: It is based on primary and secondary research where data collection has been done through survey, in-depth interviews and various reports, forecasts, and journals. Findings: The research through primary and secondary data and execution of active leisure wear substantiated the acceptance, not only by the millennials but also by the generation X. There was a demand of bigger sizes as well as more muted colours. Conclusion: The sales data paved the way for future product development in tune with the strengths of Khanna Enterprises.

Keywords: millennials, range planning, production, active leisure wear

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Authors: Yung-Shan Lu, Chia-Fone Lee, Shang-Hsuan Li, Chien-Hao Liu

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Recently, various bioelectronic devices have been developed for neurologic disease treatments via electro-stimulations such as cochlear implants and retinal prosthesis. Since the electric signal needs electrodes to be transmitted to an organism, electrodes play an important role of stimulations. The materials of stimulation electrodes affect the efficiency of the delivered currents. The higher the efficiency of the electrodes, the lower the threshold current can be used to stimulate the organism which minimizes the potential damages to the adjacent tissues. In this study, we proposed a biocompatible composite electrode composed of high-charge-capacity iridium oxide (IrOₓ) film for a bone-guide extra-cochlear implant. IrOₓ was exploited to decrease the threshold current due to its high capacitance and low impedance. The IrOₓ electrode was fabricated via microelectromechanical systems (MEMS) photolithography and examined with in-vivo tests with guinea pigs. Based on the measured responses of brain waves to sound, the results demonstrated that IrOₓ electrodes have a lower threshold current compared with the Platinum (Pt) electrodes. The research results are expected to be beneficial for implantable and biocompatible electrodes for electrical stimulations.

Keywords: cochlear implants, electrode, electrical stimulation, iridium oxide

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Authors: Bhavani Veasuvalingam

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Case-based learning (CBL) is a popular instructional method aimed to bridge theory to clinical practice. This study aims to explore CBL mixed modality curriculum in influencing students’ learning styles and strategies that support learning. An explanatory sequential mixed method study was employed with initial phase, 44-itemed Felderman’s Index of Learning Style (ILS) questionnaire employed across year one medical students (n=142) using convenience sampling to describe the preferred learning styles. The qualitative phase utilised three focus group discussions (FGD) to explore in depth on the multimodal learning style exhibited by the students. Most students preferred combination of learning stylesthat is reflective, sensing, visual and sequential i.e.: RSVISeq style (24.64%) from the ILS analysis. The frequency of learning preference from processing to understanding were well balanced, with sequential-global domain (66.2%); sensing-intuitive (59.86%), active- reflective (57%), and visual-verbal (51.41%). The qualitative data reported three major themes, namely Theme 1: CBL mixed modalities navigates learners’ learning style; Theme 2: Multimodal learners active learning strategies supports learning. Theme 3: CBL modalities facilitating theory into clinical knowledge. Both quantitative and qualitative study strongly reports the multimodal learning style of the year one medical students. Medical students utilise multimodal learning styles to attain the clinical knowledge when learning with CBL mixed modalities. Educators’ awareness of the multimodal learning style is crucial in delivering the CBL mixed modalities effectively, considering strategic pedagogical support students to engage and learn CBL in bridging the theoretical knowledge into clinical practice.

Keywords: case-based learning, learnign style, medical students, learning

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Authors: Aleš Kratochvíl, Svatomír Slavík

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The paper presents an aircraft flutter suppression by active damping of supplementary control surface at trailing edge. The mathematical model of thin oscillation airfoil with control surface driven by pilot is developed. The supplementary control surface driven by control law is added. Active damping of flutter by several control law is present. The structural model of tailplane with an aerodynamic strip theory based on the airfoil model is developed by a finite element method. The optimization process of stiffens parameters is carried out to match the structural model with results from a ground vibration test of a small sport airplane. The implementation of supplementary control surface driven by control law is present. The active damping of tailplane model is shown.

Keywords: active damping, finite element method, flutter, tailplane model

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Authors: Shiuh-Jer Huang, Yun-Han Yeh

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A 40 steps manual adjusting shock absorber was refitted with DC motor driving mechanism to construct as a semi-active suspension system for a four-wheel drive electric vehicle. Accelerometer and potentiometer sensors are installed to measure the sprung mass acceleration and suspension system compression or rebound states for control purpose. A fuzzy logic controller was designed to derive appropriate damping target based on vehicle running condition for semi-active suspension system to follow. The damping ratio control of each wheel axis suspension system is executed with a robust fuzzy sliding mode controller (FSMC). Different road surface conditions are chosen to evaluate the control performance of this semi-active suspension system based on wheel axis acceleration signal.

Keywords: semi-active suspension, electric vehicle, fuzzy sliding mode control, accelerometer

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Authors: Mohammad Saleem, Neeta Kumar, Anita Sharma, Sazina Muzammil

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It is observed that some of the dental students in our setting take less interest in medical subjects. Various teaching methods are focus of research interest currently and being tried to generate interest among students. An approach of interactive integrated tutorial was used to assess its feasibility in teaching medical subjects to dental undergraduates. The aim was to generate interest and promote active self-learning among students. The objectives were to (1) introduce the integrated interactive learning method through two departments, (2) get feedback from the students and faculty on feasibility and effectiveness of this method. Second-year students in Bachelor of Dental Surgery course were divided into two groups. Each group was asked to study physiology and pathology of a common and important condition (anemia and hypertension) in a week’s time. During the tutorial, students asked questions on physiology and pathology of that condition from each other in the presence of teachers of both physiology and pathology departments. The teachers acted only as facilitators. After the session, the feedback from students and faculty on this alternative learning method was obtained. Results: Majority of the students felt that this method of learning is enjoyable, helped to develop reasoning skills and ability to correlate and integrate the knowledge from two related fields. Majority of the students felt that this kind of learning led to better understanding of the topic and motivated them towards deep learning. Teachers observed that the study promoted interdepartmental cross-discipline collaboration and better students’ linkages. Conclusion: Interactive integrated tutorial is effective in motivating dental students for better and deep learning of medical subjects.

Keywords: active learning, education, integrated, interactive, self-learning, tutorials

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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: Abdul Rofiq Badril Rizal M. Z.

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Reading becomes one of the most important skills in teaching and learning English. The purpose of this research was to improve the students' active participation, and reading comprehension achievement by using Know, Want to Know, Learned (KWL) strategy. The research design was Classroom Action Research. The area and participants of this research were chosen by using purposive method. The data were collected by observation, a reading comprehension test, interview, and documentation. The results showed that there was significant improvement in Cycle 1 to Cycle 2 of the research. In cycle 1, the students’ active participation increased 49.77% from 28% to 77.77. In addition, in cycle 2, the students’ active participation also increased by 14.17% from 77.77% to 81.94%. The students’ reading comprehension achievement also increased by 52.14% from 25% to 77.14% in Cycle 1 and increased by 5.71% from 77.14% to 82.85% in cycle 2. It indicated that using Know, Want to Know, Learned (KWL) strategy could enhance the Seventh C grade students’ descriptive text reading comprehension achievement, and active participation.

Keywords: active participation, reading comprehension, classroom action research, Indonesian folktales

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Authors: Areti Okalidou, Paul D. Hatzigiannakoglou, Aikaterini Vatou, George Kyriafinis

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Young children are nowadays adept at using technology. Hence, computer-based auditory training programs (CBATPs) have become increasingly popular in aural rehabilitation for children with hearing loss and/or with cochlear implants (CI). Yet, their clinical utility for prognostic, diagnostic, and monitoring purposes has not been explored. The purposes of the study were: a) to develop an updated version of the auditory rehabilitation tool for Greek-speaking children with cochlear implants, b) to develop a database for behavioral responses, and c) to compare accuracy rates and reaction times in children differing in hearing status and other medical and demographic characteristics, in order to assess the tool’s clinical utility in prognosis, diagnosis, and progress monitoring. The updated version of the auditory rehabilitation tool was developed on a tablet, retaining the User-Centered Design approach and the elements of the Virtual Reality (VR) serious game. The visual stimuli were farm animals acting in simple game scenarios designed to trigger children’s responses to animal sounds, names, and relevant sentences. Based on an extended version of Erber’s auditory development model, the VR game consisted of six stages, i.e., sound detection, sound discrimination, word discrimination, identification, comprehension of words in a carrier phrase, and comprehension of sentences. A familiarization stage (learning) was set prior to the game. Children’s tactile responses were recorded as correct, false, or impulsive, following a child-dependent set up of a valid delay time after stimulus offset for valid responses. Reaction times were also recorded, and the database was in Εxcel format. The tablet version of the auditory rehabilitation tool was piloted in 22 preschool children with Νormal Ηearing (ΝΗ), which led to improvements. The study took place in clinical settings or at children’s homes. Fifteen children with CI, aged 5;7-12;3 years with post-implantation 0;11-5;1 years used the auditory rehabilitation tool. Eight children with CI were monolingual, two were bilingual and five had additional disabilities. The control groups consisted of 13 children with ΝΗ, aged 2;6-9;11 years. A comparison of both accuracy rates, as percent correct, and reaction times (in sec) was made at each stage, across hearing status, age, and also, within the CI group, based on presence of additional disability and bilingualism. Both monolingual Greek-speaking children with CI with no additional disabilities and hearing peers showed high accuracy rates at all stages, with performances falling above the 3rd quartile. However, children with normal hearing scored higher than the children with CI, especially in the detection and word discrimination tasks. The reaction time differences between the two groups decreased in language-based tasks. Results for children with CI with additional disability or bilingualism varied. Finally, older children scored higher than younger ones in both groups (CI, NH), but larger differences occurred in children with CI. The interactions between familiarization of the software, age, hearing status and demographic characteristics are discussed. Overall, the VR game is a promising tool for tracking the development of auditory skills, as it provides multi-level longitudinal empirical data. Acknowledgment: This work is part of a project that has received funding from the Research Committee of the University of Macedonia under the Basic Research 2020-21 funding programme.

Keywords: VR serious games, auditory rehabilitation, auditory training, children with cochlear implants

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Authors: V. Schmidt, L. Janovák, N. Wiegand, B. Patczai, K. Turzó

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Large bone defects are not able to heal spontaneously. Bioactive glasses seem to be appropriate (bio)materials for bone reconstruction. Bioactive glasses are osteoconductive and osteoinductive, therefore, play a useful role in bony regeneration and repair. Because of their not optimal mechanical properties (e.g., brittleness, low bending strength, and fracture toughness), their applications are limited. Bioactive glass can be used as a coating material applied on metal surfaces. In this way -when using them as implants- the excellent mechanical properties of metals and the biocompatibility and bioactivity of glasses will be utilized. Furthermore, ion release effects of bioactive glasses regarding osteogenic and angiogenic responses have been shown. Silicate bioactive glasses (45S5 Bioglass) induce the release and exchange of soluble Si, Ca, P, and Na ions on the material surface. This will lead to special cellular responses inducing bone formation, which is favorable in the biointegration of the orthopedic prosthesis. The incorporation of other additional elements in the silicate network such as fluorine, magnesium, iron, silver, potassium, or zinc has been shown, as the local delivery of these ions is able to enhance specific cell functions. Although hip and knee prostheses present a high success rate, bacterial infections -mainly implant associated- are serious and frequent complications. Infection can also develop after implantation of hip prostheses, the elimination of which means more surgeries for the patient and additional costs for the clinic. Prosthesis-related infection is a severe complication of orthopedic surgery, which often causes prolonged illness, pain, and functional loss. While international efforts are made to reduce the risk of these infections, orthopedic surgical infections (SSIs) continue to occur in high numbers. It is currently estimated that up to 2.5% of primary hip and knee surgeries and up to 20% of revision arthroplasties are complicated by periprosthetic joint infection (PJIs). According to some authors, these numbers are underestimated, and they are also increasing. Staphylococcus aureus is the leading cause of both SSIs and PJIs, and the prevalence of methicillin-resistant S. aureus (MRSA) is on the rise, particularly in the United States. These deep infections lead to implant removal and consequently increase morbidity and mortality. The study targets this clinical problem using our experience so far with the Ag-doped polymer coatings on Titanium implants. Non-modified or modified (e.g., doped with antibacterial agents, like Ag) bioactive glasses could play a role in the prevention of infections or the therapy of infected tissues. Bioactive glasses have excellent biocompatibility, proved by in vitro cell culture studies of human osteoblast-like MG-63 cells. Ag-doped bioactive glass-scaffold has a good antibacterial ability against Escherichia coli and other bacteria. It may be concluded that these scaffolds have great potential in the prevention and therapy of implant-associated bone infection.

Keywords: antibacterial agents, bioactive glass, hip and knee prosthesis, medical implants

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Authors: Fabio Rodriguez Sanchez, Josef Bruers, Iciar Arteagoitia, Carlos Rodriguez Andres

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Background: Oral implants are a routine treatment to replace lost teeth. Although they have a high rate of success, implant failures do occur. Perioperative antibiotics have been suggested to prevent postoperative infections and dental implant failures, but they remain a controversial treatment among healthy patients. The objective of this study was to determine whether antibiotic prophylaxis is a common treatment in the Netherlands among general dentists, maxillofacial-surgeons, periodontists and implantologists in conjunction with oral implant surgery among healthy patients and to assess the nature of antibiotics prescriptions in order to evaluate whether any consensus has been reached and the current recommendations are being followed. Methodology: Observational cross-sectional study based on a web-survey reported according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A validated questionnaire, developed by Deeb et al. (2015), was translated and slightly adjusted to circumstances in the Netherlands. It was used with the explicit permission of the authors. This questionnaire contained both close-ended and some open-ended questions in relation to the following topics: demographics, qualification, antibiotic type, prescription-duration and dosage. An email was sent February 2018 to a sample of 600 general dentists and all 302 oral implantologists, periodontists and maxillofacial surgeons who were recognized by the Dutch Association of Oral Implantology (NVOI) as oral health care providers placing oral implants. The email included a brief introduction about the study objectives and a link to the web questionnaire, which could be filled in anonymously. Overall, 902 questionnaires were sent. However, 29 questionnaires were not correctly received due to an incorrect email address. So a total number of 873 professionals were reached. Collected data were analyzed using SPSS (IBM Corp., released 2012, Armonk, NY). Results: The questionnaire was sent back by a total number of 218 participants (response rate=24.2%), 45 female (20.8%) and 171 male (79.2%). Two respondents were excluded from the study group because they were not currently working as oral health providers. Overall 151 (69.9%) placed oral implants on regular basis. Approximately 79 (52.7%) of these participants prescribed antibiotics only in determined situations, 66 (44.0%) prescribed antibiotics always and 5 dentists (3.3%) did not prescribe antibiotics at all when placing oral implants. Overall, 83 participants who prescribed antibiotics, did so both pre- and postoperatively (58.5%), 12 exclusively postoperative (8.5%), and 47 followed an exclusive preoperative regime (33.1%). A single dose of 2,000 mg amoxicillin orally 1-hour prior treatment was the most prescribed preoperative regimen. The most frequent prescribed postoperative regimen was 500 mg amoxicillin three times daily for 7 days after surgery. On average, oral health professionals prescribed 6,923 mg antibiotics in conjunction with oral implant surgery, varying from 500 to 14,600 mg. Conclusions: Antibiotic prophylaxis in conjunction with oral implant surgery is prescribed in the Netherlands on a rather large scale. Dutch professionals might prescribe antibiotics more cautiously than in other countries and there seems to be a lower range on the different antibiotic types and regimens being prescribed. Anyway, recommendations based on last-published evidence are frequently not being followed.

Keywords: clinical decision making, infection control, antibiotic prophylaxis, dental implants

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Authors: Vishnu Emani, Andreas Escher, Ellen Roche

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Background: Orthostatic hypotension (OH) is an autonomic disorder marked by a sudden drop in blood pressure upon standing resulting from autonomic dysfunction. OH is especially prevalent in elderly populations, affecting more than 30% of Americans over the age of 70. OH is one of the most significant risk factors for accidental falls in elderly populations, making it a crucial focus for medical and device therapies. Pharmacologic therapy with midodrine and fludrocortisone may alleviate hypotension but have significant adverse side effects. Abdominal passive compression devices (binders) are more effective than lower extremity compression stockings at mitigating postural hypotension, by improving venous return to the heart. However, abdominal binders are difficult to don and uncomfortable to wear, leading to poor compliance. A disadvantage of passive compression devices is their inability to selectively compress during the crucial moment of standing. We have recently developed an active compression device that applies external pressure on the abdomen during the transition from a prone to a supine position and conducted initial prototype testing. Methods: An active abdominal compression device was developed utilizing a simple, servo-driven straptightening mechanism to supply tension onto foam fabric, which applies pressure to the abdomen. Healthy volunteers (n=5) were utilized for prototype testing and were subjected to three conditions: no compression, passive compression (i.e. standard abdominal binder), and active compression (device prototype). Abdominal applied pressure during device activation was measured by a strain-gauge manometer placed between the skin and binder. Systolic (SBP) and mean (MAP) arterial blood pressure was measured by standard blood pressure cuff in supine position followed by repeat measurements at 1 minute intervals for 5 minutes following upright position. A survey tool was administered to determine scores (1-10) for comfort and ease of donning abdominal binders. Results: Abdominal pressure increased from 0 to 15±3 mmHg upon device activation for both passive and active compression devices. During the transition from supine to an upright position, both active and passive compression devices demonstrated significantly higher MAP compared to the no-compression condition (67±4, 68±5, 62±5 respectively, P<0.05), but there was no statistically significant difference in SBP or MAP when comparing active to passive compression. Active compression demonstrated significantly higher comfort scores (8.3±1) compared to passive compression (3.2±2) but lower when compared to no compression (10). Subjects universally reported that active compression device was easier to don compared to passive device. Conclusions: Active or passive abdominal compression prevents hypotension associated with postural changes. Active compression is associated with increased comfort and ease of donning compared to passive compression devices. Future trials are warranted to investigate the efficacy of our device in patients with OH.

Keywords: orthostatic hypotension, compression binder, abdominal binder, active abdominal compression

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Authors: B. R. Raut

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The seismic performance of 20-storey benchmark building with semi-active dampers is investigated under various earthquake ground motions. The Semi-Active Variable Friction Dampers (SAVFD) and Magnetorheological Dampers (MR) are used in this study. A recently proposed predictive control algorithm is employed for SAVFD and a simple mechanical model based on a Bouc–Wen element with clipped optimal control algorithm is employed for MR damper. A parametric study is carried out to ascertain the optimum parameters of the semi-active controllers, which yields the minimum performance indices of controlled benchmark building. The effectiveness of dampers is studied in terms of the reduction in structural responses and performance criteria. To minimize the cost of the dampers, the optimal location of the damper, rather than providing the dampers at all floors, is also investigated. The semi-active dampers installed in benchmark building effectively reduces the earthquake-induced responses. Lesser number of dampers at appropriate locations also provides comparable response of benchmark building, thereby reducing cost of dampers significantly. The effectiveness of two semi-active devices in mitigating seismic responses is cross compared. Among two semi-active devices majority of the performance criteria of MR dampers are lower than SAVFD installed with benchmark building. Thus the performance of the MR dampers is far better than SAVFD in reducing displacement, drift, acceleration and base shear of mid to high-rise building against seismic forces.

Keywords: benchmark building, control strategy, input excitation, MR dampers, peak response, semi-active variable friction dampers

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Authors: Neriman Ozada, Ebrahim Karamian, Amirsalar Khandan, Sina Ghafoorpoor Yazdi

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Natural hydroxyapatite, NHA, coatings on the surface of 316 L stainless steel implants has been widely employed in order to achieve better osteoconductivity. For coating, the plasma spraying method is generally used because they ensure adhesion between the coating and the 316 L stainless steel (SS) surface. Some compounds such as zircon (ZrSiO4) is employed as an additive in an attempt to improve HA’s mechanical properties such as wear resistance and hardness. In this study wear resistance has been carried out in different chemical compositions of coating. Therefore, nanocomposites based on NHA containing of 0 wt.%, 5 wt.%, 10 wt.%, and 15 wt.% of zircon were used as a coating on the SS implants. The samples consisted of NHA, derived from calf heated at 850 °C for 3 h. The composite mixture was coated on SS by plasma spray method. The results were estimated using the scanning electron microscopy (SEM), X-ray diffraction (XRD) techniques were utilized to characterize the shape and size of NHA powder. Disc wear test and Vickers hardness were utilized to characterize the coated nanocomposite samples. The prepared NHA powder had nano-scale morphological structure with the mean crystallite size of 30-50 nm in diameter. The wear resistance are almost 320, 380, 415, and 395 m/g and hardness are approximately 376, 391, 420, 410 VHN in ceramic composite materials containing ZrSiO4. The results have been shown that the best wear resistance and hardness occurred in the sample coated by NHA/ZrSiO4 containing of 10 wt.% of zircon.

Keywords: zircon, 316 L stainless steel, wear resistance, orthopedic applications, plasma spray

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Authors: J. Palán, M. Zemko

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COMTES FHT has been active in a field of research and development of high-strength wires for quite some time. The main material was pure titanium. The primary goal of this effort is to develop a continuous production process for ultrafine and nanostructured materials with the aid of severe plastic deformation (SPD). This article outlines mechanical and microstructural properties of the materials and the options available for testing the components made of these materials. Ti Grade 2 and Grade 4 wires are the key products of interest. Ti Grade 2 with ultrafine to nano-sized grain shows ultimate strength of up to 1050 MPa. Ti Grade 4 reaches ultimate strengths of up to 1250 MPa. These values are twice or three times as higher as those found in the unprocessed material. For those fields of medicine where implantable metallic materials are used, bulk ultrafine to nanostructured titanium is available. It is manufactured by SPD techniques. These processes leave the chemical properties of the initial material unchanged but markedly improve its final mechanical properties, in particular, the strength. Ultrafine to nanostructured titanium retains all the significant and, from the biological viewpoint, desirable properties that are important for its use in medicine, i.e. those properties which made pure titanium the preferred material also for dental implants.

Keywords: CONFORM, ECAP, rotary swaging, titanium

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Authors: Dewi Juliah Ratnaningsih, Imas Sukaesih Sitanggang

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Classification is one of data mining techniques that aims to discover a model from training data that distinguishes records into the appropriate category or class. Data mining classification methods can be applied in education, for example, to determine the classification of non-active students in Indonesia Open University. This paper presents a comparison of three methods of classification: Naïve Bayes, Bagging, and C.45. The criteria used to evaluate the performance of three methods of classification are stratified cross-validation, confusion matrix, the value of the area under the ROC Curve (AUC), Recall, Precision, and F-measure. The data used for this paper are from the non-active Indonesia Open University students in registration period of 2004.1 to 2012.2. Target analysis requires that non-active students were divided into 3 groups: C1, C2, and C3. Data analyzed are as many as 4173 students. Results of the study show: (1) Bagging method gave a high degree of classification accuracy than Naïve Bayes and C.45, (2) the Bagging classification accuracy rate is 82.99 %, while the Naïve Bayes and C.45 are 80.04 % and 82.74 % respectively, (3) the result of Bagging classification tree method has a large number of nodes, so it is quite difficult in decision making, (4) classification of non-active Indonesia Open University student characteristics uses algorithms C.45, (5) based on the algorithm C.45, there are 5 interesting rules which can describe the characteristics of non-active Indonesia Open University students.

Keywords: comparative analysis, data mining, clasiffication, Bagging, Naïve Bayes, C.45, non-active students, Indonesia Open University

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Authors: Kuang-Hsiung Tan, Chih-Chan Hu, Chien-Wu Lan, Shih-Sung Lin, Te-Jen Chang

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An active islanding detection method using disturbance signal injection with intelligent controller is proposed in this study. First, a DC\AC power inverter is emulated in the distributed generator (DG) system to implement the tracking control of active power, reactive power outputs and the islanding detection. The proposed active islanding detection method is based on injecting a disturbance signal into the power inverter system through the d-axis current which leads to a frequency deviation at the terminal of the RLC load when the utility power is disconnected. Moreover, in order to improve the transient and steady-state responses of the active power and reactive power outputs of the power inverter, and to further improve the performance of the islanding detection method, two probabilistic fuzzy neural networks (PFNN) are adopted to replace the traditional proportional-integral (PI) controllers for the tracking control and the islanding detection. Furthermore, the network structure and the online learning algorithm of the PFNN are introduced in detail. Finally, the feasibility and effectiveness of the tracking control and the proposed active islanding detection method are verified with experimental results.

Keywords: distributed generators, probabilistic fuzzy neural network, islanding detection, non-detection zone

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Authors: Pouya Khaleghi

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Dental implants are a successful treatment modality for restoring both function and aesthetics. Dental implant treatment has predictive results in the replacement of the lost teeth and has a high success rate even in the long term. The most important factor which is responsible for the positive course of implant treatment is the process of osseointegration between the implant structure and the host’s bone tissue. During recent years, many studies have focused on surgical and prosthetic factors, as well as the implant-related factors. However, implant failure still occurs despite the improvements that have led to the increased survival rate of dental implants, which suggests the possible role of some host-related risk factors. Vitamin D is a fat-soluble vitamin regulating calcium and phosphorus metabolism in tissues. The role of vitamin D in bone healing has been under investigation for several years. Vitamin D deficiency has also been associated with impaired and delayed callus formation and fractures healing; however, the role of vitamin D has not been clarified. Therefore, it is extremely important to study the phenomenon of a connection formed between bone tissue and the surface of a titanium implant and find correlations between the 25- hydroxycholecalciferol concentration in blood serum and the course of osseointegration. Because the processes of bone remodeling are very dynamic in the period of actual osseointegration, it is necessary to obtain the correct concentration of vitamin D3 metabolites in blood serum. In conclusion, the correct level of 25-hydroxycholecalciferol on the day of surgery and vitamin D deficiency treatment have a significant influence on the increase in the bone level at the implant site during the process of osseointegration assessed radiologically.

Keywords: implant, osseointegration, vitamin d, dental

Procedia PDF Downloads 174

Authors: Bilal Ahmed

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Rehabilitation of congenital and acquired maxillofacial defects is always a challenging clinical scenario. These defects pose major physiological and psychological threat not only to the patient but to the entire family. There has been an enormous scientific development in maxillofacial rehabilitation with the advent of CAD CAM, 3-D scanning, Osseo-integrated implants and improved restorative materials. There are also specialized centers with latest diagnostic and treatment facilities in the developed countries. However, in certain clinical case scenarios, conventional prosthodontic principles are still the gold standards. Similarly in a less developed world, financial and technical constraints are factors affecting treatment planning and final outcomes. However, we can do a lot of benefits to the affected human beings, even with use of simple and cost-effective conventional prosthodontic techniques and materials. These treatment strategies may sometimes be considered as intermediate or temporary options, but with regular follow-up maintenance these can be used on a definitive basis.

Keywords: maxillofacial defects, obturators, prosthodontics, medical and health sciences

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Authors: Pinar Erturk, Sevde Altuntas, Fatih Buyukserin

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In order to obtain an effective integration between an implant and a bone, implant surfaces should have similar properties to bone tissue surfaces. Especially mimicry of the chemical, mechanical and topographic properties of the implant to the bone is crucial for fast and effective osseointegration. Titanium-based biomaterials are more preferred in clinical use, and there are studies of coating these implants with oxide layers that have chemical/nanotopographic properties stimulating cell interactions for enhanced osseointegration. There are low success rates of current implantations, especially in craniofacial implant applications, which are large and vital zones, and the oxide layer coating increases bone-implant integration providing long-lasting implants without requiring revision surgery. Our aim in this study is to examine bone-cell behavior on titanium implants with an aluminum oxide layer (AAO) on effective osseointegration potential in the deformation of large zones with difficult spontaneous healing. In our study, aluminum layer coated titanium surfaces were anodized in sulfuric, phosphoric, and oxalic acid, which are the most common used AAO anodization electrolytes. After morphologic, chemical, and mechanical tests on AAO coated Ti substrates, viability, adhesion, and mineralization of adult bone cells on these substrates were analyzed. Besides with atomic layer deposition (ALD) as a sensitive and conformal technique, these surfaces were coated with pure alumina (5 nm); thus, cell studies were performed on ALD-coated nanoporous oxide layers with suppressed ionic content too. Lastly, in order to investigate the effect of the topography on the cell behavior, flat non-porous alumina layers on silicon wafers formed by ALD were compared with the porous ones. Cell viability ratio was similar between anodized surfaces, but pure alumina coated titanium and anodized surfaces showed a higher viability ratio compared to bare titanium and bare anodized ones. Alumina coated titanium surfaces, which anodized in phosphoric acid, showed significantly different mineralization ratios after 21 days over other bare titanium and titanium surfaces which anodized in other electrolytes. Bare titanium was the second surface that had the highest mineralization ratio. Otherwise, titanium, which is anodized in oxalic acid electrolyte, demonstrated the lowest mineralization. No significant difference was shown between bare titanium and anodized surfaces except AAO titanium surface anodized in phosphoric acid. Currently, osteogenic activities of these cells on the genetic level are investigated by quantitative real-time polymerase chain reaction (qRT-PCR) analysis results of RUNX-2, VEGF, OPG, and osteopontin genes. Also, as a result of the activities of the genes mentioned before, Western Blot will be used for protein detection. Acknowledgment: The project is supported by The Scientific and Technological Research Council of Turkey.

Keywords: alumina, craniofacial implant, MG-63 cell line, osseointegration, oxalic acid, phosphoric acid, sulphuric acid, titanium

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Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

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Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

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Authors: R. Rezaeipour, A. R. Mehrabi

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Recent increase of the DGs and microgrids in distribution systems, disturbs the tradition structure of the system. Coordination between protection devices in such a system becomes the concern of the network operators. This paper presents a new method for fault location detection in the active distribution networks, independent of the fault type or its resistance. The method uses synchronized voltage and current measurements at the interconnection of DG units and is able to adapt to changes in the topology of the system. The method has been tested on a 38-bus distribution system, with very encouraging results.

Keywords: fault location detection, active distribution system, micro grids, network operators

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