Search results for: superficial fascia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 174

Search results for: superficial fascia

84 Visualisation in Health Communication: Taking Weibo Interaction in COVD19 as the Example

Authors: Zicheng Zhang, Linli Zhang

Abstract:

As China's biggest social media platform, Weibo has taken on essential health communication responsibilities during the pandemic. This research takes 105 posters in 15 health-related official Weibo accounts as the analysis objects to explore COVID19 health information communication and visualisation. First, the interaction between the audiences and Weibo, including forwarding, comments, and likes, is statistically analysed. The comments about the information design are extracted manually, and then the sentiment analysis is carried out to verdict audiences' views about the poster's design. The forwarding and comments are quantified as the attention index for a reference to the degree of likes. In addition, this study also designed an evaluation scale based on the standards of Health Literacy Resource by the Centers for Medicare& Medicaid Services (US). Then designers scored all selected posters one by one. Finally, combining the data of the two parts, concluded that: 1. To a certain extent, people think that the posters do not deliver substantive and practical information; 2. Non-knowledge posters(i.e., cartoon posters) gained more Forwarding and Likes, such as Go, Wuhan poster; 3. The analysis of COVID posters is still mainly picture-oriented, mainly about encouraging people to overcome difficulties; 4. Posters for pandemic prevention usually contain more text and fewer illustrations and do not clearly show cultural differences. In conclusion, health communication usually involves a lot of professional knowledge, so visualising that knowledge in an accessible way for the general public is challenging. The relevant posters still have the problems of lack of effective communication, superficial design, and insufficient content accessibility.

Keywords: weibo, visualisation, covid posters, poster design

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83 Effect of Burdock Root Extract Concentration on Physiochemical Property of Coated Jasmine Rice by Using Top-Spay Fluidized Bed Coating Technique

Authors: Donludee Jaisut, Norihisa Kato, Thanutchaporn Kumrungsee, Kiyoshi Kawai, Somkiat Prachayawarakorn, Patchalee Tungtrakul

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Jasmine Rice is a principle food of Thai people. However, glycemic index of jasmine rice is in high level, risk of type II diabetes after consuming. Burdock root is a good source of non-starch polysaccharides such as inulin. Inulin acts as prebiotic and helps reduce blood-sugar level. The purpose of this research was to reduce digestion rate of jasmine rice by coating burdock root extract on rice surface, using top-spay fluidized bed coating technique. Coating experiments were performed by spraying burdock root solution onto Jasmine rice kernels (Khao Dawk Mali-105; KDML), which had an initial moisture content of 11.6% wet basis, suspended in the fluidized bed. The experimental conditions were: solution spray rates of 31.7 mL/min, atomization pressure of 1.5 bar, spray time of 10 min, time of drying after spraying of 30 s, superficial air velocity of 3.2 m/s and drying temperatures of 60°C. The coated rice quality was evaluated in terms of the moisture content, texture, whiteness and digestion rate. The results showed that initial and final moisture contents of samples were the same in concentration 8% (v/v) and 10% (v/v). The texture was insignificantly changed from that of uncoated sample. The whiteness values were varied on concentration of burdock root extract. Coated samples were slower digested.

Keywords: burdock root, digestion, drying, rice

Procedia PDF Downloads 272
82 Performance Investigation of Silica Gel Fluidized Bed

Authors: Sih-Li Chen, Chih-Hao Chen, Chi-Tong Chan

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Poor ventilation and high carbon dioxide (CO2) concentrations lead to the formation of sick buildings. This problem cannot simply be resolved by introducing fresh air from outdoor environments because this creates extra loads on indoor air-conditioning systems. Desiccants are widely used in air conditioning systems in tropical and subtropical regions with high humidity to reduce the latent heat load from fresh air. Desiccants are usually used as a packed-bed type, which is low cost, to combine with air-conditioning systems. Nevertheless, the pressure drop of a packed bed is too high, and the heat of adsorption caused by the adsorption process lets the temperature of the outlet air increase, bringing about an extra heat load, so the high pressure drop and the increased temperature of the outlet air are energy consumption sources needing to be resolved. For this reason, the gas-solid fluidised beds that have high heat and mass transfer rates, uniform properties and low pressure drops are very suitable for use in air-conditioning systems.This study experimentally investigates the performance of silica gel fluidized bed device which applying to an air conditioning system. In the experiments, commercial silica gel particles were filled in the two beds and to form a fixed packed bed and a fluidized bed. The results indicated that compared to the fixed packed bed device, the total adsorption and desorption by amounts of fluidized bed for 40 minutes increased 20.6% and 19.9% respectively when the bed height was 10 cm and superficial velocity was set to 2 m/s. In addition, under this condition, the pressure drop and outlet air temperature raise were reduced by 36.0% and 30.0%. Given the above results, application of the silica gel fluidized bed to air conditioning systems has great energy-saving potential.

Keywords: fluidized bed, packed bed, silica gel, adsorption, desorption, pressure drop

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81 Numerical Investigation of Pressure Drop in Core Annular Horizontal Pipe Flow

Authors: John Abish, Bibin John

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Liquid-liquid flow in horizontal pipe is investigated in order to reveal the flow patterns arising from the co-existed flow of oil and water. The main focus of the study is to identify the feasibility of reducing the pumping power requirements of petroleum transportation lines by having an annular flow of water around the thick oil core. This idea makes oil transportation cheaper and easier. The present study uses computational fluid dynamics techniques to model oil-water flows with liquids of similar density and varying viscosity. The simulation of the flow is conducted using commercial package Ansys Fluent. Flow domain modeling and grid generation accomplished through ICEM CFD. The horizontal pipe is modeled with two different inlets and meshed with O-Grid mesh. The standard k-ε turbulence scheme along with the volume of fluid (VOF) multiphase modeling method is used to simulate the oil-water flow. Transient flow simulations carried out for a total period of 30s showed significant reduction in pressure drop while employing core annular flow concept. This study also reveals the effect of viscosity ratio, mass flow rates of individual fluids and ration of superficial velocities on the pressure drop across the pipe length. Contours of velocity and volume fractions are employed along with pressure predictions to assess the effectiveness of this proposed concept quantitatively as well as qualitatively. The outcome of the present study is found to be very relevant for the petrochemical industries.

Keywords: computational fluid dynamics, core-annular flows, frictional flow resistance, oil transportation, pressure drop

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80 Evaluation of Surgical Site Infection in Bile Spillage Cases Compared to Non Bile Spillage Cases Following Laparoscopic Cholecystectomy

Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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79 The Analysis of Spatial Development: Malekan City

Authors: Rahim Sarvar, Bahram Azadbakht, Samira Safaee

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The leading goal of all planning is to attain sustainable development, regional balance, suitable distribution of activities, and maximum use of environmental capabilities in the process of development of regions. Intensive concentration of population and activities in one or some limited geographical locality is of main characteristics of most developing countries, especially Iran. Not considering the long-term programs and relying on temporary and superficial plans by people in charge of decision-making to attain their own objectives causes obstacles, resulting in unbalance development. The basic reason for these problems is to establish the development planning while economic aspects are merely considered and any attentions are not paid to social and regional feedbacks, what have been ending up to social and economic inequality, unbalanced distribution of development among the regions as well. In addition to study of special planning and structure of the county of Malekan, this research tries to achieve some other aims, i.e. recognition and introduction of approaches in order to utilize resources optimally, to distribute the population, activities, and facilities in optimum fashion, and to investigate and identify the spatial development potentials of the County. Based on documentary, descriptive, analytical, and field studies, this research employs maps to analyze the data, investigates the variables, and applies SPSS, Auto CAD, and Arc View software. The results show that the natural factors have a significant influence on spatial layout of settlements; distribution of facilities and functions are not equal among the rural districts of the county; and there is a spatial equivalence in the region area between population and number of settlements.

Keywords: development, entropy index, Malekan City, planning, regional equilibrium

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78 Correlation between Peripheral Arterial Disease and Coronary Artery Disease in Bangladeshi Population: A Five Years Retrospective Study

Authors: Syed Dawood M. Taimur

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Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

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77 Anatomical, Light and Scanning Electron Microscopical Study of Ostrich (Struthio camelus) Integument

Authors: Samir El-Gendy, Doaa Zaghloul

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The current study dealt with the gross and microscopic anatomy of the integument of male ostrich in addition to the histological features of different areas of skin by light and SEM. The ostrich skin is characterized by prominent feather follicles and bristles. The number of feather follicles was determined per cm2 in different regions. The integument of ostrich had many modifications which appeared as callosities and scales, nail and toe pads. They were sternal, pubic and Achilles tendon callosities. The vacuolated epidermal cells were seen mainly in the skin of legs and to a lesser extent in the skin of back and Achilles areas. Higher lipogenic potential was expressed by epidermis from glabrous areas of ostrich skin. The dermal papillae were found in the skin of feathered area of neck and back and this was not a common finding in bird's skin which may give resistance against shearing forces in these regions of ostrich skin. The thickness of the keratin layer of ostrich varied, being thick and characteristically loose in the skin at legs, very thin and wavy at neck, while at Achilles skin area, scale and toe pad were thick and more compact, with the thickest very dense and wavy keratin layer at the nail. The dermis consisted of superficial layer of dense irregular connective tissue characterized by presence of many vacuoles of different sizes just under the basal lamina of the epithelium of epidermis and deep layer of dense regular connective tissue. This result suggested presence of fat droplets in this layer which may be to overcome the lack of good barrier of cutaneous water loss in epidermis.

Keywords: ostrich, light microscopy, scanning electron microscopy, integument, skin modifications

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76 Role of Giardia lamblia Infection in the Pathogenesis of Gastritis in Patients with Dyspepsia

Authors: Aly Kassem, Eman A. Sabet, Hanaa A. El-Hady, Doha S. Mohamed, Abeer Sheneef, Mona Fattouh, Mamdouh M. Esmat

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Objective: Giardia lamblia parasite is the most common protozoal infection in human. Concomitant Helecobacter Pylori (H. pylori) and Giardia lamblia infection is common for their similar mode of transmission and strong correlation to socioeconomic levels. Only few reports had described gastric giardiasis. Our aim was to detect H. pylori and Giardia in gastric antral mucosal biopsies from patients with dyspepsia. The impact of both pathogens on clinical, endoscopic and histopathogical changes was studied. Methods: 48 patients with dyspepsia (group1) and 28 control patients (patients undergoing esophagogastroduodenoscopy EGD for reasons other than dyspepsia), (group 2) were studied. Endoscopic data were reported and gastric biopsy specimens were obtained for subsequent PCR assay for both organisms and for histopathological and electron microscopic examination. Results: Endoscopic antral gastritis and duodenal lesions were found in both groups, however, they were significantly more frequently in group 1 (p= 0.002 and P= 0.0005 respectively). Esophageal lesions, nodular antral gastritis, gastric ulcers and superficial corpal gastritis were found only in group 1. PCR detected H. pylori infection in 58% Vs 64 % for group 1 and group 2 respectively (P: NS). Giardia infection was present in 67 % Vs 42 % for group 1 and group 2 respectively (P=0.0003, Odd ratio=2.6). Co-infection with H. pylori and Giardia was present in 33% of group 1 Vs 36% for group 2 (P:NS). Abnormal histologic findings were found in both groups, however, intestinal metaplasia was found in group 1 only. Cellular abnormalities in the form of cytoplasmic vacuoles, mitochondrial destruction or nuclear abnormalities were found by Electron microscopic study in infected subjects of both groups. Conclusion: H. pylori is not the only gastric pathogen in our community, gastric giardiasis is another pathogen. Its contribution might be a factor in persistent dyspepsia after H. pylori eradication.

Keywords: dyspepsia, gastritis, Giardia lamblia, H. pylori

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75 A Comparative Analysis of (De)legitimation Strategies in Selected African Inaugural Speeches

Authors: Lily Chimuanya, Ehioghae Esther

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Language, a versatile and sophisticated tool, is fundamentally sacrosanct to mankind especially within the realm of politics. In this dynamic world, political leaders adroitly use language to engage in a strategic show aimed at manipulating or mechanising the opinion of discerning people. This nuanced synergy is marked by different rhetorical strategies, meticulously synced with contextual factors ranging from cultural, ideological, and political to achieve multifaceted persuasive objectives. This study investigates the (de)legitimation strategies inherent in African presidential inaugural speeches, as African leaders not only state their policy agenda through inaugural speeches but also subtly indulge in a dance of legitimation and delegitimation, performing a twofold objective of strengthening the credibility of their administration and, at times, undermining the performance of the past administration. Drawing insights from two different legitimation models and a dataset of 4 African presidential inaugural speeches obtained from authentic websites, the study describes the roles of authorisation, rationalisation, moral evaluation, altruism, and mythopoesis in unmasking the structure of political discourse. The analysis takes a mixed-method approach to unpack the (de)legitimation strategy embedded in the carefully chosen speeches. The focus extends beyond a superficial exploration and delves into the linguistic elements that form the basis of presidential discourse. In conclusion, this examination goes beyond the nuanced landscape of language as a potent tool in politics, with each strategy contributing to the overall rhetorical impact and shaping the narrative. From this perspective, the study argues that presidential inaugural speeches are not only linguistic exercises but also viable weapons that influence perceptions and legitimise authority.

Keywords: CDA, legitimation, inaugural speeches, delegitmation

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74 Free Secondary Education in Tanzania: Prospects, Challenges, and Proposals

Authors: Yazidu Saidi Mbalamula

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Free Basic Education (FBE) policy implementation in Secondary Schools has been one of thrilled undertaking both to the government and household in Tanzania. On the one hand, the government has achieved citizenry acceptance to responsibility and accountability, and on the other hand, the household has been relieved from social costs that were unbearable and deprived many Tanzanians access to basic education and secondary education in particular. Specifically, this study presents a descriptive survey conducted in two districts of Kagera region located at the northern part of Tanzania. Three objectives were pursued to identify achievements realized and challenges in the FBE implementation, and also stakeholders’ proposals were explored on how to improve FBE implementation. A sample of 91 respondents, including school managers, teachers, students, and parents, were involved in the study. Both questionnaires and interviews were used whereby the quantitative data were analyzed using Statistical Package for Social Sciences (SPSS), and content analysis was used to analyze the qualitative data. The results show that implementation of free education policy in secondary schools had far positive impact on the improvement of school management, school attendance, reduced school drop-out, reduced parents-school managers conflicts, and increased enrollment rates. Notwithstanding that, the political machinery remains instrumental to instigate policy reforms in education sector. Nevertheless, the alienating interests of politibureau, often top-down and blanketed by superficial government redness, can hardly be feasible to wield such huge programme given staggering stakeholders’ awareness of the actual requirements and unlatching resources to back up policy implementation. The study recommends that further studies on stakeholders’ conceptions on the FBE and equity of financing of basic education in Tanzania.

Keywords: capitation grant, CCM, free basic education, kagera, education policy

Procedia PDF Downloads 52
73 Complex Network Approach to International Trade of Fossil Fuel

Authors: Semanur Soyyigit Kaya, Ercan Eren

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Energy has a prominent role for development of nations. Countries which have energy resources also have strategic power in the international trade of energy since it is essential for all stages of production in the economy. Thus, it is important for countries to analyze the weakness and strength of the system. On the other side, it is commonly believed that international trade has complex network properties. Complex network is a tool for the analysis of complex systems with heterogeneous agents and interaction between them. A complex network consists of nodes and the interactions between these nodes. Total properties which emerge as a result of these interactions are distinct from the sum of small parts (more or less) in complex systems. Thus, standard approaches to international trade are superficial to analyze these systems. Network analysis provides a new approach to analyze international trade as a network. In this network countries constitute nodes and trade relations (export or import) constitute edges. It becomes possible to analyze international trade network in terms of high degree indicators which are specific to complex systems such as connectivity, clustering, assortativity/disassortativity, centrality, etc. In this analysis, international trade of crude oil and coal which are types of fossil fuel has been analyzed from 2005 to 2014 via network analysis. First, it has been analyzed in terms of some topological parameters such as density, transitivity, clustering etc. Afterwards, fitness to Pareto distribution has been analyzed. Finally, weighted HITS algorithm has been applied to the data as a centrality measure to determine the real prominence of countries in these trade networks. Weighted HITS algorithm is a strong tool to analyze the network by ranking countries with regards to prominence of their trade partners. We have calculated both an export centrality and an import centrality by applying w-HITS algorithm to data.

Keywords: complex network approach, fossil fuel, international trade, network theory

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72 Layer-By-Layer Deposition of Poly(Ethylene Imine) Nanolayers on Polypropylene Nonwoven Fabric: Electrostatic and Thermal Properties

Authors: Dawid Stawski, Silviya Halacheva, Dorota Zielińska

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The surface properties of many materials can be readily and predictably modified by the controlled deposition of thin layers containing appropriate functional groups and this research area is now a subject of widespread interest. The layer-by-layer (lbl) method involves depositing oppositely charged layers of polyelectrolytes onto the substrate material which are stabilized due to strong electrostatic forces between adjacent layers. This type of modification affords products that combine the properties of the original material with the superficial parameters of the new external layers. Through an appropriate selection of the deposited layers, the surface properties can be precisely controlled and readily adjusted in order to meet the requirements of the intended application. In the presented paper a variety of anionic (poly(acrylic acid)) and cationic (linear poly(ethylene imine), polymers were successfully deposited onto the polypropylene nonwoven using the lbl technique. The chemical structure of the surface before and after modification was confirmed by reflectance FTIR spectroscopy, volumetric analysis and selective dyeing tests. As a direct result of this work, new materials with greatly improved properties have been produced. For example, following a modification process significant changes in the electrostatic activity of a range of novel nanocomposite materials were observed. The deposition of polyelectrolyte nanolayers was found to strongly accelerate the loss of electrostatically generated charges and to increase considerably the thermal resistance properties of the modified fabric (the difference in T50% is over 20°C). From our results, a clear relationship between the type of polyelectrolyte layer deposited onto the flat fabric surface and the properties of the modified fabric was identified.

Keywords: layer-by-layer technique, polypropylene nonwoven, surface modification, surface properties

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71 Teaching Critical Thinking in Post-Conflict Countries: The University of Liberia

Authors: Kamille Beye

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Critical thinking is a topic that has been disputed in the field of education for decades, but many resulting debates have centered around strengthening critical thinking capabilities in the societies, workforces, and educational centers of the global north. In contrast, this paper provides an analysis of the teaching of critical thinking in Liberia, which has been ravaged by years of war and a recent Ebola outbreak. These crises have decimated the Liberian education sector, leading to a loss of teaching capacities that are essential to providing critical thinking education. Until recently, critical thinking had no seat at the table when the future needs of the country were discussed by the government and non-governmental agencies. Now, the University of Liberia has a bold goal to become one of the top twenty universities in West Africa in the next seven years, which has led to a focus on teaching critical thinking skills to improve learning. This paper argues that critical thinking is essential to strengthening not only the Liberian education system, but for promoting peace amongst community members, and yet it suggests that commitments to the teaching of critical thinking in Liberia have hitherto been overly superficial. Based on an initial scoping study, this paper will examine the potential impacts of teaching critical thinking skills to undergraduate students in the William V. S. Tubman School of Education at the University of Liberia on continued peacebuilding and reconstruction efforts of the country. The research contends that if critical thinking skills are taught, practiced and continually utilized, teachers and students will have the ability to engage with information and negotiate challenges to solutions in ways that are beneficial to the communities in which they live. The research will use a variety of methods, that include the California Critical Thinking Disposition Inventory. This research will demonstrate that critical thinking skills are not only needed for entering the workforce, but necessary for negotiating and expressing the needs and desires of local communities in a peaceful way.

Keywords: critical thinking, higher education, Liberia, peacebuilding, post-conflict

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70 Analytical Slope Stability Analysis Based on the Statistical Characterization of Soil Shear Strength

Authors: Bernardo C. P. Albuquerque, Darym J. F. Campos

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Increasing our ability to solve complex engineering problems is directly related to the processing capacity of computers. By means of such equipments, one is able to fast and accurately run numerical algorithms. Besides the increasing interest in numerical simulations, probabilistic approaches are also of great importance. This way, statistical tools have shown their relevance to the modelling of practical engineering problems. In general, statistical approaches to such problems consider that the random variables involved follow a normal distribution. This assumption tends to provide incorrect results when skew data is present since normal distributions are symmetric about their means. Thus, in order to visualize and quantify this aspect, 9 statistical distributions (symmetric and skew) have been considered to model a hypothetical slope stability problem. The data modeled is the friction angle of a superficial soil in Brasilia, Brazil. Despite the apparent universality, the normal distribution did not qualify as the best fit. In the present effort, data obtained in consolidated-drained triaxial tests and saturated direct shear tests have been modeled and used to analytically derive the probability density function (PDF) of the safety factor of a hypothetical slope based on Mohr-Coulomb rupture criterion. Therefore, based on this analysis, it is possible to explicitly derive the failure probability considering the friction angle as a random variable. Furthermore, it is possible to compare the stability analysis when the friction angle is modelled as a Dagum distribution (distribution that presented the best fit to the histogram) and as a Normal distribution. This comparison leads to relevant differences when analyzed in light of the risk management.

Keywords: statistical slope stability analysis, skew distributions, probability of failure, functions of random variables

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69 Complicated Corneal Ulceration in Cats: Clinical Diagnosis and Surgical Management of 80 Cases

Authors: Khaled M. Ali, Ayman A. Mostafa, Soliman M. Soliman

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Objectives: To describe the most common clinical and endoscopic findings associated with complicated corneal ulcers in cats, and to determine the short-term outcomes after surgical treatment of these cats. Animals Eighteen client-owned cats of different breeds (52 females and 28 males), ranging in age from 3 months to 6 years, with corneal ulcers. Procedures: Cats were clinically evaluated to initially determine the concurrent corneal abnormalities. Endoscopic examination was performed to determine the anterior and posterior segments abnormalities. Superficial and deep stromal ulcers were treated using conjunctival flap. Corneal sequestrum was treated by partial keratectomy and conjunctival flap. Anterior synechia was treated via peripheral iridectomy and separation of the adhesion between the iris and the inner cornea. Symblepharon was treated by removal of the adhered conjunctival membrane from the cornea. Incurable endophthalmitis was treated surgically by extirpation. Short-term outcomes after surgical managements of selected corneal abnormalities were then assessed clinically and endoscopically. Results: Deep stromal ulcer with descemetocele, endophthalmitis, symblepharon, corneal sequestration and anterior synechia with secondary glaucoma and corneal scarring were the most common complications of corneal ulcer. FHV-1 was a common etiologic factor of corneal ulceration. Persistent corneal scars of varying shape and size developed in cats with deep stromal ulcer, anterior synechia, and corneal sequestration. Conclusions: Domestic shorthaired and Persian cats were the most predisposed breeds to FHV-1 infection and subsequent corneal ulceration. Immediate management of patients with corneal ulcer would prevent serious complications. No age or sex predisposition to complicated corneal ulceration in cats.

Keywords: cats, complicated corneal ulceration, clinical, endoscopic diagnosis, FHV-1

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68 A Critical Exploration of Dominant Perspectives Regarding Inclusion and Disability: Shifts Toward Meaningful Approaches

Authors: Luigi Iannacci

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This study critically explores how disability and disability are presently and problematically configured within education. As such, pedagogies, discourses, and practices that shape this configuration are examined to forward a reconceptualization of disability as it relates to education and the inclusion of students with special needs in mainstream classroom contexts. The study examines how the dominant medical/deficit model of disability positions students with special needs and advocates for a shift towards a social/critical model of disability as applied to education and classrooms. This is demonstrated through a critical look at how language, processes, and ‘interventions’ name and address deficits people who have a disability are presumed to have and, as such, conceptualize these deficits as inherent flaws that are in need of ‘fixing.’ The study will demonstrate the necessary shifts in thinking, language and practice required to forward a critical/social model of disability. The ultimate aim of this research is to offer a much-needed reconceptualization of inclusion that recognizes disability as epistemology, identity, and diversity through a critical exploration of dominant discourses that impact language, policy, instruction and ultimately, the experiences students with disabilities have within mainstream classrooms. The presentation seeks to explore disability as neurodiversity and therefore elucidate how people with disabilities can demonstrate these ways of knowing within inclusive education that avoids superficial approaches that are not responsive to their needs. This research is, therefore, of interest and use to educators teaching at the elementary, secondary, and in-service levels as well as graduate students and scholars working in the areas of inclusion, special education, and literacy. Ultimately the presentation attempts to foster a social justice and human rights-focused approach to inclusion that is responsive to students with disabilities and, as such ensures a reconceptualization of present language, understandings and practices that continue to configure disability in problematic ways.

Keywords: inclusion, disability, critical approach, social justice

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67 The Evaluation of the Performance of CaCO3/Polymer Nano-Composites for the Preservation of Historic Limestone Monuments

Authors: Mohammed Badereldien, Rezk Diab, Mohamoud Ali, Ayman Aboelkassem

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The stone surfaces of historical architectural heritage in Egypt are under threat from of various environmental factors such as temperature fluctuation, humidity, pollution, and microbes. Due to these factors, the facades of buildings are deteriorating deformation and disfiguration of external decoration and the formation of black accretion also often from the stone works. The aim of this study is to evaluate the effectiveness of CaCO₃ nano-particles as consolidation and protection material for calcareous stone monuments. Selected tests were carried out in order to estimate the superficial consolidating and protective effect of the treatment. When applied the nanoparticles dispersed in the acrylic copolymer; poly ethylmethacrylate (EMA)/methylacrylate (MA) (70/30, respectively) (EMA)/methylacrylate (MA) (70/30, respectively). The synthesis process of CaCO₃ nanoparticles/polymer nano-composite was prepared using in situ emulsion polymerization system. The consolidation and protection were characterized by TEM, while the penetration depth, re-aggregating effects of the deposited phase, and the surface morphology before and after treatment were examined by SEM (Scanning Electron Microscopy). Improvement of the stones' mechanical properties was evaluated by compressive strength tests. Changes in water-interaction properties were evaluated by water absorption capillarity measurements, and colorimetric measurements were used to evaluate the optical appearance. Together the results appear to demonstrate that CaCO₃/polymer nanocomposite is an efficient material for the consolidation of limestone architecture and monuments. As compared with samples treated with pure acrylic copolymer without Calcium carbonate nanoparticles, for example, CaCO₃ nanoparticles are completely compatible, strengthening limestone against thermal aging and improving its mechanical properties.

Keywords: calcium carbonate nanoparticles, consolidation, nanocomposites, calcareous stone, colorimetric measurements, compressive strength

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66 Influence of UV Aging on the Mechanical Properties of Polycarbonate

Authors: S. Redjala, N. Ait Hocine, M. Gratton, N. Poirot, R. Ferhoum, S. Azem

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Polycarbonate (PC) is a promising polymer with high transparency in the range of the visible spectrum and is used in various fields, for example medical, electronic, automotive. Its low weight, chemical inertia, high impact resistance and relatively low cost are of major importance. In recent decades, some materials such as metals and ceramics have been replaced by polymers because of their superior advantages. However, some characteristics of the polymers are highly modified under the effect of ultraviolet (UV) radiation and temperature. The changes induced in the material by such aging depend on the exposure time, the wavelength of the UV radiation and the temperature level. The UV energy is sufficient to break the chemical bonds leading to a cleavage of the molecular chains. This causes changes in the mechanical, thermal, optical and morphological properties of the material. The present work is focused on the study of the effects of aging under ultraviolet (UV) radiation and under different temperature values on the physical-chemical and mechanical properties of a PC. Thus, various investigations, such as FTIR and XRD analyses, SEM and optical microscopy observations, micro-hardness measurements and monotonic and cyclic tensile tests, were carried out on the PC in the initial state and after aging. Results have shown the impact of aging on the properties of the PC studied. In fact, the MEB highlighted changes in the superficial morphology of the material by the presence of cracks and material de-bonding in the form of debris. The FTIR spectra reveal an attenuation of the peaks like the hydroxyl (OH) groups located at 3520 cm-1. The XRD lines shift towards a larger angle, reaching a maximum of 3°. In addition, Vickers micro-hardness measurements show that aging affects the surface and the core of the material, which results in different mechanical behaviours under monotonic and cyclic tensile tests. This study pointed out effects of aging on the macroscopic properties of the PC studied, in relationship with its microstructural changes.

Keywords: mechanical properties, physical-chemical properties, polycarbonate, UV aging, temperature aging

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65 Active Part of the Burnishing Tool Effect on the Physico-Geometric Aspect of the Superficial Layer of 100C6 and 16NC6 Steels

Authors: Tarek Litim, Ouahiba Taamallah

Abstract:

Burnishing is a mechanical surface treatment that combines several beneficial effects on the two steel grades studied. The application of burnishing to the ball or to the tip favors a better roughness compared to turning. In addition, it allows the consolidation of the surface layers through work hardening phenomena. The optimal effects are closely related to the treatment parameters and the active part of the device. With an improvement of 78% on the roughness, burnishing can be defined as a finishing operation in the machining range. With a 44% gain in consolidation rate, this treatment is an effective process for material consolidation. These effects are affected by several factors. The factors V, f, P, r, and i have the most significant effects on both roughness and hardness. Ball or tip burnishing leads to the consolidation of the surface layers of both grades 100C6 and 16NC6 steels by work hardening. For each steel grade and its mechanical treatment, the rational tensile curve has been drawn. Lüdwick's law is used to better plot the work hardening curve. For both grades, a material hardening law is established. For 100C6 steel, these results show a work hardening coefficient and a consolidation rate of 0.513 and 44, respectively, compared to the surface layers processed by turning. When 16NC6 steel is processed, the work hardening coefficient is about 0.29. Hardness tests characterize well the burnished depth. The layer affected by work hardening can reach up to 0.4 mm. Simulation of the tests is of great importance to provide the details at the local scale of the material. Conventional tensile curves provide a satisfactory indication of the toughness of 100C6 and 16NC6 materials. A simulation of the tensile curves revealed good agreement between the experimental and simulation results for both steels.

Keywords: 100C6 steel, 16NC6 steel, burnishing, work hardening, roughness, hardness

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64 Diversity of Dermatophytes and Keratinophilic Fungi from Inernational Tourist Spots, City of Taj Mahal

Authors: Harison Masih, Jyotsna Kiran Peter, Sundara Singh, Geetha Singh

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The present investigation deals with diversity of dermatophytes and keratinophilic fungi from different tourist spots such as Agra Fort, Akbar tomb, It-Mat-Ud-Daulah, Mariam tomb, Radha Swami Bagh, and Taj Mahal of Agra City. These fungi are medically important which causes various infections and diseases in humans and animals. The main reservoir of these pathogens are the keratinous substances that increases due to birds and animal activities in the vicinity of monuments, where thousands (5413266) annual visitors from all over the world are visiting. The soil samples were subjected to isolate the pathogenic fungi through bait technique (buffalo skin, chicken feathers, human hair and goat tail hair). Baits were spread over the soil samples and incubated at room temperature for 30-35 days and pure culture isolates were maintained in SDA medium, stored at 4°C. Highest number of visitors were (3906453) from Taj Mahal, minimum 10785 at Mariam tomb annually, the total 271 isolates were encountered from soil samples out of these 18 genera and 38 species were found in different season. Highest incidence was 4.79% frequency shown by Chrysosporium keratinophilum while least 738% frequency occurrence by Trichophyton simii in soil samples. From the present study it was concluded that the incidence of pathogenic fungal isolates were the common in tourists soil that are etiological agents of superficial mycosis. Thus, both human and animal activity seemed to play an important role in occurrence and distribution of keratinophilic and related dermatophytes at various tourist places of Agra city.

Keywords: dermatophytic fungal diversity, bait technique, visitors at tourist spots, human and animal activities, soil samples

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63 Grisotti Flap as Treatment for Central Tumors of the Breast

Authors: R. Pardo, P. Menendez, MA Gil-Olarte, S. Sanchez, E. García, R. Quintana, J. Martín

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Introduction : Within oncoplastic breast techniques there is increased interest in immediate partial breast reconstruction. The volume resected is greater than that of conventional conservative techniques. Central tumours of the breast have classically been treated with a mastectomy with regard to oncological safety and cosmetic secondary effects after wide central resection of the nipple and breast tissue beneath. Oncological results for central quadrantectomy have a recurrence level, disease- free period and survival identical to mastectomy. Grissoti flap is an oncoplastic surgical technique that allows the surgeon to perform a safe central quadrantectomy with excellent cosmetic results. Material and methods: The Grissoti flap is a glandular cutaneous advancement rotation flap that can fill the defect in the central portion of the excised breast. If the inferior border is affected by tumour and further surgery is decided upon at the Multidisciplinary Team Meeting, it will be necessary to perform a mastectomy. All patients with a Grisotti flap undergoing surgery since 2009 were reviewed obtaining the following data: age, hystopathological diagnosis, size, operating time, volume of tissue resected, postoperative admission time, re-excisions due to positive margins affected by tumour, wound dehiscence, complications and recurrence. Analysis and results of sentinel node biopsy were also obtained. Results: 12 patients underwent surgery between 2009-2015. The mean age was 54 years (34-67) . All had a preoperative diagnosis of ductal infiltrative carcinoma of less than 2 cm,. Diagnosis was made with Ultrasound, Mamography or both . Magnetic resonance was used in 5 cases. No patients had preoperative positive axilla after ultrasound exploration. Mean operating time was 104 minutes (84-130). Postoperative stay was 24 hours. Mean volume resected was 159 cc (70-286). In one patient the surgical border was affected by tumour and a further procedure with resection of the affected border was performed as ambulatory surgery. The sentinel node biopsy was positive for micrometastasis in only two cases. In one case lymphadenectomy was performed in 2009. In the other, treated in 2015, no lymphadenectomy was performed as the patient had a favourable histopathological prognosis and the multidisciplinary team meeting agreed that lymphadenectomy was not required. No recurrence has been diagnosed in any of the patients who underwent surgery and they are all disease free at present. Conclusions: Conservative surgery for retroareolar central tumours of the breast results in good local control of the disease with free surgical borders, including resection of the nipple areola complex and pectoral major muscle fascia. Reconstructive surgery with the inferior Grissoti flap adequately fills the defect after central quadrantectomy with creation of a new cutaneous disc where a new nipple areola complex is reconstructed with a local flap or micropigmentation. This avoids the need for contralateral symmetrization. Sentinel Node biopsy can be performed without added morbidity. When feasible, the Grissoti flap will avoid skin-sparing mastectomy for central breast tumours that will require the use of an expander, prosthesis or myocutaneous flap, with all the complications of a more complex operation.

Keywords: Grisotti flap, oncoplastic surgery, central tumours, breast

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62 Magnetic Chloromethylated Polymer Nanocomposite for Selective Pollutant Removal

Authors: Fabio T. Costa, Sergio E. Moya, Marcelo H. Sousa

Abstract:

Nanocomposites designed by embedding magnetic nanoparticles into a polymeric matrix stand out as ideal magnetic-hybrid and magneto-responsive materials as sorbents for removal of pollutants in environmental applications. Covalent coupling is often desired for the immobilization of species on these nanocomposites, in order to keep them permanently bounded, not desorbing or leaching over time. Moreover, unwanted adsorbates can be separated by successive washes/magnetic separations, and it is also possible to recover the adsorbate covalently bound to the nanocomposite surface through detaching/cleavage protocols. Thus, in this work, we describe the preparation and characterization of highly-magnetizable chloromethylated polystyrene-based nanocomposite beads for selective covalent coupling in environmental applications. For synthesis optimization, acid resistant core-shelled maghemite (γ-Fe₂O₃) nanoparticles were coated with oleate molecules and directly incorporated into the organic medium during a suspension polymerization process. Moreover, the cross-linking agent ethylene glycol dimethacrylate (EGDMA) was utilized for co-polymerization with the 4-vinyl benzyl chloride (VBC) to increase the resistance of microbeads against leaching. After characterizing samples with XRD, ICP-OES, TGA, optical, SEM and TEM microscopes, a magnetic composite consisting of ~500 nm-sized cross-linked polymeric microspheres embedding ~8 nm γ-Fe₂O₃ nanoparticles was verified. This nanocomposite showed large room temperature magnetization (~24 emu/g) due to the high content in maghemite (~45 wt%) and resistance against leaching even in acidic media. Moreover, the presence of superficial chloromethyl groups, probed by FTIR and XPS spectroscopies and confirmed by an amination test can selectively adsorb molecules through the covalent coupling and be used in molecular separations as shown for the selective removal of 4-aminobenzoic acid from a mixture with benzoic acid.

Keywords: nanocomposite, magnetic nanoparticle, covalent separation, pollutant removal

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61 Evaluation of the Spectrum of Cases of Perforation Peritonitis at Jawaharlal Nehru Medical College, Aligarh Muslim University

Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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60 Case Report: Mandibular Area Abscesses in Calves

Authors: Dovilė Bačėninaitė, Karina Džermeikaitė, Justinas Kirvela, Ramūnas Antanaitis

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Bacteria are often present in the mouth of cattle. Some of them can cause abscesses. Starting with severe swelling of the mouth, muscle spasm, or locked jaw, it can lead to inability to open its mouth, move the neck, cause pain while eating. While the calf is unable to eat properly, it becomes more susceptible to infectious diseases, lower weight gain can be observed. Abscesses can be considered as a continuum of oral disease, whereby early stages of the lumpy jaw could proceed from gingivitis to periodontal disease. In the event of tissue damage, bacteria can enter the bloodstream, even cause sepsis. The most common lesions occur when animals eat sharp grass, coarse fodder, sharp, piercing foreign bodies (this is especially common for calves when they are trying to eat inedible objects). A crossbred Holstein calf presented with a history of proliferative outgrowth in the mandibular region. On clinical examination, needle aspiration, mandibular swelling revealed sticky, white curd-like fluid containing. Pus bacteriology revealed gram-negative cocci. They were sensitive to amoxicillin, cephalexin, enrofloxacin, ceftiofur. Blood morphology was in physiological ranges. The calf was treated surgically. The growth was excised, the puss drained and the wound was flushed with potassium permanganate solution (0,01%). A week after clinical surgery examination was performed. The swelling was decreased. Superficial bacterial infections are often associated with poor hygiene, which should be improved before treatment is commenced. Clipping away dirty hair and gently washing affected areas of skin daily with solutions such as povidone-iodine, potassium permanganate is effective. Appropriate antibiotic therapy, based on sensitivity testing, may be used where there is evidence of systemic illness.

Keywords: calf, abscess, lumpy jaw, pus, Streptococcus, Staphylococcus, Actinobacillus, infection

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59 Higher-Level Return to Female Karate Competition Following Multiple Patella Dislocations

Authors: A. Maso, C. Bellissimo, G. Facchinetti, N. Milani, D. Panzin, D. Pogliana, L. Garlaschelli, L. Rivaroli, S. Rivaroli, M. Zurek, J. Konin

Abstract:

15 year-old female karate athlete experienced two unilateral patella dislocations: one contact and one non-contact. This challenged her from competing as planned at the regional and national competitions as a result of her inability to perform at a high level. Despite these injuries and other complicated factors, she was able to modify her training timeline and successfully perform, winning third at the National Cup. Initial pain numeric rating scale 8/10 during karate training isometric figures, taking the stairs, long walking, a positive rasp test, palpation pain on the lateral patella joint 9/10, pain performing open kinetic chain 0°-45° and close kinetic chain 30°-90°, tensor fascia lata, vastus lateralis, psoas muscles retraction/stiffness. Foot hyper pronation, internally rotated femur, and knee flexion 15° were the postural findings. Exercise prescription for three days/week for three weeks to include exercise-based rehabilitation and soft tissue mobilization with massage and foam rolling. After three weeks, the pain was improved during activity daily living 5/10, and soft tissue stiffness decreased. An additional four weeks of exercise-based rehabilitation was continued. At this time, axial x-rays and TA-GT TAC were taken, and an orthopaedic medical check was recommended to continue conservative treatment. At week seven, she performed 2/4 karate position technique without pain and 2/4 with pain. An isokinetic test was performed at week 12, demonstrating a 10% strength deficit and 6% resistance deficit both to the left hamstrings. Moreover, an 8% strength and resistance surplus to the left quadriceps was found. No pain was present during activity, daily living and sports activity, allowing a return to play training to begin. A plan for the return to play framework collaborated with her trainer, her father, a physiotherapist, a sports scientist, an osteopath, and a nutritionist. Within 4 and 5 months, both non-athlete and athlete movement quality analysis tests were performed. The plan agreed to establish a return to play goal of 7 months and the highest level return to competition goal of 9 months from the start of rehabilitation. This included three days/week of training and repeated testing of movement quality before return to competition with detectable improvements from 77% to 93%. Beginning goals of the rehabilitation plan included the importance of a team approach. The patient’s father and trainer were important to collaborate with to assure a safe and timely return to competition. The possibility of achieving the goals was strongly related to orthopaedic decision-making and progress during the first weeks of rehabilitation. Without complications or setbacks, the patient can successfully return to her highest level of competition. The patient returned to participation after five months of rehabilitation and training, and then she returned to competition at the national level in nine months. The successful return was the result of a team approach and a compliant patient with clear goals.

Keywords: karate, knee, performance, rehabilitation

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58 Regional Anesthesia: A Vantage Point for Management of Normal Pressure Hydrocephalus

Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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57 Combine Resection of Talocalcaneal Tarsal Coalition and Calcaneal Lengthening Osteotomy. Short-to-Intermediate Term Results

Authors: Naum Simanovsky, Vladimir Goldman, Michael Zaidman

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Background: The optimal algorithm for the management of symptomatic tarsal coalition is still under discussion in pediatric literature. It's debatable what surgical steps are essential to achieve the best outcome. Method: The investigators retrospectively reviewed the records of twelve patients with symptomatic tarsal coalition that were treated operatively between 2017 and 2019. Only painful flat feet were operated. Two patients were excluded from the study due to lack of sufficient follow-up. Ten of eleven feet were treated with the combination of calcaneal lengthening osteotomy (CLO) and resection of coalition (RC). Only one foot was operated with CLO alone. In half of our patients, Achilles lengthening was performed. For two children, medial plication was added. Short leg cast was applied to all children for 6-8 weeks, and soft shoe insoles for medial arch support were prescribed after. Demographic, clinical, and radiographic records were reviewed. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results: There were seven boys and three girls. The mean age at the time of surgery was 13.9 (range 12 to 17) years, and the mean follow-up was 18 (range 8 to 34) months. The early complications included one superficial wound infection and dehiscence. Late complication includes two children with residual forefoot supination. None of our patients required additional operations during the follow-up period. All feet achieved complete deformity correction or dramatic improvement. In the last follow-up, seven feet were painless, and four children had some mild pain after intensive activities. All feet achieved excellent and good scoring on AOFAS. Conclusions: Many patients with talocalcaneal coalition also have rigid or stiff, painful, flat feet. For these patients, the resection of coalition with concomitant CLO can be safely recommended.

Keywords: Tarsal coalition, calcaneal lengthening osteotomy., flat foot, coalition resection

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56 Influence of an Octenidine Based Wound Gel on Postoperative Wound Healing and Scarring after Abdominoplasty

Authors: Johannes Matiasek

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Introduction and Aims: Octenidine is a common antiseptic agent in the area of surgical interventions because of its antimicrobial efficacy and outstanding biocompatibility index. We investigate the direct postoperative application of octenilin® on typical procedures in the field of plastic surgery in a prospective, randomized controlled intervention study. The aim of this study is to determine the influence of a direct postoperative application of an octenidine-containing wound gel on wound healing and scarring after abdominoplasty. Material and Methods: In this study, we enrolled 33 patients who underwent abdominoplasty because of medical indications (e.g. Cutis laxa abdominis). To ensure an intraindividual comparison, each patient received both dressings (study-group: octenilin® wound gel; control-group: Omnistrip® dry plaster) immediately after surgery. We evaluate wound-healing tendency, pain during dressing changes and scar formation after two weeks, three, six and twelve months. Regarding scar-evaluation skin-elasticity, sebum on the skin, transepidermal waterloss, skin hydration, melanin content and erythema level were determined with special probes. Furthermore the Vancouver Scar Scale (VSS) and pain level during dressing change are determined. Results: At the time of surgery the mean patient’s age was 44.1 years. On average 5.6 dressing changes were necessary. Wound healing disorders occurred more often in the control-group. In the control-group (dry plaster Omnistrip®) patients reported significantly more pain and superficial skin injuries during dressing changes occurred. Objective scar-evaluation after 3, 6 and 12 months resulted in a significant higher skin-elasticity and significant lower transepidermal water loss in the octenilin® group which is confirmed in the VSS. Conclusion: The immediate postoperative application of the octenidine-containing hydrogel octenilin® after abdominoplasty results in favoured scar formation compared to our actual standard therapy. Less hypertrophic scar formation was observed in the study-group.

Keywords: abdominoplasty, octenidine, scarring, wound healing

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55 FEM Simulation of Tool Wear and Edge Radius Effects on Residual Stress in High Speed Machining of Inconel718

Authors: Yang Liu, Mathias Agmell, Aylin Ahadi, Jan-Eric Stahl, Jinming Zhou

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Tool wear and tool geometry have significant effects on the residual stresses in the component produced by high-speed machining. In this paper, Coupled Eulerian and Lagrangian (CEL) model is adopted to investigate the residual stress in high-speed machining of Inconel718 with a CBN170 cutting tool. The result shows that the mesh with the smallest size of 5 um yields cutting forces and chip morphology in close agreement with the experimental data. The analysis of thermal loading and mechanical loading are performed to study the effect of segmented chip morphology on the machined surface topography and residual stress distribution. The effects of cutting edge radius and flank wear on residual stresses formation and distribution on the workpiece were also investigated. It is found that the temperature within 100um depth of the machined surface increases drastically due to the more friction heat generation with the contact area of tool and workpiece increasing when a larger edge radius and flank wear are used. With the depth further increasing, the temperature drops rapidly for all cases due to the low conductivity of Inconel718. Consequently, higher and deeper tensile residual stress is generated on the superficial. Furthermore, an increased depth of plastic deformation and compressive residual stress is noticed in the subsurface, which is attributed to the reduction of the yield strength under the thermal effect. Besides, the ploughing effect produced by a larger tool edge radius contributes more than flank wear. The magnitude variation of the compressive residual stress caused by various edge radius and flank wear have a totally opposite trend, which depends on the magnitude of the ploughing and friction pressure acting on the machined surface.

Keywords: Coupled Eulerian Lagrangian, segmented chip, residual stress, tool wear, edge radius, Inconel718

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