Search results for: traces fractures
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 449

Search results for: traces fractures

359 Superiority of Bone Marrow Derived-Osteoblastic Cells (ALLOB®) over Bone Marrow Derived-Mesenchymal Stem Cells

Authors: Sandra Pietri, Helene Dubout, Sabrina Ena, Candice Hoste, Enrico Bastianelli

Abstract:

Bone Therapeutics is a bone cell therapy company addressing high unmet medical needs in the field of bone fracture repair, more specifically in non-union and delayed-union fractures where the bone repair process is impaired. The company has developed a unique allogeneic osteoblastic cell product (ALLOB®) derived from bone marrow which is currently tested in humans in the indication of delayed-union fractures. The purpose of our study was to directly compare ALLOB® vs. non-differentiated mesenchymal stem cells (MSC) for their in vitro osteogenic characteristics and their in vivo osteogenic potential in order to determine which cellular type would be the most adapted for bone fracture repair. Methods: Healthy volunteers’ bone marrow aspirates (n=6) were expended (i) into BM-MSCs using a complete MSC culture medium or (ii) into ALLOB® cells according to its manufacturing process. Cells were characterized in vitro by morphology, immunophenotype, gene expression and differentiation potential. Additionally, their osteogenic potential was assessed in vivo in the subperiosteal calvaria bone formation model in nude mice. Results: The in vitro side-by-side comparison studies showed that although ALLOB® and BM-MSC shared some common general characteristics such as the 3 minimal MSC criteria, ALLOB® expressed significantly higher levels of chondro/osteoblastic genes such as BMP2 (fold change (FC) > 100), ALPL (FC > 12), CBFA1 (FC > 3) and differentiated significantly earlier than BM-MSC toward the osteogenic lineage. Moreover the bone formation model in nude mice demonstrated that used at the same cellular concentration, ALLOB® was able to induce significantly more (160% vs.107% for control animals) bone formation than BM-MSC (118% vs. 107 % for control animals) two weeks after administration. Conclusion: Our side-by-side comparison studies demonstrated that in vitro and in vivo, ALLOB® displays superior osteogenic capacity to BM-MScs and is therefore a better candidate for the treatment of bone fractures.

Keywords: gene expression, histomorphometry, mesenchymal stem cells, osteogenic differentiation potential, preclinical

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358 Victimization in Schizophrenia: A Cross-Sectional Prospective Study

Authors: Mehmet Budak, Mehmet Fatih Ustundag

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Objectives: In this research, we studied the extent of exposure to physical violence and committing violence in patients diagnosed with schizophrenia in comparison to a control group consisting of patients with psychiatric diseases other than psychotic and mood disorders. Method: Between August 2019 and October 2019, a total of 100 hospitalized patients diagnosed with schizophrenia (clinically in remission, Brief Psychiatric Rate Scale < 30) were sequentially studied while undergoing inpatient treatment at Erenkoy Mental Health Training and Research Hospital. From the outpatient clinic, 50 patients with psychiatric disorders other than psychotic disorders or mood disorders were consecutively included as a control group. All participants were evaluated by the sociodemographic data that also questions the history of violence, physical examination, bilateral comparative hand, and forearm anterior-posterior and lateral radiography. Results: While 59% of patients with schizophrenia and 28% of the control group stated that they were exposed to physical violence at least once in a lifetime (p < 0,001); a defensive wound or fracture was detected in 29% of patients with schizophrenia and 2% of the control group (p < 0.001). On the other hand, 61% of patients diagnosed with schizophrenia, and 32% of the control group expressed that they committed physical violence at least once in a lifetime (p: 0.001). A self-destructive wound or fracture was detected in 53% of the patients with schizophrenia and 24% of the control group (p: 0,001). In the schizophrenia group, the rate of committing physical violence is higher in those with substance use compared to those without substance use (p:0.049). Also, wounds and bone fractures (boxer’s fracture) resulting from self-injury are more common in schizophrenia patients with substance use (p:0,002). In the schizophrenia group, defensive wounds and parry fractures (which are located in the hand, forearm, and arm usually occur as a result of a trial to shield the face against an aggressive attack and are known to be the indicators of interpersonal violence) are higher in those with substance use compared to those who do not (p:0,007). Conclusion: This study shows that exposure to physical violence and the rate of violence is higher in patients with schizophrenia compared to the control group. It is observed that schizophrenia patients who are stigmatized as being aggressive are more exposed to violence. Substance use in schizophrenia patients increases both exposure to physical violence and the use of physical violence. Physical examination and anamnesis that question violence are important tools to reveal the exposure to violence in patients. Furthermore, some specific bone fractures and wounds could be used to detect victimization even after plenty of time passes.

Keywords: fracture, physical violence, schizophrenia, substance use

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357 Using Computer Vision to Detect and Localize Fractures in Wrist X-ray Images

Authors: John Paul Q. Tomas, Mark Wilson L. de los Reyes, Kirsten Joyce P. Vasquez

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The most frequent type of fracture is a wrist fracture, which often makes it difficult for medical professionals to find and locate. In this study, fractures in wrist x-ray pictures were located and identified using deep learning and computer vision. The researchers used image filtering, masking, morphological operations, and data augmentation for the image preprocessing and trained the RetinaNet and Faster R-CNN models with ResNet50 backbones and Adam optimizers separately for each image filtering technique and projection. The RetinaNet model with Anisotropic Diffusion Smoothing filter trained with 50 epochs has obtained the greatest accuracy of 99.14%, precision of 100%, sensitivity/recall of 98.41%, specificity of 100%, and an IoU score of 56.44% for the Posteroanterior projection utilizing augmented data. For the Lateral projection using augmented data, the RetinaNet model with an Anisotropic Diffusion filter trained with 50 epochs has produced the highest accuracy of 98.40%, precision of 98.36%, sensitivity/recall of 98.36%, specificity of 98.43%, and an IoU score of 58.69%. When comparing the test results of the different individual projections, models, and image filtering techniques, the Anisotropic Diffusion filter trained with 50 epochs has produced the best classification and regression scores for both projections.

Keywords: Artificial Intelligence, Computer Vision, Wrist Fracture, Deep Learning

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356 Screening of Osteoporosis in Aging Populations

Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

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Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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355 Rock Slope Stabilization and Protection for Roads and Multi-Storey Structures in Jabal Omar, Saudi Arabia

Authors: Ibrahim Abdel Gadir Malik, Dafalla Siddig Dafalla, Abdelazim Ibrahim

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Jabal Omar is located in the western side of Makkah city in Saudi Arabia. The proposed Jabal Omar Development project includes several multi-storey buildings, roads, bridges and below ground structures founded at various depths. In this study, geological mapping and site inspection which covered pre-selected areas were carried out within the easily accessed parts. Geological features; including rock types, structures, degree of weathering, and geotechnical hazards were observed and analyzed with specified software and also were documented in form of photographs. The presence of joints and fractures in the area made the rock blocks small and weak. The site is full of jointing; it was observed that, the northern side consists of 3 to 4 jointing systems with 2 random fractures associated with dykes. The southern part is affected by 2 to 3 jointing systems with minor fault and shear zones. From the field measurements and observations, it was concluded that, the Jabal Omar intruded by andesitic and basaltic dykes of different thickness and orientation. These dykes made the outcrop weak, highly deformed and made the rock masses sensitive to weathering.

Keywords: rock, slope, stabilization, protection, Makkah

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354 Experimental and Numerical Studies on Earthquake Shear Rupture Generation

Authors: Louis N. Y. Wong

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En-echelon fractures are commonly found in rocks, which appear as a special set of regularly oriented and spaced fractures. By using both experimental and numerical approaches, this study investigates the interaction among them, and how this interaction finally contributes to the development of a shear rupture (fault), especially in brittle natural rocks. Firstly, uniaxial compression tests are conducted on marble specimens containing en-echelon flaws. The latter is cut by using the water abrasive jet into the rock specimens. The fracturing processes of these specimens leading to the formation of a fault are observed in detail by the use of a high speed camera. The influences of the flaw geometry on the production of tensile cracks and shear cracks, which in turn dictate the coalescence patterns of the entire set of en-echelon flaws are comprehensively studied. Secondly, a numerical study based on a recently developed contact model, flat-joint contact model using the discrete element method (DEM) is carried out to model the present laboratory experiments. The numerical results provide a quantitative assessment of the interaction of en-echelon flaws. Particularly, the evolution of the stress field, as well as the characteristics of new crack initiation, propagation and coalescence associated with the generation of an eventual shear rupture are studied in detail. The numerical results are found to agree well with the experimental results obtained in both microscopic and macroscopic observations.

Keywords: discrete element method, en-echelon flaws, fault, marble

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353 Effect of Institution Volume on Mortality and Outcomes in Osteoporotic Hip Fracture Care

Authors: J. Milton, C. Uzoigwe, O. Ayeko, B. Offorha, K. Anderson, R. G. Middleton

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Background: We used the UK National Hip Fracture database to determine the effect of institution hip fracture case volume on hip fracture healthcare outcomes in 2019. Using logistic regression for each healthcare outcome, we compared the best performing 50 units with the poorest performing 50 units in order to determine if the unit volume was associated with performance for each particular outcome. Method: We analysed 175 institutions treating a total of 67,673 patients over the course of a year. Results: The number of hip fractures seen per unit ranged between 86 and 952. Larger units tendered to perform health assessments more consistently and mobilise patients more expeditiously post-operatively. Patients treated at large institutions had shorter lengths of stay. With regard to most other outcomes, there was no association between unit case volume and performance, notably compliance with the Best Practice Tariff, time to surgery, proportion of eligible patients undergoing total hip arthroplasty, length of stay, delirium risk, and pressure sore risk assessments. Conclusion: There is no relationship between unit volume and the majority of health care outcomes. It would seem that larger institutions tend to perform better at parameters that are dependent upon personnel numbers. However, where the outcome is contingent, even partially, on physical infrastructure capacity, there was no difference between larger and smaller units.

Keywords: institution volume, mortality, neck of femur fractures, osteoporosis

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352 Bone Mineral Density and Trabecular Bone Score in Ukrainian Women with Obesity

Authors: Vladyslav Povoroznyuk, Nataliia Dzerovych, Larysa Martynyuk, Tetiana Kovtun

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Obesity and osteoporosis are the two diseases whose increasing prevalence and high impact on the global morbidity and mortality, during the two recent decades, have gained a status of major health threats worldwide. Obesity purports to affect the bone metabolism through complex mechanisms. Debated data on the connection between the bone mineral density and fracture prevalence in the obese patients are widely presented in literature. There is evidence that the correlation of weight and fracture risk is site-specific. The aim of this study was to evaluate the Bone Mineral Density (BMD) and Trabecular Bone Score (TBS) in the obese Ukrainian women. We examined 1025 40-89-year-old women, divided them into the groups according to their body mass index: Group a included 360 women with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women with no obesity and BMI of < 30 kg/m2. The BMD of total body, lumbar spine at the site L1-L4, femur and forearm were measured by DXA (Prodigy, GEHC Lunar, Madison, WI, USA). The TBS of L1-L4 was assessed by means of TBS iNsight® software installed on our DXA machine (product of Med-Imaps, Pessac, France). In general, obese women had a significantly higher BMD of lumbar spine, femoral neck, proximal femur, total body, and ultradistal forearm (p<0.001) in comparison with women without obesity. The TBS of L1-L4 was significantly lower in obese women compared to non-obese women (p<0.001). The BMD of lumbar spine, femoral neck and total body differed to a significant extent in women of 40-49, 50-59, 60-69, and 70-79 years (p<0.05). At same time, in women aged 80-89 years the BMD of lumbar spine (p=0.09), femoral neck (p=0.22) and total body (p=0.06) barely differed. The BMD of ultradistal forearm was significantly higher in women of all age groups (p<0.05). The TBS of L1-L4 in all the age groups tended to reveal the lower parameters in obese women compared with the non-obese; however, those data were not statistically significant. By contrast, a significant positive correlation was observed between the fat mass and the BMD at different sites. The correlation between the fat mass and TBS of L1-L4 was also significant, although negative. Women with vertebral fractures had a significantly lower body weight, body mass index and total body fat mass in comparison with women without vertebral fractures in their anamnesis. In obese women the frequency of vertebral fractures was 27%, while in women without obesity – 57%.

Keywords: obesity, trabecular bone score, bone mineral density, women

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351 Evidences for Better Recall with Compatible Items in Episodic Memory

Authors: X. Laurent, M. A. Estevez, P. Mari-Beffa

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A focus of recent research is to understand the role of our own response goals in the selection of information that will be encoded in episodic memory. For example, if we respond to a target in the presence of distractors, an important aspect under study is whether the distractor and the target share a common response (compatible) or not (incompatible). Some studies have found that compatible objects tend to be groups together and stored in episodic memory, whereas others found that targets in the presence of incompatible distractors are remembered better. Our current research seems to support both views. We used a Tulving-based definition of episodic memory to differentiate memory from episodic and non-episodic traces. In this task, participants first had to classify a blue object as human or animal (target) which appeared in the presence of a green one (distractor) that could belong to the same category of the target (compatible), to the opposite (incompatible) or to an irrelevant one (neutral). Later they had to report the identity (What), location (Where) and time (When) of both target objects (which had been previously responded to) and distractors (which had been ignored). Episodic memory was inferred when the three scene properties (identity, location and time) were correct. The measure of non-episodic memory consisted of those trials in which the identity was correctly remembered, but not the location or time. Our results showed that episodic memory for compatible stimuli is significantly superior to incompatible ones. In sharp contrast, non-episodic measures found superior memory for targets in the presence of incompatible distractors. Our results demonstrate that response compatibility affects the encoding of episodic and non-episodic memory traces in different ways.

Keywords: episodic memory, action systems, compatible response, what-where-when task

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350 Seismotectonic Deformations along Strike-Slip Fault Systems of the Maghreb Region, Western Mediterranean

Authors: Abdelkader Soumaya, Noureddine Ben Ayed, Mojtaba Rajabi, Mustapha Meghraoui, Damien Delvaux, Ali Kadri, Moritz Ziegler, Said Maouche, Ahmed Braham, Aymen Arfaoui

Abstract:

The northern Maghreb region (Western Mediterranean) is a key area to study the seismotectonic deformations across the Africa-Eurasia convergent plate boundary. On the basis of young geologic fault slip data and stress inversion of focal mechanisms, we defined a first-order transpression-compatible stress field and a second-order spatial variation of tectonic regime across the Maghreb region, with a relatively stable SHmax orientation from east to west. Therefore, the present-day active contraction of the western Africa-Eurasia plate boundary is accommodated by (1) E-W strike-slip faulting with a reverse component along the Eastern Tell and Saharan-Tunisian Atlas, (2) a predominantly NE trending thrust faulting with strike-slip component in the Western Tell part, and (3) a conjugate strike-slip faulting regime with a normal component in the Alboran/Rif domain. This spatial variation of the active stress field and the tectonic regime is relatively in agreement with the inferred stress information from neotectonic features. According to newly suggested structural models, we highlight the role of main geometrically complex shear zones in the present-day stress pattern of the Maghreb region. Then, different geometries of these major preexisting strike-slip faults and related fractures (V-shaped conjugate fractures, horsetail splays faults, and Riedel fractures) impose their component on the second- and third-order stress regimes. Smoothed present-day and Neotectonic stress maps (mean SHmax orientation) reveal that plate boundary forces acting on the Africa-Eurasia collisional plates control the long wavelength of the stress field pattern in the Maghreb. The seismotectonic deformations and the upper crustal stress field in the study area are governed by the interplay of the oblique plate convergence (i.e., Africa-Eurasia), lithosphere-mantle interaction, and preexisting tectonic weakness zones.

Keywords: Maghreb, strike-slip fault, seismotectonic, focal mechanism, inversion

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349 Reconstructing the Trace of Mesozoic Subduction and Its Implication on Stratigraphy Correlation between Deep Marine Sediment and Granite: Case Study of Garba Complex, South Sumatera

Authors: Fadlan Atmaja Nursiwan, Ugi Kurnia Gusti

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Garba Hill, located in Tekana Village, South Sumatera Province is comprised to South Sumatra Basin and classified as back arc basin. This area is entered as an active margin of Sundaland which experiences subduction several times since Mesozoic to recent time. The traces of Mesozoic subduction in the southern part of Sumatra island are exposed in Garba Hill area. The aim of this investigation is to study the tectonic changes in the first phase in Mesozoic era at the active margin of Sundaland which causes the rocks assemblage in Garba hill consist of continental and oceanic plate rocks which the correlation between those rocks show indistinct relation. This investigation is conducted by field observation in Tekana village and Lubar Village, Muara Dua, South Sumatra along with laboratory analysis included fossil and geochemistry analysis of radiolarian chert, petrography analysis of granite and basalt, and structural modelling. Fossil and geochemistry analysis of radiolarian chert and geochemistry of granite rocks shown the relation between the two rocks and Mesozoic subduction of Woyla terrane on western margin of Sundaland. Petrography analysis from granite and basalt depict the tectonic affinity of rocks. Moreover, structural analysis showed the changes of lineation direction from N-S to WNW-ESE.

Keywords: granite, mesozoic, radiolarian, subduction traces

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348 A Standard Operating Procedure (SOP) for Forensic Soil Analysis: Tested Using a Simulated Crime Scene

Authors: Samara A. Testoni, Vander F. Melo, Lorna A. Dawson, Fabio A. S. Salvador

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Soil traces are useful as forensic evidence due to their potential to transfer and adhere to different types of surfaces on a range of objects or persons. The great variability expressed by soil physical, chemical, biological and mineralogical properties show soil traces as complex mixtures. Soils are continuous and variable, no two soil samples being indistinguishable, nevertheless, the complexity of soil characteristics can provide powerful evidence for comparative forensic purposes. This work aimed to establish a Standard Operating Procedure (SOP) for forensic soil analysis in Brazil. We carried out a simulated crime scene with double blind sampling to calibrate the sampling procedures. Samples were collected at a range of locations covering a range of soil types found in South of Brazil: Santa Candida and Boa Vista, neighbourhoods from Curitiba (State of Parana) and in Guarani and Guaraituba, neighbourhoods from Colombo (Curitiba Metropolitan Region). A previously validated sequential analyses of chemical, physical and mineralogical analyses was developed in around 2 g of soil. The suggested SOP and the sequential range of analyses were effective in grouping the samples from the same place and from the same parent material together, as well as successfully discriminated samples from different locations and originated from different rocks. In addition, modifications to the sample treatment and analytical protocol can be made depending on the context of the forensic work.

Keywords: clay mineralogy, forensic soils analysis, sequential analyses, kaolinite, gibbsite

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347 Audit on Compliance with Ottawa Ankle Rules in Ankle Radiograph Requests

Authors: Daud Muhammad

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Introduction: Ankle radiographs are frequently requested in Emergency Departments (ED) for patients presenting with traumatic ankle pain. The Ottawa Ankle Rules (OAR) serve as a clinical guideline to determine the necessity of these radiographs, aiming to reduce unnecessary imaging. This audit was conducted to evaluate the adequacy of clinical information provided in radiograph requests in relation to the OAR. Methods: A retrospective analysis was performed on 50 consecutive ankle radiograph requests under ED clinicians' names for patients aged above 5 years, specifically excluding follow-up radiographs for known fractures. The study assessed whether the provided clinical information met the criteria outlined by the OAR. Results: The audit revealed that none of the 50 radiograph requests contained sufficient information to satisfy the Ottawa Ankle Rules. Furthermore, 10 out of the 50 radiographs (20%) identified fractures. Discussion: The findings indicate a significant lack of adherence to the OAR, suggesting potential overuse of radiography and unnecessary patient exposure to radiation. This non-compliance may also contribute to increased healthcare costs and resource utilization, as well as possible delays in diagnosis and treatment. Recommendations: To address these issues, the following recommendations are proposed: (1) Education and Training: Enhance awareness and training among ED clinicians regarding the OAR. (2) Standardised Request Forms: Implement changes to imaging request forms to mandate relevant information according to the OAR. (3) Scan Vetting: Promote awareness among radiographers to discuss the appropriateness of scan requests with clinicians. (4) Regular re-audits should be conducted to monitor improvements in compliance.

Keywords: Ottawa ankle rules, ankle radiographs, emergency department, traumatic pain

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346 Exploring the Number, Type and Level of Disability among Victims of Nepal Earthquake 2015

Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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345 In Vitro Evaluation of a Chitosan-Based Adhesive to Treat Bone Fractures

Authors: Francisco J. Cedano, Laura M. Pinzón, Camila I. Castro, Felipe Salcedo, Juan P. Casas, Juan C. Briceño

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Complex fractures located in articular surfaces are challenging to treat and their reduction with conventional treatments could compromise the functionality of the affected limb. An adhesive material to treat those fractures is desirable for orthopedic surgeons. This adhesive must be biocompatible and have a high adhesion to bone surface in an aqueous environment. The proposed adhesive is based on chitosan, given its adhesive and biocompatibility properties. Chitosan is mixed with calcium carbonate and hydroxyapatite, which contribute to structural support and a gel like behavior, and glutaraldehyde is used as a cross-linking agent to keep the adhesive mechanical performance in aqueous environment. This work aims to evaluate the rheological, adhesion strength and biocompatibility properties of the proposed adhesive using in vitro tests. The gelification process of the adhesive was monitored by oscillatory rheometry in an ARG-2 TA Instruments rheometer, using a parallel plate geometry of 22 mm and a gap of 1 mm. Time sweep experiments were conducted at 1 Hz frequency, 1% strain and 37°C from 0 to 2400 s. Adhesion strength is measured using a butt joint test with bovine cancellous bone fragments as substrates. The test is conducted at 5 min, 20min and 24 hours after curing the adhesive under water at 37°C. Biocompatibility is evaluated by a cytotoxicity test in a fibroblast cell culture using MTT assay and SEM. Rheological results concluded that the average gelification time of the adhesive is 820±107 s, also it reaches storage modulus magnitudes up to 106 Pa; The adhesive show solid-like behavior. Butt joint test showed 28.6 ± 9.2 kPa of tensile bond strength for the adhesive cured for 24 hours. Also there was no significant difference in adhesion strength between 20 minutes and 24 hours. MTT showed 70 ± 23 % of active cells at sixth day of culture, this percentage is estimated respect to a positive control (only cells with culture medium and bovine serum). High vacuum SEM observation permitted to localize and study the morphology of fibroblasts presented in the adhesive. All captured fibroblasts presented in SEM typical flatted structure with filopodia growth attached to adhesive surface. This project reports an adhesive based on chitosan that is biocompatible due to high active cells presented in MTT test and these results were correlated using SEM. Also, it has adhesion properties in conditions that model the clinical application, and the adhesion strength do not decrease between 5 minutes and 24 hours.

Keywords: bioadhesive, bone adhesive, calcium carbonate, chitosan, hydroxyapatite, glutaraldehyde

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344 Improving Diagnostic Accuracy of Ankle Syndesmosis Injuries: A Comparison of Traditional Radiographic Measurements and Computed Tomography-Based Measurements

Authors: Yasar Samet Gokceoglu, Ayse Nur Incesu, Furkan Okatar, Berk Nimetoglu, Serkan Bayram, Turgut Akgul

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Ankle syndesmosis injuries pose a significant challenge in orthopedic practice due to their potential for prolonged recovery and chronic ankle dysfunction. Accurate diagnosis and management of these injuries are essential for achieving optimal patient outcomes. The use of radiological methods, such as X-ray, computed tomography (CT), and magnetic resonance imaging (MRI), plays a vital role in the accurate diagnosis of syndesmosis injuries in the context of ankle fractures. Treatment options for ankle syndesmosis injuries vary, with surgical interventions such as screw fixation and suture-button implantation being commonly employed. The choice of treatment is influenced by the severity of the injury and the presence of associated fractures. Additionally, the mechanism of injury, such as pure syndesmosis injury or specific fracture types, can impact the stability and management of syndesmosis injuries. Ankle fractures with syndesmosis injury present a complex clinical scenario, requiring accurate diagnosis, appropriate reduction, and tailored management strategies. The interplay between the mechanism of injury, associated fractures, and treatment modalities significantly influences the outcomes of these challenging injuries. The long-term outcomes and patient satisfaction following ankle fractures with syndesmosis injury are crucial considerations in the field of orthopedics. Patient-reported outcome measures, such as the Foot and Ankle Outcome Score (FAOS), provide essential information about functional recovery and quality of life after these injuries. When diagnosing syndesmosis injuries, standard measurements, such as the medial clear space, tibiofibular overlap, tibiofibular clear space, anterior tibiofibular ratio (ATFR), and the anterior-posterior tibiofibular ratio (APTF), are assessed through radiographs and computed tomography (CT) scans. These parameters are critical in evaluating the presence and severity of syndesmosis injuries, enabling clinicians to choose the most appropriate treatment approach. Despite advancements in diagnostic imaging, challenges remain in accurately diagnosing and treating ankle syndesmosis injuries. Traditional diagnostic parameters, while beneficial, may not capture the full extent of the injury or provide sufficient information to guide therapeutic decisions. This gap highlights the need for exploring additional diagnostic parameters that could enhance the accuracy of syndesmosis injury diagnoses and inform treatment strategies more effectively. The primary goal of this research is to evaluate the usefulness of traditional radiographic measurements in comparison to new CT-based measurements for diagnosing ankle syndesmosis injuries. Specifically, this study aims to assess the accuracy of conventional parameters, including medial clear space, tibiofibular overlap, tibiofibular clear space, ATFR, and APTF, in contrast with the recently proposed CT-based measurements such as the delta and gamma angles. Moreover, the study intends to explore the relationship between these diagnostic parameters and functional outcomes, as measured by the Foot and Ankle Outcome Score (FAOS). Establishing a correlation between specific diagnostic measurements and FAOS scores will enable us to identify the most reliable predictors of functional recovery following syndesmosis injuries. This comparative analysis will provide valuable insights into the accuracy and dependability of CT-based measurements in diagnosing ankle syndesmosis injuries and their potential impact on predicting patient outcomes. The results of this study could greatly influence clinical practices by refining diagnostic criteria and optimizing treatment planning for patients with ankle syndesmosis injuries.

Keywords: ankle syndesmosis injury, diagnostic accuracy, computed tomography, radiographic measurements, Tibiofibular syndesmosis distance

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343 Finite Element Model to Evaluate Gas Conning Phenomenon in Naturally Fractured Oil Reservoirs

Authors: Reda Abdel Azim

Abstract:

Gas conning phenomenon considered one of the prevalent matter in oil field applications as it significantly affects the amount of produced oil, increase cost of production operation and it has a direct effect on oil reservoirs recovery efficiency as well. Therefore, evaluation of such phenomenon and study the reservoir mechanisms that may strongly affect invading gas to the producing formation is crucial. Gas conning is a result of an imbalance between two major forces controlling the oil production: gravitational and viscous forces especially in naturally fractured reservoirs where the capillary pressure forces are negligible. Once the gas invading the producing formation near the wellbore due to large producing oil rate, the oil gas contact will change and such reservoirs are prone to gas conning. Moreover, the oil volume expected to be produced requires the use of long horizontal perforated well. This work presents a numerical simulation study to predict and propose solutions to gas coning in naturally fractured oil reservoirs. The simulation work is based on discrete fractures and permeability tensors approaches. The governing equations are discretized using finite element approach and Galerkin’s least square technique (GLS) is employed to stabilize the equation solutions. The developed simulator is validated against Eclipse-100 using horizontal fractures. The matrix and fracture properties are modelled. Critical rate, breakthrough time and GOR are determined to be used in investigation of the effect of matrix and fracture properties on gas coning. Results show that fracture distribution in terms of diverse dip and azimuth has a great effect on conning occurring. In addition, fracture porosity, anisotropy ratio, and fracture aperture.

Keywords: gas conning, finite element, fractured reservoirs, multiphase

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342 Exploration for Magnetic Minerals Using Geophysical Logging Techniques in the Northwestern Part of Bangladesh

Authors: Md. Selim Reza, Mohammad Zohir Uddin

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Geophysical logging technique was conducted in a borehole in the north-western part of Bangladesh. The main objectives of this study were to identify the subsurface lithology and the presence of magnetic minerals within the basement complex. In this survey, full waveform sonic, magnetic susceptibility and natural gamma logs were conducted up to the depth of 660 m. From sonic log, three distinct velocity zones were observed at depths ranging from 20 m to 81 m, 81m to 360 m and 420 m to 660 m having the average velocity of 1600 m/s indicating unconsolidated sediment, 2500 m/s indicating hard, compact and matured sediments and 6300 m/s indicating basement complex respectively. Some low-velocity zones within the basement were identified as fractures/fissures. Natural gamma log was carried out only in the basement complex. According to magnetic susceptibility log, broadly three important zones were identified which had good agreement with the natural gamma, sonic as well as geological logs. The zone at the depth from 460 m to 470 m had the average susceptibility value of 3445 cgs unit. The average natural gamma value and sonic velocity in this zone are 150 cps and 3000 m/s respectively. The zone at the depth from 571 m to 598 m had the average susceptibility value of 5158 cgs unit with the average natural gamma value and sonic velocity are 160 cps and 6000 m/s respectively. On the other hand, the zone at the depth from 598 m to 620 m had the average susceptibility value of 1998 cgs unit with the average natural gamma value and sonic velocity show 200 cps and 3000 m/s respectively. From the interpretation of geophysical logs the 1st and 3rd zones within the basement complex are considered to be less significant whereas the 2nd zone is described as the most significant for magnetic minerals. Therefore, more drill holes are recommended on the anomalous body to delineate the extent, thickness and reserve of the magnetic body and further research are needed to determine the quality of mineral resources.

Keywords: basement complex, fractures/fissures, geophysical logging, lithology, magnetic susceptibility

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341 Splinting in Plastic Surgery Hand Trauma Setting

Authors: Samar Mousa, Rebecca Shirley

Abstract:

Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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340 Comparative Study in Treatment of Distal Humerus Fracture with Lateral Column Plate Percutaneous Medial Screw and Intercondylar Screw

Authors: Sameer Gupta, Prant Gupta

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Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

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339 Spontaneous Reformation of Dehiscent Frontal Sinus Wall after Endoscopic Removal of Mucocele

Authors: Tan Dexian Arthur, James Wei Ming Kwek, Ian Loh, Lee Tee Sin

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Statement of the Problem: Mucoceles most commonly affect the frontal sinus, which results from chronic obstruction of the sinus ostium or cystic dilatation of mucous glands with ductal obstruction. They are known to cause bony erosion of the sinus walls, which can lead to large defects. These defects were typically managed by obliteration or cranialization of the frontal sinus. Although short term outcomes of conservative management of significant posterior table defects from fractures are promising, there have been no studies on the long-term outcomes of large dehiscences in the posterior wall of the frontal sinus. Methodology & Findings : Computed Tomography (CT) Paranasal Sinuses images were analyzed and found complete spontaneous osteogenesis of a large dehiscent frontal sinus posterior wall, secondary to a large mucocele, 9 years from functional endoscopic sinus surgery with the defect managed conservatively. Conclusion & Significance: The dura is well known for its osteogenic properties. Prior studies have showed that dura could induce osteogenesis in cutaneous tissue in the absence of other central nervous system structures. It was also demonstrated that osteogenesis and chondrogenesis were possible in zygomatic fractures by transplanting neonatal dura grafts to the bony defects in rats. Extrapolating from these studies, the authors postulate that the presence of dura beneath the bony deformity of the posterior frontal sinus wall had likely initiated the osteogenesis and restored the bony defect in the patient. In our literature review, we did not find any reports of spontaneous osteogenesis of large frontal sinus defects. While our experience is incidental, it reinforces the osteogenetic potential of an intact dura and further highlights that selected large defects of the posterior wall of the frontal sinus can be conservatively managed.

Keywords: paranasal sinus mucocele, mucocele, osteogenesis, dehiscence

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338 A Novel Methodology for Browser Forensics to Retrieve Searched Keywords from Windows 10 Physical Memory Dump

Authors: Dija Sulekha

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Nowadays, a good percentage of reported cybercrimes involve the usage of the Internet, directly or indirectly for committing the crime. Usually, Web Browsers leave traces of browsing activities on the host computer’s hard disk, which can be used by investigators to identify internet-based activities of the suspect. But criminals, who involve in some organized crimes, disable browser file generation feature to hide the evidence while doing illegal activities through the Internet. In such cases, even though browser files were not generated in the storage media of the system, traces of recent and ongoing activities were generated in the Physical Memory of the system. As a result, the analysis of Physical Memory Dump collected from the suspect's machine retrieves lots of forensically crucial information related to the browsing history of the Suspect. This information enables the cyber forensic investigators to concentrate on a few highly relevant selected artefacts while doing the Offline Forensics analysis of storage media. This paper addresses the reconstruction of web browsing activities by conducting live forensics to identify searched terms, downloaded files, visited sites, email headers, email ids, etc. from the physical memory dump collected from Windows 10 Systems. Well-known entry points are available for retrieving all the above artefacts except searched terms. The paper describes a novel methodology to retrieve the searched terms from Windows 10 Physical Memory. The searched terms retrieved in this way can be used for doing advanced file and keyword search in the storage media files reconstructed from the file system recovery in offline forensics.

Keywords: browser forensics, digital forensics, live Forensics, physical memory forensics

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337 A Novel Study Contrasting Traditional Autopsy with Post-Mortem Computed Tomography in Falls Leading to Death

Authors: Balaji Devanathan, Gokul G., Abilash S., Abhishek Yadav, Sudhir K. Gupta

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Background: As an alternative to the traditional autopsy, a virtual autopsy is carried out using scanning and imaging technologies, mainly post-mortem computed tomography (PMCT). This facility aims to supplement traditional autopsy results and reduce or eliminate internal dissection in subsequent autopsies. For emotional and religious reasons, the deceased's relatives have historically disapproved such interior dissection. The non-invasive, objective, and preservative PMCT is what friends and family would rather have than a traditional autopsy. Additionally, it aids in the examination of the technologies and the benefits and drawbacks of each, demonstrating the significance of contemporary imaging in the field of forensic medicine. Results: One hundred falls resulting in fatalities was analysed by the writers. Before the autopsy, each case underwent a PMCT examination using a 16-slice Multi-Slice CT spiral scanner. By using specialised software, MPR and VR reconstructions were carried out following the capture of the raw images. The accurate detection of fractures in the skull, face bones, clavicle, scapula, and vertebra was better observed in comparison to a routine autopsy. The interpretation of pneumothorax, Pneumoperitoneum, pneumocephalus, and hemosiuns are much enhanced by PMCT than traditional autopsy. Conclusion. It is useful to visualise the skeletal damage in fall from height cases using a virtual autopsy based on PMCT. So, the ideal tool in traumatising patients is a virtual autopsy based on PMCT scans. When assessing trauma victims, PMCT should be viewed as an additional helpful tool to traditional autopsy. This is because it can identify additional bone fractures in body parts that are challenging to examine during autopsy, such as posterior regions, which helps the pathologist reconstruct the victim's life and determine the cause of death.

Keywords: PMCT, fall from height, autopsy, fracture

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336 Interacting with Multi-Scale Structures of Online Political Debates by Visualizing Phylomemies

Authors: Quentin Lobbe, David Chavalarias, Alexandre Delanoe

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The ICT revolution has given birth to an unprecedented world of digital traces and has impacted a wide number of knowledge-driven domains such as science, education or policy making. Nowadays, we are daily fueled by unlimited flows of articles, blogs, messages, tweets, etc. The internet itself can thus be considered as an unsteady hyper-textual environment where websites emerge and expand every day. But there are structures inside knowledge. A given text can always be studied in relation to others or in light of a specific socio-cultural context. By way of their textual traces, human beings are calling each other out: hypertext citations, retweets, vocabulary similarity, etc. We are in fact the architects of a giant web of elements of knowledge whose structures and shapes convey their own information. The global shapes of these digital traces represent a source of collective knowledge and the question of their visualization remains an opened challenge. How can we explore, browse and interact with such shapes? In order to navigate across these growing constellations of words and texts, interdisciplinary innovations are emerging at the crossroad between fields of social and computational sciences. In particular, complex systems approaches make it now possible to reconstruct the hidden structures of textual knowledge by means of multi-scale objects of research such as semantic maps and phylomemies. The phylomemy reconstruction is a generic method related to the co-word analysis framework. Phylomemies aim to reveal the temporal dynamics of large corpora of textual contents by performing inter-temporal matching on extracted knowledge domains in order to identify their conceptual lineages. This study aims to address the question of visualizing the global shapes of online political discussions related to the French presidential and legislative elections of 2017. We aim to build phylomemies on top of a dedicated collection of thousands of French political tweets enriched with archived contemporary news web articles. Our goal is to reconstruct the temporal evolution of online debates fueled by each political community during the elections. To that end, we want to introduce an iterative data exploration methodology implemented and tested within the free software Gargantext. There we combine synchronic and diachronic axis of visualization to reveal the dynamics of our corpora of tweets and web pages as well as their inner syntagmatic and paradigmatic relationships. In doing so, we aim to provide researchers with innovative methodological means to explore online semantic landscapes in a collaborative and reflective way.

Keywords: online political debate, French election, hyper-text, phylomemy

Procedia PDF Downloads 172
335 Effect of Wettability Alteration on Production Performance in Unconventional Tight Oil Reservoirs

Authors: Rashid S. Mohammad, Shicheng Zhang, Xinzhe Zhao

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In tight oil reservoirs, wettability alteration has generally been considered as an effective way to remove fracturing fluid retention on the surface of the fracture and consequently improved oil production. However, there is a lack of a reliable productivity prediction model to show the relationship between the wettability and oil production in tight oil well. In this paper, a new oil productivity prediction model of immiscible oil-water flow and miscible CO₂-oil flow accounting for wettability is developed. This mathematical model is established by considering two different length scales: nonporous network and propped fractures. CO₂ flow diffuses in the nonporous network and high velocity non-Darcy flow in propped fractures are considered by taking into account the effect of wettability alteration on capillary pressure and relative permeability. A laboratory experiment is also conducted here to validate this model. Laboratory experiments have been designed to compare the water saturation profiles for different contact angle, revealing the fluid retention in rock pores that affects capillary force and relative permeability. Four kinds of brines with different concentrations are selected here to create different contact angles. In water-wet porous media, as the system becomes more oil-wet, water saturation decreases. As a result, oil relative permeability increases. On the other hand, capillary pressure which is the resistance for the oil flow increases as well. The oil production change due to wettability alteration is the result of the comprehensive changes of oil relative permeability and capillary pressure. The results indicate that wettability is a key factor for fracturing fluid retention removal and oil enhancement in tight reservoirs. By incorporating laboratory test into a mathematical model, this work shows the relationship between wettability and oil production is not a simple linear pattern but a parabolic one. Additionally, it can be used for a better understanding of optimization design of fracturing fluids.

Keywords: wettability, relative permeability, fluid retention, oil production, unconventional and tight reservoirs

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334 A Systematic Review of Patient-Reported Outcomes and Return to Work after Surgical vs. Non-surgical Midshaft Humerus Fracture

Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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333 Ankle Fracture Management: A Unique Cross Departmental Quality Improvement Project

Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

Procedia PDF Downloads 159
332 Role of Fracturing, Brecciation and Calcite Veining in Fluids Flow and Permeability Enhancement in Low-Porosity Rock Masses: Case Study of Boulaaba Aptian Dolostones, Kasserine, Central Tunisia

Authors: Mohamed Khali Zidi, Mohsen Henchiri, Walid Ben Ahmed

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In the context of a hypogene hydrothermal travertine system, including low-porosity brittle bedrock and rock-mass permeability in Aptian dolostone of Boulaaba, Kasserine is enhanced through faulting and fracturing. This permeability enhancement related to the deformation modes along faults and fractures is likely to be in competition with permeability reduction when microcracks, fractures, and faults all become infilled with breccias and low-permeability hydrothermal precipitates. So that, fault continual or intermittent reactivation is probably necessary for them to keep their potential as structural high-permeability conduits. Dilational normal faults in strong mechanical stratigraphy associated with fault segments with dip changes are sites for porosity and permeability in groundwater infiltration and flow, hydrocarbon reservoirs, and also may be important sources of mineralization. The brecciation mechanism through dilational faulting and gravitational collapse originates according to hosting lithologies chaotic clast-supported breccia in strong lithologies such as sandstones, limestones, and dolostones, and matrix-supported cataclastic in weaker lithologies such as marls and shales. Breccias contribute to controlling fluid flow when the porosity is sealed either by low-permeability hydrothermal precipitates or by fine matrix materials. All these mechanisms of fault-related rock-mass permeability enhancement and reduction can be observed and analyzed in the region of Sidi Boulaaba, Kasserine, central Tunisia, where dilational normal faulting occurs in mechanical strong dolostone layering alternating with more weak marl and shale lithologies, has originated a variety of fault voids (fluid conduits) breccias (chaotic, crackle and mosaic breccias) and carbonate cement.

Keywords: travertine, Aptian dolostone, Boulaaba, fracturing

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331 Controlled Growth of Au Hierarchically Ordered Crystals Architectures for Electrochemical Detection of Traces of Molecules

Authors: P. Bauer, K. Mougin, V. Vignal, A. Buch, P. Ponthiaux, D. Faye

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Nowadays, noble metallic nanostructures with unique morphology are widely used as new sensors due to their fascinating optical, electronic and catalytic properties. Among various shapes, dendritic nanostructures have attracted much attention because of their large surface-to-volume ratio, high sensitivity and special texture with sharp tips and nanoscale junctions. Several methods have been developed to fabricate those specific structures such as electrodeposition, photochemical way, seed-mediated growth or wet chemical method. The present study deals with a novel approach for a controlled growth pattern-directed organisation of Au flower-like crystals (NFs) deposited onto stainless steel plates to achieve large-scale functional surfaces. This technique consists in the deposition of a soft nanoporous template on which Au NFs are grown by electroplating and seed-mediated method. Size, morphology, and interstructure distance have been controlled by a site selective nucleation process. Dendritic Au nanostructures have appeared as excellent Raman-active candidates due to the presence of very sharp tips of multi-branched Au nanoparticles that leads to a large local field enhancement and a good SERS sensitivity. In addition, these structures have also been used as electrochemical sensors to detect traces of molecules present in a solution. A correlation of the number of active sites on the surface and the current charge by both colorimetric method and cyclic voltammetry of gold structures have allowed a calibration of the system. This device represents a first step for the fabrication of MEMs platform that could ultimately be integrated into a lab-on-chip system. It also opens pathways to several technologically large-scale nanomaterials fabrication such as hierarchically ordered crystal architectures for sensor applications.

Keywords: dendritic, electroplating, gold, template

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330 Identifying Common Sports Injuries in Karate and Presenting a Model for Preventing Identified Injuries (A Case Study of East Azerbaijan, Iranian Karatekas)

Authors: Nadia Zahra Karimi Khiavi, Amir Ghiami Rad

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Due to the high likelihood of injuries in karate, karatekas' injuries warrant special treatment. This study explores the prevalence of karate injuries in East Azerbaijan, Iran and provides a model for karatekas to use in the prevention of such injuries. This study employs a descriptive approach. Male and female participants with a brown belt or above in either control or non-control styles in East Azerbaijan province are included in the study's statistical population. A statistical sample size of 100 people was computed using the tools employed (smartpls), and the samples were drawn at random from all clubs in the province with the assistance of the Karate Board in order to give a model for the prevention of karate injuries. Information was gathered by means of a survey that made use of the Standard Questionnaire for Australian Sports Medicine Injury Reports. The information is presented in the form of tables and samples, and descriptive statistics were used to organise and summarise the data. Control and non-control independent t-tests were conducted using SPSS version 20, and structural equation modelling (pls) was utilised for injury prevention modelling at a 0.05 level of significance. The results showed that the most common areas of injury among the control groups were the upper limbs (46.15%), lower limbs (34.61%), trunk (15.38%), and head and neck (3.84%). The most common types of injuries were broken bones (34.61%), sprain or strain (23.13%), bruising and contusions (23.13%), trauma to the face and mouth (11.53%), and damage to the nerves (69.69%). Uncontrolled committees are most likely to sustain injuries to the head and neck (33.33%), trunk (25.92%), upper limbs (22.22%), and lower limbs (18.51%). The most common injuries were to the mouth and face (33.33%), dislocations and fractures (22.22%), aspirin and strain (22.22%), bruises and contusions (18.51%), and nerves (70%), in that order. Among those who practice control kata, injuries to the upper limb account for 45.83%, the lower limb for 41.666%, the trunk for 8.33%, and the head and neck for 4.166%. The most common types of injuries are dislocations and fractures (41.66 per cent), aspirin and strain (29.16 per cent), bruising and bruises (16.66 per cent), and nerves (12.5%). Injuries to the face and mouth were not reported among those practising the control kata. By far, the most common sites of injury for those practising uncontrolled kata were the lower limb (43.74%), upper limb (39.13%), trunk (13.14%), and head and neck (4.34%). The most common types of injuries were dislocations and fractures (34.82%), aspirin and strain (26.08%), bruises and contusions (21.73%), mouth and face (13.14%), and nerves. Teaching the concepts of cooling and warming (0.591) and enhancing the degree of safety in the sports environment (0.413) were shown to play the most essential roles in reducing sports injuries among karate practitioners of controlling and uncontrolled styles, respectively. Use of common sports gear (0.390), Modification of training programme principles (0.341), Formulation of an effective diet plan for athletes (0.284), Evaluation of athletes' physical anatomy, physiology, chemistry, and physics (0.247).

Keywords: sports injuries, karate, prevention, cooling and warming

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