Search results for: plastic surgery

Authors: Raymond Limen Njinga, Adeneye Samuel Olaolu, Akinyode Ojumoola Ajimo

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Introduction: Measurement of entrance dose and dose at different depths is essential to avoid overdose and underdose of patients. The aim of this study is to verify the variation in the absorbed dose using a water-equivalent material. Materials and Methods: The plastic phantom was arranged on the couch of the halcyon linear accelerator by Varian, with the farmer ionization chamber inserted and connected to the electrometer. The image of the setup was taken using the High-Quality Single 1280x1280x16 higher on the service mode to check the alignment with the isocenter. The beam quality TPR₂₀,₁₀ (Tissue phantom ratio) was done to check the beam quality of the machine at a field size of 10 cm x 10 cm. The calibration was done using SAD type set-up at a depth of 5 cm. This process was repeated for ten consecutive weeks, and the values were recorded. Results: The results of the beam output for the teletherapy machine were satisfactory and accepted in comparison with the commissioned measurement of 0.62. The beam quality TPR₂₀,₁₀ (Tissue phantom ratio) was reasonable with respect to the beam quality of the machine at a field size of 10 cm x 10 cm. Conclusion: The results of the beam quality and the absorbed dose rate showed a good consistency over the period of ten weeks with the commissioned measurement value.

Keywords: linear accelerator, absorbed dose rate, isocenter, phantom, ionization chamber

Procedia PDF Downloads 44

Authors: Alvaro Jose Cordova, Hsuan Teh Hu

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The use of concrete masonry constructions in developing countries has become very frequent, especially for domestic purpose. Most of them with asymmetric wall configurations in plan resulting in significant torsional actions when subjected to seismic loads. The study consisted on the finding of a material model for hollow unreinforced concrete masonry and a validation with experimental data found in literature. Numerical simulations were performed to 20 buildings with variations in wall distributions and heights. Results were analyzed by inspection and with a non-linear static method. The findings revealed that eccentricities as well as structure rigidities have a strong influence on the overall response of concrete masonry buildings. In addition, slab rotations depicted more accurate information about the torsional behavior than maximum versus average displacement ratios. The failure modes in low buildings were characterized by high tensile strains in the first floor. Whereas in tall buildings these strains were lowered significantly by higher compression stresses due to a higher self-weight. These tall buildings developed multiple plastic hinges along the height. Finally, the non-linear static analysis exposed a brittle response for all masonry assemblies. This type of behavior is undesired in any construction and the need for a material model for reinforced masonry is pointed out.

Keywords: concrete damaged plasticity, concrete masonry, macro-modeling, nonlinear static analysis, torsional capacity

Procedia PDF Downloads 281

Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

Procedia PDF Downloads 392

Authors: Prabhu Thangaraju, Manoj Deepak, A. Sivakumar

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Removal of inter vertebral disc along with spinal fusion has many disadvantages such as causing stress fractures. If it is possible regenerate the spine it would be possible avoid the complications of the surgery and achieve better results. Our study involves the use of mesenchymal stem cells in regenerating the discs. Our study involved 10 patients who presented with degenerative disc disease between 2008-2011 in our hospital. After adequate pre-operative check prepared mesenchymal stem cells were injected into the disc spaces. These patients were subjected to conservative therapy for a minimum of six weeks before they were accepted into the study. They were followed up regularly for a minimum of 2years with serial radiographs and MRI. 8 out of the 10 patients had completed reduction in the pain. The T2 weighted MRI images in 9 out of the 10 patients showed a bright signal compared the previous Images which indicated that there was improvement in the hydration levels. From the case study of 10 patients who were subjected to mesenchymal cell therapy in our hospital, we can conclude that the use of mesenchymal cells in treatment of intervertebral disc degeneration in a safe and effective option.

Keywords: mesenchymal stem cells, intervertebral disc, the spine, disc degeneration

Procedia PDF Downloads 355

Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

Procedia PDF Downloads 127

Authors: Chirag Raval, Jimmy Toussaint, Tieuvi Nguyen, Hadi Fadaifard, George Wolberg, Steven Quarfordt, Kung-ming Jan, David S. Rumschitzki

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Numerous studies examine aquaporins’ role in osmotic water transport in various systems but virtually none focus on aquaporins’ role in hydrostatically-driven water transport involving mammalian cells save for our laboratory’s recent study of aortic endothelial cells. Here we investigate aquaporin-1 expression and function in the aortic endothelium in two high-renin rat models of hypertension, the spontaneously hypertensive genomically altered Wystar-Kyoto rat variant and Sprague-Dawley rats made hypertensive by two kidney, one clip Goldblatt surgery. We measured aquaporin-1 expression in aortic endothelial cells from whole rat aortas by quantitative immunohistochemistry, and function by measuring the pressure driven hydraulic conductivities of excised rat aortas with both intact and denuded endothelia on the same vessel. We use them to calculate the effective intimal hydraulic conductivity, which is a combination of endothelial and subendothelial components. We observed well-correlated enhancements in aquaporin-1 expression and function in both hypertensive rat models as well as in aortas from normotensive rats whose expression was upregulated by 2h forskolin treatment. Upregulated aquaporin-1 expression and function may be a response to hypertension that critically determines conduit artery vessel wall viability and long-term susceptibility to atherosclerosis. Numerous studies examine aquaporins’ role in osmotic water transport in various systems but virtually none focus on aquaporins’ role in hydrostatically-driven water transport involving mammalian cells save for our laboratory’s recent study of aortic endothelial cells. Here we investigate aquaporin-1 expression and function in the aortic endothelium in two high-renin rat models of hypertension, the spontaneously hypertensive genomically altered Wystar-Kyoto rat variant and Sprague-Dawley rats made hypertensive by two kidney, one clip Goldblatt surgery. We measured aquaporin-1 expression in aortic endothelial cells from whole rat aortas by quantitative immunohistochemistry, and function by measuring the pressure driven hydraulic conductivities of excised rat aortas with both intact and denuded endothelia on the same vessel. We use them to calculate the effective intimal hydraulic conductivity, which is a combination of endothelial and subendothelial components. We observed well-correlated enhancements in aquaporin-1 expression and function in both hypertensive rat models as well as in aortas from normotensive rats whose expression was upregulated by 2h forskolin treatment. Upregulated aquaporin-1 expression and function may be a response to hypertension that critically determines conduit artery vessel wall viability and long-term susceptibility to atherosclerosis.

Keywords: acute hypertension, aquaporin-1, hydraulic conductivity, hydrostatic pressure, aortic endothelial cells, transcellular flow

Procedia PDF Downloads 213

Authors: Roman Knizek, Denisa Knizkova, Vladimir Bajzik

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Nowadays there are countless kinds of bedsheets or mattress covers for little children which should stop any liquid getting into the mattress. It is quite easy to wash the cover of the mattress, but it is almost impossible to clean the body of a mattress which is made of latex foam, wool or synthetic materials. Children bedsheets or mattress covers are often made with plastic coating which is not steam or air permeable and therefore is not very hygienic. This is our goal: by laminating a nanofiber membrane to a suitable bedsheet textile material, we can create a bedsheet which is waterproof but at the same time steam permeable and also partially breathable, thanks to the membrane. For the same reason, nanofiber membranes are widely used in outdoor clothing. The comfort properties and durability of the new nano-membrane bedsheet were studied. The following comfort properties were investigated: steam permeability - measured in accordance with Standard ISO 11902 hydrostatic resistances - measured in accordance with Standard ISO 811 and air permeability - measured in accordance with Standard ISO 9237. The durability or more precisely the wash resistance of the nano-membrane bedsheet was also measured by submitting the sheet to 30 washing cycles. The result of our work is a children's bedsheet with a nano-membrane. The nano-membrane is made of polyurethane to keep maximum flexibility and elasticity which are essential for this product. The comfort properties of this new bedsheet are very good especially its steam permeability and hydrostatic resistance.

Keywords: bed sheet, hydrostatic resistance, nanofiber membrane, water vapour permeable

Procedia PDF Downloads 196

Authors: Han Yan, Jieren Luo, Qiuhui Yan, Xiaoqing Li

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The thermal conductivity of porous materials is closely related to the thermal and moisture environment and the overall energy consumption of the building. The study of thermal conductivity of porous materials has great significance for the realization of low energy consumption building and economic construction building. Based on the study of effective thermal conductivity of porous materials at home and abroad, the thermal conductivity under a variety of different density of polystyrene board (EPS), plastic extruded board (XPS) and polyurethane (PU) and phenolic resin (PF) in wet state through theoretical analysis and experimental research has been studied. Initially, the moisture absorption and desorption properties of specimens had been discussed under different density, which led a result indicates the moisture absorption of four porous materials all have three stages, fast, stable and gentle. For the moisture desorption, there are two types. One is the existence of the rapid phase of the stage, such as XPS board, PU board. The other one does not have the fast desorption, instead, it is more stabilized, such as XPS board, PF board. Furthermore, the relationship between water content and thermal conductivity of porous materials had been studied and fitted, which figured out that in the wake of the increasing water content, the thermal conductivity of porous material is continually improving. At the same time, this result also shows, in different density, when the same kind of materials decreases, the saturated moisture content increases. Finally, the moisture absorption and desorption properties of the four kinds of materials are compared comprehensively, and it turned out that the heat preservation performance of PU board is the best, followed by EPS board, XPS board, PF board.

Keywords: porous materials, thermal conductivity, moisture content, transient hot-wire method

Procedia PDF Downloads 169

Authors: Cui Long (Allen)

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China's attention to the Arctic began in 1925, when the country joined the Svalbard Treaty. China's participation in Arctic exploration was determined by the second and third articles of the treaty, according to which the country could conduct scientific activities in the adjacent waters of Svalbard. The first studies of the New China began in the 50s of the twentieth century. The first scientific projects on Arctic exploration began in the 80s of the twentieth century. During these years, the "National Committee of the People's Republic of China for Arctic Expeditions" and the "Institute of Polar Research" in Shanghai were established. The beginning of Deng Xiaoping's policy of openness and reform has opened a new page in China's scientific research of the Arctic. Since the 90s, the first Chinese scientific programs have been developed with foreign partners. The Chinese Academy of Sciences and its subordinate scientific institutions are actively involved in scientific activities: the Institute of Aerophysics, the Institute of Geographical Sciences and Natural Resources, the Institute of Oceanology, etc. An important event for the development of scientific research in the Arctic was China's entry into the Arctic Council in 2013 as an observer. By 2018, China had conducted nine Arctic expeditions, their purpose was to study the melting of ice and its effects on the world's climate system, as well as the impact of the Arctic climate on China and the presence of plastic waste in the Arctic was monitored. At the beginning of the new millennium, China considers the Arctic as the most important region of a geopolitical and geostrategic nature, for its further logistical and economic development.

Keywords: Arctic, China, history of Arctic research, arctic science, Chinese scientific research in the Arctic, scientific expeditions

Procedia PDF Downloads 35

Authors: Raisibe V. Mathabatha, Phatu W. Mashela, Nehemiah M. Mokgalong

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Occasional incidence of phytotoxicity in Nemarioc-BL and Nemafric-AL phytonematicides to crops raises credibility challenges that could negate their registration as commercial products. Responses of plants to phytonematicides are characterized by the existence of stimulation, neutral and inhibition phases, with the mid-point of the former being referred to as the Mean Concentration Stimulation Point (MSCP = Dm + Rh/2). The objective of this study was to determine the MCSP and the overall sensitivity (∑k) of Nemarioc-AL and Nemafric-BL phytonematicides to rough lemon seedling rootstocks using the Curve-fitting Allelochemical Response Dosage (CARD) computer-based model. Two parallel greenhouse experiments were initiated, with seven dilutions of each phytonematicide arranged in a randomised complete block design, replicated nine times. Six-month-old rough lemon seedlings were transplanted into 20-cm-diameter plastic pots, filled with steam-pasteurised river sand (300°C for 3 h) and Hygromix-T growing mixture. Treatments at 0, 2, 4, 8, 16, 32 and 164% dilutions were applied weekly at 300 ml/plant. At 84 days after the treatments, analysis of variance-significant plant variables was subjected to the CARD model to generate appropriate biological indices. Computed MCSP values for Nemarioc-AL and Nemafric-BL phytonematicides on rough lemon were 29 and 38%, respectively, whereas ∑k values were 1 and 0, respectively. At the applied concentrations, rough lemon seedlings were highly sensitive to Nemarioc-AL and Nemafric-BL phytonematicides.

Keywords: crude extracts, cucurbitacins, effective microbes, fruit extracts

Procedia PDF Downloads 133

Authors: Ghandehari Motlagh, Mohammad

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Purpose: We tried to find the most common etiologies for anisometropia in pre-op cataract cases: axial or refractive. Methods: In this cross-sectional study ,41 pre-op cataract eyes with more than 0.33 difference between axial lengths of 2 eyes were enrolled.Considered for each 1mm difference between axial lengths in long eyes( AXL more than 25):1.75-2.00 D of anisometropia, for normal eyes(AXL: 22- 25):2.50D and for short eyes (AXL less than 22):3.50-3.75 D as axial anisometropia. If there are more or lesser anisometropia, we recorded as refractive anisometropia. Results: Average of anisometropia :4.24 D, prevalence of PK or LK :1 (2.38%), kc:1(2.38%), glaucoma surgery: 1(2.38%), and pseudophakic status of the opposite eye 8(19.04%). Prevalence of axial anisometropia:21 (52.4%) and refractive anisometropia 20(47.6%).Then on basis of this study we can rely on the patient’s refraction exactly before phaco for evaluation of axial length differences between the 2 eyes, because most of the anisometropias are axial. Conclusion: In most cases, cataract does not induce significant change in refractive error (secondary myopia) and AXL difference between the 2 eyes are correlated with anisometropia.so it can be used for cataract patient’s ocular biometry evaluation. Pre-cataract refraction is a valuable variable should be measured and recorded in routin eye examination.

Keywords: ocular axial length, anisometropia, cataract, ophthalmology and optometry

Procedia PDF Downloads 365

Authors: Chao Ding, Jun Shi, Huiping Deng

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This study reports the preparation of a new type yeast-chitosan bio-microcapsule coating sodium alginate and chitosan, with good biocompatibility and mechanical strength. Focusing on the optimum preparation conditions of bio-microcapsule, a dynamic test of yeast-chitosan bio-microcapsule combined with ultrafiltration membrane was established to evaluate both the removal efficiency of major pollutants from raw water and the applicability of this system. The results of orthogonal experiments showed that the optimum preparation procedure are as follows: mix sodium alginate solution (3%) with bacteria liquid in specific proportion, drop in calcium chloride solution (4%) and solidify for 30 min; put the plastic beads into chitosan liquid (1.8%) to overlay film for 10 min and then into glutaraldehyde solution (1%) to get cross-linked for 5 min. In dynamic test, the microcapsules were effective as soon as were added in the system, without any start-up time. The removal efficiency of turbidity, ammonia nitrogen and organic matter was 60%, 80%, and 40%. Besides, the bio-microcapsules were prospective adsorbent for heavy metal; they adsorb Pb and Cr⁶⁺ in water while maintaining high biological activity to degrade ammonia nitrogen and small molecular organics through assimilation. With the presence of bio-microcapsules, the internal yeast strains’ adaptability on the external environment and resistance ability on toxic pollutants will be increased.

Keywords: ammonia nitrogen, bio-microcapsules, ultrafiltration membrane, yeast-chitosan

Procedia PDF Downloads 329

Authors: Helia Barzegar Sedigh, Farzaneh Hamedi, Payam Ashtari

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There are some limitations in common structural systems, such as providing appropriate lateral stiffness, adequate ductility, and architectural openings at the same time. Consequently, the concept of T-Resisting Frame (TRF) has been introduced to overcome all these deficiencies. The configuration of TRF in this study is a Vertical Plate Girder (VPG) which is placed within the span and two Horizontal Plate Girders (HPGs) connect VPG to side columns at each story level by the use of rigid connections. System performance is improved by utilizing rigid connections in side columns base joint. Shear yield of HPGs causes energy dissipation in TRF; therefore, high plastic deformation in web of HPGs and VPG affects the ductility of system. Moreover, in order to prevent shear buckling in web of TRF’s members and appropriate criteria for placement of web stiffeners are applied. In this paper, an experimental study is conducted by applying cyclic loading and using finite element models and numerical studies such as push over method are assessed on shear and flexural yielding of HPGs. As a result, seismic parameters indicate adequate lateral stiffness, and high ductility factor of 6.73, and HPGs’ shear yielding achieved as a proof of TRF’s better performance.

Keywords: experimental study, finite element model, flexural and shear yielding, t-resisting frame

Procedia PDF Downloads 219

Authors: Juntima Pokkrong

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The objectives of the study were to develop packaging made from rice straws left after the harvest in order to create additional value for organic rice products of Uttaradit Province and to demonstrate the technology of producing straw packaging to the community. The population was promoters of organic rice distributors, governmental organizations, consumers, and three groups of organic rice producers which are the Agriculturist Group of Khorrum Sub-district, Pichai District, Uttaradit Province; the Agriculturist Group of Wangdin Sub-district, Muang District, Uttaradit Province; and the Agriculturist Group of Wangkapi Sub-district, Muang District, Uttaradit Province. The data were collected via group discussions, and two types of questionnaires. The data acquired were then analyzed using descriptive statistic for percentage, mean, standard deviation, and content analysis. It has been found that primary packaging for one kilogram of rice requires vacuumed plastic bags made from thermoplastic or resin because they are able to preserve the quality of rice for a long time, and they are also very cheap. For secondary packaging, the making of straw paper was studied and applied. Straw paper can be used for various purposes, and in this study, it was used to create the secondary packaging models in compliance with packaging preferences acquired from the questionnaires. The models were surveyed among the population for their opinion using satisfaction questionnaires, and the result was overall highly satisfactory.

Keywords: environmentally friendly, organic rice, packaging, straw paper

Procedia PDF Downloads 230

Authors: M. M. Hassani, S. Ammann, F. K. Wittel, P. Niemz, H. J. Herrmann

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Application of engineered wood, especially in the form of glued-laminated timbers has increased significantly. Recent progress in plywood made of high strength and high stiffness hardwoods, like European beech, gives designers in general more freedom by increased dimensional stability and load-bearing capacity. However, the strong hygric dependence of basically all mechanical properties renders many innovative ideas futile. The tendency of hardwood for higher moisture sorption and swelling coefficients lead to significant residual stresses in glued-laminated configurations, cross-laminated patterns in particular. These stress fields cause initiation and evolution of cracks in the bond-lines resulting in: interfacial de-bonding, loss of structural integrity, and reduction of load-carrying capacity. Subsequently, delamination of glued-laminated timbers made of hardwood elements can be considered as the dominant failure mechanism in such composite elements. In addition, long-term creep and mechano-sorption under changing environmental conditions lead to loss of stiffness and can amplify delamination growth over the lifetime of a structure even after decades. In this study we investigate the delamination process of adhesively bonded hardwood (European beech) elements subjected to changing climatic conditions. To gain further insight into the long-term performance of adhesively bonded elements during the design phase of new products, the development and verification of an authentic moisture-dependent constitutive model for various species is of great significance. Since up to now, a comprehensive moisture-dependent rheological model comprising all possibly emerging deformation mechanisms was missing, a 3D orthotropic elasto-plastic, visco-elastic, mechano-sorptive material model for wood, with all material constants being defined as a function of moisture content, was developed. Apart from the solid wood adherends, adhesive layer also plays a crucial role in the generation and distribution of the interfacial stresses. Adhesive substance can be treated as a continuum layer constructed from finite elements, represented as a homogeneous and isotropic material. To obtain a realistic assessment on the mechanical performance of the adhesive layer and a detailed look at the interfacial stress distributions, a generic constitutive model including all potentially activated deformation modes, namely elastic, plastic, and visco-elastic creep was developed. We focused our studies on the three most common adhesive systems for structural timber engineering: one-component polyurethane adhesive (PUR), melamine-urea-formaldehyde (MUF), and phenol-resorcinol-formaldehyde (PRF). The corresponding numerical integration approaches, with additive decomposition of the total strain are implemented within the ABAQUS FEM environment by means of user subroutine UMAT. To predict the true stress state, we perform a history dependent sequential moisture-stress analysis using the developed material models for both wood substrate and adhesive layer. Prediction of the delamination process is founded on the fracture mechanical properties of the adhesive bond-line, measured under different levels of moisture content and application of the cohesive interface elements. Finally, we compare the numerical predictions with the experimental observations of de-bonding in glued-laminated samples under changing environmental conditions.

Keywords: engineered wood, adhesive, material model, FEM analysis, fracture mechanics, delamination

Procedia PDF Downloads 414

Authors: Mehdi Modabberifar, Milad Roodi, Ehsan Souri

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In recent years, honeycomb fiber reinforced plastic (FRP) sandwich panels have been increasingly used in various industries. Low weight, low price, and high mechanical strength are the benefits of these structures. However, their mechanical properties and behavior have not been fully explored. The objective of this study is to conduct a combined numerical-statistical investigation of honeycomb FRP sandwich beams subject to torsion load. In this paper, the effect of geometric parameters of the sandwich panel on the maximum shear strain in both face and core and angle of torsion in a honeycomb FRP sandwich structures in torsion is investigated. The effect of Parameters including core thickness, face skin thickness, cell shape, cell size, and cell thickness on mechanical behavior of the structure were numerically investigated. Main effects of factors were considered in this paper and regression equations were derived. Taguchi method was employed as experimental design and an optimum parameter combination for the maximum structure stiffness has been obtained. The results showed that cell size and face skin thickness have the most significant impacts on torsion angle, maximum shear strain in face and core.

Keywords: finite element, honeycomb FRP sandwich panel, torsion, civil engineering

Procedia PDF Downloads 402

Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

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Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

Procedia PDF Downloads 101

Authors: S. Alireza Mirghasemi, Elly Trepman, Mohammad Saleh Sadeghi, Narges Rahimi Gabaran, Shervin Rashidinia

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Bone marrow edema syndrome (BMES) is an uncommon and self-limited syndrome characterized by atraumatic extremity pain with unknown of etiology. Symptom onset may include sudden or gradual swelling and pain at rest or during activity, usually at night. This syndrome mostly affects middle-aged men and younger women who have pain in the lower extremities. The most common sites involved with BMES, in decreasing order of frequency, are the bones about the hip, knee, ankle, and foot. The diagnosis of BMES is made with magnetic resonance imaging to exclude other causes of bone marrow edema. The correct diagnosis often is delayed because of the low prevalence and nonspecific signs in the foot and ankle. This delay may intensify bone pain and impair patient function and quality of life. The goal of BMES treatment is to relieve pain and shorten disease duration. Treatment options are limited and may include symptomatic treatment, pharmacologic treatment, and surgery.

Keywords: transient osteoporosis, bone marrow edema syndrome, iloprost, bisphosphonates

Procedia PDF Downloads 349

Authors: Gabrielle Holt

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This paper is looking to prove the efficacy of the Schulte Holt IOL Toric Calculator Processor (Schulte Holt ITCP). It has been completed using manually inputted data into the Barrett Toric Calculator and comparing the number of minutes taken to complete the Toric calculations, the number of errors identified during completion, and distractions during completion. It will then compare that data to the number of minutes taken for the Schulte Holt ITCP to complete also, using the Barrett method, as well as the number of errors identified in the Schulte Holt ITCP. The data clearly demonstrate a momentous advantage to the Schulte Holt ITCP and notably reduces time spent doing Toric Calculations, as well as reducing the number of errors. With the ever-growing number of cataract surgeries taking place around the world and the waitlists increasing -the Schulte Holt IOL Toric Calculator Processor may well demonstrate a way forward to increase the availability of ophthalmologists and ophthalmic staff while maintaining patient safety.

Keywords: Toric, toric lenses, ophthalmology, cataract surgery, toric calculations, Barrett

Procedia PDF Downloads 71

Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia

Procedia PDF Downloads 324

Authors: M. Arunachalam, M. Pandey

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Nacre, a biological material that forms the inner-layer of sea shells can achieve high toughness and strength by way of staggered arrangement of strong tablets with soft and weak organic interface. Under applied loads the tablets slide over the adjacent tablets, thus generating inelastic deformation and toughness on macroscopic scale. A two dimensional finite element based homogenization methodology is adopted for obtaining the effective material properties of Nacre using a representative volume element (RVE) at finite deformations. In this work, the material behaviour for tablet and interface are assumed to be Isotropic elastic and Isotropic elastic-perfectly plastic with strain softening respectively. Numerical experiments such as uniaxial tension test along X, Y directions and simple shear test are performed on the RVE with uniform displacement and periodic constraints applied at the RVE boundaries to obtain the anisotropic homogenized response and maximum local stresses within each constituents of Nacre. Homogenized material model is then tested for macroscopic structure under three point bending condition and the results obtained are comparable with the results obtained for detailed microstructure based structure, thus homogenization provides a bridge between macroscopic scale and microscopic scale and homogenized material properties obtained from microstructural (RVE) analysis could be used in large scale structural analysis.

Keywords: finite element, homogenization, inelastic deformation, staggered arrangement

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Authors: B. S. Premalatha, Kausalya Sahani

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Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

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Authors: Meenakshi Barsaul Chauhan, Aastha Chauhan, Shilpa Hurmade, Rajeev Sen, Jyotsna Sen, Monika Dalal

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Introduction: Ovarian masses are common forms of neoplasm in women and represent 2/3rd of gynaecological malignancies. A pre-operative suggestion of malignancy can guide the gynecologist to refer women with suspected pelvic mass to a gynecological oncologist for appropriate therapy and optimized treatment, which can improve survival. In the younger age group preoperative differentiation into benign or malignant pathology can decide for conservative or radical surgery. Imaging modalities have a definite role in establishing the diagnosis. By using International Ovarian Tumor Analysis (IOTA) classification with sonography, costly radiological methods like Magnetic Resonance Imaging (MRI) / computed tomography (CT) scan can be reduced, especially in developing countries like India. Thus, this study is being undertaken to evaluate the role of clinical methods and sonography for diagnosis of the nature of the ovarian tumor. Material And Methods: This prospective observational study was conducted on 40 patients presenting with ovarian masses, in the Department of Obstetrics and Gynaecology, at a tertiary care center in northern India. Functional cysts were excluded. Ultrasonography and color Doppler were performed on all the cases.IOTA rules were applied, which take into account locularity, size, presence of solid components, acoustic shadow, dopper flow etc . Magnetic Resonance Imaging (MRI) / computed tomography (CT) scans abdomen and pelvis were done in cases where sonography was inconclusive. In inoperable cases, Fine needle aspiration cytology (FNAC) was done. The histopathology report after surgery and cytology report after FNAC was correlated statistically with the pre-operative diagnosis made clinically and sonographically using IOTA rules. Statistical Analysis: Descriptive measures were analyzed by using mean and standard deviation and the Student t-test was applied and the proportion was analyzed by applying the chi-square test. Inferential measures were analyzed by sensitivity, specificity, negative predictive value, and positive predictive value. Results: Provisional diagnosis of the benign tumor was made in 16(42.5%) and of the malignant tumor was made in 24(57.5%) patients on the basis of clinical findings. With IOTA simple rules on sonography, 15(37.5%) were found to be benign, while 23 (57.5%) were found to be malignant and findings were inconclusive in 2 patients (5%). FNAC/Histopathology reported that benign ovarian tumors were 14 (35%) and 26(65%) were malignant, which was taken as the gold standard. The clinical finding alone was found to have a sensitivity of 66.6% and a specificity of 90.9%. USG alone had a sensitivity of 86% and a specificity of 80%. When clinical findings and IOTA simple rules of sonography were combined (excluding inconclusive masses), the sensitivity and specificity were 83.3% and 92.3%, respectively. While including inconclusive masses, sensitivity came out to be 91.6% and specificity was 89.2. Conclusion: IOTA's simple sonography rules are highly sensitive and specific in the prediction of ovarian malignancy and also easy to use and easily reproducible. Thus, combining clinical examination with USG will help in the better management of patients in terms of time, cost and better prognosis. This will also avoid the need for costlier modalities like CT, and MRI.

Keywords: benign, international ovarian tumor analysis classification, malignant, ovarian tumours, sonography

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Authors: Javier Fernandez, Mayte Medina, Rafael Fernandez de Canete, Nuria Alcain, Juan Carlos Ramos-Diaz

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At present, the experimentation of anesthetic drugs on patients requires a regulation protocol, and the response of each patient to several doses of entry drug must be well known. Therefore, the development of pharmacological dose control systems is a promising field of research in anesthesiology. In this paper, it has been developed a non-linear compartmental the pharmacokinetic-pharmacodynamical model which describes the anesthesia depth effect in a sufficiently reliable way over a set of patients with the depth effect quantified by the Bi-Spectral Index. Afterwards, an Artificial Neural Network (ANN) predictive controller has been designed based on the depth of anesthesia model so as to keep the patient in the optimum condition while he undergoes surgical treatment. For the purpose of quantifying the efficiency of the neural predictive controller, a classical proportional-integral-derivative controller has also been developed to compare both strategies. Results show the superior performance of predictive neural controller during BiSpectral Index reference tracking.

Keywords: anesthesia, bi-spectral index, neural network control, pharmacokinetic-pharmacodynamical model

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Authors: Mandeep Kataria, Ritu Narula, Navneet Kaur

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Asparagine is vital amino acid which is required for the development of brain and it regulates the equilibrium of central nervous system. Asparagine is the chief amino acid that forms acrylamide in baked food by reacting with reducing sugars at high temperature ( Millard Reaction i.e. amino acids and sugars give new flavors at high temperature). It can also be a parameter of freshness in fruit juices because on storage of juices at 37°C caused an 87% loss in the total free amino acids and major decrease was recorded in asparagine contents. With this significance of monitoring asparagine, in the present work a biosensor for determining asparagine in fruit juices is developed. For the construction of biosensor L-asparaginase enzyme (0.5 IU) was co-immobilized with phenol red on TEOS chitosan sol-gel plastic disc and fixed on the fiber optic tip. Tip was immersed in a cell having 5ml of substrate and absorption was noted at response time of 5 min with 10-1 - 10-10 M concentrations of asparagine at 538 nm. L-asparaginase was extracted and from Solanum nigrum Asparagine biosensor was applied fruit juices on the monitoring asparagine contents. L-asparagine concentration found to be present in fruit juices like Guava Juice, Apple Juice, Mango Juice, Litchi juice, Strawberry juice, Pineapple juice Lemon juice, and Orange juice. Hence the developed biosensor has commercial aspects in quality insurance of fruit juices.

Keywords: fiber optic biosensor, chitosan, teos, l-asparaginase

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Authors: Bahar Basturk, Secil Celik Erbas, Sevket Can Sarikaya

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Composites combining the particulates and polymer components have attracted great interest in various application areas such as packaging, furniture, electronics and automotive industries. For strengthening the plastic matrices, the utilization of natural fillers instead of traditional reinforcement materials has received increased attention. The properties of natural filler based polymer composites (NFPC) may be improved by applying proper surface modification techniques to the powder phase of the structures. In this study, acorn powder-epoxy and pine corn powder-epoxy composites containing up to 45% weight percent particulates were prepared by casting method. Alkali treatment and acetylation techniques were carried out to the natural particulates for investigating their influences under mechanical forces. The effects of filler type and content on the tensile properties of the composites were compared with neat epoxy. According to the quasi-static tensile tests, the pine cone based composites showed slightly higher rigidity and strength properties compared to the acorn reinforced samples. Furthermore, the structures independent of powder type and surface modification technique, showed higher tensile properties with increasing the particle content.

Keywords: natural fillers, polymer composites, surface modifications, tensile properties

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Authors: Akram Khelaifia, Nesreddine Djafar Henni

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Reinforced concrete shear walls are essential components in protecting buildings from seismic forces by providing both strength and stiffness. This study focuses on optimizing the placement of shear walls in a high seismic zone. Through nonlinear analyses conducted on an eight-story building, various scenarios of shear wall positions are investigated to evaluate their impact on seismic performance. Employing a performance-based seismic design (PBSD) approach, the study aims to meet acceptance criteria related to inter-story drift ratio and damage levels. The findings emphasize the importance of concentrating shear walls in the central area of the building during the design phase. This strategic placement proves more effective compared to peripheral distributions, resulting in reduced inter-story drift and mitigated potential damage during seismic events. Additionally, the research explores the use of shear walls that completely infill the frame, forming compound shapes like Box configurations. It is discovered that incorporating such complete shear walls significantly enhances the structure's reliability concerning inter-story drift. Conversely, the absence of complete shear walls within the frame leads to reduced stiffness and the potential deterioration of short beams.

Keywords: performance level, pushover analysis, shear wall, plastic hinge, nonlinear analyses

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Authors: Wahid Terro, Franco Lugnani, Miray Terro

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Roughly 90% of mouth cancer is squamous cell carcinoma. Oral region metastases are considered uncommon. The most frequent sources of metastatic tumors to the mouth are primary cancers from the lung and breast, with the latter being the most common site for tumors that metastasize to the jawbones. Treatment involves surgery, radiation, chemotherapy or a combination of these. However, these treatment modalities entail severe aesthetic and functional side effects. The aim of this article is to present an alternative and unprecedented treatment modality for metastatic mandibular bone carcinoma – Cryosurgery. A 37-year-old female patient presented with gradually increasing pain over several weeks whose radiological tests revealed a formation of mass in the left mandibular ramus. A biopsy obtained by bone puncture of the ramus was reported to be metastatic breast squamous cell carcinoma. The patient has been successfully treated without esthetic and functional side effects by using cryosurgery. We conclude that it is value promoting this method for current and future use.

Keywords: squamous cell carcinoma, mandible, cryosurgery, metastasis

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Authors: A. Armin, R. Fotouhi, W. Szyszkowski

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This paper is part of a study to develop robots for farming. As such power requirement to operate equipment attach to such robots become an important factor. Soil-tool interaction play major role in power consumption, thus predicting accurately the forces which act on the blade during the farming is prime importance for optimal designing of farm equipment. In this paper a finite element investigation for tillage tools and soil interaction is described by using an inelastic constitutive material law for agriculture application. A 3-dimentional (3D) nonlinear finite element analysis (FEA) is developed to examine behavior of a blade with different rake angles moving in a block of soil, and to estimate the blade force. The soil model considered is an elastic-plastic with non-associated Drucker-Prager material model. Special use of contact elements are employed to consider connection between soil-blade and soil-soil surfaces. The FEA results are compared with experiment ones, which show good agreement in accurately predicting draft forces developed on the blade when it moves through the soil. Also, a very good correlation was obtained between FEA results and analytical results from classical soil mechanics theories for straight blades. These comparisons verified the FEA model developed. For analyzing complicated soil-tool interactions and for optimum design of blades, this method will be useful.

Keywords: finite element analysis, soil-blade contact modeling, blade force, mechanical engineering

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Authors: Alan S. Weber

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This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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