Search results for: Mataram canal

Authors: R. L. P. De Lima, F. C. B. Boogaard, R. E. De Graaf-Van Dinther

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Blue-green algae blooms (cyanobacteria) is currently a relevant ecological problem that is being addressed by most water authorities in the Netherlands. These can affect recreation areas by originating unpleasant smells and toxins that can poison humans and animals (e.g. fish, ducks, dogs). Contamination events usually take place during summer months, and their frequency is increasing with climate change. Traditional monitoring of this bacteria is expensive, labor-intensive and provides only limited (point sampling) information about the spatial distribution of algae concentrations. Recently, a novel handheld sensor allowed water authorities to quicken their algae surveying and alarm systems. This study converted the mentioned algae sensor into a mobile platform, by combining it with an underwater remotely operated vehicle (also equipped with other sensors and cameras). This provides a spatial visualization (mapping) of algae concentrations variations within the area covered with the drone, and also in depth. Measurements took place in different locations in the Netherlands: i) lake with thick silt layers at the bottom, very eutrophic former bottom of the sea and frequent / intense mowing regime; ii) outlet of waste water into large reservoir; iii) urban canal system. Results allowed to identify probable dominant causes of blooms (i), provide recommendations for the placement of an outlet, day-night differences in algae behavior (ii), or the highlight / pinpoint higher algae concentration areas (iii). Although further research is still needed to fully characterize these processes and to optimize the measuring tool (underwater drone developments / improvements), the method here presented can already provide valuable information about algae behavior and spatial / temporal variability and shows potential as an efficient monitoring system.

Keywords: blue-green algae, cyanobacteria, underwater drones / ROV / AUV, water quality monitoring

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Authors: Osama Ahmed Ibrahim Masoud, Mohamed Ibrahim Mohamed Abdelhadi, Ahmed Mohamed Seddik Hassan

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The problem of study focuses on thermal comfort realization in a residential building during hot and dry climate periods consumes a major electrical energy for air conditioning operation. Thermal comfort realization in a residential building during such climate becomes more difficult regarding the phenomena of climate change, and the use of building and construction materials which have the feature of heat conduction as (bricks-reinforced concrete) and the global energy crises. For that, this study aims to how to realize internal thermal comfort through how to make the best use of building services (temporarily used service spaces) for reducing the electrical energy transfer and saving self-shading. In addition, the possibility of reduction traditional energy (fossil fuel) consumed in cooling through the use of building services for reducing the internal thermal comfort and the relationship between them. This study is based on measuring the consumed electrical energy rate in cooling (by using Design-Builder program) for a residential building (the place of study is: Egypt- Suez Canal- Suez City), this design model has lots of alternatives designs for the place of building services (center of building- the eastern front- southeastern front- the southern front- the south-west front, the western front). The building services are placed on the fronts with different rates for determining the best rate on fronts which realizes thermal comfort with the lowest of energy consumption used in cooling. Findings of the study indicate to that the best position for building services is on the west front then the south-west front, and the more the building services increase, the more energy consumption used in cooling of residential building decreases. Recommendations indicate to the need to study the building services positions in the new projects progress to select the best alternatives to realize ‘Energy conservation’ used in cooling or heating into the buildings in general, residential buildings particularly.

Keywords: residential buildings, energy conservation, thermal comfort, building services, temporary used service spaces, DesignBuilder

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Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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Authors: E.K.K. Agyeman, P. Mousseau, A. Sarda, D. Edelin

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The uniform and controlled cooling of hot metals by the circulation of water in canals remains a challenge due to the phase change of the water and the high heat fluxes associated with the phase change. This is because, during the cooling process, the phases are not uniformly distributed along the canals with the liquid phase dominating at the entrances of the canals and the gaseous phase dominating towards the exits. The difference in thermal properties between both phases leads to a heterogeneous temperature distribution in the part being cooled. Slowing down the cooling process is also a challenge due to the high heat fluxes associated with the phase change of water. This study investigates the use of multiple water jets for the controlled and homogenous cooling of hot metal parts and the effect of gravity on the effectiveness of the cooling process with a potential application in the cooling of composite forming moulds. A hole is bored at the centre of a steel block along its length. The jets are generated from the holes of a perforated steel pipe which is placed along the centre of the hole bored in the steel block. The evolution of the temperature with respect to time on the external surface of the steel block is measured simultaneously by thermocouples and an infrared camera. Different jet positions are tested in order to identify the jet placement configuration that ensures the most homogenous cooling of the block while the cooling speed is controlled by an intermittent impingement of the jets. In order to study the effect of gravity on the cooling process, a scenario where the jets are oriented in the opposite direction to that of gravity is compared to one where the jets are aligned in the same direction as gravity. It’s observed that orienting the jets in the direction of gravity reduces the effectiveness of the cooling process on the face of the block facing the impinging jets. This is due to the formation of a deeper pool of water due to the effect gravity and of the curved surface of the canal. This deeper pool of water influences the boiling regime characterized by a slower bubble evacuation when compared to the scenario where the jets are opposed to gravity.

Keywords: cooling speed, gravity, homogenous cooling, jet impingement

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Authors: Soledad Carinelli, Iñigo Fernández, José Luis González-Mora, Pedro A. Salazar-Carballo

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Mastitis is the most relevant inflammatory disease in cattle, affecting the animal health and causing important economic losses on dairy farms. This disease takes place in the mammary gland or udder when some opportunistic microorganisms, such as Staphylococcus aureus, Streptococcus agalactiae, Corynebacterium bovis, etc., invade the teat canal. According to the severity of the inflammation, mastitis can be classified as sub-clinical, clinical and chronic. Standard methods for mastitis detection include counts of somatic cells, cell culture, electrical conductivity of the milk, and California test (evaluation of “gel-like” matrix consistency after cell lysed with detergents). However, these assays present some limitations for accurate detection of subclinical mastitis. Currently, haptoglobin, an acute phase protein, has been proposed as novel and effective biomarker for mastitis detection. In this work, an electrochemical biosensor based on polydopamine-modified magnetic nanoparticles (MNPs@pDA) for haptoglobin detection is reported. Thus, MNPs@pDA has been synthesized by our group and functionalized with hemoglobin due to its high affinity to haptoglobin protein. The protein was labeled with specific antibodies modified with alkaline phosphatase enzyme for its electrochemical detection using an electroactive substrate (1-naphthyl phosphate) by differential pulse voltammetry. After the optimization of assay parameters, the haptoglobin determination was evaluated in milk. The strategy presented in this work shows a wide range of detection, achieving a limit of detection of 43 ng/mL. The accuracy of the strategy was determined by recovery assays, being of 84 and 94.5% for two Hp levels around the cut off value. Milk real samples were tested and the prediction capacity of the electrochemical biosensor was compared with a Haptoglobin commercial ELISA kit. The performance of the assay has demonstrated this strategy is an excellent and real alternative as screen method for sub-clinical bovine mastitis detection.

Keywords: bovine mastitis, haptoglobin, electrochemistry, magnetic nanoparticles, polydopamine

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Authors: Sarita Magu, Deepak Singh

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Study Design: This prospective study was conducted at the department of Radio Diagnosis, at Pt B.D. Sharma PGIMS, Rohtak in 57 patients of spine injury on radiographs or radiographically normal patients with neurological deficits presenting within 72 hours of injury. Aims: Evaluation of the role of Magnetic Resonance Imaging (MRI) in Spinal Trauma Patients and to compare MRI findings with clinical profile and neurological status of the patient and to correlate the MRI findings with neurological recovery of the patient and predict the outcome. Material and Methods: Neurological status of patients was assessed at the time of admission and discharge in all the patients and at long term interval of six months to one year in 27 patients as per American spine injury association classification (ASIA). On MRI cord injury was categorized into cord hemorrhage, cord contusion, cord edema only, and normal cord. Quantitative assessment of injury on MRI was done using mean canal compromise (MCC), mean spinal cord compression (MSCC) and lesion length. Neurological status at admission and neurological recovery at discharge and long term follow up was compared with various qualitative cord findings and quantitative parameters on MRI. Results: Cord edema and normal cord was associated with favorable neurological outcome. Cord contusion show lesser neurological recovery as compared to cord edema. Cord hemorrhage was associated with worst neurological status at admission and poor neurological recovery. Mean MCC, MSCC, and lesion length values were higher in patients presenting with ASIA A grade injury and showed decreasing trends towards ASIA E grade injury. Patients showing neurological recovery over the period of hospital stay and long term follow up had lower mean MCC, MSCC, and lesion length as compared to patients showing no neurological recovery. The data was statistically significant with p value <.05. Conclusion: Cord hemorrhage and higher MCC, MSCC and lesion length has poor prognostic value in spine injury patients.

Keywords: spine injury, cord hemorrhage, cord contusion, MCC, MSCC, lesion length, ASIA grading

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Authors: Naziha Mokadem, Rainier Dennis, Ingrid Dennis

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In South Africa, Karst aquifers are receiving greater attention since they provide large supplies of water which is used for domestic and agricultural purposes as well as for industry. Accordingly, a better insight into the origin of water mineralization and the geochemical processes controlling the recharge of the aquifer is crucial. Analyses of geochemical and environmental isotopes could lead to relevant information regarding karstification and infiltration processes, groundwater chemistry and isotopy. A study was conducted in a typical karst landscape of Wonderfonteinspruit catchment, also known as Wonderfonteinspruit Valley in North-western -South Africa. Furthermore, fifty-two samples were collected from (35 boreholes, 5 surface waters, 4 Dams, 4 springs, 1 canal, 2 pipelines, 1 cave) within the study area for hydrochemistry and 2H and 18O analysis. The determination of the anions (Cl-, SO42-, NO2, NO3-) were performed using Metrohm ion chromatography, model: 761 compact IC, with a precision of ± 0.001 mg/l. While, the cations (Na+, Mg2+, K+, Ca2+) were determined using Metrohm ion chromatography, Model: ICP-MS 7500 series. The alkalinity (Alk) was determined by pH meter with volumetric titration using HCL to pH 4.5; 4.2; and 8.2. In addition, 18O and 2H relative to the Vienna-Standard Mean Ocean Water (RVSMOW), were determined by picarro L2130-I Isotopic H2O (Cavity Ringdown laser spectrometer, Picarro Ltd). The hydrochemical analysis of Wonderfonteinspruit groundwater showed a dominance of the cations Ca-Mg and the anion HCO3. Piper diagram shows that the groundwater sample of study area is characterized by four hydrochemical facies: Two main groups: (1) Ca–Mg–Cl–SO4; (2) Ca–Mg–HCO3 and two minor groups: (3) Ca–Mg–Cl; (4) Na–K–HCO3. The majority of boreholes of Malmani (Transvaal Supergroup) aquifer are plotted in Ca–Mg–HCO3.Oxygen-18 (18O‰SMOW) and deuterium (D‰SMOW) isotopic data indicate that the aquifer’s recharge is influenced by two phenomena; precipitation rates for most of the samples and river flow (Wonderfonteinspruit, Middelvieinspruit, Renfonteinspruit) for some samples.

Keywords: South Africa, Wonderfonteinspruit Valley, isotopic, hydrochemical, carbonate aquifers

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Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

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Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

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Authors: Omer Al-Kaabi, Ahmed Nasr, Abdullah Al-Ghafri, Mohammed Abdelfattah

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The Falaj system, derived from natural water sources, is a man-made canal system designed to supply communities of farmers with water for domestic and agricultural purposes. For thousands of years, Falaj has served communities by harnessing the force of gravity; it persists as a vital water management system in numerous regions across the Sultanate of Oman. Remarkably, predates the establishment of many fundamental hydraulic principles used today. Al-Khatmain Falaj, with its accessibility and historical significance spanning over 2000 years, was chosen as the focal point of this study. The research aimed to investigate the efficiency of Al-Khatmain Falaj in meeting specific water demands. The HEC-RAS model was utilized to visualize water flow dynamics within the Falaj channels, accompanied by graphical representations of pertinent variables. The application of HEC-RAS helped to measure different water flow scenarios within the channel, enabling a clear comparison with the demand area catchment. The cultivated land of Al-Khatmain is 723,124 m² and consists of 16,873 palm trees representing 91% of the total area and the remaining 9% is mixed types of trees counted 3,920 trees. The study revealed a total demand of 8,244 m³ is required to irrigate the cultivated land. Through rigorous analysis, the study has proven that the Falaj system in Al-Khatmain operates with high efficiency, as the average annual water supply is 9676.8 m3/day. Additionally, the channel designed at 0.6m width x 0.3m height efficiently holds the optimal water supply, with an average flow depth of 0.21m. Also, the system includes an overflow drainage channel to mitigate floods and prevent crop damage based on seasonal requirements. This research holds promise for examining diverse hydrological conditions and devising effective strategies to manage scenarios of both high and low flow rates.

Keywords: Al-Khatmain, sustainability, Falaj, HEC-RAS, water management system

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Authors: Nura Brimo, Dilek Cokeliler Serdaroglu, Tansel Uyar, Busra Uysal, Elif Bahar Cakici, Miris Dikmen, Zerrin Canturk

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Background: A combination of antibiotics, including metronidazole (MET), ciprofloxacin (CIP), and minocycline (MINO), has been demonstrated to disinfect bacteria in necrotic teeth before regenerative processes. It has been presented clinically that antibiotic pastes may drive to possible stem cell death and difficulties in removing from the canal system, which can limit the regenerative procedure. This study was designed to (1) synthesize nanofibrous webs containing various concentrations of different medicaments (triple, double, and calcium hydroxide,Ca(OH)2), and (2) coat thiselectrospun fibrous gutta-percha (GP) cones. Methods: Poly(vinylpyrrolidone) (PVP)-based electrospun fibrous webs were processed with low medicaments concentrations. Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Spectroscopy (EDX), and X-Ray Photoelectron Spectroscopy (XPS) were carried out to investigate fiber morphology, antibiotic incorporation, and characterized GP-coated fibrous webs, respectively. The chemical and physical properties of dentine were carried out via Fourier Transform Infrared Spectroscopy (FTIR) and Nano-SEM, respectively. The antimicrobial properties of the different fibrous webs were assessed against various bacteria by direct nanofiber/bacteria contact. Cytocompatibility was measured by applying the MTT method. Results: The mean fiber diameter of the experiment groups of medicament-containing fibers ranged in the nm scale and was significantly smaller than PVP fibers. EDX analysis confirmed the presence of medicaments in the nanofibers. XPS analysis presented a complete coating of the fibers with GPs; FTIR and Nano-SEM showed no chemical and physical configuration of intracanal medicaments on the dentine surface. Meanwhile, nanofibrous webs led to a significant reduction in the percentage of viable bacteria compared with the negative control and PVP. Conclusion: Our findings suggest that TA-NFs, DA-NFs, and Cₐ(OH)₂)-NFs coated GP cones have significant potential in eliminating intracanal bacteria, cell-friendly behavior, and clinical usage features.

Keywords: drug delivery, drug carrier, electrospinning, nano/microfibers, regenerative endodontic, morphology

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Authors: Henry Ataburo, Dominic Essuman, Emmanuel Kwabena Anin

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Recent trends of catastrophic events, such as the Covid-19 pandemic, the Suez Canal blockage, the Russia-Ukraine conflict, the Israel-Hamas conflict, and the climate change crisis, continue to devastate supply chains and the broader society. Prior authors have advocated for a simultaneous pursuit of resilience and sustainability as crucial for navigating these challenges. Nevertheless, the relationship between resilience and sustainability is a rather complex one: resilience and sustainability are considered unrelated, substitutes, or complements. Scholars also suggest that different firms prioritize resilience and sustainability differently for varied strategic reasons. However, we know little about whether, how, and when these choices produce different typologies of firms to explain differences in financial and market performance outcomes. This research draws inferences from the systems configuration approach to organizational fit to contend that a taxonomy of firms may emerge based on how firms configure resilience and environmental sustainability. The study further examines the effects of these taxonomies on financial and market performance in differing transportation disruption conditions. Resilience is operationalized as a firm’s ability to adjust current operations, structure, knowledge, and resources in response to disruptions, whereas environmental sustainability is operationalized as the extent to which a firm deploys resources judiciously and keeps the ecological impact of its operations to the barest minimum. Using primary data from 199 firms in Ghana and cluster analysis as an analytical tool, the study identifies four clusters of firms based on how they prioritize resilience and sustainability: Cluster 1 - "strong, moderate resilience, high sustainability firms," Cluster 2 - "sigh resilience, high sustainability firms," Cluster 3 - "high resilience, strong, moderate sustainability firms," and Cluster 4 - "weak, moderate resilience, strong, moderate sustainability firms". In addition, ANOVA and regression analysis revealed the following findings: Only clusters 1 and 2 were significantly associated with both market and financial performance. Under high transportation disruption conditions, cluster 1 firms excel better in market performance, whereas cluster 2 firms excel better in financial performance. Conversely, under low transportation disruption conditions, cluster 1 firms excel better in financial performance, whereas cluster 2 firms excel better in market performance. The study provides theoretical and empirical evidence of how resilience and environmental sustainability can be configured to achieve specific performance objectives under different disruption conditions.

Keywords: resilience, environmental sustainability, developing economy, transportation disruption

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Authors: Moustafa Osman Mohammed

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Integration sustainability outcomes give attention to construction ecology in the design review of urban environments to comply with Earth’s System that is composed of integral parts of the (i.e., physical, chemical and biological components). Naturally, exchange patterns of industrial ecology have consistent and periodic cycles to preserve energy flows and materials in Earth’s System. When engineering topology is affecting internal and external processes in system networks, it postulated the valence of the first-level spatial outcome (i.e., project compatibility success). These instrumentalities are dependent on relating the second-level outcome (i.e., participant security satisfaction). Construction ecology approach feedback energy from resources flows between biotic and abiotic in the entire Earth’s ecosystems. These spatial outcomes are providing an innovation, as entails a wide range of interactions to state, regulate and feedback “topology” to flow as “interdisciplinary equilibrium” of ecosystems. The interrelation dynamics of ecosystems are performing a process in a certain location within an appropriate time for characterizing their unique structure in “equilibrium patterns”, such as biosphere and collecting a composite structure of many distributed feedback flows. These interdisciplinary systems regulate their dynamics within complex structures. These dynamic mechanisms of the ecosystem regulate physical and chemical properties to enable a gradual and prolonged incremental pattern to develop a stable structure. The engineering topology of construction ecology for integration sustainability outcomes offers an interesting tool for ecologists and engineers in the simulation paradigm as an initial form of development structure within compatible computer software. This approach argues from ecology, resource savings, static load design, financial other pragmatic reasons, while an artistic/architectural perspective, these are not decisive. The paper described an attempt to unify analytic and analogical spatial modeling in developing urban environments as a relational setting, using optimization software and applied as an example of integrated industrial ecology where the construction process is based on a topology optimization approach.

Keywords: construction ecology, industrial ecology, urban topology, environmental planning

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Authors: Osama Moustafa Zayed

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Aim of the work: To evaluate the effectiveness of venous glucose, levels of serum lactate and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients. Compared to the predictive value of Trauma and injury severity (TRISS) and Acute Physiology And Chronic Health Evaluation IV (APACHE IV). Introduction: Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Trauma accounts for 5 million deaths per year. Prediction of mortality in trauma patients is an important part of trauma care. Several trauma scores have been devised to predict injury severity and risk of mortality. The trauma and injury severity score (TRISS) was most common used. Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. So we hypothesized that alterations in admission glucose, lactate levels and base deficit would be an early and easy rapid predictor of mortality. Patient and Method: a comparative cross-sectional study. 282 Polytraumatized patients attended to the Emergency Department(ED) of the Suez Canal university Hospital constituted. The period from 1/1/2012 to 1/4/2013 was included. Results: We found that the best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients is = 90, with 77% sensitivity and 89% specificity using area under the ROC curve (0.89) at (95%CI). APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar (RBS) for prediction of mortality was>140 mg/dl, with 89%, sensitivity, 49% specificity. The best cut off value of base deficit for prediction of mortality was less than -5.6 with 64% sensitivity, 93% specificity. The best cutoff point of lactate for prediction of mortality was > 2.6 mmol/L with 92%, sensitivity, 42% specificity. Conclusion: According to our results from all evaluated predictors of mortality (laboratory and scores) and mortality based on the estimated cutoff values using ROC curves analysis, the highest risk of mortality was found using a cutoff value of 90 in TRISS score while with laboratory parameters the highest risk of mortality was with serum lactate > 2.6 . Although that all of the three parameter are accurate in predicting mortality in poly-traumatized patients and near with each other, as in serum lactate the area under the curve 0.82, in BD 0.79 and 0.77 in RBS.

Keywords: APACHE IV, emergency department, polytraumatized patients, serum lactate

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Authors: Wei Ting Han, Shiann-Far Kung

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In the early time, most of the arable land is dry farming and using rainfall as water sources for irrigation in Tainan county. After the Chia-nan Irrigation System (CIS) was completed in 1930, Chia-nan Plain was more efficient allocation of limited water sources or irrigation, because of the benefit from irrigation systems, drainage systems, and land improvement projects. The problem of long-term drought, flood and salt damage in the past were also improved by CIS. The canal greatly improved the paddy field area and agricultural output, Tainan county has become one of the important agricultural producing areas in Taiwan. With the development of water conservancy facilities, affected by national policies and other factors, many agricultural communities and settlements are formed indirectly, also promoted the change of settlement patterns and internal structures. With the development of historical geographic information system (HGIS), Academia Sinica developed the WebGIS theme with the century old maps of Taiwan which is the most complete historical map of database in Taiwan. It can be used to overlay historical figures of different periods, present the timeline of the settlement change, also grasp the changes in the natural environment or social sciences and humanities, and the changes in the settlements presented by the visualized areas. This study will explore the historical development and spatial characteristics of the settlements in various areas of Tainan County. Using of large-scale areas to explore the settlement changes and spatial patterns of the entire county, through the dynamic time and space evolution from Japanese rule to the present day. Then, digitizing the settlement of different periods to perform overlay analysis by using Taiwan historical topographic maps in 1904, 1921, 1956 and 1989. Moreover, using document analysis to analyze the temporal and spatial changes of regional environment and settlement structure. In addition, the comparison analysis method is used to classify the spatial characteristics and differences between the settlements. Exploring the influence of external environments in different time and space backgrounds, such as government policies, major construction, and industrial development. This paper helps to understand the evolution of the settlement space and the internal structural changes in Tainan County.

Keywords: historical geographic information system, overlay analysis, settlement change, Tainan County

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Authors: Antoine Villa, Moustapha Mohamedou, Florence Pilliere, Catherine Verdun-Esquer, Mathieu Molimard, Mohamed Sidatt Cheikh El Moustaph, Mireille Canal-Raffin

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Context: In Mauritania, the activity of the National Center of Oncology (NCO) has steadily risen leading to an increase in the handling of antineoplastic drugs (AD) by healthcare professionals. In this context, the AD contamination of those professionals is a major concern for occupational physicians. It has been evaluated using biological monitoring of occupational exposure (BMOE). Methods: The intervention took place in 2015, in 2 care units, and evaluated nurses preparing and/or infusing AD and agents in charge of hygiene. Participants provided a single urine sample, at the end of the week, at the end of their shift. Five molecules were sought using specific high sensitivity methods (UHPLC-MS/MS) with very low limits of quantification (LOQ) (cyclophosphamide (CP), Ifosfamide (IF), methotrexate (MTX): 2.5ng/L; doxorubicin (Doxo): 10ng/L; α-fluoro-β-alanine (FBAL, 5-FU metabolite): 20ng/L). A healthcare worker was considered as 'contaminated' when an AD was detected at a urine concentration equal to or greater than the LOQ of the analytical method or at trace concentration. Results: Twelve persons participated (6 nurses, 6 agents in charge of hygiene). Twelve urine samples were collected and analyzed. The percentage of contamination was 66.6% for all participants (n=8/12), 100% for nurses (6/6) and 33% for agents in charge of hygiene (2/6). In 62.5% (n=5/8) of the contaminated workers, two to four of the AD were detected in the urine. CP was found in the urine of all contaminated workers. FBAL was found in four, MTX in three and Doxo in one. Only IF was not detected. Urinary concentrations (all drugs combined) ranged from 3 to 844 ng/L for nurses and from 3 to 44 ng/L for agents in charge of hygiene. The median urinary concentrations were 87 ng/L, 15.1 ng/L and 4.4 ng/L for FBAL, CP and MTX, respectively. The Doxo urinary concentration was found 218ng/L. Discussion: There is no current biological exposure index for the interpretation of AD contamination. The contamination of these healthcare professionals is therefore established by the detection of one or more AD in urine. These urinary contaminations are higher than the LOQ of the analytical methods, which must be as low as possible. Given the danger of AD, the implementation of corrective measures is essential for the staff. Biological monitoring of occupational exposure is the most reliable process to identify groups at risk, tracing insufficiently controlled exposures and as an alarm signal. These results show the necessity to educate professionals about the risks of handling AD and/or to care for treated patients.

Keywords: antineoplastic drugs, Mauritania, biological monitoring of occupational exposure, contamination

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Authors: Arpit Gite

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Purpose: We have evaluated the role of Total Neoadjuvant Therapy in patients with Locally Advanced Rectal cancer by giving Chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and, after that, the strategy of wait and watch. Methods: In this prospective case series, we evaluated the results of three locally advanced Rectal cancers, two cases Stage II (cT3N0) and one case Stage III ( cT4aN2). All three patients' growth was 4-6 cm from the anal verge. We have treated with Chemoradiotherapy to dose of 45Gy/25 Fractions to elective nodal regions (Inguinal node in anal canal Involvement)and Primary and mesorectum (Phase I) followed by 14.4Gy/8 Fractions to Primary and Mesorectum(Phase II) to a total dose of 59.4Gy/33 Fractions with concurrent chemotherapy Tab Capecitabine 825mg/m2 PO BD with Radiation therapy. After 6 weeks of completion of Chemoradiotherapy, advised six cycles of consolidative chemotherapy, CAPEOX regimen, Oxaliplatin 130mg/m2 on day 1 and Capecitabine 1000mg/m2 PO BD on days 1-14 repeated on a 21-day cycle for a total of six cycles. The primary endpoint is Disease-free survival (DFS); the secondary endpoint is adverse events related to chemoradiotherapy. Radiation toxicity is assessed by RTOG criteria, and chemotherapy toxicity is assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Results: After 6 weeks of completion of Chemoradiotherapy, we did PET-CT of all three patients; all three patients had a clinically complete response and we advised 6 cycles of consolidative chemotherapy. After completion of consolidative chemotherapy, again PET-CT and sigmoidoscopy, all three patients had complete response on PET-CT and no lesions on sigmoidoscopy and kept all three patients on wait and watch.2 patients had Grade 2 skin toxicities,1 patient had Grade 1 skin toxicity, .2 patients had Grade 2 lower GI toxicities, and 1 patient had Grade lower GI toxicity, both according to RTOG criteria. 3 patients had Grade 2 diarrhea due to capecitabine, and 1 patient had Grade 1 thrombocytopenia due to oxaliplatin assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Conclusion: Sphincter Preservation is possible with this regimen in those who don’t want to opt for surgery or in case of low-lying rectal cancer.

Keywords: locally advanced rectal cancer, sphincter preservation, chemoradiotherapy, consolidative chemotherapy

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Authors: Zeena Dcosta, Junaid Ahmed, Ceena Denny, Nandita Shenoy

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In the field of dentistry, there are many conditions which warrant the requirement of three-dimensional imaging that can aid in diagnosis and therapeutic management. Cone beam computed tomography (CBCT) is considered highly accurate in producing a three-dimensional image of an object and provides a complete insight of various findings in the captured volume. But, most of the clinicians focus primarily on the teeth and jaws and numerous unanticipated clinically significant incidental findings may be missed out. Rapid integration of CBCT into the practice of dentistry has led to the detection of various incidental findings. However, the prevalence of these incidental findings is still unknown. Thus, the study aimed to discern the reason for referral and to identify incidental findings on the referred CBCT scans. Patient’s demographic data such as age and gender was noted. CBCT scans of multiple fields of views (FOV) were considered. The referral for CBCT scans was broadly classified into two major categories: diagnostic scan and treatment planning scan. Any finding on the CBCT volumes, other than the area of concern was recorded as incidental finding which was noted under airway, developmental, pathological, endodontics, TMJ, bone, soft tissue calcifications and others. Few of the incidental findings noted under airway were deviated nasal septum, nasal turbinate hypertrophy, mucosal thickening and pneumatization of sinus. Developmental incidental findings included dilaceration, impaction, pulp stone and gubernacular canal. Resorption of teeth and periapical pathologies were noted under pathological incidental findings. Root fracture along with over and under obturation was noted under endodontics. Incidental findings under TMJ were flattening, erosion and bifid condyle. Enostosis and exostosis were noted under bone lesions. Tonsillolth, sialolith and calcified styloid ligament were noted under soft tissue calcifications. Incidental findings under others included foreign body, fused C1- C2 vertebrae, nutrient canals, and pneumatocyst. Maxillofacial radiologists should be aware of possible incidental findings and should be vigilant about comprehensively evaluating the entire captured volume, which can help in early diagnosis of any potential pathologies that may go undetected. Interpretation of CBCT is truly an art and with the experience, we can unravel the secrets hidden in the grey shades of the radiographic image.

Keywords: cone beam computed tomography, incidental findings, maxillofacial region, radiologist

Procedia PDF Downloads 209

Authors: E. K. K. Agyeman, P. Mousseau, A. Sarda, D. Edelin

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During the cooling of hot metals by the circulation of water in canals formed by boring holes in the metal, the rapid phase change of the water due to the high initial temperature of the metal leads to a non homogenous distribution of the phases within the canals. The liquid phase dominates towards the entrance of the canal while the gaseous phase dominates towards the exit. As a result of the different thermal properties of both phases, the metal is not uniformly cooled. This poses a problem during the cooling of moulds, where a uniform temperature distribution is needed in order to ensure the integrity of the part being formed. In this study, the simultaneous use of multiple water jets and an airflow for the uniform and controlled cooling of a steel block is investigated. A circular hole is bored at the centre of the steel block along its length and a perforated steel pipe is inserted along the central axis of the hole. Water jets that impact the internal surface of the steel block are generated from the perforations in the steel pipe when the water within it is put under pressure. These jets are oriented in the opposite direction to that of gravity. An intermittent airflow is imposed in the annular space between the steel pipe and the surface of hole bored in the steel block. The evolution of the temperature with respect to time of the external surface of the block is measured with the help of thermocouples and an infrared camera. Due to the high initial temperature of the steel block (350 °C), the water changes phase when it impacts the internal surface of the block. This leads to high heat fluxes. The strategy used to control the cooling speed of the block is the intermittent impingement of its internal surface by the jets. The intervals of impingement and of non impingement are varied in order to achieve the desired result. An airflow is used during the non impingement periods as an additional regulator of the cooling speed and to improve the temperature homogeneity of the impinged surface. After testing different jet positions, jet speeds and impingement intervals, it’s observed that the external surface of the steel block has a uniform temperature distribution along its length. However, the temperature distribution along its width isn’t uniform with the maximum temperature difference being between the centre of the block and its edge. Changing the positions of the jets has no significant effect on the temperature distribution on the external surface of the steel block. It’s also observed that reducing the jet impingement interval and increasing the non impingement interval slows down the cooling of the block and improves upon the temperature homogeneity of its external surface while increasing the duration of jet impingement speeds up the cooling process.

Keywords: cooling speed, homogenous cooling, jet impingement, phase change

Procedia PDF Downloads 125

Authors: Abel Mahowe

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Furrow erosion is the major problem menacing sustainability of irrigation in Malawi and polluting water bodies resulting in death of many aquatic animals. Many rivers in Malawi are drying due to some poor practices that are being practiced around these water bodies, furrow erosion is one of the cause of sedimentation in these rivers although it has gradual effect on deteriorating of these rivers hence neglected, but has got long term disastrous effect on water bodies. Many aquatic animals also suffer when these sediments are taken into these water bodies. An assessment of effect of manure treatment on furrow erosion was carried out in Sagawika irrigation scheme located in Kasungu District north part of Malawi. The soil on the field was clay loam and had just been tilled. The average furrow slope of 0.2% and was divided into two blocks, A and B. Each block had 20V-shaped furrow having a length of 10 m. Three different manure were used to construct these furrows by mixing it with soil which was moderately moist and 5 furrows from each block were constructed without manure. In each block 5furrow were made using a specific type of manure, and one set of five furrows in each block was made without manure treatment. The types of manure that were used were goat manure, pig manure, and manure from crop residuals. The manure application late was 5 kg/m. The furrow was constructed at a spacing of 0.6 m. Tomato was planted in the two blocks at spacing of 0.15 m between rows and 0.15 m between planting stations. Irrigation water was led from feeder canal into the irrigation furrows using siphons. The siphons discharge into each furrow was set at 1.86 L/S. The ¾ rule was used to determine the cut-off time for the irrigation cycles in order to reduce the run-off at the tail end. During each irrigation cycle, samples of the runoff water were collected at one-minute intervals and analyzed for total sediment concentration for use in estimating the total soil sediment loss. The results of the study have shown that a significant amount of soil is lost in soils without many organic matters, there was a low level of erosion in furrows that were constructed using manure treatment within the blocks. In addition, the results have shown that manure also differs in their ability to control erosion since pig manure proved to have greater abilities in binding the soil together than other manure since they were reduction in the amount of sediments at the tail end of furrows constructed by this type of manure. The results prove that manure contains organic matters which helps soil particles to bind together hence resisting the erosive force of water. The use of manure when constructing furrows in soil with less organic matter can highly reduce erosion hence reducing also pollution of water bodies and improve the conditions of aquatic animals.

Keywords: aquatic, erosion, furrow, soil

Procedia PDF Downloads 286

Authors: Natalia Uribe Corrales, María Fernanda Benavides Erazo, Santiago Henao Villegas

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Introduction: Transport is a crucial link in the porcine chain because it is considered a stressful event in the animal, due to it is a new environment, which generates new interactions, together with factors such as speed, noise, temperature changes, vibrations, deprivation of food and water. Therefore, inadequate handling at this stage can lead to bruises, musculoskeletal injuries, fatigue, and mortality, resulting in canal seizures and economic losses. Objective: To characterize the transport and driving practices for the mobilization of standing pigs directed to slaughter plants in the Valle de Aburrá, Antioquia, Colombia in 2017. Methods: A descriptive cross-sectional study was carried out with the transporters arriving at the slaughterhouses approved by National Institute for Food and Medicine Surveillance (INVIMA) during 2017 in the Valle de Aburrá. The process of obtaining the samples was made from probabilistic sampling. Variables such as journey time, mechanical technical certificate, training in animal welfare, driving speed, material, and condition of floors and separators, supervision of animals during the trip, load density and mortality were analyzed. It was approved by the ethics committee for the use and care of animals CICUA of CES University, Act number 14 of 2015. Results: 190 trucks were analyzed, finding that 12.4% did not have updated mechanical technical certificate; the transporters experience in pig’s transportation was an average of 9.4 years (d.e.7.5). The 85.8% reported not having received training in animal welfare. Other results were that the average speed was 63.04km/hr (d.e 13.46) and the 62% had floors in good condition; nevertheless, the 48% had bad conditions on separators. On the other hand, the 88% did not supervise their animals during the journey, although the 62.2% had an adequate loading density, in relation to the average mortality was 0.2 deaths/travel (d.e. 0.5). Conclusions: Trainers should be encouraged on issues such as proper maintenance of vehicles, animal welfare, obligatory review of animals during mobilization and speed of driving, as these poorly managed indicators generate stress in animals, increasing generation of injuries as well as possible accidents; also, it is necessary to continue to improve aspects such as aluminum floors and separators that favor easy cleaning and maintenance, as well as the appropriate handling in the density of load that generates animal welfare.

Keywords: animal welfare, driving practices, pigs, truck infrastructure

Procedia PDF Downloads 208

Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

Procedia PDF Downloads 101

Authors: Robnier Reyes, Andrew J. P. Marques, Joel Ramjist, Chris R. Pasarikovski, Victor X. D. Yang

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Over the past three decades, surgical robotic systems have demonstrated their ability to improve surgical outcomes. The LBR Med is a collaborative robotic arm that is meant to work with a surgeon to streamline surgical workflow. It has 7 degrees of freedom and thus can be easily oriented. Position and torque sensors at each joint allow it to maintain a position accuracy of 150 µm with real-time force and torque feedback, making it ideal for complex surgical procedures. Spinal fusion procedures involve the placement of as many as 20 pedicle screws, requiring a great deal of accuracy due to proximity to the spinal canal and surrounding vessels. Any deviation from intended path can lead to major surgical complications. Assistive surgical robotic systems are meant to serve as collaborative devices easing the workload of the surgeon, thereby improving pedicle screw placement by mitigating fatigue related inaccuracies. Moreover, robotic spinal systems have shown marked improvements over conventional freehanded techniques in both screw placement accuracy and fusion quality and have greatly reduced the need for screw revision, intraoperatively and post-operatively. However, current assistive spinal fusion robots, such as the ROSA Spine, are limited in functionality to positioning surgical instruments. While they offer a small degree of improvement in pedicle screw placement accuracy, they do not alleviate surgeon fatigue, nor do they provide real-time force and torque feedback during screw insertion. We propose a semi-autonomous surgical robot workflow for spinal fusion where the surgeon guides the robot to its initial position and orientation, and the robot drives the pedicle screw accurately into the vertebra. Here, we demonstrate feasibility by inserting pedicle screws into ex-vivo bovine rib bone. The robot monitors position, force and torque with respect to predefined values selected by the surgeon to ensure the highest possible spinal fusion quality. The workflow alleviates the strain on the surgeon by having the robot perform the screw placement while the ability to monitor the process in real-time keeps the surgeon in the system loop. The approach we have taken in terms of level autonomy for the robot reflects its ability to safely collaborate with the surgeon in the operating room without external navigation systems.

Keywords: ex vivo bovine bone, pedicle screw, surgical robot, surgical workflow

Procedia PDF Downloads 168

Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

Procedia PDF Downloads 84

Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

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Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

Procedia PDF Downloads 90

Authors: M. Keršič, M. Lužnik, J. Lužnik

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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

Procedia PDF Downloads 190

Authors: Mohamed Ahmed Abdelmawla

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Calling to achieve Millennium Development Goals (MDGs) engaged with agriculture, i.e. poverty alleviation targets, human resources involved in agricultural sectors with special emphasis on irrigation must receive wealth of practical experience and training. Increased food production, including staple food, is needed to overcome the present and future threats to food security. This should happen within a framework of sustainable management of natural resources, elimination of unsustainable methods of production and poverty reduction (i.e. axes of modernization). A didactic tool to confirm the task of wise and maximum utility is the best management and accurate measurement, as major requisites for modernization process. The key component to modernization as a warranted goal is adhering great attention to management and measurement issues via capacity building. As such, this paper stressed the issues of discharge management and measurement by Field Outlet Pipes (FOP) for selected ones within the Gezira Scheme, where randomly nine FOPs were selected as representative locations. These FOPs extended along the Gezira Main Canal at Kilo 57 areas in the South up to Kilo 194 in the North. The following steps were followed during the field data collection and measurements: For each selected FOP, a 90 v- notch thin plate weir was placed in such away that the water was directed to pass only through the notch. An optical survey level was used to measure the water head of the notch and FOP. Both calculated discharge rates as measured by the v – notch, denoted as [Qc], and the adopted discharges given by (MOIWR), denoted as [Qa], are tackled for the average of three replicated readings undertaken at each location. The study revealed that the FOP overestimates and sometimes underestimates the discharges. This is attributed to the fact that the original design specifications were not fulfilled or met at present conditions where water is allowed to flow day and night with high head fluctuation, knowing that the FOP is non modular structure, i.e. the flow depends on both levels upstream and downstream and confirmed by the results of this study. It is convenient and formative to quantify the discharge in FOP with weirs or Parshall flumes. Cropping calendar should be clearly determined and agreed upon before the beginning of the season in accordance and consistency with the Sudan Gezira Board (SGB) and Ministry of Irrigation and Water Resources. As such, the water indenting should be based on actual Crop Water Requirements (CWRs), not on rules of thumb (420 m3/feddan, irrespective of crop or time of season).

Keywords: management, measurement, MDGs, modernization

Procedia PDF Downloads 251

Authors: Benoit Atge, Alice Dhersin, Oscar Da Silva Cacao, Beatrice Martinez, Dominique Ducint, Catherine Verdun-Esquer, Isabelle Baldi, Mathieu Molimard, Antoine Villa, Mireille Canal-Raffin

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Introduction: Healthcare workers' exposure to antineoplastic drugs (AD) is a burning issue for occupational medicine practitioners. Biological monitoring of occupational exposure (BMOE) is an essential tool for assessing AD contamination of healthcare workers. In addition to BMOE, surface sampling is a useful tool in order to understand how workers get contaminated, to identify sources of environmental contamination, to verify the effectiveness of surface decontamination way and to ensure monitoring of these surfaces. The objective of this work was to develop a complete tool including a kit for surface sampling and a quantification analytical method for AD traces detection. The development was realized with the three following criteria: the kit capacity to sample in every professional environment (healthcare services, veterinaries, etc.), the detection of very low AD traces with a validated analytical method and the easiness of the sampling kit use regardless of the person in charge of sampling. Material and method: AD mostly used in term of quantity and frequency have been identified by an analysis of the literature and consumptions of different hospitals, veterinary services, and home care settings. The kind of adsorbent device, surface moistening solution and mix of solvents for the extraction of AD from the adsorbent device have been tested for a maximal yield. The AD quantification was achieved by an ultra high-performance liquid chromatography method coupled with tandem mass spectrometry (UHPLC-MS/MS). Results: With their high frequencies of use and their good reflect of the diverse activities through healthcare, 15 AD (cyclophosphamide, ifosfamide, doxorubicin, daunorubicin, epirubicin, 5-FU, dacarbazin, etoposide, pemetrexed, vincristine, cytarabine, methothrexate, paclitaxel, gemcitabine, mitomycin C) were selected. The analytical method was optimized and adapted to obtain high sensitivity with very low limits of quantification (25 to 5000ng/mL), equivalent or lowest that those previously published (for 13/15 AD). The sampling kit is easy to use, provided with a didactic support (online video and protocol paper). It showed its effectiveness without inter-individual variation (n=5/person; n= 5 persons; p=0,85; ANOVA) regardless of the person in charge of sampling. Conclusion: This validated tool (sampling kit + analytical method) is very sensitive, easy to use and very didactic in order to control the chemical risk brought by AD. Moreover, BMOE permits a focal prevention. Used in routine, this tool is available for every intervention of occupational health.

Keywords: surface contamination, sampling kit, analytical method, sensitivity

Procedia PDF Downloads 132

Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

Procedia PDF Downloads 60

Authors: Mohamed Elkashouty, Mohamed Yehia, Ahmed Tawfuk

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The study area is located in the southern part of Giza Governorate at both side of the Nile Valley. A combination of major and trace elements have been used to classify surface- and ground-waters in El Kurimat village, Egypt. The main purpose of the project is to investigate the surface-and ground-waters quality and hydrochemical evaluation. The situation is further complicated by contamination with lithogenic and anthropogenic (agricultural and sewage wastewaters) sources and low groundwater management strategies. The Quaternary aquifer consists of sands and gravels of Pleistocene age intercalated with clay lenses and overlain by silty clay aquitard (Holocene). The semi-pervious silty clay aquitard of the Holocene Nile sediments cover the Quaternary aquifer in most areas. The groundwater flows generally from southwest to northeast. To achieve this target, thirty five and seventy three samples were collected from surface– and ground-waters within summer and winter seasons 2009-2010). Total dissolved solids (TDS), cations, anions, NO2, NO3, PO4 , Al, Ba, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn, As, F, Sb, Se, Sn, Sr and V) were determined in water samples. Grain size analysis was achieved to eight soil samples and measured the organic matter percent in different fractions. The TDS concentration is high in Arab El Ein canal by lithogenic and anthropogenic sources. The average concentrations of TDS in the River Nile are 245 (summer) and 254 ppm (winter). NO3 content ranges from 1.7 to 12 mg/l (summer), while in winter it ranges from 0.4 to 2.4. Most of the toxic metal concentrations are below the drinking and irrigation guidelines except Mn, V, Cr, Al, and Fe, which are higher than the guidelines in some canals and drains. The TDS concentration in groundwater increases toward northeastern and northwestern part of the study area (i.e. toward limestone plateau). It is due to hydrogeological interconnection between Quaternary and Eocene aquifer (saline water), wastewater dump and recharge from wadi El Atfihi wastewater. There is a good match between the hydrogeology and the hydrogeochemistry. Total dissolved solid in groundwater increases toward southwestern part, may be due to hydrogeological interconnection between Quaternary and Eocene aquifer and leakage from agricultural waste water of El Mohut drain. Fe, Mn, Cr, Al, PO4 and NO3 concentrations are high due to anthropogenic sources, therefore they are unsuitable for drinking. The average concentration of Cr, Cu, Fe, Mn &Zn are higher in winter than those in summer due to winter drought. The organic matter content in soil are increases in the northeastern and southwestern part, with different fractions, sue to agricultural wastewaters. Reused of contaminated surface- and ground-waters samples by mixing with fresh water (By AquaChem) was estimated to increase the income per capita.

Keywords: surface water, groundwater, major ions, toxic metals

Procedia PDF Downloads 293

Authors: María Canal-Rodríguez, María Arnaiz, Natalia Rey-Raap, Ana Arenillas, Jon Ajuria

Abstract:

The constant demand of electrical energy, as well as the increase in environmental concern, lead to the necessity of investing in clean and eco-friendly energy sources that implies the development of enhanced energy storage devices. Li-ion batteries (LIBs) and Electrical double layer capacitors (EDLCs) are the most widespread energy systems. Batteries are able to storage high energy densities contrary to capacitors, which main strength is the high-power density supply and the long cycle life. The combination of both technologies gave rise to Li-ion capacitors (LICs), which offers all these advantages in a single device. This is achieved combining a capacitive, supercapacitor-like positive electrode with a faradaic, battery-like negative electrode. Due to the abundance and affordability, dual carbon-based LICs are nowadays the common technology. Normally, an Active Carbon (AC) is used as the EDLC like electrode, while graphite is the material commonly employed as anode. LICs are potential systems to be used in applications in which high energy and power densities are required, such us kinetic energy recovery systems. Although these devices are already in the market, some drawbacks like the limited power delivered by graphite or the energy limiting nature of AC must be solved to trigger their used. Focusing on the anode, one possibility could be to replace graphite with Hard Carbon (HC). The better rate capability of the latter increases the power performance of the device. Moreover, the disordered carbonaceous structure of HCs enables storage twice the theoretical capacity of graphite. With respect to the cathode, the ACs are characterized for their high volume of micropores, in which the charge is storage. Nevertheless, they normally do not show mesoporous, which are really important mainly at high C-rates as they act as transport channels for the ions to reach the micropores. Usually, the porosity of ACs cannot be tailored, as it strongly depends on the precursor employed to get the final carbon. Moreover, they are not characterized for having a high electrical conductivity, which is an important characteristic to get a good performance in energy storage applications. A possible candidate to substitute ACs are carbon aerogels (CAs). CAs are materials that combine a high porosity with great electrical conductivity, opposite characteristics in carbon materials. Furthermore, its porous properties can be tailored quite accurately according to with the requirements of the application. In the present study, CAs with controlled porosity were obtained from polymerization of resorcinol and formaldehyde by microwave heating. Varying the synthesis conditions, mainly the amount of precursors and pH of the precursor solution, carbons with different textural properties were obtained. The way the porous characteristics affect the performance of the cathode was studied by means of a half-cell configuration. The material with the best performance was evaluated as cathode in a LIC versus a hard carbon as anode. An analogous full LIC made by a high microporous commercial cathode was also assembled for comparison purposes.

Keywords: li-ion capacitors, energy storage, tailored porosity, carbon aerogels

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