Search results for: elective cesarean section

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

Procedia PDF Downloads 69

Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

Procedia PDF Downloads 68

Authors: Masoud Mahdavi

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During an earthquake, the structure is subjected to seismic loads that cause tension in the members of the building. The use of energy dissipation elements in the structure reduces the percentage of seismic forces on the main members of the building (especially the columns). Steel plate shear wall, as one of the most widely used types of energy dissipation element, has evolved today, and regular drilling of its inner plate is one of the common cases. In the present study, using a finite element method, the shear wall of the steel plate is designed as a floor (with dimensions of 447 × 6/246 cm) with Abacus software and in three different modes on which a cyclic load has been applied. The steel shear wall has a horizontal element (beam) with a reduced beam section (RBS). The hole in the interior plate of the models is created in such a way that it has the process of increasing the area, which makes the effect of increasing the surface area of the hole on the seismic performance of the steel shear wall completely clear. In the end, it was found that with increasing the opening level in the steel shear wall (with reduced cross-section beam), total displacement and plastic strain indicators increased, structural capacity and total energy indicators decreased and the Mises Monson stress index did not change much.

Keywords: steel plate shear wall with opening, cyclic loading, reduced cross-section beam, finite element method, Abaqus software

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Authors: Jizhi Zhao, Qiliang Zhou, Muxuan Tao

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The calculation of the ultimate loading capacity of composite frame beams is an important step in the design of composite frame structural systems. Currently, the plastic limit theory is mainly used for this calculation in the codes adopted by many countries; however, the effective slab width recommended in most codes is based on the elastic theory, which does not accurately reflect the complex stress mechanism at the beam-column joints in the ultimate loading state. Therefore, the authors’ research group put forward the Compression-on-Column-Face mechanism and Tension-on-Transverse-Beam mechanism to explain the mechanism in the ultimate loading state. Formulae are derived for calculating the effective slab width in composite frames with rectangular/square-section columns under ultimate lateral loading. Moreover, this paper discusses the calculation method of the effective slab width for the beam-end flexural strength of composite frames with circular-section columns. The proposed design formula is suitable for exterior and interior joints. Finally, this paper compares the proposed formulae with available formulae in other literature, current design codes, and experimental results, providing the most accurate results to predict the effective slab width and ultimate loading capacity.

Keywords: composite frame structure, effective slab width, circular-section column, design formulae, ultimate loading capacity

Procedia PDF Downloads 111

Authors: A. Pesin, D. Pustovoytov, A. Kolesnik, M. Sverdlik

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Rolling disturbances often arise which might lead to defects such as nonflatness, warpage, corrugation, etc. Numerous methods of compensation for such disturbances are well known. However, most of them preserve the initial form of transverse flow of the strip, such as convex, concave or asymmetric (for example, sphenoid). Sometimes, the form inherited (especially asymmetric) is undesirable. Technical solutions have been developed which include providing conditions for transverse metal flow in deformation zone. It should be noted that greater reduction is followed by transverse flow increase, while less reduction causes a corresponding decrease in metal flow for differently deformed metal lengths to remain approximately the same and in order to avoid the defects mentioned above. One of the solutions suggests sequential strip deforming from rectangular cross-section profile with periodical rectangular grooves back into rectangular profile again. The work was carried out in DEFORM 3D program complex. Experimental rolling was performed on laboratory mill 150. Comparison of experimental and theoretical results demonstrated good correlation.

Keywords: FEM, cross-section deformation, mechanical engineering, applied mechanics

Procedia PDF Downloads 336

Authors: Yasar Pala, Safa Senaysoy, Emre Calis

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In this paper, structural behavior and improvement of buckling behavior of cold formed steel uprights with open cross-section used storage rack system are studied. As a first step, in the case of a stiffener having an inclined part on the flange, experimental and nonlinear finite element analysis are carried out for three different upright lengths. In the uprights with long length, global buckling is observed while distortional buckling and local buckling are observed in the uprights with medium length and those with short length, respectively. After this point, the study is divided into two groups. One of these groups is the case where the stiffener on the flange is folded at 90°. For this case, four different distances of the stiffener from the web are taken into account. In the other group, the case where different depth of stiffener on the web is considered. Combining experimental and finite element results, the cross-section giving the ultimate critical buckling load is selected.

Keywords: steel, upright, buckling, modes, nonlinear finite element analysis, optimization

Procedia PDF Downloads 245

Authors: Cau Tran, Tu Nguyen, Tien Pham

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Model-based design (MBD) is a mathematical and visual technique for addressing design issues in the fields of communications, signal processing, and complicated control systems. It is utilized in several automotive, aerospace, industrial, and motion control applications. Virtual models are at the center of the software development process with model based design. A method used in the creation of embedded software is model-based design. In this study, the LAT motor is modeled in a simulation environment, and the LAT motor control is designed with a cascade structure, a speed and current control loop, and a controller that is used in the next part. A PID structure serves as this controller. Based on techniques and motor parameters that match the design goals, the PID controller is created for the model using traditional design principles. The MBD approach will be used to build embedded software for motor control. The paper will be divided into three distinct sections. The first section will introduce the design process and the benefits and drawbacks of the MBD technique. The design of control software for LAT motors will be the main topic of the next section. The experiment's results are the subject of the last section.

Keywords: model based design, limited angle torque, intellectual property core, hardware description language, controller area network, user datagram protocol

Procedia PDF Downloads 85

Authors: Ho Young Kim, Jae Hoon Lee, Do Kyu Hwang, Im Jong Kwahk, Tae Hoon Kim, Seung Hoon Lee

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Hollow section for bridge columns has some advantages. However, current seismic design codes do not provide design regulations for hollow bridge piers. There have been many experimental studied for hollow reinforced concrete piers in the world. But, Study for hollow section for bridge piers in Korea has been begun with approximately 2000s. There has been conducted experimental study for hollow piers of flexural controlled sections by Yeungnam University, Sung kyunkwan University, Korea Expressway Corporation in 2009. This study concluded that flexural controlled sections for hollow piers showed the similar behavior to solid sections. And there have been conducted experimental study for hollow piers of compression controlled sections by Yeungnam University, Korea Institute of Construction Technology in 2012. This study concluded that compression controlled sections for hollow piers showed compression fracture of concrete in inside wall face. Samsung C&T Engineering & Construction Group has been conducted study with Yeungnam University for reduce the quantity of reinforcement details about hollow piers. Reduce the quantity of reinforcement details are triangular cross tie. This study concluded that triangular reinforcement details showed the similar behavior as compared with existing reinforcement details.

Keywords: hollow pier, flexural controlled section, compression controlled section, reduce the quantity of reinforcement, details

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Authors: Pedro Gómez-del-Hoyo, Jose-Luis Bárcena-Humanes, Nerea del-Rey-Maestre, María-Pilar Jarabo-Amores, David Mata-Moya

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A study of achievable coverages using passive radar systems in terrestrial traffic monitoring applications is presented. The study includes the estimation of the bistatic radar cross section of different commercial vehicle models that provide challenging low values which make detection really difficult. A semi-urban scenario is selected to evaluate the impact of excess propagation losses generated by an irregular relief. A bistatic passive radar exploiting UHF frequencies radiated by digital video broadcasting transmitters is assumed. A general method of coverage estimation using electromagnetic simulators in combination with estimated car average bistatic radar cross section is applied. In order to reduce the computational cost, hybrid solution is implemented, assuming free space for the target-receiver path but estimating the excess propagation losses for the transmitter-target one.

Keywords: bistatic radar cross section, passive radar, propagation losses, radar coverage

Procedia PDF Downloads 317

Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

Procedia PDF Downloads 107

Authors: Attiq Ur Rahman Dogar, Sohaib Ishaq

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Pakistan had experienced rapid motorization in the last decade. Due to the soft leasing schemes of banks and increase in average household income, even the middle class can now afford cars. The public transit system is inadequate and sparse. Due to these reasons, traffic demand on urban arterials has increased manifold. Poor urban transit planning and aging transportation systems have resulted in traffic congestion. The focus of this study is to improve traffic flow on a section of N-5 passing through the Rawalpindi downtown. Present efforts aim to carry out the analysis of traffic conditions on this section and to investigate the impact of traffic signal co-ordination on travel time. In addition to signal co-ordination, we also examined the effect of different infrastructure improvements on the travel time. After the economic analysis of alternatives and discussions, the improvement plan for Rawalpindi downtown urban arterial section is proposed for implementation.

Keywords: signal coordination, infrastructure intervention, infrastructure improvement, cycle length, fuel consumption cost, travel time cost, economic analysis, travel time, Rawalpindi, Pakistan, traffic signals

Procedia PDF Downloads 302

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: Cem Çindaş, Serkan Şimşek

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In this paper, the study and design of a 3-dB 90° directional coupler operating in the S-band is proposed. The coupler employs symmetrical multi-section coupled lines designed in a stripline technique. Design is realized in AWR Design Environment and CST Microwave Studio. Using these two programs played a key role in attaining outcomes swiftly and precisely. The simulation results show that the coupler maintains amplitude consistency within ± 0.3 dB, isolation and reflection losses better than 16 dB, and phase difference between two output ports of 88º±0.6˚ in the 1.7 – 4.35 GHz range. This simulation results indicate an improvement is achieved in fractional bandwidth (FBW) performance around the center frequency of f0 = 3 GHz.

Keywords: coupled stripline, directional coupler, multi-section coupler, symmetrical coupler

Procedia PDF Downloads 54

Authors: Moizza Tahir, Uzma Bashir, Aisha Akhtar, Zainab Ansari, Sameen Ansari, Muhammad Ali Tahir

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Cancer burden has globally increased. Among cutaneous cancers basal cell carcinoma constitute vast majority of skin cancer. There is need for appropriate diagnostic, therapeutic and prognostic significance evaluation for skin cancers Present study report intraoperative frozen section (FS) histopathological clearance for excision of BCC in a tertiary care center and find the frequency of involvement of surgical margin with reference to anatomical site, with size and surgical technique. It was prospective open label interventional study conducted at Dermatology department of tertiary care hospital Rawalpindi Pakistan in lais on with histopathology department from January 2023 to April 2024. Total of thirty-six (n = 36) patients between age 45-80 years with basal cell carcinoma of 10-20mm on face were included following inclusion exclusion criteria by purposive sampling technique. Informed consent was taken. Surgical excision was performed and intraoperative frozen section histopathology clearance of tumor margin was taken from histopathologist on telephone. Surgical reconstruction was done. Final Histopathology report was reexamined on day 10th for margin and depth clearance. Descriptive statistics were calculated for age, gender, sun exposure, reconstructive technique, anatomical site, and tumor free margin report on frozen section analysis. Chi square test was employed for statistical significance of involvement of surgical margin with reference to anatomical site, size and decision on reconstructive surgical technique, p value of <0.05 was considered significant. Total of 36 patients of BCC were enrolled, males 12 (33.3%) and females were 24 (66.6%). Age ranged from 45 year to 80 year mean of 58.36 ±SD7.8. Size of BCC ranged from 10mm to 35mm mean of 25mm ±SD 0.63. Morphology was nodular 18 (50%), superficial spreading 11(30.6%), morphoeic 1 (2.8%) and ulcerative in 6(16.7%) cases. Intraoperative frozen section for histopathological margin clearance with 2-3 mm safety margin and surgical technique has p-value0.51, for anatomical site p value 0.24 and size p-0.84. Intraoperative frozen section (FS) histopathological clearance for BCC face with 2-3mm safety margin with reference to reconstructive technique, anatomical site and size of BCC were insignificant.

Keywords: basal cell carcinoma, tumor free amrgin, basal cell carcinoma and frozen section, safety margin

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Authors: Michal Duchek, Jan Palán, Tomas Kubina

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Bars made of titanium grade 2 and grade 4 were subjected to rotary forging with up to 2.2 true strain reduction in the cross-section from 10 to 3.81 mm. During progressive deformation, grain refinement in the transverse direction took place. In the longitudinal direction, ultrafine microstructure has not developed. It has been demonstrated that titanium grade 2 strengthens more than grade 4. The ultimate tensile strength increased from 650 MPa to 1040 MPa in titanium grade 4. Hardness profiles on the cross section in both materials show an increase in the centre of the wire.

Keywords: commercial-purity titanium, wire, rotary swaging, tensile test, hardness, modulus of elasticity, microstructure

Procedia PDF Downloads 220

Authors: Oum Elkhir Mahmoudi, Nebiha Ben Haj Ali

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Micropaleontological, sedimentological and statistical studies were carried out on the late Paleocene-early Eocene succession of Sra Ouertaine and Dyr El Kef in Northern open phosphatic Basin of Tunisia. Based on the abundance and stratigraphic distribution of planktic foraminiferal species, five planktic zones have been recognized from the base to the top of the phosphatic layers. The El Acarinina sibaiyaensis Zone, the E2 Pseudohastigerina wilcoxensis Zone, the E3 Morozovella marginodentata Zone, the E4 Morozovella formosa Zones and the E5 Morozovella subbotinae Zone. The placement of Paleocene-Eocene boundary (PETM) is just below the base of the phosphatic interval. The ETM-2 event may be detectable in the analyzed biotic record of Sra Ouertaine. Based on benthic assemblages, abundances, cluster and multivariate statistical analyses, two biofacies were recognized for each section. The recognized ecozones are typical of warm and shallow water inner neritic setting (dominance of epifaunal fauna Anomalinoides, Dentalina and Cibicidoides associated with Frondicularia phosphatica, Trochamminoides globigeriniformis and Eponides elevatus). The paleoenvironment is eutrophic (presence of several bolivinitids and verneuilinids). For the Dyr El Kef section and P5 and E2 of Sra Ouertaine section, our records indicate that paleoenvironment is influenced by coastal upwelling without oxygen-deficiency, the paleodepth is estimated to be around 50 m. The paleoecosystem is diversified and balanced with a general tendency to stressed condition. While the upper part of Sra Ouertaine section is more eutrophic, influenced by coastal upwelling with oxygen-deficiency, the paleodepth is estimated to be less than 50 m and the ecosystem is unsettled.

Keywords: Tunisia, Sra ouertaine Dyr el kef, early Eocene, foraminifera, chronostratigraphy, paleoecology, paleoenvironment

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Authors: Adonis Menezes, J. C. Passos

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The current panorama of technology in heat transfer and the scarcity of information about the convective boiling of CO₂ and hydrocarbon in small diameter channels motivated the development of this work. Among non-halogenated refrigerants, CO₂/ R744 has distinct thermodynamic properties compared to other fluids. The R744 presents significant differences in operating pressures and temperatures, operating at higher values compared to other refrigerants, and this represents a challenge for the design of new evaporators, as the original systems must normally be resized to meet the specific characteristics of the R744, which creates the need for a new design and optimization criteria. To carry out the convective boiling tests of CO₂, an experimental apparatus capable of storing (m= 10kg) of saturated CO₂ at (T = -30 ° C) in an accumulator tank was used, later this fluid was pumped using a positive displacement pump with three pistons, and the outlet pressure was controlled and could reach up to (P = 110bar). This high-pressure saturated fluid passed through a Coriolis type flow meter, and the mass velocities varied between (G = 20 kg/m².s) up to (G = 1000 kg/m².s). After that, the fluid was sent to the first test section of circular cross-section in diameter (D = 4.57mm), where the inlet and outlet temperatures and pressures, were controlled and the heating was promoted by the Joule effect using a source of direct current with a maximum heat flow of (q = 100 kW/m²). The second test section used a cross-section with multi-channels (seven parallel channels) with a square cross-section of (D = 2mm) each; this second test section has also control of temperature and pressure at the inlet and outlet as well as for heating a direct current source was used, with a maximum heat flow of (q = 20 kW/m²). The fluid in a biphasic situation was directed to a parallel plate heat exchanger so that it returns to the liquid state, thus being able to return to the accumulator tank, continuing the cycle. The multi-channel test section has a viewing section; a high-speed CMOS camera was used for image acquisition, where it was possible to view the flow patterns. The experiments carried out and presented in this report were conducted in a rigorous manner, enabling the development of a database on the convective boiling of the R744 in macro and micro channels. The analysis prioritized the processes from the beginning of the convective boiling until the drying of the wall in a subcritical regime. The R744 resurfaces as an excellent alternative to chlorofluorocarbon refrigerants due to its negligible ODP (Ozone Depletion Potential) and GWP (Global Warming Potential) rates, among other advantages. The results found in the experimental tests were very promising for the use of CO₂ in micro-channels in convective boiling and served as a basis for determining the flow pattern map and correlation for determining the heat transfer coefficient in the convective boiling of CO₂.

Keywords: convective boiling, CO₂/R744, macro-channels, micro-channels

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Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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Authors: Vinod B. Suryawanshi, Ajit D. Kelkar

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Glass fiber reinforced composites materials, due their unique properties such as high mechanical strength to weight ratio, corrosion resistance, and impact resistance have huge potential as structural materials in automotive, construction and transportation applications. However, these properties often come at higher cost owing to complex design methods, difficult manufacturing processes and raw material cost. In this paper, a cost effective design and manufacturing approach for a composite cantilever beam structure is presented. A constant stress (variable cross section) beam concept has been used to design and optimize the shape of composite cantilever beam and thus obtain the reduction in material used. The variable cross section beam was fabricated from the glass epoxy prepregs using cost effective out of autoclave process. The drop ply technique has been successfully used to obtain the variation in the cross section along the span of the beam. In order to test the beam and validate the design, the beam was subjected to different end loads. Strain gauges were mounted along the length of the beam to obtain strains in the beam at different sections and loads. The strain values were used to calculate the flexural strength and bending stresses in the beam. The stresses obtained through strain measurements from the experiment were found to be uniform along the span of the beam, and thus validates the design. Finally, the finite element model for the constant stress beam was developed using commercial finite element simulation software. It was observed that the simulation results agreed very well with the experimental results.

Keywords: beams, composites, constant cross-section, structures

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Authors: Vivek Saxena, Shreshtha Saxena

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Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance first recognized during pregnancy. Uncontrolled or untreated GDM is associated with various adverse outcomes to the maternal and fetal health. Overt diabetes mellitus may also develop in such patients. It is universally accepted fact that first and foremost management to treat GDM is dietary control and lifestyle modification even before starting any oral hypoglycemic agent (OHA) or insulin. So, proper dietary management and little changes in the patient’s lifestyle are very effective for reducing her plasma glucose level. Objectives: Proper counselling of the patients and flexibility in their lifestyle and diet can effectively control the plasma glucose level in GDM patients. Methods: Total 60 GDM patients of age > 18 years were taken. We had three counselling sessions with the patient and other members of the family like husband, parents, and in-laws at different intervals, discussed their lifestyle and diet pattern, helped them to eliminate the factors those had an adverse effect on plasma glucose level and promoted them to acquire a healthy lifestyle. We have counselled the patient and her family member separately and then together also. They have explained how increased plasma glucose level can be effectively controlled with the little modification in their diet and routine activities. They were also taught to remain stress-free during their rest of antenatal period. We have excluded the patients from our study who were diabetic before pregnancy and patients with other comorbid illnesses like hypothyroidism and valvular heart disease. Results and conclusions: Results were very rewarding as patients could acquire a lifestyle of their choice. They were happy because extra pill burden was not there. All the 60 patients were normoglycemic in remaining antenatal period, 48 patients were delivered normally and 12 patients underwent cesarean section due to various reasons.Regular counselling of the patients regarding their disease and little alterations in diet and lifestyle controlled the plasma glucose level much effectively. The things were more easier and effective when we included other family members during our counselling session because they play a major role in patient’s day to day activity and influence her life.

Keywords: dietary management, gestational diabetes mellitus, impaired glucose tolerance, oral hypoglycemic agent, pregnancy

Procedia PDF Downloads 144

Authors: Nurdiani Zamhari, Abang Annuar Ehsan

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The 3 dB directional coupler is designed by using silicon-on-insulator (SOI) large cross-section and simulate by Beam Propagation Method at the communication wavelength of 1.55 µm and 1.48 µm. The geometry is shaped with rib height (H) of 6 µm and varied in step factor (r) which is 0.5, 0.6, 0.7 and 0.8. The wave guide spacing is also fixed to 5 µm and the slab width is symmetrical. In general, the 3 dB coupling lengths for four different cross-sections are several millimetre long. The 1.48 of wavelength give the longer coupling length if compare to 1.55 at the same step factor (r). Besides, the low loss propagation is achieved with less than 2 % of propagation loss.

Keywords: 3 dB directional couplers, silicon-on-insulator, symmetrical rib waveguide, OptiBPM 9

Procedia PDF Downloads 499

Authors: Paola Pannuzzo, Tak-Ming Chan

Abstract:

In seismic applications, hollow steel sections show, beyond undeniable esthetical appeal, promising structural advantages since, unlike open section counterparts, they are not susceptible to weak-axis and lateral-torsional buckling. In particular, hot-finished hollow steel sections have homogeneous material properties and favorable ductility but have been underutilized for cyclic bending. The main reason is that the parameters affecting their hysteretic behaviors are not yet well understood and, consequently, are not well exploited in existing codes of practice. Therefore, experimental investigations have been conducted on a wide range of hot-finished rectangular hollow section beams with the aim to providing basic knowledge for evaluating their seismic performance. The section geometry (width-to-thickness and depth-to-thickness ratios) and the type of loading (monotonic and cyclic) have been chosen as the key parameters to investigate the cyclic effect on the rotational capacity and to highlight the differences between monotonic and cyclic load conditions. The test results provide information on the parameters that affect the cyclic performance of hot-finished hollow steel beams and can be used to assess the design provisions stipulated in the current seismic codes of practice.

Keywords: bending, cyclic test, finite element modeling, hollow sections, hot-finished sections

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Authors: S. Bahadır Yüksel, Alptuğ Ünal

Abstract:

The composite shear walls (CSW) with steel encased profiles can be used as lateral-load resisting systems for buildings that require considerable large lateral-load capacity. The aim of this work is to propose the experimental work conducted on CSW having L section folded plate (L shape steel made-up sections) as longitudinal reinforcement in boundary regions. The study in this paper present the experimental test conducted on CSW having L section folded plate as longitudinal reinforcement in boundary regions. The tested 1/3 geometric scaled CSW has aspect ratio of 3.2. L-shape structural steel materials with 2L-19x57x7mm dimensions were placed in shear wall boundary zones. The seismic behavior of CSW test specimen was investigated by evaluating and interpreting the hysteresis curves, envelope curves, rigidity and consumed energy graphs of this tested element. In addition to this, the experimental results, deformation and cracking patterns were evaluated, interpreted and suggestions of the design recommendations were proposed.

Keywords: shear wall, composite shear wall, boundary reinforcement, earthquake resistant structural design, L section

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Authors: V. Lukášová, P. Peukert, V. Votrubec

Abstract:

Thermal conductivity in the x, y and z-directions was measured on a pultruded profile that was manufactured by the technology of pulling from glass fibers and a polyester matrix. The results of measurements of thermal conductivity showed considerable variability in different directions. The caused variability in thermal conductivity was expected due fraction variations. The cross-section of the pultruded profile was scanned. An image analysis illustrated an uneven distribution of the fibers and the matrix in the cross-section. The distribution of these inequalities was processed into a Voronoi diagram in the observed area of the pultruded profile cross-section. In order to verify whether the variation of the fiber volume fraction in the pultruded profile can affect its thermal conductivity, the numerical simulations in the ANSYS Fluent were performed. The simulation was based on the geometry reconstructed from image analysis. The aim is to quantify thermal conductivity numerically. Above all, images with different volume fractions were chosen. The results of the measured thermal conductivity were compared with the calculated thermal conductivity. The evaluated data proved a strong correlation between volume fraction and thermal conductivity of the pultruded profile. Based on presented results, a modification of production technology may be proposed.

Keywords: pultrusion profile, volume fraction, thermal conductivity, numerical simulation

Procedia PDF Downloads 327

Authors: Sakir Tasdemir, Mustafa Altin, Gamze Fahriye Pehlivan, Sadiye Didem Boztepe Erkis, Ismail Saritas, Selma Tasdemir

Abstract:

Artificial intelligence applications are commonly used in industry in many fields in parallel with the developments in the computer technology. In this study, a fire room was prepared for the resistance of wooden construction elements and with the mechanism here, the experiments of polished materials were carried out. By utilizing from the experimental data, an artificial neural network (ANN) was modeled in order to evaluate the final cross sections of the wooden samples remaining from the fire. In modelling, experimental data obtained from the fire room were used. In the system developed, the first weight of samples (ws-gr), preliminary cross-section (pcs-mm2), fire time (ft-minute), fire temperature (t-oC) as input parameters and final cross-section (fcs-mm2) as output parameter were taken. When the results obtained from ANN and experimental data are compared after making statistical analyses, the data of two groups are determined to be coherent and seen to have no meaning difference between them. As a result, it is seen that ANN can be safely used in determining cross sections of wooden materials after fire and it prevents many disadvantages.

Keywords: artificial neural network, final cross-section, fire retardant polishes, fire safety, wood resistance.

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Authors: P. Wongmatar, C. Hansapinyo, C. Buachart

Abstract:

Failure of typical seismic frames has been found by plastic hinge occurring on beams section near column faces. Past researches shown that the seismic capacity of the frames can be enhanced if the plastic hinges of the beams are shifted away from the column faces. This paper presents detailing of reinforcements in the interior beam–column connections aiming to relocate the plastic hinge of reinforced concrete and precast concrete frames. Four specimens were tested under quasi-static cyclic load including two monolithic specimens and two precast specimens. For one monolithic specimen, typical seismic reinforcement was provided and considered as a reference specimen named M1. The other reinforced concrete frame M2 contained additional intermediate steel in the connection area compared with the specimen M1. For the precast specimens, embedded T-section steels in joint were provided, with and without diagonal bars in the connection area for specimen P1 and P2, respectively. The test results indicated the ductile failure with beam flexural failure in monolithic specimen M1 and the intermediate steel increased strength and improved joint performance of specimen M2. For the precast specimens, cracks generated at the end of the steel inserts. However, slipping of reinforcing steel lapped in top of the beams was seen before yielding of the main bars leading to the brittle failure. The diagonal bars in precast specimens P2 improved the connection stiffness and the energy dissipation capacity.

Keywords: relocation, plastic hinge, intermediate bar, T-section steel, precast concrete frame

Procedia PDF Downloads 259

Authors: Mengmeng Liu, J. David Frost

Abstract:

Interstate highway system within the Atlanta Perimeter plays an important role in residents’ daily life. The serious influence of Atlanta I-85 Collapses implies that transportation system in the region lacks a cohesive and comprehensive transportation plan. Therefore, disaster resilience analysis of the transportation system is necessary. Resilience is the system’s capability to persist or to maintain transportation services when exposed to changes or shocks. This paper analyzed the resilience of the whole transportation system within the Perimeter and see how removing interstates within the Perimeter will affect the resilience of the transportation system. The data used in the paper are Atlanta transportation networks and LEHD Origin-Destination Employment Statistics data. First, we calculate the traffic flow on each road section based on LEHD data assuming each trip travel along the shortest travel time paths. Second, we calculate the measure of resilience, which is flow-based connectivity and centrality of the transportation network, and see how they will change if we remove each section of interstates from the current transportation system. Finally, we get the resilience function curve of the interstates and identify the most resilient interstates section. The resilience analysis results show that the framework of calculation resilience is effective and can provide some useful information for the transportation planning and sustainability analysis of the transportation infrastructures.

Keywords: connectivity, interstate highway system, network analysis, resilience analysis

Procedia PDF Downloads 237

Authors: Julia A. Ermakova

Abstract:

This study aimed to investigate the efficacy of a physical rehabilitation program for postpartum women. The program was developed with the purpose of restoring physical performance in women during the postpartum period. The research employed a variety of methods, including an analysis of scientific literature, pedagogical testing and experimentation, mathematical processing of study results, and physical performance assessment using a range of tests. The program recommends refraining from abdominal exercises during the first 6-8 months following a cesarean section and avoiding exercises with weights. Instead, a feasible training regimen that gradually increases in intensity several times a week is recommended, along with moderate cardio exercises such as walking, bodyweight training, and a separate workout component that targets posture improvement. Stretching after strength training is also encouraged. The necessary equipment includes comfortable sports attire with a chest support top, mat, push-ups, resistance band, timer, and clock. The motivational aspect of the program is paramount, and the mentee's positive experience with the workout regimen includes feelings of lightness in the body, increased energy, and positive emotions. The gradual reduction of body size and weight loss due to an improved metabolism also serves as positive reinforcement. The mentee's progress can be measured through various means, including an external assessment of her form, body measurements, weight, BMI, and the presence or absence of slouching in everyday life. The findings of this study reveal that the program is effective in restoring physical performance in postpartum women. The mentee achieved weight loss and almost regained her pre-pregnancy shape while her self-esteem improved. Her waist, shoulder, and hip measurements decreased, and she displayed less slouching in her daily life. In conclusion, the developed physical rehabilitation program for postpartum women is an effective means of restoring physical performance. It is crucial to follow the recommended training regimen and equipment to avoid limitations and ensure safety during the postpartum period. The motivational component of the program is also fundamental in encouraging positive reinforcement and improving self-esteem.

Keywords: physical rehabilitation, postpartum, methodology, postpartum recovery, rehabilitation

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Authors: Ali Alshamrani

Abstract:

This article aims to give a comprehensive and critical review of sukuk issuance in Saudi Arabia, and the extent to which the issuance of sukuk in Saudi Arabia is consistent with Shariah requirements. The article is divided into two sections. Accordingly, the first section of this article begins with an examination of sukuk in general, and includes the concept of sukuk, the basic principles of sukuk, common types of sukuk, and a critical analysis of the most important differences between sukuk and conventional bonds. The second section gives a critical analysis of how sukuk work in Saudi Arabia, offering the regulatory framework of the issuance of sukuk in the KSA, and the legal challenges from Shariah point of view, and provide recommendations to overcome these challenges.

Keywords: sukuk issuance, Shariah, Saudi Arabia, capital market authority

Procedia PDF Downloads 454

Authors: Samarpreet Singh, Gerald Giesbrecht

Abstract:

Both c-section and antibiotic exposure are linked to gut microbiota imbalance in infants. Such disturbance is associated with the Hypothalamic-Pituitary-Adrenal (HPA) axis function. However, the literature only has contradicting evidence for the association between c-sections and the HPA axis. Therefore, this study aims to test if the mode of delivery and antibiotics exposure is associated with the HPA axis. Also, whether exposure to both interacts with the HPA-axis. It was hypothesized that associations and interactions would be observed. Secondary data analysis was used for this co-relational study. Data for the mode of delivery and antibiotics exposure variables were documented from hospital records or self-questionnaires. In addition, cortisol levels (Area under the curve with respect to increasing (AUCi) and Area under the curve with respect to ground (AUCg)) were based on saliva collected from three months old during the infant’s visit to the lab and after drawing blood. One-way and between-subject ANOVA analyses were run on data. No significant association between delivery mode and infant cortisol level was found, AUCi and AUCg, p > .05. Only the infant’s AUCg was found to be significantly higher if there were antibiotics exposure at delivery (p = .001) or their mothers were exposed during pregnancy (p < .05). Infants born by c-section and exposed to antibiotics at three months had higher AUCi than those born vaginally, p < .02. These results imply that antibiotic exposure before three months is associated with an infant’s stress response. The association might increase if antibiotic exposure occurs three months after a c-section birth. However, more robust and causal evidence in future studies is needed, given a variable group’s statistically weak sample size. Nevertheless, the results of this study still highlight the unintended consequences of antibiotic exposure during delivery and pregnancy.

Keywords: HPA-axis, antibiotics, c-section, gut-microbiota, development, stress

Procedia PDF Downloads 51