Search results for: never pressure injury
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4747

Search results for: never pressure injury

4627 Nutrition Intervention for Spinal Cord Injury in Critical Care

Authors: Dina Muharib

Abstract:

Specific metabolic challenges are present following spinal cord injury. The acute stage is characterized by a reduction in metabolic activity, as well as a negative nitrogen balance that cannot be corrected, even with aggressive nutritional support. Metabolic demands need to be accurately monitored to avoid overfeeding. Enteral feeding is the optimal route following SCI. When oral feeding is not possible, nasogastric, followed by nasojejunal, then by percutaneous endoscopic gastrostomy, if necessary, is suggested.

Keywords: SCI, energy, protein, nutrition assessment, eneral feeding, nitrogen balance

Procedia PDF Downloads 450
4626 The Correlation of Physical Activity and Plantar Pressure in Young Adults

Authors: Lovro Štefan

Abstract:

Background: The main purpose of the present study was to explore the correlations between physical activity and peak plantar pressure in dynamic mode. Methods: Participants were one hundred forty-six first-year university students (30.8% girls). Plantar pressure generated under each region of the foot (forefoot, midfoot, and heel) was measured by using Zebris dynamometric platform (Isny, Germany). The level of physical activity (PA) was calculated with the International Physical Activity questionnaire (IPAQ - short form). Results: In boys, forefoot peak plantar pressure was correlated with moderate PA (MPA; r=-0.21), vigorous PA (VPA; r=-0.18), and moderate-to-vigorous PA (MVPA; r=-0.28). No significant correlations with other foot regions (p>0.05) were observed. In girls, forefoot peak plantar pressure was correlated with MPA (r =-0.30), VPA (r=-0.39) and MVPA (r=-0.38). Also, heel peak pressure was significantly correlated with MPA (r=-0.33), while no significant correlations with VPA (r=0.05) and MVPA (r=-0.15) were observed. Conclusion: This study shows that different intensities of PA were mostly correlated with forefoot peak plantar pressure in both boys and girls. Therefore, strategies that reduce plantar pressure through a more active lifestyle should be implemented within the education system.

Keywords: pedobarography, youth, exercise, associations

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4625 Predictive Value of Coagulopathy in Patients with Isolated Blunt Traumatic Brain Injury: A Cohort of Pakistani Population

Authors: Muhammad Waqas, Shahan Waheed, Mohsin Qadeer, Ehsan Bari, Salman Ahmed, Iqra Patoli

Abstract:

Objective: To determine the value of aPTT, platelets and INR as the predictor of unfavorable outcomes in patients with blunt isolated traumatic brain injury. Methods: This was an observational cohort study conducted in a tertiary care facility from 1st January 2008 to 31st December 2012. All the patients with isolated traumatic brain injury presenting within 24 hours of injury were included in the study. Coagulation parameters at presentation were recorded and Glasgow Outcome Scale calculated on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Relationship of coagulopathy with GOS and unfavorable outcomes was calculated using Spearman`s correlation and area under curve ROC analysis. Results: 121 patients were included in the study. The incidence of coagulopathy was found to be 6 %. aPTT was found to a significantly associated with unfavorable outcomes with an AUC = 0.702 (95%CI = 0.602-0.802). Predictive value of platelets and INR was not found to be significant. Conclusion: Incidence of coagulopathy was found to be low in current population compared to data from the West. aPTT was found to be a good predictor of unfavorable outcomes compared with other parameters of coagulation.

Keywords: aPTT, coagulopathy, unfavorable outcomes, parameters

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4624 Low Energy Mechanism in Pelvic Trauma at Elderly

Authors: Ravid Yinon

Abstract:

Introduction: Pelvic trauma causes high mortality, particularly among the elderly population. Pelvic injury ranges from low-energy incidents such as falls to high-energy trauma like motor vehicle accidents. The mortality rate among high-energy trauma patients is higher, as can be expected. The elderly population is more vulnerable to pelvic trauma even at low energy mechanisms due to the fragility and diminished physiological reserve of these patients. The aim of this study is to examine whether there is a higher long-term mortality in pelvic injuries in the elderly from the low-energy mechanism than those injured in high energy. Methods: A retrospective cohort study was conducted in a level 1 trauma center with injured patients aged 65 years and over with pelvic trauma. The patients were divided into two groups of low and high-energy mechanisms of injury. Multivariate analysis was conducted to characterize the differences between the groups. Results: There were 585 consecutive injured patients over the age of 65 with a documented pelvic injury who were treated at the primary trauma center between 2008-2020. The injured in the high energy group were younger (mean HE- 75.18, LE-80.73), with fewer comorbidities (mean 0.78 comorbidities at HE and 1.28 at LE), more men (52.6% at HE and 27.4% at LE), were consumed more treatments facilities such as angioembolization, ICU admission, emergency surgeries and blood products transfusion and higher mortality rate at admission (HE- 19/133, 14.28%, LE- 10/452, 2.21%) compared to the low energy group. However, in a long-term follow-up of one year after the injury, mortality in the low-energy group was significantly higher (HE- 14/114, 12.28%, LE- 155/442, 35.06%). Discussion: Although it can be expected that in the mechanism of high energy, the mortality rate in the long term would be higher, it was found that mortality at the low energy patient was higher. Apparently, low-energy pelvic injury in geriatric patients is a measure of frailty in these patients, causes injury to more frail and morbid patients, and is a predictor of mortality in this population in the long term. Conclusion: The long-term follow-up of injured elderly with pelvic trauma should be more intense, and the healthcare provider should put more emphasis on the rehabilitation of these special patient populations in an attempt to prevent long-term mortality.

Keywords: pelvic trauma, elderly trauma, high energy trauma, low energy trauma

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4623 The Impact of Temperature on the Threshold Capillary Pressure of Fine-Grained Shales

Authors: Talal Al-Bazali, S. Mohammad

Abstract:

The threshold capillary pressure of shale caprocks is an important parameter in CO₂ storage modeling. A correct estimation of the threshold capillary pressure is not only essential for CO₂ storage modeling but also important to assess the overall economical and environmental impact of the design process. A standard step by step approach has to be used to measure the threshold capillary pressure of shale and non-wetting fluids at different temperatures. The objective of this work is to assess the impact of high temperature on the threshold capillary pressure of four different shales as they interacted with four different oil based muds, air, CO₂, N₂, and methane. This study shows that the threshold capillary pressure of shale and non-wetting fluid is highly impacted by temperature. An empirical correlation for the dependence of threshold capillary pressure on temperature when different shales interacted with oil based muds and gasses has been developed. This correlation shows that the threshold capillary pressure decreases exponentially as the temperature increases. In this correlation, an experimental constant (α) appears, and this constant may depend on the properties of shale and non-wetting fluid. The value for α factor was found to be higher for gasses than for oil based muds. This is consistent with our intuition since the interfacial tension for gasses is higher than those for oil based muds. The author believes that measured threshold capillary pressure at ambient temperature is misleading and could yield higher values than those encountered at in situ conditions. Therefore one must correct for the impact of temperature when measuring threshold capillary pressure of shale at ambient temperature.

Keywords: capillary pressure, shale, temperature, thresshold

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4622 Effects of Pore-Water Pressure on the Motion of Debris Flow

Authors: Meng-Yu Lin, Wan-Ju Lee

Abstract:

Pore-water pressure, which mediates effective stress and shear strength at grain contacts, has a great influence on the motion of debris flow. The factors that control the diffusion of excess pore-water pressure play very important roles in the debris-flow motion. This research investigates these effects by solving the distribution of pore-water pressure numerically in an unsteady, surging motion of debris flow. The governing equations are the depth-averaged equations for the motion of debris-flow surges coupled with the one-dimensional diffusion equation for excess pore-water pressures. The pore-pressure diffusion equation is solved using a Fourier series, which may improve the accuracy of the solution. The motion of debris-flow surge is modelled using a Lagrangian particle method. From the computational results, the effects of pore-pressure diffusivities and the initial excess pore pressure on the formations of debris-flow surges are investigated. Computational results show that the presence of pore water can increase surge velocities and then changes the profiles of depth distribution. Due to the linear distribution of the vertical component of pore-water velocity, pore pressure dissipates rapidly near the bottom and forms a parabolic distribution in the vertical direction. Increases in the diffusivity of pore-water pressure cause the pore pressures decay more rapidly and then decrease the mobility of the surge.

Keywords: debris flow, diffusion, Lagrangian particle method, pore-pressure diffusivity, pore-water pressure

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4621 The Effects of the GAA15 (Gaelic Athletic Association 15) on Lower Extremity Injury Incidence and Neuromuscular Functional Outcomes in Collegiate Gaelic Games: A 2 Year Prospective Study

Authors: Brenagh E. Schlingermann, Clare Lodge, Paula Rankin

Abstract:

Background: Gaelic football, hurling and camogie are highly popular field games in Ireland. Research into the epidemiology of injury in Gaelic games revealed that approximately three quarters of the injuries in the games occur in the lower extremity. These injuries can have player, team and institutional impacts due to multiple factors including financial burden and time loss from competition. Research has shown it is possible to record injury data consistently with the GAA through a closed online recording system known as the GAA injury surveillance database. It has been established that determining the incidence of injury is the first step of injury prevention. The goals of this study were to create a dynamic GAA15 injury prevention programme which addressed five key components/goals; avoid positions associated with a high risk of injury, enhance flexibility, enhance strength, optimize plyometrics and address sports specific agilities. These key components are internationally recognized through the Prevent Injury, Enhance performance (PEP) programme which has proven reductions in ACL injuries by 74%. In national Gaelic games the programme is known as the GAA15 which has been devised from the principles of the PEP. No such injury prevention strategies have been published on this cohort in Gaelic games to date. This study will investigate the effects of the GAA15 on injury incidence and neuromuscular function in Gaelic games. Methods: A total of 154 players (mean age 20.32 ± 2.84) were recruited from the GAA teams within the Institute of Technology Carlow (ITC). Preseason and post season testing involved two objective screening tests; Y balance test and Three Hop Test. Practical workshops, with ongoing liaison, were provided to the coaches on the implementation of the GAA15. The programme was performed before every training session and game and the existing GAA injury surveillance database was accessed to monitor player’s injuries by the college sports rehabilitation athletic therapist. Retrospective analysis of the ITC clinic records were performed in conjunction with the database analysis as a means of tracking injuries that may have been missed. The effects of the programme were analysed by comparing the intervention groups Y balance and three hop test scores to an age/gender matched control group. Results: Year 1 results revealed significant increases in neuromuscular function as a result of the GAA15. Y Balance test scores for the intervention group increased in both the posterolateral (p=.005 and p=.001) and posteromedial reach directions (p= .001 and p=.001). A decrease in performance was determined for the three hop test (p=.039). Overall twenty-five injuries were reported during the season resulting in an injury rate of 3.00 injuries/1000hrs of participation; 1.25 injuries/1000hrs training and 4.25 injuries/1000hrs match play. Non-contact injuries accounted for 40% of the injuries sustained. Year 2 results are pending and expected April 2016. Conclusion: It is envisaged that implementation of the GAA15 will continue to reduce the risk of injury and improve neuromuscular function in collegiate Gaelic games athletes.

Keywords: GAA15, Gaelic games, injury prevention, neuromuscular training

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4620 Using Analytics to Redefine Athlete Resilience

Authors: Phil P. Wagner

Abstract:

There is an overwhelming amount of athlete-centric information available for sport practitioners in this era of tech and big data, but protocols in athletic rehabilitation remain arbitrary. It is a common assumption that the rate at which tissue heals amongst individuals is the same; yielding protocols that are entirely time-based. Progressing athletes through rehab programs that lack individualization can potentially expose athletes to stimuli they are not prepared for or unnecessarily lengthen their recovery period. A 7-year aggregated and anonymous database was used to develop reliable and valid assessments to measure athletic resilience. Each assessment utilizes force plate technology with proprietary protocols and analysis to provide key thresholds for injury risk and recovery. Using a T score to analyze movement qualities, much like the Z score used for bone density from a Dexa scan, specific prescriptions are provided to mitigate the athlete’s inherent injury risk. In addition to obliging to surgical clearance, practitioners must put in place a clearance protocol guided by standardized assessments and achievement in strength thresholds. In order to truly hold individuals accountable (practitioners, athletic trainers, performance coaches, etc.), success in improving pre-defined key performance indicators must be frequently assessed and analyzed.

Keywords: analytics, athlete rehabilitation, athlete resilience, injury prediction, injury prevention

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4619 CFD Simulation of the Inlet Pressure Effects on the Cooling Capacity Enhancement for Vortex Tube with Couple Vortex Chambers

Authors: Nader Pourmahmoud, Amir Hassanzadeh

Abstract:

This article investigates the effects of inlet pressure in a newly introduced vortex tube which has been equipped with an additional vortex chamber. A 3-D compressible turbulent flow computation has been carried out toward analysis of complex flow field in this apparatus. Numerical results of flows are derived by utilizing the standard k-ε turbulence model for analyzing high rotating complex flow field. The present research has focused on cooling effect and given a characteristics curve for minimum cool temperature. In addition, the effect of inlet pressure for both chambers has been studied in details. To be presented numerical results show that the effect of inlet pressure in second chamber has more important role in improving the performance of the vortex tube than first one. By increasing the pressure in the second chamber, cold outlet temperature reaches a higher decrease. When both chambers are fed with high pressure fluid, best operation condition of vortex tube occurs. However, it is not possible to feed both chambers with high pressure due to the conditions of working environment.

Keywords: energy separation, inlet pressure, numerical simulation, vortex chamber, vortex tube

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4618 Finite Element Modeling of a Lower Limb Based on the East Asian Body Characteristics for Pedestrian Protection

Authors: Xianping Du, Runlu Miao, Guanjun Zhang, Libo Cao, Feng Zhu

Abstract:

Current vehicle safety standards and human body injury criteria were established based on the biomechanical response of Euro-American human body, without considering the difference in the body anthropometry and injury characteristics among different races, particularly the East Asian people with smaller body size. Absence of such race specific design considerations will negatively influence the protective performance of safety products for these populations, and weaken the accuracy of injury thresholds derived. To resolve these issues, in this study, we aim to develop a race specific finite element model to simulate the impact response of the lower extremity of a 50th percentile East Asian (Chinese) male. The model was built based on medical images for the leg of an average size Chinese male and slightly adjusted based on the statistical data. The model includes detailed anatomic features and is able to simulate the muscle active force. Thirteen biomechanical tests available in the literature were used to validate its biofidelity. Using the validated model, a pedestrian-car impact accident taking place in China was re-constructed computationally. The results show that the newly developed lower leg model has a good performance in predicting dynamic response and tibia fracture pattern. An additional comparison on the fracture tolerance of the East Asian and Euro-American lower limb suggests that the current injury criterion underestimates the degree of injury of East Asian human body.

Keywords: lower limb, East Asian body characteristics, traffic accident reconstruction, finite element analysis, injury tolerance

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4617 Numerical Study of Off-Design Performance of a Highly Loaded Low Pressure Turbine Cascade

Authors: Shidvash Vakilipour, Mehdi Habibnia, Rouzbeh Riazi, Masoud Mohammadi, Mohammad H. Sabour

Abstract:

The flow field passing through a highly loaded low pressure (LP) turbine cascade is numerically investigated at design and off-design conditions. The Field Operation And Manipulation (OpenFOAM) platform is used as the computational Fluid Dynamics (CFD) tool. Firstly, the influences of grid resolution on the results of k-ε, k-ω, and LES turbulence models are investigated and compared with those of experimental measurements. A numerical pressure under-shoot is appeared near the end of blade pressure surface which is sensitive to grid resolution and flow turbulence modeling. The LES model is able to resolve separation on a coarse and fine grid resolutions. Secondly, the off-design flow condition is modeled by negative and positive inflow incidence angles. The numerical experiments show that a separation bubble generated on blade pressure side is predicted by LES. The total pressure drop is also been calculated at incidence angle between -20◦ and +8◦. The minimum total pressure drop is obtained by k-ω and LES at the design point.

Keywords: low pressure turbine, off-design performance, openFOAM, turbulence modeling, flow separation

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4616 Pattern of External Injuries Sustained during Bomb Blast Attacks in Karachi, Pakistan from 2000 to 2007

Authors: Arif Anwar Surani, Salman Ali, Asif Surani, Sohaib Zahid, Akbar Shoukat Ali, Zeeshan-Ul-Hassan Usmani, Joseph Varon, Salim Surani

Abstract:

Objective: Terrorism and suicidal bomb blast attacks are commonplace in Karachi, Pakistan. During the years 2000 to 2007, there were over 60 bomb explosions resulting in more than 1500 casualties. These explosions produce a wide variety of external injuries. We undertook this study to evaluate pattern of external injury produced after bomb blast attacks and to compare injury profile resulting from explosions in open versus semi-confined blast environments. Method: A retrospective, cross-sectional, study was conducted to review injuries sustained after bomb blast attacks in Karachi, Pakistan, from January 2000 to October 2007. Emergency medical records and medico legal certificates of patients presented to three major public sector hospitals of Karachi were evaluated using self-design proforma. Results: Data of 481 victims meet inclusion criteria and were incorporated for final analysis. Of these, 63.6% were injured in open spaces and 36.4% were injured in semi-confined blast environments. Lacerations were commonly encountered as external injury (47.7%) followed by penetrating wounds (15.3%). Lower and upper extremities were most commonly affected (38.6% and 19% respectively). Open and semi-confined blast environments produced a specific injury pattern and profile (p=<0.001). Conclusions: Bomb blast attacks in Karachi produce an external injury pattern consistent with other studies, with exception of an increased frequency in penetrating wounds. Semi-confined blast environments were associated with severe injuries. Further studies are required to better classify injuries and their severity based on standardized scoring systems. Effective emergency response systems must be designed to cope with mass causalities following bomb explosions.

Keywords: bomb blast attacks, injury pattern, external injury, open space, semi-confined space, blast environment

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4615 [Keynote Speech]: Experimental Study on the Effects of Water-in-Oil Emulsions to the Pressure Drop in Pipeline Flow

Authors: S. S. Dol, M. S. Chan, S. F. Wong, J. S. Lim

Abstract:

Emulsion formation is unavoidable and can be detrimental to an oil field production. The presence of stable emulsions also reduces the quality of crude oil and causes more problems in the downstream refinery operations, such as corrosion and pipeline pressure drop. Hence, it is important to know the effects of emulsions in the pipeline. Light crude oil was used for the continuous phase in the W/O emulsions where the emulsions pass through a flow loop to test the pressure drop across the pipeline. The results obtained shows that pressure drop increases as water cut is increased until it peaks at the phase inversion of the W/O emulsion between 30% to 40% water cut. Emulsions produced by gradual constrictions show a lower stability as compared to sudden constrictions. Lower stability of emulsions in gradual constriction has the higher influence of pressure drop compared to a sudden sharp decrease in diameter in sudden constriction. Generally, sudden constriction experiences pressure drop of 0.013% to 0.067% higher than gradual constriction of the same ratio. Lower constriction ratio cases cause larger pressure drop ranging from 0.061% to 0.241%. Considering the higher profitability in lower emulsion stability and lower pressure drop at the developed flow region of different constrictions, an optimum design of constriction is found to be gradual constriction with a ratio of 0.5.

Keywords: constriction, pressure drop, turbulence, water-in-oil emulsions

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4614 Effect of Swelling Pressure on Drug Release from Polyelectrolyte Micro-Hydrogel Particles

Authors: Mina Boroujerdi, Javad Tavakoli

Abstract:

Hydrogels are extensively studied as matrices for the controlled release of drugs. To evaluate the mobility of embedded molecules, these drug delivery systems are usually characterized by release studies. In this contribution, an electronic device for swelling pressure measurement during drug release from hydrogel network was developed. Also, poly acrylic acid micro particles were prepared for prolonged and sustained controlled acetaminophen release. Effect of swelling pressure on drug release from micro particles studied under different environment pH in order to predict release profile in gastro-intestine medium. Swelling ratio and swelling pressure were measured in different pH.

Keywords: swelling pressure, drug delivery, hydrogel, polyelectrolyte

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4613 Effect of Number of Baffles on Pressure Drop and Heat Transfer in a Shell and Tube Heat Exchanger

Authors: A. Falavand Jozaei, A. Ghafouri, M. Mosavi Navaei

Abstract:

In this paper for a given heat duty, study of number of baffles on pressure drop and heat transfer is considered in a STHX (Shell and Tube Heat Exchanger) with single segmental baffles. The effect of number of baffles from 9 to 52 baffles (baffle spacing variations from 4 to 24 inches) over OHTC (Overall Heat Hransfer Coefficient) to pressure drop ratio (U/Δp ratio). The results show that U/Δp ratio is low when baffle spacing is minimum (4 inches) because pressure drop is high; however, heat transfer coefficient is very significant. Then, with the increase of baffle spacing, pressure drop rapidly decreases and OHTC also decreases, but the decrease of OHTC is lower than pressure drop, so (U/Δp) ratio increases. After increasing baffles more than 12 inches, variation in pressure drop is gradual and approximately constant and OHTC decreases; Consequently, U/Δp ratio decreases again. If baffle spacing reaches to 24 inches, STHX will have minimum pressure drop, but OHTC decreases, so required heat transfer surface increases and U/Δp ratio decreases. After baffle spacing more than 12 inches, variation of shell side pressure drop is negligible. So optimum baffle spacing is suggested between 8 to 12 inches (43 to 63 percent of inside shell diameter) for a sufficient heat duty and low pressure drop.

Keywords: shell and tube heat exchanger, single segmental baffle, overall heat transfer coefficient, pressure drop

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4612 Importance of Solubility and Bubble Pressure Models to Predict Pressure of Nitrified Oil Based Drilling Fluid in Dual Gradient Drilling

Authors: Sajjad Negahban, Ruihe Wang, Baojiang Sun

Abstract:

Gas-lift dual gradient drilling is a solution for deepwater drilling challenges. As well, Continuous development of drilling technology leads to increase employment of mineral oil based drilling fluids and synthetic-based drilling fluids, which have adequate characteristics such as: high rate of penetration, lubricity, shale inhibition and low toxicity. The paper discusses utilization of nitrified mineral oil base drilling for deepwater drilling and for more accurate prediction of pressure in DGD at marine riser, solubility and bubble pressure were considered in steady state hydraulic model. The Standing bubble pressure and solubility correlations, and two models which were acquired from experimental determination were applied in hydraulic model. The effect of the black oil correlations, and new solubility and bubble pressure models was evaluated on the PVT parameters such as oil formation volume factor, density, viscosity, volumetric flow rate. Eventually, the consequent simulated pressure profile due to these models was presented.

Keywords: solubility, bubble pressure, gas-lift dual gradient drilling, steady state hydraulic model

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4611 Carvacrol Attenuates Lung Injury in Rats with Severe Acute Pancreatitis

Authors: Salim Cerig, Fatime Geyikoglu, Pınar Akpulat, Suat Colak, Hasan Turkez, Murat Bakir, Mirkhalil Hosseinigouzdagani, Kubra Koc

Abstract:

This study was designed to evaluate whether carvacrol (CAR) could provide protection against lung injury by acute pancreatitis development. The rats were randomized into groups to receive (I) no therapy; (II) 50 μg/kg cerulein at 1h intervals by four intraperitoneal injections (i.p.); (III) 50, 100 and 200 mg/kg CAR by one i.p.; and (IV) cerulein+CAR after 2h of cerulein injection. 12h later, serum samples were obtained to assess pancreatic function the lipase and amylase values. The animals were euthanized and lung samples were excised. The specimens were stained with hematoxylin-eosin (H&E), periodic acid–Schif (PAS), Mallory's trichrome and amyloid. Additionally, oxidative DNA damage was determined by measuring as increases in 8-hydroxy-deoxyguanosine (8-OH-dG) adducts. The results showed that the serum activity of lipase and amylase in AP rats were significantly reduced after the therapy (p<0.05). We also found that the 100 mg/kg dose of CAR significantly decreased 8-OH-dG levels. Moreover, the severe pathological findings in the lung such as necrosis, inflammation, congestion, fibrosis, and thickened alveolar septum were attenuated in the AP+CAR groups when compared with AP group. Finally, the magnitude of the protective effect on lung is certain, and CAR is an effective therapy for lung injury caused by AP.

Keywords: antioxidant activity, acute pancreatitis, carvacrol, experimental, lung injury, oxidative DNA damage

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4610 Psychological Intervention for Partners Post-Stroke: A Case Study

Authors: Natasha Yasmin Felles, Gerard Riley

Abstract:

Background and Aims: Relationship breakdown is typical when one partner lives with an acquired brain injury caused by issues like a stroke. Research has found that the perception of relationship satisfaction decreases following such an injury among non-injured partners. Non-injured partners also are found to experience caregiver stress/burden as they immediately have to take the role of a caregiver along with being a partner of the injured. Research has also found that the perception of a continuous relationship, i.e. the perception of the relationship to be essentially the same as it was before the injury, also changes among those caregiving partners. However, there is a lack of available intervention strategies that can help those partners with both individual and relationship difficulties. The aim of this case study was to conduct a pilot test of an intervention aimed to explore whether it is possible to support a partner to experience greater continuity within the relationship poststroke, and what benefits such a change might have. Method: A couple, where one partner experienced an acquired brain injury poststroke were provided with Integrated Behavioural Couples Therapy for 3-months. The intervention addressed goals identified as necessary by the couple and by the formulation of their individual and relationship difficulties, alongside the goal of promoting relationship continuity. Before and after measures were taken using a battery of six questionnaires to evaluate changes in perceptions of continuity, stress, and other aspects of the relationship. Results: Both quantitative and qualitative data showed that relationship continuity was improved after the therapy, as were the measures of stress and other aspects of the relationship. The stress felt by the person with the acquired brain injury also showed some evidence of improvement. Conclusion: The study found that perceptions of relationship continuity can be improved by therapy and that improving these might have a beneficial impact on the stress felt by the carer, their satisfaction with the relationship and overall levels of conflict and closeness within the relationship. The study suggested the value of further research on enhancing perceptions of continuity in the relationship after an acquired brain injury. Currently, the findings of the study have been used to develop a pilot feasibility study to collect substantive evidence on the impact of the intervention on the couples and assess its feasibility and acceptability, which will help in further developing a specific generalized relationship continuity intervention, that will be beneficial in preventing relationship breakdown in the future.

Keywords: acquired brain injury, couples therapy, relationship continuity, stroke

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4609 The Effect of Peer Pressure and Leisure Boredom on Substance Use Among Adolescents in Low-Income Communities in Capetown

Authors: Gaironeesa Hendricks, Shazly Savahl, Maria Florence

Abstract:

The aim of the study is to determine whether peer pressure and leisure boredom influence substance use among adolescents in low-income communities in Cape Town. Non-probability sampling was used to select 296 adolescents between the ages of 16–18 from schools located in two low-income communities. The measurement tools included the Drug Use Disorders Identification Test, the Resistance to Peer Influence and Leisure Boredom Scales. Multiple regression revealed that the combined influence of peer pressure and leisure boredom predicted substance use, while peer pressure emerged as a stronger predictor than leisure boredom on substance use among adolescents.

Keywords: substance use, peer pressure, leisure boredom, adolescents, multiple regression

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4608 Heuristic Approaches for Injury Reductions by Reduced Car Use in Urban Areas

Authors: Stig H. Jørgensen, Trond Nordfjærn, Øyvind Teige Hedenstrøm, Torbjørn Rundmo

Abstract:

The aim of the paper is to estimate and forecast road traffic injuries in the coming 10-15 years given new targets in urban transport policy and shifts of mode of transport, including injury cross-effects of mode changes. The paper discusses possibilities and limitations in measuring and quantifying possible injury reductions. Injury data (killed and seriously injured road users) from six urban areas in Norway from 1998-2012 (N= 4709 casualties) form the basis for estimates of changing injury patterns. For the coming period calculation of number of injuries and injury rates by type of road user (categories of motorized versus non-motorized) by sex, age and type of road are made. A prognosticated population increase (25 %) in total population within 2025 in the six urban areas will curb the proceeded fall in injury figures. However, policy strategies and measures geared towards a stronger modal shift from use of private vehicles to safer public transport (bus, train) will modify this effect. On the other side will door to door transport (pedestrians on their way to/from public transport nodes) imply a higher exposure for pedestrians (bikers) converting from private vehicle use (including fall accidents not registered as traffic accidents). The overall effect is the sum of these modal shifts in the increasing urban population and in addition diminishing return to the majority of road safety countermeasures has also to be taken into account. The paper demonstrates how uncertainties in the various estimates (prediction factors) on increasing injuries as well as decreasing injury figures may partly offset each other. The paper discusses road safety policy and welfare consequences of transport mode shift, including reduced use of private vehicles, and further environmental impacts. In this regard, safety and environmental issues will as a rule concur. However pursuing environmental goals (e.g. improved air quality, reduced co2 emissions) encouraging more biking may generate more biking injuries. The study was given financial grants from the Norwegian Research Council’s Transport Safety Program.

Keywords: road injuries, forecasting, reduced private care use, urban, Norway

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4607 Dynamic Active Earth Pressure on Flexible Cantilever Retaining Wall

Authors: Snehal R. Pathak, Sachin S. Munnoli

Abstract:

Evaluation of dynamic earth pressure on retaining wall is a topic of primary importance. In present paper, dynamic active earth pressure and displacement of flexible cantilever retaining wall has been evaluated analytically using 2-DOF mass-spring-dashpot model by incorporating both wall and backfill properties. The effect of wall flexibility on dynamic active earth pressure and wall displacement are studied and presented in graphical form. The obtained results are then compared with the various conventional methods, experimental analysis and also with PLAXIS analysis. It is observed that the dynamic active earth pressure decreases with increase in the wall flexibility while wall displacement increases linearly with flexibility of the wall. The results obtained by proposed 2-DOF analytical model are found to be more realistic and economical.

Keywords: earth pressure, earthquake, 2-DOF model, Plaxis, retaining walls, wall movement

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4606 Non-Homogeneity in a Thick Walled Rotating Circular Cylinder under Varying Pressure

Authors: Jatinder Kaur, Pankaj Thakur

Abstract:

The effect of pressure and temperature in non-homogeneous circular cylinder by taking non-homogeneity of material in terms of compressibility c=c₀r⁻ᵏ has been observed. From the results, it could be seen that for K<0, high pressure is required in the initial yielding state than for the case K >0. Under thermal conditions for value K<0, lesser amount of pressure is required for initial yielding, and further, the amount keeps on decreasing with an increase in temperature. Curves are drawn between pressure and radii ratio for initial and fully plastic state with and without temperature conditions. Further graphs between stresses (hoop and radial) and radii ratio for fully plastic state with and without temperature conditions are also drawn and concluded that hoop stresses become minimum with the increase in temperature as compared to radial stresses.

Keywords: cylinder, elastic, plastic, copper, steel, stresses, pressure, load

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4605 Altered Lower Extremity Biomechanical Risk Factor Related to Anterior Cruciate Ligament Injury in Athlete with Functional Ankle Instability

Authors: Mohammad Karimizadehardakani, Hooman Minoonejad, Reza Rajabi, Ali Sharifnejad

Abstract:

Background: Ankle sprain is one of the most important risk factor of anterior cruciate ligament (ACL) injury. Also, functional ankle instability (FAI) population has alterations in lower extremity sagittal plane biomechanics during landing task. We want to examine whether biomechanical alterations demonstrated by FAI patients are associated with the mechanism of ACL injury during high risk and sport related tasks. Methods: Sixteen basketball player with FAI and 16 non-injured control performed a single-leg cross drop landing. Knee sagittal and frontal (ATSF) was calculated. Independent t-tests, multiple linear regression, and Pearson correlation were used for analysis data. Result: Subject with FAI showed more peak ATFS, posterior ground reaction force (GRF) and less knee flexion, compared to the controls (P= 0.001, P= 0.004, P= 0.011). Knee flexion (r= −0.824, P = 0.011) and posterior GRF (r= 0.901, P = .001) were correlated with ATSF; Posterior GRF was factor that most explained the variance in ATSF (R2= 0.645; P = .001) in the FAI group. Conclusions: Result of our study showed there is a potential biomechanical relationship between the presence of FAI and risk factors associated with ACL injury mechanism.

Keywords: functional ankle instability, anterior cruciate ligament, biomechanics, risk factor

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4604 The Influence of Winding Angle on Functional Failure of FRP Pipes

Authors: Roham Rafiee, Hadi Hesamsadat

Abstract:

In this study, a parametric finite element modeling is developed to analyze failure modes of FRP pipes subjected to internal pressure. First-ply failure pressure and functional failure pressure was determined by a progressive damage modeling and then it is validated using experimental observations. The influence of both winding angle and fiber volume fraction is studied on the functional failure of FRP pipes and it corresponding pressure. It is observed that despite the fact that increasing fiber volume fraction will enhance the mechanical properties, it will be resulted in lower values for functional failure pressure. This shortcoming can be compensated by modifying the winding angle in angle plies of pipe wall structure.

Keywords: composite pipe, functional failure, progressive modeling, winding angle

Procedia PDF Downloads 532
4603 The Impact of Intestinal Ischaemia-Reperfusion Injury upon the Biological Function of Mesenteric Lymph

Authors: Beth Taylor, Kojima Mituaki, Atsushi Senda, Koji Morishita, Yasuhiro Otomo

Abstract:

Intestinal ischaemia-reperfusion injury drives systemic inflammation and organ failure following trauma/haemorrhagic shock (T/HS), through the release of pro-inflammatory mediators into the mesenteric lymph (ML). However, changes in the biological function of ML are not fully understood, and therefore, a specific model of intestinal ischaemia-reperfusion injury is required to obtain ML for the study of its biological function upon inflammatory cells. ML obtained from a model of intestinal ischaemia-reperfusion injury was used to assess biological function upon inflammatory cells and investigate changes in the biological function of individual ML components. An additional model was used to determine the effect of vagal nerve stimulation (VNS) upon biological function. Rat ML was obtained by mesenteric lymphatic duct cannulation before and after occlusion of the superior mesenteric artery (SMAO). ML was incubated with human polymorphonuclear neutrophils (PMNs), monocytes and lymphocytes, and the biological function of these cells was assessed. ML was then separated into supernatant, exosome and micro-vesicle components, and biological activity was compared in monocytes. A model with an additional VNS phase was developed, in which the right cervical vagal nerve was exposed and stimulated, and ML collected for comparison of biological function with the conventional model. The biological function of ML was altered by intestinal ischaemia-reperfusion injury, increasing PMN activation, monocyte activation, and lymphocyte apoptosis. Increased monocyte activation was only induced by the exosome component of ML, with no significant changes induced by the supernatant or micro-vesicle components. VNS partially attenuated monocyte activation, but no attenuation of PMN activation was observed. Intestinal ischaemia-reperfusion injury induces changes in the biological function of ML upon both innate and adaptive inflammatory cells, supporting the role of intestinal ischaemia-reperfusion injury in driving systemic inflammation following T/HS. The exosome component of ML appears to be critical to the transport of pro-inflammatory mediators in ML. VNS partially attenuates changes in innate inflammatory cell biological activity observed, presenting possibilities for future novel treatment development in multiple organ failure patients.

Keywords: exosomes, inflammation, intestinal ischaemia, mesenteric lymph, vagal stimulation

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4602 Preventive Effects of Motorcycle Helmets on Clinical Outcomes in Motorcycle Crashes

Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

Abstract:

Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

Procedia PDF Downloads 169
4601 Effect of Current Density, Temperature and Pressure on Proton Exchange Membrane Electrolyser Stack

Authors: Na Li, Samuel Simon Araya, Søren Knudsen Kær

Abstract:

This study investigates the effects of operating parameters of different current density, temperature and pressure on the performance of a proton exchange membrane (PEM) water electrolysis stack. A 7-cell PEM water electrolysis stack was assembled and tested under different operation modules. The voltage change and polarization curves under different test conditions, namely current density, temperature and pressure, were recorded. Results show that higher temperature has positive effect on overall stack performance, where temperature of 80 ℃ improved the cell performance greatly. However, the cathode pressure and current density has little effect on stack performance.

Keywords: PEM electrolysis stack, current density, temperature, pressure

Procedia PDF Downloads 185
4600 High-pressure Crystallographic Characterization of f-block Element Complexes

Authors: Nicholas B. Beck, Thomas E. Albrecht-Schönzart

Abstract:

High-pressure results in decreases in the bond lengths of metal-ligand bonds, which has proven to be incredibly informative in uncovering differences in bonding between lanthanide and actinide complexes. The degree of f-electron contribution to the metal ligand bonds has been observed to increase under pressure by a far greater degree in the actinides than the lanthanides, as revealed by spectroscopic studies. However, the actual changes in bond lengths have yet to be quantified, although computationally predicted. By using high-pressure crystallographic techniques, crystal structures of lanthanide complexes have been obtained at pressures up to 5 GPa for both hard and soft-donor ligands. These studies have revealed some unpredicted changes in the coordination environment as well as provided experimental support to computational results

Keywords: crystallography, high-pressure, lanthanide, materials

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4599 The Effect of Melatonin on Acute Liver Injury: Implication to Shift Work Related Sleep Deprivation

Authors: Bing-Fang Lee, Srinivasan Periasamy, Ming-Yie Liu

Abstract:

Shift work sleep disorder is a common problem in industrialized world. It is a type of circadian rhythmic sleep disorders characterized by insomnia and sleep deprivation. Lack of sleep in workers may lead to poor health conditions such as hepatic dysfunction. Melatonin is a hormone secreted by the pineal gland to alleviate insomnia. Moreover, it is a powerful antioxidant and may prevent acute liver injury. Therefore, workers take in melatonin to deal with sleep-related health is an important issue. The aim of this study was to investigate the effect of melatonin on an acute hepatic injury model sinusoidal obstruction syndrome (SOS) in mice. Male C57BL/6 mice were injected with a single dose (500 mg/kg) of monocrotaline (MCT) to induce SOS. Melatonin (1, 3, 10 and 30 mg/kg) was injected 1 h before MCT treatment. After 24 h of MCT treatment, mice were sacrificed. The blood and liver were collected. Organ damage was evaluated by serum biochemistry, hematology analyzer, and histological examination. Low doses of melatonin (1 and 3 mg/kg) had no protective effect on SOS. However, high doses (10 and 30 mg/kg) exacerbated SOS. In addition, it not only increased serum glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and extended liver damage indicated by histological examination but also decreased platelet levels, lymphocyte ratio, and glutathione level; it had no effect on malondialdehyde and nitric oxide level in SOS mice. To conclude, melatonin may exacerbate MCT-induced SOS in mice. Furthermore, melatonin might have a synergistic action with SOS. Usage of melatonin for insomnia by people working in long shift must be cautioned; it might cause acute hepatic injury.

Keywords: acute liver injury, melatonin, shift work, sleep deprivation

Procedia PDF Downloads 181
4598 Pressure Losses on Realistic Geometry of Tracheobronchial Tree

Authors: Michaela Chovancova, Jakub Elcner

Abstract:

Real bronchial tree is very complicated piping system. Analysis of flow and pressure losses in this system is very difficult. Due to the complex geometry and the very small size in the lower generations is examination by CFD possible only in the central part of bronchial tree. For specify the pressure losses of lower generations is necessary to provide a mathematical equation. Determination of mathematical formulas for calculating the pressure losses in the real lungs is due to its complexity and diversity lengthy and inefficient process. For these calculations is necessary the lungs to slightly simplify (same cross-section over the length of individual generation) or use one of the models of lungs. The simplification could cause deviations from real values. The article compares the values of pressure losses obtained from CFD simulation of air flow in the central part of the real bronchial tree with the values calculated in a slightly simplified real lungs by using a mathematical relationship derived from the Bernoulli equation and continuity equation. Then, evaluate the desirability of using this formula to determine the pressure loss across the bronchial tree.

Keywords: pressure gradient, airways resistance, real geometry of bronchial tree, breathing

Procedia PDF Downloads 314