Search results for: group size
11931 Effect of Operative Stabilization on Rib Fracture Healing in Porcine Experimental Model: A Pilot Study
Authors: Maria Stepankova, Lucie Vistejnova, Pavel Klein, Tereza Blassova, Marketa Slajerova, Radek Sedlacek, Martin Bartos, Jaroslav Chlupac
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Background: Clinical outcome benefits of the segment rib fracture surgical therapy are well known and follow from better stabilization of the chest wall. Despite this, some authors still incline to conservative therapy and point out to possible rib fracture healing failure in connection with the bone vascular supply disturbance caused by metal plate implantation. This suggestion met neither experimental nor clinical verification and remains the object of discussion. In our pilot study we investigated the titanium plate fixation effect on the rib fracture healing in porcine model and its histological, biomechanical and radiological aspects. Materials and Method: Two porcine models (experimental group) underwent the operative chest wall stabilization with a titanium plate implantation after osteotomy. Two other porcine models (control group) were treated conservatively after osteotomy. Three weeks after surgery, all animals were sacrificed, treated ribs were explanted and the histological analysis, µCT imaging and biomechanical testing of the calluses tissue were performed. Results: In µCT imaging, experimental group showed a higher cortical bone volume compared to the control group. Histological analysis using the non-decalcified bone tissue blocks demonstrated more maturated callus with higher newly-formed osseous tissue ratio in experimental group in comparison to controls. In contrast, no significant differences in bone blood vessels supply in both groups were observed. This finding suggests that the bone blood supply in experimental group was not impaired. Biomechanical analysis using 3-point bending test demonstrated significantly higher bending stiffness and the maximum force in experimental group. Conclusion: Based on our observation, it could be concluded, that the titanium plate fixation of the rib fractures leads to faster bone callus maturation whereas does not cause the vascular supply impairment after 3 weeks and thus has a beneficial effect on the rib fracture healing.Keywords: bone vascular supply, chest wall stabilization, fracture healing, histological analysis, titanium plate implantation
Procedia PDF Downloads 14111930 Interpretation of Two Indices for the Prediction of Cardiovascular Risk in Pediatric Obesity
Authors: Mustafa M. Donma, Orkide Donma
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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.Keywords: APRI, children, FIB-4, obesity, triglycerides
Procedia PDF Downloads 34911929 Integrating Service Learning into a Business Analytics Course: A Comparative Investigation
Authors: Gokhan Egilmez, Erika Hatfield, Julie Turner
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In this study, we investigated the impacts of service-learning integration on an undergraduate level business analytics course from multiple perspectives, including academic proficiency, community awareness, engagement, social responsibility, and reflection. We assessed the impact of the service-learning experience by using a survey developed primarily based on the literature review and secondarily on an ad hoc group of researchers. Then, we implemented the survey in two sections, where one of the sections was a control group. We compared the results of the empirical survey visually and statistically.Keywords: business analytics, service learning, experiential education, statistical analysis, survey research
Procedia PDF Downloads 11211928 An Attempt of Cost Analysis of Heart Failure Patients at Cardiology Department at Kasr Al Aini Hospitals: A Micro-Costing Study from Social Perspective
Authors: Eman Elsebaie, A. Sedrak, R. Ziada
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Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.Keywords: health care cost, heart failure, hospitalization, inpatient
Procedia PDF Downloads 24311927 Comparison Between Partial Thickness Skin Graft Harvesting From Scalp and Lower Limb for Scalp Defect
Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou
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Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.Keywords: donor site, graft, scalp, partial thickness
Procedia PDF Downloads 9311926 Morphological Characteristics and Bioreactivity of Inhalable Particles during the Temple Fair in Kaifeng
Authors: Qiao Yushuang, Shao Longyi
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This paper presents the result of plasmid assay of inhalable particulates PM10 and PM2.5 that were collected during the period of the 11th Hanyuan temple fair of ancestor worship in Kaifeng City. By use of a high-resolution Field Emission Scanning Electron Microscopy (FESEM) and image analysis (IA) technology, the morphological characteristics and Particle Size Distribution (PSD) of each were analyzed and the Bioreactivity of PM10 was evaluated by using plasmid DNA assay. The result shows that, as the dominant component of the samples taken in the urban area of Kaifeng City, the mineral particles, compared with the other components including the soot aggregates, coal ash, and unidentified particles, have a much greater amount and volume. The mineral particles exhibited a decentralized quantity - size distribution, whose presence could be available among the particles sizing 2.5μm or smaller. In contrast, the volume-size distribution of mineral particles is scattered in a relatively narrow range of between1μm and 2.5μm. According to the plasmid assay the TD50 (toxic dose of PM causing 50% of plasmid damage, expressed in μg/ml) of water-soluble PM10 and whole fraction of Kaifeng airborne PM10 was measured respectively at 220-208μg/ml and 300-400μg/ml versus 160μg/ml and 190μg/ml for PM2.5. It can be seen that the whole fraction of airborne particles caused more oxidative damage than the water-soluble fractions, and the PM2.5 has a greater oxidative capacity than the PM10.Keywords: inhalable particulates (PM10 and PM2.5), morphological features, bioreactivity, Kaifeng
Procedia PDF Downloads 19511925 Understanding the Nature of Blood Pressure as Metabolic Syndrome Component in Children
Authors: Mustafa M. Donma, Orkide Donma
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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.Keywords: blood pressure, children, index, metabolic syndrome, obesity
Procedia PDF Downloads 11911924 Achieving Appropriate Use of Antibiotics through Pharmacists’ Intervention at Practice Point: An Indian Study Report
Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta
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Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling
Procedia PDF Downloads 18411923 Working within the Zone of Proximal Development: Does It Help for Reading Strategy?
Authors: Mahmood Dehqan, Peyman Peyvasteh
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In recent years there has been a growing interest in issues concerning the impact of sociocultural theory (SCT) of learning on different aspects of second/foreign language learning. This study aimed to find the possible effects of sociocultural teaching techniques on reading strategy of EFL learners. Indeed, the present research compared the impact of peer and teacher scaffolding on EFL learners’ reading strategy use across two proficiency levels. To this end, a pre-test post-test quasi-experimental research design was used and two instruments were utilized to collect the data: Nelson English language test and reading strategy questionnaire. Ninety five university students participated in this study were divided into two groups of teacher and peer scaffolding. Teacher scaffolding group received scaffolded help from the teacher based on three mechanisms of effective help within ZPD: graduated, contingent, dialogic. In contrast, learners of peer scaffolding group were unleashed from the teacher-fronted classroom as they were asked to carry out the reading comprehension tasks with the feedback they provided for each other. Results obtained from ANOVA revealed that teacher scaffolding group outperformed the peer scaffolding group in terms of reading strategy use. It means teacher’s scaffolded help provided within the learners’ ZPD led to better reading strategy improvement compared with the peer scaffolded help. However, the interaction effect between proficiency factor and teaching technique was non-significant, leading to the conclusion that strategy use of the learners was not affected by their proficiency level in either teacher or peer scaffolding groups.Keywords: peer scaffolding, proficiency level, reading strategy, sociocultural theory, teacher scaffolding
Procedia PDF Downloads 38311922 Effect of vr Based Wii Fit Training on Muscle Strength, Sensory Integration Ability and Walking Abilities in Patients with Parkinson's Disease: A Randomized Control Trial
Authors: Ying-Yi Laio, Yea-Ru Yang, Yih-Ru Wu, Ray-Yau Wang
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Background: Virtual reality (VR) systems are proved to increase motor performance in stroke and elderly. However, the effects have not been established in patients with Parkinson’s disease (PD). Purpose: To examine the effects of VR based training in improving muscle strength, sensory integration ability and walking abilities in patients with PD by a randomized controlled trial. Method: Thirty six participants with diagnosis of PD were randomly assigned to one of the three groups (n=12 for each group). Participants received VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group received no structured exercise program but fall-prevention education. Outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment (FGA). All outcomes were assessed at baseline, after training and at 1-month follow-up. Results: Both VRWii and TE groups showed more improvement in level walking velocity, stride length, FGA, muscle strength and vestibular system integration than control group after training and at 1-month follow-up. The VRWii training, but not the TE training, resulted in more improvement in visual system integration than the control. Conclusions: VRWii training is as beneficial as traditional exercise in improving walking abilities, sensory integration ability and muscle strength in patients with PD, and such improvements persisted at least for 1 month. The VRWii training is then suggested to be implemented in patients with PD.Keywords: virtual reality, walking, sensory integration, muscle strength, Parkinson’s disease
Procedia PDF Downloads 33211921 Evaluation of Phonophoresis with Dexamethasone in Treatment of Hypertrophic Burn Scar
Authors: Alireza Pishgahi, Mohammad Rahbar, Javad Shokri, Shahla Dareshiri, Yaghoub Salekzamani, Fariba Eslamian
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Background and Objectives: Hypertrophic scars are one of the complications following a burn injury. Intralesional corticosteroid injection is an invasive method for treatment of this complication. We had design a single blinded randomized control trial to deliver dexamethasone by phonophoresis and evaluate its efficacy on hypertrophic burn scars characteristics. Material and Methods: 56 cases of hypertrophic burn scar due to burn injury allocated randomly to dexamethasone and control group. Individuals in case group received 10 sessions of dexamethasone 0.4% phonophoresis. Patients in control group had placebo phonophoresis (ultrasound with normal routine aquatic gel without any dexamethasone) with the same protocol. At the beginning of study and one week after last session, hypertrophic scar characteristics and pruritus were measured by ‘Vancouver Scar Scale’, and ‘5-D Pruritus Scale’ respectively in both groups. Results: Despite mild improvement in Vancouver Scar Scale score one week after intervention in dexamethasone phonophoresis group in comparison to control subjects, but this difference was not significant (p=0.08). Pruritus score perceived subjectively were significantly lower one week after intervention in dexamethasone groups in comparison to control subjects (p=0.00). Conclusion: Dexamethasone phonophoresis is a safe and effective treatment method for burn hypertrophic scar pruritus, but its efficacy for scar characteristics improvement needs to be evaluated by larger studies with long-term follow-up period.Keywords: dexamethasone, hypertrophic scar, phonophoresis, pruritus
Procedia PDF Downloads 17311920 Influence of Densification Process and Material Properties on Final Briquettes Quality from FastGrowing Willows
Authors: Peter Križan, Juraj Beniak, Ľubomír Šooš, Miloš Matúš
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Biomass treatment through densification is very suitable and important technology before its effective energy recovery. Densification process of biomass is significantly influenced by various technological and also material parameters which are ultimately reflected on the final solid Biofuels quality. The paper deals with the experimental research of the relationship between technological and material parameters during densification of fast-growing trees, roundly fast-rowing willow. The main goal of presented experimental research is to determine the relationship between pressing pressure raw material fraction size from a final briquettes density point of view. Experimental research was realized by single-axis densification. The impact of fraction size with interaction of pressing pressure and stabilization time on the quality properties of briquettes was determined. These parameters interaction affects the final solid biofuels (briquettes) quality. From briquettes production point of view and also from densification machines constructions point of view is very important to know about mutual interaction of these parameters on final briquettes quality. The experimental findings presented here are showing the importance of mentioned parameters during the densification process.Keywords: briquettes density, densification, fraction size, pressing pressure, stabilization time
Procedia PDF Downloads 36911919 The Impact of Combined Loading on Lateral Capacity and Group Efficiency of Helical Piles
Authors: Hesham Hamdy Abdulmohsen, Ahmed Shawky Abdel Aziz, Mona Fawzy Aldaghma
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Helical piles have gained significant attention as efficient alternatives for deep foundations due to their rapid installation process and dual functionality in compression and tension. They experience various combinations of axial and lateral loads. While extensive research has explored helical pile behavior under individual axial or lateral loads, the effects of combined axial compression and lateral loads still need further study. This paper compares experimental and numerical (PLAXIS-3D) results for vertical helical-pile groups under combined loads. The study aims to clarify the impact of key factors, including helix location and lateral load direction, on the lateral capacity of helical-pile groups and, consequently, their overall efficiency. The study concludes that the lateral capacity of the helical-pile group significantly depends on the helix location within the pile shaft length. Optimal lateral performance occurs when helices are positioned at a depth ratio of H/L = 0.4. Furthermore, rectangular plan distribution groups exhibit greater lateral capacity when subjected to lateral loads aligned with their long axis. The presence of vertical compression loading enhances the lateral capacity of the group, with the specific enhancement depending on the value of the vertical compression load, lateral load direction, and helix location.Keywords: experimental, numerical model, lateral loading, group efficiency, helical piles
Procedia PDF Downloads 4711918 Impact of the Dog-Technic for D1-D4 and Longitudinal Stroke Technique for Diaphragm on Peak Expiratory Flow (PEF) in Asthmatic Patients
Authors: Victoria Eugenia Garnacho-Garnacho, Elena Sonsoles Rodriguez-Lopez, Raquel Delgado-Delgado, Alvaro Otero-Campos, Jesus Guodemar-Perez, Angelo Michelle Vagali, Juan Pablo Hervas-Perez
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Asthma is a heterogeneous disease which has always had a drug treatment. Osteopathic treatment that we propose is aimed, seen through a dorsal manipulation (Dog Technic D1-D4) and a technique for diaphragm (Longitudinal Stroke) forced expiratory flow in spirometry changes there are in particular that there is an increase in the volumes of the Peak Flow and Post intervention and effort and that the application of these two techniques together is more powerful if we applied only a Longitudinal (Stroke). Also rating if this type of treatment will have repercussions on breathlessness, a very common symptom in asthma. And finally to investigate if provided vertebra pain decreased after a manipulation. Methods—Participants were recruited between students and professors of the University, aged 18-65, patients (n = 18) were assigned randomly to one of the two groups, group 1 (longitudinal Stroke and manipulation dorsal Dog Technic) and group 2 (diaphragmatic technique, Longitudinal Stroke). The statistical analysis is characterized by the comparison of the main indicator of obstruction of via area PEF (peak expiratory flow) in various situations through the peak flow meter Datospir Peak-10. The measurements were carried out in four phases: at rest, after the stress test, after the treatment, after treatment and the stress test. After each stress test was evaluated, through the Borg scale, the level of Dyspnea on each patient, regardless of the group. In Group 1 in addition to these parameters was calculated using an algometer spinous pain before and after the manipulation. All data were taken at the minute. Results—12 Group 1 (Dog Technic and Longitudinal Stroke) patients responded positively to treatment, there was an increase of 5.1% and 6.1% of the post-treatment PEF and post-treatment, and effort. The results of the scale of Borg by which we measure the level of Dyspnea were positive, a 54.95%, patients noted an improvement in breathing. In addition was confirmed through the means of both groups group 1 in which two techniques were applied was 34.05% more effective than group 2 in which applied only a. After handling pain fell by 38% of the cases. Conclusions—The impact of the technique of Dog-Technic for D1-D4 and the Longitudinal Stroke technique for diaphragm in the volumes of peak expiratory flow (PEF) in asthmatic patients were positive, there was a change of the PEF Post intervention and post-treatment, and effort and showed the most effective group in which only a technique was applied. Furthermore this type of treatment decreased facilitated vertebrae pain and was efficient in the improvement of Dyspnea and the general well-being of the patient.Keywords: ANS, asthma, manipulation, manual therapy, osteopathic
Procedia PDF Downloads 29011917 A Comparison between Virtual Case-Based Learning and Traditional Learning: The Effect on Undergraduate Nursing Students’ Performance during Covid-19: A Pilot Study
Authors: Aya M. Aboudesouky
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Covid-19 has changed and affected the whole world dramatically in a new way that the entire world, even scientists, have not imagined before. The educational institutions around the world have been fighting since Covid-19 hit the world last December to keep the educational process unchanged for all students. E-learning was a must for almost all US universities during the pandemic. It was specifically more challenging to use online case-based learning instead of regular classes among nursing students who take practical education. This study aims to examine the difference in performance and satisfaction between nursing students taking traditional education and those who take virtual case-based education during their practical study. This study enrolls 40 last-year nursing undergraduates from a mid-sized university in Western Pennsylvania. The study uses a convenient sample. Students will be divided into two groups; a control group that is exposed to traditional teaching strategy and a treatment group that is exposed to a case-based teaching strategy. The module designed for this study is a total parenteral nutrition (TPN) module that will be taught for one month. The treatment group (n=20) utilizes the virtual simulation of the CBL method, while the control group (n=20) uses the traditional lecture-based teaching method. Student evaluations are collected after a month by using the survey to attain the students’ learning satisfaction and self-evaluation of the course. The post-test is used to assess the end of the course performance.Keywords: virtual case-based learning, traditional education, nursing education, Covid-19 crisis, online practical education
Procedia PDF Downloads 13011916 Photopolymerization of Dimethacrylamide with (Meth)acrylates
Authors: Yuling Xu, Haibo Wang, Dong Xie
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A photopolymerizable dimethacrylamide was synthesized and copolymerized with the selected (meth)acrylates. The polymerization rate, degree of conversion, gel time, and compressive strength of the formed neat resins were investigated. The results show that in situ photo-polymerization of the synthesized dimethacrylamide with comonomers having an electron-withdrawing and/or acrylate group dramatically increased the polymerization rate, degree of conversion, and compressive strength. On the other hand, an electron-donating group on either carbon-carbon double bond or the ester linkage slowed down the polymerization. In contrast, the triethylene glycol dimethacrylate-based system did not show a clear pattern. Both strong hydrogen-bonding between (meth)acrylamide and organic acid groups may be responsible for higher compressive strengths. Within the limitation of this study, the photo-polymerization of dimethacrylamide can be greatly accelerated by copolymerization with monomers having electron-withdrawing and/or acrylate groups. The monomers with methacrylate group can significantly reduce the polymerization rate and degree of conversion.Keywords: photopolymerization, dimethacrylamide, the degree of conversion, compressive strength
Procedia PDF Downloads 15811915 Bone Mineral Density of the Lumbar Spine, Femur in Elite Egyptian Male Swimmers
Authors: Magdy Abouzeid
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Introduction: Physical activity has been shown to have a positive effect on bone mineral density (BMD) and bone mineral content (BMC) among children, adolescents, and adults. Sports characterized by little or moderate weight bearing or impact have a low osteogenic effect. However, the action of such sports on bone turnover remains unclear. Swimming, as a non-weight-bearing sport, has been considered to be insignificant in the maintenance of bone mass. Purpose: To examine this issue we measured (BMD) and(BMC) of the lumbar spine, proximal femur via dual energy x-ray absorptiometry in the group of elite male swimmers, and determine the effect of swimming training on bone health and compared the results with matched controls group in age, body weight and height. Materials and Methods: Twenty-five male swimmers (age 20.7+/-0.8 years) training for 12-15 hours/week; and the controls group consisted of 25 non-active male (age 21.3 +/-1.3 years) were studied BMD and BMC of lumbar spine, femur were assessed via (DXA) absorptiometry. Results: There was significant difference between swimmers and control group in BMD and BMC, BMD of Swimmers was significantly greater than controls at all sites. The lumbar spine (1, 08 +/-0.202 vs., 0717+0.57 gxcm (-2), right proximal femur (1, 02 +/-, 044 vs., 771+/-, 027 gxcm (-2), and left proximal femur (1.374+/-0.212 vs. 1.01 +/-0.141 gxcm (-2). Swimmers were significantly taller, and had greater BMC and BMD compared to the controls group (P<0.001). Conclusions: These results suggest that swimming training may be beneficial in the prevention or therapy of OSTEOPENIA, and may lead to increased (BMD) and (BMC) for male swimmers. Swimming may be an effective non-pharmacological intervention for the adults and adolescent. Further research with younger athletes of another type of aquatics sport is warranted to better identify the periods of BMD development during which Aquatics sport has the greatest impact on bone health.Keywords: bone mineral density, lumbar spine, femur, swimming, DXA absorptiometry
Procedia PDF Downloads 32511914 Conjugated Chitosan-Carboxymethyl-5-Fluorouracil Nanoparticles for Skin Delivery
Authors: Mazita Mohd Diah, Anton V. Dolzhenko, Tin Wui Wong
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Nanoparticles, being small with a large specific surface area, increase solubility, enhance bioavailability, improve controlled release and enable precision targeting of the entrapped compounds. In this study, chitosan as polymeric permeation enhancer was conjugated to a polar pro-drug, carboxymethyl-5-fluorouracil (CMFU) to increase the skin drug permeation. Chitosan-CMFU conjugate was synthesized using chemical conjugation process through succinate linker. It was then transformed into nanoparticles via spray drying method. The conjugation was elucidated using Fourier Transform Infrared and Proton Nuclear Magnetic Resonance techniques. The nanoparticle size, size distribution, zeta potential, drug content, skin permeation and retention profiles were characterized. The conjugation was denoted using 1H NMR by new peaks at signal δ = 4.184 ppm (singlet, 2H for CH2) and 7.676-7.688 ppm (doublet, 1H for C6) attributed to CMFU in chitosan-CMFU NMR spectrum. The nanoparticles had profiles of particle size: 93.97 ±35.11 nm, polydispersity index: 0.40 ± 0.14, zeta potential: +18.25 ±2.95 mV and drug content: 6.20 ± 1.98 % w/w. Almost 80 % w/w CMFU in the form of nanoparticles permeated through the skin in 24 hours and close to 50 % w/w permeation occurred in first 1-2 hours. Without conjugation to chitosan and nanoparticulation, less than 40 % w/w CMFU permeated through the skin in 24 hours. The skin drug retention likewise was higher with chitosan-CMFU nanoparticles (15.34 ± 5.82 % w/w) than CMFU (2.24 ± 0.57 % w/w). CMFU, through conjugation with chitosan permeation enhancer and processed in nanogeometry, had its skin permeation and retention degree promoted.Keywords: carboxymethyl-5-fluorouracil, chitosan, conjugate, skin permeation, skin retention
Procedia PDF Downloads 36711913 An Experimental Study on the Effect of Operating Parameters during the Micro-Electro-Discharge Machining of Ni Based Alloy
Authors: Asma Perveen, M. P. Jahan
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Ni alloys have managed to cover wide range of applications such as automotive industries, oil gas industries, and aerospace industries. However, these alloys impose challenges while using conventional machining technologies. On the other hand, Micro-Electro-Discharge machining (micro-EDM) is a non-conventional machining method that uses controlled sparks energy to remove material irrespective of the materials hardness. There has been always a huge interest from the industries for developing optimum methodology and parameters in order to enhance the productivity of micro-EDM in terms of reducing machining time and tool wear for different alloys. Therefore, the aims of this study are to investigate the effects of the micro-EDM process parameters, in order to find their optimal values. The input process parameters include voltage, capacitance, and electrode rotational speed, whereas the output parameters considered are machining time, entrance diameter of hole, overcut, tool wear, and crater size. The surface morphology and element characterization are also investigated with the use of SEM and EDX analysis. The experimental result indicates the reduction of machining time with the increment of discharge energy. Discharge energy also contributes to the enlargement of entrance diameter as well as overcut. In addition, tool wears show reduction with the increase of discharge energy. Moreover, crater size is found to be increased in size along with the increment of discharge energy.Keywords: micro holes, micro EDM, Ni Alloy, discharge energy
Procedia PDF Downloads 27611912 Synthesis and Characterization of Amino-Functionalized Polystyrene Nanoparticles as Reactive Filler
Authors: Yaseen Elhebshi, Abdulkareem Hamid, Nureddin Bin Issa, Xiaonong Chen
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A convenient method of preparing ultrafine polystyrene latex nano-particles with amino groups on the surface is developed. Polystyrene latexes in the size range 50–400 nm were prepared via emulsion polymerization, using sodium dodecyl sulfate (SDS) as surfactant. Polystyrene with amino groups on the surface will be fine to use as organic filler to modify rubber. Transmission electron microscopy (TEM) was used to observe the morphology of silicon dioxide and functionalized polystyrene nano-particles. The nature of bonding between the polymer and the reactive groups on the filler surfaces was analyzed using Fourier transform infrared spectroscopy (FTIR). Scanning electron microscopy (SEM) was employed to examine the filler surface.Keywords: reactive filler, emulsion polymerization, particle size, polystyrene nanoparticles
Procedia PDF Downloads 35111911 Project HDMI: A Hybrid-Differentiated Mathematics Instruction for Grade 11 Senior High School Students at Las Piñas City Technical Vocational High School
Authors: Mary Ann Cristine R. Olgado
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Diversity in the classroom might make it difficult to promote individualized learning, but differentiated instruction that caters to students' various learning preferences may prove to be beneficial. Hence, this study examined the effectiveness of Hybrid-Differentiated Mathematics Instruction (HDMI) in improving the students’ academic performance in Mathematics. It employed the quasi-experimental research design by using a comparative analysis of the two variables: the experimental and control groups. The learning styles of the students were identified using the Grasha-Riechmann Student Learning Style Scale (GRSLSS), which served as the basis for designing differentiated action plans in Mathematics. In addition, adapted survey questionnaires, pre-tests, and post-tests were used to gather information and were analyzed using descriptive and correlational statistics to find the relationship between variables. The experimental group received differentiated instruction for a month, while the control group received traditional teaching instruction. The study found that Hybrid-Differentiated Mathematics Instruction (HDMI) improved the academic performance of Grade 11-TVL students, with the experimental group performing better than the control group. This program has effectively tailored the teaching methods to meet the diverse learning needs of the students, fostering and enhancing a deeper understanding of mathematical concepts in Statistics & Probability, both within and beyond the classroom.Keywords: differentiated instruction, hybrid, learning styles, academic performance
Procedia PDF Downloads 6411910 Osteoactivin Is a Specific Biomarker in Bone and Cartilage Metabolism
Authors: Gulnara Azizova, Naila Hasanova, Nazenin Hasanzade
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The aim of study is to investigate the role of osteoactivin as a more sensitive and modern diagnostic biomarker that has a prognostic value in metabolic and repair processes occurring in bone and cartilage tissue in osteoporosis and osteoporotic fractures. Osteoactivin (OA) is a new glycoprotein that is highly expressed during osteoblast differentiation. It was first discovered in an osteopetrotic rat model using mRNA . This study was carried out on patients between the ages of 45-83 from the Department of Traumatology and placed in 3 groups: group I - 14 patients with osteoporosis, group II - 15 patients with non-osteoporotic fractures, group III - 25 patients with osteoporotic fractures. The control group consisted of 14 healthy people. To monitor changes in osteoactivin, blood samples were taken at 3 stages: on day 1 before treatment, on day 10 of treatment, and 1 month after treatment. The concentration of OA in the blood serum was determined by ELISA method on the immunoassay analyzer “Mindray MR- 96A” using a set of reagents from the company Boster ( ELISA Kit PicoKine, USA). The statistical evaluation was performed by using SPSS 22.0 program (IBM SPSS Inc., USA). Compared to the control, osteoactivin concentration increased by 66.2% in patients with osteoporosis, 54.1% in patients with non-osteoporotic fractures, and 80.2% in patients with osteoporotic fractures, indicating that it plays an important role in the pathogenesis of osteoporotic fractures. At 1 month after treatment, osteoactivin concentration increased by 81.6% in patients with non-osteoporotic fractures. The lack of a significant change in osteoporotic fractures is explained by the late healing of these fractures. Based on the sensitivity and specificity indicators, the ROC curve was created and it was determined that osteoactivin is a test with high general diagnostic value, specificity and informativeness in the prognosis of osteoporosis and osteoporotic fractures, and can be used throughout the treatment period.Keywords: osteoactivin, bone, osteoporosis., cartilage
Procedia PDF Downloads 3111909 Anti-Ulcer Activity of Hydro Alcoholic Extract of Ficus bengalensis Linn Bark in Experimental Rats
Authors: Jagdish Baheti, Sampat Navale
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The present study was performed to evaluate the anti-ulcerogenic activity of hydro-alcoholic extract of Ficus bengalensis Linn. against ethanol-induced gastric mucosal injury in rats and pylorus ligation gastric secretion in rats. Five groups of adult wistar rats were orally pre-treated respectively with carboxy methyl cellulose (CMC) solution (ulcer control group), Omeprazole 20 mg/kg (reference group), and 100, 200 and 300 mg/kg F. bengalensis Linn. bark extract in CMC solution (experimental groups), one hour before oral administration of absolute ethanol to generate gastric mucosal injury. Rats were sacrificed and the ulcer index, gastric volume, gastric pH, free acidity, total acidity of the gastric content was determined. Grossly, the ulcer control group exhibited severe mucosal injury, whereas pre-treatment with F. bengalensis Linn. bark extract exhibited significant protection of gastric mucosal injury in both model. Histological studies revealed that ulcer control group exhibited severe damage of gastric mucosa, along with edema and leucocytes infiltration of submucosal layer compared to rats pre-treated with F. bengalensis Linn. bark extract which showed gastric mucosal protection, reduction or absence of edema and leucocytes infiltration of submucosal layer. Acute toxicity study did not manifest any toxicological signs in rats. The present finding suggests that F. bengalensis Linn. bark extract promotes ulcer protection as ascertained grossly and histologically compared to the ulcer control group.Keywords: Ficus bengalensis Linn., gastric ulcer, hydroalcoholic, pylorus ligation
Procedia PDF Downloads 29511908 Morphological Characterization and Gas Permeation of Commercially Available Alumina Membrane
Authors: Ifeyinwa Orakwe, Ngozi Nwogu, Edward Gobina
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This work presents experimental results relating to the structural characterization of a commercially available alumina membrane. A γ-alumina mesoporous tubular membrane has been used. Nitrogen adsorption-desorption, scanning electron microscopy and gas permeability test has been carried out on the alumina membrane to characterize its structural features. Scanning electron microscopy (SEM) was used to determine the pore size distribution of the membrane. Pore size, specific surface area and pore size distribution were also determined with the use of the Nitrogen adsorption-desorption instrument. Gas permeation tests were carried out on the membrane using a variety of single and mixed gases. The permeabilities at different pressure between 0.05-1 bar and temperature range of 25-200oC were used for the single and mixed gases: nitrogen (N2), helium (He), oxygen (O2), carbon dioxide (CO2), 14%CO₂/N₂, 60%CO₂/N₂, 30%CO₂/CH4 and 21%O₂/N₂. Plots of flow rate verses pressure were obtained. Results got showed the effect of temperature on the permeation rate of the various gases. At 0.5 bar for example, the flow rate for N2 was relatively constant before decreasing with an increase in temperature, while for O2, it continuously decreased with an increase in temperature. In the case of 30%CO₂/CH4 and 14%CO₂/N₂, the flow rate showed an increase then a decrease with increase in temperature. The effect of temperature on the membrane performance of the various gases is presented and the influence of the trans membrane pressure drop will be discussed in this paper.Keywords: alumina membrane, Nitrogen adsorption-desorption, scanning electron microscopy, gas permeation, temperature
Procedia PDF Downloads 32511907 Antibacterial Activity and Cytotoxicity of Silver Nanoparticles Synthesized by Moringa oleifera Extract as Reducing Agent
Authors: Temsiri Suwan, Penpicha Wanachantararak, Sakornrat Khongkhunthian, Siriporn Okonogi
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In the present study, silver nanoparticles (AgNPs) were synthesized by green synthesis approach using Moringa oleifera aqueous extract (ME) as a reducing agent and silver nitrate as a precursor. The obtained AgNPs were characterized using UV-Vis spectroscopy (UV-Vis), dynamic light scattering (DLS), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and X-ray diffractometry (XRD). The results from UV-Vis revealed that the maximum absorption of AgNPs was at 430 nm and the EDX spectrum confirmed Ag element. The results from DLS indicated that the amount of ME played an important role in particle size, size distribution, and zeta potential of the obtained AgNPs. The smallest size (62.4 ± 1.8 nm) with narrow distribution (0.18 ± 0.02) of AgNPs was obtained after using 1% w/v of ME. This system gave high negative zeta potential of -36.5 ± 2.8 mV. SEM results indicated that the obtained AgNPs were spherical in shape. Antibacterial activity using dilution method revealed that the minimum inhibitory and minimum bactericidal concentrations of the obtained AgNPs against Streptococcus mutans were 0.025 and 0.1 mg/mL, respectively. Cytotoxicity test of AgNPs on adenocarcinomic human alveolar basal epithelial cells (A549) indicated that the particles impacted against A549 cells. The percentage of cell growth inhibition was 87.5 ± 3.6 % when only 0.1 mg/mL AgNPs was used. These results suggest that ME is the potential reducing agent for green synthesis of AgNPs.Keywords: antibacterial activity, Moringa oleifera extract, reducing agent, silver nanoparticles
Procedia PDF Downloads 11611906 Clinical Profile of Oral Sensory Abilities in Developmental Dysarthria
Authors: Swapna N., Deepthy Ann Joy
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One of the major causes of communication disorders in pediatric population is Motor speech disorders. These disorders which affect the motor aspects of speech articulators can have an adverse effect on the communication abilities of children in their developmental period. The motor aspects are dependent on the sensory abilities of children with motor speech disorders. Hence, oral sensorimotor evaluation is an important component in the assessment of children with motor speech disorders. To our knowledge, the importance of oral motor examination has been well established, yet the sensory assessment of the oral structures has received less focus. One of the most common motor speech disorders seen in children is developmental dysarthria. The present study aimed to assess the orosensory aspects in children with developmental dysarthria (CDD). The control group consisted of 240 children in the age range of four and eight years which was divided into four subgroups (4-4.11, 5-5.11, 6-6.11 and 7-7.11 years). The experimental group consisted of 15 children who were diagnosed with developmental dysarthria secondary to cerebral palsy who belonged in the age range of four and eight years. The oro-sensory aspects such as response to touch, temperature, taste, texture, and orofacial sensitivity were evaluated and profiled. For this purpose, the authors used the ‘Oral Sensorimotor Evaluation Protocol- Children’ which was developed by the authors. The oro-sensory section of the protocol was administered and the clinical profile of oro-sensory abilities of typically developing children and CDD was obtained for each of the sensory abilities. The oro-sensory abilities of speech articulators such as lips, tongue, palate, jaw, and cheeks were assessed in detail and scored. The results indicated that experimental group had poorer scores on oro-sensory aspects such as light static touch, kinetic touch, deep pressure, vibration and double simultaneous touch. However, it was also found that the experimental group performed similar to control group on few aspects like temperature, taste, texture and orofacial sensitivity. Apart from the oro-motor abilities which has received utmost interest, the variation in the oro-sensory abilities of experimental and control group is highlighted and discussed in the present study. This emphasizes the need for assessing the oro-sensory abilities in children with developmental dysarthria in addition to oro-motor abilities.Keywords: cerebral palsy, developmental dysarthria, orosensory assessment, touch
Procedia PDF Downloads 16411905 Synthesising Highly Luminescent CdTe Quantum Dots Using Cannula Hot Injection Method
Authors: Erdem Elibol, Musa Cadırcı, Nedim Tutkun
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Recently, colloidal quantum dots (CQDs) have drawn increasing attention due to their unique size tunability, which makes them potential candidates for numerous applications including photovoltaic, LEDs, and imaging. However, the main challenge to exploit CQDs properly is that there has not been an effective method to produce them with highly crystalline form and narrow size dispersion. Hot injection method is one of the widely used techniques to produce high-quality nanoparticles. In this method, the key parameter is to reduce the time for injection of the precursors into each other, which yields fast and constant nucleation rate and hence to highly monodisperse QDs. In conventional hot injection method, the injection of precursors is carried out using standard lab syringes with long needles. However, this technique is relatively slow and thus will result in poor optical properties in QDs. In this work, highly luminescent CdTe QDs were synthesised by transferring hot precursors into each other using cannula method. Unlike regular syringe technique, with the help of high pressure difference between two precursors’ flasks and wide cross-section of cannula, the hot cannulation process is too short which yields narrow size distribution and high quantum yield of CdTe QDs. Here QDs with full width half maximum (FWHM) of 28 nm was achieved. In addition, the photoluminescence quantum yield of our samples was measured to be about 21 ± 0.9 which is at least twice the previous record values for CdTe QDs wherein syringe was used to transfer precursors.Keywords: CdTe, hot injection method, luminescent, quantum dots
Procedia PDF Downloads 32311904 Evaluation of a Mindfulness and Self-Care-Based Intervention for Teachers to Enhance Mental Health
Authors: T. Noichl, M. Cramer, G. E. Dlugosch, I. Hosenfeld
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Teachers are exposed to a variety of stresses in their work context. These can have a negative impact on physical and psychological well-being. The online training ‘Better Living! Self-care for teachers’ is based on the training ‘Better Living! Self-care for mental health professionals’, which has been proven to be effective over a period of 3 years. The training for teachers is being evaluated for its effectiveness between October 2021 and March 2023 in a study funded by the German Federal Ministry of Education and Research. The aim of the training is to promote self-care and mindfulness among participants and thereby to foster well-being. The concept of self-care was already mentioned in antiquity and was also named as an imperative by philosophers such as Socrates and Epictetus. In the absence of a universal understanding of self-care today, the following definition was developed within the research group: Self-care is 1) facing oneself in a loving and appreciative way, 2) taking one's own needs seriously, and 3) actively contributing to one's own well-being. The study is designed as a randomized wait-control group repeated-measures design with 4 (treatment group) resp. 6 (wait-control group) measurement points. Central dependent variables are self-care, mindfulness, stress, and well-being. To assess the long-term effectiveness of training participation, these constructs are surveyed at the beginning and the end of the training as well as five weeks and one year later. Based on the results of the evaluation with mental health professionals, it is expected that participation will lead to an increase in subjective well-being, self-care, and mindfulness. The first results of the evaluation study are presented and discussed with regard to the effectiveness of the training among teachers.Keywords: longitudinal intervention study, mindfulness, self-care, teachers’ mental health, well-being
Procedia PDF Downloads 10311903 Study the Influence of the Type of Cast Iron Chips on the Quality of Briquettes Obtained with Controlled Impact
Authors: Dimitar N. Karastoianov, Stanislav D. Gyoshev, Todor N. Penchev
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Preparation of briquettes of metal chips with good density and quality is of great importance for the efficiency of this process. In this paper are presented the results of impact briquetting of grey cast iron chips with rectangular shape and dimensions 15x25x1 mm. Density and quality of briquettes of these chips are compared with those obtained in another work of the authors using cast iron chips with smaller sizes. It has been found that by using a rectangular chips with a large size are produced briquettes with a very low density and poor quality. From the photographs taken by X-ray tomography, it is clear that the reason for this is the orientation of the chip in the peripheral wall of the briquettes, which does not allow of the air to escape from it. It was concluded that in order to obtain briquettes of cast iron chips with a large size, these chips must first be ground, for example in a small ball mill.Keywords: briquetting, chips, impact, rocket engine
Procedia PDF Downloads 52611902 Horizontal Bone Augmentation Using Two Membranes at Dehisced Implant Sites: A Randomized Clinical Study
Authors: Monika Bansal
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Background: Placement of dental implant in narrow alveolar ridge is challenging to be treated. GBR procedure is currently most widely used to augment the deficient alveolar ridges and to treat the fenestration and dehiscence around dental implants. Thus, the objectives of the present study were to evaluate as well as compare the clinical performance of collagen membrane and titanium mesh for horizontal bone augmentation at dehisced implant sites. Methods and material: Total 12 single edentulous implant sites with buccal bone deficiency in 8 subjects were equally divided and treated simultaneously with either of the two membranes and DBBM(Bio-Oss) bone graft. Primary outcome measurements in terms of defect height and defect width were made using a calibrated plastic periodontal probe. Re-entry surgery was performed to remeasure the augmented site and to remove Ti-mesh at 6th month. Independent paired t-tests for the inter-group comparison and student-paired t-tests for the intra-group comparison were performed. The differences were considered to be significant at p ≤ 0.05. Results: Mean defect fill with respect to height and width was 3.50 ± 0.54 mm (87%) and 2.33 ± 0.51 mm (82%) for collagen membrane and 3.83 ± 0.75 mm (92%) and 2.50 ± 0.54 mm (88%) for Ti-mesh group respectively. Conclusions: Within the limitation of the study, it was concluded that mean defect height and width after 6 months were statistically significant within the group without significant difference between them, although defect resolution was better in Ti-mesh.Keywords: collagen membrane, dehiscence, dental implant, horizontal bone, augmentation, ti-mesh
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