Search results for: iliac vein compression syndrome

Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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Authors: Elżbieta Turska

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Introduction: One of the most difficult times in a person’s life is adolescence. The experiences in this period may shape the future life of this person to a large extent. This is the reason why many young people experience sadness, dejection, hopelessness, sense of worthlessness, as well as losing interest in various activities and social relationships, all of which are often classified as mood disorders. As many as 15-40% adolescents experience depressed moods and for most of them they resolve and are not carried into adulthood. However, (5-6%) of those affected by mood disorders develop the depressive syndrome and as many as (1-3%) develop full-blown clinical depression. Materials: A large questionnaire was given to 2508 students, aged 13–16 years old, and one of its parts was the Burns checklist, i.e. the standard test for identifying depressed mood. The questionnaire asked about many aspects of the student’s life, it included a total of 53 questions, most of which had subquestions. It is important to note that the data suffered from many problems, the most important of which were missing data and collinearity. Aim: In order to identify the correlates of mood disorders we built predictive models which were then trained and validated. Our aim was not to be able to predict which students suffer from mood disorders but rather to explore the factors influencing mood disorders. Methods: The problems with data described above practically excluded using all classical statistical methods. For this reason, we attempted to use the following Artificial Intelligence (AI) methods: classification trees with surrogate variables, random forests and xgboost. All analyses were carried out with the use of the mlr package for the R programming language. Resuts: The predictive model built by classification trees algorithm outperformed the other algorithms by a large margin. As a result, we were able to rank the variables (questions and subquestions from the questionnaire) from the most to least influential as far as protection against mood disorder is concerned. Thirteen out of twenty most important variables reflect the relationships with parents. This seems to be a really significant result both from the cognitive point of view and also from the practical point of view, i.e. as far as interventions to correct mood disorders are concerned.

Keywords: mood disorders, adolescents, family, artificial intelligence

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Authors: Kayode Oshinubi, Brice Kammegne, Jacques Demongeot

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The use of mathematical tools like Partial Differential Equations and Ordinary Differential Equations have become very important to predict the evolution of a viral disease in a population in order to take preventive and curative measures. In December 2019, a novel variety of Coronavirus (SARS-CoV-2) was identified in Wuhan, Hubei Province, China causing a severe and potentially fatal respiratory syndrome, i.e., COVID-19. Since then, it has become a pandemic declared by World Health Organization (WHO) on March 11, 2020 which has spread around the globe. A reaction-diffusion system is a mathematical model that describes the evolution of a phenomenon subjected to two processes: a reaction process in which different substances are transformed, and a diffusion process that causes a distribution in space. This article provides a mathematical study of the Susceptible, Exposed, Infected, Recovered, and Vaccinated population model of the COVID-19 pandemic by the bias of reaction-diffusion equations. Both local and global asymptotic stability conditions for disease-free and endemic equilibria are determined using the Lyapunov function are considered and the endemic equilibrium point exists and is stable if it satisfies Routh–Hurwitz criteria. Also, adequate conditions for the existence and uniqueness of the solution of the model have been proved. We showed the spatial distribution of the model compartments when the basic reproduction rate $\mathcal{R}_0 < 1$ and $\mathcal{R}_0 > 1$ and sensitivity analysis is performed in order to determine the most sensitive parameters in the proposed model. We demonstrate the model's effectiveness by performing numerical simulations. We investigate the impact of vaccination and the significance of spatial distribution parameters in the spread of COVID-19. The findings indicate that reducing contact with an infected person and increasing the proportion of susceptible people who receive high-efficacy vaccination will lessen the burden of COVID-19 in the population. To the public health policymakers, we offered a better understanding of the COVID-19 management.

Keywords: COVID-19, SEIRV epidemic model, reaction-diffusion equation, basic reproduction number, vaccination, spatial distribution

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Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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Authors: Mohammed S. Bhader, Abdullah A. Ghaddaf, Anas Alamoudi, Amal Abualola, Renad Kalantan, Noura Alkhulaifi, Ibrahim Halawani, Mohammed Alhindi

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Background: Noninvasive neurally adjusted ventilatory assist (NAVA) is a relatively new mode of noninvasive ventilation with promising clinical and patient-ventilator outcomes for preterm infants. The aim of this systematic review was to compare NAVA to nasal continuous or positive airway pressure (NCPAP) or intermittent positive airway pressure (NIPP) for preterm infants. Methods: We searched the online databases Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared NAVA to NCPAP or NIPP for preterm infants < 37 weeks gestational age. We sought to evaluate the following outcomes: noninvasive intubation failure rate, desaturation rate, the fraction of inspired oxygen (FiO2), and length of stay in the neonatal intensive care unit (NICU). We used the mean difference (MD) to represent continuous outcomes, while the odds ratio (OR) was used to represent dichotomous outcomes. Results: A total of 11 RCTs that enrolled 429 preterm infants were deemed eligible. NAVA showed similar clinical outcomes to NCPAP or NIPP with respect to noninvasive intubation failure (RR for NAVA versus NCPAP: 0.82, 95% confidence interval (CI): 0.49 to 1.37), desaturation rate (RR for NAVA versus NCPAP: 0.69, 95%CI: 0.36 to 1.29; RR for NAVA versus NIPP: 0.58, 95%CI: 0.08 to 4.25), FiO2 (MD for NAVA versus NCPAP: –0.01, 95%CI: –0.04 to 0.02; MD for NAVA versus NIPP: –7.16, 95%CI: –22.63 to 8.31), and length of stay in the NICU (MD for NAVA versus NCPAP: 1.34, 95%CI: –4.17 to 6.85). Conclusion: NAVA showed similar clinical and ventilator-related outcomes compared to the usual care noninvasive respiratory support measures NCPAP or NIPP for preterm infants.

Keywords: preterm infants, noninvasive neurally adjusted ventilatory assist, NIV-NAVA, non-invasive ventilation, nasal continuous or positive airway pressure, NCPAP, intermittent positive airway pressure ventilation, NIPP, respiratory distress syndrome, RDS

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Authors: Ambra Giovannelli, Erika Maria Archilei

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The electrical power consumption related to refrigeration systems is evaluated to be in the order of 15% of the total electricity consumption worldwide. For this reason, in the last years several energy saving techniques have been suggested to reduce the power demand of refrigeration and air conditioning plants. The research work deals with the development of an innovative internal power recovery system for industrial cryogenic cooling plants. Such system is based on a Compressor-Expander Group (CEG). Both the expander and the compressor have been designed starting from automotive turbocharging components, strongly modified to take refrigerant fluid properties and specific system requirements into consideration. A preliminary choice of the machines (radial compressors and expanders) among existing components available on the market was realised according to the rules of the similarity theory. Once the expander was selected, it was strongly modified and performance verified by means of steady-state 3D CFD simulations. This paper focuses the attention on the development of the second CEG main component: the compressor. Once the preliminary selection has been done, the compressor geometry has been modified to take the new boundary conditions into account. In particular, the impeller has been machined to address the required total enthalpy increase. Such evaluation has been carried out by means of a simplified 1D model. Moreover, a vaneless diffuser has been added, modifying the shape of casing rear and front disks. To verify the performance of the modified compressor geometry and suggest improvements, a numerical fluid dynamic model has been set up and the commercial Ansys-CFX software has been used to perform steady-state 3D simulations. In this work, all the numerical results will be shown, highlighting critical aspects and suggesting further developments to increase compressor performance and flexibility.

Keywords: vapour compression systems, energy saving, refrigeration plant, organic fluids, centrifugal compressor

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Authors: Mingke Ma

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The recent discovery of the High-Income Trap phenomena and the established Middle-Income Trap literature have identified the similarity of the structural challenges that both Mainland China and Taiwan have been facing since the simultaneous growth slowdown from the 2000s. Mainland China and Taiwan’s ineffectiveness in productivity growth weakened their overall competitiveness in Global Value Chains. With the subsequent decline of industrial profitability, social compression from late development persists and jeopardises the social cohesion. From Ma Ying-jeou’s ‘633’ promise and Tsai Ing-wen’s ‘5+2’ industrial framework to Mainland China’s 11th to 14th Five-Year Plans, leaderships across the Strait have been striving to constitute new models for inclusive and sustainable development through policy responses. This study argues that social consensuses that have been constructed by the domestic political processes define the feasibility of the reform strategies, which further construct the conditions for Cross-Strait interactions. Based on the existing literature of New Institutional Economics, Middle/High Income Trap, and Compressed Development, this study adopts a Historical Institutionalist analytical framework to identify how the historical path-dependency contributes to the contemporary growth constraints in both economies and the political difficulty on navigating the institutional and Organisational change. It continues by tracing the political process of economic reform to examine the sustainability and resilience of the manifested social consensus that had empowered the proposed policy frameworks. Afterwards, it examines how the political outcomes in such a simultaneous process shared by both Mainland China and Taiwan construct the social, economic, institutional, and political foundations of contemporary Cross-Strait engagement.

Keywords: historical institutionalism, political economy, cross-strait relations, high/middle income trap

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Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

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

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

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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Authors: Timmis W., Simms M., Thomas C.

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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

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Authors: Ari Prasetyo, Taufik Faturohman

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The COVID-19 pandemic in Indonesia is part of the ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was confirmed to have spread to Indonesia on 2 March 2020. Moreover, the government of Indonesia has been conducting a local lockdown to limit people's movement from one city to another city. Therefore, this situation has impact on business operation, especially on highway companies listed on the Indonesia stock exchange. This study evaluates and measures three companies’ financial performance and health conditions before and during the COVID-19 pandemic from 2016 – 2020. The measurement is conducted by using financial ratio analysis and the Altman Z-score method. The ratio used to measure the financial ratio analysis is taken from the decree of the Ministry of SOE’s KEP-100/MBU/2002 about the company’s health level condition. From the decree, there are eight financial ratios used such as return on equity (ROE), return on investment (ROI), current ratio, cash ratio, collection period, inventory turnover, total asset turnover, and total equity to total asset. Altman Z-score is used to calculate the financial distress condition. The result shows that the highway companies for the period 2016 – 2020 are as follows: PT Jasa Marga (Persero) Tbk (AA, BB, BB, BB, C), PT Citra Marga Nusaphala Persada Tbk (BB, AA, BB, BBB, C), and PT Nusantara Infrastructure Tbk (BB, BB, AA, BBB, C). In addition, the Altman Z-score assessment performed in 2016-2020 shows that PT Jasa Marga (Persero) Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020. PT Citra Marga Nusaphala Persada Tbk was in the grey zone area for 2015-2019 and in the distress zone for 2020. PT Nusantara Infrastructure Tbk was in the grey zone area for 2015-2018 and in the distress zone for 2019-2020.

Keywords: financial performance, financial ratio, Altman Z-score, financial distress, highway company

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Authors: Joanna Estkowska

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Sensory integration methods are very useful and improve daily functioning autistic and mentally disabled children. Autism is a neurobiological disorder that impairs one's ability to communicate with and relate to others as well as their sensory system. Children with autism, even highly functioning kids, can find it difficult to process language with surrounding noise or smells. They are hypersensitive to things we can ignore such as sight, sounds and touch. Adolescents with highly functioning autism or Asperger Syndrome can study Science and Math but the social aspect is difficult for them. Nature science is an area of study that attracts many of these kids. It is a systematic field in which the children can focus on a small aspect. If you follow these rules you can come up with an expected result. Sensory integration program and systematic classroom observation are quantitative methods of measuring classroom functioning and behaviors from direct observations. These methods specify both the events and behaviors that are to be observed and how they are to be recorded. Our students with and without autism attended the lessons in the classroom of nature science in the school and in the laboratory of University of Science and Technology in Bydgoszcz. The aim of this study is investigation the effects of sensory integration methods in teaching to students with autism. They were observed during experimental lessons in the classroom and in the laboratory. Their physical characteristics, sensory dysfunction, and behavior in class were taken into consideration by comparing their similarities and differences. In the chemistry classroom, every autistic student is paired with a mentor from their school. In the laboratory, the children are expected to wear goggles, gloves and a lab coat. The chemistry classes in the laboratory were held for four hours with a lunch break, and according to the assistants, the children were engaged the whole time. In classroom of nature science, the students are encouraged to use the interactive exhibition of chemical, physical and mathematical models constructed by the author of this paper. Our students with and without autism attended the lessons in those laboratories. The teacher's goals are: to assist the child in inhibiting and modulating sensory information and support the child in processing a response to sensory stimulation.

Keywords: autism spectrum disorder, science education, sensory integration techniques, student with special educational needs

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Authors: O. A. Apampa, Y. A. Jimoh

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The paper reports the investigation of Corn Cob Ash as a chemical stabilizing agent for laterite soils. Corn cob feedstock was obtained from Maya, a rural community in the derived savannah agro-ecological zone of South-Western Nigeria and burnt to ashes of pozzolanic quality. Reddish brown silty clayey sand material characterized as AASHTO A-2-6(3) lateritic material was obtained from a borrow pit in Abeokuta and subjected to strength characterization tests according to BS 1377: 2000. The soil was subsequently mixed with CCA in varying percentages of 0-7.5% at 1.5% intervals. The influence of CCA stabilized soil was determined for the Atterberg limits, compaction characteristics, CBR and the unconfined compression strength. The tests were repeated on laterite cement-soil mixture in order to establish a basis for comparison. The result shows a similarity in the compaction characteristics of soil-cement and soil-CCA. With increasing addition of binder from 1.5% to 7.5%, Maximum Dry Density progressively declined while the OMC steadily increased. For the CBR, the maximum positive impact was observed at 1.5% CCA addition at a value of 85% compared to the control value of 65% for the cement stabilization, but declined steadily thereafter with increasing addition of CCA, while that of soil-cement continued to increase with increasing addition of cement beyond 1.5% though at a relatively slow rate. Similar behavior was observed in the UCS values for the soil-CCA mix, increasing from a control value of 0.4 MN/m2 to 1.0 MN/m2 at 1.5% CCA and declining thereafter, while that for soil-cement continued to increase with increasing cement addition, but at a slower rate. This paper demonstrates that CCA is effective for chemical stabilization of a typical Nigerian AASHTO A-2-6 lateritic soil at maximum stabilizer content limit of 1.5% and therefore recommends its use as a way of finding further application for agricultural waste products and achievement of environmental sustainability in line with the ideals of the millennium development goals because of the economic and technical feasibility of the processing of the cobs from corn.

Keywords: corn cob ash, pozzolan, cement, laterite, stabilizing agent, cation exchange capacity

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Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Cognitive impairment is commonly encountered problem in children with various clinical diseases, including Down syndrome, autism spectrum disorder, brain injury, and others. Cognitive impairment limits participation in education and society, and this further hinders development in cognition. However, young children with cognitive impairment tend not to respond well to traditional cognitive treatments, therefore alternative treatment choices are need. As a cognitive training program, touch screen technology can easily be applied to very young children by involving visual and auditory support. Injini was developed as tablet computer based cognitive rehabilitation program for young children or individuals with severe cognitive impairment, which targeted on cognitive ages of 18 to 36 months. The aim of this study was to evaluate the efficacy of a tablet computer based cognitive rehabilitation program (Injini) for children with cognitive impairment. 38 children between cognitive ages of 18 to 36 months confirmed by cognitive evaluations were recruited and randomly assigned to the intervention group (n=20) and the control group (n=18). The intervention group received tablet computer based cognitive rehabilitation program (Injini) for 30 minutes per session, twice a week, over a period of 12 weeks, in addition to the traditional rehabilitation program. The control group received traditional rehabilitation program only. Mental score of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), Laboratory Temperament Assessment Battery (Lab-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. When comparing the baseline characteristics, there was no significant difference between the two groups in the measurements of cognitive function. After 12 weeks of treatment, both group showed improvements in all measurements. However, in comparison of improvements after treatment, the intervention group showed more improvements in the mental score of BSID II, social function domain of PEDI, observation domain of Lab-TAB, and GAS, as compared to the control group. Application of the tablet computer based cognitive rehabilitation program (Injini) would be beneficial for improvement of cognitive function in young children with cognitive impairment.

Keywords: cognitive therapy, computer-assisted therapy, early intervention, tablets

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Authors: Shima Taheri, Simon Clark

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Concrete is an essential building material used in the majority of structures. Degradation of concrete over time increases the life-cycle cost of an asset with an estimated annual cost of billions of dollars to national economies. Most of the concrete failure occurs due to cracks, which propagate through a structure and cause weakening leading to failure. Stopping crack propagation is thus the key to protecting concrete structures from failure and is the best way to prevent inconveniences and catastrophes. Furthermore, the majority of cracks occur deep within the concrete in inaccessible areas and are invisible to normal inspection. Few materials intrinsically possess self-healing ability, but one that does is concrete. However, self-healing in concrete is limited to small dormant cracks in a moist environment and is difficult to control. In this project, we developed a method for self-healing of nascent fractures in concrete components through the automatic release of self-curing healing agents encapsulated in breakable nano- and micro-structures. The Poly(methyl methacrylate) (PMMA) based two-part adhesive is encapsulated in core-shell structures with brittle/weak inert shell, synthesized via miniemulsion/solvent evaporation polymerization. Stress fields associated with propagating cracks can break these capsules releasing the healing agents at the point where they are needed. The shell thickness is playing an important role in preserving the content until the final setting of concrete. The capsules can also be surface functionalized with carboxyl groups to overcome the homogenous mixing issues. Currently, this formulated self-healing system can replace up to 1% of cement in a concrete formulation. Increasing this amount to 5-7% in the concrete formulation without compromising compression strength and shrinkage properties, is still under investigation. This self-healing system will not only increase the durability of structures by stopping crack propagation but also allow the use of less cement in concrete construction, thereby adding to the global effort for CO2 emission reduction.

Keywords: self-healing concrete, concrete crack, concrete deterioration, durability

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Authors: Ravinder Singh, Pratima Syal

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Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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Authors: Dinka Fikadu, Mulugeta Shegaze

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Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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Authors: Junaid Mahmood Alam, Sana Anwar, Sarah Sughra Asghar

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Chronic hepatitis or Hepatitis C viral (HCV) infection has been identified as one of the factors that could elicit autoimmune disease resulting in the development of auto-antibodies. Furthermore, HCV is implicated in contravening of forbearance to antigens, therefore, inciting auto-reactivity. In this regard, several near and past studies noted the prevalence of thyroid dysfunction and production of anti-thyroid antibodies (ATAb) such as anti-thyroid peroxidase (AntiTPO) and anti-thyroglobulin (AntiTG) in patients with HCV. Likewise, one of the etiologies of augmentation of thyroid disease is basically interferon therapy for HCV infections, for which a number of autoimmune diseases have been noted including Grave’s disease, Hishimoto thyroiditis. A prospectively case-control study was therefore carried out at department of clinical biochemistry lab services and chemical pathology in collaboration with department of clinical microbiology, at Liaquat National Hospital and Medical College, Karachi Pakistan for the period January 2015 to December 2017. Two control groups were inducted for comparison purpose, control group 1 = without HCV infection and with thyroid disorders (n = 20), control group 2 = with HCV infection and without thyroid disorders (n = 20), whereas HCV infected were n = 40 where more than half were noted to be positive for either of HCV IgG and Ag. In HCV group, patients with existing sub-clinical hypothyroidism and clinical hyperthyroidism were less than 5%. Analysis showed the presence of AntiTG in 12 HCV patients (30%), AntiTPO in 15 (37.5%) and both AntiTG and antiTPO in 10 patients (25%). Only 3 patients were found with the history of anti-thyroid auto-antibodies (7.5%) and one with parents and relatives with auto-immune disorders (2.5%). Patients that remained untreated were 12 (30%), under treatment 18 (45%) and with complete-course of treatment 10 (25%). As per review of the literature, meta-analysis of evident data and cross-sectional studies of selective cohorts (as studied in presented research), thyroid connection is designated as one of the most recurrent endocrine ailment associated with chronic HCV infection. Moreover, it also represents an extrahepatic disease in the continuum of HCV syndrome. In conclusion, HCV patients were more likely to encompass thyroid disorders especially related to development of either of ATAb or both antiTG and AntiTPO.

Keywords: Hepatitis C viral (HCV) infection, anti-thyroid antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies

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Authors: Zsuzsanna Schnell, Francesca Ervas

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Background: Our study aims to clarify how language fosters further cognitive development and how we eventually arrive at the complex human specific skill of pragmatic competence and reveal what levels of mentalization and theory of mind are in place before language. Method: Our experimental pragmatic investigation maps the interaction of mentalization and pragmatic competence. We map the different levels of mentalization that empower different levels of pragmatic meaning construction and evaluate the results with statistical analysis (MannWhitney and ANOVA). Analyzing the comprehension of literal and non-compositional (figurative) utterances, we apply linguistic trials, among them metaphor-, irony-, irony with surface cue-, humor- and the recognition of maxim infringements trial in neurotypical (NT) preschoolers with a coherent and comparative methodology. Results: The findings reveal the relationship and direction of interaction between Language and theory of mind. On the one hand social-cognitive skills enhance, facilitate and provide a basis for language acquisition, and in return linguistic structures (DeVilliers 2000, 2007) provide a framework for further development of mentalizing skills. Conclusions: Findings confirm that this scaffolding becomes a mutually supportive system where language and social cognition develops in interaction. Certain stages in ToM development serve as a precursor of understanding grammatically complex sentences, like embedded phrases which mirror embedded mental states; which, in turn, facilitates the development of pragmatic competence, thus, the social use of language, integrating social, cognitive, linguistic and psychological factors in discourse. Future implications: Our investigation functions as a differential-diagnostic measure, with typically developing results thus serve as a baseline in further empirical research for atypical cases. This enables the study of populations where language and ToM development is disturbed, reveals how language and ToM are acquired and interact, and gives an insight into what this has to do with clinical symptoms. This in turn can reveal the causal link to the syndrome at hand, which can set directions for therapeutic development and training.

Keywords: theory of mind, language development, mentalization, language philosophy, experimental pragmatics

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Authors: M. Ghosh, A. Miroux, L. A. I. Kestens

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At molecular or micrometre scale, practically all materials are neither homogeneous nor isotropic. The concept of texture is used to identify the structural features that cause the properties of a material to be anisotropic. For metallic materials, the anisotropy of the mechanical behaviour originates from the crystallographic nature of plastic deformation, and is therefore controlled by the crystallographic texture. Anisotropy in mechanical properties often constitutes a disadvantage in the application of materials, as it is often illustrated by the earing phenomena during drawing. However, advantages may also be attained when considering other properties (e.g. optimization of magnetic behaviour to a specific direction) by controlling texture through thermo-mechanical processing). Nevertheless, in order to have better control over the final properties it is essential to relate texture with materials processing route and subsequently optimise their performance. However, up to date, few studies have been reported about the evolution of texture in 6061 aluminium alloy during warm processing (from room temperature to 250ºC). In present investigation, recrystallized 6061 aluminium alloy samples were subjected to tensile and plane strain compression (PSC) at room and warm temperatures. The gradual change of texture following both deformation modes were measured and discussed. Tensile tests demonstrate the mechanism at low strain while PSC does the same at high strain and eventually simulate the condition of rolling. Cube dominated texture of the initial rolled and recrystallized AA6061 sheets were replaced by domination of S and R components after PSC at room temperature, warm temperature (250ºC) though did not reflect any noticeable deviation from room temperature observation. It was also noticed that temperature has no significant effect on the evolution of grain morphology during PSC. The band contrast map revealed that after 30% deformation the substructure inside the grain is mainly made of series of parallel bands. A tendency for decrease of Cube and increase of Goss was noticed after tensile deformation compared to as-received material. Like PSC, texture does not change after deformation at warm temperature though. n-fibre was noticed for all the three textures from Goss to Cube.

Keywords: AA 6061, deformation, temperature, tensile, PSC, texture

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Authors: Yu-Ju Hsieh, Lin-Hung Lin, Wen-Hui Chang

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This study was designed as an interventional research and intended to validate whether the introduction of drinking vinegar every day can reduce and even prevent urinary tract infection in Taiwan home stayed disabilities who using indwelling catheter. The data was collected from the subjects who have received home care case at northern Taiwan, according to the questionnaire and a medical records retroactive methodology, the subjects were informed and consent to drink 15ml of table vinegar in a daily diet, and through routine urine testing and culture study. Home care nurses would assist collecting urine at the point of before and after a meal from total 35 studied subjects per month, and total collected 4 times for testing. The results showed that when the average age of study subjects was 65.46 years and catheter indwelling time was 15 years, drinking table vinegar could inhibit the activity of E. coli O157: H7 and reduce its breeding. Before drinking table vinegar daily, the subjects’ urine pH value was 7.0-8.0, and the average was 7.5, and the urine PH value dropped to 6.5 after drinking table vinegar for a month. There were two purple urine cases whose urine were changed from purple to normal color after two weeks of drinking, and the protein and bacteria values of urine gradually improved. Urine smell unpleasant before attending to this study, and the symptom improved significantly only after 1 week, and the urine smell returned to normal ammonia and became clean after 1 month later. None of these subjects received treatment in a hospital due to urinary tract infection, and there were no signs of bleeding in all cases during this study. The subjects of this study are chronic patients with a long-term bedridden catheterization; drinking cranberry juice is an economic burden for them, and also highly prohibited for diabetes patients. By adapting to use cheaper table vinegar to acidified urine and improve its smell and ease Purple Urine Syndrome, to furthermore, proven urinary tract infection, it can also to reduce the financial burden on families, the cost of social resources and the rate of re-admission.

Keywords: table vinegar, urinary tract infection, disability patients, long-term indwelling catheter

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Authors: Nikhil Padhye

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Recently a new phenomenon for bonding of polymeric films in solid-state, at ambient temperatures well below the glass transition temperature of the polymer, has been reported. This is achieved by bulk plastic compression of polymeric films held in contact. Here we analyze the process of cold-rolling of polymeric films via finite element simulations and illustrate a flexible and modular experimental rolling-apparatus that can achieve bonding of polymeric films through cold-rolling. Firstly, the classical theory of rolling a rigid-plastic thin-strip is utilized to estimate various deformation fields such as strain-rates, velocities, loads etc. in rolling the polymeric films at the specified feed-rates and desired levels of thickness-reduction(s). Predicted magnitudes of slow strain-rates, particularly at ambient temperatures during rolling, and moderate levels of plastic deformation (at which Bauschinger effect can be neglected for the particular class of polymeric materials studied here), greatly simplifies the task of material modeling and allows us to deploy a computationally efficient, yet accurate, finite deformation rate-independent elastic-plastic material behavior model (with inclusion of isotropic-hardening) for analyzing the rolling of these polymeric films. The interfacial behavior between the roller and polymer surfaces is modeled using Coulombic friction; consistent with the rate-independent behavior. The finite deformation elastic-plastic material behavior based on (i) the additive decomposition of stretching tensor (D = De + Dp, i.e. a hypoelastic formulation) with incrementally objective time integration and, (ii) multiplicative decomposition of deformation gradient (F = FeFp) into elastic and plastic parts, are programmed and carried out for cold-rolling within ABAQUS Explicit. Predictions from both the formulations, i.e., hypoelastic and multiplicative decomposition, exhibit a close match. We find that no specialized hyperlastic/visco-plastic model is required to describe the behavior of the blend of polymeric films, under the conditions described here, thereby speeding up the computation process .

Keywords: Polymer Plasticity, Bonding, Deformation Induced Mobility, Rolling

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Authors: Tim Bolle, Franziska Kreimendahl, Thomas Gries, Stefan Jockenhoevel

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The therapeutic treatment of extensive, deep wounds is limited. Autologous split-skin grafts are used as a so-called ‘gold standard’. Most common deficits are the defects at the donor site, the risk of scarring as well as the limited availability and quality of the autologous grafts. The aim of this project is a tissue engineered dermal-epidermal skin replacement to overcome the limitations of the gold standard. A key requirement for the development of such a three-dimensional implant is the formation of a functional capillary-like network inside the implant to ensure a sufficient nutrient and gas supply. Tailored three-dimensional warp knitted spacer fabrics are used to reinforce the mechanically week fibrin gel-based scaffold and further to create a directed in vitro pre-vascularization along the parallel-oriented pile yarns within a co-culture. In this study various three-dimensional warp knitted spacer fabrics were developed in a factorial design to analyze the influence of the machine parameters such as the stitch density and the pattern of the fabric on the scaffold performance and further to determine suitable parameters for a successful fibrin gel-incorporation and a physiological performance of the scaffold. The fabrics were manufactured on a Karl Mayer double-bar raschel machine DR 16 EEC/EAC. A fine machine gauge of E30 was used to ensure a high pile yarn density for sufficient nutrient, gas and waste exchange. In order to ensure a high mechanical stability of the graft, the fabrics were made of biocompatible PVDF yarns. Key parameters such as the pore size, porosity and stress/strain behavior were investigated under standardized, controlled climate conditions. The influence of the input parameters on the mechanical and morphological properties as well as the ability of fibrin gel incorporation into the spacer fabric was analyzed. Subsequently, the pile yarns of the spacer fabrics were colonized with Human Umbilical Vein Endothelial Cells (HUVEC) to analyze the ability of the fabric to further function as a guiding structure for a directed vascularization. The cells were stained with DAPI and investigated using fluorescence microscopy. The analysis revealed that the stitch density and the binding pattern have a strong influence on both the mechanical and morphological properties of the fabric. As expected, the incorporation of the fibrin gel was significantly improved with higher pore sizes and porosities, whereas the mechanical strength decreases. Furthermore, the colonization trials revealed a high cell distribution and density on the pile yarns of the spacer fabrics. For a tailored reinforcing structure, the minimum porosity and pore size needs to be evaluated which still ensures a complete incorporation of the reinforcing structure into the fibrin gel matrix. That will enable a mechanically stable dermal graft with a dense vascular network for a sufficient nutrient and oxygen supply of the cells. The results are promising for subsequent research in the field of reinforcing mechanically weak biological scaffolds and develop functional three-dimensional scaffolds with an oriented pre-vascularization.

Keywords: fibrin-gel, skin replacement, spacer fabric, pre-vascularization

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Authors: Joana Antunes, Thomas Levée, Barbara Radovani, Anu Suonpää, Paulina Saloranta, Liji Sobhana, Petri Ihalainen

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Lignin is an important component in the exploitation of lignocellulosic biomass. It has been shown that within the next years, the yield of added-value lignin-based chemicals and materials will generate renewable alternatives to oil-based products (e.g. polymeric composites, resins and adhesives) and enhance the economic feasibility of biorefineries. In this paper, a novel technology for lignin valorisation (METNIN™) is presented. METNIN™ is based on the oxidative action of an alkaliphilic enzyme in aqueous alkaline conditions (pH 10-11) at mild temperature (40-50 °C) combined with a cascading membrane operation, yielding a collection of lignin fractions (from oligomeric down to mixture of tri-, di- and monomeric units) with distinct molecular weight distribution, low polydispersity and favourable physicochemical properties. The alkaline process conditions ensure the high processibility of crude lignin in an aqueous environment and the efficiency of the enzyme, yielding better compatibility of lignin towards targeted applications. The application of a selected lignin fraction produced by METNIN™ as a suitable lignopolyol to completely replace a commercial polyol in polyurethane rigid foam formulations is presented as a prototype. Liquid lignopolyols with a high lignin content were prepared by oxypropylation and their full utilization in the polyurethane rigid foam formulation was successfully demonstrated. Moreover, selected technical specifications of different foam demonstrators were determined, including closed cell count, water uptake and compression characteristics. These specifications are within industrial standards for rigid foam applications. The lignin loading in the lignopolyol was a major factor determining the properties of the foam. In addition to polyurethane foam demonstrators, other examples of lignin-based products related to resins and sizing applications will be presented.

Keywords: enzyme, lignin valorisation, polyol, polyurethane foam

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Authors: Timine Suoware, Sylvester Edelugo, Charles Amgbari

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Natural fibre composites (NFC) are becoming very attractive especially for automotive interior and non-structural building applications because they are biodegradable, low cost, lightweight and environmentally friendly. NFC are known to release high combustible products during exposure to heat atmosphere and this behaviour has raised concerns to end users. To improve on their fire response, flame retardants (FR) such as aluminium tri-hydroxide (ATH) and ammonium polyphosphate (APP) are incorporated during processing to delay the start and spread of fire. In this paper, APP was modified with Gum Arabic powder (GAP) and synergized with carbon black (CB) to form new FR species. Four FR species at 0, 12, 15 and 18% loading ratio were added to oil palm fibre polyester composite (OPFC) panels as follows; OPFC12%APP-GAP, OPFC15%APP-GAP/CB, OPFC18%ATH/APP-GAP and OPFC18%ATH/APPGAP/CB. The panels were produced using hand lay-up compression moulding and cured at room temperature. Specimens were cut from the panels and these were tested for ignition time (Tig), peak heat released rate (HRRp), average heat release rate (HRRavg), peak mass loss rate (MLRp), residual mass (Rm) and average smoke production rate (SPRavg) using cone calorimeter apparatus as well as the available flame energy (ɸ) in driving the flame using radiant panel flame spread apparatus. From the ignitability data obtained at 50 kW/m2 heat flux (HF), it shows that the hybrid FR modified with APP that is OPFC18%ATH/APP-GAP exhibited superior flame retardancy and the improvement was based on comparison with those without FR which stood at Tig = 20 s, HRRp = 86.6 kW/m2, HRRavg = 55.8 kW/m2, MLRp =0.131 g/s, Rm = 54.6% and SPRavg = 0.05 m2/s representing respectively 17.6%, 67.4%, 62.8%, 50.9%, 565% and 62.5% improvements less than those without FR (OPFC0%). In terms of flame spread, the least flame energy (ɸ) of 0.49 kW2/s3 for OPFC18%ATH/APP-GAP caused early flame regression. This was less than 39.6 kW2/s3 compared to those without FR (OPFC0%). It can be concluded that hybrid FR modified with APP could be useful in the automotive and building industries to delay the start and spread of fire.

Keywords: flame retardant, flame regression, oil palm fibre, composite panel

Procedia PDF Downloads 128

Authors: Gi-Young Park, Dong Rak Kwon, Sung Cheol Cho

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Objective: The synovium is known to be involved in many pathological characteristic processes. Also, synovitis is common in advanced osteoarthritis. We aimed to evaluate the clinical, radiographic, and ultrasound findings in patients with knee osteoarthritis and to compare the clinical and imaging findings between knee osteoarthritis with and without synovial hypertrophy confirmed by ultrasound. Methods: One hundred knees (54 left, 46 right) in 95 patients (64 women, 31 men; mean age, 65.9 years; range, 43-85 years) with knee osteoarthritis were recruited. The Visual Analogue Scale (VAS) was used to assess the intensity of knee pain. The severity of knee osteoarthritis was classified according to Kellgren and Lawrence's (K-L) grade on a radiograph. Ultrasound examination was performed by a physiatrist who had 24 years of experience in musculoskeletal ultrasound. Ultrasound findings, including the thickness of joint effusion in the suprapatellar pouch, synovial hypertrophy, infrapatellar tendinosis, meniscal tear or extrusion, and Baker cyst, were measured and detected. The thickness of knee joint effusion was measured at the maximal anterior-posterior diameter of fluid collection in the suprapatellar pouch. Synovial hypertrophy was identified as the soft tissue of variable echogenicity, which is poorly compressible and nondisplaceable by compression of an ultrasound transducer. The knees were divided into two groups according to the presence of synovial hypertrophy. The differences in clinical and imaging findings between the two groups were evaluated by independent t-test and chi-square test. Results: Synovial hypertrophy was detected in 48 knees of 100 knees on ultrasound. There were no significant differences in demographic parameters and VAS score except in sex between the two groups (P<0.05). Medial meniscal extrusion and tear were significantly more frequent in knees with synovial hypertrophy than those in knees without synovial hypertrophy. K-L grade and joint effusion thickness were greater in patients with synovial hypertrophy than those in patients without synovial hypertrophy (P<0.05). Conclusion: Synovial hypertrophy in knee osteoarthritis was associated with greater suprapatellar joint effusion and higher K-L grade and maybe a characteristic ultrasound feature of late knee osteoarthritis. These results suggest that synovial hypertrophy on ultrasound can be regarded as a predictor of rapid progression in patients with knee osteoarthritis.

Keywords: knee osteoarthritis, synovial hypertrophy, ultrasound, K-L grade

Procedia PDF Downloads 76

Authors: Safitri Nur Wulandari, M. Ivan Adi Perdana, Prathisto L. Panuntun Unggul, R. Dary Wira Mahadika

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In road construction on the soft soil, we need a soil improvement method to improve the soil bearing capacity of the land base so that the soil can withstand the traffic loads. Most of the land in Indonesia has a soft soil, where soft soil is a type of clay that has the consistency of very soft to medium stiff, undrained shear strength, Cu <0:25 kg/cm2, or the estimated value of NSPT <5 blows/ft. This study focuses on the analysis of the effect on preloading load (embarkment) to the amount of settlement ratio on the under of embarkment that will impact on the building cracks around of embarkment. The method used in this research is a superposition method for embarkment distribution on 27 locations with undisturbed soil samples at some borehole point in Java and Kalimantan, Indonesia. Then correlating the results of settlement plate monitoring on the field with Asaoka method. The results of settlement plate monitoring taken from an embarkment of Ahmad Yani airport in Semarang on 32 points. Where the value of Cc (index compressible) soil data based on some laboratory test results, while the value of Cc is not tested obtained from empirical formula Ardhana and Mochtar, 1999. From this research, the results of the field monitoring showed almost the same results with an empirical formulation with the standard deviation of 4% where the formulation of the empirical results of this analysis obtained by linear formula. Value empirical linear formula is to determine the effect of compression heap area as high as 4,25 m is 3,1209x + y = 0.0026 for the slope of the embankment 1: 8 for the same analysis with an initial height of embankment on the field. Provided that at the edge of the embankment settlement worth is not equal to 0 but at a quarter of embankment has a settlement ratio average 0.951 and at the edge of embankment has a settlement ratio 0,049. The influence areas around of embankment are approximately 1 meter for slope 1:8 and 7 meters for slope 1:2. So, it can cause the building cracks, to build in sustainable development.

Keywords: building cracks, influence area, settlement plate, soft soil, empirical formula, embankment

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Authors: Elena Vinogradova, Aleksei Pleshakov, Aleksei Yakovlev

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During the flight of a supersonic aircraft under various conditions (altitude, Mach, etc.), it becomes necessary to coordinate the operating modes of the air intake and engine. On the supersonic aircraft, it’s been done by changing various control factors (the angle of rotation of the wedge panels and etc.). This paper investigates the possibility of using modern optimization methods to determine the optimal position of the supersonic air intake wedge panels in order to maximize the total pressure recovery coefficient. Modern software allows us to conduct auto-optimization, which determines the optimal position of the control elements of the investigated product to achieve its maximum efficiency. In this work, the flow in the supersonic aircraft inlet has investigated and optimized the operation of the flaps of the supersonic inlet in an aircraft in a 2-D setting. This work has done using ANSYS CFX software. The supersonic aircraft inlet is a flat adjustable external compression inlet. The braking surface is made in the form of a three-stage wedge. The IOSO NM software package was chosen for optimization. Change in the position of the panels of the input device is carried out by changing the angle between the first and second steps of the three-stage wedge. The position of the rest of the panels is changed automatically. Within the framework of the presented work, the position of the moving air intake panel was optimized under fixed flight conditions of the aircraft under a certain engine operating mode. As a result of the numerical modeling, the distribution of total pressure losses was obtained for various cases of the engine operation, depending on the incoming flow velocity and the flight altitude of the aircraft. The results make it possible to obtain the maximum total pressure recovery coefficient under given conditions. Also, the initial geometry was set with a certain angle between the first and second wedge panels. Having performed all the calculations, as well as the subsequent optimization of the aircraft input device, it can be concluded that the initial angle was set sufficiently close to the optimal angle.

Keywords: optimal angle, optimization, supersonic air intake, total pressure recovery coefficient

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Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: decision support system, event-sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine

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Authors: Manuela Caciula, Luis Torres, Simion Tomoiaga

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Introduction: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), more commonly referred to as COVID-19, has wreaked havoc on all facets of higher education since its inception in late 2019. College students, in particular, significantly reduced their daily energy expenditure and increased the time spent sitting to listen to online classes and complete their studies from home. This change, in combination with the associated COVID-19 lockdown, presumably decreased physical activity levels, increased mental health symptoms, and led to the promotion of unhealthy eating habits. Objectives: The main objective of this study was to determine the current self-reported physical activity levels, mental health symptoms, and body composition of college students after the COVID-19 lockdown in order to develop future interventions for the overall improvement of health. Methods: All participants completed pre-existing, well-validated surveys for both physical activity (International Physical Activity Questionnaire - long form) and mental health (Hospital Anxiety and Depression Scale). Body composition was assessed in person with the use of an Inbody 570 device. Results: Of the 90 American college students (M age = 22.52 ± 4.54, 50 females) who participated in this study, depressive and anxious symptom scores consistent with 58% (N = 52) heightened symptomatology, 17% (N = 15) moderate borderline symptomatology, and 25% (N = 23) asymptomatology were reported. In regard to physical activity, 79% (N = 71) of the students were highly physically active, 18% (N = 16) were moderately active, and 3% (N = 3) reported low levels of physical activity. Additionally, 46% (N = 41) of the students maintained an unhealthy body fat percentage based on World Health Organization recommendations. Strong, significant relationships were found between anxiety and depression symptomatology and body fat percentage (P = .003) and skeletal muscle mass (P = .015), with said symptomatology increasing with added body fat and decreasing with added skeletal muscle mass. Conclusions: Future health interventions for American college students should be focused on strategies to reduce stress, anxiety, and depressive characteristics, as well as nutritional information on healthy eating, regardless of self-reported physical activity levels.

Keywords: physical activity, mental health, body composition, COVID-19

Procedia PDF Downloads 98