Search results for: and total knee replacement

Authors: Anna Hadamus, Patryk Wasowski, Anna Mosiolek, Zbigniew Wronski, Sebastian Wojtowicz, Dariusz Bialoszewski

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Introduction: Kinesiology Taping is a very popular physiotherapy method, often used for healthy people, especially athletes, in order to stimulate the muscles and improve their performance. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on the joint position sense in active motion. Material and Methods: The study involved 50 healthy people - 30 men and 20 women, mean age was 23.2 years (range 18-30 years). The exclusion criteria were injuries and operations of the knee, which could affect the test results. The participants were divided randomly into two equal groups. The first group consisted of individuals with the applied Kinesiology Taping muscle application (KT group), whereas in the rest of the individuals placebo application from red adhesive tape was used (placebo group). Both applications were to enhance the effects of quadriceps muscle activity. Joint position sense (JPS) was evaluated in this study. Error of Active Reproduction of the Joint Position (EARJP) of the knee was measured in 45° flexion. The test was performed prior to applying the patch, with the applied application, then 24 hours after wearing, and after removing the tape. The interval between trials was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. We calculated distribution characteristics, Wilcoxon test, Friedman‘s ANOVA and Mann-Whitney U test. Results. In the KT group and the placebo group average test score of JPS before applying application KT were 3.48° and 5.16° respectively, after its application it was 4.84° and 4.88°, then after 24 hours of experiment JPS was 5.12° and 4.96°, and after application removal we measured 3.84° and 5.12° respectively. Differences over time in any of the groups were not statistically significant. There were also no significant differences between the groups. Conclusions: 1. Applying Kinesiology Taping to quadriceps muscle had no significant effect on the knee joint proprioception. Its use in order to improve sensorimitor skills seems therefore to be unreasonable. 2. No differences between applications of KT and placebo indicates that the clinical effect of stretch tape is minimal or absent. 3. The results are the basis for the continuation of prospective, randomized trials of numerous study groups.

Keywords: joint position sense, kinesiology taping, kinesiotaping, knee

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Authors: Muzeyyen Balcikanli, Selma Ozaslan, Osman Sahin, Burak Uzal, Erdogan Ozbay

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In this study, the effect of nano-CaCO3 replacement with cement on the nano-mechanical properties of cement paste was investigated. Hydrophobic and hydrophilic characteristics Two types of nano CaCO3 were replaced with Portland cement at 0, 0.5 and 1%. Water to (cement+nano-CaCO3) ratio was kept constant at 0.5 for all mixtures. 36 indentations were applied on each cement paste, and the values of nano-hardness and elastic modulus of cement pastes were determined from the indentation depth-load graphs. Then, by getting the average of them, nano-hardness and elastic modulus were identified for each mixture. Test results illustrate that replacement of hydrophilic n-CaCO3 with cement lead to a significant increase in nano-mechanical properties, however, replacement of hydrophobic n-CaCO3 with cement worsened the nano-mechanical properties considerably.

Keywords: nanoindenter, CaCO3, nano-hardness, nano-mechanical properties

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Authors: Juliane P. De Oliveira, Carlos H. Dos Santos, Marcia Shoji, Maria E. C. Ferreira, Natalia U. Yamaguchi

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The construction sector is considered a major generator of environmental impacts due to the high consumption of natural resources and waste generation. Thus, this article aims to evaluate the performance of a concrete produced by the partial and total replacement of natural coarse aggregate by recycled coarse aggregate, derived from the concrete residue of buildings and demolitions. The study was made by comparing the compressive strength and absorption of three different concrete traces, keeping the water/cement factor of 0.60 and changing only the proportions of recycled coarse aggregate between 0%, 50% and 100%. Traces 50% and 100% obtained good results by comparing the actual specific mass, because the material used is lighter to the natural coarse aggregate. It was concluded that the concrete produced with recycled aggregates, even with inferior results, can be used where it is not needed a structural function, giving an adequate destination to the construction and demolition waste and consequently reducing the extraction and consumption of natural resources.

Keywords: green concrete, recycled aggregate, recycling, sustainable development

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Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

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Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

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Authors: Min-Tsai Lai, Taqwa Hariguna

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This paper presents a periodical replacement model for a system, considering the concept of single and cumulative repair cost limits simultaneously. The failures are divided into two types. Minor failure can be corrected by minimal repair and serious failure makes the system breakdown completely. When a minor failure occurs, if the repair cost is less than a single repair cost limit L1 and the accumulated repair cost is less than a cumulative repair cost limit L2, then minimal repair is executed, otherwise, the system is preventively replaced. The system is also replaced at time T or at serious failure. The optimal period T minimizing the long-run expected cost per unit time is verified to be finite and unique under some specific conditions.

Keywords: repair-cost limit, cumulative repair-cost limit, minimal repair, periodical replacement policy

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Authors: K. Chalernpon, P. Aroonjarattham, K. Aroonjarattham

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Total hip replacement had been one of the most successful operations in hip arthritis surgery. The purpose of this research had been to develop a dynamic hip contact of Thai femoral bone to analyze the stress distribution on the implant and the strain distribution on the bone model under daily activities and compared with the static load simulation. The results showed the different of maximum von Mises stress 0.14 percent under walking and 0.03 percent under climbing stair condition and the different of equivalent total strain 0.52 percent under walking and 0.05 percent under climbing stair condition. The muscular forces should be evaluated with dynamic condition to reduce the maximum von Mises stress and equivalent total strain.

Keywords: dynamic loading, static load, hip prosthesis, Thai femur, femoral bone, finite element analysis

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Authors: Tae-ho Chung, Chul Park, Gi-wook Shin, Joo-min Kim, Seong-hyun Kim, Namjung Kim

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Mealworm (Tenebrio molitor) was evaluated to investigate the effect of partial or total replacement of fish meal in diets for white shrimp, Litopenaeus vannamei. Experimental groups of shrimp with average initial body weight (2.43 ± 0.54 g) were fed each with 4 isonitrogeneous (38% crude protein) diets formulated to include 0, 25, 50 and 100% (diets 1 to 4, respectively) of fish meal substituted with mealworm. After eight weeks of feeding trials, shrimp fed with diet 3 and 4 revealed the highest values for live weight gain(8.01 ± 2.51 and 7.93 ± 1.12), specific growth rates (2.70 ± 1.12 and 2.59 ± 0.51) as well as better feed conversion ratio (2.69 ± 0.09 and 2.72 ± 0.19) compared to the control group with statistically significant manner (p<0.05). Survival range was 98% in all the treatments. An increase in weight gain and other growth associated parameters was observed with higher replacement. These results clearly indicate that 50% and 100% of fish meal protein in shrimp diet can be replaced by mealworm not only without any adverse effect but also the effect of promoting growth performance.

Keywords: mealworm, Litopenaeus vannamei, Tenebrio molitor, white shrimp

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Authors: Renate Krassnig, Gloria M. Hohenberger, Uldis Berzins, Stefen Fischerauer

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Background: Only a few reports discuss the effectiveness of intraoperative radiographs for placing femoral components. Therefore there is no international standard in using intraoperative imaging in the proceeding of total hip replacement. Method: Case report; an 84-year-old female patient underwent changing the components of the Total hip arthroplasty (THA) because of aseptic loosening. Due to circumstances, the surgeon decided to implant a cemented femoral component. The procedure was without any significant abnormalities. The first postoperative radiograph was planned after recovery – as usual. The x-ray imaging showed a misplaced femoral component. Therefore a CT-scan was performed additionally and the malposition of the cemented femoral component was confirmed. The patient had to undergo another surgery – removing of the cemented femoral component and implantation of a new well placed one. Conclusion: Intraoperative imaging of the femoral component is not a common standard but this case shows that intraoperative imaging is a useful method for detecting errors and gives the surgeon the opportunity to correct errors intraoperatively.

Keywords: femoral component, intraoperative imaging, malplacement, revison

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Authors: Mohammed Abed, Rita Nemes

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In this study different amounts of waste cellular concrete powder (WCCP) as replacement of cement have been investigated as an attempt to produce green binder, which is useful for sustainable construction applications. From zero to up to 60% of WCCP by mass replacement amounts of cement has been conducted. Consistency, compressive strength, bending strength and the activity index of WCCP through seven to ninety days old specimens have been examined, where the optimum WCCP replacement was up to 30%, depending on which the activity index still increased to the end of test period (90 days) and this could be an evidence for its continuity to increase for longer age. Also up to 30% of WCCP increased the bending strength to be higher than the control one. The main point in the present study that there is a possibility of replacing cement by 30% of WCCP, however, it is preferable to be less than this amount.

Keywords: cellular concrete powder, waste cellular concrete powder (WCCP), supplementary cementatious material, SCM, activity index, mechanical properties

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Authors: Ronald Croce, Timothy Quinn, John Miller

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Incomplete activation, or activation failure, of motor units during maximal voluntary contractions is often referred to as muscle inhibition (MI), and is defined as the inability of the central nervous system to maximally drive a muscle during a voluntary contraction. The purpose of the present study was to assess the interrelationship amongst peak torque (PT), muscle inhibition (MI; incomplete activation of motor units), and voluntary muscle activation (VMA) of the quadriceps’ muscle group as a function of knee angle and muscle length during maximal voluntary isometric contractions (MVICs). Nine young adult males (mean + standard deviation: age: 21.58 + 1.30 years; height: 180.07 + 4.99 cm; weight: 89.07 + 7.55 kg) performed MVICs in random order with the knee at 15, 55, and 95° flexion. MI was assessed using the interpolated twitch technique and was estimated by the amount of additional knee extensor PT evoked by the superimposed twitch during MVICs. Voluntary muscle activation was estimated by root mean square amplitude electromyography (EMGrms) and mechanomyography (MMGrms) of agonist (vastus medialis [VM], vastus lateralis [VL], and rectus femoris [RF]) and antagonist (biceps femoris ([BF]) muscles during MVICs. Data were analyzed using separate repeated measures analysis of variance. Results revealed a strong dependency of quadriceps’ PT (p < 0.001), MI (p < 0.001) and MA (p < 0.01) on knee joint position: PT was smallest at the most shortened muscle position (15°) and greatest at mid-position (55°); MI and MA were smallest at the most shortened muscle position (15°) and greatest at the most lengthened position (95°), with the RF showing the greatest change in MA. It is hypothesized that the ability to more fully activate the quadriceps at short compared to longer muscle lengths (96% contracted at 15°; 91% at 55°; 90% at 95°) might partly compensate for the unfavorable force-length mechanics at the more extended position and consequent declines in VMA (decreases in EMGrms and MMGrms muscle amplitude during MVICs) and force production (PT = 111-Nm at 15°, 217-NM at 55°, 199-Nm at 95°). Biceps femoris EMG and MMG data showed no statistical differences (p = 0.11 and 0.12, respectively) at joint angles tested, although there were greater values at the extended position. Increased BF muscle amplitude at this position could be a mechanism by which anterior shear and tibial rotation induced by high quadriceps’ activity are countered. Measuring and understanding the degree to which one sees MI and VMA in the QF muscle has particular clinical relevance because different knee-joint disorders, such ligament injuries or osteoarthritis, increase levels of MI observed and markedly reduced the capability of full VMA.

Keywords: electromyography, interpolated twitch technique, mechanomyography, muscle activation, muscle inhibition

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Authors: Liqiang Duan, Ma Jingkai, Lv Zhipeng, Haifan Cai

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The integrated solar combined cycle (ISCC) system has a series of advantages such as increasing the system power generation, reducing the cost of solar power generation, less pollutant and CO₂ emission. In this paper, the parabolic trough collectors with direct steam generation (DSG) technology are considered to replace the heat load of heating surfaces in heat regenerator steam generation (HRSG) of a conventional natural gas combined cycle (NGCC) system containing a PG9351FA gas turbine and a triple pressure HRSG with reheat. The detailed model of the NGCC system is built in ASPEN PLUS software and the parabolic trough collectors with DSG technology is modeled in EBSILON software. ISCC-DSG systems with the replacement of single, two, three and four heating surfaces are studied in this paper. Results show that: (1) the ISCC-DSG systems with the replacement heat load of HPB, HPB+LPE, HPE2+HPB+HPS, HPE1+HPE2+ HPB+HPS are the best integration schemes when single, two, three and four stages of heating surfaces are partly replaced by the parabolic trough solar energy collectors with DSG technology. (2) Both the changes of feed water flow and the heat load of the heating surfaces in ISCC-DSG systems with the replacement of multi-stage heating surfaces are smaller than those in ISCC-DSG systems with the replacement of single heating surface. (3) ISCC-DSG systems with the replacement of HPB+LPE heating surfaces can increase the solar power output significantly. (4) The ISCC-DSG systems with the replacement of HPB heating surfaces has the highest solar-thermal-to-electricity efficiency (47.45%) and the solar radiation energy-to-electricity efficiency (30.37%), as well as the highest exergy efficiency of solar field (33.61%).

Keywords: HRSG, integration scheme, parabolic trough collectors with DSG technology, solar power generation

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Authors: Chungyu Chen, Yi-Cheng Chen, Po-Hsian Hsu, Hsin-Ying Chen, Yen-Po Hsiao

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The purpose of this study was to assess the muscular strength performance of upper and lower extremity in isokinetic system for the youth judo players, and also to compare the strength difference between major techniques. Sixteen male and 20 female judo players (age: 16.7 ± 1.6 years old, training age: 4.5 ± 0.8 years) were served as the volunteers for this study. There were 21 players major hand techniques and 15 players major foot techniques. The Biodex S4 Pro was used to assess the strength performance of extensor and flexor of concentric action under the load condition of 30 degree/sec, 60 degree/sec, and 120 degree/sec for elbow joints and knee joints. The strength parameters were included the maximal torque, the normalized maximal torque, the average power, and the average maximal torque. A t test for independent groups was used to evaluate whether hand major and foot major differ significantly with an alpha level of .05. The result showed the maximal torque of left knee extensor in foot major players (243.5 ± 36.3 Nm) was higher significantly than hand major (210.7 ± 21.0 Nm) under the load of 30 degree/sec (p < .05). There were no differences in upper extremity strength between the hand and foot techniques major in three loads (ps < .05). It indicated that the judo player is required to develop the upper extremity strength overall to secure the execution of major techniques.

Keywords: knee, elbow, power, judo

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Authors: Narin Charoenphun, Praopen Rattanadee, Chaiporn Phaephiromrat

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One of the most important intricacies of cooking is seasoning which is the process of adding salt, herbs, or spices to food to enhance the flavor. Sodium chloride (NaCl) was added in seasoning powder for taste-improving and shelf life of products. However, the raised blood pressure caused by eating too much NaCl may damage the arteries leading to the heart. Interestingly, NaCl replacement with other substance is essential for consumer. The objective of this study was to investigate the effects of NaCl replacement with potassium chloride (KCl) on the sensory characteristics and physiochemical properties of longan seasoning powder. Five longan seasoning Powder were replaced sodium chloride with KCl at 0, 25, 50 75 and 100%. Mixture design with 2 replications was performed. Sensory characteristics on overall flavor, saltiness, sweetness, bitterness and overall liking were investigated using 12 descriptive trained panelists. Results revealed that NaCl and KCl had effects on saltiness, bitterness and overall liking. As the level of KCl substituted increased, the overall flavor and sweetness of powdered seasoning from longan were not significantly (p < 0.05). This resulted in the decrease of overall liking of the products. In addition, increasing the level of KCl substituted resulted in the drop of saltiness but out of bitterness of the products. Saltiness of powdered seasoning from longan with replacement levels of 50, 75 and 100% KCl different when compared to that of 0% KCl. Bitterness of powdered seasoning from longan with replacement levels of 50, 75 and 100% KCl different when compared to that of 0% KCl. Moreover, consumer acceptance test was conducted (n=100). In conclusion, the optimum formulation contained of 32.0% longan powder, 28.0% sugar, 15.0% NaCl, 5% KCl, 16.0% pork powder, 3.0% pepper powder, and 3.0% garlic powder that would meet acceptability scores of at least 7 or like moderately.

Keywords: longan, seasoning, NaCl, KCl

Procedia PDF Downloads 253

Authors: Abdul Rahim Al Umairi, Hamed Al Kindi

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The cement production process significantly contributes to greenhouse gas emissions, accounting for 25% of total industrial emissions. This study systematically examined new, underutilized materials—sewage sludge ash (SSA), marble waste (MW), and calcined clay (CC)—to evaluate their effects when partially replacing white Portland cement (WPC) in cement paste formulations. Various replacement proportions (10%, 20%, and 30%) were tested, along with different treatment temperatures (600°C, 630°C, 730°C, and 850°C) for SSA and CC. To gain a deeper understanding of the resulting materials, analyses such as XRF, XRD, and SEM were conducted. The highest compressive strength recorded for the 28-day cured cement paste was 91 MPa when 20% SSA (treated at 600°C) was used, compared to just 53 MPa for the control sample. Conversely, CC exhibited minimal enhancement in compressive strength, while MW had detrimental effects. Additionally, replacing WPC with SSA and CC at 9% and 21% resulted in slight improvements in compressive strength. This research highlights the potential of utilizing underexploited materials like SSA to improve the mechanical and chemical properties of cement paste, indicating that further investigation is necessary to enhance environmental sustainability.

Keywords: sewage sludge ash, calcined clay, marble waste, cement

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Authors: Passant Youssef, Ahmed El-Tair, Amr El-Nemr

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Lately, with the environmental changes, enthusiasts trigger to stop the contamination of environment. Thus, various efforts were exerted for innovating environmental friendly concrete to sustain as a ‘Green Building’ material. Green building materials consider the cement industry as one of the most sources of air pollutant with high rate of carbon dioxide (CO₂) emissions. Several methods were developed to extensively reduce the influence of cement industry on environment. These methods such as using supplementary cementitious material or improving the cement manufacturing process are still under investigation. However, with the presence of recycled wastes from construction and finishing materials, the use of supplementary cementitious materials seems to provide an economic solution. Furthermore, it improves the mechanical properties of cement paste, in addition to; it modulates the workability and durability of concrete. In this paper, the glass powder was considered to be used as partial replacement of cement. This study provided the mechanical influence for using the glass powder as partial replacement of cement. In addition, it examines the microstructure of cement mortar using scanning electron microscope and X-ray diffraction. The cement in concrete is replaced by waste glass powder in steps of 5%, 10%, 15%, 20% and 25% by weight of cement and its effects on compressive and flexure strength were determined after 7 and 28 days. It was found that the 5% glass powder replacement increased the 7 days compressive strength by 20.5%, however, there was no increase in compressive strength after 28 days; which means that the glass powder did not react in the cement mortar due to its amorphous nature on the long run, and it can act as fine aggregate better that cement replacement. As well as, the 5% and 10% glass powder replacement increased the 28 days flexural strength by 46.9%. SEM micrographs showed very dense matrix for the optimum specimen compared to control specimen as well; some glass particles were clearly observed. High counts of silica were optimized from XRD while amorphous materials such as calcium silicate cannot be directly detected.

Keywords: supplementary materials, glass powder, concrete, cementitious materials

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Authors: Xiaopeng Shang, Xin YU, Jun CHANG

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Calcium barium sulphoaluminate (CBSA), derived from calcium sulphoaluminate(CSA), has excellent cementitious properties. In this study, the sintering system of CBSA with a theoretical stoichiometric Ca3BaAl6SO16 was investigated. Rietveld refinement was performed using TOPAS 4.2 software to quantitatively calculate the content of CBSA and the actual ionic site occupancy of Ba2+. The results indicate that the contents of Ca4-xBaxAl6SO16 increases with increasing sintering temperature in the 1200℃-1400℃ ranges. When sintered at 1400℃ for 180min, the content of CBSA reaches 88.4%. However, CBSA begins to decompose at 1440℃ and the content of which decreases. The replacement rate of Ba2+ was also enlarged by increasing sintering temperature and prolonged sintering time. Sintering at 1400℃ for 180min is considered as the optimum when replacement rate of Ba2+ and the content of CBSA were taken into account. Ca3.2Ba0.8Al6SO16 with a content of 88.4% was synthesized.

Keywords: calcium barium sulphoaluminate, sintering system, Ba2+ replacement rate, Rietveld refinement

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Authors: Vatsal Patel, Niraj Shah

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The aim of the research reported in this paper is to assess the Strength and durability performance of High Performance Concrete containing different percentages of waste marble powder produced from marble industry. Concrete mixes possessing a target mean compressive strength of 70MPa were prepared with 0%,5%,10%,15% and 20% cement replacement by waste marble powder with W/B =0.33. More specifically, the compressive strength, flexural strength, chloride penetration, sorptivity and accelerated corrosion were determined. Concrete containing 10% waste marble powder proved to have best Mechanical and durability properties than other mixtures made with binary blends. However, poorer performance was noticeable when replacement percentage was higher. The replacement of Waste Marble Powder will have major environmental benefits.

Keywords: durability, high performance concrete, marble waste powder, sorptivity, accelerated corrosion

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Authors: Vu Hoang Thu Huong

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Background and Purpose: The effects of Extracorporeal Shockwave Therapy (ESWT) in the participants with knee osteoarthritis (KOA) were unclear on physical performance although its effects on pain had been investiagted. This study aims to explore the effects of ESWT on pain relief and physical performance on KOA. Methods: The studies with the randomized controlled design to investigate the effects of ESWT on KOA were systematically searched using inclusion and exclusion criteria through seven electronic databases including Pubmed etc. between 1990 and Dec 2022. To summarize those data, visual analog scale (VAS) or pain scores were determined for measure of pain intensity. Range of knee motion, or the scores of physical activities including Lequesne index (LI), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were determined for measure of physical performances. The first evaluate after treatment period was define as the effect of post-treatment period or immediately effect; and the last evaluate was defined as the effect of following period or the end effect in our study. Data analysis was performed using RevMan 5.4.1 software. A significant level was set at p<0.05. Results: Eight studies (number of participant= 499) reporting the ESWT effects on mild-to-moderate severity (Grades I to III Kellgren–Lawrence) of KOA were qualified for meta-analysis. Compared with sham or placebo group, the ESWT group had a significant decrease of VAS rest score (0.90[0.12~1.67] as mean difference [95% confidence interval]) and pain score WOMAC (2.49[1.22~3.76]), and a significant improvement of physical performance with a decrease of the scores of WOMAC activities (8.18[3.97~12.39]), LI (3.47[1.68~5.26]), and KOOS (5.87[1.73~ 10.00]) in the post-treatment period. There were also a significant decrease of WOMAC pain score (2.83[2.12~3.53]) and a significant decrease of the scores of WOMAC activities (9.47[7.65~11.28]) and LI (4.12[2.34 to 5.89]) in the following period. Besides, compared with other treatment groups, ESWT also displayed the improvement in pain and physical performance, but it is not significant. Conclusions: The ESWT was effective and valuable method in pain relief as well as in improving physical activities in the participants with mild-to-moderate KOA. Clinical Relevance: There are the effects of ESWT on pain relief and the improvement of physical performance in the with KOA.

Keywords: knee osteoarthritis, extracorporeal shockwave therapy, pain relief, physical performance, shockwave

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Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

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Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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Authors: Kai Way Li, Lang Gan

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Slip &Fall are common in Taiwan. They could result in injuries and even fatalities. Official statistics indicate that more than 15% of all occupational incidences were slip/fall related. All the workers in Taiwan are required by the law to join the worker’s insurance program administered by the Bureau of Labor Insurance (BLI). The BLI is a government agency under the supervision of the Ministry of Labor. Workers claim with the BLI for insurance compensations when they suffer fatalities or injuries at work. Injuries statistics based on worker’s compensation claims were rarely studied. The objective of this study was to quantify the injury statistics and financial cost due to slip-fall incidences based on the BLI compensation records. Compensation records in the BLI during 2007 to 2013 were retrieved. All the original application forms, approval opinions, results for worker’s compensations were in hardcopy and were stored in the BLI warehouses. Xerox copies of the claims, excluding the personal information of the applicants (or the victim if passed away), were obtained. The content in the filing forms were coded in an Excel worksheet for further analyses. Descriptive statistics were performed to analyze the data. There were a total of 35,024 claims including 82 deaths, 878 disabilities, and 34,064 injuries/illnesses which were slip/fall related. It was found that the average losses for the death cases were 40 months. The total dollar amount for these cases paid was 86,913,195 NTD. For the disability cases, the average losses were 367.36 days. The total dollar amount for these cases paid was almost 2.6 times of those for the death cases (233,324,004 NTD). For the injury/illness cases, the average losses for the illness cases were 58.78 days. The total dollar amount for these cases paid was approximately 13 times of those of the death cases (1134,850,821 NTD). For the applicants/victims, 52.3% were males. There were more males than females for the deaths, disability, and injury/illness cases. Most (57.8%) of the female victims were between 45 to 59 years old. Most of the male victims (62.6%) were, on the other hand, between 25 to 39 years old. Most of the victims were in manufacturing industry (26.41%), next the construction industry (22.20%), and next the retail industry (13.69%). For the fatality cases, head injury was the main problem for immediate or eventual death (74.4%). For the disability case, foot (17.46%) and knee (9.05%) injuries were the leading problems. The compensation claims other than fatality and disability were mainly associated with injuries of the foot (18%), hand (12.87%), knee (10.42%), back (8.83%), and shoulder (6.77%). The slip/fall cases studied indicate that the ratios among the death, disability, and injury/illness counts were 1:10:415. The ratios of dollar amount paid by the BLI for the three categories were 1:2.6:13. Such results indicate the significance of slip-fall incidences resulting in different severity. Such information should be incorporated in to slip-fall prevention program in industry.

Keywords: epidemiology, slip and fall, social burden, workers’ compensation

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Authors: Muhammad Javed Bhatti, Tariq Ali, Muazz Ali

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Due to growing environmental awareness in Pakistan, the researchers are increasingly turning to assess and analyze properties of industrial waste and finding solutions on using industrial waste as secondary material. Due to industrialization, enormous by-products are produced and to utilize these by-products is the main challenge faced in Pakistan. Induction furnace slag is one of the industrial by-products from the iron and steel making industries. This paper highlights the true utilization of induction furnace slag as partial replacement of fine aggregate. For the experimental investigation, mixes were prepared with fine aggregate replacement using 0 percent, 5 percent, 10 percent, 15 percent, 20 percent, 25 percent, 30 percent, 35 percent and 40 percent induction furnace slag to evaluate the workability, compaction factor, compressive strength, flexural strength, modulus of elasticity.

Keywords: compressive strength, deflection, induction furnace slag, workability

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Authors: Wan-I Chen, Tsung-I Pai

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Future the society aging of population will create the social problem has not had the good mechanism solution in the Asian country, especially in Taiwan. In the future ten year the people in Taiwan must facing the condition which is localization aging social problem. In this situation, how to use the spatial in eco way to development space use to solve the old age spatial demand is the way which might develop in the future Taiwan society. Over the next 10 years, taking care of the aging people will become part of the social problem of aging phenomenon. The research concentrate in the feasibility of spatial substitution, secondary use of spatial might solve out of spatial problem for aging people. In order to prove the space usable, the research required to review the project with the support system and infill system for space experiment, by using network grid way. That defined community level of space elements location relationship, make new definitions of space and return to cooperation. Research to innovation in the the appraisal space causes the possibility, by spatial replacement way solution on spatial insufficient suitable condition. To evaluation community spatial by using the support system and infill system in order to see possibilities of use in replacement inner space and modular architecture into housing. The study is discovering the solution on the Eco way to develop space use to figure out the old age spatial demand.

Keywords: sustainable use, space conversion, integration, replacement


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Authors: I. A. Harris, J. M. Naylor

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Antibiotic guidelines are published in order to reduce the risk of perioperative infection in orthopaedics. We surveyed 20 orthopaedic hospitals in Australia to determine their protocols for antibiotic prophylaxis around joint replacement surgery. We tested the protocols against Australian guidelines. We found that less than half of all protocols adhered to Australian guidelines. This indicates that current practice may lead to increased infection rates and increased antibiotic resistance.

Keywords: antibiotics, practice guidelines, orthopaedic surgery, joint replacement

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Authors: Mahnaz Manafi Dizaj Yekan, Mostafa Mazaheri Tehrani, Javad Hesari

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Physicochemical properties of Ultrafiltered White cheese analogues made with substituting 1/3 and 2/3 of the dairy fat with vegetable fat, margarine, were studied during ripening. Results showed replacement of milk fat by margarine made to more hardness and springiness in cheese samples and overcome to softening of texture as one of the main defects of UF white cheeses. Analysis of Fatty acids Profiles of samples fat by Gas Chromatography revealed cheese analogues samples had higher ratio of unsaturated to saturated fatty acids and can led to improve nutritional quality of product. Sensorial characteristics of analogue cheeses were similar to control samples with respect to color but better than control samples in stiffness, while overall acceptance of analogues with 1/3 fat replacement was similar to control cheeses and better than analogue cheeses with 2/3 fat replacement.

Keywords: analogue cheese, uf white cheese, margarine, stiffness, springiness, fatty acids profiles

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Authors: T. B. Anil Kumar, Mallikarjun Hiremath, V. Ramachandra

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The present experimental investigation deals with the quality performance analysis of cement concrete with 0, 15 and 25% fly ash and 0, 0.2, 0.4 and 0.6% of polypropylene fibers by weight of cement. The various test parameters like workability, unit weight, compressive strength, flexural strength, split tensile strength and abrasion resistance are detailed in the analysis. The compressive strength of M40 grade concrete attains higher value by the replacement of cement by 15% fly ash and at 0.4% PP after 28 and 56 days of curing. Higher flexural strength of concrete was observed by the replacement of cement by 15% fly ash with 0.2% PP after 28 and 56 days of curing. Similarly, split tensile strength value also increases and attains higher value by the replacement of cement by 15% fly ash with 0.4% PP after 28 and 56 days of curing. The percentage of wear gets reduced to 30 to 33% by the addition of fibers at 0.2%, 0.4% and 0.6% in cement concrete replaced by 15 and 25% fly ash. Hence, it is found that the pavement thickness gets reduced up to 20% when compared with plain concrete slab by the 15% fly ash treated with 0.2% PP fibers and also reduced up to 27% of surface course cost.

Keywords: cement, fly ash, polypropylene fiber, pavement design, cost analysis

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Authors: Asis Kumar Khan, Rajeev Kumar Goel

Abstract:

Recent infrastructure growth all around the world lead to increase in demand for concrete day by day. Cement being binding material for concrete the usage of cement also gone up significantly. Cement manufacturing utilizes abundant natural resources and causes environment pollution by releasing a huge quantity of CO₂ into the atmosphere. So, it is high time to look for alternates to reduce the cement consumption in concrete. Geopolymer concrete is one such material which utilizes the industrial waste such as fly ash, ground granulated blast furnace slag and low-cost alkaline liquids such as sodium hydroxide and sodium silicate to produce the concrete. On the other side, river sand is becoming very expensive due to its large-scale depletion at source and the high cost of transportation. In this view, river sand is replaced by crushed sand in this study. In this work, an attempt has been made to understand the durability parameters of geopolymer concrete by partially replacing fly ash with cement. Fly ash is replaced by cement at various levels e.g., from 0 to 50%. Concrete cubes of 100x100x100mm were used for investigating different durability parameters. The various parameters studied includes compressive strength, split tensile strength, drying shrinkage, sodium sulphate attack resistance, sulphuric acid attack resistance and chloride permeability. Highest compressive strength & highest split tensile strength is observed in 30% replacement level. Least drying is observed with 30% replacement level. Very good resistance for sulphuric acid & sodium sulphate is found with 30% replacement. However, it was not possible to find out the chloride permeability due to the high conductivity of geopolymer samples of all replacement levels.

Keywords: crushed sand, compressive strength, drying shrinkage, geopolymer concrete, split tensile strength, sodium sulphate attack resistance, sulphuric acid attack resistance

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Authors: Mohamed T. El-Hawary, Carsten Koenke, Amr M. El-Nemr, Nagy F. Hanna

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Sustainable construction materials using solid construction wastes are of great environmental and economic significance. Construction wastes, demolishing wastes, and wastes coming out from the preparation of traditional materials could be used in sustainable concrete manufacture, which is the main scope of this paper. Ceramics, clay bricks, marble, recycled concrete, and many other materials should be tested and validated for use in the manufacture of green concrete. Introducing waste materials in concrete helps in reducing the required landfills, leaving more space for land investments, and decrease the environmental impact of the concrete buildings industry in both stages -construction and demolition-. In this paper, marble aggregate is used as a replacement for the natural aggregate in sustainable green concrete production. The results showed that marble aggregates can be used as a full replacement for the natural aggregates in eco-friendly green concrete.

Keywords: coarse aggregate replacement, economical designs, green concrete, marble aggregates, sustainability, waste management

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Authors: Kalyan Kumar Moulick

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In this paper the author studied the possibilities of using Rice Husk Ash (RHA) available in India; to produce concrete. The effect of RHA on concrete discussed. Traditional uses of Rice Husk in India pointed out and the advantages of using RHA in making concrete highlighted. Suggestion provided regarding prospective application of RHA concrete in India which in turn will definitely reduce the cost of concrete and environmental friendly due to utilization of waste and replacement of Cement.

Keywords: cement replacement, concrete, environmental friendly, rice husk ash

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Ravande Kishore

Abstract:

The paper present the results of experimental investigation carried out to understand the mechanical properties of concrete containing marble dust. Two grades of concrete viz. M25 and M35 have been considered for investigation. For each grade of concrete five replacement percentages of sand viz. 5%, 10%, 15%, 20% and 25% by marble dust have been considered. In all, 12 concrete mix cases including two control concrete mixtures have been studied to understand the key properties such as Compressive strength, Modulus of elasticity, Modulus of rupture and Split tensile strength. Development of Compressive strength is also investigated. In general, the results of investigation indicated improved performance of concrete mixture containing marble dust. About 21% increase in Compressive strength is noticed for concrete mixtures containing 20% marble dust and 80% river sand. An overall assessment of investigation results pointed towards high potential for marble dust as alternative construction material coming from waste generated in marble industry.

Keywords: construction material, partial replacement, marble dust, compressive strength

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