Search results for: contact lens-associated complications

Authors: Srinivasulu Dasaiah, Kalyan Yakkala, Gangadhar Battala, Pavan Kumar Pindi, Ramakrishna Naidu Gurijala

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Tinospora cordifolia leaves biomass used for the removal fluoride from aqueous solutions. Batch biosorption technique was applied, pH, contact time, biosorbent dose and initial fluoride concentration was studied. The Scanning Electron Microscopy (SEM) and Fourier Transform Infrared (FTIR) techniques used to study the surface characteristics and the presence of chemical functional groups on the biosorbent. Biosorption isotherm models and kinetic models were applied to understand the sorption mechanism. Results revealed that pH, contact time, biosorbent dose and initial fluoride concentration played a significant effect on fluoride removal from aqueous solutions. The developed biosorbent derived from Tinospora cordifolia leaves biomass found to be a low-cost biosorbent and could be used for the effective removal of fluoride in synthetic as well as real water samples.

Keywords: biosorption, contact time, fluoride, isotherms

Procedia PDF Downloads 159

Authors: Mohammad Emran, Colton Wayne, Shannon M Koehler, P. Stephen Almond, Haroon Patel

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Purpose: Assessment of anastomotic perfusion in Hirschsprung disease using Indocyanine Green (ICG)-near-infrared (NIR) fluorescence angiography. Introduction: Anastomotic stricture and leak are well-known complications of Hirschsprung pull-through procedures. Complications are due to tension, infection, and/or poor perfusion. While a surgeon can visually determine and control the amount of tension and contamination, assessment of perfusion is subject to surgeon determination. Intraoperative use of ICG-NIR enhances this decision-making process by illustrating perfusion intensity and adequacy in the pulled-through bowel segment. This technique, proven to reduce anastomotic stricture and leak in adults, has not been studied in children to our knowledge. ICG, an FDA approved, nontoxic, non-immunogenic, intravascular (IV) dye, has been used in adults and children for over 60 years, with few side effects. ICG-NIR was used in this report to demonstrate the adequacy of perfusion during transanal pullthrough for Hirschsprung’s disease. Method: 8 patients with Hirschsprung disease were evaluated with ICG-NIR technology. Levels of affected area ranged from sigmoid to total colonic Hirschsprung disease. After leveling, but prior to anastomosis, ICG was administered at 1.25 mg (< 2 mg/kg) and perfusion visualized using an NIR camera, before and during anastomosis. Video and photo imaging was performed and perfusion of the bowel was compared to surrounding tissues. This showed the degree of perfusion and demarcation of perfused and non-perfused bowel. The anastomosis was completed uneventfully and the patients all did well. Results: There were no complications of stricture or leak. 5 of 8 patients (62.5%) had modification of the plan based on ICG-NIR imaging. Conclusion: Technologies that enhance surgeons’ ability to visualize bowel perfusion prior to anastomosis in Hirschsprung’s patients may help reduce post-operative complications. Further studies are needed to assess the potential benefits.

Keywords: colonic anastomosis, fluorescence angiography, Hirschsprung disease, pediatric surgery, SPY

Procedia PDF Downloads 117

Authors: Nikolay Konukhov

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This paper to report on a new analytic model for predicting microcontact resistance and the design, fabrication, and testing of microelectromechanical systems (MEMS) metal contact switches with sputtered bimetallic (i.e., gold (Au)-on-Au-platinum (Pt), (Au-on-Au-(6.3at%)Pt)), binary alloy (i.e., Au-palladium (Pd), (Au-(3.7at%)Pd)), and ternary alloy (i.e., Au-Pt-copper (Cu), (Au-(5.0at%)Pt-(0.5at%)Cu)) electric contacts. The microswitches with bimetallic and binary alloy contacts resulted in contact resistance values between 1–2

Keywords: alloys, electric contacts, microelectromechanical systems (MEMS), microswitch

Procedia PDF Downloads 148

Authors: S. Yeo, M. Mathur

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

Keywords: pregnancy, obesity, caesarean, infection

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Authors: Tilouche Rahma, Sayeb Soumaya, Ben Hassen Mohamed

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The wettability of materials is a very important aspect of surface science, it presents a key factor providing the best characteristic of product, especially in hygienic field. Hydrophobic polypropylene is used as nonwoven topsheet in disposable diaper, for its interesting properties (toughness, lightness...) by comparing with traditional product previously used. SURFACTANTs are widely used to reduce contact angle (water contact angles larger than 90° on smooth surfaces) and to change wetting properties. In the present work, we study ways to obtain hydrophilic polypropylene surface, by the deposition of a variety of surfactant on surfaces of varying morphology. We used two different methods for surface wetting: Spraying method and the coating method. The concentration of the wetting agent, the type of non-woven fabric and the parameters in the method for controlling, hugely affect the quality of treatment. Therefore need that the treatment is effective in terms of contact angle without affecting the mechanical properties of the nonwoven. For the assessment of the quality of treatment, two methods are used: The measurement of the contact angle and the strike trough time. Also, with subjective evaluation by Hedonic test (which involves the consumer preference (naive panel: group of moms). Finally, we selected the better treated topsheet referring to the assessment results.

Keywords: SURFACTANT, topsheet polypropylene, hydrophilic, hydrophobic

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Authors: Neveen AlQasas, Daniel Johnson

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Membranes for water treatment are an established technology that attracts great attention due to its simplicity and cost effectiveness. However, membranes in operation suffer from the adverse effect of membrane fouling. Bio-fouling is a phenomenon that occurs at the water-membrane interface, and is a dynamic process that is initiated by the adsorption of dissolved organic material, including biomacromolecules, on the membrane surface. After initiation, attachment of microorganisms occurs, followed by biofilm growth. The biofilm blocks the pores of the membrane and consequently results in reducing the water flux. Moreover, the presence of a fouling layer can have a substantial impact on the membrane separation properties. Understanding the mechanism of the initiation phase of biofouling is a key point in eliminating the biofouling on membrane surfaces. The adhesion and attachment of different fouling materials is affected by the surface properties of the membrane materials. Therefore, surface properties of different polymeric materials had been studied in terms of their surface energies and Hansen solubility parameters (HSP). The difference between the combined HSP parameters (HSP distance) allows prediction of the affinity of two materials to each other. The possibilities of measuring the HSP of different polymer films via surface measurements, such as contact angle has been thoroughly investigated. Knowing the HSP of a membrane material and the HSP of a specific foulant, facilitate the estimation of the HSP distance between the two, and therefore the strength of attachment to the surface. Contact angle measurements using fourteen different solvents on five different polymeric films were carried out using the sessile drop method. Solvents were ranked as good or bad solvents using different ranking method and ranking was used to calculate the HSP of each polymeric film. Results clearly indicate the absence of a direct relation between contact angle values of each film and the HSP distance between each polymer film and the solvents used. Therefore, estimating HSP via contact angle alone is not sufficient. However, it was found if the surface tensions and viscosities of the used solvents are taken in to the account in the analysis of the contact angle values, a prediction of the HSP from contact angle measurements is possible. This was carried out via training of a neural network model. The trained neural network model has three inputs, contact angle value, surface tension and viscosity of solvent used. The model is able to predict the HSP distance between the used solvent and the tested polymer (material). The HSP distance prediction is further used to estimate the total and individual HSP parameters of each tested material. The results showed an accuracy of about 90% for all the five studied films

Keywords: surface characterization, hansen solubility parameter estimation, contact angle measurements, artificial neural network model, surface measurements

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Authors: Deok Hyun Han

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Objective: To explore outcomes of UventaTM metallic ureteral stent between malignant and benign ureteral obstruction. Methods: We reviewed the medical records of 90 consecutive patients who underwent Uventa stent placement for benign or malignant ureteral obstruction from December 2009 to June 2013. We evaluated the clinical outcomes, complications, and reasons and results for unexpected stent removals. Results: The median follow-up was 10.7 (0.9 – 41) months. From a total of 125 ureter units, there were 24 units with benign obstructions and 101 units with malignant obstructions. Initial technical successes were achieved in all patients. The overall success rate was 70.8% with benign obstructions and 84.2% with malignant obstructions. The major reasons for treatment failure were stent migration (12.5%) in benign and tumor progression (11.9%) in malignant obstructions. The overall complication rate was similar between benign and malignant obstructions (58.3% and 42.6%), but severe complications, which are Clavien grade 3 or more, occurred in 41.7% of benign and 6.9% of malignant obstructions. The most common complications were stent migration (25.0%) in benign obstructions and persistent pain (14.9%) in malignant obstructions. The stent removal was done in 16 units; nine units that were removed by endoscopy and seven units were by open surgery. Conclusions: In malignant ureteral obstructions, the Uventa stent showed favorable outcomes with high success rate and acceptable complication rate. However, in benign ureteral obstructions, overall success rate and complication rate were less favorable. Malignant ureteral obstruction seems to be appropriate indication of Uventa stent placement. However, in chronic diffuse benign ureteral obstructions the decision of placement of Uventa stent has to be careful.

Keywords: cause, complication, ureteral obstruction, metal stent

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Authors: Wenxuan Li, Lei Li, Jin Li, Yuanhang He

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This paper designed a secure chip for IoT communication security integrated with the PUF-based firmware protection scheme. Then, the Xilinx Kintex-7 and STM-32 were used for the prototype verification. Firmware protection worked well on FPGA and embedded platforms. For the ASIC implementation of the PUF module, contact PUF is chosen. The post-processing method and its improvement are analyzed with emphasis. This paper proposed a more efficient post-processing method for contact PUF named SXOR, which has practical value for realizing lightweight security modules in IoT devices. The analysis was carried out under the hypothesis that the contact holes are independent and combine the existing data in the open literature. The post-processing effects of SXOR and XOR are basically the same under the condition that the proposed post-processing circuit occupies only 50.6% of the area of XOR. The average Hamming weight of the PUF output bit sequence obtained by the proposed post-processing method is 0.499735, and the average Hamming weight obtained by the XOR-based post-processing method is 0.499999.

Keywords: PUF, IoT, authentication, secure communication, encryption, XOR

Procedia PDF Downloads 115

Authors: Gaurav Bisht, Rahul Rathnakumar, Ravikumar Duggirala

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Predictive simulations are one of the key focus areas in safety-critical industries such as aerospace and high-performance automotive engineering. The stone-chipping study is one such effort taken up by the industry to predict and evaluate the damage caused due to gravel impact on vehicles. This paper describes a finite elements based method that can simulate the ejection of gravel chips from a vehicle tire. The FE simulations were used to obtain the initial ejection velocity of the stones for various driving conditions using a computational contact mechanics approach. To verify the accuracy of the tire model, several parametric studies were conducted. The FE simulations resulted in stone loft velocities ranging from 0–8 m/s, regardless of tire speed. The stress on the tire at the instant of initial contact with the stone increased linearly with vehicle speed. Mesh convergence studies indicated that a highly resolved tire mesh tends to result in better momentum transfer between the tire and the stone. A fine tire mesh also showed a linearly increasing relationship between the tire forward speed and stone lofting speed, which was not observed in coarser meshes. However, it also highlighted a potential challenge, in that the ejection velocity vector of the stone seemed to be sensitive to the mesh, owing to the FE-based contact mechanical formulation of the problem.

Keywords: abaqus, contact mechanics, foreign object debris, stone chipping

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Authors: Arun Prasad

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Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.

Keywords: laparoscopy, hernia, mesh, surgery

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Authors: C. Catalina Zapata, Z. Claudia Montoya

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Transplant from hematopoietic parents (THP) or medulla (MT) is a procedure used to replace the medulla that does not work as part of a disease or when it is destroyed either by a treatment of high medication doses against cancer or by radiation. The transplant process has three stages, a stage prior to transplant, during and after the transplant. It is held with the help of an interdisciplinary team, including nursing, carrying out mainly educative procedures to warrant the adhesion and the changes in lifestyles needed to whom will undergo this procedure. The aim of the study was to assess the results of an educative procedure by nursing, on adult patients subjected to a transplant from hematopoietic parents at a high complexity institution of Medellin city, Colombia. This study had an observational longitudinal design. According to the rules of protocol, the educative activity must be held on all patients joining the procedure. Four instruments were designed in order to collect all the information. One of them to measure the sociodemographic variables, another one to measure self-care practices, another one to measure transplant knowledge and its cares and the other one to measure the 30-day post-transplant complications. The last three instruments were applied before and after the educative procedure. A univaried analysis was carried out but the bivaried analysis was not carried out since there were not statistically meaningful differences before and after. Within the results, ten patients were evaluated. The average age was 38.2 (13.38 SD – standard deviation), 8/10 were men. Some self-care practices such us having pets and plants and consuming some specific food as well as little use of UV protection are all present in this type of patients and are not modified after the procedure. In measuring the knowledge, something stands out among the answers. It is the fact that some patients do not know what the medulla is, the nature of separating wastes at home and the need to consult about vomit and nausea. The most frequent complications during the first thirty days were: nausea, vomit, fever, and rash. They are considered to be expected within this period. Patients do not exhibit differences in their level of knowledge before and after the educative procedure by nursing. The patients’ self-care practices do not involve all the necessary ones to avoid complications. During the first 30 days, most of the complications are typical of the transplant process from hematopoietic parents.

Keywords: bone marrow transplant, education, family, nursing, patients, Transplantation of hematopoietic progenitors

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Authors: Misho Matsankov, Stoyan Petrov

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The paper presents the methodology and the obtained mathematical models for determining the value of the grounding resistance of a disconnected conductor in a three-phase power line, for which the contact voltage is safe, by taking into account the potentials, induced by the non-disconnected phase conductors. The mathematical models have been obtained by implementing the experimental design techniques.

Keywords: contact voltage, experimental design, induced voltage, safety

Procedia PDF Downloads 159

Authors: Paul Dunst, Ing. Tobias Hemsel, Ing. Habil. Walter Sextro

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The use of fine powders with high cohesive and adhesive properties leads to challenges during transport, mixing and dosing in industrial processes, which have not been satisfactorily solved so far. Due to the increased contact forces at the transporting parts (e. g. pipe-wall and transport screws), conventional transport systems and also vibratory conveyors reach their limits. Often, flowability increasing additives that need to be removed again in later process steps are the only option to achieve wanted transport results. A rather new ultrasound-assisted powder transport system showed to overcome some of the issues by manipulating the effective friction between powder and transport pipe. Within this contribution, the transport mechanism will be introduced shortly, together with preliminary transport results. As the tangential force of the transport pipe and the powder is the main influencing factor within the transport process, a test stand for measuring tangential forces of a powder-wall contact in the presence of an ultrasonic vibration orthogonal to the contact plane was built. Measurements for a sample powder show that the effective tangential force can already be significantly reduced at very low ultrasonic amplitude. As a result of the measurements, an empirical model for the relationship of tangential force, contact parameters and ultrasonic excitation is presented. This model was used to adjust the driving parameters of the powder transport system, resulting in better performance.

Keywords: powder transport, ultrasound, friction, friction manipulation, vibratory conveyor

Procedia PDF Downloads 131

Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Daoud, Leila Keskes, Tarek Rebai

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Introduction: Recurrent pregnancy loss (RPL) defined as two or more pregnancy losses, is a serious clinical problem. Methylene-tetrahydro-folate-reductase (MTHFR) polymorphisms, commonly the variant C677T is recognized as an inherited thrombophilia which might affect embryonic development and pregnancy success and cause pregnancy complications as RPL. Material and Methods DNA was extracted from peripheral blood samples and PCR-RFLP was performed for the molecular diagnosis of the C677T MTHFR polymorphism among 70 patients (35 couples) with more than 2 fetal losses. Aims and Objective: The aim of this study is to determine the frequency of MTHFR C677T among Tunisian couples with RPL and to critically analyze the available literature on the importance of MTHFR polymorphism testing in the management of RPL. Result and comments: No C677T mutation was detected in the carriers of RPL. This result would be related to sample size and to different criteria (number of abortion), - The association between MTHFR polymorphisms and pregnancy complications has been reported but with controversial results. - A lack of evidence for MTHFR polymorphism testing previously recommended by ACMG (American College of Medical medicine). Our study highlights the importance of screening of MTHFR polymorphism since the real impact of such thrombotic molecular defect on the pregnancy outcome is evident. - Folic supplementation of these patients during pregnancy can prevent such complications and lead to a successful pregnancy outcome.

Keywords: methylenetetrahydrofolate reductase, C677T, recurrent pregnancy loss, genetic testing

Procedia PDF Downloads 285

Authors: J. R. Ashrapov, G. A. Alihodzhaeva, D. E. Abdullaev, N. R. Kadirbekov

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Diagnosis of brain tumors is one of the challenges, as several central nervous system diseases run the same symptoms. Modern diagnostic techniques such as CT, MRI helps to significantly improve the surgery in the operating period, after surgery, after allowing time to identify postoperative complications in neurosurgery. Purpose: To study the MRI characteristics and localization of brain tumors in children and to detect the postoperative complications in the postoperative period. Materials and methods: A retrospective study of treatment of 62 children with brain tumors in age from 2 to 5 years was performed. Results of the review: MRI scan of the brain of the 62 patients 52 (83.8%) case revealed a brain tumor. Distribution on MRI of brain tumors found in 15 (24.1%) - glioblastomas, 21 (33.8%) - astrocytomas, 7 (11.2%) - medulloblastomas, 9 (14.5%) - a tumor origin (craniopharyngiomas, chordoma of the skull base). MRI revealed the following characteristic features: an additional sign of the heterogeneous MRI signal of hyper and hypointensive T1 and T2 modes with a different perifocal swelling degree with involvement in the process of brain vessels. The main objectives of postoperative MRI study are the identification of early or late postoperative complications, evaluation of radical surgery, the identification of the extended-growing tumor that (in terms of 3-4 weeks). MRI performed in the following cases: 1. Suspicion of a hematoma (3 days or more) 2. Suspicion continued tumor growth (in terms of 3-4 weeks). Conclusions: Magnetic resonance tomography is a highly informative method of diagnostics of brain tumors in children. MRI also helps to determine the effectiveness and tactics of treatment and the follow up in the postoperative period.

Keywords: brain tumors, children, MRI, treatment

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Authors: Ernests Jansons, Karlis Agris Gross

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Winter brings snow and ice in the Northern Europe and with it the need to move safely over ice. It has been customary to select an appropriate material surface for movement over ice, but another way to influence the interaction with ice is to modify the ice surface. The objective of this work was to investigate the influence of ice topography on initiating movement over ice and on sliding velocity over ice in the laboratory and real-life conditions. The ice was prepared smooth, scratched or with solidified ice-droplets to represent the surface of ice after ice rain. In the laboratory, the coefficient of friction and the sliding velocity were measured, but the sliding velocity measured at the skeleton push-start facility. The scratched ice surface increased the resistance to movement and also showed the slowest sliding speed. Sliding was easier on the smooth ice and ice covered with frozen droplets. The contact surface was measured to determine the effect of contact area with sliding. Results from laboratory tests will be compared to loading under heavier loads to show the influence of load on sliding over different ice surfaces. This outcome provides a useful indicator for pedestrians and road traffic on the safety of movement over different ice surfaces as well as a reference for those involved with winter sports.

Keywords: contact area, friction, ice topography, sliding velocity

Procedia PDF Downloads 218

Authors: Carmela Perta

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Among the studies flourished in the field of historical sociolinguistics, mainly in the strand devoted to English history, during its Medieval and early modern phases, multilingual texts had been analysed using theories and models coming from contact linguistics, thus applying synchronic models and approaches to the past. This is true also in the case of contact phenomena which would transcend the writing level involving the language systems implicated in contact processes to the point of perceiving a new variety. This is the case for medieval administrative-commercial texts in which, according to some Scholars, the degree of fusion of Anglo-Norman, Latin and middle English is so high a mixed code emerges, and there are recurrent patterns of mixed forms. Interesting is a collection of multilingual business writings by John Balmayn, an Englishman overseeing a large shipment in Tuscany, namely the Cantelowe accounts. These documents display various analogies with multilingual texts written in England in the same period; in fact, the writer seems to make use of the above-mentioned patterns, with Middle English, Latin, Anglo-Norman, and the newly added Italian. Applying an atomistic yet dynamic approach to the study of contact phenomena, we will investigate these documents, trying to explore the nature of the switching forms they contain from an intra-writer variation perspective. After analysing the accounts and the type of multilingualism in them, we will take stock of the assumed mixed code nature, comparing the characteristics found in this genre with modern assumptions. The aim is to evaluate the possibility to consider the switching forms as core elements of a mixed code, used as professional variety among merchant communities, or whether such texts should be analysed from a switching perspective.

Keywords: historical sociolinguistics, historical code switching, letters, medieval england

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Authors: Huang Haoxin

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Large dark current at room temperature has long been the major bottleneck that impedes the development of high-performance infrared photodetectors towards miniaturization and integration. Although infrared photodetectors based on layered 2D narrow bandgap semiconductors have shown admirable advantages compared with those based on conventional compounds, which typically suffer from expensive cryogenic operations, it is still urgent to develop a simple but effective strategy to further reduce the dark current. Herein, a tellurium (Te) based infrared photodetector is reported with a specifically designed asymmetric electrical contact area. The deliberately introduced asymmetric electrical contact raises the electric field intensity difference in the Te channel near the drain and the source electrodes, resulting in spontaneous asymmetric carrier diffusion under global infrared light illumination under zero bias. Specifically, the Te-based photodetector presents promising detector performance at room temperature, including a low dark current of≈1 nA, an ultrahigh photocurrent/dark current ratio of 1.57×10⁴, a high specific detectivity (D*) of 3.24×10⁹ Jones, and relatively fast response speed of ≈720 μs at zero bias. The results prove that the simple design of asymmetric electrical contact areas can provide a promising solution to high-performance 2D semiconductor-based infrared photodetectors working at room temperature.

Keywords: asymmetrical contact, tellurium, dark current, infrared photodetector, sensitivity

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Authors: Ibrahim Mohamed Ibrahim Hassanin, Hany Hassan Mostafa, Mona Mohamed Shaban, Ahlam El Said Kamel

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Background: New so-called minimally invasive devices have been developed to limit groin pain after sling placement for treatment of stress urinary incontinence (SUI) to minimize the risk of postoperative pain and organ perforation. A new generation of suburethral slings was described that avoided skin incision to pull out and tension the sling. Evaluation of this device through prospective short-term series has shown controversial results compared with other tension-free techniques. The aim of this study is to compare success rates and complications for tension-free vaginal tape secur (TVT secur) and trans-obturator sub urethral tape inside-out technique (TVT-O) for treatment of stress urinary incontinence (SUI). Materials and Methods: Fifty patients with genuine SUI were divided into two groups: group S (n=25) were operated upon using (TVT secur) and group O (n=25) were operated upon using trans-obturator suburethral tape inside-out technique (TVT-O). Success rate, quality of life and postoperative complications such as groin pain, urgency, urine retention and vaginal tape erosion were reported in both groups at one, three, and six months after surgery. Results: As regards objective cure rate at one, three, six months intervals; there was a significant difference between group S (56%, 64%, and 60%), and group O (80%, 88%, and 88%) respectively (P <0.05). As regards subjective cure rate at one, three, six months intervals; there was a significant difference between group S (44%, 44%, and 48%), and group O (76%, 80%, and 80%) respectively (P <0.05). Quality of life (QoL) parameters improved significantly in cured patients with no difference between both groups. As regards complications, group O had a higher frequency of complications than group S; groin pain (12% vs 12% p= 0.05), urgency (4% (1 case) vs 0%), urine retention (8% (2 cases) vs 0%), vaginal tape erosion (4% (1 case) vs 0%). No cases were complicated with wound infection. Conclusion: Compared to TVT secur, TVT-O showed higher subjective and objective cure rates after six months but higher rate of complications. Both techniques were comparable as regards improvement of quality of life after surgery.

Keywords: stress urinary incontinence, trans-vaginal tape-obturator, TVT Secur, TVT-O

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Authors: Ferhat Kadioglu

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A clamped-free vibrating beam technique was used to evaluate dynamic properties of glass fiber reinforced polymer matrix composite. In the experiment, an electromagnetic shaker and a non-contact laser head were used to vibrate and to take the response of the specimens, respectively. Test results showed that damping and elastic modulus of the material, as dynamic properties, could be obtained successfully using this technique. It was found that the balanced and symmetric specimens with 45 degrees are the best for damping performance. It is believed that such results could be used for the modal design of aerospace structures.

Keywords: composite materials, damping values, dynamic properties, non-contact measurements

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Authors: Clara Luwe, Oliver Harness, Helena Meally, Kim Martin, Alexandra Harrington

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Background: The role of ‘Renal Specialist Podiatrist’ originated in 2022 due to prevailing evidence of patients with diabetes and end-stage renal disease (ESRD) on haemodialysis (HD) and active ulcerations that were at higher risk of rapid deterioration, foot-related hospital admissions, and lower limb amputations. This role started in April 2022 with the aim of screening all patients on haemodialysis and instigating preventative measures to reduce serious foot related complications. Methods: A comprehensive neurovascular foot assessment was completed to establish baseline vascular status and identify those with peripheral arterial disease (PAD) for all patients on HD. Individual’s foot risk was stratified, advice and education tailored and issued. Identifying all diabetes patients on HD as high-risk for diabetic foot complications. Major Findings: All patients screened revealed over half of the caseload had diabetes, and more than half had a clinical presentation of PAD. All those presenting with ulcerations had a diagnosis of diabetes. Of the presenting ulcerations, the majority of these ulcers predated the renal specialist post and were classified as severe >3 SINBAD Score. Since April’22, complications have been identified quicker, reducing the severity (SINBAD<3 or below), and have improved healing times, in line with the national average. During the eight months of the role being in place, we have seen a reduction in minor amputations and no major amputations. Conclusion: By screening all patients on haemodialysis and focusing on education, early recognition of complications, appropriate treatment, and timely onward referral, we can reduce the risk of foot Diabetic foot ulcerations and lower limb amputations. Having regular podiatry input to stratify and facilitate high-risk, active wound patients across different services has helped to keep these patients stable, prevent amputations, and reduce foot-related hospital admissions and mortality from foot-related disease. By improving the accessibility to a specialist podiatrist, patients felt able to raise concerns sooner. This has helped to implement treatment at the earliest possible opportunity, enabling the identification and healing of ulcers at an earlier and less complex stage (SINBAD <3), thus, preventing potential limb-threatening complications.

Keywords: renal, podiatry, haemodialysis, prevention, early detection

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Authors: Nauman A. Siddiqui

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High performance requirement of aircrafts and marines industry demands to cater major industrial problems like wetting, high-speed efficiency, and corrosion resistance. These problems can be resolved by producing the hydrophobic surfaces on the metal substrate. By anodization process, the surface of AA 7075 has been modified and achieved a rough surface with a porous aluminum oxide (Al2O3) structure at nano-level. This surface modification process reduces the surface contact energy and increases the liquid contact angle which ultimately enhances the anti-icing properties. Later the Silane and Polyurethane (PU) coatings on the anodized surface have produced a contact angle of 130°. The results showed a good water repellency and self-cleaning properties. Using SEM analysis, micrographs revealed the round nano-porous oxide structure on the substrate. Therefore this technique can help in increasing the speed efficiency by reducing the friction with the outer interaction and can also be declared as a green technique since it is user-friendly.

Keywords: AA 7075, hydrophobicity, silanes, polyurethane, anodization

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Authors: Jeounghee Kim

Abstract:

Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Lakshmana Ravi Raj Gali, K. Sridhar Reddy, M. Amaranatha Reddy

Abstract:

Load transfer between adjacent slabs of the jointed plain concrete pavement (JPCP) system is inevitable for long-lasting performance. Dowel bars are generally used to ensure sufficient degree of load transfer, in addition to the load transferred by aggregate interlock mechanism at the joints. Joint efficiency is the measure of joint quality, a major concern and therefore the dowel bar system should be designed and constructed well. The interaction between dowel bars and concrete that includes various parameters of dowel bar and concrete will explain the degree of joint efficiency. The present study focuses on the methodology of selecting contact stiffness, which quantifies dowel-concrete interaction. In addition, a parametric study which focuses on the effect of dowel diameter, dowel shape, the spacing between dowel bars, joint opening, the thickness of the slab, the elastic modulus of concrete, and concrete cover on contact stiffness was also performed. The results indicated that the thickness of the slab is most critical among various parameters to explain the joint efficiency. Further displacement equivalency method was proposed to find out the contact stiffness. The proposed methodology was validated with the available field surface deflection data collected by falling weight deflectometer (FWD).

Keywords: contact stiffness, displacement equivalency method, Dowel-concrete interaction, joint behavior, 3D numerical simulation

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Authors: Varsha Singh, Shraddha Prajapati, M. B. Kiran

Abstract:

Texture identification is useful in predicting the functionality of a component. Many of the existing texture identification methods are of contact in nature, which limits its measuring speed. These contact measurement techniques use a diamond stylus and the diamond stylus being sharp going to damage the surface under inspection and hence these techniques can be used in statistical sampling. Though these contact methods are very accurate, they do not give complete information for full characterization of surface. In this context, the presented method assumes special significance. The method uses a relatively low cost vision system for image acquisition. Software is developed based on wavelet transform, for analyzing texture images. Specimens are made using different manufacturing process (shaping, grinding, milling etc.) During experimentation, the specimens are illuminated using proper lighting and texture images a capture using CCD camera connected to the vision system. The software installed in the vision system processes these images and subsequently identify the texture of manufacturing processes.

Keywords: diamond stylus, manufacturing process, texture identification, vision system

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Authors: Mahdi Sadeghian, Somaye Sadeghian, Reza Dinarvand

Abstract:

This paper is going to discuss two issues encountered in using PLAXIS. Both issues were monitored during application of PLAXIS to estimate the excavation-induced displacement. Column Soil Mixing (CSM) was applied to stabilise the excavation. It was understood that the estimated excavation induced deformation at the top of the CSM blocks highly depends on the material type defining pavement material adjacent to the CSM blocks. Cohesive material for pavement will result in the unrealistic connection between pavement and CSM even by defining an interface element. To find the most realistic approach, the interface defined in three different manners (1) no interface elements were applied (2) a non-cohesive soil layer was defined between pavement and CSM block to represent the friction between these materials (3) built-in interface elements in PLAXIS was used to define the boundary between the pavement and the CSM block. The result showed that the option 2 would result in more realistic results. The second issue was in the modelling of the contact line between the CSM block and an inclined layer underneath. The analysis result showed that the excavation-induced deformation highly depends on how the PLAXIS user defines the contact area. It was understood that if the contact area had defined as a point in which CSM block had intersected the layer underneath the estimated lateral displacement of CSM block would be unrealistically lower than the model in which the contact area was defined as a line.

Keywords: PLAXIS, FEM, CSM, Excavation-Induced Deformation

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Authors: Karolina Siejka, Monika Piekarska, Monika Zbroja, Weronika Cyranka, Maryla Kuczynska, Magdalena Grzegorczyk, Malgorzata Nowakowska, Agnieszka Brodzisz, Magdalena Maria Wozniak

Abstract:

Crohn’s disease is one of chronic inflammatory bowel diseases. It is increasing in prevalence worldwide, especially with young people. The disease usually occurs in the second to the fourth decade of life. Traditionally is diagnosed by clinical indicates, endoscopic, and histological findings. Magnetic Resonance Enterography (MRE) can demonstrate mural and extramural inflammatory signs and complications, which make it a valuable diagnostic modality. The study included 76 adults and 36 children diagnosed with Crohn’s disease. Each patient underwent MRE with intravenous administration of a contrast agent. All the studies were performed using Siemens Aera 1.5T scanner according to a local study protocol. Whenever applicable, MR Enterography findings were verified with endoscopy. Forty adults and all 36 children had an active phase of Crohn’s disease; five adults had a chronic phase of the disease; one adult had both chronic and active inflammatory features. Thirty adults have no sings of pathology. In both adult and pediatric groups the most commonly observed manifestation of active disease was thickened edematous ileum wall (26 adults and 36 children). Adults had Bauhin’s valve edema in 58% cases (n=23) and mesenteric changes in 34% cases (n=9). To compare, 32 children had Bauhin’s valve edema (89%) and, in 23 cases, was found inflammatory infiltration of the peri-intestinal fat (64%). The involvement of the large intestine was more common among children (100%). Complications of Crohn’s disease were found commonly in adults (40% of adults, 22% of children). There were observed 18 fistulas (14 adults, four children) and six abscesses (2 adults, four children). MRE is a reliable method in the evaluation of Crohn’s disease activity, especially of its complications. The lack of radiations makes MRE well-tolerated modality, which can be often repeated, particularly in young patients. The disease had different medical sings depending on age – children often had a more active inflammatory process, but there were more complications in the adult group.

Keywords: Crohn's disease, diagnostics, inflammatory bowel disease, magnetic resonance enterography, MRE

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Authors: WooYoung Jung, V. Sim

Abstract:

This paper presents numerical analysis in terms of buckling resistance strength of polymer matrix composite (PMC) infill panels system under the influence of temperature on the foam core. Failure mode under in-plane compression is investigated by means of numerical analysis with ABAQUS platform. Parameters considered in this study are contact length and both the type of foam for core and the variation of its Young's Modulus under the thermal influence. Variation of temperature is considered in static cases and only applied to core. Indeed, it is shown that the effect of temperature on the panel system mechanical properties is significance. Moreover, the variations of temperature result in the decrements of the system strength. This is due to the polymeric nature of this material. Additionally, the contact length also displays the effect on performance of infill panel. Their significance factors are based on type of polymer for core. Hence, by comparing difference type of core material, the variation can be reducing.

Keywords: buckling, contact length, foam core, temperature dependent

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Authors: Kamelia Hamza

Abstract:

Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.

Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders

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Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

Abstract:

Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

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