Search results for: percutaneous medial screw
161 Experimental Study on Hardness and Impact Strength of Polyethylene/Carbon Composites
Authors: Armin Najipour, A. M. Fattahi
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The aim of this research was to investigate the effect of the addition of multi walled carbon nanotubes on the mechanical properties of polyethylene/carbon nanotube nanocomposites. To do so, polyethylene and carbon nanotube were mixed in different weight percentages containing 0, 0.5, 1, and 1.5% carbon nanotube in two screw extruder apparatus by fusion. Then the nanocomposite samples were molded in injection apparatus according to ASTM: D6110 standard. The effects of carbon nanotube addition in 4 different levels and injection pressure in 2 levels on the hardness and impact strength of the nanocomposite samples were investigated. The results showed that the addition of carbon nanotube had a significant effect on improving hardness and impact strength of the nanocomposite samples such that by adding 1% w/w carbon nanotube, the impact strength and hardness of the samples improved to 74% and 46.7% respectively. Also, according to the results, the effect of injection pressure on the results was much less than that of carbon nanotube weight percentage.Keywords: carbon nanotube, injection molding, mechanical properties, nanocomposite, polyethylene
Procedia PDF Downloads 321160 Using Audit Tools to Maintain Data Quality for ACC/NCDR PCI Registry Abstraction
Authors: Vikrum Malhotra, Manpreet Kaur, Ayesha Ghotto
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Background: Cardiac registries such as ACC Percutaneous Coronary Intervention Registry require high quality data to be abstracted, including data elements such as nuclear cardiology, diagnostic coronary angiography, and PCI. Introduction: The audit tool created is used by data abstractors to provide data audits and assess the accuracy and inter-rater reliability of abstraction performed by the abstractors for a health system. This audit tool solution has been developed across 13 registries, including ACC/NCDR registries, PCI, STS, Get with the Guidelines. Methodology: The data audit tool was used to audit internal registry abstraction for all data elements, including stress test performed, type of stress test, data of stress test, results of stress test, risk/extent of ischemia, diagnostic catheterization detail, and PCI data elements for ACC/NCDR PCI registries. This is being used across 20 hospital systems internally and providing abstraction and audit services for them. Results: The data audit tool had inter-rater reliability and accuracy greater than 95% data accuracy and IRR score for the PCI registry in 50 PCI registry cases in 2021. Conclusion: The tool is being used internally for surgical societies and across hospital systems. The audit tool enables the abstractor to be assessed by an external abstractor and includes all of the data dictionary fields for each registry.Keywords: abstraction, cardiac registry, cardiovascular registry, registry, data
Procedia PDF Downloads 105159 Neural Correlates of Decision-Making Under Ambiguity and Conflict
Authors: Helen Pushkarskaya, Michael Smithson, Jane E. Joseph, Christine Corbly, Ifat Levy
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Studies of decision making under uncertainty generally focus on imprecise information about outcome probabilities (“ambiguity”). It is not clear, however, whether conflicting information about outcome probabilities affects decision making in the same manner as ambiguity does. Here we combine functional Magnetic Resonance Imaging (fMRI) and a simple gamble design to study this question. In this design, the levels of ambiguity and conflict are parametrically varied, and ambiguity and conflict gambles are matched on both expected value and variance. Behaviorally, participants avoided conflict more than ambiguity, and attitudes toward ambiguity and conflict did not correlate across subjects. Neurally, regional brain activation was differentially modulated by ambiguity level and aversion to ambiguity and by conflict level and aversion to conflict. Activation in the medial prefrontal cortex was correlated with the level of ambiguity and with ambiguity aversion, whereas activation in the ventral striatum was correlated with the level of conflict and with conflict aversion. This novel double dissociation indicates that decision makers process imprecise and conflicting information differently, a finding that has important implications for basic and clinical research.Keywords: decision making, uncertainty, ambiguity, conflict, fMRI
Procedia PDF Downloads 564158 Manufacturing of Twist-Free Surfaces by Magnetism Aided Machining Technologies
Authors: Zs. Kovács, Zs. J. Viharos, J. Kodácsy
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As a well-known conventional finishing process, the grinding is commonly used to manufacture seal mating surfaces and bearing surfaces, but is also creates twisted surfaces. The machined surfaces by turning or grinding usually have twist structure on the surfaces, which can convey lubricants such as conveyor screw. To avoid this phenomenon, have to use special techniques or machines, for example start-stop turning, tangential turning, ultrasonic protection or special toll geometries. All of these solutions have high cost and difficult usability. In this paper, we describe a system and summarize the results of the experimental research carried out mainly in the field of Magnetic Abrasive Polishing (MAP) and Magnetic Roller Burnishing (MRB). These technologies are simple and also green while able to produce twist-free surfaces. During the tests, C45 normalized steel was used as workpiece material which was machined by simple and Wiper geometrical turning inserts in a CNC turning lathe. After the turning, the MAP and MRB technologies can be used directly to reduce the twist of surfaces. The evaluation was completed by advanced measuring and IT equipment.Keywords: magnetism, finishing, polishing, roller burnishing, twist-free
Procedia PDF Downloads 576157 Investigation of Mechanical and Rheological Properties of Poly (trimethylene terephthalate) (PTT)/Polyethylene Blend Using Carboxylate and Ionomer as Compatibilizers
Authors: Wuttikorn Chayapanja, Sutep Charoenpongpool, Manit Nithitanakul, Brian P. Grady
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Poly (trimethylene terephthalate) (PTT) is a linear aromatic polyester with good strength and stiffness, good surface appearance, low shrinkage and war page, and good dimensional stability. However, it has low impact strength which is a problem in automotive application. Thus, modification of PTT with the other polymer or polymer blending is a one way to develop a new material with excellence properties. In this study, PTT/High Density Polyethylene (HDPE) blends and PTT/Linear Low Density Polyethylene (LLDPE) blends with and without compatibilizers base on maleic anhydride grafted HDPE (MAH-g-HDPE) and ethylene-methacrylic acid neutralized sodium metal (Na-EMAA) were prepared by a twin-screw extruder. The blended samples with different ratios of polymers and compatibilizers were characterized on mechanical and rheological properties. Moreover, the phase morphology and dispersion size were studied by using SEM to give better understanding of the compatibility of the blends.Keywords: poly trimethylene terephthalate, polyethylene, compatibilizer, polymer blend
Procedia PDF Downloads 414156 Experimental Investigation of Cold-Formed Steel-Timber Board Composite Floor Systems
Authors: Samar Raffoul, Martin Heywood, Dimitrios Moutaftsis, Michael Rowell
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This paper comprises an experimental investigation into the structural performance of cold formed steel (CFS) and timber board composite floor systems. The tests include a series of small-scale pushout tests and full-scale bending tests carried out using a refined loading system to simulate uniformly distributed constant load. The influence of connection details (screw spacing and adhesives) on floor performance was investigated. The results are then compared to predictions from relevant existing models for composite floor systems. The results of this research demonstrate the significant benefits of considering the composite action of the boards in floor design. Depending on connection detail, an increase in flexural stiffness of up to 40% was observed in the floor system, when compared to designing joists individually.Keywords: cold formed steel joists, composite action, flooring systems, shear connection
Procedia PDF Downloads 129155 Experimental Study on Tensile Strength of Polyethylene/Carbon Injected Composites
Authors: Armin Najipour, A. M. Fattahi
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The aim of this research was to investigate the effect of the addition of multi walled carbon nanotubes on the mechanical properties of polyethylene/carbon nanotube nanocomposites. To do so, polyethylene and carbon nanotube were mixed in different weight percentages containing 0, 0.5, 1, and 1.5% carbon nanotube in two screw extruder apparatus by fusion. Then the nanocomposite samples were molded in injection apparatus according to ASTM:D638 standard. The effects of carbon nanotube addition in 4 different levels on the tensile strength, elastic modulus and elongation of the nanocomposite samples were investigated. The results showed that the addition of carbon nanotube had a significant effect on improving tensile strength of the nanocomposite samples such that by adding 1% w/w carbon nanotube, the tensile strength 23.4%,elastic modulus 60.4%and elongation 29.7% of the samples improved. Also, according to the results, Manera approximation model at percentages about 0.5% weight and modified Halpin-Tsai at percentages about 1% weight lead to favorite and reliable results.Keywords: carbon nanotube, injection molding, Mechanical properties, Nanocomposite, polyethylene
Procedia PDF Downloads 270154 Improvement of Thermal Stability in Ethylene Methyl Acrylate Composites for Gasket Application
Authors: Pemika Ketsuwan, Pitt Supaphol, Manit Nithitanakul
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A typical used of ethylene methyl acrylate (EMA) gasket is in the manufacture of optical lens, and often, they are deteriorated rapidly due to high temperature during the process. The objective of this project is to improve the thermal stability of the EMA copolymer gasket by preparing EMA with cellulose and silica composites. Hydroxy propyl methyl cellulose (HPMC) and Carboxy methyl cellulose (CMC) were used in preparing of EMA/cellulose composites and fumed silica (SiO2) was used in preparing EMA/silica composites with different amounts of filler (3, 5, 7, 10, 15 wt.%), using a twin screw extruder at 160 °C and the test specimens were prepared by the injection molding machine. The morphology and dispersion of fillers in the EMA matrix were investigated by field emission scanning electron microscopy (FESEM). The thermal stability of the composite was determined by thermal gravimetric analysis (TGA), and differential scanning calorimeter (DSC). Mechanical properties were evaluated by tensile testing. The developed composites were found to enhance thermal and mechanical properties when compared to that of the EMA copolymer alone.Keywords: ethylene methyl acrylate, HPMC, Silica, Thermal stability
Procedia PDF Downloads 122153 Prospective Randomized Trial of Na/K Citrate for the Prevention of Contrast-Induced Nephropathy in High-Risk Patients
Authors: Leili Iranirad, Mohammad Saleh Sadeghi, Seyed Fakhreddin Hejazi, Negar Vakili Razlighi
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Objective: Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) is an unknown acute kidney injury (AKI) occurring after exposure to contrast media (CM). Contrast agents are most often used for diagnostic procedures or therapeutic angiographic interventions. Recently, Na/K citrate as a urine alkalinization has been evaluated for the prevention of CIN. We conducted this experiment to evaluate the efficiency of Na/K citrate on CIN in high-risk patients treated with cardiac catheterization. Methods: A prospective randomized clinical trial was conducted on 400 patients having moderate to high-risk factors for CIN treated with elective percutaneous coronary intervention (PCI) and were assigned randomly to the control group or the Na/K citrate group. The Na/K citrate group (n=200) received 5 g Na/K citrate solution, which was diluted in 200 mL water two h before and four hours after the first administration and intravenous hydration for two h prior to and six h after the procedure, while the control group (n=200) only received intravenous hydration. Serum creatinine (SCr) was calculated prior to the contrast exposure and after 48 h. CIN was described as a 25% increase in creatinine of serum (SCr) or >0.5 mg/dl 48 h after contrast administration. Results: CIN was observed in 33 patients (16.5%) in the control group and in 6 patients (3%) in the Na/K citrate group. A significant variation was recorded in the CIN incidence between the two groups 48 h after the radiocontrast agent administration (p < 0.001). Conclusion: Our results show that Na/K citrate is useful and substantially reduces the incidence of CIN.Keywords: contrast media, citrate, PCI
Procedia PDF Downloads 104152 Acoustic Radiation Force Impulse Elastography of the Hepatic Tissue of Canine Brachycephalic Patients
Authors: A. C. Facin, M. C. Maronezi , M. P. Menezes, G. L. Montanhim, L. Pavan, M. A. R. Feliciano, R. P. Nociti, R. A. R. Uscategui, P. C. Moraes
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The incidence of brachycephalic syndrome (BS) in the clinical routine of small animals has increased significantly giving the higher proportion of brachycephalic pets in the last years and has been considered as an animal welfare problem. The treatment of BS is surgical and the clinical signs related can be considerably attenuated. Nevertheless, the systemic effects of the BS are still poorly reported and little is known about these when the surgical correction is not performed early. Affected dogs are more likely to develop cardiopulmonary, gastrointestinal and sleep disorders in which the chronic hypoxemia plays a major role. This syndrome is compared with the obstructive sleep apnea (OSA) in humans, both considered as causes of systemic and metabolic dysfunction. Among the several consequences of the BS little is known if the syndrome also affects the hepatic tissue of brachycephalic patients. Elastography is a promising ultrasound technique that evaluates tissue elasticity and has been recently used with the purpose of diagnosis of liver fibrosis. In medicine, it is a growing concern regarding the hepatic injury of patients affected by OSA. This prospective study hypothesizes if there is any consequence of BS in the hepatic parenchyma of brachycephalic dogs that don’t receive any surgical treatment. This study was conducted following the approval of the Animal Ethics and Welfare Committee of the Faculdade de Ciências Agrárias e Veterinárias, UNESP, Campus Jaboticabal, Brazil (protocol no 17944/2017) and funded by Sao Paulo Research Foundation (FAPESP, process no 2017/24809-4). The methodology was based in ARFI elastography using the ACUSON S2000/SIEMENS device, with convex multifrequential transducer and specific software as well as clinical evaluation of the syndrome, in order to determine if they can be used as a prognostic non-invasive tool. On quantitative elastography, it was collected three measures of shear wave velocity (meters per second) and depth in centimeters in the left lateral, left medial, right lateral, right medial and caudate lobe of the liver. The brachycephalic patients, 16 pugs and 30 french bulldogs, were classified using a previously established 4-point functional grading system based on clinical evaluation before and after a 3-minute exercise tolerance test already established and validated. The control group was based on the same features collected in 22 beagles. The software R version 3.3.0 was used for the analysis and the significance level was set at 0.05. The data were analysed for normality of residuals and homogeneity of variances by Shapiro-Wilks test. Comparisons of parametric continuous variables between breeds were performed by using ANOVA with a post hoc test for pair wise comparison. The preliminary results show significant statistic differences between the brachycephalic groups and the control group in all lobes analysed (p ≤ 0,05), with higher values of shear wave velocities in the hepatic tissue of brachycephalic dogs. In this context, the results obtained in this study contributes to the understanding of BS as well as its consequences in our patients, reflecting in evidence that one more systemic consequence of the syndrome may occur in brachycephalic patients, which was not related in the veterinary literature yet.Keywords: airway obstruction, brachycephalic airway obstructive syndrome, hepatic injury, obstructive sleep apnea
Procedia PDF Downloads 117151 Utilization of Mustard Leaves (Brassica juncea) Powder for the Development of Cereal Based Extruded Snacks
Authors: Maya S. Rathod, Bahadur Singh Hathan
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Mustard leaves are rich in folates, vitamin A, K and B-complex. Mustard greens are low in calories and fats and rich in dietary fiber. They are rich in potassium, manganese, iron, copper, calcium, magnesium and low in sodium. It is very rich in antioxidants and Phytonutrients. For the optimization of process variables (moisture content and mustard leave powder), the experiments were conducted according to central composite Face Centered Composite design of RSM. The mustard leaves powder was replaced with composite flour (a combination of rice, chickpea and corn in the ratio of 70:15:15). The extrudate was extruded in a twin screw extruder at a barrel temperature of 120°C. The independent variables were mustard leaves powder (2-10 %) and moisture content (12-20 %). Responses analyzed were bulk density, water solubility index, water absorption index, lateral expansion, hardness, antioxidant activity, total phenolic content and overall acceptability. The optimum conditions obtained were 7.19 g mustard leaves powder in 100 g premix having 16.8 % moisture content (w.b).Keywords: extrusion, mustard leaves powder, optimization, response surface methodology
Procedia PDF Downloads 543150 Rheological and Thermomechanical Properties of Graphene/ABS/PP Nanocomposites
Authors: Marianna I. Triantou, Konstantina I. Stathi, Petroula A. Tarantili
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In the present study, the incorporation of graphene into blends of acrylonitrile-butadiene-styrene terpolymer with polypropylene (ABS/PP) was investigated focusing on the improvement of their thermomechanical characteristics and the effect on their rheological behavior. The blends were prepared by melt mixing in a twin-screw extruder and were characterized by measuring the MFI as well as by performing DSC, TGA and mechanical tests. The addition of graphene to ABS/PP blends tends to increase their melt viscosity, due to the confinement of polymer chains motion. Also, graphene causes an increment of the crystallization temperature (Tc), especially in blends with higher PP content, because of the reduction of surface energy of PP nucleation, which is a consequence of the attachment of PP chains to the surface of graphene through the intermolecular CH-π interaction. Moreover, the above nanofiller improves the thermal stability of PP and increases the residue of thermal degradation at all the investigated compositions of blends, due to the thermal isolation effect and the mass transport barrier effect. Regarding the mechanical properties, the addition of graphene improves the elastic modulus, because of its intrinsic mechanical characteristics and its rigidity, and this effect is particularly strong in the case of pure PP.Keywords: acrylonitrile-butadiene-styrene terpolymer, blends, graphene, polypropylene
Procedia PDF Downloads 368149 Ultrasound Guided Treatment of Carpal Tunnel Syndrome
Authors: Kazem Shakouri, Alireza Pishgahi, Homayoun Sadeghi-bBazargani, Shahla Dareshiri
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Introduction: Carpal Tunnel Syndrome has numerous nonsurgical treatments including splint, physical therapy and corticosteroid injections. Aim: The purpose of this study was to evaluate the effectiveness of an ultrasound guided treatment procedure, for individuals with severe carpal tunnel syndrome. Materials and Method: 20 patients with an electrodiagnostic evidence of severe carpal tunnel syndrome were treated by an office-based ultrasound guided procedure (combination of percutaneous needle release of carpal tunnel and corticosteroid injection). Electrodiagnostic (nerve conduction study), clinical (Boston Carpal Tunnel Questionnaire, grip strength) and ultrasonic (median nerve and carpal tunnel cross-sectional area) measurements were recorded at baseline and one month after intervention. Results: Our preliminary data analysis showed that in one month follow up, patients had a significantly smaller cross-sectional area of the median nerve compared to pretreatment values (mean difference 0.06; 95%CI: 0.02-0.1; p < 0.001). In addition, patients had significantly less functional impairment (mean difference 35; 95% CI:28.7-43.4 ; p < 0.001), and an improved hand grip strength in one month follow up (mean difference 5.4; 95%CI: 3.1-7.8; p < 0.001;). There were no significant complications. Conclusion: Patients with severe carpal tunnel syndrome, who are candidates for surgical intervention, can consider office-based ultrasound guided needle release of carpal tunnel as an alternative safe treatment.Keywords: Carpal Tunnel Syndrome, needle release, pain, ultrasound
Procedia PDF Downloads 247148 Finite Element Analysis of Dental Implant for Prosthesis
Authors: Mayur Chaudhari, Ashutosh Gaikwad, Shubham Kavathale, Aditya Mule, Dilip Panchal, Puja Verma
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The purpose of this investigation was to locate restorative bio-materials for the manufacture of implants and crowns. A three-dimensional (3D) finite element analysis (FEA) was carried out to evaluate the stress distribution in the implant and abutment with several types of bio-materials and various prosthetic crowns. While the dental implant, abutment, and screw were subjected to a vertical impact force, the effects of mechanical characteristics such as Young's modulus and Poisson's ratio were evaluated and contrasted. Crowns are made from zirconia, cobalt, ceramic, acrylic resin, and porcelain materials. Implants are made from materials such as titanium, zirconia, PEEK, and CFR-PEEK. SolidWorks was used to create the 3D geometry, and Ansys Software was used to analyze it. The results show that using CFR-PEEK implants and an acrylic resin crown resulted in less bone stress than using alternative materials. In order to reduce the amount of stress on the bone and possibly prevent implant failure, the study's findings support the use of a CFR PEEK implant, abutment, and crown in bruxism patients.Keywords: biomaterials, implant, crown, abutment
Procedia PDF Downloads 60147 Co-Liquefaction of Cellulosic Biomass and Waste Plastics
Authors: Katsumi Hirano, Yusuke Kakuta, Koji Yoshida, Shozo Itagaki, Masahiko Kajioka, Toshihiko Okada
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A conversion technology of cellulosic biomass and waste plastics to liquid fuel at low pressure and low temperature has been investigated. This study aims at the production of the liquefied fuel (CPLF) of substituting diesel oil by mixing cellulosic biomass and waste plastics in the presence of solvent. Co-liquefaction of cellulosic biomass (Japan cedar) and polypropylene (PP) using wood tar or mineral oil as solvent at 673K with an autoclave was carried out. It was confirmed that the co-liquefaction gave CPLF in a high yield among the cases of wood or of polypropylene Which was ascribed the acceleration of decomposition of plastics by radicals derived from the decomposition of wood. The co-liquefaction was also conducted by a small twin screw extruder. It was found that CPLF was obtained in the co-liquefaction, And the acceleration of decomposition of plastics in the presence of cellulosic biomass. The engine test of CPLF showed that the engine performances, Compression ignition and combustion characteristics were almost similar to those of diesel fuel at any mixing ratio of CPLF and any load, Therefore, CPLF could be practically used as alternative fuel for diesel engines.Keywords: Cellulosic Biomass, Co-liquefaction, Solvent, Waste Plastics
Procedia PDF Downloads 372146 Social and Cognitive Stress Impact on Neuroscience and PTSD
Authors: Sadra Abbasi
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The complex connection between psychological stress and the onset of different diseases has been an ongoing issue in the mental health field for a long time. Multiple studies have demonstrated that long-term stress can greatly heighten the likelihood of developing health issues like heart disease, cancer, arthritis, and severe depression. Recent research in cognitive science has provided insight into the intricate processes involved in posttraumatic stress disorder (PTSD), suggesting that distinct memory systems are accountable for both vivid reliving and normal autobiographical memories of traumatic incidents, as proposed by dual representation theory. This theory has important consequences for our comprehension of the neural mechanisms involved in fear and behavior related to threats, highlighting the amygdala-hippocampus-medial prefrontal cortex circuit as a crucial component in this process. This particular circuit, extensively researched in behavioral neuroscience, is essential for regulating the body's reactions to stress and trauma. This review will examine how incorporating a modern neuroscience viewpoint into an integrative case formulation offers a current way to comprehend the intricate connections among psychological stress, trauma, and disease.Keywords: social, cognitive, stress, neuroscience, behavior, PTSD
Procedia PDF Downloads 36145 Depth of Penetration and Nature of Interferential Current in Cutaneous, Subcutaneous and Muscle Tissues
Authors: A. Beatti, L. Chipchase, A. Rayner, T. Souvlis
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The aims of this study were to investigate the depth of interferential current (IFC) penetration through soft tissue and to investigate the area over which IFC spreads during clinical application. Premodulated IFC and ‘true’ IFC at beat frequencies of 4, 40 and 90Hz were applied via four electrodes to the distal medial thigh of 15 healthy subjects. The current was measured via three Teflon coated fine needle electrodes that were inserted into the superficial layer of skin, then into the subcutaneous tissue (≈1 cm deep) and then into muscle tissue (≈2 cm deep). The needle electrodes were placed in the middle of the four IFC electrodes, between two channels and outside the four electrodes. Readings were taken at each tissue depth from each electrode during each treatment frequency then digitized and stored for analysis. All voltages were greater at all depths and locations than baseline (p < 0.01) and voltages decreased with depth (P=0.039). Lower voltages of all currents were recorded in the middle of the four electrodes with the highest voltage being recorded outside the four electrodes in all depths (P=0.000).For each frequency of ‘true’ IFC, the voltage was higher in the superficial layer outside the electrodes (P ≤ 0.01).Premodulated had higher voltages along the line of one circuit (P ≤ 0.01). Clinically, IFC appears to pass through skin layers to depth and is more efficient than premodulated IFC when targeting muscle tissue.Keywords: electrotherapy, interferential current, interferential therapy, medium frequency current
Procedia PDF Downloads 346144 Performance of Constant Load Feed Machining for Robotic Drilling
Authors: Youji Miyake
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In aircraft assembly, a large number of preparatory holes are required for screw and rivet joints. Currently, many holes are drilled manually because it is difficult to machine the holes using conventional computerized numerical control(CNC) machines. The application of industrial robots to drill the hole has been considered as an alternative to the CNC machines. However, the rigidity of robot arms is so low that vibration is likely to occur during drilling. In this study, it is proposed constant-load feed machining as a method to perform high-precision drilling while minimizing the thrust force, which is considered to be the cause of vibration. In this method, the drill feed is realized by a constant load applied onto the tool so that the thrust force is theoretically kept below the applied load. The performance of the proposed method was experimentally examined through the deep hole drilling of plastic and simultaneous drilling of metal/plastic stack plates. It was confirmed that the deep hole drilling and simultaneous drilling could be performed without generating vibration by controlling the tool feed rate in the appropriate range.Keywords: constant load feed machining, robotic drilling, deep hole, simultaneous drilling
Procedia PDF Downloads 194143 Endoscopic Ultrasound-Guided Choledochoduodenostomy in an Advanced Extrahepatic Cholangiocarcinoma
Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho
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Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided
Procedia PDF Downloads 185142 The Fabrication and Characterization of Hierarchical Carbon Nanotube/Carbon Fiber/High-Density Polyethylene Composites via Twin-Screw Extrusion
Authors: Chao Hu, Xinwen Liao, Qing-Hua Qin, Gang Wang
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The hierarchical carbon nanotube (CNT)/carbon fiber (CF)/high density polyethylene (HDPE) was fabricated via compound extrusion and injection molding, in which to author’s best knowledge CNT was employed as a nano-coatings on the surface of CF for the first time by spray coating technique. The CNT coatings relative to CF was set at 1 wt% and the CF content relative to the composites varied from 0 to 25 wt% to study the influence of CNT coatings and CF contents on the mechanical, thermal and morphological performance of this hierarchical composites. The results showed that with the rise of CF contents, the mechanical properties, including the tensile properties, flexural properties, and hardness of CNT/CF/HDPE composites, were effectively improved. Furthermore, the CNT-coated composites showed overall higher mechanical performance than the uncoated counterparts. It can be ascribed to the enhancement of interfacial bonding between the CF and HDPE via the incorporation of CNT, which was demonstrated by the scanning electron microscopy observation. Meanwhile, the differential scanning calorimetry data indicated that by the introduction of CNT and CF, the crystallization temperature and crystallinity of HDPE were affected while the melting temperature did not have an obvious alteration.Keywords: carbon fibers, carbon nanotubes, extrusion, high density polyethylene
Procedia PDF Downloads 138141 Computed Tomography Guided Bone Biopsies: Experience at an Australian Metropolitan Hospital
Authors: K. Hinde, R. Bookun, P. Tran
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Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.Keywords: bone biopsy, computed tomography, core biopsy, histopathology
Procedia PDF Downloads 200140 Comparative Study of Impact Strength and Fracture Morphological of Nano-CaCO3 and Nanoclay Reinforced HDPE Nanocomposites
Authors: Harun Sepet, Necmettin Tarakcioglu
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The present study investigated the impact strength and fracture mechanism of nano-CaCO3 and nanoclay reinforced HDPE nanocomposites by using Charpy impact test. The nano-CaCO3 and nanoclay reinforced HDPE granules were prepared by the melt blending method using a compounder system, which consists of industrial banbury mixer, single screw extruder and granule cutting in industrial-scale. The nano-CaCO3 and nanoclay reinforced HDPE granules were molded using an injection-molding machine as plates, and then impact samples were cut by using punching die from the nanocomposite plates. As a result of impact experiments, nano-CaCO3 and nanoclay reinforced HDPE nanocomposites were determined to have lower impact energy level than neat HDPE. Also, the impact strength of HDPE further decreased by addition nanoclay compared to nano-CaCO3. The occurred fracture areas with the impact were detected by SEM examination. It is understood that fracture surface morphology changes when nano-CaCO3 and nanoclay ratio increases. The fracture surface changes were examined to determine the fracture mechanism of nano-CaCO3 and nanoclay reinforced HDPE nanocomposites.Keywords: charpy, HDPE, industrial scale nano-CaCO3, nanoclay, nanocomposite
Procedia PDF Downloads 410139 Blend of Polyamide 6 with Polybutylene Terephthalate Compatibilized with Epoxidized Natural Rubber (ENR-25) and N Butyl Acrylate Glycidyl Methacrylate Ethylene (EBa-GMA)
Authors: Ramita Vongrat, Pornsri Sapsrithong, Manit Nithitanakul
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In this work, blends of polyamide 6 (PA6) and polybutylene terephthalate (PBT) were successfully prepared. The effect of epoxidized natural rubber (ENR-25) and n butyl acrylate glycidyl methacrylate ethylene (EBa-GMA) as a compatibilizer on properties of PA6/PBT blends was also investigated by varying amount of ENR-50 and EBa-GMA, i.e., 0, 0.1, 0.5, 5 and 10 phr. All blends were prepared and shaped by using twin-screw extruder at 230 °C and injection molding machine, respectively. All test specimens were characterized by phase morphology, impact strength, tensile, flexural properties, and hardness. The results exhibited that phase morphology of PA6/PBT blend without compatibilizer was incompatible. This could be attributed to poor interfacial adhesion between the two polymers. SEM micrographs showed that the addition of ENR-25 and EBa-GMA improved the compatibility of PA6/PBT blends. With the addition of ENR-50 as a compatibilizer, the uniformity and the maximum reduction of dispersed phase size were observed. Additionally, the results indicate that, as the amount of ENR-25 increased, and EBa-GMA increased, the mechanical properties, including stress at the peak, tensile modulus, and izod impact strength, were also improved.Keywords: EBa-GMA, epoxidized natural rubber-25, polyamide 6, polybutylene terephthalate
Procedia PDF Downloads 168138 Fracture Dislocation of Upper Sacrum in an Adolescent: Case Report and Review of Literature
Authors: S. Alireza Mirghasemi, Narges Rahimi Gabaran
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Although sacral fractures in children are rare due to the fact that the occurrence of pelvic fracture is not common in childhood. Sacral fractures present a high risk of neurological damage. This kind of fracture is often missed because the routine pelvic X-rays imaging scarcely show this fracture. Also, the treatment is controversial, and it ranges from fine reduction to conservative treatments without any try to reduce the dislocation. In this article, a case of fracture dislocation of S1 and S2 along with a suggested diagnostic test and treatment based on similar cases are presented. The case investigates a 14-year-old boy who entered the hospital one week after a car accident that knocked him to the ground in crawling position and a rack fell down on his body. Pain and tenderness in the sacral region and a fracture in the left leg were notable--we detected incomplete bilateral palsy of L5, S1 and S2 roots. In radiographs of the spine fracture dislocation of S1, the sacral fracture was seen. The treatment included a skeletal traction with a halo over the patient’s head and two femoral pins. After one week, another surgery was performed in order to stabilize and reduce the fracture, and we employed a posterior approach with CD and a pedicular screw. After two years of follow-up, the fracture is completely cured without any loss of reduction.Keywords: adolescent, fracture in adolescent, fracture dislocation, sacrum
Procedia PDF Downloads 292137 Endoscopic Treatment of Esophageal Injuries Using Vacuum Therapy
Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev
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Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy
Procedia PDF Downloads 105136 Unusual High Origin and Superficial Course of Radial Artery: A Case Report with Embryological Explanation
Authors: Anasuya Ghosh, Subhramoy Chaudhury
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During routine cadaveric dissection at gross anatomy lab of our institution, a radial artery was found with unusual origin and superficial course. Normally the radial artery takes its origin as one of the terminal branches of brachial artery at the level of the neck of radius. It usually lies along the lateral border of fore arm deep to the brachioradialis muscle. While dissecting a 72-year-old Caucasian female cadaver, it was found that the right sided radial artery originated from the upper part of brachial artery of arm, 2 cm below the lower border of teres major muscle, from the lateral aspect of brachial artery. Then the radial artery superficially crossed the brachial artery and median nerve from lateral to medial direction and rested superficially at the cubital fossa. Embryologically, it can be explained as a failure of disappearance, or abnormal persistence of some insignificant embryonic vessels may give rise to this kind of vascular anomalies. As radial artery is one of the most important upper limb arteries, its variation and related complications are clinically significant. This unusual origin and course of radial artery should be kept in mind by all healthcare providers including surgeons and radiologists during routine venipuncture, orthopedic and plastic surgeries of arm, coronary angiographic procedures in radial approach etc. to prevent unwanted complications.Keywords: brachial artery anomalies, brachio-radial artery, high origin radial artery, superficial radial artery
Procedia PDF Downloads 325135 Nonlinear Defects and Discombinations in Anisotropic Solids
Authors: Ashkan Golgoon, Arash Yavari
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In this paper, we present some analytical solutions for the stress fields of nonlinear anisotropic solids with line and point defects distributions. In particular, we determine the induced stress fields of a parallel cylindrically-symmetric distribution of screw dislocations in infinite orthotropic and monoclinic media as well as a cylindrically-symmetric distribution of parallel wedge disclinations in an infinite orthotropic medium. For a given distribution of edge dislocations, the material manifold is constructed using Cartan's moving frames and the stress field is obtained assuming that the medium is orthotropic. Also, we consider a spherically-symmetric distribution of point defects in a transversely isotropic spherical ball. We show that for an arbitrary incompressible transversely isotropic ball with the radial material preferred direction, a uniform point defect distribution results in a uniform hydrostatic stress field inside the spherical region the distribution is supported in. Finally, we find the stresses induced by a discombination in an orthotropic medium.Keywords: defects, disclinations, dislocations, monoclinic solids, nonlinear elasticity, orthotropic solids, transversely isotropic solids
Procedia PDF Downloads 254134 Quantification of Soft Tissue Artefacts Using Motion Capture Data and Ultrasound Depth Measurements
Authors: Azadeh Rouhandeh, Chris Joslin, Zhen Qu, Yuu Ono
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The centre of rotation of the hip joint is needed for an accurate simulation of the joint performance in many applications such as pre-operative planning simulation, human gait analysis, and hip joint disorders. In human movement analysis, the hip joint center can be estimated using a functional method based on the relative motion of the femur to pelvis measured using reflective markers attached to the skin surface. The principal source of errors in estimation of hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone. One of the main objectives in human movement analysis is the assessment of soft tissue artefact as the accuracy of functional methods depends upon it. Various studies have described the movement of soft tissue artefact invasively, such as intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess the displacements of the markers relative to the underlying bone using optical motion capture data and tissue thickness from ultrasound measurements during flexion, extension, and abduction (all with knee extended) of the hip joint. Results show that the artefact skin marker displacements are non-linear and larger in areas closer to the hip joint. Also marker displacements are dependent on the movement type and relatively larger in abduction movement. The quantification of soft tissue artefacts can be used as a basis for a correction procedure for hip joint kinematics.Keywords: hip joint center, motion capture, soft tissue artefact, ultrasound depth measurement
Procedia PDF Downloads 281133 Phonetics and Phonological Investigation of Geminates and Gemination in Some Indic Languages
Authors: Hifzur Ansary
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The aim and scope of the present research are to delve into the form of geminates and the process of gemination with special reference to Indic Languages. This work presents the results of a cross-linguistic investigation of word-medial geminate consonants. This study is a theoretical as well as experimental, that is, it is based not only on impressionistic data from Indic languages but also on an instrumental analysis of the data. The primary data have been collected from the native speakers. The secondary data have been collected from printed materials such as journals, grammar books and other published articles. The observations made in this study have been checked with a number of educated native speakers of Bangla and Telugu. The study focuses on geminates and gemination in Bangla (Indo-Aryan Language Family) and Telugu (Dravidian Language family) exhaustively. Thus this study also attempts to posit the valid geminates in Bangali and Telugu and provides an account of gemination in these languages. It also makes a comparison of singletons and geminated consonants. It describes the distribution of geminate phonemes and non-geminate phonemes of Bangla and Telugu. The present research would also investigate the vowel lengthening in Bangla with respect to gemination. The study also explains how gemination processes present in Indian Languages are transferred to Indian English.Keywords: geminate consonant, singleton-geminate contrast, different types of assimilation, gemination derives from borrowed words
Procedia PDF Downloads 287132 Difficulties in Pronouncing the English Bilabial Plosive Sounds among EFL Students
Authors: Ali Mohammed Saleh Al-Hamzi
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This study aims at finding out the most difficult position in pronouncing the bilabial plosive sounds at the fourth level of English foreign language students of the Faculty of Education, Mahweet, Sana’a University in Yemen. The subject of this study were 50 participants from English foreign language students aged 22-25. In describing sounds according to their place of articulation, sounds are classified as bilabial, labiodental, dental, alveolar, post-alveolar, palato-alveolar retroflex, palatal, velar, uvular, and glottal. In much the same way, sounds can be described in their manner of articulation as plosives, nasals, affricates, flaps, taps, rolls, fricatives, laterals, frictionless continuants, and semi-vowels. For English foreign language students in Yemen, there are some articulators that are difficult to pronounce. In this study, the researcher focuses on difficulties in pronouncing the English bilabial plosive sounds among English foreign language students. It can be in the initial, medial, and final positions. The problem discussed in this study was: which position is the most difficult in pronouncing the English bilabial plosive sounds? To solve the problem, a descriptive qualitative method was conducted in this study. The data were collected from each English bilabial plosive sounds produced by students. Finally, the researcher reached that the most difficult position in pronouncing the English bilabial plosive sounds is when English bilabial plosive /p/ and /b/ occur word-finally, where both are voiceless.Keywords: difficulty, EFL students’ pronunciation, bilabial sounds, plosive sounds
Procedia PDF Downloads 146