Search results for: hind limb

Authors: Elissa D. Ledoux, Eric J. Barth

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Producing custom orthotic devices is a time-consuming and iterative process. Efficiency could be increased with a smart CAD program to rapidly generate custom part files for 3D printing, reducing the need for a skilled orthosis technician as well as the hands-on time required. Anthropometric data for the hand was analyzed in order to determine dimensional relationships and reduce the number of measurements needed to parameterize the hand. Using these relationships, a smart CAD package was developed to produce custom sized hand orthosis parts downloadable for 3D printing. Results showed that the number of anatomical parameters required could be reduced from 8 to 3, and the relationships hold for 5th to 95th percentile male hands. CAD parts regenerate correctly for the same range. This package could significantly impact the orthotics industry in terms of expedited production and reduction of required human resources and patient contact.

Keywords: CAD, hand, orthosis, orthotic, rehabilitation robotics, upper limb

Procedia PDF Downloads 195

Authors: Sharmila Sakravarthy

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Prison administration in India, even though an important limb of the criminal justice system are worse off in terms of overcrowding, prolonged detention of under-trial prisoners, and a host of other problems. Considering the statistics of the prison population, over a thousand three hundred prisons across the country were overcrowded, even to the extent of more than six hundred percent. A total of eighteen thousand eight hundred and fifty-eight female prisoners were in India, out of which thirteen thousand hundred and sixty-five were under trials and five thousand and sixty-three convicts. A total of around one thousand seven hundred thirty-five children are residing in prisons along with their mothers. District prisons are more overcrowded than the other prisons, and their practices are at odd with human rights standards. This article examines a range of issues in prisons throughout India including pretrial detention, overcrowding, resources and governance, women and children in prison and rehabilitation. A substantial amount of space is devoted to the reforms that are occurring across the nation, and recommendations are made with regard to what further reforms are necessary.

Keywords: human rights, overcrowding, prisons, rehabilitation

Procedia PDF Downloads 93

Authors: Kourosh Fatehi, Niloofar Hanafi

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One of the challenges in providing optimal prosthetic legs for lower limb amputees is to select the appropriate foot stiffness that suits their individual needs and preferences. Foot stiffness affects various aspects of walking, such as stability, comfort, and energy expenditure. However, the current prescription process is largely based on trial-and-error, manufacturer recommendations, or clinician judgment, which may not reflect the prosthesis user’s subjective experience or psychophysical sensitivity. Therefore, there is a need for more scientific and technological tools to measure and understand how prosthesis users perceive and prefer different foot stiffness levels, and how this preference relates to clinical outcomes. This review covers how to measure and design lower leg prostheses based on user preference and foot stiffness. It also explores how these factors affect walking outcomes and quality of life, and identifies the current challenges and gaps in this field from a mechanical engineering standpoint.

Keywords: perception, preference, prosthetics, stiffness

Procedia PDF Downloads 50

Authors: Saria Almarzook, Monika Reissmann, Gudrun Brockmann

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Due to its history, occurrence in different ecosystems and diverse using, the modern horse (Equus caballus) shows large variability in size, appearance, behavior and habits. At all times, breeders try to create groups (breeds, strains) representing high homology but showing clear differences in comparison to other groups. A great interest of analyzing phenotypic and genetic traits looking for real diversity and genetic uniqueness existents for Arabian horses in Syria. 90 Arabian horses from governmental research center of Arabian horses in Damascus were included. The horses represent three strains (Kahlawi, Saklawi, Hamdani) originated from different geographical zones. They were raised on the same farm, under stable conditions. Twelve phenotypic traits were measured: wither height (WH), croup width (CW), croup height (CH), neck girth (NG), thorax girth (TG), chest girth (ChG), chest depth (ChD), chest width (ChW), back line length (BLL), body length (BL), fore cannon length (FCL) and hind cannon length (HCL). The horses were divided into groups according to age (less than 2 years, 2-4 years, 4-9 years, over 9 years) and to sex (male, female). The statistical analyzes show that age has significant influence of WH while the strain has only a very limited effect. On CW, NG, BLL, FCL and HCL, there is only a significant influence of sex. Age has significant effect on CH and BL. All sources of classes have a significant effect on TG, ChG, ChD and ChW. Strain has a significant effect on the BL. These results provide first information for real biodiversity in and between the strains and can be used to develop the breeding work in the Arabian horse breed.

Keywords: Arabian horse, phenotypic traits, strains, Syria

Procedia PDF Downloads 363

Authors: John Yahng, Riteesh Bookun

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Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenmosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

Procedia PDF Downloads 267

Authors: Kamal Chafiq, Youssef Hadzine, Adel Elmekkaoui, Othmane Benlenda, Houssam Rajad, Soukaina Wakrim, Hicham Nassik

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Guillain-Barré syndrome/Miller Fishe syndrome (GBS/MFS) overlap syndrome is an extremely rare variant of Guillain-Barré syndrome (GBS) in which Miller Fisher syndrome (MFS) coexists with other characteristics of GBS, such as limb weakness, paresthesia, and facial paralysis. We report the clinical case of a 12-year-old patient, with no pathological history, who acutely presents with ophthalmoplegia, areflexia, facial diplegia, and swallowing and phonation disorders, followed by progressive, descending, and symmetrical paresis affecting first the upper limbs and then the lower limbs. An albuminocytological dissociation was found in the cerebrospinal fluid study. Magnetic resonance imaging of the spinal cord showed enhancement and thickening of the cauda equina roots. The patient was treated with immunoglobulins with a favorable clinical outcome.

Keywords: Guillain-Barré syndrome, Miller Fisher syndrome, overlap syndrome, anti-GQ1b antibodies

Procedia PDF Downloads 38

Authors: Mohammed S. Alqahtani, Paulo J. Bartolo

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External fixation is a common technique for the treatment and stabilization of bone fractures. Different designs have been proposed by companies and research groups, but all of them present limitations such as high weight, not comfortable to use, and not customized to individual patients. This paper proposes a lightweight customized external fixator, overcoming some of these limitations. External fixators are designed using a set of techniques such as medical imaging, CAD modelling, finite element analysis, and full factorial design of experiments. Key design parameters are discussed, and the optimal set of parameters is used to design the final external fixator. Numerical simulations are used to validate design concepts. Results present an optimal external fixation design with weight reduction of 13% without compromising its stiffness and structural integrity. External fixators are also designed to be additively manufactured, allowing to develop a strategy for personalization.

Keywords: computer-aided design modelling, external fixation, finite element analysis, full factorial, personalization

Procedia PDF Downloads 131

Authors: John Yahng, Hansraj Riteesh Bookun

Abstract:

Popliteal artery aneurysms (PAAs) are the most common arterial aneurysm of the periphery. It is defined as focal dilation of the artery more than 50% of the normal vessel diameter which usually varies between 7 mm to 11 mm. The most common presentation for PAAs is claudication due to luminal stenosis secondary to mural thrombus or acute limb ischaemia due to occlusive thrombosis or distal thromboembolism. It is less common for patients to present with non-ischaemic symptoms secondary to mass effect and compression of adjacent structures, and of these, presentation with common peroneal nerve compression is particularly uncommon. We present a rare case of a 92-year-old female patient presenting with 4-month history of left foot drop with radiological evidence of common peroneal nerve compression secondary to PAA of 22 mm by 21mm in size. To the best of our knowledge, this is the smallest reported popliteal aneurysm presenting with foot drop. We also present the endovascular treatment option taken in our case.

Keywords: aneurysm, foot drop, peroneal nerve, popliteal

Procedia PDF Downloads 374

Authors: Jun Yang, Ching-Liang Hsieh, Yi-Wen Lin

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Chronic inflammatory pain results from peripheral tissue injury or local inflammation to increase the release of protons, histamines, adenosine triphosphate, and several proinflammatory cytokines. Transient receptor potential vanilloid 1 (TRPV1) is involved in fibromyalgia, neuropathic, and inflammatory pain; however, its exact mechanisms in chronic inflammatory pain are still unclear. We investigate the analgesic effect of EA by injecting complete Freund’s adjuvant (CFA) in the hind paw of mice to induce chronic inflammatory pain ( > 14 d). Our results showed that EA significantly reduced chronic mechanical and thermal hyperalgesia in the chronic inflammatory pain model. Chronic mechanical and thermal hyperalgesia was also abolished in TRPV1−/− mice. TRPV1 increased in the dorsal root ganglion (DRG) and spinal cord (SC) at 2 weeks after CFA injection. The expression levels of downstream molecules such as pPKA, pPI3K, and pPKC increased, as did those of pERK, pp38, and pJNK. Transcription factors (pCREB and pNFκB) and nociceptive ion channels (Nav1.7 and Nav1.8) were involved in this process. Inflammatory mediators such as GFAP (Glial fibrillary acidic protein), S100B, and RAGE (Receptor for advanced glycation endproducts) were also involved. The expression levels of these molecules were reduced in EA (electroacupuncture) and TRPV1−/−mice but not in the sham EA group. The present study demonstrated that EA or TRPV1 gene deletion reduced chronic inflammatory pain through TRPV1 and related molecules. In addition, our data provided evidence to support the clinical use of EA for treating chronic inflammatory pain.

Keywords: auricular electric-stimulation, epileptic seizures, anti-inflammation, electroacupuncture

Procedia PDF Downloads 147

Authors: Scott M. Black, Craig Maclean, Pauline Hall Barrientos, Konstantinos Ritos, Asimina Kazakidi

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Aortic aneurysms and dissections are leading causes of death in cardiovascular disease. Both inevitably lead to hemodynamic instability without surgical intervention in the form of vascular stent-graft deployment. An accurate description of the aortic geometry and blood flow in patient-specific cases is vital for treatment planning and long-term success of such grafts, as they must generate physiological branch perfusion and in-stent hemodynamics. The aim of this study was to create patient-specific computational fluid dynamics (CFD) models through a multi-modality, multi-dimensional approach with boundary condition optimization to predict branch flow rates and in-stent hemodynamics in custom stent-graft configurations. Three-dimensional (3D) thoracoabdominal aortae were reconstructed from four-dimensional flow-magnetic resonance imaging (4D Flow-MRI) and computed tomography (CT) medical images. The former employed a novel approach to generate and enhance vessel lumen contrast via through-plane velocity at discrete, user defined cardiac time steps post-hoc. To produce patient-specific boundary conditions (BCs), the aortic geometry was reduced to a one-dimensional (1D) model. Thereafter, a zero-dimensional (0D) 3-Element Windkessel model (3EWM) was coupled to each terminal branch to represent the distal vasculature. In this coupled 0D-1D model, the 3EWM parameters were optimized to yield branch flow waveforms which are representative of the 4D Flow-MRI-derived in-vivo data. Thereafter, a 0D-3D CFD model was created, utilizing the optimized 3EWM BCs and a 4D Flow-MRI-obtained inlet velocity profile. A sensitivity analysis on the effects of stent-graft configuration and BC parameters was then undertaken using multiple stent-graft configurations and a range of distal vasculature conditions. 4D Flow-MRI granted unparalleled visualization of blood flow throughout the cardiac cycle in both the pre- and postsurgical states. Segmentation and reconstruction of healthy and stented regions from retrospective 4D Flow-MRI images also generated 3D models with geometries which were successfully validated against their CT-derived counterparts. 0D-1D coupling efficiently captured branch flow and pressure waveforms, while 0D-3D models also enabled 3D flow visualization and quantification of clinically relevant hemodynamic parameters for in-stent thrombosis and graft limb occlusion. It was apparent that changes in 3EWM BC parameters had a pronounced effect on perfusion distribution and near-wall hemodynamics. Results show that the 3EWM parameters could be iteratively changed to simulate a range of graft limb diameters and distal vasculature conditions for a given stent-graft to determine the optimal configuration prior to surgery. To conclude, this study outlined a methodology to aid in the prediction post-surgical branch perfusion and in-stent hemodynamics in patient specific cases for the implementation of custom stent-grafts.

Keywords: 4D flow-MRI, computational fluid dynamics, vascular stent-grafts, windkessel

Procedia PDF Downloads 149

Authors: John Tolentino, Yong Seok Park

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There are currently many people living with limb loss in the USA. The main causes for amputation can range from vascular disease, to trauma, or cancer. This number is expected increase over the next decade. Many patients have a single prosthetic for the first year but end up getting a second one to accommodate their changing physique. Afterwards, the prosthesis gets replaced every three to five years depending on how often it is used. This could cost the patient up to $500,000 throughout their lifetime. Complications do not end there, however. Due to the absence of nerves, it becomes more difficult to traverse terrain with a prosthetic. Moving on an incline or decline becomes difficult, thus curbs and stairs can be a challenge. Certain physical activities, such as cycling, could be even more strenuous. It will need to be relearned to accommodate for the change in weight, center of gravity, and transfer of energy from the leg to the pedal. The purpose of this research project is to develop a new, alternate below-knee cycling prosthetic using Dieter & Schmidt’s design process approach. It will be subjected to fatigue analysis under dynamic loading to observe the limitations as well as the strengths and weaknesses of the prosthetic. Benchmark comparisons will be made between existing prosthetics and the proposed one, examining the benefits and disadvantages. The resulting prosthetic will be 3D printed using acrylonitrile butadiene styrene (ABS) or polycarbonate (PC) plastic.

Keywords: 3D Printing, Cycling, Prosthetic design, Synthetic design.

Procedia PDF Downloads 112

Authors: Dawood Aghamohammadi, Mahmoud Eidi, Alireza Pishgahi, Azam Esmaeilnejad

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Adenosine has an analgesic and anti-inflammatory role and its injections are used for peri-operative pain management. We want to study efficacy of intrathecal injection of adenosine for post operative radicular pain after lumbar discectomy. 40 patients with unilevel lumbar discectomy who had radicular lower limb pain were treated by 1000 micrograms of intrathecal injection of adenosine. Pain severity, pain killer consumption per day and sleep quality were assessed during a 3 months follow up period. Radicular pain severity was significantly reduced in 3 month follow-up period in comparison to the baseline (F=19760, DF=2.53, p-value<0.001). Further painkiller medication consumption rate in average during 3 month follow-up period after injection was significantly lower in comparison to baseline (F= 19.244, df= 1.98, p-value<0.001). This study suggests that intrathecal injection of adenosine is a safe method in order to reduce postoperative pain after lumbar discectomy.

Keywords: adenosine, intrathecal injection, discectomy, neuropathic pain

Procedia PDF Downloads 232

Authors: Tianyu Cao, KIRA (Ruizhi Zhao)

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The purpose of our research is to study the possibility of people with physical disabilities manipulating mechanical prostheses through brain-computer interface (BCI) technology. The brain-machine interface (BCI) of the neural prosthesis records signals from neurons and uses mathematical modeling to decode them, converting desired movements into body movements. In order to improve the patient's neural control, the prosthesis is given a natural feeling. It records data from sensitive areas from the body to the prosthetic limb and encodes signals in the form of electrical stimulation to the brain. In our research, the brain-computer interface (BCI) is a bridge connecting patients’ cognition and the real world, allowing information to interact with each other. The efficient work between the two is achieved through external devices. The flow of information is controlled by BCI’s ability to record neuronal signals and decode signals, which are converted into device control. In this way, we could encode information and then send it to the brain through electrical stimulation, which has significant medical application.

Keywords: biomedical engineering, brain-computer interface, prosthesis, neural control

Procedia PDF Downloads 145

Authors: Lajeesh Jabbar, Shibu T. Varghese

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Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.

Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures

Procedia PDF Downloads 388

Authors: R. Periyasamy, Deepak Joshi, Sneh Anand

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Foot posture assessment is important to evaluate foot type, causing gait and postural defects in all age groups. Although different methods are used for classification of foot arch type in clinical/research examination, there is no clear approach for selecting the most appropriate measurement system. Therefore, the aim of this study was to develop a system for evaluation of foot type as clinical decision-making aids for diagnosis of flat and normal arch based on the Arch Index (AI) and foot pressure distribution parameter - Power Ratio (PR) data. The accuracy of the system was evaluated for 27 subjects with age ranging from 24 to 65 years. Foot area measurements (hind foot, mid foot, and forefoot) were acquired simultaneously from foot pressure intensity image using portable PedoPowerGraph system and analysis of the image in frequency domain to obtain foot pressure distribution parameter - PR data. From our results, we obtain 100% classification accuracy of normal and flat foot by using the linear discriminant analysis method. We observe there is no misclassification of foot types because of incorporating foot pressure distribution data instead of only arch index (AI). We found that the mid-foot pressure distribution ratio data and arch index (AI) value are well correlated to foot arch type based on visual analysis. Therefore, this paper suggests that the proposed system is accurate and easy to determine foot arch type from arch index (AI), as well as incorporating mid-foot pressure distribution ratio data instead of physical area of contact. Hence, such computational tool based system can help the clinicians for assessment of foot structure and cross-check their diagnosis of flat foot from mid-foot pressure distribution.

Keywords: arch index, computational tool, static foot pressure intensity image, foot pressure distribution, linear discriminant analysis

Procedia PDF Downloads 479

Authors: Alabi Olushola John, Ogbiko Anthonia, Tsado Daniel Nma, Mbajiorgu Ejike Felix, Adama Theophilus Zubairu

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A total of thirty (30) goats weighting between 5.8 and 7.3 kg were used to determine the growth performance, body linear measurements and body condition score of Semi intensively manged Savanna Brown goats fed enzyme treated sawdust diets (ETSD). They divided into five dietary treatments (T) groups with three replications using a completely randomized design. Treatment one (1) comprises of animals fed diet on 0 % enzyme treated sawdust while Treatment 2 (T2), Treatment 3 (T3), Treatment 4 (T4) and Treatment 5 (T5) comprises of animals fed diets containing 10, 20, 30 and 40 % enzyme treated sawdust diets, respectively. The study lasted 16 weeks. Data on growth performance parameters, body linear measurement (height at wither, body length, chest girth, hind leg length, foreleg length, facial length) and body condition score were collected and analyzed using one way analysis of variance. No significant difference (p>0.05) was observed in the all growth performance parameters and linear body measurements. However, significant difference was observed in body length and daily body length gains with highest value observed in animals fed the control diets (7.38 and 0.08 cm respectively) and animals on 30 % ETSD (7.25 and 0.07 cm respectively) and lowest values (4.75 and 0.05 cm respectively) were observed in animals fed 10 % ETSD among the treatment groups. It was, therefore, concluded that enzyme treated sawdust can be used in the diets of Savanna Brown goats up to 40 % replacement for maize offal since this treatment improved the body length and daily body length gains.

Keywords: performance, sawdust, enzyme treated, semi-intensively, replacement

Procedia PDF Downloads 66

Authors: Fhulufhelo Ramukhithi, Kgothatso Masethe, Tlou Chokoe, Ayanda Maqhashu, Julius Sebei, Tshililo Raphulu, Joseph Mugwabana

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Phenotypic characterisation ensures that the physical appearance of an animal is well documented. The information provided by this phenotypic characterisation study is important for planning management and the use of animal genetic resources. The aim of this study was to characterise the phenotypic characteristics of Bapedi sheep. Bapedi sheep are at risk of extinction like most of the indigenous breeds. As a result, a total of 196 Bapedi ewes and 35 rams were used. Phenotypic-qualitative characteristics were evaluated through visual appraisal. Phenotypic-quantitative characteristics such as body parts measurements were obtained using a flexible tape (cm), while body weight were obtained by using a weighing scale (kg). Bapedi rams (97 %) had higher satisfactory body condition when compared to ewes (75 %). A higher proportion of Bapedi sheep that did not have ticks observed (ewes = 87 % and rams = 91 %). Brown and white colour combination (head x body) was dominating in Bapedi sheep (80 % ewes and 91 % rams). Bapedi ewes did not have any horns; however, 3 % of rams had them. Bapedi sheep had a higher proportion of brown eyes, moderate neck, stiff sideways ears and normal front legs. Bapedi rams had a higher proportion of well-balanced and good attached testicles. Bapedi ewes had average (45 %), small (40 %) and big udders (15 %). Bapedi rams had a significantly higher body weight, height, depth, hearth girth circumference, rump width, hind leg width and length compared to ewes. However, both Bapedi rams and ewes had similar age, body condition score, tail length, length below hock and knee. In conclusion, Bapedi sheep had a higher satisfactory body condition and brown and white colour combination. Some of Bapedi rams’ quantitative characteristics were higher compared to ewes.

Keywords: extinction, indigenous, phenotypic, smallstock

Procedia PDF Downloads 184

Authors: Chung Hyun Goh, Armin Yazdanshenas, X. Neil Dong, Yong Tai Wang

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Physical rehabilitation is a necessary step in regaining lower body function after a partial paralysis caused by a spinal cord injury or a stroke. The purpose of this paper is to present the development and optimization of a training device that accurately recreates the motions in a gait cycle with the goal of rehabilitation for individuals with incomplete spinal cord injuries or who are victims of a stroke. A functional electrical stimulator was used in conjunction with the training device to stimulate muscle groups pertaining to rehabilitative walking. The feasibility and reliability of the design are presented. To validate the design functionality, motion analyses of the knee and ankle gait paths were made using motion capture systems. Key results indicate that the robotic walking training device provides a viable mode of physical rehabilitation.

Keywords: functional electrical stimulation, rehabilitative walking, robotic walking training device, spinal cord injuries

Procedia PDF Downloads 120

Authors: Pengfan Wu, Xiaoan Chen, Ye He, Tianchi Chen

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This paper introduces the design of an unpowered knee exoskeleton to assist human walking by redistributing the moment of the knee joint during stair descent (SD). Considering the knee moment varying with the knee joint angle and the work of the knee joint is all negative, the custom-built spring was used to convert negative work into the potential energy of the spring during flexion, and the obtained energy work as assistance during extension to reduce the consumption of lower limb muscles. The human-machine adaptability problem was left by traditional rigid wearable due to the knee involves sliding and rotating without a fixed-axis rotation, and this paper designed the two-direction grooves to follow the human-knee kinematics, and the wire spring provides a certain resistance to the pin in the groove to prevent extra degrees of freedom. The experiment was performed on a normal stair by healthy young wearing the device on both legs with the surface electromyography recorded. The results show that the quadriceps (knee extensor) were reduced significantly.

Keywords: unpowered exoskeleton, stair descent, knee compliant joint, energy redistribution

Procedia PDF Downloads 102

Authors: Hafiz Faisal Siddique, Adnan Ahmed Mazari, Antonin Havelka

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Compression socks are highly recommended textile garment for pressure exertion on the lower part of leg. The extent of compression that a patient can easily manage depends on stage (limb size and shape) of venous disease and his activities (mobility, age). Due to dynamic mechanical influence, the socks destroy their extent of pressure exertion around the leg. The main aim of this research is to investigate how the performance of compression socks is deteriorated due to expected induced wearing mechanical impacts. Wearing mechanical impacts influence the durability parameter i.e. tensile energy loss. For tensile energy loss, cut-strip samples were interacted to constant rate of loading and un-loading, cyclic-loading upto 15th cycles for ±5mm extension (considering muscles expansion and relaxation) and were dwelled (stayed) for 3 minutes at 25%, 50% and 75% extension levels, simultaneously. Statistical validation of tensile energy loss was performed by introducing measures of correlation, p-value (≤ 0.05), R-square values using MINITAB 17 software.

Keywords: compression socks, loading and unloading, 15th cyclic loading, Dwell time effect

Procedia PDF Downloads 130

Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

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Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

Procedia PDF Downloads 38

Authors: Hind Bouami

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Handling life-critical systems complexity requires to be equipped with appropriate technology and the right human agents’ functions such as knowledge, experience, and competence in problem’s prevention and solving. Human agents are involved in the management and control of human-machine system’s performance. Documenting human agent’s situation awareness is crucial to support human-machine designers’ decision-making. Knowledge about risks, critical parameters and factors that can impact and threaten automation system’s performance should be collected using preventive and retrospective approaches. This paper aims to document operators’ situation awareness through the analysis of automated organizations’ feedback. The analysis of automated hospital pharmacies feedbacks helps to identify and control critical parameters influencing human machine interaction in order to enhance system’s performance and security. Our human machine system evaluation approach has been deployed in Macon hospital center’s pharmacy which is equipped with automated drug dispensing systems since 2015. Automation’s specifications are related to technical aspects, human-machine interaction, and human aspects. The evaluation of drug delivery automation performance in Macon hospital center has shown that the performance of the automated activity depends on the performance of the automated solution chosen, and also on the control of systemic factors. In fact, 80.95% of automation specification related to the chosen Sinteco’s automated solution is met. The performance of the chosen automated solution is involved in 28.38% of automation specifications performance in Macon hospital center. The remaining systemic parameters involved in automation specifications performance need to be controlled.

Keywords: life-critical systems, situation awareness, human-machine interaction, decision-making

Procedia PDF Downloads 156

Authors: Amlan Datta

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Dengue is an arboviral, vector borne infection, quite prevalent in tropical countries such as India. Approximately, 1 to 25% of cases may give rise to neurological complication, such as, seizure, delirium, Guillian-Barre syndrome (GBS), multiple cranial nerve palsies, intracranial thrombosis, stroke-like presentations, to name a few. Dengue fever, as an antecedent to GBS is uncommon, especially in adults.Here, we report a case about a middle aged lady who presented with an acute onset areflexic ascending type of polyradiculoneuropathy along with bilateral lower motor neuron type of facial nerve palsy, as well as abducens and motor component of trigeminal (V3) weakness. Her respiratory and neck muscles were spared. She had an established episode of dengue fever (NS1 and dengue IgM positive) 7 days prior to the weakness. Nerve conduction study revealed a demyelinating polyradiculopathy of both lower limbs and cerebrospinal fluid examination showed albuminocytological dissociation. She was treated with 5 days of intravenous immunoglobulin (IVIg), following which her limb weakness improved considerably. This case highlights GBS as a potential complication following dengue fever.

Keywords: areflexic, demyelinating, dengue, polyradiculoneuropathy

Procedia PDF Downloads 225

Authors: Sukwoong Kang

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Background: The application of light-emitting diode (LED)-dependent photobiomodulation (PBM) in promoting post-tendon injury healing has been recently reported. Despite the establishment of a theoretical basis for ligament restoration through PBM, the lack of any empirical evidence deems this therapeutic strategy contentious. Therefore, the aim of this study was to investigate the potency of LED-based PBM in facilitating tendon healing in a murine model. Methods: Migration kinetics were analyzed at two specific wavelengths: 630 and 880 nm. The Achilles tendon in the hind limbs of Balb/c mice was severed via Achilles tendon transection. Subsequently, the mice were randomized into LED non-irradiation and LED irradiation groups. Mice with intact tendons were employed as healthy controls. The wounds were LED-irradiated for 20 min daily for two days. Histological properties, tendon healing mediators, and inflammatory mediators were screened on day 14. Results: The roundness of the nuclei and fiber structure, indicating the degree of infiltrated inflammatory cells and severity of fiber fragmentation, respectively, were considerably lower in the LED irradiation group than in the LED non-irradiation group. Immunohistochemical analysis depicted an increase in tenocytes (SCX+ cells) and a recovery of wounds with reduced fibrosis (lower collagen 3 and TGF-β1) in the LED irradiation group during healing; conversely, the LED non-irradiation group exhibited tissue fibrosis. The ratio of M2 macrophages to total macrophages was higher in the LED irradiation group than in the injured group. Conclusion: LED-based PBM in the Achilles tendon rupture murine model effectuated a rapid restoration of histological and immunochemical outcomes. The aforementioned findings suggest that LED-based PBM presents remarkable potential as an adjunct therapeutic for tendon healing and warrants further research to standardize various parameters to advance and establish it as a reliable treatment regime.

Keywords: photobiomodulation, light-emitting diode, tendon, regeneration

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Authors: Ogar Ofut Tumenayu, Olga Shabalina

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This paper describes the application of two types of pedagogical agents’ technology with different functions in an adaptive educational game with the sole aim of improving learning and enhancing interactivities in Digital Educational Games (DEG). This idea could promote the elimination of some problems of DEG, like isolation in game-based learning, by introducing a tutor and tutee pedagogical agents. We present an analysis of a learning companion interacting in a peer tutoring environment as a step toward improving social interactions in the educational game environment. We show that tutor and tutee agents use different interventions and interactive approaches: the tutor agent is engaged in tracking the learner’s activities and inferring the learning state, while the tutee agent initiates interactions with the learner at the appropriate times and in appropriate manners. In order to provide motivation to prevent mistakes and clarity a game task, the tutor agent uses the help dialog tool to provide assistance, while the tutee agent provides collaboration assistance by using the hind tool. We presented our idea on a prototype game called “Pyramid Programming Game,” a 2D game that was developed using Libgdx. The game's Pyramid component symbolizes a programming task that is presented to the player in the form of a puzzle. During gameplay, the Agents can instruct, direct, inspire, and communicate emotions. They can also rapidly alter the instructional pattern in response to the learner's performance and knowledge. The pyramid must be effectively destroyed in order to win the game. The game also teaches and illustrates the advantages of utilizing educational agents such as TrA and TeA to assist and motivate students. Our findings support the idea that the functionality of a pedagogical agent should be dualized into an instructional and learner’s companion agent in order to enhance interactivity in a game-based environment.

Keywords: tutor agent, tutee agent, learner’s companion interaction, agent collaboration

Procedia PDF Downloads 41

Authors: Yousef Alqaryouti, Mariam Al Suwaidi, Raed Mohmood AlKhuwaildi, Hind Kolthoum, Issa Youssef, Mohammed Al Imam

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The UAE has experienced rapid economic growth due to its mature oil production industry, leading to a surge in urbanization and infrastructure development in the construction sector. Sustainable development practices are becoming increasingly important, and the UAE government has taken proactive measures to promote them, including the introduction of sustainable building codes, energy-efficient technologies, and renewable energy sources. Initiatives such as the Masdar City project and the Emirates Green Building Council further demonstrate the government's commitment to a cleaner and healthier environment. By adopting sustainable practices, the UAE can reduce its carbon footprint, lessen its reliance on fossil fuels, and achieve cost savings in the long run. The purpose of this paper is to conduct a thorough review of the current state of sustainability in the construction industry of the UAE. Our research methodology includes a local market survey and qualitative observational analysis of executed housing construction projects by the Mohammed Bin Rashid Housing Establishment. The market survey assesses eleven different challenging factors that affect sustainable construction project delivery. The qualitative observational research is based on data collected from three projects, including construction progress, bill of quantity, and construction program. The study concludes that addressing these challenges requires a collaborative team approach, incentivized contracts, traditional project management practices, an integrated project team, and an increase in sustainability awareness among stakeholders. The recommendations proposed in this study aim to promote and improve the application of sustainability in the UAE's construction industry for the future.

Keywords: sustainability, construction, challenges, opportunities, case study, market survey

Procedia PDF Downloads 31

Authors: Basuki Supartono

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Introduction: Diabetic wound risks limb amputation, and the healing remains challenging. Chronic Hyperglycemia caused the insufficient inflammatory response and impaired ability of the cells to regenerate. Tissue Engineering Technique is mandatory. Methods: Tissue engineering (TE)-based therapy Utilizing mononuclear cells, plasma rich platelets, and collagen applied on the damaged tissue Results: TE technique resulting in acceptable outcomes. The wound healed completely in 2 months. No adverse effects. No allergic reaction. No morbidity and mortality Discussion: TE-based therapy utilizing mononuclear cells, plasma rich platelets, and collagen are safe and comfortable to fix damaged tissues. These components stop the chronic inflammatory process and increase cells' ability for regeneration and restoration of damaged tissues. Both of these allow the wound to regenerate and heal. Conclusion: TE-based therapy is safe and effectively treats unhealed diabetic lesion.

Keywords: diabetic foot lesion, tissue engineering technique, wound healing, stemcells

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Authors: Sa'ad M. Ismail, Hung-Hsun Yen, Christina M. Murray, Helen M. S. Davies

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In the dog, the median sacral crest is formed by the fusion of three sacral spinous processes. In greyhounds with standard sacrums, this fusion in the median sacral crest consists of the fusion of three sacral spinous processes while it consists of four in greyhounds with sacrocaudal fusion. In the present study, variations in the angulation of the first sacral spinous process in association with different types of sacrocaudal fusion in the greyhound were investigated. Sacrums were collected from 207 greyhounds (102 sacrums; type A (unfused) and 105 with different types of sacrocaudal fusion; types: B, C and D). Sacrums were cleaned by boiling and dried and then were placed on their ventral surface on a flat surface and photographed from the left side using a digital camera at a fixed distance. The first sacral spinous process angle (1st SPA) was defined as the angle formed between the cranial border of the cranial ridge of the first sacral spinous process and the line extending across the most dorsal surface points of the spinous processes of the S1, S2, and S3. Image-Pro Express Version 5.0 imaging software was used to draw and measure the angles. Two photographs were taken for each sacrum and two repeat measurements were also taken of each angle. The mean value of the 1st SPA in greyhounds with sacrocaudal fusion was less (98.99°, SD ± 11, n = 105) than those in greyhounds with standard sacrums (99.77°, SD ± 9.18, n = 102) but was not significantly different (P < 0.05). Among greyhounds with different types of sacrocaudal fusion the mean value of the 1st SPA was as follows: type B; 97.73°, SD ± 10.94, n = 39, type C: 101.42°, SD ± 10.51, n = 52, and type D: 94.22°, SD ± 11.30, n = 12. For all types of fusion these angles were significantly different from each other (P < 0.05). Comparing the mean value of the1st SPA in standard sacrums (Type A) with that for each type of fusion separately showed that the only significantly different angulation (P < 0.05) was between standard sacrums and sacrums with sacrocaudal fusion sacrum type D (only body fusion between the S1 and Ca1). Different types of sacrocaudal fusion were associated with variations in the angle of the first sacral spinous process. These variations may affect the alignment and biomechanics of the sacral area and the pattern of movement and/or the force produced by both hind limbs to the cranial parts of the body and may alter the loading of other parts of the body. We concluded that any variations in the sacrum anatomical features might change the function of the sacrum or surrounding anatomical structures during movement.

Keywords: angulation of first sacral spinous process, biomechanics, greyhound, locomotion, sacrocaudal fusion

Procedia PDF Downloads 287

Authors: Hind Hassan Arruwaite

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Conceptual metaphor is a cognitive semantic tool that provides access to people's conceptual systems. The correlation in the human conceptual system surpasses limited time and specific cultures. The universal associations provide universal schemas that organize people's conceptualization of the world. The study aims to explore how the cultural associations used in conceptual metaphors create commonalities and harmony between people of the world. In the research methodology, the researcher implemented Critical Metaphor Analysis, Metaphor Candidate Identification and Metaphor Identification Procedure models to deliver qualitative and descriptive findings. The semantic tension was the key criterion in identifying metaphorically used words in the headlines. The research materials are the oil trade conceptual metaphors used in the headlines of Arab News and Saudi Gazette Newspapers. The data will be uploaded to the self-constructed corpus to examine electronic lists for identifying conceptual metaphors. The study investigates the types of conceptual metaphors used in the headlines of the newspapers, the cultural associations identified in the conceptual metaphors, and whether the identified cultural associations in conceptual metaphors create universal conceptual schemas. The study aligned with previous seminal works on conceptual metaphor theory in emphasizing the distinctive power of conceptual metaphors in exposing the cultural associations that unify people's perceptions. The correlation of people conceptualization provides universal schemas that involve elements of human sensorimotor experiences. The study contributes to exposing the shared cultural associations that ensure the commonality of all humankind's thinking mechanism.

Keywords: critical discourse analysis, critical metaphor analysis, conceptual metaphor theory, primary and specific metaphors, corpus-driven approach, universal associations, image schema, sensorimotor experience, oil trade

Procedia PDF Downloads 177

Authors: Seraj Makkawi, Abdulaziz A. Alqarni, Himyan Alghaythee, Suzan Y. Alharbi, Anmar Fatani, Reem Adas, Ahmad R. Abuzinadah

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Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a neurodegenerative disease that involves both the upper and lower motor neurons. Familial ALS, including superoxide dismutase 1 (SOD1) mutation, accounts for 5-10% of all cases of ALS. Typically, the symptoms of ALS are purely motor, though coexistent sensory symptoms have been reported in rare cases. In this report, we describe the case of a 47- year-old man who presented with progressive bilateral lower limb weakness and numbness for the last four years. A nerve conduction study (NCS) showed evidence of coexistent axonal sensorimotor polyneuropathy in addition to the typical findings of ALS in needle electromyography. Genetic testing confirmed the diagnosis of familial ALS secondary to the SOD1 genetic mutation. This report highlights that the presence of sensory symptoms should not exclude the possibility of ALS in an appropriate clinical setting.

Keywords: Saudi Arabia, polyneuropathy, SOD1 gene mutation, familial amyotrophic lateral sclerosis, amyotrophic lateral sclerosis

Procedia PDF Downloads 120