Search results for: open temporomandibular joint surgery

Authors: Bibi Somayeh Aliakbari, Niknaz Kachooei, Fatemeh Amiri Najafabadi

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According to the results of contemporary urbanism, social living moved into buildings and the quality of urban space has been declining. But still, there are life in open public space and it is one of reason attendance and activities of people in open public spaces.The purpose of this research is finding reason creation friendly public space in urban spaces and also use these in new urban spaces.The research methodology consisted of a qualitative model based on observation and graphical analysis. In this paper case study is public space historical, moderns in urban scales and local scales in Iran.This paper shows that Existence of friendly public space in cities cause is attendance and activities of people in open public spaces that it is reason the revitalization of public open spaces in cities.

Keywords: public space, public open space, friendly public space, Iran

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Saman Namvarrechi, Armin A. Dormeny, Javad Dargahi, Mojtaba Kahrizi

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Since last two decades, minimally invasive surgery (MIS) has grown significantly due to its advantages compared to the traditional open surgery like less physical pain, faster recovery time and better healing condition around incision regions; however, one of the important challenges in MIS is getting an effective sensing feedback within the patient’s body during operations. Therefore, surgeons need efficient tactile sensing like determining the hardness of contact tissue for investigating the patient’s health condition. In such a case, MIS tactile sensors are preferred to be able to provide force/pressure sensing, force position, lump detection, and softness sensing. Among different pressure sensor technologies, the piezoelectric operating principle is the fittest for MIS’s instruments, such as catheters. Using PVDF with its copolymer, TrFE, as a piezoelectric material, is a common method of design and fabrication of a tactile sensor due to its ease of implantation and biocompatibility. In this research, PVDF-TrFE polymer is deposited via spin-coating method and treated with various post-deposition processes to investigate its piezoelectricity and amount of electroactive β phase. These processes include different post thermal annealing, the effect of spin-coating speed, different layer of deposition, and the presence of additional hydrate salt. According to FTIR spectroscopy and SEM images, the amount of the β phase and porosity of each sample is determined. In addition, the optimum experimental study is established by considering every aspect of the fabrication process. This study clearly shows the effective way of deposition and fabrication of a tactile PVDF-TrFE based sensor and an enhancement methodology to have a higher β phase and piezoelectric constant in order to have a better sense of touch at the end effector of biomedical devices.

Keywords: β phase, minimally invasive surgery, piezoelectricity, PVDF-TrFE, tactile sensor

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Authors: Abdullah Kattan, Khalid Alzahrani, Saud Alsaleh, Loui Ezzat, Khalid Murad, Bader Alghamdi

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Background and Significance: Patients are often bothered by the excess skin laxity and redundancy that they are left with after losing weight. Body-contouring surgery offers a solution to this problem; however, there is scarce literature on the psychological and social effects of these surgeries. This study was conducted to assess the psychosocial impact of body-contouring surgery on patients after weight loss. Methodology: In this cross-sectional study, a specifically designed questionnaire was administered to forty three patients whom have undergone body-contouring surgery. All included patients had lost no less than 20 Kg before body-contouring surgery, and were interviewed at least 6 months after surgery. The twenty-question interviewer based questionnaire was used to assess the psychosocial status of the patients before and after undergoing body-contouring surgery. The questionnaire assessed the quality of life (social life, job performance and sexual activity), presence of symptoms of depression and overall satisfaction. Data was analyzed as paired variables in SPSS using McNemar’s test. Results: Among the 43 participants, 19 (44.2%) have undergone mammoplasty, 12 (27.9%) have undergone abdominoplasty and the remainder of the patients have undergone other various procedures including brachioplasty, thigh lifts and nick liposuction. The mean age of patients was 34 +/- 10, the sample included 24 (55.8%) females and 19 (44.2%) males. The patients’ quality of life significantly improved in the following areas; social life (P<0.001), job performance (P<0.002) and sexual activity (P<0.001). Moreover, 17 (39.5%) patients suffered symptoms of depression before body-contouring surgery; however, only 1 (2.3%) patient suffered symptoms of depression after surgery. Overall satisfaction rate was found to be 62.8%; with mammoplasty being the highest satisfaction rate procedure (66.6 %). Conclusion: Body-contouring surgery after weight loss has shown to improve the psychological and social aspects in patients. These findings have been found to be consistent with the majority of relevant published studies, further increasing reliability of our study.

Keywords: abdominoplasty, body-contouring, mammoplasty, psychosocial

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Authors: Wilaiwan Sornpoon, Sébastien Bonnet, Savitri Garivait

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Open burning of sugarcane fields is recognized to have a negative impact on soil by degrading its properties, especially soil organic carbon (SOC) content. Better understating the effect of open burning on soil carbon dynamics is crucial for documenting the carbon sequestration capacity of agricultural soils. In this study, experiments to investigate soil carbon stocks under burned and unburned sugarcane plantation systems in Thailand were conducted. The results showed that cultivation fields without open burning during 5 consecutive years enabled to increase the SOC content at a rate of 1.37 Mg ha-1y-1. Also it was found that sugarcane fields burning led to about 15% reduction of the total carbon stock in the 0-30 cm soil layer. The overall increase in SOC under unburned practice is mainly due to the large input of organic material through the use of sugarcane residues.

Keywords: soil organic carbon, soil inorganic carbon, carbon sequestration, open burning, sugarcane

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Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad

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Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.

Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis

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Authors: Eunice H. Li

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This e-poster explores some of the issues that are linked to Open Educational Resources (OER). It describes how OER is explained by experts in the field and relates its value in attaining and using knowledge. ‘Open', 'open pedagogy', self-direction, freedom, and autonomy are the main issues identified for the discussion. All of these issues make essential contributions to OER in one way or another. Nevertheless, there are seemingly areas of contentions with regard to applying these concepts in teaching and learning practices. For this e-Poster, it is the teaching-learning aspects of OER that it is primarily concerned with. The basis for the discussion comes from a 2013 critique of OER presented by Jeremy Knox of the University of Edinburgh, tutor of the MSc in Digital Education Programme. This discussion is also supported by the analysis of other research work and papers in this area. The general view on OER is that it is a useful tool for the advancement of learner-centred models of education, but in whatever context, pedagogy cannot be diminished and overlooked. It should take into consideration how to deal with the issues identified above in order to allow learners to gain full benefit from OER.

Keywords: open, pedagogy, e-learning technologies, autonomy, knowledge

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Authors: Sophia Fry, Mahir Irtiza, Alexa Hoffman, Yousef Sardahi

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This study presents an intelligent control algorithm for a flexible robotic arm. Fuzzy control is used to control the motion of the arm to maintain the arm tip at the desired position while reducing vibration and increasing the system speed of response. The Fuzzy controller (FC) is based on adding the tip angular position to the arm deflection angle and using their sum as a feedback signal to the control algorithm. This reduces the complexity of the FC in terms of the input variables, number of membership functions, fuzzy rules, and control structure. Also, the design of the fuzzy controller is model-free and uses only our knowledge about the system. To show the efficacy of the FC, the control algorithm is implemented on the flexible joint manipulator (FJM) developed by Quanser. The results show that the proposed control method is effective in terms of response time, overshoot, and vibration amplitude.

Keywords: fuzzy logic control, model-free control, flexible joint manipulators, nonlinear control

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Authors: Abhishek Gandhi, Naresh Bhatnagar

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In this article, a new technique has been developed to manufacture open cell extruded thermoplastic foamed sheets with the aid of extrudate surface-quenching phenomenon. As the extrudate foam exits the die, its surface is rapidly quenched which results in freezing of cells on the surface, while the cells at the core continue to grow and leads to development of open-cellular microstructure at the core. Influence of chill roll temperature was found to be extremely significant in developing porous morphological attributes. Subsequently, synergistic effect of blowing agent content and chill roll temperature was examined for their expansion ratio and open-cell microstructure. Further, chill roll rotating speed was found extremely significant in obtaining open-cellular foam structures. This study intends to enhance the understanding of researchers working in the area of open-cell foam processing.

Keywords: foams, porous materials, morphology, composite, microscopy, open-cell foams

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Authors: Hamid Ahmadi, Shadi Asoodeh

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The fatigue life of tubular joints commonly found in offshore industry is not only dependent on the value of hot-spot stress (HSS), but is also significantly influenced by the through-the-thickness stress distribution characterized by the degree of bending (DoB). The determination of DoB values in a tubular joint is essential for improving the accuracy of fatigue life estimation using the stress-life (S–N) method and particularly for predicting the fatigue crack growth based on the fracture mechanics (FM) approach. In the present paper, data extracted from finite element (FE) analyses of tubular KT-joints, verified against experimental data and parametric equations, was used to investigate the effects of geometrical parameters on DoB values at the crown 0˚, saddle, and crown 180˚ positions along the weld toe of central brace in tubular KT-joints subjected to axial loading. Parametric study was followed by a set of nonlinear regression analyses to derive DoB parametric formulas for the fatigue analysis of KT-joints under axial loads. The tubular KT-joint is a quite common joint type found in steel offshore structures. However, despite the crucial role of the DoB in evaluating the fatigue performance of tubular joints, this paper is the first attempt to study and formulate the DoB values in KT-joints.

Keywords: tubular KT-joint, fatigue, degree of bending (DoB), axial loading, parametric formula

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Authors: Morteza Aien, Masoud Rashidinejad, Mahmud Fotuhi-Firuzabad

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Power systems are innately uncertain systems. To face with such uncertain systems, robust uncertainty assessment tools are appealed. This paper inspects the uncertainty assessment formulation of the load flow (LF) problem considering different kinds of uncertainties, developed in its companion paper through some case studies. The proposed methodology is based on the evidence theory and joint propagation of possibilistic and probabilistic uncertainties. The load and wind power generation are considered as probabilistic uncertain variables and the electric vehicles (EVs) and gas turbine distributed generation (DG) units are considered as possibilistic uncertain variables. The cumulative distribution function (CDF) of the system output parameters obtained by the pure probabilistic method lies within the belief and plausibility functions obtained by the joint propagation approach. Furthermore, the imprecision in the DG parameters is explicitly reflected by the gap between the belief and plausibility functions. This gap, due to the epistemic uncertainty on the DG resources parameters grows as the penetration level increases.

Keywords: electric vehicles, joint possibilistic- probabilistic uncertainty modeling, uncertain load flow, wind turbine generator

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Authors: Ming Ma, Rui Li

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In the highly urbanized district, green open space is playing an important role in human’s health and wellbeing as a physical, aesthetic and natural environment resources. The aim of this paper is to close this gap through providing a comprehensive, qualitative meta-analysis of existing studies related to this issue. A systematic scoping of current quantitative research is conducted which mostly focused on cross-sectional survey and experimental studies. Health benefits from contact with green open space could be categorized into physical health, psychological health and social wellbeing. Mechanism for the health related to green open space could be clearly identified with the regard to natural restoration, physical activities and social capital. These results indicate a multiple pathways framework between the health benefits and mechanism. In order to support design and planning, the most evident relationship was picked up that people could psychologically benefit from green open space through outdoors physical activities. Additionally, three design and planning strategies are put forward. Various and multi-level contacts with green open space would be considered as an explanation of the pathway results and tie to bridge the health to design and planning. There is a need to carry out long-term research emphasizing on causal relationship between health and green open space through excluding cofounding factors such as self-selection.

Keywords: urban green open space, planning and design, health benefit, mechanism, pathway framework

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Authors: M. P. E. E Silva, A. M. Galloway, A. I. Toumpis

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An increasing concern exists in the welding industry in terms of faster joining processes. Methods such as the alternation between shielding gases such Ar, CO₂ and He have been able to provide improved penetration of the joint, reduced heat transfer to the workpiece, and increased travel speeds of the welding torch. Nitrogen as a shielding gas is not desirable due to its reactive behavior within the arc plasma, being absorbed by the molten pool during the welding process. Below certain amounts, nitrogen is not harmful. However, the nitrogen threshold is reduced during the solidification of the joint, and if its subsequent desorption is not completed on time, gas entrapment and blowhole formation may occur. The present study expanded the use of the alternating shielding gas method in the gas metal arc welding (GMAW) process by alternately supplying Ar/5%N₂ and He. Improvements were introduced in terms of joint strength and grain refinement. Microstructural characterization findings showed porosity-free welds with reduced inclusion formation while mechanical tests such as tensile and bend tests confirmed the reinforcement of the joint by the addition of nitrogen. Additionally, significant reductions of the final distortion of the workpiece were found after the welding procedure as well as decreased heat affected zones and temperatures of the weld.

Keywords: alternating shielding gas method, GMAW, grain refinement, nitrogen, porosity, mechanical testing

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Authors: Suraya Mohamad Nadzir, Badrol Ahmad, Norlia Berahim

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T91 steel has been used as construction material for superheater tubes in sub-critical and super critical boiler. This steel was developed with higher creep strength property as compared to conventional low alloy steel. However, this steel is also susceptible to materials degradation due to its sensitivity to heat treatment especially Post Weld Heat Treatment (PWHT) after weld repair process. Review of PWHT process shows that the holding temperature may different from one batch to other batch of samples depending on the material composition. This issue was reviewed by many researchers and one of the potential solutions is the development of weld repair process without PWHT. This process is possible with the use of temper bead welding technique. However, study has shown the hardness value across the weld joint with exception of PWHT is much higher compare to recommended hardness value. Based on the above findings, a study to evaluate the microstructure and hardness changes of T91 weld joint after heating at 560°C at varying duration was carried out. This study was carried out to evaluate the possibility of self-tempering process during in-service period. In this study, the T91 weld joint was heat-up in air furnace at 560°C for duration of 50 and 150 hours. The heating process was controlled with heating rate of 200°C/hours, and cooling rate about 100°C/hours. Following this process, samples were prepared for the microstructure examination and hardness evaluation. Results have shown full tempered martensite structure and acceptance hardness value was achieved after 50 hours heating. This result shows that the thin component such as T91 superheater tubes is able to self-tempering during service hour.

Keywords: T91, weld-joint, tempered martensite, self-tempering

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Authors: Luksanaporn Krungkraipetch

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Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: S. D. El Wakil

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The research work reported here was aimed at investigating the feasibility of joining high-porosity stainless steel discs and wrought iron bars by friction welding. The sound friction-welded joints were then subjected to a metallurgical investigation and an analysis of failure resulting from tensile loading. Discs having 50 mm diameter and 10 mm thickness were produced by loose sintering of stainless steel powder at a temperature of 1350 ^oC in an argon atmosphere for one hour. Minor machining was then carried out to control the dimensions of the discs, and the density of each disc could then be determined. The level of porosity was calculated and was found to be about 40% in all of those discs. Solid wrought iron bars were also machined to facilitate tensile testing of the joints produced by friction welding. Using our previously gained experience, the porous stainless steel disc and the wrought iron tube were successfully friction welded. SEM was employed to examine the fracture surface after a tensile test of the joint in order to determine the type of failure. It revealed that the failure did not occur in the joint, but rather in the in the porous metal in the area adjacent to the joint. The load carrying capacity was actually determined by the strength of the porous metal and not by that of the welded joint. Macroscopic and microscopic metallographic examinations were also performed and showed that the welded joint involved a dense heat-affected zone where the porous metal underwent densification at elevated temperature, explaining and supporting the findings of the SEM study.

Keywords: fracture of friction-welded joints, metallurgy of friction welding, solid-porous structures, strength of joints

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Authors: Ihab Saad Ahmed

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Background For Siewert type I and II gastroesophageal junction tumor (GEJ) laparoscopic proximal gastrectomy can be performed. It is associated with several perioperative benefits compared with open proximal gastrectomy. The use of laparoscopic proximal gastrectomy (LPG) has become an increasingly popular approach for select tumors Methods We describe our technique for LPG, including the preoperative work-up, illustrated images of the main principle steps of the surgery, and our postoperative course. Results Thirteen pts (nine males, four female) with type I, II (GEJ) adenocarcinoma had laparoscopic radical proximal gastrectomy and D2 lymphadenectomy. All of our patient received neoadjuvant chemotherapy, eleven patients had intrathoracic anastomosis through mini thoracotomy (two hand sewn end to end anastomoses and the other 9 patient end to side using circular stapler), two patients with intrathoracic anastomosis had flap and wrap technique, two patients had thoracoscopic esophageal and mediastinal lymph node dissection with cervical anastomosis The mean blood loss 80ml, no cases were converted to open. The mean operative time 250 minute Average LN retrieved 19-25, No sever complication such as leakage, stenosis, pancreatic fistula ,or intra-abdominal abscess were reported. Only One patient presented with empyema 1.5 month after discharge that was managed conservatively. Conclusion For carefully selected patients, LPG in GEJ tumour type I and II is a safe and reasonable alternative for open technique , which is associated with similar oncologic outcomes and low morbidity. It showed less blood loss, respiratory infections, with similar 1- and 3-year survival rates.

Keywords: LPG(laparoscopic proximal gastrectomy, GEJ( gastroesophageal junction tumour), d2 lymphadenectomy, neoadjuvant cth

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Authors: Hendra Wibowo, Suprayitno Wardoyo, Dhama Shinta

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Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB.

Keywords: pediatric, pulmonary, surgery, therapy, tuberculosis

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Authors: Ossama Salman

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Background and objective: Sacroiliac joint pain is a common cause for chronic axial low back pain, with up to 20% prevalence rate. To date, no effective long-term treatment intervention has been embarked on yet. The aim of our study was to compare steroid block to radiofrequency ablation for SIJ pain conditions. Methods: A randomized, blind, study was conducted in 30 patients with sacroiliac joint pain. Fifteen patients received radiofrequency denervation of L4-5 primary dorsal rami and S1-3 lateral sacral branch, and 15 patients received steroid under fluoroscopy. Those in the steroid group who did not respond to steroid injections were offered to cross over to get radiofrequency ablation. Results: At 1-, 3- and 6-months post-intervention, 73%, 60% and 53% of patients, respectively, gained ≥ 50 % pain relief in the radiofrequency (RF) ablation group. In the steroid group, at one month post intervention follow up, only 20% gained ≥ 50 % pain relief, but failed to show any improvement at 3 months and 6 months follow up. Conclusions: Radiofrequency ablation at L4 and L5 primary dorsal rami and S1-3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder.

Keywords: lateral branch denervation, LBD, radio frequency, RF, sacroiliac joint, SIJ, visual analogue scale, VAS

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Authors: Renee Moten

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Introduction: Knee pain becomes chronic because the therapy used focuses only on the symptoms of knee pain and not the causes of knee pain. Preventing knee injuries is not in the toolbox of the traditional practitioner. This research was done to show that we must reduce the inflammation (holistically), reduce the swelling and regain flexibility before considering any type of exercise. This method of performing the correct exercise stops the bowing of the knee, corrects the walking gait, and starts to relieve knee, hip, back, and shoulder pain. Method: The holistic method that is used to heal knees is called the Knee Pain Recipe. It’s a six step system that only uses alternative medicine methods to reduce, relieve and restore knee joint mobility. The system is low cost, with no hospital bills, no physical therapy, and no painkillers that can cause damage to the kidneys and liver. This method has been tested on 200 women with knee, back, hip, and shoulder pain. Results: All 200 women reduce their knee pain by 50%, some by as much as 90%. Learning about ankle and foot flexibility, along with understanding the kinetic chain, helps improve the walking gait, which takes the pressure off the knee, hip and back. The knee pain recipe also has helped to reduce the need for a cortisone injection, stem cell procedures, to take painkillers, and surgeries. What has also been noted in the research was that if the women's knees were too far gone, the Knee Pain Recipe helped prepare the women for knee replacement surgery. Conclusion: It is believed that the Knee Pain Recipe, when performed by men and women from around the world, will give them a holistic alternative to drugs, injections, and surgeries.

Keywords: knee, surgery, healing, holistic

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Authors: P. Saleh, G. Challita, R. Hazimeh, K. Khalil

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In this paper 3D FEM analysis was carried out on double lap bonded joint with composite adherents subjected to dynamic shear. The adherents are made of Carbon/Epoxy while the adhesive is epoxy Araldite 2031. The maximum average shear stress and the stress homogeneity in the adhesive layer were examined. Three fibers textures were considered: UD; 2.5D and 3D with same volume fiber then a parametric study based on changing the thickness and the type of fibers texture in 2.5D was accomplished. Moreover, adherents’ dissimilarity was also investigated. It was found that the main parameter influencing the behavior is the longitudinal stiffness of the adherents. An increase in the adherents’ longitudinal stiffness induces an increase in the maximum average shear stress in the adhesive layer and an improvement in the shear stress homogeneity within the joint. No remarkable improvement was observed for dissimilar adherents.

Keywords: adhesive, composite adherents, impact shear, finite element

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Authors: Albert Suryaprawira

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The Nasion-Sella Line (NSL) has been used for several years as a reference line in longitudinal growth study. Therefore this line is considered to be stable not only to evaluate treatment outcome and to predict relapse possibility but also to manage prognosis. This is a radiographic superimposition of an adult male aged 19 years who complained of difficulty in aesthetic, talking and chewing. Patient has a midface hypoplasia profile (concave). He was diagnosed to have a severe Skeletal Class III with Class III malocclusion, increased lower vertical height, and an anterior open bite. A pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. A panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, a pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, a post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition using NSL as a reference line between those radiographs was performed to analyse the outcome. It is important to describe the amount of hard and soft tissue movement and to predict the possibility of relapse after the surgery. The patient also needs to understand all the surgical plan, outcome and relapse prevention. The surgical management included maxillary impaction and advancement of Le Fort I osteotomy. The evaluation using NSL as a reference was a very useful method in determining the outcome and prognosis.

Keywords: Nasion-Sella Line, midface hypoplasia, Le Fort 1, maxillary advancement

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Authors: Daniel N. L. Alves, Marcelo C. Rodrigues, Jose G. de Almeida

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The search for structural efficiency in mechanical systems has been strongly exerted with aim of economic optimization and structural safety. As soon, to understand the response of materials when submitted to adverse conditions is essential to design a safety project. This work investigates the presence of cracks in dissimilar welded joints (DWJ). Its fracture toughness responses depend upon the heterogeneity present in these joints. Thus, this work aim analyzing the behavior of the crack tip zone located in a buttery dissimilar welded joint (ASTM A-36, Inconel, and AISI 8630 M) used in the union of pipes present in the offshore oil production lines. The crack was placed 1 mm from fusion line (FL) Inconel-AISI 8630 M toward the AISI 8630 M. Finite Element Method (FEM) was used to analyze stress and strain fields generated during the loading imposed on the specimen. It was possible observing critical stress area by the numerical tool as well as a preferential plastic flow was also observed in the sample of dissimilar welded joint, which can be considered a harbinger of the crack growth path. The results obtained through numerical analysis showed a convergent behavior in relation to the plastic flow, qualitatively and quantitatively, in agreement with previous performed.

Keywords: crack, dissimilar welded joint, numerical analysis, strain field, the stress field

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Authors: Meghana Pandit, Abhishek Chakraborty

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There are a multitude of factors that influence the clinical success of bariatric surgery. This study seeks to determine the efficacy of preoperative weight management education. The Food and Fitness Program at Mount Sinai serves to educate patients on topics such as stress management, sleep habits, body image, nutrition, and exercise 5-6 months before their surgeries to slowly decrease their weight. Each month, patients are weighed, and a different topic is presented. To evaluate the longitudinal effects of these lectures, patient’s weights are evaluated at the first appointment, before an informative lecture is presented. Weights are then reevaluated at the last appointment before the surgery. The weights were statistically analyzed using a paired t-test and the results demonstrated a statistically significant difference (p < .0001, n=55). Thus, it is reasonable to conclude that the education paradigm employed successfully empowered patients to maintain and reduce their gross BMI before clinical intervention.

Keywords: bariatric, surgery, weight, education

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Authors: Abdulmagid A. Khattabi, Abdul Fatah M. Emhamed

Abstract:

The steel alloy Introduced after becoming carbon-steel does not meet the requirements of engineering industry; and it cannot be obtained tensile strength from carbon-steel higher than (700MPa), the low alloy steel enters in a lot of heavy engineering equipment parts, molds, agricultural equipment and other industry. In addition, that may be exposed to in-service failure, which may require returned to work, to do the repairs or maintenance by one of the welding methods available. The ability of steel weld determined through palpation of the cracks, which can reduce by many ways. These ways are often expensive and difficult to implement, perhaps the control to choose the type of electrode welding user is one of the easiest and least expensive applications. It has been welding the steel low alloys high resistance by manual metal arc (MMA), and by using a set of welding electrodes which varying in chemical composition and in their prices as well and test their effect on tensile strength. Results showed that using the poles of welding, which have a high proportion of iron powder and low hydrogen. The Tensile resistance is (484MPa) and the weld joint efficiency was (56.9%), but when (OK 47.04) electrode was used the tensile strength increased to (720MPa) and the weld joint efficiency to (84.7%). Using the cheapest electrode (OK 45.00) the weld joint efficiency did not exceed (24.2%), but when using the most expensive electrode (OK 91.28) the weld joint efficiency is (38.1%).

Keywords: steel low alloys high resistance, electrodes welding, tensile test

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Authors: Saba Ebrahimi, Saeed Ahmadian, Hedie Ashrafi

Abstract:

Selecting appropriate patients for surgery is one of the main issues in thoracic surgery (TS). Both short-term and long-term risks and benefits of surgery must be considered in the patient selection criteria. There are some limitations in the existing datasets of TS patients because of missing values of attributes and imbalanced distribution of survival classes. In this study, a novel ensemble architecture of deep learning networks is proposed based on stacking different linear and non-linear layers to deal with imbalance datasets. The categorical and numerical features are split using different layers with ability to shrink the unnecessary features. Then, after extracting the insight from the raw features, a novel biased-kernel layer is applied to reinforce the gradient of the minority class and cause the network to be trained better comparing the current methods. Finally, the performance and advantages of our proposed model over the existing models are examined for predicting patient survival after thoracic surgery using a real-life clinical data for lung cancer patients.

Keywords: deep learning, ensemble models, imbalanced classification, lung cancer, TS patient selection

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Authors: Ferhat Kadioglu, Hasan Puskul

Abstract:

A composite material with carbon fiber and polymer matrix has been used as adherent for manufacturing adhesive joints. In order to evaluate different fiber orientations on joint performance, the adherents with the 0°, ±15°, ±30°, ±45° fiber orientations were used in the single lap joint configuration. The joints with an overlap length of 25 mm were prepared according to the ASTM 1002 specifications and subjected to tensile loadings. The structural adhesive used was a two-part epoxy to be cured at 70°C for an hour. First, mechanical behaviors of the adherents were measured using three point bending test. In the test, considerations were given to stress to failure and elastic modulus. The results were compared with theoretical ones using rule of mixture. Then, the joints were manufactured in a specially prepared jig, after a proper surface preparation. Experimental results showed that the fiber orientations of the adherents affected the joint performance considerably; the joints with ±45° adherents experienced the worst shear strength, half of those with 0° adherents, and in general, there was a great relationship between the fiber orientations and failure mechanisms. Delamination problems were observed for many joints, which were thought to be due to peel effects at the ends of the overlap. It was proved that the surface preparation applied to the adherent surface was adequate. For further explanation of the results, a numerical work should be carried out using a possible non-linear analysis.

Keywords: composite materials, adhesive bonding, bonding strength, lap joint, tensile strength

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Authors: Akhatjon Nasullaev, Raffaella Manzini, Vincent Frigant

Abstract:

The prior research largely discussed open innovation practices both in large and small and medium-sized enterprises (SMEs). Open Innovation compels firms to observe and analyze the external environment in order to tap new opportunities for inbound and/or outbound flows of knowledge, ideas, work in progress innovations. As SMEs are different from their larger counterparts, they face several limitations in utilizing open innovation activities, such as resource scarcity, unstructured innovation processes and underdeveloped innovation capabilities. Technology intelligence – the process of systematic acquisition, assessment and communication of information about technological trends, opportunities and threats can mitigate this limitation by enabling SMEs to identify technological and market opportunities in timely manner and undertake sound decisions, as well as to realize a ‘first mover advantage’. Several studies highlighted firm-level barriers to successful implementation of open innovation practices in SMEs, namely challenges in partner selection, intellectual property rights and trust, absorptive capacity. This paper aims to investigate the question how technology intelligence can be useful for SMEs to overcome the barriers to effective open innovation. For this, we conduct a case study in four Estonian life-sciences SMEs. Our findings revealed that technology intelligence can support SMEs not only in inbound open innovation (taking into account inclination of most firms toward technology exploration aspects of open innovation) but also outbound open innovation. Furthermore, the results of this study state that, although SMEs conduct technology intelligence in unsystematic and uncoordinated manner, it helped them to increase their innovative performance.

Keywords: technology intelligence, open innovation, SMEs, life sciences

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Authors: Changwon Kwak, Innjoon Park, Dongin Jang

Abstract:

Seismic load affects the behavior of underground structure like tunnel broadly. Seismic soil-structure interaction can play an important role in the dynamic behavior of tunnel. In this research, twin tunnel with flexible joint was physically modeled and the dynamic centrifuge test was performed to investigate seismic behavior of twin tunnel. Seismic waves have different frequency were exerted and the characteristics of response were obtained from the test. Test results demonstrated the amplification of peak acceleration in the longitudinal direction in seismic waves. The effect of the flexible joint was also verified. Additionally, 3-dimensional finite difference dynamic analysis was conducted and the analysis results exhibited good agreement with the test results.

Keywords: 3-dimensional finite difference dynamic analysis, dynamic centrifuge test, flexible joint, seismic soil-structure interaction

Procedia PDF Downloads 228

Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

Abstract:

Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

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