Search results for: continuous peripheral nerve blocks

Authors: Takuro Kida, Yuichi Kida

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We show a base of the new trend of algorithm mathematically that treats a historical reason of continuous discrimination in the world as well as its solution by introducing new concepts of parallel world that includes an invisible set of errors as its companion. With respect to a matrix operator-filter bank that the matrix operator-analysis-filter bank H and the matrix operator-sampling-filter bank S are given, firstly, we introduce the detailed algorithm to derive the optimum matrix operator-synthesis-filter bank Z that minimizes all the worst-case measures of the matrix operator-error-signals E(ω) = F(ω) − Y(ω) between the matrix operator-input-signals F(ω) and the matrix operator-output signals Y(ω) of the matrix operator-filter bank at the same time. Further, feedback is introduced to the above approximation theory and it is indicated that introducing conversations with feedback does not superior automatically to the accumulation of existing knowledge of signal prediction. Secondly, the concept of category in the field of mathematics is applied to the above optimum signal approximation and is indicated that the category-based approximation theory is applied to the set-theoretic consideration of the recognition of humans. Based on this discussion, it is shown naturally why the narrow perception that tends to create isolation shows an apparent advantage in the short term and, often, why such narrow thinking becomes intimate with discriminatory action in a human group. Throughout these considerations, it is presented that, in order to abolish easy and intimate discriminatory behavior, it is important to create a parallel world of conception where we share the set of invisible error signals, including the words and the consciousness of both worlds.

Keywords: signal prediction, pseudo inverse matrix, artificial intelligence, conditional optimization

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Authors: Chun Hsien Wu, Guan Xuan Wu, Hsia Ying Cheng, Shyh Ming Kuo

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Articular cartilage is composed of chondrocytes and extracellular matrix, such as collagen fibers, glycosaminoglycans, etc., which play an important role in lubricating and cushion joint activities. The phenotypic expression and metabolic activity of chondrocytes are extremely important in maintaining the functions of articular cartilage. In in vitro passaged culture of chondrocytes, chondrocytes gradually lose their original cell phenotype and morphology, which is called dedifferentiation. After continuous passaged culture of chondrocytes or induction by inflammatory factor IL-1, chondrocytes changed their phenotype and morphology. Also, the extracellular matrix type II collagen and GAG secretion were significantly reduced, while type I and X collagen were synthesized. Farnesol is an anti-inflammatory and antioxidant sesquiterpene compound that has the specific property of promoting collagen production. The purpose of this study was to investigate whether farnesol could restore the original type II collagen synthesis and, furthermore, the mechanisms of farnesol on the synthesis of type II collagen from the de-differentiated chondrocytes. The obtained results showed that the de-differentiated chondrocytes significantly restored to secret type II collagen and GAG (2.5-folds increases), and the secretion of collagen I and X and PGE2 synthesis were also significantly reduced after being treated with farnesol, indicating that farnesol had a restoration/re-differentiation effect on de-differentiated chondrocytes. The de-differentiated chondrocytes exhibited decreased expression of PPAR-γ and upregulated TGF-β expression to increase the MMP-13 expression. Higher expression of MMP-13 caused chondrocytes to secret type X collagen. On the contrary, increasing the expression of PPAR-γ would benefit the production of type II collagen. As shown, the PPAR-γ expression increased, and MMP-13 expression decreased after being treated with farnesol, indicating a possible signal pathway of farnesol to restore the production of type II collagen. However, more detailed mechanisms still need to evaluate.

Keywords: chondrocytes, de-differentiation, farnesol, re-differentiation

Procedia PDF Downloads 125

Authors: Muhammad Hakim Bin Mat Tasir, Erwan Shahfizad Hasidan, Hamidah Makmor Bakry, M. Hafiz B. Izhar

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Every key performance indicator used to monitor a project’s construction progress emphasizes trade productivity or specific commodity run-down curves. Examples include the productivity of welding by the number of joints completed per day, quantity of NDT (Non-Destructive Tests) inspection per day, etc. This perspective is based on progress and productivity; however, it does not enable a system perspective of how we produce. This paper uses a project production system perspective by which projects are a collection of production systems comprising the interconnected network of processes and operations that represent all the work activities to execute a project from start to finish. Furthermore, it also uses the 5 Levels of production system optimization as a frame. The goal of the paper is to describe the application of Project Production Control (PPC) to control and improve the performance of several production processes associated with the fabrication and assembly of a Central Processing Platform (CPP) Jacket, part of an offshore mega project. More specifically, the fabrication and assembly of buoyancy tanks as they were identified as part of the critical path and required the highest demand for capacity. In total, seven buoyancy tanks were built, with a total estimated weight of 2,200 metric tons. These huge buoyancy tanks were designed to be reversed launching and self-upending of the jacket, easily retractable, and reusable for the next project, ensuring sustainability. Results showed that an effective application of PPC not only positively impacted construction progress and productivity but also exposed sources of detrimental variability as the focus of continuous improvement practices. This approach augmented conventional project management practices, and the results had a high impact on construction scheduling, planning, and control.

Keywords: offshore, construction, project management, sustainability

Procedia PDF Downloads 59

Authors: Eric Sitorus, Septian Prahastudhi, Turgod Nainggolan, Erwin Riyanto

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Mining by block or panel caving is a mining method that takes advantage of fractures within an ore body, coupled with gravity, to extract material from a predetermined column of ore. The caving column is weakened from beneath through the use of undercutting, after which the ore breaks up and is extracted from below in a continuous cycle. The nature of this method induces cyclical stresses on the pillars of excavations as stress is built up and released over time, which has a detrimental effect on both the installed ground support and the rock mass itself. Ground support capacity, especially on the production where excavation void ratio is highest, is subjected to heavy loading. Strain above threshold of the elongation of support capacity can yield resulting in damage to excavations. Geotechnical engineers must evaluate not only the remnant capacity of ground support systems but also investigate depth of rock mass yield within pillars, backs and floors. Ground Penetrating Radar (GPR) is a geophysical method that has the ability to evaluate rock mass damage using electromagnetic waves. This paper illustrates a case study from the Grasberg mining complex where non-invasive information on the depth of damage and condition of the remaining rock mass was required. GPR with 100 MHz antenna resolution was used to obtain images of the subsurface to determine rehabilitation requirements prior to recommencing production activities. The GPR surveys were used to calibrate the reflection coefficient response of varying rock mass conditions to known Rock Quality Designation (RQD) parameters observed at the mine. The calibrated GPR survey allowed site engineers to map subsurface conditions and plan rehabilitation accordingly.

Keywords: block caving, ground penetrating radar, reflectivity, RQD

Procedia PDF Downloads 134

Authors: Medina Kadiri

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Blue-green otherwise called cyanobacteria, produce an array of biotoxins grouped into five categories notably hapatotoxins, neurotoxins, cytotoxins, dermatotoxins, and irritant toxins. Microcystins which are examples of hepatotoxins produced by blue-green algae Microcystins comprise the most common group of the cyanobacterial toxins. Blue-green algae flourish in aquatic environments, whether marine, brackish or freshwater, producing blooms in different forms such as microscopic, mats, or unsightly odoriferous scums. Microcystins biotoxins cause a plethora of animal and human hazards such as liver damage/cirrhosis and cancer, kidney damage, dermatitis, tinnitus, gastroenteritis, sore throat, nausea, myalgia, neurological problems, respiratory irritation and death. Water samples were collected from coastal regions of Nigeria in March 2014, June 2014, October 2014 and January 2015 and analyzed with Enzyme Linked Immunosorbent Assay (ELISA) kits. Microcystin biotoxin was recorded in all sites both during dry and wet seasons. The range of microcystins found was 0.000041-There was a seasonal trend of increasing microcystin concentrations from March till Octobers and a decrease thereafter. Generally in the oceanic waters, microcystin levels were highest at Cross Rivers in March and January, Barbeach in June and Lekki in October. In the adjoining riverine ecosystems, on the other hand, the highest concentrations of microcystin were observed at Akwa Ibom in March, June and October and in Bayelsa in January. Continuous monitoring and screening of coastal water bodies is suggested to minimize the health risks of cyanobacterial biotoxins to coastal communities of Nigeria.

Keywords: biotoxins, harmful algae, marine, microcystin, Nigeria

Procedia PDF Downloads 284

Authors: Fasil Wagnew, Kefyalew Addis Alene, Setegn Eshetie, Tom Wingfield, Matthew Kelly, Darren Gray

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Introduction: Undernutrition is a major and under-appreciated risk factor for TB, which is estimated to be responsible for 1.9 million TB cases per year globally. The effectiveness of micronutrient supplementation on TB treatment outcomes and its prognostic markers such as sputum conversion and serum zinc, retinol, and hemoglobin levels has been poorly understood. This systematic review and meta-analysis aimed to determine the association between zinc and vitamin A supplementation and TB treatment outcomes and its prognostic markers. Methods: A systematic literature search for randomized controlled trials (RCTs) was performed in PubMed, Embase, and Scopus databases. Meta-analysis with a random effect model was performed to estimate risk ratio (RR) and mean difference (MD), with a 95% confidence interval (CI), for dichotomous and continuous outcomes, respectively. Results: Our search identified 2,195 records. Of these, nine RCTs consisting of 1,375 participants were included in the final analyses. Among adults with pulmonary TB, zinc (RR: 0.94, 95%CI: 0.86, 1.03), vitamin A (RR: 0.90, 95%CI: 0.80, 1.01), and combined zinc and vitamin A (RR: 0.98, 95%CI: 0.89, 1.08) supplementation were not significantly associated with TB treatment success. Combined zinc and vitamin A supplementation was significantly associated with increased sputum smear conversion at 2 months (RR: 1.16, 95%CI: 1.03, 1.32), serum zinc levels at 2 months (MD of 0.86umol/l, 95% CI: 0.14, 1.57), serum retinol levels at 2 months (MD: 0.06umol/l, 95 % CI: 0.04, 0.08) and 6 months (MD: 0.12umol/l, 95 % CI: 0.10, 0.14), and serum hemoglobin level at 6 months (MD: 0.29 ug/dl, 95% CI: 0.08 to 0.51), among adults with TB. Conclusions: Providing zinc and vitamin A supplementation to adults with pulmonary TB during treatment may increase early sputum smear conversion, serum zinc, retinol, and hemoglobin levels. However, the use of zinc, vitamin A, or both were not associated with TB treatment success.

Keywords: zinc and vitamin A supplementation, tuberculosis, treatment outcomes, meta-analysis, RCT

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Authors: Yixin Yan, Miao Yan, Irini Angelidaki, Ioannis Fotidis

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Ammonia, which derives from the degradation of urea and protein-substrates, is the major toxicant of the commercial anaerobic digestion reactors causing loses of up to 1/3 of their practical biogas production, which reflects directly on the overall revenue of the plants. The current experimental work is aiming to alleviate the ammonia inhibition in anaerobic digestion (AD) process by developing an innovative bioaugmentation method of ammonia tolerant methanogenic consortia. The ammonia tolerant consortia were cultured in batch reactors and immobilized together with biochar in agar (customized inocula). Three continuous stirred-tank reactors (CSTR), fed with the organic fraction of municipal solid waste at a hydraulic retention time of 15 days and operated at thermophilic (55°C) conditions were assessed. After an ammonia shock of 4 g NH4+-N L-1, the customized inocula were bioaugmented into the CSTR reactors to alleviate ammonia toxicity effect on AD process. Recovery rate of methane production and methanogenic activity will be assessed to evaluate the bioaugmentation performance, while 16s rRNA gene sequence will be used to reveal the difference of microbial community changes through bioaugmentation. At the microbial level, the microbial community structures of the four reactors will be analysed to find the mechanism of bioaugmentation. Changes in hydrogen formation potential will be used to predict direct interspecies electron transfer (DIET) between ammonia tolerant methanogens and syntrophic bacteria. This experimental work is expected to create bioaugmentation inocula that will be easy to obtain, transport, handled and bioaugment in AD reactors to efficiently alleviate the ammonia toxicity, without alternating any of the other operational parameters including the ammonia-rich feedstocks.

Keywords: artisanal fishing waste, acidogenesis, volatile fatty acids, pH, inoculum/substrate ratio

Procedia PDF Downloads 127

Authors: Partha Sarathi Nayek, Abhiparna Dasgupta, Maheshreddy Gade

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Earth retaining structure plays a vital role in stabilizing unstable road cuts and slopes in the mountainous region. The retaining structures located in seismically active regions like the Himalayas may experience moderate to severe earthquakes. An earthquake produces two kinds of ground motion: permanent quasi-static displacement (fault rapture) on the fault rupture plane and transient vibration, traveling a long distance. There has been extensive research work to understand the dynamic behavior of retaining structures subjected to transient ground motions. However, understanding the effect caused by fault rapture phenomena on retaining structures is limited. The presence of shallow crustal active faults and natural slopes in the Himalayan region further highlights the need to study the response of retaining structures subjected to fault rupture phenomena. In this paper, an attempt has been made to understand the dynamic response of the cantilever retaining wall subjected to surface fault rupture. For this purpose, a 2D finite element model consists of a retaining wall, backfill and foundation have been developed using Abaqus 6.14 software. The backfill and foundation material are modeled as per the Mohr-Coulomb failure criterion, and the wall is modeled as linear elastic. In this present study, the interaction between backfill and wall is modeled as ‘surface-surface contact.’ The entire simulation process is divided into three steps, i.e., the initial step, gravity load step, fault rupture step. The interaction property between wall and soil and fixed boundary condition to all the boundary elements are applied in the initial step. In the next step, gravity load is applied, and the boundary elements are allowed to move in the vertical direction to incorporate the settlement of soil due to the gravity load. In the final step, surface fault rupture has been applied to the wall-backfill system. For this purpose, the foundation is divided into two blocks, namely, the hanging wall block and the footwall block. A finite fault rupture displacement is applied to the hanging wall part while the footwall bottom boundary is kept as fixed. Initially, a numerical analysis is performed considering the reverse fault mechanism with a dip angle of 45°. The simulated result is presented in terms of contour maps of permanent displacements of the wall-backfill system. These maps highlighted that surface fault rupture can induce permanent displacement in both horizontal and vertical directions, which can significantly influence the dynamic behavior of the wall-backfill system. Further, the influence of fault mechanism, dip angle, and surface fault rupture position is also investigated in this work.

Keywords: surface fault rupture, retaining wall, dynamic response, finite element analysis

Procedia PDF Downloads 106

Authors: Bulcha Belay Etana, Benny Malengier, Janarthanan Krishnamoorthy, Timothy Kwa, Lieva VanLangenhove

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Electromyography measures the electrical activity of muscles using surface electrodes or needle electrodes to monitor various disease conditions. Recent developments in the signal acquisition of electromyograms using textile electrodes facilitate wearable devices, enabling patients to monitor and control their health status outside of healthcare facilities. Here, we have developed and tested wearable textile electrodes to acquire electromyography signals from patients suffering from Parkinson’s disease and incorporated a feedback-control system to relieve muscle cramping through thermal stimulus. In brief, the textile electrodes made of stainless steel was knitted into a textile fabric as a sleeve, and their electrical characteristic, such as signal-to-noise ratio, was compared with traditional electrodes. To relieve muscle cramping, a heating element made of stainless-steel conductive yarn sewn onto cotton fabric, coupled with a vibration system, was developed. The system integrated a microcontroller and a Myoware muscle sensor to activate the heating element as well as the vibration motor when cramping occurs, and at the same time, the element gets deactivated when the muscle cramping subsides. An optimum therapeutic temperature of 35.5 °C is regulated by continuous temperature monitoring to deactivate the heating system when this threshold value is reached. The textile electrode exhibited a signal-to-noise ratio of 6.38dB, comparable to that of the traditional electrode’s value of 7.05 dB. For a given 9 V power supply, the rise time was about 6 minutes for the developed heating element to reach an optimum temperature.

Keywords: smart textile system, wearable electronic textile, electromyography, heating textile, vibration therapy, Parkinson’s disease

Procedia PDF Downloads 106

Authors: Maria Luiza D. Ramiento, Maria Lissette D. Lucas

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Electricity is said to serve as the backbone of modern technology. Considering this, electricity consumption has dynamically grown due to the continuous demand. An alternative producer of energy concerning electricity must therefore be given focus. Microbial fuel cell wholly characterizes a new method of renewable energy recovery: the direct conversion of organic matter to electricity using bacteria. Electricity is produced as fuel or new food is given to the bacteria. The study concentrated in determining the feasibility of electricity production from local benthic zones. Microbial fuel cells were constructed to harvest the possible electricity and to test the presence of electricity producing microorganisms. Soil samples were gathered from Calumpang River, Palawan Mangrove Forest, Rosario River and Batangas Port. Eleven modules were constructed for the different trials of the soil samples. These modules were made of cathode and anode chambers connected by a salt bridge. For 85 days, the harvested voltage was measured daily. No parameter is added for the first 24 days. For the next 61 days, acetic acid was included in the first and second trials of the modules. Each of the trials of the soil samples gave a positive result in electricity production.There were electricity producing microbes in local benthic zones. It is observed that the higher the organic content of the soil sample, the higher the electricity harvested from it. It is recommended to identify the specific species of the electricity-producing microorganism present in the local benthic zone. Complement experiments are encouraged like determining the kind of soil particles to test its effect on the amount electricity that can be harvested. To pursue the development of microbial fuel cells by building a closed circuit in it is also suggested.

Keywords: microbial fuel cell, benthic zone, electricity, reduction-oxidation reaction, bacteria

Procedia PDF Downloads 400

Authors: Oksana Razina, Shakeel Ahmad, Jessie Qun Ren, Olufemi Isiaq

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The modern life of businesses is categorically reliant on their established position online, where digital (and particularly website) content plays a significant role as the first point of information. Digital content, therefore, becomes essential – from making the first impression to the building and development of client relationships. Despite a number of valuable papers suggesting a strategic approach when dealing with digital data, other sources often do not view or accept the approach to digital content as a holistic or continuous process. Associations are frequently made with merely a one-off marketing campaign or similar. The challenge is to establish an agreed definition for the notion of Digital Content Strategy, which currently does not exist, as DCS is viewed from an excessive number of different angles. A strategic approach to content, nonetheless, is required, both practically and contextually. The researchers, therefore, aimed at attempting to identify the key content components comprising a digital content strategy to ensure all the aspects were covered and strategically applied – from the company’s understanding of the content value to the ability to display flexibility of content and advances in technology. This conceptual project evaluated existing literature on the topic of Digital Content Strategy (DCS) and related aspects, using the PRISMA Systematic Review Method, Document Analysis, Inclusion and Exclusion Criteria, Scoping Review, Snow-Balling Technique and Thematic Analysis. The data was collected from academic and statistical sources, government and relevant trade publications. Based on the suggestions from academics and trading sources related to the issues discussed, the researchers revealed the key actions for content creation and attempted to define the notion of DCS. The major finding of the study presented Key Content Components of Digital Content Strategy and can be considered for implementation in a business retail setting.

Keywords: digital content strategy, key content components, websites, digital marketing strategy

Procedia PDF Downloads 145

Authors: Kaveri Dutta, Ratna Sharma

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Indian traditional textile is a synthesis of various cultures. Art and crafts of a country showcases the rich cultural and artistic history of that nation. Prehistorically Indian handicrafts were basically made for day to day use; the yearning for aesthetic application soon saw the development of flooding designs and motifs. Similarly, Bagh print a traditional hand block Print with natural colours an Indian handicraft practiced in Bagh, Madhya Pradesh(India). Bagh print has its roots in Sindh, which is now a part of Pakistan. The present form of Bagh printing actually started in 1962 when the craftsmen migrated from Manavar to the neighboring town of Bagh situated in Madhya Pradesh and hence Bagh has always been associated with this printing style. Bagh printing basically involved blocks that are carved onto motifs that represent flora such as Jasmine, Mushroom leheriya and so on. There are some prints that were inspired by the jaali work that embellished the Taj Mahal and various other forts. Inspiration is also drawn from the landscapes and geometrical figures. The motifs evoke various moods in the serenity of the prints and that is the catchy element of Bagh prints. The development in this traditional textile is as essential as in another field. Nowadays fashion trends are fragile and innovative changes over existing fashion field in the short span is the demand of times. We must make efforts to preserve this cultural heritage of arts and crafts and this is done either by documenting the various ancient traditions or by making a blend of it. Since this craft is well known over the world, but the need is to document the original motif, fabric, technology and colors used in contemporary fashion. Hence keeping above points in mind this study on bagh print textiles of Madhya Pradesh work has been formulated. The information incorporated in the paper was based on secondary data taken from relevant books, journals, museum visit and articles. Besides for the demographic details and working profile of the artisans dealt with printing, an interview schedule was carried out in three regions of Madhya Pradesh. This work of art was expressed in Cotton fabric. For this study selected traditional motifs for Bang printing was used. Some of the popular traditional Bagh motifs are Jasmine, Mushroom leheriya, geometrical figures and jaali work. The Bagh printed cotton fabrics were developed into a range of men’s ethic wear in combination with embroideries from Rajasthan. Products developed were bandhgala jackets, kurtas, serwani and dupattas. From the present study, it can be observed that the embellished traditional Bang printed range of ethnic men’s wear resulted in the fresh and colourful pattern. The embroidered Bagh printed cotton fabric also created a huge change in a positive way among artisans of the three regions.

Keywords: art and craft of Madhya Pradesh, evolution of printing in India, history of Bagh printing, sources of inspiration

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Authors: V. N. Chebotkevich, E. E. Schetinkina, V. V. Burylev, E. I. Kaytandzhan, N. P. Stizhak

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Objective: Blood stream infections (BSI) are severe, life-threatening illness for immuno compromised patients with hematological malignancies. We report the trend in blood-stream infections in this group of patients in the period 1991-2013. Methods: A total of 4742 blood samples investigated. All blood cultures were incubated in a continuous monitoring system for 7 days before discarding negative. On signaled positive, organism was identified by conventional methods. The Real-time polymerase chain reaction (PCR) was used for the indication of human herpes virus 6 (HHV-6), Cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Results: Between 1991 and 2001 the incidence of Gram-positive bacteria (Staphylococcus epidermidis, Staphylococcus aureus) being the most common germs isolated (70,9%) were as Gram-negative rods (Escherichia coli, Klebsiella spp., Pseudomonas spp.) – 29,1%. In next decade 2002-2012 the number of Gram-negative bacteria was increased up to 40.2%. It is shown that the incidence of bacteremia was significantly more frequent at the background of detectable Cytomegalovirus and Epstein-Barr virus-specific DNA in blood. Over recent years, an increased frequency of micro mycetes was registered in blood of the patients with hematological malignancies (Candida spp. was predominant). Conclusion: Accurate and timely detection of BSI is important in determining appropriate treatment of infectious complications in patients with hematological malignancies. The isolation of Staphylococcus epidermidis from blood cultures remains a clinical dilemma for physicians and microbiologists. But in many cases this agent is of the clinical significance in immunocompromised patients with hematological malignancies. The role of CMV and EBV in development of bacteremia was demonstrated.

Keywords: infectious complications, blood stream infections, bacteremia, hemoblastosis

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Authors: Vibeke Sorensen, Nagaraju Thummanapalli, J. Stephen Lansing

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Inspired by the indigenous people of Borneo, Indonesia and their traditional bark cloth, artist and professor Vibeke Sorensen executed a “digital unwrapping” of several trees in Southeast Asia using a digital panorama camera and digitally “stitched” them together for printing onto sustainable silk and fashioning into the “Tree Dress”. This dress is a symbolic “un-wrapping” and “re-wrapping” of the tree’s bark onto a person as a second skin. The “digital bark” is directly responsive to the real tree through embedded and networked electronics that connect in real-time to sensors at the physical site of the living tree. LEDs and circuits inserted into the dress display the continuous measurement of the O2 / CO2, temperature, humidity, and light conditions at the tree. It is an “Internet of Living Things” (IOLT) textile that can be worn to track and interact with it. The computer system connecting the dress and the tree converts the gas emission data at the site of the real tree into sound and music as sonification. This communicates not only the scientific data but also translates it into a poetic representation. The wearer of the garment can symbolically identify with the tree, or “become one” with it by adorning its “skin.” In this way, the wearer also becomes a human agent for the tree, bringing its actual condition to direct perception of the wearer and others who may engage it. This project is an attempt to bring greater awareness to issues of deforestation by providing a direct access to living things separated by physical distance, and hopefully, to increase empathy for them by providing a way to sense individual trees and their daily existential condition through remote monitoring of data. Further extensions to this project and related issues of sustainability include the use of recycled and alternative plant materials such as bamboo and air plants, among others.

Keywords: IOLT, sonification, sustainability, tree, wearable technology

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Authors: Othman Maklouf, Abdunnaser Tresh

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Land vehicle navigation is subject of great interest today. Global Positioning System (GPS) is the main navigation system for positioning in such systems. GPS alone is incapable of providing continuous and reliable positioning, because of its inherent dependency on external electromagnetic signals. Inertial Navigation (INS) is the implementation of inertial sensors to determine the position and orientation of a vehicle. The availability of low-cost Micro-Electro-Mechanical-System (MEMS) inertial sensors is now making it feasible to develop INS using an inertial measurement unit (IMU). INS has unbounded error growth since the error accumulates at each step. Usually, GPS and INS are integrated with a loosely coupled scheme. With the development of low-cost, MEMS inertial sensors and GPS technology, integrated INS/GPS systems are beginning to meet the growing demands of lower cost, smaller size, and seamless navigation solutions for land vehicles. Although MEMS inertial sensors are very inexpensive compared to conventional sensors, their cost (especially MEMS gyros) is still not acceptable for many low-end civilian applications (for example, commercial car navigation or personal location systems). An efficient way to reduce the expense of these systems is to reduce the number of gyros and accelerometers, therefore, to use a partial IMU (ParIMU) configuration. For land vehicular use, the most important gyroscope is the vertical gyro that senses the heading of the vehicle and two horizontal accelerometers for determining the velocity of the vehicle. This paper presents a field experiment for a low-cost strap down (ParIMU)\GPS combination, with data post processing for the determination of 2-D components of position (trajectory), velocity and heading. In the present approach, we have neglected earth rotation and gravity variations, because of the poor gyroscope sensitivities of our low-cost IMU (Inertial Measurement Unit) and because of the relatively small area of the trajectory.

Keywords: GPS, IMU, Kalman filter, materials engineering

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Authors: Daniel Asiamah Ameyaw

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This research attempts to investigate how lecturer evaluation makes a difference in enhancing higher education teaching and learning processes. The research questions to guide this research work states first as, “What are the perspectives on the difference made by evaluating academic teachers in order to enhance higher education teaching and learning processes?” and second, “What are the implications of the findings for Policy and Practice?” Data for this research was collected mainly through interviewing and partly documents review. Data analysis was conducted under the framework of grounded theory. The findings showed that for individual lecturer level, lecturer evaluation provides a continuous improvement of teaching strategies, and serves as source of data for research on teaching. At the individual student level, it enhances students learning process; serving as source of information for course selection by students; and by making students feel recognised in the educational process. At the institutional level, it noted that lecturer evaluation is useful in personnel and management decision making; it assures stakeholders of quality teaching and learning by setting up standards for lecturers; and it enables institutions to identify skill requirement and needs as a basis for organising workshops. Lecturer evaluation is useful at national level in terms of guaranteeing the competencies of graduates who then provide the needed manpower requirement of the nation. Besides, it mentioned that resource allocation to higher educational institution is based largely on quality of the programmes being run by the institution. The researcher concluded, that the findings have implications for policy and practice, therefore, higher education managers are expected to ensure that policy is implemented as planned by policy-makers so that the objectives can successfully be achieved.

Keywords: academic quality, higher education, lecturer evaluation, teaching and learning processes

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Authors: Imad Abdelhamid El-Haci, Wissame Mazari, Fayçal Hassani, Fawzia Atik Bekkara

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Much attention has been paid to the antioxidants, which are expected to prevent food and living systems from peroxidative damage. Incorporation of synthetic antioxidants in food products is under strict regulation due to the potential health hazards caused by such compounds. The use of plants as traditional health remedies is very popular and important for 80% of the world’s population in African, Asian, Latin America and Middle Eastern Countries. Their use is reported to have minimal side effects. In recent years, pharmaceutical companies have spent considerable time and money in developing therapeutics based upon natural products extracted from plants. In other part, due to the continuous emergence of antibiotic-resistant strains there is continual demand for new antibiotics. Chemical compounds from medicinal plant especially are targeted by many researches. In this light, genus Polygonum (Polygonaceae), comprising about 45 genera (300 species), is distributed worldwide, mostly in north temperate regions. They have been reported to have uses in traditional medicine, such as anti-inflammation, promoting blood circulation, dysentery, diuretic, haemorrhage and many other uses. In our study, Polygonum maritimum (from Algerian coast) was extracted with 80% methanol to obtain a crude extract. P. maritimum extract (PME) had a very high content of total phenol, which was 352.49 ± 18.03 mg/g dry weight, expressed as gallic acid equivalent. PME exhibited excellent antioxidant activity, as measured using DPPH and H2O2 scavenging assays. It also showed a high antibacterial activity against gram positive bacterial strains: Bacillus cereus, Bacillus subtilis and Staphylococcus aureus with an MIC 0,12 mg/mL.

Keywords: Polygonum maritimum, crude extract, antioxidant activity, antibacterial activity

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Authors: Gopal Lamichhane, Biswash Sapkota, Grinsun Sharma, Mahendra Adhikari

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Urolithiasis is a condition in which insoluble or less soluble salts like oxalate, phosphate etc. precipitate in urinary tract and causes obstruction in ureter resulting renal colic or sometimes haematuria. It is the third most common disorder of urinary tract affecting nearly 2% of world’s population. Poor urinary drainage, microbial infection, oxalate and calcium containing diet, calciferol, hyperparathyroidism, cysteine in urine, gout, dysfunction of intestine, drought environment, lifestyle, exercise, stress etc. are risk factors for urolithiasis. Wide ranges of treatments are available in allopathic system of medicine but reoccurrence is unpreventable even with the surgical removal of stone or lithotripsy. So, people prefer alternative medicinal systems such as Unani, homeopathic, ayurvedic etc. systems of medicine due to their fewer side effects over allopathic counterpart. Different plants based ethnomedicines are being well established by their continuous effective use in human since long time in treatment of urinary problem. Many studies have scientifically proved those ethnomedicines for antiurolithiatic effect in animal and in vitro model. Plant-based remedies were found to be therapeutically effective for both prevention as well as cure of calcium oxalate urolithiasis. Plants were known to show these effects through a combination of many effects such as antioxidant, diuretic, hypocalciuric, urine alkalinizing effect in them. Berberine, triterpenoids, lupeol are the phytochemicals established for antiurolithiatic effect. Hence, plant-based medicine can be the effective herbal alternative as well as means of discovery of novel drug molecule for curing urolithiatic disorder and should be focused on further research to discover their value in coming future.

Keywords: urolithiasis, herbal medicine, ethnomedicine, kidney stone, calcium oxalate

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Authors: Gozel Judakova, Markus Bause

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We present and analyze reliable numerical techniques for simulating complex flow and transport phenomena related to natural gas transportation in pipelines. Such kind of problems are of high interest in the field of petroleum and environmental engineering. Modeling and understanding natural gas flow and transformation processes during transportation is important for the sake of physical realism and the design and operation of pipeline systems. In our approach a two fluid flow model based on a system of coupled hyperbolic conservation laws is considered for describing natural gas flow undergoing hydratization. The accurate numerical approximation of two-phase gas flow remains subject of strong interest in the scientific community. Such hyperbolic problems are characterized by solutions with steep gradients or discontinuities, and their approximation by standard finite element techniques typically gives rise to spurious oscillations and numerical artefacts. Recently, stabilized and discontinuous Galerkin finite element techniques have attracted researchers’ interest. They are highly adapted to the hyperbolic nature of our two-phase flow model. In the presentation a streamline upwind Petrov-Galerkin approach and a discontinuous Galerkin finite element method for the numerical approximation of our flow model of two coupled systems of Euler equations are presented. Then the efficiency and reliability of stabilized continuous and discontinous finite element methods for the approximation is carefully analyzed and the potential of the either classes of numerical schemes is investigated. In particular, standard benchmark problems of two-phase flow like the shock tube problem are used for the comparative numerical study.

Keywords: discontinuous Galerkin method, Euler system, inviscid two-fluid model, streamline upwind Petrov-Galerkin method, twophase flow

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Authors: Alvyra Galkienė, Ona Monkevičienė

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The full participation of all pupils in the overall educational process is defined by the concept of inclusive education, which is gradually evolving in education policy and practice. It includes the full participation of all pupils in a shared learning experience and educational practices that address barriers to learning. Inclusive education applying the principles of Universal Design for Learning (UDL), which includes promoting students' involvement in learning processes, guaranteeing a deep understanding of the analysed phenomena, initiating self-directed learning, and using e-tools to create a barrier-free environment, is a prerequisite for the personal success of each pupil. However, the sustainability of quality education is affected by the transformation of education systems. This was particularly evident during the period of the forced transition from contact to distance education in the COVID-19 pandemic. Research Problem: The transformation of the educational environment from real to virtual one and the loss of traditional forms of educational support highlighted the need for new research, revealing the individual profiles of teachers using UDL-based learning and the pathways of sustainable transfer of successful practices to non-conventional learning environments. Research Methods: In order to identify individual latent teacher profiles that encompass the essential components of UDL-based inclusive teaching and direct leadership of students' learning, the quantitative analysis software Mplius was used for latent profile analysis (LPA). In order to reveal proven, i.e., sustainable, pathways for the transit of the components of UDL-based inclusive learning to distance learning, latent profile transit analysis (LPTA) via Mplius was used. An online self-reported questionnaire was used for data collection. It consisted of blocks of questions designed to reveal the experiences of subject teachers in contact and distance learning settings. 1432 Lithuanian, Latvian, and Estonian subject teachers took part in the survey. Research Results: The LPA analysis revealed eight latent teacher profiles with different characteristics of UDL-based inclusive education or traditional teaching in contact teaching conditions. Only 4.1% of the subject teachers had a profile characterised by a sustained UDL approach to teaching: promoting pupils' self-directed learning; empowering pupils' engagement, understanding, independent action, and expression; promoting pupils' e-inclusion; and reducing the teacher's direct supervision of the students. Other teacher profiles were characterised by limited UDL-based inclusive education either due to the lack of one or more of its components or to the predominance of direct teacher guidance. The LPTA analysis allowed us to highlight the following transit paths of teacher profiles in the extreme conditions of the transition from contact to distance education: teachers staying in the same profile of UDL-based inclusive education (sustainable transit) or jumping to other profiles (unsustainable transit in case of barriers), and teachers from other profiles moving to this profile (ongoing transit taking advantage of the changed new possibilities in the teaching process).

Keywords: distance education, latent teacher profiles, sustainable transit, UDL

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Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

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Authors: M. Shaheed Hartley

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Science and mathematics are regarded as gateway subjects in South Africa as they are the perceived route to careers in science, engineering, technology and mathematics (STEM). One of the biggest challenges that the country faces is the poor achievement of learners in these two learning areas in the external high school exit examination. To compound the problem many national and international benchmark tests paint a bleak picture of the state of science and mathematics in the country. In an attempt to address this challenge, the education department of the Eastern Cape Province invited the Science Learning Centre of the University of the Western Cape to provide training to their science teachers in the form of a structured course conducted on a part-time basis in 2010 and 2011. The course was directed at improving teachers’ content knowledge, pedagogical strategies and practical and experimental skills. A total of 41 of the original 50 science teachers completed the course and received their certificates in 2012. As part of their continuous professional development, 31 science teachers enrolled for BEd Hons in science education in 2013 and 28 of them completed the course in 2014. These students graduated in 2015. Of the 28 BEd Hons students who completed the course 23 registered in 2015 for Masters in Science Education and were joined by an additional 3 students. This paper provides a reflection by science educators on the training, supervision and mentorship provided to them as students of science education. The growth and development of students through their own reflection and understanding as well as through the eyes of the lecturers and supervisors that took part in the training provide the evaluation of the professional development process over the past few years. This study attempts to identify the merits, challenges and limitations of this project and the lessons to be learnt on such projects. It also documents some of the useful performance indicators with a view to developing a framework for good practice for such programmes.

Keywords: reflection, science education, professional development, rural schools

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Authors: Fangyuan Shao, Wei Liu, Deli Gao

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Polycrystalline diamond compact (PDC) bits have occupied a large market of unconventional oil and gas drilling. The application of PDC bits benefits from the efficient rock breaking of PDC cutters. In response to increasingly complex formations, many shaped cutters have been invited, but many of them have not been solved by the mechanism of rock breaking. In this paper, two kinds of PDC cutters: a new axe-shaped (NAS) cutter and cylindrical cutter (benchmark) were studied by laboratory experiments. NAS cutter is obtained by optimizing two sides of axe-shaped cutter with curved surfaces. All the cutters were put on a vertical turret lathe (VTL) in the laboratory for cutting tests. According to the cutting distance, the VTL tests can be divided into two modes: single-turn rotary cutting and continuous cutting. The cutting depth of cutting (DOC) was set at 1.0 mm and 2.0 mm in the former mode. The later mode includes a dry VTL test for thermal stability and a wet VTL test for wear resistance. Load cell and 3D optical profiler were used to obtain the value of cutting forces and wear area, respectively. Based on the findings of the single-turn rotary cutting VTL tests, the performance of A NAS cutter was better than the benchmark cutter on elastoplastic material cutting. The cutting forces (normal forces, tangential force, and radial force) and special mechanical energy (MSE) of a NAS cutter were lower than that of the benchmark cutter under the same condition. It meant that a NAS cutter was more efficient on elastoplastic material breaking. However, the wear resistance of a new axe-shaped cutter was higher than that of a benchmark cutter. The results of the dry VTL test showed that the thermal stability of a NAS cutter was higher than that of a benchmark cutter. The cutting efficiency can be improved by optimizing the geometric structure of the PDC cutter. The change of thermal stability may be caused by the decrease of the contact area between cutter and rock at given DOC. The conclusions of this paper can be used as an important reference for PDC cutters designers.

Keywords: axe-shaped cutter, PDC cutter, rotary cutting test, vertical turret lathe

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Authors: Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail, Brian Davies

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The construction industry, particularly tunnel construction, exposes workers to respirable crystalline silica (RCS), which can cause incurable illnesses such as silicosis and lung cancer. Despite various control measures, exposures remain inadequately controlled. This research aimed to identify the barriers and challenges hindering the implementation of effective controls and the adoption of safe work practices to protect workers from RCS exposure in tunnelling. A mixed-method approach was employed for this research. Tunnel construction workers were observed, surveyed and interviewed to gauge their knowledge and attitudes and understand their challenges in reducing RCS exposure. The preliminary analysis of the data reveals a diverse array of sociotechnical factors interacting to influence RCS exposure. It is noteworthy that participants consistently emphasised the project as the most exemplary one they have been involved in, although there is room for improvement. While there is a commendable level of knowledge about RCS exposure and control in tunnelling, there is a striking lack of perceived satisfaction regarding dust control. Several factors were identified as interacting to prevent the effective management of dust. These include perceived time pressure, absence of on-tool dust controls, low risk perceptions among workers, and inadequate enforcement of controls. Moreover, participants highlighted communication and heat-related challenges as hindrances to the continuous wear of respirators. This research highlights the need for a paradigm shift in tunnel construction to address the barriers associated with RCS exposure reduction. It emphasises the importance of collaboration among various stakeholders, advocating for more effective controls and enforcement strategies and enhanced worker education through knowledge sharing.

Keywords: respirable crystalline silica, dust control, worker practices, exposure prevention, silicosis

Procedia PDF Downloads 68

Authors: L. Angiuli, L. Trizio, R. Giua, A. Digilio, M. Tutino, P. Dambruoso, F. Mazzone, C. M. Placentino

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In the winter of 2014 a series of measurements were performed to evaluate the behavior of real-time PAHs and black carbon analyzers in a coke oven plant located in Taranto, a city of Southern Italy. Data were collected both insides than outside the plant, at air quality monitoring sites. Contemporary measures of PM2.5 and PM1 were performed. Particle-bound PAHs were measured by two methods: (1) aerosol photoionization using an Ecochem PAS 2000 analyzer, (2) PM2.5 and PM1 quartz filter collection and analysis by gas chromatography/mass spectrometry (GC/MS). Black carbon was determined both in real-time by Magee Aethalometer AE22 analyzer than by semi-continuous Sunset Lab EC/OC instrument. Detected PM2.5 and PM1 levels were higher inside than outside the plant while PAHs real-time values were higher outside than inside. As regards PAHs, inside the plant Ecochem PAS 2000 revealed concentrations not significantly different from those determined on the filter during low polluted days, but at increasing concentrations the automated instrument underestimated PAHs levels. At the external site, Ecochem PAS 2000 real-time concentrations were steadily higher than those on the filter. In the same way, real-time black carbon values were constantly lower than EC concentrations obtained by Sunset EC/OC in the inner site, while outside the plant real-time values were comparable to Sunset EC values. Results showed that in a coke plant real-time analyzers of PAHs and black carbon in the factory configuration provide qualitative information, with no accuracy and leading to the underestimation of the concentration. A site specific calibration is needed for these instruments before their installation in high polluted sites.

Keywords: black carbon, coke oven plant, PAH, PAS, aethalometer

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Authors: Sigal Portnoy, Jason Friedman, Eitan Raveh

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Introduction: Sensory substitution is possible due to the capacity of our brain to adapt to information transmitted by a synthetic receptor via an alternative sensory system. Practical sensory substitution systems are being developed in order to increase the functionality of individuals with sensory loss, e.g. amputees. For upper limb prosthetic-users the loss of tactile feedback compels them to allocate visual attention to their prosthesis. The effect of adding vibrotactile feedback (VTF) to the applied force has been studied, however its effect on the allocation if visual attention during dual-tasking and the response during misleading visual feedback have not been studied. We hypothesized that VTF will improve the performance and reduce visual attention during dual-task assignments in healthy individuals using a robotic hand and improve the performance in a standardized functional test, despite the presence of misleading visual feedback. Methods: For the dual-task paradigm, twenty healthy subjects were instructed to toggle two keyboard arrow keys with the left hand to retain a moving virtual car on a road on a screen. During the game, instructions for various activities, e.g. mix the sugar in the glass with a spoon, appeared on the screen. The subject performed these tasks with a robotic hand, attached to the right hand. The robotic hand was controlled by the activity of the flexors and extensors of the right wrist, recorded using surface EMG electrodes. Pressure sensors were attached at the tips of the robotic hand and induced VTF using vibrotactile actuators attached to the right arm of the subject. An eye-tracking system tracked to visual attention of the subject during the trials. The trials were repeated twice, with and without the VTF. Additionally, the subjects performed the modified box and blocks, hidden from eyesight, in a motion laboratory. A virtual presentation of a misleading visual feedback was be presented on a screen so that twice during the trial, the virtual block fell while the physical block was still held by the subject. Results: This is an ongoing study, which current results are detailed below. We are continuing these trials with transradial myoelectric prosthesis-users. In the healthy group, the VTF did not reduce the visual attention or improve performance during dual-tasking for the tasks that were typed transfer-to-target, e.g. place the eraser on the shelf. An improvement was observed for other tasks. For example, the average±standard deviation of time to complete the sugar-mixing task was 13.7±17.2s and 19.3±9.1s with and without the VTF, respectively. Also, the number of gaze shifts from the screen to the hand during this task were 15.5±23.7 and 20.0±11.6, with and without the VTF, respectively. The response of the subjects to the misleading visual feedback did not differ between the two conditions, i.e. with and without VTF. Conclusions: Our interim results suggest that the performance of certain activities of daily living may be improved by VTF. The substitution of visual sensory input by tactile feedback might require a long training period so that brain plasticity can occur and allow adaptation to the new condition.

Keywords: prosthetics, rehabilitation, sensory substitution, upper limb amputation

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Authors: Mailin Misson, Bo Jin, Sheng Dai, Hu Zhang

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Advances in biotechnology have witnessed a growing interest in enzyme applications for the development of green and sustainable bio processes. While known as powerful bio catalysts, enzymes are no longer of economic value when extended to large commercialization. Alternatively, immobilization technology allows enzyme recovery and continuous reuse which subsequently compensates high operating costs. Employment of enzymes on nano structured materials has been recognized as a promising approach to enhance enzyme catalytic performances. High porosity, inter connectivity and self-assembling behaviors endow nano fibers as exciting candidate for enzyme carrier in bio reactor systems. In this study, nano fibers were successfully fabricated via electro spinning system by optimizing the polymer concentration (10-30 %, w/v), applied voltage (10-30 kV) and discharge distance (11-26 cm). Microscopic images have confirmed the quality as homogeneous and good fiber alignment. The nano fibers surface was modified using strong oxidizing agent to facilitate bio molecule binding. Bovine serum albumin and β-galactosidase enzyme were employed as model bio catalysts and immobilized onto the oxidized surfaces through covalent binding. Maximum enzyme adsorption capacity of the modified nano fibers was 3000 mg/g, 3-fold higher than the unmodified counterpart (1000 mg/g). The highest immobilization yield was 80% and reached the saturation point at 2 mg/ml of enzyme concentration. The results indicate a significant increase of activity retention by the enzyme-bound modified nano fibers (80%) as compared to the nascent one (60%), signifying excellent enzyme-nano carrier bio compatibility. The immobilized enzyme was further used for the bio conversion of dairy wastes into value-added products. This study demonstrates great potential of acid-modified electrospun polystyrene nano fibers as enzyme carriers.

Keywords: immobilization, enzyme, nanocarrier, nanofibers

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Authors: Saeed Poormoaied

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Perishability and developing an intelligent control policy for perishable items are the major concerns of marketing managers in a supply chain. In this study, we address a two-echelon supply chain problem for perishable items with a single vendor and a single buyer. The buyer adopts an aged-based continuous review policy which works by taking both the stock level and the aging process of items into account. The vendor works under the warehouse framework, where its lot size is determined with respect to the batch size of the buyer. The model holds for a positive and fixed lead time for the buyer, and zero lead time for the vendor. The demand follows a Poisson process and any unmet demand is lost. We provide exact analytic expressions for the operational characteristics of the system by using the renewal reward theorem. Items have a fixed lifetime after which they become unusable and are disposed of from the buyer's system. The age of items starts when they are unpacked and ready for the consumption at the buyer. When items are held by the vendor, there is no aging process which results in no perishing at the vendor's site. The model is developed under the centralized framework, which takes the expected profit of both vendor and buyer into consideration. The goal is to determine the optimal policy parameters under the service level constraint at the retailer's site. A sensitivity analysis is performed to investigate the effect of the key input parameters on the expected profit and order quantity in the supply chain. The efficiency of the proposed age-based policy is also evaluated through a numerical study. Our results show that when the unit perishing cost is negligible, a significant cost saving is achieved.

Keywords: two-echelon supply chain, perishable items, age-based policy, renewal reward theorem

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

Procedia PDF Downloads 139

Authors: Jawaher F. Alsharef, Abdullah A. Ghaddaf, Mohammed S. Alomari, Abdullah A. Al Qurashi, Ahmed S. Abdulhamid, Mohammed S. Alshehri, Majed Alosaimi

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Botulinum toxin type A (BTX-A) is the most popular therapeutic agent for muscle relaxation and pain control. Lately, BTX-A injection received great interest as a part of multimodal pain management for lower limb lengthening and deformity correction. This systematic review aimed to determine the role of BTX-A injection in pain management for during lower limb lengthening and/or deformity correction. We searched Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared the BTX-A injection to placebo for individuals undergoing lower limb lengthening and/or deformity correction. We sought to evaluate the following outcomes: pain on visual analogue scale (VAS), range of motion parameters, average opioid consumption, and adverse events. The standardized mean difference (SMD) was used to represent continuous outcomes while risk ratio (RR) was used to represent dichotomous outcomes. A total of 4 RCTs that enrolled 257 participants (337 limbs) deemed eligible. Adjuvant BTX-A injection showed a significant reduction in post-operative pain compared to placebo (SMD=–0.28, 95% CI –0.53 to –0.04). No difference was found between BTX-A injection and placebo in terms of range of motion parameters, average opioid consumption, or adverse events after surgical limb lengthening and/or deformity correction (RR= 0.77, 95% CI –0.58 to 1.03). Conclusions: Adjuvant BTX-A injection conferred a discernible reduction in post-operative pain during surgical limb lengthening and/or deformity without increasing the risk of adverse events.

Keywords: botulinum toxin type A, limb lengthening, distraction osteogenesis, deformity correction, pain management

Procedia PDF Downloads 142