Search results for: Lateral Geniculate Nucleus
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 880

Search results for: Lateral Geniculate Nucleus

730 Lateral Retroperitoneal Transpsoas Approach: A Practical Minimal Invasive Surgery Option for Treating Pyogenic Spondylitis of the Lumbar Vertebra

Authors: Sundaresan Soundararajan, Chor Ngee Tan

Abstract:

Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

Procedia PDF Downloads 145
729 Association of Laterality and Sports Specific Rotational Preference with Number of Injuries in Artistic Gymnasts

Authors: Teja Joshi

Abstract:

Laterality has shown to play a role in performance as well as injuries especially in unilateral sports disciplines. Uniquely, Artistic Gymnastics involves combination of unilateral, bilateral and complex multi-planer elements as well as gymnastics specific rotational preference. Therefore, this study was conducted to explore if any such preferences are associated with number of injuries in artistic gymnasts. To explore the association between lateral preferences, rotational preferences and injuries incidence in artistic gymnastics. Artistic gymnasts above 16 years of age, were invited to participate in an online survey. The survey included consent, lateral preference inventory, injury data collection according to anatomical locations and rotational preference for selected gymnastics elements performed on the floor exercise. SPSS version 24 was used to analyse Non-parametric data using Kruskal-Wallis (K- independent test) test. Multiple regression was performed to identify the predictor for injuries and their side in gymnasts. Total number of injuries per gymnast was associated with handedness (p value-0.049) and no significant association was noted for footdness (p value-0.207), eyedness (p value-0.491) and eardness (p value-0.798). Additionally, rotational preferences did not influence number of injuries (p value-0.521). In multiple regression, eyedness was identified as a predicting factor to determine the number of injuries. Rotational preferences were neither determined as a national strategy nor a product of lateral preference. Dominant hand had higher number of injuries in artistic gymnasts. Rotational preference is independent of laterality, number of injuries and nationality.

Keywords: sports injury, rotational preference, gymnastics, handedness

Procedia PDF Downloads 83
728 Influence of Footing Offset over Stability of Geosynthetic Reinforced Soil Abutments with Variable Facing under Lateral Excitation

Authors: Ashutosh Verma, Satyendra MIttal

Abstract:

The loss of strength at the facing-reinforcement interface brought on by the seasonal thermal expansion/contraction of the bridge deck has been responsible for several geosynthetic reinforced soil abutment failures over the years. This results in excessive settlement below the bridge seat, which results in bridge bumps along the approach road and shortens abutment's design life. There are surely a wide variety of facing configurations available to designers when choosing the sort of facade. These layouts can generally be categorised into three groups: continuous, full height rigid (FHR) and modular (panels/block). The current work aims to experimentally explore the behavior of these three facing categories using 1g physical model testing under serviceable cyclic lateral displacements. With configurable facing arrangements to represent these three facing categories, a field instrumented GRS abutment prototype was modelled into a N scaled down 1g physical model (N = 5) to reproduce field behavior. Peak earth pressure coefficient (K) on the facing and vertical settlement of the footing (s/B) for footing offset (x/H) as 0.1, 0.2, 0.3, 0.4 and 0.5 at 100 cycles have been measured for cyclic lateral displacement of top of facing at loading rate of 1mm/min. Three types of cyclic displacements have been carried out to replicate active condition (CA), passive condition (CP), and active-passive condition (CAP) for each footing offset. The results demonstrated that a significant decrease in the earth pressure over the facing occurs when footing offset increases. It is worth noticing that the highest rate of increment in earth pressure and footing settlement were observed for each facing configuration at the nearest footing offset. Interestingly, for the farthest footing offset, similar responses of each facing type were observed, which indicates that the upon reaching a critical offset point presumably beyond the active region in the backfill, the lateral responses become independent of the stresses from the external footing load. Evidently, the footing load complements the stresses developed due to lateral excitation resulting in significant footing settlements for nearer footing offsets. The modular facing proved inefficient in resisting footing settlement due to significant buckling along the depth of facing. Instead of relative displacement along the depth of facing, continuous facing rotates around the base when it fails, especially for nearer footing offset causing significant depressions in the backfill area surrounding the footing. FHR facing, on the other hand, have been successful in confining the stresses in the soil domain itself reducing the footing settlement. It may be suitably concluded that increasing the footing offset may render stability to the GRS abutment with any facing configuration even for higher cycles of excitation.

Keywords: GRS abutments, 1g physical model, footing offset, cyclic lateral displacement

Procedia PDF Downloads 56
727 Comparative Study on Efficacy and Clinical Outcomes in Minimally Invasive Surgery Transforaminal Interbody Fusion vs Minimally Invasive Surgery Lateral Interbody Fusion

Authors: Sundaresan Soundararajan, George Ezekiel Silvananthan, Chor Ngee Tan

Abstract:

Introduction: Transforaminal Interbody Fusion (TLIF) has been adopted for many decades now, however, XLIF, still in relative infancy, has grown to be accepted as a new Minimally Invasive Surgery (MIS) option. There is a paucity of reports directly comparing lateral approach surgery to other MIS options such as TLIF in the treatment of lumbar degenerative disc diseases. Aims/Objectives: The objective of this study was to compare the efficacy and clinical outcomes between Minimally Invasive Transforaminal Interbody Fusion (TLIF) and Minimally Invasive Lateral Interbody Fusion (XLIF) in the treatment of patients with degenerative disc disease of the lumbar spine. Methods: A single center, retrospective cohort study involving a total of 38 patients undergoing surgical intervention between 2010 and 2013 for degenerative disc disease of lumbar spine at single L4/L5 level. 18 patients were treated with MIS TLIF, and 20 patients were treated with XLIF. Results: The XLIF group showed shorter duration of surgery compared to the TLIF group (176 mins vs. 208.3 mins, P = 0.03). Length of hospital stay was also significantly shorter in XLIF group (5.9 days vs. 9 days, p = 0.03). Intraoperative blood loss was favouring XLIF as 85% patients had blood loss less than 100cc compared to 58% in the TLIF group (P = 0.03). Radiologically, disc height was significantly improved post operatively in the XLIF group compared to the TLIF group (0.56mm vs. 0.39mm, P = 0.01). Foraminal height increment was also higher in the XLIF group (0.58mm vs. 0.45mm , P = 0.06). Clinically, back pain and leg pain improved in 85% of patients in the XLIF group and 78% in the TLIF group. Post op hip flexion weakness was more common in the XLIF group (40%) than in the TLIF group (0%). However, this weakness resolved within 6 months post operatively. There was one case of dural tear and surgical site infection in the TLIF group respectively and none in the XLIF group. Visual Analog Scale (VAS) score 6 months post operatively showed comparable reduction in both groups. TLIF group had Owsterty Disability Index (ODI) improvement on 67% while XLIF group showed improvement of 70% of its patients. Conclusions: Lateral approach surgery shows comparable clinical outcomes in resolution of back pain and radiculopathy to conventional MIS techniques such as TLIF. With significantly shorter duration of surgical time, minimal blood loss and shorter hospital stay, XLIF seems to be a reasonable MIS option compared to other MIS techniques in treating degenerative lumbar disc diseases.

Keywords: extreme lateral interbody fusion, lateral approach, minimally invasive, XLIF

Procedia PDF Downloads 182
726 X-Bracing Configuration and Seismic Response

Authors: Saeed Rahjoo, Babak H. Mamaqani

Abstract:

Concentric bracing systems have been in practice for many years because of their effectiveness in reducing seismic response. Depending on concept, seismic design codes provide various response modification factors (R), which itself consists of different terms, for different types of lateral load bearing systems but configuration of these systems are often ignored in the proposed values. This study aims at considering the effect of different x-bracing diagonal configuration on values of ductility dependent term in R computation. 51 models were created and nonlinear push over analysis has been performed. The main variables of this study were the suitable location of X–bracing diagonal configurations, which establishes better nonlinear behavior in concentric braced steel frames. Results show that some x-bracing diagonal configurations improve the seismic performance of CBF significantly and explicit consideration of lateral load bearing systems seems necessary.

Keywords: bracing configuration, concentrically braced frame (CBF), push over analyses, response reduction factor

Procedia PDF Downloads 318
725 Improvement of Ride Comfort of Turning Electric Vehicle Using Optimal Speed Control

Authors: Yingyi Zhou, Tohru Kawabe

Abstract:

With the spread of EVs (electric Vehicles), the ride comfort has been gaining a lot of attention. The influence of the lateral acceleration is important for the improvement of ride comfort of EVs as well as the longitudinal acceleration, especially upon turning of the vehicle. Therefore, this paper proposes a practical optimal speed control method to greatly improve the ride comfort in the vehicle turning situation. For consturcting this method, effective criteria that can appropriately evaluate deterioration of ride comfort is derived. The method can reduce the influence of both the longitudinal and the lateral speed changes for providing a confortable ride. From several simulation results, we can see the fact that the method can prevent aggravation of the ride comfort by suppressing the influence of longitudinal speed change in the turning situation. Hence, the effectiveness of the method is recognized.

Keywords: electric vehicle, speed control, ride comfort, optimal control theory, driving support system

Procedia PDF Downloads 184
724 Analysis Rotor Bearing System Dynamic Interaction with Bearing Supports

Authors: V. T. Ngo, D. M. Xie

Abstract:

Frequently, in the design of machines, some of parameters that directly affect the rotor dynamics of the machines are not accurately known. In particular, bearing stiffness support is one such parameter. One of the most basic principles to grasp in rotor dynamics is the influence of the bearing stiffness on the critical speeds and mode shapes associated with a rotor-bearing system. Taking a rig shafting as an example, this paper studies the lateral vibration of the rotor with multi-degree-of-freedom by using Finite Element Method (FEM). The FEM model is created and the eigenvalues and eigenvectors are calculated and analyzed to find natural frequencies, critical speeds, mode shapes. Then critical speeds and mode shapes are analyzed by set bearing stiffness changes. The model permitted to identify the critical speeds and bearings that have an important influence on the vibration behavior.

Keywords: lateral vibration, finite element method, rig shafting, critical speed

Procedia PDF Downloads 309
723 Special Features Of Phacoemulsification Technique For Dense Cataracts

Authors: Shilkin A.G., Goncharov D.V., Rotanov D.A., Voitecha M.A., Kulyagina Y.I., Mochalova U.E.

Abstract:

Context: Phacoemulsification is a surgical technique used to remove cataracts, but it has a higher number of complications when dense cataracts are present. The risk factors include thin posterior capsule, dense nucleus fragments, and prolonged exposure to high-power ultrasound. To minimize these complications, various methods are used. Research aim: The aim of this study is to develop and implement optimal methods of ultrasound phacoemulsification for dense cataracts in order to minimize postoperative complications. Methodology: The study involved 36 eyes of dogs with dense cataracts over a period of 5 years. The surgeries were performed using a LEICA 844 surgical microscope and an Oertli Faros phacoemulsifier. The surgical techniques included the optimal technique for breaking the nucleus, bimanual surgery, and the use of Akahoshi prechoppers. Findings: The complications observed during the surgery included rupture of the posterior capsule and the need for anterior vitrectomy. Complications in the postoperative period included corneal edema and uveitis. Theoretical importance: This study contributes to the field by providing insights into the special features of phacoemulsification for dense cataracts. It highlights the importance of using specific techniques and settings to minimize complications. Data collection and analysis procedures: The data for the study were collected from surgeries performed on dogs with dense cataracts. The complications were documented and analyzed. Question addressed: The study addressed the question of how to minimize complications during phacoemulsification surgery for dense cataracts. Conclusion: By following the optimal techniques, settings, and using prechoppers, the surgery for dense cataracts can be made safer and faster, minimizing the risks and complications.

Keywords: dense cataracts, phacoemulsification, phacoemulsification of cataracts in elderly dogs, осложнения факоэмульсификации

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722 Development of a Finite Element Model of the Upper Cervical Spine to Evaluate the Atlantoaxial Fixation Techniques

Authors: Iman Zafarparandeh, Muzammil Mumtaz, Paniz Taherzadeh, Deniz Erbulut

Abstract:

The instability in the atlantoaxial joint may occur due to cervical surgery, congenital anomalies, and trauma. There are different types of fixation techniques proposed for restoring the stability and preventing harmful neurological deterioration. Application of the screw constructs has become a popular alternative to the older techniques for stabilizing the joint. The main difference between the various screw constructs is the type of the screw which can be lateral mass screw, pedicle screw, transarticular screw, and translaminar screw. The aim of this paper is to study the effect of three popular screw constructs fixation techniques on the biomechanics of the atlantoaxial joint using the finite element (FE) method. A three-dimensional FE model of the upper cervical spine including the skull, C1 and C2 vertebrae, and groups of the existing ligaments were developed. The accurate geometry of the model was obtained from the CT data of a 35-year old male. Three screw constructs were designed to compare; Magerl transarticular screw (TA-Screw), Goel-Harms lateral mass screw and pedicle screw (LM-Screw and Pedicle-Screw), and Wright lateral mass screw and translaminar screw (LM-Screw and TL-Screw). Pure moments were applied to the model in the three main planes; flexion (Flex), extension (Ext), axial rotation (AR) and lateral bending (LB). The range of motion (ROM) of C0-C1 and C1-C2 segments for the implanted FE models are compared to the intact FE model and the in vitro study of Panjabi (1988). The Magerl technique showed less effect on the ROM of C0-C1 than the other two techniques in sagittal plane. In lateral bending and axial rotation, the Goel-Harms and Wright techniques showed less effect on the ROM of C0-C1 than the Magerl technique. The Magerl technique has the highest fusion rate as 99% in all loading directions for the C1-C2 segment. The Wright technique has the lowest fusion rate in LB as 79%. The three techniques resulted in the same fusion rate in extension loading as 99%. The maximum stress for the Magerl technique is the lowest in all load direction compared to other two techniques. The maximum stress in all direction was 234 Mpa and occurred in flexion with the Wright technique. The maximum stress for the Goel-Harms and Wright techniques occurred in lateral mass screw. The ROM obtained from the FE results support this idea that the fusion rate of the Magerl is more than 99%. Moreover, the maximum stress occurred in each screw constructs proves the less failure possibility for the Magerl technique. Another advantage of the Magerl technique is the less number of components compared to other techniques using screw constructs. Despite the benefits of the Magerl technique, there are drawbacks to using this method such as reduction of the C1 and C2 before screw placement. Therefore, other fixation methods such as Goel-Harms and Wright techniques find the solution for the drawbacks of the Magerl technique by adding screws separately to C1 and C2. The FE model implanted with the Wright technique showed the highest maximum stress almost in all load direction.

Keywords: cervical spine, finite element model, atlantoaxial, fixation technique

Procedia PDF Downloads 355
721 Modified Side Plate Design to Suppress Lateral Torsional Buckling of H-Beam for Seismic Application

Authors: Erwin, Cheng-Cheng Chen, Charles J. Salim

Abstract:

One of the method to solve the lateral torsional buckling (LTB) problem is by using side plates to increased the buckling resistance of the beam. Some modifications in designing the side plates are made in this study to simplify the construction in the field and reduce the cost. At certain region, side plates are not added: (1) At the beam end to preserve some spaces for bolt installation, but the beam is strengthened by adding cover plate at both flanges and (2) at the middle span of the beam where the moment is smaller. Three small scale full span beam specimens are tested under cyclic loading to investigate the LTB resistant and the ductility of the proposed design method. Test results show that the LTB deformation can be effectively suppressed and very high ductility level can be achieved. Following the test, a finite element analysis (FEA) model is established and is verified using the test results. An intensive parametric study is conducted using the established FEA model. The analysis reveals that the length of side plates is the most important parameter determining the performance of the beam and the required side plates length is determined by some parameters which are (1) beam depth to flange width ratio, (2) beam slenderness ratio (3) strength and thickness of the side plates, (4) compactness of beam web and flange, and (5) beam yield strength. At the end of the paper, a design formula to calculate the required side plate length is suggested.

Keywords: cover plate, earthquake resistant design, lateral torsional buckling, side plate, steel structure

Procedia PDF Downloads 144
720 Surgical Prep-Related Burns in Laterally Positioned Hip Procedures

Authors: B. Kenny, M. Dixon, A. Boshell

Abstract:

The use of alcoholic surgical prep was recently introduced into the Royal Newcastle Center for elective procedures. In the past 3 months there have been a significant number of burns believed to be related to ‘pooling’ of this surgical prep in patients undergoing procedures where they are placed in the lateral position with hip bolsters. The aim of the audit was to determine the reason for the burns, analyze what pre-existing factors may contribute to the development of the burns and what can be changed to prevent further burns occurring. All patients undergoing a procedure performed on the hip who were placed in the lateral position with sacral and anterior, superior iliac spine (ASIS) support with ‘bolsters’ were included in the audit. Patients who developed a ‘burn’ were recorded, details of the surgery, demographics, surgical prep used and length of surgery were obtained as well as photographs taken to document the burn. Measures were then taken to prevent further burns and the efficacy was documented. Overall 14 patients developed burns over the ipsilateral ASIS. Of these, 13 were Total Hip Arthroplasty (THA) and 1 was a removal of femoral nail. All patients had Chlorhexidine 0.5% in Alcohol 70% Tinted Red surgical preparation or Betadine Alcoholic Skin Prep (70% etoh). Patients were set up in the standard lateral decubitus position with sacral and bilateral ASIS bolsters with a valband covering. 86% of patients were found to have pre-existing hypersensitivities to various substances. There is very little literature besides a few case reports on surgical prep-related burns. The case reports that do exist are related to the use of tourniquet-related burns and there is no mention in the literature examining ‘bolster’ related burns. The burns are hypothesized to be caused by pooling of the alcoholic solution which is amplified by the use of Valband.

Keywords: arthroplasty, chemical burns, wounds, rehabilitation

Procedia PDF Downloads 274
719 Seismic Performance Evaluation of the Composite Structural System with Separated Gravity and Lateral Resistant Systems

Authors: Zi-Ang Li, Mu-Xuan Tao

Abstract:

During the process of the industrialization of steel structure housing, a composite structural system with separated gravity and lateral resistant systems has been applied in engineering practices, which consists of composite frame with hinged beam-column joints, steel brace and RC shear wall. As an attempt in steel structural system area, seismic performance evaluation of the separated composite structure is important for further application in steel housing. This paper focuses on the seismic performance comparison of the separated composite structural system and traditional steel frame-shear wall system under the same inter-story drift ratio (IDR) provision limit. The same architectural layout of a high-rise building is designed as two different structural systems at the same IDR level, and finite element analysis using pushover method is carried out. Static pushover analysis implies that the separated structural system exhibits different lateral deformation mode and failure mechanism with traditional steel frame-shear wall system. Different indexes are adopted and discussed in seismic performance evaluation, including IDR, safe factor (SF), shear wall damage, etc. The performance under maximum considered earthquake (MCE) demand spectrum shows that the shear wall damage of two structural systems are similar; the separated composite structural system exhibits less plastic hinges; and the SF index value of the separated composite structural system is higher than the steel frame shear wall structural system.

Keywords: finite element analysis, new composite structural system, seismic performance evaluation, static pushover analysis

Procedia PDF Downloads 106
718 Deep Foundations: Analysis of the Lateral Response of Closed Ended Steel Tubular Piles Embedded in Sandy Soil Using P-Y Curves

Authors: Ameer A. Jebur, William Atherton, Rafid M. Alkhaddar, Edward Loffill

Abstract:

Understanding the behaviour of the piles under the action of the independent lateral loads and the precise prediction of the capacity of piles subjected to different lateral loads are vital topics in foundation design and analysis. Moreover, the laterally loaded behaviour of deep foundations penetrated in cohesive and non-cohesive soils is basically analysed by the Winkler Model (beam on elastic foundation), in which the interaction between the pile embedded depth and contacted soil is simulated by nonlinear p–y curves. The presence of many approaches to interpret the behaviour of soil-pile interaction has resulted in numerous outputs and indicates that no general approach has yet been adopted. The current study presents the result of numerical modelling of the behaviour of steel tubular piles (25.4mm) outside diameter with various embedment depth-to-diameter ratios (L/d) embedded in a sand calibrated chamber of known relative density. The study revealed that the shear strength parameters of the sand specimens and the (L/d) ratios are the most significant factor influencing the response of the pile and its capacity while taking into consideration the complex interaction between the pile and soil. Good agreement has been achieved when comparing the application of this modelling approach with experimental physical modelling carried out by another researcher.

Keywords: deep foundations, slenderness ratio, soil-pile interaction, winkler model (beam on elastic foundation), non-cohesive soil

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717 Effect of Oxytocin on Cytosolic Calcium Concentration of Alpha and Beta Cells in Pancreas

Authors: Rauza Sukma Rita, Katsuya Dezaki, Yuko Maejima, Toshihiko Yada

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Oxytocin is a nine-amino acid peptide synthesized in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) of the hypothalamus. Oxytocin promotes contraction of the uterus during birth and milk ejection during breast feeding. Although oxytocin receptors are found predominantly in the breasts and uterus of females, many tissues and organs express oxytocin receptors, including the pituitary, heart, kidney, thymus, vascular endothelium, adipocytes, osteoblasts, adrenal gland, pancreatic islets, and many cell lines. On the other hand, in pancreatic islets, oxytocin receptors are expressed in both α-cells and β-cells with stronger expression in α- cells. However, to our knowledge there are no reports yet about the effect of oxytocin on cytosolic calcium reaction on α and β-cell. This study aims to investigate the effect of oxytocin on α-cells and β-cells and its oscillation pattern. Islet of Langerhans from wild type mice were isolated by collagenase digestion. Isolated and dissociated single cells either α-cells or β-cells on coverslips were mounted in an open chamber and superfused in HKRB. Cytosolic concentration ([Ca2+]i) in single cells were measured by fura-2 microfluorimetry. After measurement of [Ca2+]i, α-cells were identified by subsequent immunocytochemical staining using an anti-glucagon antiserum. In β-cells, the [Ca2+]i increase in response to oxytocin was observed only under 8.3 mM glucose condition, whereas in α-cells, [Ca2+]i an increase induced by oxytocin was observed in both 2.8 mM and 8.3 mM glucose. The oscillation incidence was induced more frequently in β-cells compared to α-cells. In conclusion, the present study demonstrated that oxytocin directly interacts with both α-cells and β-cells and induces increase of [Ca2+]i and its specific patterns.

Keywords: α-cells, β-cells, cytosolic calcium concentration, oscillation, oxytocin

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716 A Study of Evaporative Heat Loss from the Skin of Baby Elephants (Elephas maximus maximus) at Elephant Transit Home

Authors: G .D. B. N. Kulasaooriya, H. B. S. Ariyarathne, I. Abeygunawardene, A. A. J. Rafarathne, B. V. Perera

Abstract:

Elephant is the largest resident of the wild and has small surface to volume ratio as well as less number of sweat glands which cause challenges to the thermoregulation of this mammal. However, this megaherbivore has adopted specialised meachanisms to maintain its thermal balance through behavioral adaptations, ear flapping and well anastomosed arterioles and venules of the ear. Nevertheless, little is known on the involvement of the skin in the process of thermoregulation. The present study was undertaken to monitor the water evaporation rate from the skin of unrestrained wild elephant calves throughout the day and to understand its importance in the thermoregulation. Seven baby elephants housed in the elephant transit home, Udawalawe were used. Ambient temparature, relative humidity (RH) and radiation heat load was monitored throughout the day of the study period. Similarly, surface temparature of the skin was taken at six points including lateral ear pinna, lateral body and the rump during the same period. The skin water evaporation was also measured from the same sites using cobolt chloride method. The surface are of the skin was determined by assigning geometrical shapes to each body part. The results showed that the ambient temperature gradually increased with the day reaching maximum around 3.00 pm. The relative humidity was lowest early in the morning. The radiation heat load did not show any significant change in the study period. The skin temperature was different among lateral ear pinna, lateral body and the rump where the highest temperature was on the rump and the lowest on the lateral ear pinna. The skin temperature gradually increase with increasing ambient temperature but there was not a strong correlation (R2 =53.53) between these two. The skin temperature had strong correlation with RH (p<0.05 R2 =70.84% ) but a significant relationship was not considered since the radiation heat load was not varying in large scale. The skin evaporative water loss had a weak negative correlation with ambient temperature (correlation coefficient= -0.01) whereas strong positive correlation with RH (correlation coefficient= 25.275 ) and no corelation with radiation heat load. It also appeared that skin water loss increases as the skin temperature increased. In the present study, it was observed that on average, skin of the baby elephant looses 403 g/m2/h of water. Based on these observations it can be concluded that a large volume of water is evaporated from the skin of baby elephants and evaporative heat loss may be contributing significantly to the thermoregulation. However, further investigation on the influence of environmental factors on evaporative heat loss has to be conducted to understand the thermoregulatory mechanisms of the baby elephant.

Keywords: thermoregulation, behavioral adaptations, evaporation, elephant

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715 Relation between Chronic Mechanical Low Back Pain and Hip Rotation

Authors: Mohamed M. Diab, Koura G. Mohamed, A. Balbaa, Radwan Sh. Ahamed

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Background: Chronic mechanical low back pain (CMLBP) is the most common complaint of the working-age population. Mechanical low back pain is often a chronic, dull, aching pain of varying intensity that affects the lower spine. In the current proposal the hip rotation-CMLBP relationship is based on that limited hip motion will be compensated by motion in the lumbopelvic region and this increase force translates to the lumbar spine. The purpose of this study was to investigate if there a relationship between chronic mechanical low back pain (CMLBP) and hip medial and lateral rotation (peak torque and Range of motion (ROM) in patients with CMLBP. Methods: Sixty patients with CMLBP diagnosed by an orthopedist participated in the current study after signing a consent form. Their mean of age was (23.76±2.39) years, mean of weight (71.8±12.7) (Kg), mean of height (169.65±7.49) (Cm) and mean of BMI (25.5±3.86) (Kg/m2). Visual Analogue Scale (VAS) was used to assess pain. Fluid Filled Inclinometer was used to measure Hip rotation ROM (medial and lateral). Isokinetic Dynamometer was used to measure peak torque of hip rotators muscles (medial and lateral), concentric peak torque with tow Isokinetic speeds (60ᵒ/sec and 180ᵒ/sec) was selected to measure peak torque. Results: The results of this study demonstrated that there is poor relationship between pain and hip external rotation ROM, also there is poor relation between pain and hip internal rotation ROM. There is poor relation between pain and hip internal rotators peak torque and hip external rotators peak torque in both speeds. Conclusion: Depending on the current study it is not recommended to give an importance to hip rotation in treating Chronic Mechanical Low Back Pain.

Keywords: hip rotation ROM, hip rotators strength, low back pain, chronic mechanical

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714 Study of the Morpho-Sedimentary Evolution of Tidal Mouths on the Southern Fringe of the Gulf of Gabes, Southeast of Tunisia: Hydrodynamic Circulation and Associated Sedimentary Movements

Authors: Chadlia Ounissi, Maher Gzam, Tahani Hallek, Salah Mahmoudi, Mabrouk Montacer

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This work consists of a morphological study of the coastal domain at the central fringe of the Gulf of Gabes, Southeast of Tunisia, belonging to the structural domain of the maritime Jeffara. The diachronic study of tidal mouths in the study area and the observation of morphological markers revealed the existence of hydro-sedimentary processes leading to sedimentary accumulation and filling of the estuarine system. This filling process is materialized by the genesis of a sandy cord and the lateral migration of the tidal mouth. Moreover, we have been able to affirm, by the use of satellite images, that the dominant and responsible current at this particular coastal morphology is directed to the North, having constituted a controversy on the occurrence of what is previously mentioned in the literature. The speed of the lateral displacement of the channel varies as a function of the hydrodynamic forcing. Wave-dominated sites recorded the fastest speed (18 m/year) in the image of the mouth of Wadi el Melah. Tidal dominated sites in the Wadi Zerkine satellite image recorded a very low lateral migration (2 m / year). This variation in speed indicates that the intensity of the coastal current is uneven along the coast. This general pattern of hydrodynamic circulation, to the north, of the central fringe of the Gulf of Gabes, is disturbed by hydro-sedimentary cells.

Keywords: tidal mouth, direction of current, filling, sediment transport, Gulf of Gabes

Procedia PDF Downloads 254
713 Randomized, Controlled Blind Study Comparing Sacroiliac Intra-Articular Steroid Injection to Radiofrequency Denervation for Management of Sacroiliac Joint Pain

Authors: Ossama Salman

Abstract:

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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712 Development of a Three-Dimensional-Flywheel Robotic System

Authors: Chung-Chun Hsiao, Yu-Kai, Ting, Kai-Yuan Liu, Pang-Wei Yen, Jia-Ying Tu

Abstract:

In this paper, a new design of spherical robotic system based on the concepts of gimbal structure and gyro dynamics is presented. Robots equipped with multiple wheels and complex steering mechanics may increase the weight and degrade the energy transmission efficiency. In addition, the wheeled and legged robots are relatively vulnerable to lateral impact and lack of lateral mobility. Therefore, the proposed robotic design uses a spherical shell as the main body for ground locomotion, instead of using wheel devices. Three spherical shells are structured in a similar way to a gimbal device and rotate like a gyro system. The design and mechanism of the proposed robotic system is introduced. In addition, preliminary results of the dynamic model based on the principles of planar rigid body kinematics and Lagrangian equation are included. Simulation results and rig construction are presented to verify the concepts.

Keywords: gyro, gimbal, lagrange equation, spherical robots

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711 Additional Pathological Findings Using MRI on Patients with First Time Traumatic Lateral Patella Dislocation: A Study of 150 Patients

Authors: Ophir Segal, Daniel Weltsch, Shay Tenenbaum, Ran Thein

Abstract:

Purpose: Patients with lateral patellar dislocation (LPD) are not always referred to perform an MRI. This might be the case in first time LPD patients without surgical indications or in patients with recurrent LPD who had MRI in previous episodes. Unfortunately, in some cases, there are additional knee pathological findings, which include tearing of the collateral or cruciate ligaments and injury to the tendons or menisci. These findings might be overlooked during the physical examination or masked by nonspecific clinical findings like knee pain, effusion, or hemarthrosis. The prevalence of these findings, which can be revealed by MRI, is misreported in literature and is considered rare. In our practice, all patients with LPD are sent for MRI after LPD. Therefore, we have designed a retrospective comparative study to evaluate the prevalence of additional pathological findings in patients with acute traumatic LPD that had performed MRI, comparing different groups of patients according to age, sex, and Tibial Tuberosity-Trochlear Groove(TT-TG) distance. Methods: MRI of the knee in patients after traumatic LPD were evaluated for the presence of additional pathological findings such as injuries to ligaments: Anterior/Posterior cruciate ligament(ACL, PCL), Medial/Lateral collateral ligament(MCL, LCL), injuries to tendons(QUADICEPS, PATELLAR), menisci(Medial/Lateral meniscus(MM, LM)) and tibial plateau, by a fellowship-trained, senior musculoskeletal radiologist. A comparison between different groups of patients was performed according to age (age group < 25 years, age group > 25 years), sex (Male/Female group), and TT-TG distance (TT-TG<15 groups, TT-TG>15 groups). A descriptive and comparative statistical analysis was performed. Results: 150 patients were included in this study. All suffered from LPD between the years 2012-2017 (mean age 21.3( ± SD 8.9), 86 males). ACL, PCL, MCL, and LCL complete or partial tears were found in 17(11.3%), 3(2%), 22(14.6%), and 4(2.7%) of the patients, respectively. MM and LM tears were found in 10(6.7%) and 3(2%) of the patients, respectively. A higher prevalence of PCL injury, MM tear, and LM tear were found in the older age group compared to the younger group of patients (10.5% vs. 1.8%, 18.4% vs. 2.7%, and 7.9% vs. 0%, respectively, p<0.05). A higher prevalence of non-displaced MM tear and LCL injury was found in the male group compared to the female group (8.1% vs. 0% and 8.1% vs. 0% respectively, p<0.05). A higher prevalence of ACL injury was found in the normal TT-TG group compared to the pathologic TT-TG group (17.5% vs. 2.3%, p= 0.0184). Conclusions: Overall, 43 out of 150 (28.7%) of the patient's MRI’s were positive for additional pathological radiological findings. Interestingly, a higher prevalence of additional pathologies was found in the groups of patients with a lower risk for recurrent LPD, including males, patients older than 25, and patients with TT-TG lower than 15mm, and therefore might not be referred for an MRI scan. Thus, we recommend a strict physical examination, awareness to the high prevalence of additional pathological findings, and to consider performing an MRI in all patients after LPD.

Keywords: additional findings, lateral patellar dislocation (LPD), MRI scan, traumatic patellar dislocation, cruciate ligaments injuries, menisci injuries, collateral ligaments injuries

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710 A Review of Kinematics and Joint Load Forces in Total Knee Replacements Influencing Surgical Outcomes

Authors: Samira K. Al-Nasser, Siamak Noroozi, Roya Haratian, Adrian Harvey

Abstract:

A total knee replacement (TKR) is a surgical procedure necessary when there is severe pain and/or loss of function in the knee. Surgeons balance the load in the knee and the surrounding soft tissue by feeling the tension at different ranges of motion. This method can be unreliable and lead to early failure of the joint. The ideal kinematics and load distribution have been debated significantly based on previous biomechanical studies surrounding both TKRs and normal knees. Intraoperative sensors like VERASENSE and eLibra have provided a method for the quantification of the load indicating a balanced knee. A review of the literature written about intraoperative sensors and tension/stability of the knee was done. Studies currently debate the quantification of the load in medial and lateral compartments specifically. However, most research reported that following a TKR the medial compartment was loaded more heavily than the lateral compartment. In several cases, these results were shown to increase the success of the surgery because they mimic the normal kinematics of the knee. In conclusion, most research agrees that an intercompartmental load differential of between 10 and 20 pounds, where the medial load was higher than the lateral, and an absolute load of less than 70 pounds was ideal. However, further intraoperative sensor development could help improve the accuracy and understanding of the load distribution on the surgical outcomes in a TKR. A reduction in early revision surgeries for TKRs would provide an improved quality of life for patients and reduce the economic burden placed on both the National Health Service (NHS) and the patient.

Keywords: intraoperative sensors, joint load forces, kinematics, load balancing, and total knee replacement

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709 Effects of Axial Loads and Soil Density on Pile Group Subjected to Triangular Soil Movement

Authors: Ihsan Al-Abboodi, Tahsin Toma-Sabbagh

Abstract:

Laboratory tests have been carried out to investigate the response of 2x2 pile group subjected to triangular soil movement. The pile group was instrumented with displacement and tilting devices at the pile cap and strain gauges on two piles of the group. In this paper, results from four model tests were presented to study the effects of axial loads and soil density on the lateral behavior of piles. The responses in terms of bending moment, shear force, soil pressure, deflection, and rotation of piles were compared. Test results indicate that increasing the soil strength could increase the measured moment, shear, soil pressure, and pile deformations. Most importantly, adding loads to the pile cap induces additional moment to the head of front-pile row unlike the back-pile row which was influenced insignificantly.

Keywords: pile group, passive piles, lateral soil movement, soil density, axial loads

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708 Lateral Torsional Buckling Investigation on Welded Q460GJ Structural Steel Unrestrained Beams under a Point Load

Authors: Yue Zhang, Bo Yang, Gang Xiong, Mohamed Elchalakanic, Shidong Nie

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This study aims to investigate the lateral torsional buckling of I-shaped cross-section beams fabricated from Q460GJ structural steel plates. Both experimental and numerical simulation results are presented in this paper. A total of eight specimens were tested under a three-point bending, and the corresponding numerical models were established to conduct parametric studies. The effects of some key parameters such as the non-dimensional member slenderness and the height-to-width ratio, were investigated based on the verified numerical models. Also, the results obtained from the parametric studies were compared with the predictions calculated by different design codes including the Chinese design code (GB50017-2003, 2003), the new draft version of Chinese design code (GB50017-201X, 2012), Eurocode 3 (EC3, 2005) and the North America design code (ANSI/AISC360-10, 2010). These comparisons indicated that the sectional height-to-width ratio does not play an important role to influence the overall stability load-carrying capacity of Q460GJ structural steel beams with welded I-shaped cross-sections. It was also found that the design methods in GB50017-2003 and ANSI/AISC360-10 overestimate the overall stability and load-carrying capacity of Q460GJ welded I-shaped cross-section beams.

Keywords: experimental study, finite element analysis, global stability, lateral torsional buckling, Q460GJ structural steel

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707 Super Harmonic Nonlinear Lateral Vibration of an Axially Moving Beam with Rotating Prismatic Joint

Authors: M. Najafi, S. Bab, F. Rahimi Dehgolan

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The motion of an axially moving beam with rotating prismatic joint with a tip mass on the end is analyzed to investigate the nonlinear vibration and dynamic stability of the beam. The beam is moving with a harmonic axially and rotating velocity about a constant mean velocity. A time-dependent partial differential equation and boundary conditions with the aid of the Hamilton principle are derived to describe the beam lateral deflection. After the partial differential equation is discretized by the Galerkin method, the method of multiple scales is applied to obtain analytical solutions. Frequency response curves are plotted for the super harmonic resonances of the first and the second modes. The effects of non-linear term and mean velocity are investigated on the steady state response of the axially moving beam. The results are validated with numerical simulations.

Keywords: super harmonic resonances, non-linear vibration, axially moving beam, Galerkin method

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706 Influence of Strengthening with Perforated Steel Plates on the Behavior of Infill Walls and RC Frame

Authors: Eray Ozbek, Ilker Kalkan, S. Oguzhan Akbas, Sabahattin Aykac

Abstract:

The contribution of the infill walls to the overall earthquake response of a structure is limited and this contribution is generally ignored in the analyses. Strengthening of the infill walls through different techniques has been and is being studied extensively in the literature to increase this limited contribution and the ductilities and energy absorption capacities of the infill walls to create non-structural components where the earthquake-induced energy can be absorbed without damaging the bearing components of the structural frame. The present paper summarizes an extensive research project dedicated to investigate the effects of strengthening the brick infill walls of a reinforced concrete (RC) frame on its lateral earthquake response. Perforated steel plates were used in strengthening due to several reasons, including the ductility and high deformation capacity of these plates, the fire resistant, recyclable and non-cancerogenic nature of mild steel, and the ease of installation and removal of the plates to the wall with the help of anchor bolts only. Furthermore, epoxy, which increases the cost and amount of labor of the strengthening process, is not needed in this technique. The individual behavior of the strengthened walls under monotonic diagonal and lateral reversed cyclic loading was investigated within the scope of the study. Upon achieving brilliant results, RC frames with strengthened infill walls were tested and are being tested to examine the influence of this strengthening technique on the overall behavior of the RC frames. Tests on the wall and frame specimens indicated that the perforated steel plates contribute to the lateral strength, rigidity, ductility and energy absorption capacity of the wall and the infilled frame to a major extent.

Keywords: infill wall, strengthening, external plate, earthquake behavior

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705 Seismic Assessment of Passive Control Steel Structure with Modified Parameter of Oil Damper

Authors: Ahmad Naqi

Abstract:

Today, the passively controlled buildings are extensively becoming popular due to its excellent lateral load resistance circumstance. Typically, these buildings are enhanced with a damping device that has high market demand. Some manufacturer falsified the damping device parameter during the production to achieve the market demand. Therefore, this paper evaluates the seismic performance of buildings equipped with damping devices, which their parameter modified to simulate the falsified devices, intentionally. For this purpose, three benchmark buildings of 4-, 10-, and 20-story were selected from JSSI (Japan Society of Seismic Isolation) manual. The buildings are special moment resisting steel frame with oil damper in the longitudinal direction only. For each benchmark buildings, two types of structural elements are designed to resist the lateral load with and without damping devices (hereafter, known as Trimmed & Conventional Building). The target building was modeled using STERA-3D, a finite element based software coded for study purpose. Practicing the software one can develop either three-dimensional Model (3DM) or Lumped Mass model (LMM). Firstly, the seismic performance of 3DM and LMM models was evaluated and found excellent coincide for the target buildings. The simplified model of LMM used in this study to produce 66 cases for both of the buildings. Then, the device parameters were modified by ± 40% and ±20% to predict many possible conditions of falsification. It is verified that the building which is design to sustain the lateral load with support of damping device (Trimmed Building) are much more under threat as a result of device falsification than those building strengthen by damping device (Conventional Building).

Keywords: passive control system, oil damper, seismic assessment, lumped mass model

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704 35 MHz Coherent Plane Wave Compounding High Frequency Ultrasound Imaging

Authors: Chih-Chung Huang, Po-Hsun Peng

Abstract:

Ultrasound transient elastography has become a valuable tool for many clinical diagnoses, such as liver diseases and breast cancer. The pathological tissue can be distinguished by elastography due to its stiffness is different from surrounding normal tissues. An ultrafast frame rate of ultrasound imaging is needed for transient elastography modality. The elastography obtained in the ultrafast system suffers from a low quality for resolution, and affects the robustness of the transient elastography. In order to overcome these problems, a coherent plane wave compounding technique has been proposed for conventional ultrasound system which the operating frequency is around 3-15 MHz. The purpose of this study is to develop a novel beamforming technique for high frequency ultrasound coherent plane-wave compounding imaging and the simulated results will provide the standards for hardware developments. Plane-wave compounding imaging produces a series of low-resolution images, which fires whole elements of an array transducer in one shot with different inclination angles and receives the echoes by conventional beamforming, and compounds them coherently. Simulations of plane-wave compounding image and focused transmit image were performed using Field II. All images were produced by point spread functions (PSFs) and cyst phantoms with a 64-element linear array working at 35MHz center frequency, 55% bandwidth, and pitch of 0.05 mm. The F number is 1.55 in all the simulations. The simulated results of PSFs and cyst phantom which were obtained using single, 17, 43 angles plane wave transmission (angle of each plane wave is separated by 0.75 degree), and focused transmission. The resolution and contrast of image were improved with the number of angles of firing plane wave. The lateral resolutions for different methods were measured by -10 dB lateral beam width. Comparison of the plane-wave compounding image and focused transmit image, both images exhibited the same lateral resolution of 70 um as 37 angles were performed. The lateral resolution can reach 55 um as the plane-wave was compounded 47 angles. All the results show the potential of using high-frequency plane-wave compound imaging for realizing the elastic properties of the microstructure tissue, such as eye, skin and vessel walls in the future.

Keywords: plane wave imaging, high frequency ultrasound, elastography, beamforming

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703 Diversity and Use of Agroforestry Yards of Family Farmers of Ponte Alta – Gama, Federal District, Brazil

Authors: Kever Bruno Paradelo Gomes, Rosana Carvalho Martins

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The home gardens areas are production systems, which are located near the homes and are quite common in the tropics. They consist of agricultural and forest species and may also involve the raising of small animals to produce food for subsistence as well as income generation, with a special focus on the conservation of biodiversity. Home gardens are diverse Agroforestry systems with multiple uses, among many, food security, income aid, traditional medicine. The work was carried out on rural properties of the family farmers of the Ponte Alta Rural Nucleus, Gama Administrative Region, in the city of Brasília, Federal District- Brazil. The present research is characterized methodologically as a quantitative, exploratory and descriptive nature. The instruments used in this research were: bibliographic survey and semi-structured questionnaire. The data collection was performed through the application of a semi-structured questionnaire, containing questions that referred to the perception and behavior of the interviewed producer on the subject under analysis. In each question, the respondent explained his knowledge about sustainability, agroecological practices, environmental legislation, conservation methods, forest and medicinal species, ago social and socioeconomic characteristics, use and purpose of agroforestry and technical assistance. The sample represented 55.62% of the universe of the study. We interviewed 99 people aged 18-83 years, with a mean age of 49 years. The low level of education, coupled with the lack of training and guidance for small family farmers in the Ponte Alta Rural Nucleus, is one of the limitations to the development of practices oriented towards sustainable and agroecological agriculture in the nucleus. It is observed that 50.5% of the interviewed people landed with agroforestry yards less than 20 years ago, and only 16.17% of them are older than 35 years. In identifying agriculture as the main activity of most of the rural properties studied, attention is drawn to the cultivation of medicinal plants, fruits and crops as the most extracted products. However, it is verified that the crops in the backyards have the exclusive purpose of family consumption, which could be complemented with the marketing of the surplus, as well as with the aggregation of value to the cultivated products. Initiatives such as this may contribute to the increase in family income and to the motivation and value of the crop in agroecological gardens. We conclude that home gardens of Ponte Alta are highly diverse thus contributing to local biodiversity conservation of are managed by women to ensure food security and allows income generation. The tradition of existing knowledge on the use and management of the diversity of resources used in agroforestry yards is of paramount importance for the development of sustainable alternative practices.

Keywords: agriculture, agroforestry system, rural development, sustainability

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702 Lateral Torsional Buckling Resistance of Trapezoidally Corrugated Web Girders

Authors: Annamária Käferné Rácz, Bence Jáger, Balázs Kövesdi, László Dunai

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Due to the numerous advantages of steel corrugated web girders, its application field is growing for bridges as well as for buildings. The global stability behavior of such girders is significantly larger than those of conventional I-girders with flat web, thus the application of the structural steel material can be significantly reduced. Design codes and specifications do not provide clear and complete rules or recommendations for the determination of the lateral torsional buckling (LTB) resistance of corrugated web girders. Therefore, the authors made a thorough investigation regarding the LTB resistance of the corrugated web girders. Finite element (FE) simulations have been performed to develop new design formulas for the determination of the LTB resistance of trapezoidally corrugated web girders. FE model is developed considering geometrical and material nonlinear analysis using equivalent geometric imperfections (GMNI analysis). The equivalent geometric imperfections involve the initial geometric imperfections and residual stresses coming from rolling, welding and flame cutting. Imperfection sensitivity analysis was performed to determine the necessary magnitudes regarding only the first eigenmodes shape imperfections. By the help of the validated FE model, an extended parametric study is carried out to investigate the LTB resistance for different trapezoidal corrugation profiles. First, the critical moment of a specific girder was calculated by FE model. The critical moments from the FE calculations are compared to the previous analytical calculation proposals. Then, nonlinear analysis was carried out to determine the ultimate resistance. Due to the numerical investigations, new proposals are developed for the determination of the LTB resistance of trapezoidally corrugated web girders through a modification factor on the design method related to the conventional flat web girders.

Keywords: corrugated web, lateral torsional buckling, critical moment, FE modeling

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701 Osteosuture in Fixation of Displaced Lateral Third Clavicle Fractures: A Case Report

Authors: Patrícia Pires, Renata Vaz, Bárbara Teles, Marco Pato, Pedro Beckert

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Introduction: The management of lateral third clavicle fractures can be challenging due to difficulty in distinguishing subtle variations in the fracture pattern, which may be suggestive of potential fracture instability. They occur most often in men between 30 and 50 years of age, and in individuals over 70 years of age, its distribution is equal between both men and women. These fractures account for 10%–30% of all clavicle fractures and roughly 30%–45% of all clavicle nonunion fractures. Lateral third clavicle fractures may be treated conservatively or surgically, and there is no gold standard, although the risk of nonunion or pseudoarthrosis impacts the recommendation of surgical treatment when these fractures are unstable. There are many strategies for surgical treatment, including locking plates, hook plates fixation, coracoclavicular fixation using suture anchors, devices or screws, tension band fixation with suture or wire, transacromial Kirschner wire fixation and arthroscopically assisted techniques. Whenever taking the hardware into consideration, we must not disregard that obtaining adequate lateral fixation of small fragments is a difficult task, and plates are more associated to local irritation. The aim of the appropriate treatment is to ensure fracture healing and a rapid return to preinjury activities of daily living but, as explained, definitive treatment strategies have not been established and the variety of techniques avalilable add up to the discussion of this topic. Methods and Results: We present a clinical case of a 43-year-old man with the diagnosis of a lateral third clavicle fracture (Neer IIC) in the sequence of a fall on his right shoulder after a bicycle fall. He was operated three days after the injury, and through K-wire temporary fixation and indirect reduction using a ZipTight, he underwent osteosynthesis with an interfragmentary figure-of-eight tension band with polydioxanone suture (PDS). Two weeks later, there was a good aligment. He kept the sling until 6 weeks pos-op, avoiding efforts. At 7-weeks pos-op, there was still a good aligment, starting the physiotherapy exercises. After 10 months, he had no limitation in mobility or pain and returned to work with complete recovery in strength. Conclusion: Some distal clavicle fractures may be conservatively treated, but it is widely accepted that unstable fractures require surgical treatment to obtain superior clinical outcomes. In the clinical case presented, the authors chose an osteosuture technique due to the fracture pattern, its location. Since there isn´t a consensus on the prefered fixation method, it is important for surgeons to be skilled in various techniques and decide with their patient which approach is most appropriate for them, weighting the risk-benefit of each method. For instance, with the suture technique used, there is no wire migration or breakage, and it doesn´t require a reoperation for hardware removal; there is also less tissue exposure since it requires a smaller approach in comparison to the plate fixation and avoids cuff tears like the hook plate. The good clinical outcome on this case report serves the purpose of expanding the consideration of this method has a therapeutic option.

Keywords: lateral third, clavicle, suture, fixation

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