Search results for: abdominal wall defect

Authors: Christopher Oyediran, Nicola Ubayasiri, Christopher Gough

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Splenic artery aneurysms are often clinically occult, occasionally identified incidentally with imaging. The pathogenesis of aneurysms is complex, but certain factors are thought to contribute to their development. Given the potential fatal complications of rupture, a high index of suspicion is required to make an early diagnosis. We present a case of a 36-year-old female with a history of endometriosis and multiple sclerosis who presented to the Emergency Department with sudden onset epigastric pain and collapse. On arrival, she was pale and clammy with profound tachycardia and hypotension. An ultrasound done in the resuscitation department revealed abdominal free fluid. She was resuscitated with blood and transferred for emergent laparotomy. Laparotomy revealed massive haemoperitoneum from the spleen. She underwent emergency splenectomy and inspection of the spleen revealed a splenic artery aneurysm. She received our massive transfusion protocol followed by a short stay on ITU, making a good post-operative recovery and was discharged home a week later.

Keywords: aneurysm, human chorionic gonadotrophin (hCG), resuscitation, laparotomy

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Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: Amin Eslami, Jafar Bolouri Bazaz

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Excavation and retaining walls are of challenging issues in civil engineering. In this study, the behavior of one the important type of supporting systems called Contiguous Bored Pile (CBP) retaining wall is investigated using a physical model. Besides, a comparison is made between two modes of free end piles(soft bed) and fixed end piles (stiff bed). Also a back calculation of effective length (the real free length of pile) is done by measuring lateral deflection of piles in different stages of excavation in both a forementioned cases. Based on observed results, for the fixed end mode, the effective length to free length ratio (Leff/L0) is equal to unity in initial stages of excavation and less than 1 in its final stages in a decreasing manner. While this ratio for free end mode, remains constant during all stages of excavation and is always less than unity.

Keywords: contiguous bored pile wall, effective length, fixed end, free end, free length

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Authors: Jooyoung Park, Junkyeong Kim, Aoqi Zhang, Seunghee Park

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Non-destructive testing on cable is in great demand due to safety accidents at sites where many equipments using cables are installed. In this paper, the quantitative change of the obtained signal was analyzed using a magnetic flux leakage (MFL) method. A two-dimensional simulation was conducted with a FEM model replicating real elevator cables. The simulation data were compared for three parameters (depth of defect, width of defect and inspection velocity). Then, an experiment on same conditions was carried out to verify the results of the simulation. Signals obtained from both the simulation and the experiment were transformed to characterize the properties of the damage. Throughout the results, a cable damage detection based on an MFL method was confirmed to be feasible. In further study, it is expected that the MFL signals of an entire specimen will be gained and visualized as well.

Keywords: magnetic flux leakage (mfl), cable damage detection, non-destructive testing, numerical simulation

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Authors: Cha’o-Kuang Chen, Ching-Chang Cho

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This paper investigates the natural convection heat transfer performance in a complex-wavy-wall cavity filled with power-law fluid. In performing the simulations, the continuity, Cauchy momentum and energy equations are solved subject to the Boussinesq approximation using a finite volume method. The simulations focus specifically on the effects of the flow behavior index in the power-law model and the Rayleigh number on the flow streamlines, isothermal contours and mean Nusselt number within the cavity. The results show that pseudoplastic fluids have a better heat transfer performance than Newtonian or dilatant fluids. Moreover, it is shown that for Rayleigh numbers greater than Ra=103, the mean Nusselt number has a significantly increase as the flow behavior index is decreased.

Keywords: non-Newtonian fluid, power-law fluid, natural convection, heat transfer enhancement, cavity, wavy wall

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Authors: Ali Kezmane, Said Boukais, Mohand Hamizi

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This paper presents an analytical study on the behavior of reinforced concrete walls with rectangular cross section. Several experiments on such walls have been selected to be studied. Database from various experiments were collected and nominal shear wall strengths have been calculated using formulas, such as those of the ACI (American), NZS (New Zealand), Mexican (NTCC), and Wood and Barda equations. Subsequently, nominal shear wall strengths from the formulas were compared with the ultimate shear wall strengths from the database. These formulas vary substantially in functional form and do not account for all variables that affect the response of walls. There is substantial scatter in the predicted values of ultimate shear strength. Two new semi empirical equations are developed using data from tests of 57 walls for transitions walls and 27 for slender walls with the objective of improving the prediction of peak strength of walls with the most possible accurate.

Keywords: shear strength, reinforced concrete walls, rectangular walls, shear walls, models

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Authors: Said Boukais, Ali Kezmane, Kahil Amar, Mohand Hamizi, Hannachi Neceur Eddine

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This paper presents an analytical study on the behavior of rectangular reinforced concrete walls with an aspect ratio between one and tow. Several experiments on such walls have been selected to be studied. Database from various experiments were collected and nominal wall strengths have been calculated using formulas, such as those of the ACI (American), NZS (New Zealand), Mexican (NTCC), and Wood equation for shear and strain compatibility analysis for flexure. Subsequently, nominal ultimate wall strengths from the formulas were compared with the ultimate wall strengths from the database. These formulas vary substantially in functional form and do not account for all variables that affect the response of walls. There is substantial scatter in the predicted values of ultimate strength. New semi empirical equation are developed using data from tests of 46 walls with the objective of improving the prediction of ultimate strength of walls with the most possible accuracy and for all failure modes.

Keywords: prediction, ultimate strength, reinforced concrete walls, walls, rectangular walls

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Authors: A. Anbu Raj, V. Mugendiren

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Sheet metal forming is a vital manufacturing process used in automobile, aerospace, agricultural industries, etc. Incremental forming is a promising process providing a short and inexpensive way of forming complex three-dimensional parts without using die. The aim of this research is to study the forming behaviour of AA 5052, Aluminium Alloy, using incremental forming and also to study the FLD of cone shape AA 5052 Aluminium Alloy at room temperature and various annealing temperature. Initially the surface roughness and wall thickness through incremental forming on AA 5052 Aluminium Alloy sheet at room temperature is optimized by controlling the effects of forming parameters. The central composite design (CCD) was utilized to plan the experiment. The step depth, feed rate, and spindle speed were considered as input parameters in this study. The surface roughness and wall thickness were used as output response. The process performances such as average thickness and surface roughness were evaluated. The optimized results are taken for minimum surface roughness and maximum wall thickness. The optimal results are determined based on response surface methodology and the analysis of variance. Formability Limit Diagram is constructed on AA 5052 Aluminium Alloy at room temperature and various annealing temperature by using optimized process parameters from the response surface methodology. The cone has higher formability than the square pyramid and higher wall thickness distribution. Finally the FLD on cone shape and square pyramid shape at room temperature and the various annealing temperature is compared experimentally and simulated with Abaqus software.

Keywords: incremental forming, response surface methodology, optimization, wall thickness, surface roughness

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Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

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Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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Authors: Angelis P. Barlampas

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Theoretical background Disorders of fixation and rotation of the large intestine, result in the existence of its parts in ectopic anatomical positions. In case of symptomatology, the clinical picture is complicated by the possible symptomatology of the neighboring anatomical structures and a differential diagnostic problem arises. Target The purpose of this work is to demonstrate the difficulty of revealing the real cause of abdominal pain, in cases of anatomical variants and the decisive contribution of imaging and especially that of computed tomography. Methods A patient came to the emergency room, because of acute pain in the right hypochondrium. Clinical examination revealed tenderness in the gallbladder area and a positive Murphy's sign. An ultrasound exam depicted a normal gallbladder and the patient was referred for a CT scan. Results Flexible, unfixed ascending colon and cecum, located in the anatomical region of the right mesentery. Opacities of the surrounding peritoneal fat and a small linear concentration of fluid can be seen. There was an appendix of normal anteroposterior diameter with the presence of air in its lumen and without clear signs of inflammation. There was an impression of possible inflammatory swelling at the base of the appendix, (DD phenomenon of partial volume; e.t.c.). Linear opacities of the peritoneal fat in the region of the second loop of the duodenum. Multiple diverticula throughout the colon. Differential Diagnosis The differential diagnosis includes the following: Inflammation of the base of the appendix, diverticulitis of the cecum-ascending colon, a rare case of second duodenal loop ulcer, tuberculosis, terminal ileitis, pancreatitis, torsion of unfixed cecum-ascending colon, embolism or thrombosis of a vascular intestinal branch. Final Diagnosis There is an unfixed cecum-ascending colon, which is exhibiting diverticulitis.

Keywords: unfixed cecum-ascending colon, abdominal pain, malrotation, abdominal CT, congenital anomalies

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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

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Authors: Muhammad Usman, Munir Ahmed

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The demand of high-rise buildings has grown fast during the past decades. The design of these buildings by using RC core wall have been widespread nowadays in many countries. The RC core wall (RCCW) buildings encompasses central core wall and boundary columns joined through post tension slab at different floor levels. The core wall often provides greater stiffness as compared to the collective stiffness of the boundary columns. Hence, the core wall dominantly resists lateral loading i.e. wind or earthquake load. Non-linear response history analysis (NLRHA) procedure is the finest seismic design procedure of the times for designing high-rise buildings. The modern design tools for nonlinear response history analysis and performance based design has provided more confidence to design these structures for high-rise buildings. NLRHA requires selection and scaling of ground motions to match design spectrum for site specific conditions. Designers use several techniques for scaling ground motion records (time series). Time domain and frequency domain scaling are most commonly used which comprises their own benefits and drawbacks. Due to lengthy process of NLRHA, application of only one technique is conceivable. To the best of author’s knowledge, no consensus on the best procedures for the selection and scaling of the ground motions is available in literature. This research aims to provide the finest ground motion scaling technique specifically for designing 40 story high-rise RCCW buildings. Seismic response of 40 story RCCW building is checked by applying both the frequency domain and time domain scaling. Variable sites are selected in three critical seismic zones of Pakistan. The results indicates that there is extensive variation in seismic response of building for these scaling. There is still a need to build a consensus on the subjected research by investigating variable sites and buildings heights.

Keywords: 40-storied RC core wall building, nonlinear response history analysis, ground motions, time domain scaling, frequency domain scaling

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Authors: Marzieh Zarei

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Well instability is one of the most fundamental challenges faced by the oil and gas industry. Well wall stability analysis is a gap to be filled in the oil industry. The collection of static data such as well logging leads to the construction of a geomechanical numerical model, which will help in assessing the probable risks in future drilling. In this paper, geomechanical model was designed, and mechanical properties of the rock was determined at all points of the model. It was found the safe mud window was determined and the minimum and maximum mud pressures were determined in the ranges of 70-60 MPa and 110-100 MPa, respectively.

Keywords: geomechanics, numerical model, well stability, in-situ stress, underbalanced drilling

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Authors: T. S. Almutairi, Paul May, Neil Allan

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The geometrical, electronic and magnetic properties of the neutral Mg center and MgN₃ cluster in diamond have been studied theoretically in detail by means of an HSE06 Hamiltonian that includes a fraction of the exact exchange term; this is important for a satisfactory picture of the electronic states of open-shell systems. Another batch of the calculations by GGA functionals have also been included for comparison, and these support the results from HSE06. The local perturbations in the lattice by introduced Mg defect are restricted in the first and second shell of atoms before eliminated. The formation energy calculated with HSE06 and GGA of single Mg agrees with the previous result. We found the triplet state with C₃ᵥ is the ground state of Mg center with energy lower than the singlet with C₂ᵥ by ~ 0.1 eV. The recent experimental ZPL (557.4 nm) of Mg center in diamond has been discussed in the view of present work. The analysis of the band-structure of the MgN₃ cluster confirms that the MgN₃ defect introduces a shallow donor level in the gap lying within the conduction band edge. This observation is supported by the EMM that produces n-type levels shallower than the P donor level. The formation energy of MgN₂ calculated from a 2NV defect (~ 3.6 eV) is a promising value from which to engineer MgN₃ defects inside the diamond. Ion-implantation followed by heating to about 1200-1600°C might induce migration of N related defects to the localized Mg center. Temperature control is needed for this process to restore the damage and ensure the mobilities of V and N, which demands a more precise experimental study.

Keywords: empirical marker method, generalised gradient approximation, Heyd–Scuseria–Ernzerhof screened hybrid functional, zero phono line

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Authors: Prabir Patel, Eugene Ming Han Lim

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Introduction: Current literature shows that postoperative pulmonary complications following abdominal surgery may be reduced by using lower than conventional tidal volumes intraoperatively together with moderate levels of positive end expiratory pressure (PEEP). The recent studies demonstrated significant reduction demonstrated significant reduction in major complications in elective abdominal surgery through the use of lower tidal volumes (6-8 ml/kg predicted body weight), PEEP of 5 cmH20 and recruitment manoeuvres compared to higher ‘conventional’ volumes (10-12 mls/kg PBW) without lung recruitment. Our objective was to retrospectively audit current practice for patients undergoing major abdominal surgery in Sir Charles Gairdner Hospital. Methods: Patients over 18 undergoing elective general surgery lasting more than 3 hours and intubated during the duration of procedure were included in this audit. Data was collected over a 6 month period. Patients who had hepatic surgery, procedures necessitating one-lung ventilation, transplant surgery, documented history of pulmonary or intracranial hypertension were excluded. Results: 58 suitable patients were identified and notes were available for 54 patients. Key findings: Average peak airway pressure was 21cmH20 (+4), average peak airway pressure was less than 30 cmH20 in all patients, and less than 25 cmH20 in 80% of the cases. PEEP was used in 81% of the cases. Where PEEP was used, 75% used PEEP more than or equal to 5 cmH20. Average tidal volume per actual body weight was 7.1 ml/kg (+1.6). Average tidal volume per predicted body weight (PBW) was 8.8 ml/kg (+1.5). Average tidal volume was less than 10 ml/kg PBW in 90% of cases; 6-8 ml/kg PBW in 40% of the cases. There was no recorded use of recruitment manoeuvres in any cases. Conclusions: In the vast majority of patients undergoing prolonged abdominal surgery, a lung protective strategy using moderate levels of PEEP, peak airway pressures of less than 30 cmH20 and tidal volumes of less than 10 cmH20/kg PBW was utilised. A recent randomised control trial demonstrated benefit from utilising even lower volumes (6-8 mls/kg) based on findings in critical care patients, but this was compared to volumes of 10-12 ml/kg. Volumes of 6-8 ml/kg PBW were utilised in 40% of cases in this audit. Although theoretically beneficial, clinical benefit of lower volumes than what is currently practiced in this institution remains to be seen. The incidence of pulmonary complications was much lower than in the other cited studies and a larger data set would be required to investigate any benefit from lower tidal volume ventilation. The volumes used are comparable to results from published local and international data but PEEP utilisation was higher in this audit. Strategies that may potentially be implemented to ensure and maintain best practice include pre-operative recording of predicted body weight, adjustment of default ventilator settings and education/updates of current evidence.

Keywords: anaesthesia, intraoperative ventilation, PEEP, tidal volume

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Authors: Madeleine Cox

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Objective: discussion of diagnosis of vernix caseosa peritonitis, recovery and subsequent caesarean seciton Case: 30 year old G4P1 presented in labour at 40 weeks, planning a vaginal birth afterprevious caesarean section. She underwent an emergency caesarean section due to concerns for fetal wellbeing on CTG. She was found to have a thin lower segment with a very small area of dehiscence centrally. The operation was uncomplicated, and she recovered and went home 2 days later. She then represented to the emergency department day 6 post partum feeling very unwell, with significant abdominal pain, tachycardia as well as urinary retention. Raised white cell count of 13.7 with neutrophils of 11.64, CRP of 153. An abdominal ultrasound was poorly tolerated by the patient and did not aide in the diagnosis. Chest and abdominal xray were normal. She underwent a CT chest and abdomen, which found a small volume of free fluid with no apparent collection. Given no obvious cause of her symptoms were found and the patient did not improve, she had a repeat CT 2 days later, which showed progression of free fluid. A diagnostic laparoscopy was performed with general surgeons, which reveled turbid fluid, an inflamed appendix which was removed. The patient improved remarkably post operatively. The histology showed periappendicitis with acute appendicitis with marked serosal inflammatory reaction to vernix caseosa. Following this, the patient went on to recover well. 4 years later, the patient was booked for an elective caesarean section, on entry into the abdomen, there were very minimal adhesions, and the surgery and her subsequent recovery was uncomplicated. Discussion: this case represents the diagnostic dilemma of a patient who presents unwell without a clear cause. In this circumstance, multiple modes of imaging did not aide in her diagnosis, and so she underwent diagnostic surgery. It is important to evaluate if a patient is or is not responding to the typical causes of post operative pain and adjust management accordingly. A multiteam approach can help to provide a diagnosis for these patients. Conclusion: Vernix caseosa peritonitis is a rare cause of acute abdomen post partum. There are few reports in the literature of the initial presentation and no reports on the possible effects on future pregnancies. This patient did not have any complications in her following pregnancy or delivery secondary to her diagnosis of vernix caseosa peritonitis. This may assist in counselling other women who have had this uncommon diagnosis.

Keywords: peritonitis, obstetrics, caesarean section, pain

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Authors: Nosheen Zareen Khan, Abdul Majeed Siddiqui, Muhammad Afzal Rana

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The steady flow of a second order fluid through constricted tube with slip velocity at wall is modeled and analyzed theoretically. The governing equations are simplified by implying no slip in radial direction. Based on Karman Pohlhausen procedure polynomial solution for axial velocity profile is presented. An expressions for pressure gradient, shear stress, separation and reattachment points and radial velocity are also calculated. The effect of slip and no slip velocity on velocity, shear stress, pressure gradient are discussed and depicted graphically. It is noted that when Reynolds number increases velocity of the fluid decreases in both slip and no slip conditions. It is also found that the wall shear stress, separation and reattachment points are strongly effected by Reynolds number.

Keywords: approximate solution, constricted tube, non-Newtonian fluids, Reynolds number

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Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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Authors: Florian Kiebert, Hagen Schmidt

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Standing surface acoustic waves (sSAWs) have already been used to manipulate particles in a microfluidic channel made of polydimethylsiloxan (PDMS). Usually two identical facing interdigital transducers (IDTs) are exploited to form an sSAW. Further, it has been reported that an sSAW can be generated by a single IDT using a superstrate resonating cavity or a PDMS post. Nevertheless, both setups utilising a traveling surface acoustic wave (tSAW) to create an sSAW for particle manipulation are costly. We present a simplified setup with a tSAW and a PDMS channel to form an sSAW. The incident tSAW is reflected at the rear PDMS channel wall and superimposed with the reflected tSAW. This superpositioned waves generates an sSAW but only at regions where the distance to the rear channel wall is smaller as the attenuation length of the tSAW minus the channel width. Therefore in a channel of 500µm width a tSAW with a wavelength λ = 120 µm causes a sSAW over the whole channel, whereas a tSAW with λ = 60 µm only forms an sSAW next to the rear wall of the channel, taken into account the attenuation length of a tSAW in water. Hence, it is possible to concentrate and trap particles in a defined region of the channel by adjusting the relation between the channel width and tSAW wavelength. Moreover, it is possible to generate a particle gradient over the channel width by picking the right ratio between channel wall and wavelength. The particles are moved towards the rear wall by the acoustic streaming force (ASF) and the acoustic radiation force (ARF) caused by the tSAW generated bulk acoustic wave (BAW). At regions in the channel were the sSAW is dominating the ARF focuses the particles in the pressure nodes formed by the sSAW caused BAW. On the one side the ARF generated by the sSAW traps the particle at the center of the tSAW beam, i. e. of the IDT aperture. On the other side, the ASF leads to two vortices, one on the left and on the right side of the focus region, deflecting the particles out of it. Through variation of the applied power it is possible to vary the number of particles trapped in the focus points, because near to the rear wall the amplitude of the reflected tSAW is higher and, therefore, the ARF of the sSAW is stronger. So in the vicinity of the rear wall the concentration of particles is higher but decreases with increasing distance to the wall, forming a gradient of particles. The particle gradient depends on the applied power as well as on the flow rate. Thus by variation of these two parameters it is possible to change the particle gradient. Furthermore, we show that the particle gradient can be modified by changing the relation between the channel width and tSAW wavelength. Concluding a single IDT generates an sSAW in a PDMS microchannel enables particle gradient generation in a well-defined microfluidic flow system utilising the ARF and ASF of a tSAW and an sSAW.

Keywords: ARF, ASF, particle manipulation, sSAW, tSAW

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Authors: Huirui Han, Chao Zhang

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The rod bundle is used in the fuel assembly of the supercritical water-cooled nuclear reactor. In the rod bundle, the coolant absorbs the heat contributed by the fission process. Because of the dramatic variations in the thermophysical properties of water at supercritical conditions, it is essential to investigate the heat transfer characteristics of supercritical water in the rod bundle to ensure the safety of the nuclear power plant. In this study, the effects of the flow direction, including horizontal, upward, and downward, on the fluid flow and heat transfer of the supercritical water in the rod bundle were studied numerically. The results show the possibility of gap vortices in the flow subchannels of the rod bundle. In addition, the distributions of the circumferential wall temperature show differences in different flow direction conditions. It was also found that the circumferential cladding surface temperature distribution in the upward flow condition is extremely non-uniform, and there is a large difference between the maximum wall temperatures for different fuel rods.

Keywords: heat transfer, rod bundle, supercritical water, wall temperature

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Authors: N. Ploysook, R. Rugsaj, C. Suvanjumrat

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The characteristic requirement for producing rectangular shape bottles was a uniform thickness of the plastic bottle wall. Die shaping was a good technique which controlled the wall thickness of bottles. An advance technology which was the finite element method (FEM) for blowing parison to be a rectangular shape bottle was conducted to reduce waste plastic from a trial and error method of a die shaping and parison control method. The artificial intelligent (AI) comprised of artificial neural network and genetic algorithm was selected to optimize the die gap shape from the FEM results. The application of AI technique could optimize the suitable die gap shape for the parison blow molding which did not depend on the parison control method to produce rectangular bottles with the uniform wall. Particularly, this application can be used with cheap blow molding machines without a parison controller therefore it will reduce cost of production in the bottle blow molding process.

Keywords: AI, bottle, die shaping, FEM

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Authors: Shivam Patel, Abdullah Y. Usmani

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Physiological flow under rest and exercise conditions in patient-specific cerebral aneurysm models is numerically investigated. A finite-volume based code with BiCGStab as the linear equation solver is used to simulate unsteady three-dimensional flow field through the incompressible Navier-Stokes equations. Flow characteristics are first established in a healthy cerebral artery for both physiological conditions. The effect of saccular aneurysm on cerebral hemodynamics is then explored through a comparative analysis of the velocity distribution, nature of flow patterns, wall pressure and wall shear stress (WSS) against the reference configuration. The efficacy of coil embolization as a potential strategy of surgical intervention is also examined by modelling coil as a homogeneous and isotropic porous medium where the extended Darcy’s law, including Forchheimer and Brinkman terms, is applicable. The Carreau-Yasuda non-Newtonian blood model is incorporated to capture the shear thinning behavior of blood. Rest and exercise conditions correspond to normotensive and hypertensive blood pressures respectively. The results indicate that the fluid impingement on the outer wall of the arterial bend leads to abnormality in the distribution of wall pressure and WSS, which is expected to be the primary cause of the localized aneurysm. Exercise correlates with elevated flow velocity, vortex strength, wall pressure and WSS inside the aneurysm sac. With the insertion of coils in the aneurysm cavity, the flow bypasses the dilatation, leading to a decline in flow velocities and WSS. Particle residence time is observed to be lower under exercise conditions, a factor favorable for arresting plaque deposition and combating atherosclerosis.

Keywords: 3D FVM, Cerebral aneurysm, hypertension, coil embolization, non-Newtonian fluid

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Authors: A. Fogliata, L. Martiniello, A. Ambretti

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Introduction: The significance of balance and stability in physical education among adolescents is well-established. This study aims to assess the efficacy of Centering (CENT), which employs intra-abdominal pressure (IAP) in line with the Synchrony Method, in optimizing balance and reducing perceived stress. Materials and Methods: A 6-week intervention was conducted on a sample of adolescents, divided into a control group and an experimental group that incorporated CENT into their physical education program. The Stork Balance Test and the Perceived Stress Scale (PSS) were used to measure changes. Results: Findings revealed a significant enhancement in the balance of both the dominant and non-dominant limbs in the experimental group compared to the control group. Moreover, the PSS test indicated a reduction in perceived stress within the experimental group. Conclusion: Integrating the centering technique into physical education programs can lead to substantial improvements in adolescents' balance and stability, in addition to a reduction in perceived stress levels. These findings suggest the need for further research on broader populations to solidify these pivotal outcomes.

Keywords: adolescents, physical education, balance, centering, intra-abdominal pressure

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Authors: Mike R. Bambach

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Increasing awareness of environmental concerns is leading a drive towards more sustainable structural products for the built environment. Natural fibres such as flax, jute and hemp have recently been considered for fibre-resin composites, with a major motivation for their implementation being their notable sustainability attributes. While recent decades have seen substantial interest in the use of such natural fibres in composite materials, much of this research has focused on the materials aspects, including fibre processing techniques, composite fabrication methodologies, matrix materials and their effects on the mechanical properties. The present study experimentally investigates the compression strength of structural channel sections of flax, jute and hemp, with a particular focus on their suitability for residential stud wall applications. The section geometry is optimised for maximum strength via the introduction of complex stiffeners in the webs and flanges. Experimental results on both natural fibre composite channel sections and typical steel and timber residential wall studs are compared. The geometrically optimised natural fibre composite channels are shown to have compression capacities suitable for residential wall stud applications, identifying them as a potentially viable alternative to traditional building materials in such application, and potentially other light structural applications.

Keywords: channel sections, natural fibre composites, residential stud walls, structural composites

Procedia PDF Downloads 290

Authors: Jyun-Huei Huang, Ting-I Lee

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Urban heat island effect is derived from the reduction of vegetative cover by urban development. Because plants can improve air quality and microclimate, green walls have been applied as a sustainable design approach to cool building temperature. By using plants to green vertical surfaces, they decrease room temperature and, as a result, decrease the energy use for air conditioning. Based on their structures, green walls can be divided into two categories, green façades and living walls. A green façade uses the climbing ability of a plant itself, while a living wall assembles planter modules. The latter one is widely adopted in public space, as it is time-effective and less limited. Although a living wall saves energy spent on cooling, it is not necessarily cost-effective from the perspective of a lifecycle analysis. The Italian study shows that the overall benefit of a living wall is only greater than its costs after 47 years of its establishment. In Taiwan, urban greening policies encourage establishment of green walls by referring to their benefits of energy saving while neglecting their low performance on cost-effectiveness. Thus, this research aims at understanding the perception of appliers and consumers on the cost-effectiveness of their living wall products from the lifecycle viewpoint. It adopts semi-structured interviews and field observations on the maintenance of the products. By comparing the two results, it generates insights for sustainable urban greening policies. The preliminary finding shows that stakeholders do not have a holistic sense of lifecycle or cost-effectiveness. Most importantly, a living wall well maintained is often with high input due to the availability of its maintenance budget, and thus less sustainable. In conclusion, without a comprehensive sense of cost-effectiveness throughout a product’s lifecycle, it is very difficult for suppliers and consumers to maintain a living wall system while achieve sustainability.

Keywords: case study, maintenance, post-occupancy evaluation, vertical greening

Procedia PDF Downloads 240

Authors: K. A.Veselova, N. V.Gromova, I. N.Antonova, I. N. Kalakutskii

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There are many diseases and incidents that may result facial defects and deformities: cancer, trauma, burns, congenital anomalies, and autoimmune diseases. In some cases, patient may acquire atypically extensive facial defect, including more than one anatomical region or, by contrast, atypically small defect (e.g. partial auricular defect). The anaplastology gives us opportunity to help patient with facial disfigurement in cases when plastic surgery is contraindicated. Using of implant retention for facial prosthesis is strongly recommended because improves both aesthetic and functional results and makes using of the prosthesis more comfortable. Prostheticly oriented fixture position is extremely important for aesthetic and functional long-term result; however, the optimal site for fixture placement is not clear in cases with atypical configuration of facial defect. The objective of this report is to demonstrate challenges in fixture position determination we have faced with and offer the solution. In this report, four cases of implant-supported facial prosthesis are described. Extra-oral implants with four millimeter length were used in all cases. The decision regarding the quantity of surgical stages was based on anamnesis of disease. Facial prostheses were manufactured according to conventional technique. Clinical and technological difficulties and mistakes are described, and prostheticly oriented approach for determination of fixture position is demonstrated. The case with atypically large combined orbital and nasal defect resulting after arteriovenous malformation is described: the correct positioning of artificial eye was impossible due to wrong position of the fixture (with suprastructure) located in medial aspect of supraorbital rim. The suprastructure was unfixed and this fixture wasn`t used for retention in order to achieve appropriate artificial eye placement and better aesthetic result. In other case with small partial auricular defect (only helix and antihelix were absent) caused by squamoized cell carcinoma T1N0M0 surgical template was used to avoid the difficulties. To achieve the prostheticly oriented fixture position in case of extremely small defect the template was made on preliminary cast using vacuum thermoforming method. Two radiopaque markers were incorporated into template in preferable for fixture placement positions taking into account future prosthesis configuration. The template was put on remaining ear and cone-beam CT was performed to insure, that the amount of bone is enough for implant insertion in preferable position. Before the surgery radiopaque markers were extracted and template was holed for guide drill. Fabrication of implant-retained facial prostheses gives us opportunity to improve aesthetics, retention and patients’ quality of life. But every inaccuracy in planning leads to challenges on surgery and prosthetic stages. Moreover, in cases with atypically small or extended facial defects prostheticly oriented approach for determination of fixture position is strongly required. The approach including surgical template fabrication is effective, easy and cheap way to avoid mistakes and unpredictable result.

Keywords: anaplastology, facial prosthesis, implant-retained facial prosthesis., maxillofacil prosthese

Procedia PDF Downloads 71

Authors: Maarten J. Van der Burgt

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A universe containing matter and antimatter can only exist when matter and antimatter repel each other. Such a system, where like attracts like and like repels unlike, will always expand. Calculations made for such a symmetric universe demonstrate that the expansion is consistent with Hubble’s law, the observed increase in the expansion velocity with time, the initial high acceleration and the foam structure of the universe. Conversely, these observations can be considered as proof for a symmetrical universe and for antimatter possessing a negative gravitational mass. A second proof can be found by reinterpreting the behavior of relativistic moving charged particles. Attributing their behavior to a charge defect of √(1-v2/c2) instead of to a mass defect of 1/√(1-v2/c2) makes it plausible that gravitation is an electromagnetic force, as already suggested by Feynman. This would automatically imply that antimatter has a negative gravitational mass. These proofs underpin the untenability of the Weak Equivalence Principle which states that in a gravitational field all structure less point-like particles follow the same path.

Keywords: celestial mechanics, cosmology, gravitation astrophysics, origin of structure, miscellaneous (matter and antimatter)

Procedia PDF Downloads 202

Authors: Muizz Sanni-Anibire

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The 21st century has witnessed growing concerns for the protection of built facilities against natural and man-made disasters. Studies in earthquake resistant buildings, fire, and explosion resistant buildings now dominate the arena. To protect people and facilities from the effects of the explosion, reinforced concrete walls have been designed to be blast resistant. Understanding the performance of these walls is a key step in ensuring the safety of built facilities. Blast walls are mostly designed using simple techniques such as single degree of freedom (SDOF) method, despite the increasing use of multi-degree of freedom techniques such as the finite element method. This study is the first stage of a continuous research into the safety and reliability of blast walls. It presents the SDOF approach applied to the analysis of a concrete wall panel under three representative bomb situations. These are motorcycle 50 kg, car 400kg and also van with the capacity of 1500 kg of TNT explosive.

Keywords: blast wall, safety, protection, explosion

Procedia PDF Downloads 241

Authors: Mingming Leng

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Wal-Mart has allocated considerable human resources for its quality assurance program, in which the largest retailer serves its supply chains as a quality gatekeeper. Asda Stores Ltd., the second largest supermarket chain in Britain, is now investing £27m in significantly increasing the frequency of quality control checks in its supply chains and thus enhancing quality across its fresh food business. Moreover, Tesco, the largest British supermarket chain, already constructed a quality assessment center to carry out its gatekeeping responsibility. Motivated by the above practices, we consider a supply chain in which a retailer plays the gatekeeping role in quality assurance by identifying defects among a manufacturer's products prior to selling them to consumers. The impact of a retailer's gatekeeping activity on pricing and quality assurance in a supply chain has not been investigated in the operations management area. We draw a number of managerial insights that are expected to help practitioners judiciously consider the quality gatekeeping effort at the retail level. As in practice, when the retailer identifies a defective product, she immediately returns it to the manufacturer, who then replaces the defect with a good quality product and pays a penalty to the retailer. If the retailer does not recognize a defect but sells it to a consumer, then the consumer will identify the defect and return it to the retailer, who then passes the returned 'unidentified' defect to the manufacturer. The manufacturer also incurs a penalty cost. Accordingly, we analyze a two-stage pricing and quality decision problem, in which the manufacturer and the retailer bargain over the manufacturer's average defective rate and wholesale price at the first stage, and the retailer decides on her optimal retail price and gatekeeping intensity at the second stage. We also compare the results when the retailer performs quality gatekeeping with those when the retailer does not. Our supply chain analysis exposes some important managerial insights. For example, the retailer's quality gatekeeping can effectively reduce the channel-wide defective rate, if her penalty charge for each identified de-fect is larger than or equal to the market penalty for each unidentified defect. When the retailer imple-ments quality gatekeeping, the change in the negotiated wholesale price only depends on the manufac-turer's 'individual' benefit, and the change in the retailer's optimal retail price is only related to the channel-wide benefit. The retailer is willing to take on the quality gatekeeping responsibility, when the impact of quality relative to retail price on demand is high and/or the retailer has a strong bargaining power. We conclude that the retailer's quality gatekeeping can help reduce the defective rate for consumers, which becomes more significant when the retailer's bargaining position in her supply chain is stronger. Retailers with stronger bargaining powers can benefit more from their quality gatekeeping in supply chains.

Keywords: bargaining, game theory, pricing, quality, supply chain

Procedia PDF Downloads 250

Authors: C. Lanzerstorfer, M. Hinterberger

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The iron content of the ore used is crucial for the productivity and coke consumption rate in blast furnace pig iron production. Therefore, most iron ore deposits are processed in beneficiation plants to increase the iron content and remove impurities. In several comminution stages, the particle size of the ore is reduced to ensure that the iron oxides are physically liberated from the gangue. Subsequently, physical separation processes are applied to concentrate the iron ore. The fine-grained ore concentrates produced need to be transported, stored, and processed. For smooth operation of these processes, the flow properties of the material are crucial. The flowability of powders depends on several properties of the material: grain size, grain size distribution, grain shape, and moisture content of the material. The flowability of powders can be measured using ring shear testers. In this study, the influence of the moisture content on the flowability for the Krivoy Rog magnetite iron ore concentrate was investigated. Dry iron ore concentrate was mixed with varying amounts of water to produce samples with a moisture content in the range of 0.2 to 12.2%. The flowability of the samples was investigated using a Schulze ring shear tester. At all measured values of the normal stress (1.0 kPa – 20 kPa), the flowability decreased significantly from dry ore to a moisture content of approximately 3-5%. At higher moisture contents, the flowability was nearly constant, while at the maximum moisture content the flowability improved for high values of the normal stress only. The results also showed an improving flowability with increasing consolidation stress for all moisture content levels investigated. The wall friction angle of the dust with carbon steel (S235JR), and an ultra-high molecule low-pressure polyethylene (Robalon) was also investigated. The wall friction angle increased significantly from dry ore to a moisture content of approximately 3%. For higher moisture content levels, the wall friction angles were nearly constant. Generally, the wall friction angle was approximately 4° lower at the higher wall normal stress.

Keywords: iron ore concentrate, flowability, moisture content, wall friction angle

Procedia PDF Downloads 292