Search results for: cerebral perfusion pressure

Authors: Sarayu Vanga, Jorge Galeano-Cabral, Kaya Wei

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Cerebral hypoxia refers to a condition in which there is a decrease in oxygen supply to the brain. Patients suffering from this condition experience a decrease in their body temperature. While there isn't any cure to treat cerebral hypoxia as of date, certain procedures are utilized to help aid in the treatment of the condition. Regulating the body temperature is an example of one of those procedures. Hypoxia is well known to reduce the body temperature of mammals, although the neural origins of this response remain uncertain. In order to speed recovery from this condition, it is necessary to maintain a stable body temperature. In this study, we present an approach to regulating body temperature for patients who suffer from cerebral hypoxia or other similar conditions. After a thorough literature study, we propose the use of thermoelectric blankets, which are temperature-controlled thermal blankets based on thermoelectric devices. These blankets are capable of heating up and cooling down the patient to stabilize body temperature. This feature is possible through the reversible effect that thermoelectric devices offer while behaving as a thermal sensor, and it is an effective way to stabilize temperature. Thermoelectricity is the direct conversion of thermal to electrical energy and vice versa. This effect is now known as the Seebeck effect, and it is characterized by the Seebeck coefficient. In such a configuration, the device has cooling and heating sides with temperatures that can be interchanged by simply switching the direction of the current input in the system. This design integrates various aspects, including a humidifier, ventilation machine, IV-administered medication, air conditioning, circulation device, and a body temperature regulation system. The proposed design includes thermocouples that will trigger the blanket to increase or decrease a set temperature through a medical temperature sensor. Additionally, the proposed design allows an efficient way to control fluctuations in body temperature while being cost-friendly, with an expected cost of 150 dollars. We are currently working on developing a prototype of the design to collect thermal and electrical data under different conditions and also intend to perform an optimization analysis to improve the design even further. While this proposal was developed for treating cerebral hypoxia, it can also aid in the treatment of other related conditions, as fluctuations in body temperature appear to be a common symptom that patients have for many illnesses.

Keywords: body temperature regulation, cerebral hypoxia, thermoelectric, blanket design

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Authors: L. Parisi

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A blood pressure monitor or sphygmomanometer can be either manual or automatic, employing respectively either the auscultatory method or the oscillometric method. The manual version of the sphygmomanometer involves an inflatable cuff with a stethoscope adopted to detect the sounds generated by the arterial walls to measure blood pressure in an artery. An automatic sphygmomanometer can be effectively used to monitor blood pressure through a pressure sensor, which detects vibrations provoked by oscillations of the arterial walls. The pressure sensor implemented in this device improves the accuracy of the measurements taken.

Keywords: blood pressure, blood saturation, sensors, actuators, design improvement

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Authors: Hashem M. Alargha, Mohammad O. Hamdan, Waseem H. Aziz

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Aerobatic and military pilots are subjected to high gravitational forces that could cause blackout, physical injuries or death. A CFD simulation using fluid-solid interactions scheme has been conducted to investigate the gravitational effects and hazards inside cerebral aneurysms. Medical data have been used to derive the size and geometry of a simple aneurysm on a T-shaped bifurcation. The results show that gravitational force has no effect on maximum Wall Shear Stress (WSS); hence, it will not cause aneurysm initiation/formation. However, gravitational force cause causes hypertension which could contribute to aneurysm rupture.

Keywords: aneurysm, cfd, wall shear stress, gravity, fluid dynamics, bifurcation artery

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Authors: Claire Stafford, Charles Golden, Daniel Amen, Kristen Willeumier

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The aim of this study is to investigate the effect of the administration of the Conners Continuous Performance Test (CPT-3) on cerebral blood flow (CBF) in adults with ADHD. The data for this study was derived from a large SPECT database. Participants in the ADHD group (n=81, Mage=37.97) were similar to those in the healthy control group (n=8503, Mage=41.86). All participants were assessed for cerebral blood flow levels before and after CPT-3 administration. Both age and gender were considered covariates. Multiple 2-by-2 ANCOVAs with repeated measures were conducted with sphericity assumed. The main effects of CPT-3 administration on CBF levels were significant in the left and right side of the frontal and occipital, and right temporal lobe. The main effects of ADHD diagnosis were significant in all brain areas assessed. The interaction between CPT-3 administration and ADHD diagnosis was significant in the left and right side of the limbic system, basal ganglia, the frontal lobe, and occipital lobe. Post hoc tests with a Bonferroni adjustment revealed that CBF levels increased following CPT-3 administration but less so in the ADHD group. Individuals had higher levels of CBF following the administration of CPT-3. Due to a significant interaction, we can infer that ADHD diagnosis changes the effect of CPT-3 administration on CBF levels. This is consistent with our hypothesis considering that CPT-3 is a test of sustained attention, a common challenge for children with ADHD. The aforementioned interaction was not found to be significant in the parietal lobe. This may be due to the nature of CPT- 3 which does not require an integration of sensory information.

Keywords: SPECT, ADHD, conners continuous performance test, cerebral blood flow

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Authors: A. Gagat-Matuła

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There is a definite lack – in Poland, as well as around the world – of empirical studies of families raising handicapped child, in which one parent migrates. In diagnostics of the functioning of such families emphasis should be placed not only on the difficulties, but most of all it should be indicated what possibilities are there for the family and how it overcomes the difficulties. Migration of a parent on the one hand is a chance to improve the family’s material situation. In certain circumstances this may only be an “escape” into work from the issues associated with the upbringing and rehabilitation of a handicapped child. The aim of the study was to learn the functioning of a temporarily single parent family system as a result of migration of a parent from the perspective of adolescents with cerebral palsy. The study was conducted in the year 2013 in the area of Eastern Poland. It involved an analysis of 70 persons (with cerebral palsy in an intellectual capacity) from families in which at least one of the parents migrates. The study incorporated the diagnostic survey method. These tools were used: Family Evaluation Scales (SOR) adapted for Poland by Andrzej Margasiński. The explorations in this study indicate, that 47% of studied temporarily single parent families are balanced models. This is evidence of the resources at the disposal of the family which, despite the disability of the child and temporary separation, is able to function properly. The conducted studies show, that 37% of temporarily single parent families are imbalanced models in the perception of adolescents with cerebral palsy. These families experience functional difficulties and require psychological and pedagogical support. There is a need for building skills related to effective coping with family stress. Especially considering, that families of an imbalanced type do not use the internal and external resources of the family system. Such a situation may deepen the disarrangement of family life. In intermediate families (16%) there are also temporary difficulties in functioning. Separation anxiety experienced by mothers may disrupt relations and introduce additional stress factors. For that reason it is important to provide support for women with difficulties coping with the emotions associated with raising handicapped adolescents and migratory separation.

Keywords: child with cerebral palsy, family, migration, parents

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

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

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

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Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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Authors: Hadj Abd El Kader Benghenia, Fethi Bereksi Reguig

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In clinical medicine, blood pressure, raised blood hemodynamic monitoring is rich pathophysiological information of cardiovascular system, of course described through factors such as: blood volume, arterial compliance and peripheral resistance. In this work, we are interested in analyzing these signals to propose a detection algorithm to delineate the different sequences and especially systolic blood pressure (SBP), diastolic blood pressure (DBP), and the wave and dicrotic to do their analysis in order to extract the cardiovascular parameters.

Keywords: blood pressure, SBP, DBP, detection algorithm

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Authors: Sinem O. Aktan, Musa Y. Akkurt

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Experimental pressure calibration methods can be classified into three areas: (1) measurements in liquid or gas systems, (2) measurements in static-solid media systems, and (3) measurements in dynamic shock systems. Fluid (liquid and gas) systems high accuracies can be obtainable and commonly used for the calibration method of a pressure sensor. Pressure calibrations can be performed for metrological traceability in two ways, which are on-site (field) and in the laboratory. Laboratory and on-site calibration procedures and the requirements of the DKD-R-6-1 and Euramet cg-17 guidelines will also be addressed. In this study, calibration methods of direct and indirect reading pressure sensor and measurement uncertainty contributions will be explained.

Keywords: pressure metrology, pressure calibration, dead-weight tester, pressure uncertainty

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Authors: Shabnam Sarwar, Franck Lacoeuille, Nadia Withofs, Roland Hustinx

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After the development of a potential surrogate of MAA, and its successful application for the diagnosis of pulmonary embolism in artificially embolized rats’ lungs, this microparticulate system were radiolabelled with gallium-68 to synthesize 68Ga-SBMP with high radiochemical purity >99%. As a prerequisite step of clinical trials, 68Ga- labelled starch based microparticles (SBMP) were analysed for their in-vivo behavior in small animals. The purpose of the presented work includes the ex-vivo biodistribution studies of 68Ga-SBMP in order to assess the activity uptake in target organs with respect to time, excretion pathways of the radiopharmaceutical, %ID/g in major organs, T/NT ratios, in-vivo stability of the radiotracer and subsequently the microparticles in the target organs. Radiolabelling of starch based microparticles was performed by incubating it with 68Ga generator eluate (430±26 MBq) at room temperature and pressure without using any harsh reaction condition. For Ex-vivo biodistribution studies healthy White Wistar rats weighing between 345-460 g were injected intravenously 68Ga-SBMP 20±8 MBq, containing about 2,00,000-6,00,000 SBMP particles in a volume of 700µL. The rats were euthanized at predefined time intervals (5min, 30min, 60min and 120min) and their organ parts were cut, washed, and put in the pre-weighed tubes and measured for radioactivity counts through automatic Gamma counter. The 68Ga-SBMP produced >99% RCP just after 10-20 min incubation through a simple and robust procedure. Biodistribution of 68Ga-SBMP showed that initially just after 5 min post injection major uptake was observed in the lungs following by blood, heart, liver, kidneys, bladder, urine, spleen, stomach, small intestine, colon, skin and skeleton, thymus and at last the smallest activity was found in brain. Radioactivity counts stayed stable in lungs with gradual decrease with the passage of time, and after 2h post injection, almost half of the activity were seen in lungs. This is a sufficient time to perform PET/CT lungs scanning in humans while activity in the liver, spleen, gut and urinary system decreased with time. The results showed that urinary system is the excretion pathways instead of hepatobiliary excretion. There was a high value of T/NT ratios which suggest fine tune images for PET/CT lung perfusion studies henceforth further pre-clinical studies and then clinical trials should be planned in order to utilize this potential lung perfusion agent.

Keywords: starch based microparticles, gallium-68, biodistribution, target organs, excretion pathways

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Authors: Nouri, K., Ghassem Alaskari, M., K., Amiri Hazaveh, A., Nabi Bidhendi, M.

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Pore pressure is one on the key Petrophysical parameter in exploration discussion and survey on hydrocarbon reservoir. Determination of pore pressure in various levels of drilling and integrity of drilling mud and high pressure zones in order to restrict blow-out and following damages are significant. The pore pressure is obtained by seismic and well logging data. In this study the pore pressure and over burden pressure through the matrix stress and Tarzaqi equation and other related formulas are calculated. By making a comparison on variation of density log in over normal pressure zones with change of sonic impedance under influence of compressional, shear, and Stonely waves, the correlation level of sonic impedance with density log is studied. The level of correlation and variation trend is recorded in sonic impedance under influence Stonely wave with density log that key factor in recording of over burden pressure and pore pressure in Tarzaqi equation is high. The transition time is in divert relation with porosity and fluid type in the formation and as a consequence to the pore pressure. The density log is a key factor in determination of pore pressure therefore sonic impedance under Stonley wave is denotes well the identification of high pressure besides other used factors.

Keywords: pore pressure, stonely wave, density log, sonic impedance, high pressure zone

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Authors: Shyamani Hettiarachchi, Gopi Kitnasamy

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Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.

Keywords: cerebral palsy, CPQOL, culture, quality of life

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Authors: Aicha Rima Cheniti, Hatem Besbes, Joseph Haggege, Christophe Sintes

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In this paper, we are interested to determine the carbon dioxide pressure in the arterial blood through radial velocity difference. The blood was modeled as a two phase mixture (an aqueous carbon dioxide solution with carbon dioxide gas) by Drift flux model and the Young-Laplace equation. The distributions of mixture velocities determined from the considered model permitted the calculation of the radial velocity distributions with different values of mean mixture pressure and the calculation of the mean carbon dioxide pressure knowing the mean mixture pressure. The radial velocity distributions are used to deduce a calculation method of the mean mixture pressure through the radial velocity difference between two positions which is measured by ultrasound. The mean carbon dioxide pressure is then deduced from the mean mixture pressure.

Keywords: mean carbon dioxide pressure, mean mixture pressure, mixture velocity, radial velocity difference

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Authors: Vinod Kumar, Navin Kumar, Surjit Angra, Prince Sharma

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This paper presents the design analysis of saddle support of a horizontal pressure vessel. Since saddle have the vital role to support the pressure vessel and to maintain its stability, it should be designed in such a way that it can afford the vessel load and internal pressure of the vessel due to liquid contained in the vessel. A model of horizontal pressure vessel and saddle support is created in Ansys. Stresses are calculated using mathematical approach and Ansys software. The analysis reveals the zone of high localized stress at the junction part of the pressure vessel and saddle support due to operating conditions. The results obtained by both the methods are compared with allowable stress value for safe designing.

Keywords: ANSYS, pressure vessel, saddle, support

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Authors: K. Hiro, Y. Imai, T. Sasayama

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Cavitation under static negative pressure is not revealed well. The Berthelot method to generate such negative pressure can be a means to study cavitation inception. In this study, metal Berthelot tubes built in observation windows are newly developed and are checked whether high static negative pressure is generated or not. Negative pressure in the tube with a pair of a corundum plate and an aluminum gasket increased with temperature cycles. The trend was similar to that as reported before.

Keywords: Berthelot method, cavitation, negative pressure, observation

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Authors: K. AlJimaz, A. Abdullah, A. Abdulsalam, K. Ebdah, A. Abdalrasheed

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Understanding flow distribution and head losses is essential to design and calculate Thermo fluid parameters in order to reduce the pressure to a certain required pressure. This paper discusses the ways acquired in design and simulation to create and design an impedance box that reduces pressure. It's controlled by specific scientific principles such as Bernoulli’s principle and conservation of mass. In this paper, the design is made using SOLIDWORKS, and the simulation is done using ANSYS software to solve differential equations and study the parameters in the 3D model, also to understand how the design of this box reduced the pressure. The design was made so that fluid enters at a certain pressure of 3000 Pa in a single inlet; then, it exits from six outlets at a pressure of 300 Pa with respect to the conservation of mass principle. The effect of the distribution of flow and the head losses has been noticed that it has an impact on reducing the pressure since other factors, such as friction, were neglected and also the temperature, which was constant. The design showed that the increase in length and diameter of the pipe helped to reduce the pressure, and the head losses contributed significantly to reduce the pressure to 10% of the original pressure (from 3000 Pa to 300 Pa) at the outlets.

Keywords: box, pressure, thermodynamics, 3D

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Authors: Mohd Hazwan bin Yusof, Hiroshi Katanoda

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In order to clarify the structure of the cold flow discharged from the vortex tube (VT), the pressure of the cold flow was measured, and a simple flow visualization technique using a 0.75 mm-diameter needle and an oily paint is made to study the reverse flow at the cold exit. It is clear that a negative pressure and positive pressure region exist at a certain pressure and cold fraction area, and that a reverse flow is observed in the negative pressure region.

Keywords: flow visualization, pressure measurement, reverse flow, vortex tube

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Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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Authors: Mohamed A. Eid, Sobhy M. Aly

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Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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Authors: Kirankumar B. Balavalad, Bhagyashree Mudhol, B. G. Sheeparamatti

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MEMS sensor have gained popularity in automotive, biomedical, and industrial applications. In this paper, the design and simulation of conventional, slotted, and perforated MEMS capacitive pressure sensor is proposed. Polysilicon material is used as diaphragm material that deflects due to applied pressure. Better sensitivity is the main advantage of conventional pressure sensor as compared with other two sensors and perforated pressure sensor achieves large operating pressure range. The proposed MEMS sensor demonstrated with diaphragm length 50um, gap depth 3um is being modelled. The simulation is carried out for different types of MEMS capacitive pressure sensor using COMSOL Multiphysics and Coventor ware.

Keywords: MEMS, conventional pressure sensor, slotted and perforated diaphragm, COMSOL multiphysics, coventor ware

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Authors: Sahib Dino Naseerani

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The presented scientific text discusses the concept of imaginary pressure and its role in different relative motions. It explores how imaginary pressure, which is the combined effect of external atmospheric pressure and real pressure, affects various substances and their physical properties. The study aims to understand the impact of imaginary pressure and its potential applications in different contexts, such as spaceflight. The main objective of this study is to investigate the role of imaginary pressure on different relative motions. Specifically, the researchers aim to examine how imaginary pressure affects the contraction and mass variation of a body when it is in motion at the speed of light. The study seeks to provide insights into the behavior and consequences of imaginary pressure in various scenarios. The data was collected using three research papers. This research contributes to a better understanding of the theoretical implications of imaginary pressure. It elucidates how imaginary pressure is responsible for the contraction and mass variation of a body in motion, particularly at the speed of light. The findings shed light on the behavior of substances under the influence of imaginary pressure, providing valuable insights for future scientific studies. The study addresses the question of how imaginary pressure influences various relative motions and their associated physical properties. It aims to understand the role of imaginary pressure in the contraction and mass variation of a body, particularly at high speeds. By examining different substances in liquid and solid forms, the research explores the consequences of imaginary pressure on their volume, length, and mass.

Keywords: imaginary pressure, contraction, variation, relative motion

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Authors: Zainul Huda, Mohammed Hani Ajani

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The design, manufacture, and operation of thin-walled pressure vessels must be based on maximum safe operating pressure and an adequate factor of safety (FoS). This research paper first reports experimental evaluation of longitudinal and hoops stresses based on working pressure as well as maximum pressure; and then includes a critical study of factor of safety (FoS) in the design of a glass fiber pressure vessel. Experimental work involved the use of measuring instruments and the readings from pressure gauges. Design calculations involved the computations of design stress and FoS; the latter was based on breaking strength of 55 MPa for the glass fiber (pressure-vessel material). The experimentally determined FoS value has been critically compared with the general FoS allowed in the design of glass fiber pressure vessels.

Keywords: thin-walled pressure vessel, hoop stress, longitudinal stress, factor of safety (FoS), fiberglass

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Authors: Zainul Huda, Mohammad Hani Ajani

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The design, manufacture, and operation of thin-walled pressure vessels must be based on maximum safe operating pressure and an adequate factor of safety (FoS). This research paper first reports experimental evaluation of longitudinal and hoops stresses based on working pressure as well as maximum pressure; and then includes a critical study of factor of safety (FoS) in the design of a glass fiber pressure vessel. Experimental work involved the use of measuring instruments and the readings from pressure gauges. Design calculations involved the computations of design stress and FoS; the latter was based on breaking strength of 55 MPa for the glass fiber (pressure-vessel material). The experimentally determined FoS value has been critically compared with the general FoS allowed in the design of glass fiber pressure vessels.

Keywords: thin-walled pressure vessel, hoop stress, longitudinal stress, factor of safety (FoS), fiberglass

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Authors: Jaspal Rana

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Oxidative stress has been identified as an underlying cause of ischemia-reperfusion (IR) related cognitive dysfunction and brain damage. Therefore, antioxidant based therapies to treat IR injury are being investigated. Allium cepa L. (onion) is used as culinary medicine and is documented to have marked antioxidant effects. Hence, the present study was designed to evaluate the effect of A. cepa outer scale extract (ACE) against IR induced cognition and biochemical deficit in mice. ACE was prepared by maceration with 70% methanol and fractionated into ethylacetate and aqueous fractions. Bilateral common carotid artery occlusion for 10 min followed by 24 h reperfusion was used to induce cerebral IR injury. Following IR injury, ACE (100 and 200 mg/kg) was administered orally to animals for 7 days once daily. Behavioral outcomes (memory and sensorimotor functions) were evaluated using Morris water maze and neurological severity score. Cerebral infarct size, brain thiobarbituric acid reactive species, reduced glutathione, and superoxide dismutase activity was also determined. Treatment with ACE significantly ameliorated IR mediated deterioration of memory and sensorimotor functions and rise in brain oxidative stress in animals. The results of the present investigation revealed that ACE improved functional outcomes after cerebral IR injury which may be attributed to its antioxidant properties.

Keywords: ischemia-reperfusion, neuroprotective, stroke, antioxidant

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Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu

Abstract:

Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.

Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities

Procedia PDF Downloads 107

Authors: Raed H. Allawi

Abstract:

Formation pressure is the most critical parameter in hydrocarbon exploration and exploitation. Specifically, predicting abnormal pressures (high formation pressures) and subnormal pressure zones can provide valuable information to minimize uncertainty for anticipated drilling challenges and risks. This study aims to interpret and delineate the pore and fracture pressure of the Mishrif reservoir in the southern Iraq Oilfield. The data required to implement this study included acoustic compression wave, gamma-ray, bulk density, and drilling events. Furthermore, supporting these models needs the pore pressure measurement from the Modular Formation Dynamics Tester (MDT). Many measured values of pore pressure were used to validate the accurate model. Using sonic velocity approaches, the mean absolute percentage error (MAPE) was about 4%. The fracture pressure results were consistent with the measurement data, actual drilling report, and events. The model's results will be a guide for successful drilling in future wells in the same oilfield.

Keywords: pore pressure, fracture pressure, overburden pressure, effective stress, drilling events

Procedia PDF Downloads 50

Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

Abstract:

Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

Procedia PDF Downloads 297

Authors: Sharifullah Ahmed, P. Eng

Abstract:

The Axle Pressure and the Consolidation Pressure decrease with the height of the highway embankment and the depth of subsoil. This reduction of pressure depends on the height and width of the embankment. The depth is defined as the significantly stressed zone at which the pressure is reduced to 0.2 or 20%. The axle pressure is reduced to 7% for embankment height 1-3m and to 0.7% for embankment height 4-12m at the bottom level of Highway Embankment. This observation implies that, the portion of axle pressure transferred to subsoil underlying the embankment is not significant for ESAL factor 4.8. The 70% consolidation to have occurred after the construction of the surface layer of pavement. Considering this ratio of post construction settlement, 70% consolidation pressure (Δσ70) is used in this analysis. The magnitude of influence depth or Significant Stressed Zone (Ds) had been obtained for the range of crest width (at the top level of the embankment) is kept between 5m and 50m and for the range of embankment height from 1.0m to 12.0m considering 70% of consolidation pressure (Δσ70). Significantly stressed zones (Ds) for 70% embankment pressure are found as 2-6.2He for embankment top width 5-50m.

Keywords: consolidation pressure, consolidation settlement, ESAL, highway embankment, HS 20-44, significant stressed zone, stress distribution

Procedia PDF Downloads 64

Authors: R. Kiš, M. Malcho, M. Janovcová

Abstract:

This work aims to present a numerical analysis of the natural gas which flows through a high-pressure pipeline and an orifice plate, through the use of CFD methods. The paper contains CFD calculations for the flow of natural gas in a pipe with different geometry used for the orifice plates. One of them has a standard geometry and a shape without any deformation and the other is deformed by the action of the pressure differential. It shows the behaviour of natural gas in a pipeline using the velocity profiles and pressure fields of the gas in both models with their differences. The entire research is based on the elimination of any inaccuracy which should appear in the flow of the natural gas measured in the high-pressure pipelines of the gas industry and which is currently not given in the relevant standard.

Keywords: orifice plate, high-pressure pipeline, natural gas, CFD analysis

Procedia PDF Downloads 358

Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

Abstract:

Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

Procedia PDF Downloads 406