Search results for: eccentric fixation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 244

Search results for: eccentric fixation

214 Co-Limitation of Iron Deficiency in Stem Allantoin and Amino-N Formation of Peanut Plants Intercropped with Cassava

Authors: Hong Li, Tingxian Li, Xudong Wang, Weibo Yang

Abstract:

Co-limitation of iron (Fe) deficiency in legume nitrogen fixation process is not well understood. Our objectives were to examine how peanut plants cope with Fe deficiency with the rhizobial inoculants and N-nutrient treatments. The study was conducted in the tropical Hainan Island during 2012-2013. The soil was strongly acidic (pH 4.6±0.7) and deficient in Fe (9.2±2.3 mg/kg). Peanut plants were intercropped with cassava. The inoculants and N treatments were arranged in a split-plot design with three blocks. Peanut root nodulation, stem allantoin, amino acids and plant N derived from fixation (P) reduced with declining soil Fe concentrations. The treatment interactions were significant on relative ureide % and peanut yields (P<0.05). Residual fixed N from peanut plants was beneficial to cassava plants. It was concluded that co-variance of Fe deficiency could influence peanut N fixation efficiency and rhizobia and N inputs could help improving peanut tolerance to Fe deficiency stress.

Keywords: amino acids, plant N derived from N fixation, root nodulation, soil Fe co-variance, stem ureide, peanuts, cassava

Procedia PDF Downloads 268
213 Effect of Low Level Laser for Athletic Achilles Tendinopathy: A Systematic Review

Authors: Sameh Eldaly, Rola Essam

Abstract:

Objective: The purpose of this study was to determine the benefits of low-level laser therapy for Athletic Achilles Tendinopathy. Data sources: Search strategies were conducted on 2 Randomized control trial and one pilot study. Results: three trials (103 participants) were analyzed. Laser therapy associated to eccentric exercises, when compared to eccentric exercises and placebo, had low to very low certainty of evidence in pain and function assessment. Conclusion: those three trials evidenced low to very low effect of LLLT, and the results are insufficient to support the routine use LLLT for Achilles tendinopathy.

Keywords: achilles tendinopathy, evidence-based, low-level laser therapy, review

Procedia PDF Downloads 55
212 The Effects of Chamomile on Serum Levels of Inflammatory Indexes to a Bout of Eccentric Exercise in Young Women

Authors: K. Azadeh, M. Ghasemi, S. Fazelifar

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Aim: Changes in stress hormones can be modify response of immune system. Cortisol as the most important body corticosteroid is anti-inflammatory and immunosuppressive hormone. Normal levels of cortisol in humans has fluctuated during the day, In other words, cortisol is released periodically, and regulate through the release of ACTH circadian rhythm in every day. Therefore, the aim of this study was to determine the effects of Chamomile on serum levels of inflammatory indexes to a bout of eccentric exercise in young women. Methodology: 32 women were randomly divided into 4 groups: high dose of Chamomile, low dose of Chamomile, ibuprofen and placebo group. Eccentric exercise included 5 set and rest period between sets was 1 minute. For this purpose, subjects warm up 10 min and then done eccentric exercise. Each participant completed 15 repetitions with optional 20 kg weight or until can’t continue moving. When the subject was no longer able to continue to move, immediately decreased 5 kg from the weight and the protocol continued until cause exhaustion or complete 15 repetitions. Also, subjects received specified amount of ibuprofen and Chamomile capsules in target groups. Blood samples in 6 stages (pre of starting pill, pre of exercise protocol, 4, 24, 48 and 72 hours after eccentric exercise) was obtained. The levels of cortisol and adrenocorticotropic hormone levels were measured by ELISA way. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p < 0/05 accepted. Results: The results showed that Individual characteristics including height, weight, age and body mass index were not significantly different among the four groups. Analyze of data showed that cortisol and ACTH basic levels significantly decreased after supplementation consumption, but then gradually significantly increased in all stages of post exercise. In High dose of Chamomile group, increasing tendency of post exercise somewhat less than other groups, but not to a significant level. The inter-group analysis results indicate that time effect had a significant impact in different stages of the groups. Conclusion: The results of this study, one session of eccentric exercise increased cortisol and ACTH hormone. The results represent the effect of high dose of Chamomile in the prevention and reduction of increased stress hormone levels. As regards use of medicinal plants and ibuprofen as a pain medication and inflammation has spread among athletes and non-athletes, the results of this research can provide information about the advantages and disadvantages of using medicinal plants and ibuprofen.

Keywords: chamomile, inflammatory indexes, eccentric exercise, young girls

Procedia PDF Downloads 398
211 Mechanical Responses to Hip Versus Knee Induced Muscle Fatigue in Patellofemoral Pain Syndrome

Authors: Eman Ahmed Ahmed, Ghada Abdelmoneim Mohamed, Hamada Ahmed Hamada, Nagui Sobhi Nassif

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Impaired skeletal muscle endurance may be an important causal factor in the development of patellofemoral pain syndrome (PFPS). However, there is lack of information regarding the effect of hip versus knee muscle fatigue on isokinetic parameters, and myoelectric activity of hip and knee muscles in these patients. Purpose: The study was conducted to investigate the effect of hip abductors versus knee extensors fatigue protocol on knee proprioception, hip and knee muscle strength and their myoelectric activity in patients with PFPS. Methods: Fifteen female patients with PFPS participated in the study. They were tested randomly under two fatiguing conditions; hip abductors and knee extensors fatigue protocols. Isolated muscle fatigue of two muscles was induced isokinetically on the affected side in a two separate sessions with a rest interval of at least three days. After determining peak torque, patients performed continuous maximal concentric-eccentric contraction of the selected muscle until the torque output dropped below 50% of peak torque value for 3 consecutive repetitions. Knee proprioception, eccentric hip abductors' peak torque, eccentric knee extensors' peak torque, EMG ratio of vastus medialis obliquus (VMO) / vastus lateralis (VL), and EMG activity of gluteus medius (GM) muscle, were recorded before and immediately after each fatigue protocol using the Biodex Isokinetic system and EMG Myosystem. Results: Two-way within subject MANOVA revealed that eccentric knee extensors’ peak torque decreased significantly after hip abductors fatigue protocol compared to pre fatigue condition (p<0.05). On the other hand, there was no statistically significant difference in the eccentric hip abductors’ peak torque after admitting knee extensors fatigue protocol (p > 0.05). Moreover, no significant difference was found in knee proprioception, EMG ratio of VMO/VL, and EMG activity of GM muscle, after either hip or knee fatigue protocol (p>0.05). Conclusion: A hip focused rehabilitation program may be beneficial in improving knee function through correcting faulty kinematics and hence decrease knee loading in patients with PFPS.

Keywords: electromyography, knee proprioception, mechanical responses, muscle fatigue, patellofemoral pain syndrome

Procedia PDF Downloads 280
210 Evaluation of Nitrogen Fixation Capabilities of Selected Pea Lines Grown under Different Environmental Conditions in Canadian Prairie

Authors: Chao Yang, Rosalind Bueckert, Jeff Schoenau, Axel Diederichsen, Hossein Zakeri, Tom Warkentin

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Pea is a very popular pulse crop that widely grew in Western Canadian prairie. However, the N fixation capabilities of these pea lines were not well evaluated under local environmental conditions. In this study, 2 supernodulating mutants Frisson P64 Sym29, Frisson P88 Sym28 along with their wild parent Frisson, 1 hypernodulating mutant Rondo-nod3 (fix+) along with its wild parent Rondo, 1 non-nodulating mutant Frisson P56 (nod-) and 2 commercial pea cultivar CDC Meadow and CDC Dakota which are widely planted in Western Canada were selected in order to evaluate the capabilities of their BNF, biomass, and yield production in symbiosis with R. leguminosarumbv. viciae, Our results showed different environmental conditions and variation of pea lines could both significantly impact days to flowering (DTF), days to podding (DTP), biomass and yield of tested pea lines (P < 0.0001), suggesting consideration of environmental factors could be important when selecting pea cultivar for local farming under different soil zones in Western Canada. Significant interaction effects between environmental conditions and pea lines were found on pea N fixation as well (P = 0.001), suggesting changes in N fixation capability of the same pea cultivar when grown under different environmental conditions. Our results provide useful information for farming and better opportunity for selection of pea cultivars with higher N-fixing capacity during breeding programs in Western Canada.

Keywords: Canadian prairie, environmental condition, N fixation, pea cultivar

Procedia PDF Downloads 318
209 The Effect of Vertical Shear-link in Improving the Seismic Performance of Structures with Eccentrically Bracing Systems

Authors: Mohammad Reza Baradaran, Farhad Hamzezarghani, Mehdi Rastegari Ghiri, Zahra Mirsanjari

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Passive control methods can be utilized to build earthquake resistant structures, and also to strengthen the vulnerable ones. One of the most effective, yet simple passive control methods is the use of vertical shear-links (VSL) in systems with eccentric bracing. In fact, vertical shear-links dissipate the earthquake energy and act like a ductile fuse. In this paper, we studied the effect of this system in increasing the ductility and energy dissipation and also modeled the behavior of this type of eccentric bracing, and compared the hysteresis diagram of the modeled samples with the laboratory samples. We studied several samples of frames with vertical shear-links in order to assess the behavior of this type of eccentric bracing. Each of these samples was modeled in finite element software ANSYS 9.0, and was analyzed under the static cyclic loading. It was found that vertical shear-links have a more stable hysteresis loops. Another analysis showed that using honeycomb beams as the horizontal beam along with steel reinforcement has no negative effect on the hysteresis behavior of the sample.

Keywords: vertical shear-link, passive control, cyclic analysis, energy dissipation, honeycomb beam

Procedia PDF Downloads 455
208 Study on Errors in Estimating the 3D Gaze Point for Different Pupil Sizes Using Eye Vergences

Authors: M. Pomianek, M. Piszczek, M. Maciejewski

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The binocular eye tracking technology is increasingly being used in industry, entertainment and marketing analysis. In the case of virtual reality, eye tracking systems are already the basis for user interaction with the environment. In such systems, the high accuracy of determining the user's eye fixation point is very important due to the specificity of the virtual reality head-mounted display (HMD). Often, however, there are unknown errors occurring in the used eye tracking technology, as well as those resulting from the positioning of the devices in relation to the user's eyes. However, can the virtual environment itself influence estimation errors? The paper presents mathematical analyses and empirical studies of the determination of the fixation point and errors resulting from the change in the size of the pupil in response to the intensity of the displayed scene. The article contains both static laboratory tests as well as on the real user. Based on the research results, optimization solutions were proposed that would reduce the errors of gaze estimation errors. Studies show that errors in estimating the fixation point of vision can be minimized both by improving the pupil positioning algorithm in the video image and by using more precise methods to calibrate the eye tracking system in three-dimensional space.

Keywords: eye tracking, fixation point, pupil size, virtual reality

Procedia PDF Downloads 106
207 Assessment of the Biological Nitrogen Fixation in Soybean Sown in Different Types of Moroccan Soils

Authors: F. Z. Aliyat, B. Ben Messaoud, L. Nassiri, E. Bouiamrine, J. Ibijbijen

Abstract:

The present study aims to assess the biological nitrogen fixation in the soybean tested in different Moroccan soils combined with the rhizobial inoculation. These effects were evaluated by the plant growth mainly by the aerial biomass production, total nitrogen content and the proportion of the nitrogen fixed. This assessment clearly shows that the inoculation with bacteria increases the growth of soybean. Five different soils and a control (peat) were used. The rhizobial inoculation was performed by applying the peat that contained a mixture of 2 strains Sinorhizobium fredii HH103 and Bradyrhizobium. The biomass, the total nitrogen content and the proportion of nitrogen fixed were evaluated under different treatments. The essay was realized at the greenhouse the Faculty of Sciences, Moulay Ismail University. The soybean has shown a great response for the parameters assessed. Moreover, the best response was reported by the inoculated plants compared to non- inoculated and to the absolute control. Finally, good production and the best biological nitrogen fixation present an important ecological technology to improve the sustainable production of soybean and to ensure the increase of the fertility of soils.

Keywords: biological nitrogen fixation, inoculation, rhizobium, soybean

Procedia PDF Downloads 143
206 Biomechanics of Atalantoaxial Complex for Various Posterior Fixation Techniques

Authors: Arun C. O., Shrijith M. B., Thakur Rajesh Singh

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The study aims to analyze and understand the biomechanical stability of the atlantoaxial complex under different posterior fixation techniques using the finite element method in the Indian context. The conventional cadaveric studies performed show heterogeneity in biomechanical properties. The finite element method being a versatile numerical tool, is being wisely used for biomechanics analysis of atlantoaxial complex. However, the biomechanics of posterior fixation techniques for an Indian subject is missing in the literature. It is essential to study in this context as the bone density and geometry of vertebrae vary from region to region, thereby requiring different screw lengths and it can affect the range of motion(ROM), stresses generated. The current study uses CT images for developing a 3D finite element model with C1-C2 geometry without ligaments. Instrumentation is added to this geometry to develop four models for four fixation techniques, namely C1-C2 TA, C1LM-C2PS, C1LM-C2Pars, C1LM-C2TL. To simulate Flexion, extension, lateral bending, axial rotation, 1.5 Nm is applied to C1 while the bottom nodes of C2 are fixed. Then Range of Motion (ROM) is compared with the unstable model(without ligaments). All the fixation techniques showed more than 97 percent reduction in the Range of Motion. The von-mises stresses developed in the screw constructs are obtained. From the studies, it is observed that Transarticular technique is most stable in Lateral Bending, C1LM-C2 Translaminar is found most stable in Flexion/extension. The Von-Mises stresses developed minimum in Trasarticular technique in lateral bending and axial rotation, whereas stress developed in C2 pars construct minimum in Flexion/ Extension. On average, the TA technique is stable in all motions and also stresses in constructs are less in TA. Tarnsarticular technique is found to be the best fixation technique for Indian subjects among the 4 methods.

Keywords: biomechanics, cervical spine, finite element model, posterior fixation

Procedia PDF Downloads 117
205 Arthroscopic Fixation of Posterior Cruciate Ligament Avulsion Fracture through Posterior Trans Septal Portal Using Button Fixation Device: Mini Tight Rope

Authors: Ratnakar Rao, Subair Khan, Hari Haran

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Posterior cruciate ligament (PCL) avulsion fractures is a rare condition and commonly mismanaged.Surgical reattachment has been shown to produce better result compared with conservative management.Only few techniques are reported in arthroscopic fixation of PCL Avulsion Fracture and they are complex.We describe a new technique in fixation of the PCL Avulsion fracture through a posterior trans septal portal using button fixation device (Mini Tight Rope). Eighteen patients with an isolated posterior cruciate ligament avulsion fracture were operated under arthroscopy. Standard Antero Medial Portal and Antero Lateral portals made and additional Postero Medial and Postero Lateral portals made and trans Septal portal established. Avulsion fracture identified, elevated, prepared. Reduction achieved using PCL Tibial guide (Arthrex) and fixation was achieved using Mini Tight Rope,Arthrex (2 buttons with a suture). Reduction confirmed using probe and Image intensifier. Postoperative assessment made clinically and radiologically. 15 patients had good to excellent results with no posterior sag or instability. The range of motion was normal. No complications were recorded per operatively. 2 patients had communition of the fragment while drilling, for one patient it was managed by suturing technique and the second patient PCL Reconstruction was done. One patient had persistent instability with poor outcome. Establishing trans septal portal helps in better visualization of the posterior compartment of the knee. Assessment of the bony fragment, preparation 0f the bone bed andit protects from injury to posterior neurovascular structures. Fixation using the button with suture (Mini Tight Rope) is stable and easily reproducible for PCL Avulsion fracture with single large fragment.

Keywords: PCL avulsion, arthroscopy, transeptal, minitight rope technique

Procedia PDF Downloads 233
204 The Effect of Low Power Laser on CK and Some of Markers Delayed Onset Muscle Soreness (DOMS)

Authors: Bahareh Yazdanparast Chaharmahali

Abstract:

The study showed effect of low power laser therapy on knee range of motion (flexion and extension), resting angle of knee joint, knee circumference and rating of delayed onset muscle soreness induced pain, 24 and 48 hours after eccentric training of knee flexor muscle (hamstring muscle). We investigate the effects of pulsed ultrasound on swelling, relaxed, flexion and extension knee angle and pain. 20 volunteers among girl students of college voluntary participated in this research. After eccentric training, subjects were randomly divided into two groups, control and laser therapy. In day 1 and in order to induce delayed onset muscle soreness, subjects eccentrically trained their knee flexor muscles. In day 2, subjects were randomly divided into two groups: control and low power laser therapy. 24 and 48 hours after eccentric training. Variables (knee flexion and extension, srang of motion, resting knee joint angle and knee circumferences) were measured and analyzed. Data are reported as means ± standard error (SE) and repeated measured was used to assess differences within groups. Methods of treatment (low power laser therapy) have significant effects on delayed onset muscle soreness markers. 24 and 48 hours after training a significant difference was observed between mean pains of 2 groups. This difference was significant between low power laser therapy and C groups. The Bonferroni post hock is significant. Low power laser therapy trophy as used in this study did significantly diminish the effects of delayed – onset muscle soreness on swelling, relaxed – knee extension and flexion angle.

Keywords: creatine kinase, DOMS, eccentric training, low power laser

Procedia PDF Downloads 219
203 Plant Growth, Symbiotic Performance and Grain Yield of 63 Common Bean Genotypes Grown Under Field Conditions at Malkerns Eswatini

Authors: Rotondwa P. Gunununu, Mustapha Mohammed, Felix D. Dakora

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Common bean is the most importantly high protein grain legume grown in Southern Africa for human consumption and income generation. Although common bean can associate with rhizobia to fix N₂ for bacterial use and plant growth, it is reported to be a poor nitrogen fixer when compared to other legumes. N₂ fixation can vary with legume species, genotype and rhizobial strain. Therefore, screening legume germplasm can reveal rhizobia/genotype combinations with high N₂-fixing efficiency for use by farmers. This study assessed symbiotic performance and N₂ fixation in 63 common bean genotypes under field conditions at Malkerns Station in Eswatini, using the ¹⁵N natural abundance technique. The shoots of common bean genotypes were sampled at a pod-filling stage, oven-dried (65oC for 72h), weighed, ground into a fine powder (0.50 mm sieve), and subjected to ¹⁵N/¹⁴N isotopic analysis using mass spectrometry. At maturity, plants from the inner rows were harvested for the determination of grain yield. The results revealed significantly higher modulation (p≤0.05) in genotypes MCA98 and CIM-RM01-97-8 relative to the other genotypes. Shoot N concentration was highest in genotype MCA 98, followed by KAB 10 F2.8-84, with most genotypes showing shoot N concentrations below 2%. Percent N derived from atmospheric N₂ fixation (%Ndfa) differed markedly among genotypes, with CIM-RM01-92-3 and DAB 174, respectively, recording the highest values of 66.65% and 66.22 % N derived from fixation. There were also significant differences in grain yield, with CIM-RM02-79-1 producing the highest yield (3618.75 kg/ha). These results represent an important contribution in the profiling of symbiotic functioning of common bean germplasm for improved N₂ fixation.

Keywords: nitrogen fixation, %Ndfa, ¹⁵N natural abundance, grain yield

Procedia PDF Downloads 183
202 Pruning Residue Effects on Symbiotic N₂ Fixation and δ¹³C Isotopic Composition of Sesbania sesban and Cajanus cajan

Authors: I. T. Makhubedu, B. A. Letty, P. F. Scogings, P. L. Mafongoya

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Despite their potential importance in recycling dinitrogen (N2) fixed in alley cropping systems, the effects of tree pruning residues on symbiotic N2 fixation are poorly studied. A 2 x 2 x 2 factorial experiment was conducted to evaluate the effects of pruning residue management and pruning date on symbiotic performance and

Keywords: alley cropping, management, N₂ fixed, natural abundance, recycling

Procedia PDF Downloads 179
201 Simulation of Nano Drilling Fluid in an Extended Reach Well

Authors: Lina Jassim, Robiah Yunus, , Amran Salleh

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Since nano particles have been assessed as thermo stabilizer, rheology enhancer, and ecology safer, nano drilling fluid can be utilized to overcome the complexity of hole cleaning in highly deviated interval of an extended reach wells. The eccentric annular flow is a flow with special considerations; it forms a vital part of drilling fluid flow analysis in an extended reach wells. In this work eccentric, dual phase flow (different types of rock cuttings with different size were blended with nano fluid) through horizontal well (an extended reach well) are simulated with the help of CFD, Fluent package. In horizontal wells flow occurs in an adverse pressure gradient condition, that makes the particle inside it susceptible to reversed flow. Thus the flow has to be analyzed in a three dimensional manner. Moreover the non-Newtonian behavior of the nano fluid makes the problem really challenging in numerical and physical aspects. The primary objective of the work is to establish a relationship between different flow characteristics with the speed of inner wall rotation. The nano fluid flow characteristics include swirl of flow and its effect on wellbore cleaning ability , wall shear stress and its effect on fluid viscosity to suspend and carry the rock cuttings, axial velocity and its effect on transportation of rock cuttings to the wellbore surface, finally pressure drop and its effect on managed of drilling pressure. The importance of eccentricity of the inner cylinder has to be analyzed as a part of it. Practical horizontal well flows contain a good amount of particles (rock cuttings) with moderate axial velocity, which verified nano drilling fluid ability of carrying and transferring cuttings particles in the highly deviated eccentric annular flow is also of utmost importance.

Keywords: Non-Newtonian, dual phase, eccentric annular, CFD

Procedia PDF Downloads 407
200 Effect of Kinesio Taping on Anaerobic Power and Maximum Oxygen Consumption after Eccentric Exercise

Authors: Disaphon Boobpachat, Nuttaset Manimmanakorn, Apiwan Manimmanakorn, Worrawut Thuwakum, Michael J. Hamlin

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Objectives: To evaluate effect of kinesio tape compared to placebo tape and static stretching on recovery of anaerobic power and maximal oxygen uptake (Vo₂max) after intensive exercise. Methods: Thirty nine untrained healthy volunteers were randomized to 3 groups for each intervention: elastic tape, placebo tape and stretching. The participants performed intensive exercise on the dominant quadriceps by using isokinetic dynamometry machine. The recovery process was evaluated by creatine kinase (CK), pressure pain threshold (PPT), muscle soreness scale (MSS), maximum voluntary contraction (MVC), jump height, anaerobic power and Vo₂max at baseline, immediately post-exercise and post-exercise day 1, 2, 3 and 7. Results: The kinesio tape, placebo tape and stretching groups had significant changes of PPT, MVC, jump height at immediately post-exercise compared to baseline (p < 0.05), and changes of MSS, CK, anaerobic power and Vo₂max at day 1 post-exercise compared to baseline (p < 0.05). There was no significant difference of those outcomes among three groups. Additionally, all experimental groups had little effects on anaerobic power and Vo₂max compared to baseline and compared among three groups (p > 0.05). Conclusion: Kinesio tape and stretching did not improve recovery of anaerobic power and Vo₂max after eccentric exercise compared to placebo tape.

Keywords: stretching, eccentric exercise, Wingate test, muscle soreness

Procedia PDF Downloads 108
199 Effects of Excess-Iron Stress on Symbiotic Nitrogen Fixation Efficiency of Yardlong-Bean Plants

Authors: Hong Li, Tingxian Li, Xudong Wang, Qinghuo Lin

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Excess-iron (Fe) stresses involved in legume symbiotic nitrogen fixation are not understood. Our objectives were to investigate the tolerance of yardlong-bean plants to soil excess-Fe stress and antagonistic effects of organic amendments and rhizobial inoculants on plant root nodulation and stem ureide formation. The study was conducted in the tropical Hainan Island during 2012-2013. The soil was strongly acidic (pH 5.3±0.4) and highly variable in Fe concentrations(596±79 mg/kg). The treatments were arranged in a split-plot design with three blocks. The treatment effects were significant on root nodulation, stem ureide, amino acids, plant N/Fe accumulation and bean yields (P<0.05). The yardlong-bean stem allantoin, amino acids and nitrate concentrations and relative ureide % declined with high soil Fe concentrations (>300 mg/kg). It was concluded that the co-variance of excess Fe stress could inhibit legume symbiotic N fixation efficiency. Organic amendments and rhizobial inoculants could help improve crop tolerance to excess Fe stress.

Keywords: atmospheric N fixation, root nodulation, soil Fe co-variance, stem ureide, yardlong-bean plants

Procedia PDF Downloads 248
198 Behavior of Square Reinforced-Concrete Columns Strengthened with Carbon Fiber Reinforced Polymers under Eccentric Loading

Authors: Dana J. Abed, Mu'tasim S. Abdel-Jaber, Nasim K. Shatarat

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In this paper, an experimental study on twelve square columns was conducted to investigate the influence of cross-sectional size on axial compressive capacity of carbon fiber reinforced polymers (CFRP) wrapped square reinforced concrete (RC) short columns subjected to eccentric loadings. The columns were divided into three groups with three cross sections (200×200×1200, 250×250×1500 and 300×300×1800 mm). Each group was tested under two different eccentricities: 10% and 20% of the width of samples measured from the center of the column cross section. Four columns were developed in each arrangement. Two columns in each category were left unwrapped as control samples, and two were wrapped with one layer CFRP perpendicular to the specimen surface. In general; CFRP sheets has enhanced the performance of the strengthened columns compared to the control columns. It was noticed that the percentage of compressive capacity enhancement was decreased by increasing the cross-sectional size, and increasing loading eccentricity generally leads to reduced load bearing capacity in columns. In the same group specimens, when the eccentricity increased the percentage of enhancement in load carrying capacity was increased. The study concludes that the optimum use of the CFRP sheets for axial strength enhancement is for smaller cross-section columns under higher eccentricities.

Keywords: CFRP, columns, eccentric loading, cross-sectional

Procedia PDF Downloads 150
197 Effectiveness of Centromedullary Fixation by Metaizeau Technique in Challenging Pediatric Fractures

Authors: Mohammad Arshad Ikram

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We report three cases of challenging fractures in children treated by intramedullary fixation using the Metaizeau method and achieved anatomical reduction with excellent clinical results. Jean-Paul Metaizeau described the centromedullary fixation for the radial neck in 1980 using K-wires Radial neck fractures are uncommon in children. Treatment of severely displaced fractures is always challenging. Closed reduction techniques are more popular as compared to open reduction due to the low risk of complications. Metaizeau technique of closed reduction with centromedullary pinning is a commonly preferred method of treatment. We present two cases with a severely displaced radial neck fracture, treated by this method and achieved sound union; anatomical position of the radial head and full function were observed two months after surgery. Proximal humerus fractures are another uncommon injury in children accounting for less than 5% of all pediatric fractures. Most of these injuries occur through the growth plate because of its relative weakness. Salter-Harris type I is commonly seen in the younger age group, whereas type II & III occurs in older children and adolescents. In contrast to adults, traumatic glenohumeral dislocation is an infrequently observed condition among children. A combination of proximal humerus fracture and glenohumeral dislocation is extremely rare and occurs in less than 2% of the pediatric population. The management of this injury is always challenging. Treatment ranged from closed reduction with and without internal fixation and open reduction with internal fixation. The children who had closed reduction with centromedullary fixation by the Metaizeau method showed excellent results with the return of full movements at the shoulder in a short time without any complication. We present the case of a child with anterior dislocation of the shoulder associated with a complete displaced proximal humerus metaphyseal fracture. The fracture was managed by closed reduction and then fixation by two centromedullary K-wires using the Metaizeau method, achieving the anatomical reduction of the fracture and dislocation. This method of treatment enables us to achieve excellent radiological and clinical results in a short time.

Keywords: glenohumeral, Metaizeau method, pediatric fractures, radial neck

Procedia PDF Downloads 76
196 The Effects of Inferior Tilt Fixation on a Glenoid Components in Reverse Shoulder-Arthroplasty

Authors: Soo Min Kim, Soo-Won Chae, Soung-Yon Kim, Haea Lee, Ju Yong Kang, Juneyong Lee, Seung-Ho Han

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Reverse total shoulder arthroplasty (RTSA) has become an effective treatment option for cuff tear arthropathy and massive, irreparable rotator cuff tears and indications for its use are expanding. Numerous methods for optimal fixation of the glenoid component have been suggested, such as inferior overhang, inferior tilt, to maximize initial fixation and prevent glenoid component loosening. The inferior tilt fixation of a glenoid component has been suggested, which is expected to decrease scapular notching and to improve the stability of a glenoid component fixation in reverse total shoulder arthroplasty. Inferior tilt fixation of the glenoid component has been suggested, which can improve stability and, because it provides the most uniform compressive forces and imparts the least amount of tensile forces and micromotion, reduce the likelihood of mechanical failure. Another study reported that glenoid component inferior tilt improved impingement-free range of motion as well as minimized the scapular notching. Several authors have shown that inferior tilt of a glenoid component reduces scapular notching. However, controversy still exists regarding its importance in the literature. In this study the influence of inferior tilt fixation on the primary stability of a glenoid component has been investigated. Finite element models were constructed from cadaveric scapulae and glenoid components were implanted with neutral and 10° inferior tilts. Most previous biomechanical studies regarding the effect of glenoid component inferior tilt used a solid rigid polyurethane foam or sawbones block, not cadaveric scapulae, to evaluate the stability of the RTSA. Relative micromotions at the bone-glenoid component interface, and the distribution of bone stresses under the glenoid component and around the screws were analyzed and compared between neutral and 10° inferior tilt groups. Contact area between bone and screws and cut surface area of the cancellous bone exposed after reaming of the glenoid have also been investigated because of the fact that cancellous and cortical bone thickness vary depending on the resection level of the inferior glenoid bone. The greater relative micromotion of the bone-glenoid component interface occurred in the 10° inferior tilt group than in the neutral tilt group, especially at the inferior area of the bone-glenoid component interface. Bone stresses under the glenoid component and around the screws were also higher in the 10° inferior tilt group than in the neutral tilt group, especially at the inferior third of the glenoid bone surface under the glenoid component and inferior scapula. Thus inferior tilt fixation of the glenoid component may adversely affect the primary stability and longevity of the reverse total shoulder arthroplasty.

Keywords: finite element analysis, glenoid component, inferior tilt, reverse total shoulder arthroplasty

Procedia PDF Downloads 269
195 Comparison Between Tension Band Wiring Using K-Wires and Cannulated Screws in Transverse Patella Fracture Fixation

Authors: Daniel Francis, Mo Yassin

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Transverse patella fractures are routinely fixed using tension band wiring (TBW) using Kirschner wires and a wire in the shape of a figure of 8. The idea of the study was to compare the outcomes of the traditional technique against the more recently used cannulated screws and fiber tape in the shape of a figure of 8. We performed a retrospective cohort study of all the surgically fixed patella fractures from the year 2019 to 2022. The patients were divided into two groups TBW group and cannulated screws group. The primary outcome measure was the failure of fixation and the need for the removal of metalwork. Twenty-six patellar fractures were studied. TBW was used in 14 (53.8%), and cannulated screws were used for fixation in 12 (46.2%). There was one incident of metalwork failure in the TBW and one incident in the cannulated screws group. Five (35.7%) of patients in the TBW needed symptomatic metal work removed and One (8.3%) in the cannulated screw group. In both groups, the rate of fixation failure was low. Symptomatic implants, the most common complication observed, were higher in the TBW group in our practice. Although the small numbers in both groups, the hope of this study is to shine the light on the use of cannulated screws for patella fractures as it would reduce the need for a second operation and reduce the load on the already stretched services as well as improving the patient experience by not requiring further surgery. Although this is not a brand-new technique, it is not commonly used as there have not yet been any studies that demonstrate the lower rates of second surgery needed.

Keywords: patella, tension band wiring, randomised, new technique

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194 An Inquiry on Imaging of Soft Tissues in Micro-Computed Tomography

Authors: Matej Patzelt, Jana Mrzilkova, Jan Dudak, Frantisek Krejci, Jan Zemlicka, Zdenek Wurst, Petr Zach, Vladimir Musil

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Introduction: Micro-CT is well used for examination of bone structures and teeth. On the other hand visualization of the soft tissues is still limited. The goal of our study was to elaborate methodology for soft tissue samples imaging in micro-CT. Methodology: We used organs of rats and mice. We either did a preparation of the organs and fixation in contrast solution or we did cannulation of blood vessels and their injection for imaging of the vascular system. First, we scanned native specimens, then we created corrosive specimens by resins. In the next step, we injected vascular system either by Aurovist contrast agent or by Exitron. In the next step, we focused on soft tissues contrast increase. We scanned samples fixated in Lugol solution, samples fixated in pure ethanol and in formaldehyde solution. All used methods were afterwards compared. Results: Native specimens did not provide sufficient contrast of the tissues in any of organs. Corrosive samples of the blood stream provided great contrast and details; on the other hand, it was necessary to destroy the organ. Further examined possibility was injection of the AuroVist contrast that leads to the great bloodstream contrast. Injection of Exitron contrast agent comparing to Aurovist did not provide such a great contrast. The soft tissues (kidney, heart, lungs, brain, and liver) were best visualized after fixation in ethanol. This type of fixation showed best results in all studied tissues. Lugol solution had great results in muscle tissue. Fixation by formaldehyde solution showed similar quality of contrast in the tissues like ethanol. Conclusion: Before imaging, we need to, first, determinate which structures of the soft tissues we want to visualize. In the case of the bloodstream, the best was AuroVist and corrosive specimens. Muscle tissue is best visualized by Lugol solution. In the case of the organs containing cavities, like kidneys or brain, the best way was ethanol fixation.

Keywords: experimental imaging, fixation, micro-CT, soft tissues

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193 Experimental and Numerical Study of Ultra-High-Performance Fiber-Reinforced Concrete Column Subjected to Axial and Eccentric Loads

Authors: Chengfeng Fang, Mohamed Ali Sadakkathulla, Abdul Sheikh

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Ultra-high-performance fiber reinforced concrete (UHPFRC) is a specially formulated cement-based composite characterized with an ultra-high compressive strength (fc = 240 MPa) and a low water-cement ratio (W/B= 0.2). With such material characteristics, UHPFRC is favored for the design and constructions of structures required high structural performance and slender geometries. Unlike conventional concrete, the structural performance of members manufactured with UHPFRC has not yet been fully studied, particularly, for UHPFRC columns with high slenderness. In this study, the behaviors of slender UHPFRC columns under concentric or eccentric load will be investigated both experimentally and numerically. Four slender UHPFRC columns were tested under eccentric loads with eccentricities, of 0 mm, 35 mm, 50 mm, and 85 mm, respectively, and one UHPFRC beam was tested under four-point bending. Finite element (FE) analysis was conducted with concrete damage plasticity (CDP) modulus to simulating the load-middle height or middle span deflection relationships and damage patterns of all UHPFRC members. Simulated results were compared against the experimental results and observation to gain the confidence of FE model, and this model was further extended to conduct parametric studies, which aim to investigate the effects of slenderness regarding failure modes and load-moment interaction relationships. Experimental results showed that the load bearing capacities of the slender columns reduced with an increase in eccentricity. Comparisons between load-middle height and middle span deflection relationships as well as damage patterns of all UHPFRC members obtained both experimentally and numerically demonstrated high accuracy of the FE simulations. Based on the available FE model, the following parametric study indicated that a further increase in the slenderness of column resulted in significant decreases in the load-bearing capacities, ductility index, and flexural bending capacities.

Keywords: eccentric loads, ductility index, RC column, slenderness, UHPFRC

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192 Nitrogen Fixation of Soybean Approaches for Enhancing under Saline and Water Stress Conditions

Authors: Ayman El Sabagh, AbdElhamid Omar, Dekoum Assaha, Khair Mohammad Youldash, Akihiro Ueda, Celaleddin Barutçular, Hirofumi Saneoka

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Drought and salinity stress are a worldwide problem, constraining global crop production seriously. Hence, soybean is susceptible to yield loss from water deficit and salinity stress. Therefore, different approaches have been suggested to solve these issues. Osmoprotectants play an important role in protection the plants from various environmental stresses. Moreover, organic fertilization has several beneficial effects on agricultural fields. Presently, efforts to maximize nitrogen fixation in soybean are critical because of widespread increase in soil degradation in Egypt. Therefore, a greenhouse research was conducted at plant nutritional physiology laboratory, Hiroshima University, Japan for assessing the impact of exogenous osmoregulators and compost application in alleviating the adverse effects of salinity and water stress on soybean. Treatments was included (i) water stress treatments (different soil moisture levels consisting of (100%, 75%, and 50% of field water holding capacity), (ii) salinity concentrations (0 and 15 mM) were applied in fully developed trifoliolate leaf node (V1), (iii) compost treatments (0 and 24 t ha-1) and (iv) the exogenous, proline and glycine betaine concentrations (0 mM and 25 mM) for each, was applied at two growth stages (V1 and R1). The seeds of soybean cultivar Giza 111, was sown into basin from wood (length10 meter, width 50cm, height 50cm and depth 350cm) containing a soil mixture of granite regosol soil and perlite (2:1 v/v). The nitrogen-fixing activity was estimated by using gas chromatography and all measurements were made in three replicates. The results showed that water deficit and salinity stress reduced biological nitrogen fixation and specific nodule activity than normal irrigation conditions. Exogenous osmoprotectants were improved biological nitrogen fixation and specific nodule activity as well as, applying of compost led to improving many of biological nitrogen fixation and specific nodule activity with superiority than stress conditions. The combined application compost fertilizer and exogenous osmoprotectants were more effective in alleviating the adverse effect of stress to improve biological nitrogen fixation and specific nodule activity of Soybean.

Keywords: a biotic stress, biological nitrogen fixation, compost, osmoprotectants, specific nodule activity, soybean

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191 Comparison of the Effects of Rod Types of Rigid Fixation Devices on the Loads in the Lumbar Spine: A Finite Element Analysis

Authors: Bokku Kang, Changsoo Chon, Han Sung Kim

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We developed new design of rod of pedicle screw system that is beneficial in maintaining the spacing between the vertebrae and assessed the performance of the posterior fixation screw systems by numerical analysis according to the range of motion (flexion, extension, lateral bending, and axial rotation) of the vertebral column after inserting the pedicle screws. The simulation results showed that the conventional rod was the most low equivalent stress value among implant units in the case of flexion, extension and lateral bending of the vertebrae. In all cases except the torsional rotation, the results showed that the stress level of the single and double rounded rod exceeded about 30% to 70% compare to the conventional rod. Therefore, this product is not suitable for actual application in the field yet and it seems that product design optimization is necessary. Acknowledgement: This research was supported by the Ministry of Trade, Industry & Energy (MOTIE), Korea Institute for Advancement of Technology (KIAT) through the Encouragement Program for The Industries of Economic Cooperation Region.

Keywords: lumber spine, internal fixation device, finite element method, biomechanics

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

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

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

Keywords: lateral third, clavicle, suture, fixation

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189 The Healing Theatre: Beyond Alienation and Fixation Discourse of Three Theatrical Personalities in Bode Ojoniyi’s Dramaturgy

Authors: Oluwafemi Akinlawon Atoyebi

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This paper examines alienation and fixation as critical issues of/around mental health -crisis, sickness, and healing- through ‘Bode Ojoniyi’s dramaturgy. Two of his dramatic memoirs, arguably written to address such a life-threatening crisis between him and his employer, where he externalizes perhaps his psychological crisis, are critically analysed. This is done through a reading of the three theatrical phenomena of the actor, the character, and the audience against how he plays around the concepts of alienation and fixation within the totality of his dramaturgy beyond what could be seen as a mere academic exercise. The paper situates his apt understanding of their representations as a reflective force of a consciousness that defies psychosomatic existential conflicts. It does so by adopting a qualitative method of analysis through a critical reading of the two dramatic memoirs. It also carries out a survey on the audience that experienced the performances of the memoirs and an interview with Ojoniyi. Using Jean-Paul Sartre’s Theory of Existential Consciousness, the study discovers that there is a way the three phenomena of the actor, the character, and the audience do find expression in Ojoniyi as an existential omniscient playwright-actor-character-audience who is able to transcend the parochialism of an alienated and a fixated self; that beyond the limiting artistic purview, the theatre as a stage is a phenomenon that is capable of capturing the totality of the experiences of a man in his world and that, often time, the depressed are victims of the myopic syndrome as they probably could not see or reflect on/about their realities beyond the self and the play of a casual order. The study concludes that the therapeutic effect of Ojoniyi’s dramatic memoirs, in their reading or performance, is needed by all and should be explored in proffering cures for psychosomatic patients, for it promises to be essentially useful beyond its confine –the Arts.

Keywords: alienation, fixation, the healing theatre, theatrical personalities

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188 The Effect of Screw Parameters on Pullout Strength of Screw Fixation in Cervical Spine

Authors: S. Ritddech, P. Aroonjarattham, K. Aroonjarattham

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The pullout strength had an effect on the stability of plate screw fixation when inserted in the cervical spine. Nine different titanium alloy bone screws were used to test the pullout strength through finite element analysis. The result showed that the Moss Miami I can bear the highest pullout force at 1,075 N, which causes the maximum von Mises stress at 858.87 MPa, a value over the yield strength of titanium. The bone screw should have large outer diameter, core diameter and proximal root radius to increase the pullout strength.

Keywords: pullout strength, screw parameter, cervical spine, finite element analysis

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187 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures

Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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186 Variation in N₂ Fixation and N Contribution by 30 Groundnut (Arachis hypogaea L.) Varieties Grown in Blesbokfontein Mpumalanga Province, South Africa

Authors: Titus Y. Ngmenzuma, Cherian. Mathews, Feilx D. Dakora

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In Africa, poor nutrient availability, particularly N and P, coupled with low soil moisture due to erratic rainfall, constitutes the major crop production constraints. Although inorganic fertilizers are an option for meeting crop nutrient requirements for increased grain yield, the high cost and scarcity of inorganic inputs make them inaccessible to resource-poor farmers in Africa. Because crops grown on such nutrient-poor soils are micronutrient deficient, incorporating N₂-fixing legumes into cropping systems can sustainably improve crop yield and nutrient accumulation in the grain. In Africa, groundnut can easily form an effective symbiosis with native soil rhizobia, leading to marked N contribution in cropping systems. In this study, field experiments were conducted at Blesbokfontein in Mpumalanga Province to assess N₂ fixation and N contribution by 30 groundnut varieties during the 2018/2019 planting season using the ¹⁵N natural abundance technique. The results revealed marked differences in shoot dry matter yield, symbiotic N contribution, soil N uptake and grain yield among the groundnut varieties. The percent N derived from fixation ranged from 37 to 44% for varieties ICGV131051 and ICGV13984. The amount of N-fixed ranged from 21 to 58 kg/ha for varieties Chinese and IS-07273, soil N uptake from 31 to 80 kg/ha for varieties IS-07947 and IS-07273, and grain yield from 193 to 393 kg/ha for varieties ICGV15033 and ICGV131096, respectively. Compared to earlier studies on groundnut in South Africa, this study has shown low N₂ fixation and N contribution to the cropping systems, possibly due to environmental factors such as low soil moisture. Because the groundnut varieties differed in their growth, symbiotic performance and grain yield, more field testing is required over a range of differing agro-ecologies to identify genotypes suitable for different cropping environments

Keywords: ¹⁵N natural abundance, percent N derived from fixation, amount of N-fixed, grain yield

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185 Midface Trauma: Outpatient Follow-Up and Surgical Treatment Times

Authors: Divya Pathak, James Sloane

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Surgical treatment of midface fractures should ideally occur within two weeks of injury, after which bony healing and consolidation make the repair more difficult for the operating surgeon. The oral and maxillofacial unit at the Royal Surrey Hospital is the tertiary referral center for maxillofacial trauma from five regional hospitals. This is a complete audit cycle of midface trauma referrals managed over a one year period. The standard set was that clinical assessment of the midface fracture would take place in a consultant led outpatient clinic within 7 days, and when indicated, surgical fixation would occur within 10 days of referral. Retrospective data was collected over one year (01/11/2018 - 31/12/2019). Three key changes were implemented: an IT referral mailbox, standardization of an on-call trauma table, and creation of a trauma theatre list. Re-audit was carried out over six months completing the cycle. 283 midface fracture referrals were received, of which 22 patients needed surgical fixation. The average time from referral to outpatient follow-up improved from 14.5 days to 8.3 days, and time from referral to surgery improved from 21.5 days to 11.6 days. Changes implemented in this audit significantly improved patient prioritization to appropriate outpatient clinics and shortened time to surgical intervention.

Keywords: maxillofacial trauma, midface trauma, oral and maxillofacial surgery, surgery fixation

Procedia PDF Downloads 115