Search results for: joint audit
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1382

Search results for: joint audit

1082 Utility of Range of Motion Measurements on Classification of Athletes

Authors: Dhiraj Dolai, Rupayan Bhattacharya

Abstract:

In this study, a comparison of Range Of Motion (ROM) of middle and long-distance runners and swimmers has been made. The mobility of the various joints is essential for the quick movement of any sportsman. Knowledge of a ROM helps in preventing injuries, in repeating the movement, and in generating speed and power. ROM varies among individuals, and it is influenced by factors such as gender, age, and whether the motion is performed actively or passively. ROM for running and swimming, both performed with due consideration on speed, plays an important role. The time of generation of speed and mobility of the particular joints are very important for both kinds of athletes. The difficulties that happen during running and swimming in the direction of motion is changed. In this study, data were collected for a total of 102 subjects divided into three groups: control group (22), middle and long-distance runners (40), and swimmers (40), and their ages are between 12 to 18 years. The swimmers have higher ROM in shoulder joint flexion, extension, abduction, and adduction movement. Middle and long-distance runners have significantly greater ROM from Control Group in the left shoulder joint flexion with a 5.82 mean difference. Swimmers have significantly higher ROM from the Control Group in the left shoulder joint flexion with 24.84 mean difference and swimmers have significantly higher ROM from the Middle and Long distance runners in left shoulder flexion with 19.02 mean difference. The picture will be clear after a more detailed investigation.

Keywords: range of motion, runners, swimmers, significance

Procedia PDF Downloads 97
1081 Structural Performance Evaluation of Segmented Wind Turbine Blade Through Finite Element Simulation

Authors: Chandrashekhar Bhat, Dilifa Jossley Noronha, Faber A. Saldana

Abstract:

Transportation of long turbine blades from one place to another is a difficult process. Hence a feasibility study of modularization of wind turbine blade was taken from structural standpoint through finite element analysis. Initially, a non-segmented blade is modeled and its structural behavior is evaluated to serve as reference. The resonant, static bending and fatigue tests are simulated in accordance with IEC61400-23 standard for comparison purpose. The non-segmented test blade is separated at suitable location based on trade off studies and the segments are joined with an innovative double strap bonded joint configuration. The adhesive joint is modeled by adopting cohesive zone modeling approach in ANSYS. The developed blade model is analyzed for its structural response through simulation. Performances of both the blades are found to be similar, which indicates that, efficient segmentation of the long blade is possible which facilitates easy transportation of the blades and on site reassembling. The location selected for segmentation and adopted joint configuration has resulted in an efficient segmented blade model which proves the methodology adopted for segmentation was quite effective. The developed segmented blade appears to be the viable alternative considering its structural response specifically in fatigue within considered assumptions.

Keywords: modularization, fatigue, cohesive zone modeling, wind turbine blade

Procedia PDF Downloads 414
1080 Visco-Hyperelastic Finite Element Analysis for Diagnosis of Knee Joint Injury Caused by Meniscal Tearing

Authors: Eiji Nakamachi, Tsuyoshi Eguchi, Sayo Yamamoto, Yusuke Morita, H. Sakamoto

Abstract:

In this study, we aim to reveal the relationship between the meniscal tearing and the articular cartilage injury of knee joint by using the dynamic explicit finite element (FE) method. Meniscal injuries reduce its functional ability and consequently increase the load on the articular cartilage of knee joint. In order to prevent the induction of osteoarthritis (OA) caused by meniscal injuries, many medical treatment techniques, such as artificial meniscus replacement and meniscal regeneration, have been developed. However, it is reported that these treatments are not the comprehensive methods. In order to reveal the fundamental mechanism of OA induction, the mechanical characterization of meniscus under the condition of normal and injured states is carried out by using FE analyses. At first, a FE model of the human knee joint in the case of normal state – ‘intact’ - was constructed by using the magnetron resonance (MR) tomography images and the image construction code, Materialize Mimics. Next, two types of meniscal injury models with the radial tears of medial and lateral menisci were constructed. In FE analyses, the linear elastic constitutive law was adopted for the femur and tibia bones, the visco-hyperelastic constitutive law for the articular cartilage, and the visco-anisotropic hyperelastic constitutive law for the meniscus, respectively. Material properties of articular cartilage and meniscus were identified using the stress-strain curves obtained by our compressive and the tensile tests. The numerical results under the normal walking condition revealed how and where the maximum compressive stress occurred on the articular cartilage. The maximum compressive stress and its occurrence point were varied in the intact and two meniscal tear models. These compressive stress values can be used to establish the threshold value to cause the pathological change for the diagnosis. In this study, FE analyses of knee joint were carried out to reveal the influence of meniscal injuries on the cartilage injury. The following conclusions are obtained. 1. 3D FE model, which consists femur, tibia, articular cartilage and meniscus was constructed based on MR images of human knee joint. The image processing code, Materialize Mimics was used by using the tetrahedral FE elements. 2. Visco-anisotropic hyperelastic constitutive equation was formulated by adopting the generalized Kelvin model. The material properties of meniscus and articular cartilage were determined by curve fitting with experimental results. 3. Stresses on the articular cartilage and menisci were obtained in cases of the intact and two radial tears of medial and lateral menisci. Through comparison with the case of intact knee joint, two tear models show almost same stress value and higher value than the intact one. It was shown that both meniscal tears induce the stress localization in both medial and lateral regions. It is confirmed that our newly developed FE analysis code has a potential to be a new diagnostic system to evaluate the meniscal damage on the articular cartilage through the mechanical functional assessment.

Keywords: finite element analysis, hyperelastic constitutive law, knee joint injury, meniscal tear, stress concentration

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1079 Using Multiple Strategies to Improve the Nursing Staff Edwards Lifesciences Hemodynamic Monitoring Correctness of Operation

Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

Abstract:

Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

Procedia PDF Downloads 51
1078 Strengthening of Reinforced Concrete Beam-Column Joint by Reversible Mixed Technologies of FRP

Authors: Nasser-Eddine Attari

Abstract:

After the earthquake many structures were classified as slightly damaged and, being uneconomic to replace them, at least in the short term, suitable means of repairs of the beam column joint area are being studied. Furthermore there exist a large number of buildings that need retrofitting of the joints before the next earthquake. The paper reports the results of the experimental programme, constituted of three beam-column reinforced concrete joints at a scale of one to three (1/3) tested under the effect of a pre-stressed axial load acting over the column. The beams were subjected at their ends to an alternate cyclic loading under displacement control to simulate a seismic action. Strain and cracking fields were monitored with the help a digital recording camera. Following the analysis of the results, a comparison can be made between the performances in terms of ductility, strength and mode of failure of the different strengthening solution considered.

Keywords: fibrereinforced polymers, joints, reinforced concrete, beam columns

Procedia PDF Downloads 473
1077 The Strength and Metallography of a Bimetallic Friction Stir Bonded Joint between AA6061 and High Hardness Steel

Authors: Richard E. Miller

Abstract:

12.7-mm thick plates of 6061-T6511 aluminum alloy and high hardness steel (528 HV) were successfully joined by a friction stir bonding process using a tungsten-rhenium stir tool. Process parameter variation experiments, which included tool design geometry, plunge and traverse rates, tool offset, spindle tilt, and rotation speed, were conducted to develop a parameter set which yielded a defect free joint. Laboratory tensile tests exhibited yield stresses which exceed the strengths of comparable AA6061-to-AA6061 fusion and friction stir weld joints. Scanning electron microscopy and energy dispersive X-ray spectroscopy analysis also show atomic diffusion at the material interface region.

Keywords: dissimilar materials, friction stir, welding, materials science

Procedia PDF Downloads 236
1076 The Relationship between Employee Commitment, Job Satisfaction and External Market Orientation in Vietnamese Joint-Stock Commercial Banks

Authors: Nguyen Ngoc Que Tran

Abstract:

Purpose: The purpose of this paper is to investigate the relationship between internal market orientation, external market orientation, employee commitment and job satisfaction. Design/methodology/approach: This study collected data through a survey and utilized simple linear regression and multiple regression analysis to determine if there was any support for the research hypotheses as presented in the previous chapter. Findings: Using data from 256 employees of four leading joint stock banks in Vietnam, the empirical results indicates that employee commitment is positively related with external market orientation, job satisfaction is positively related to employee commitment, and employee commitment and job satisfaction are positively related to external market orientation. However, job satisfaction has no significant positive effect on external market orientation. Theoretical contribution: The primary contribution to marketing theory arising from this study is the integration of job satisfaction, employee commitment, and external market orientation in a single research model. Practical implications: The major contribution to practice is an external market oriented bank has to respond rapidly to the future needs and preferences of its customers. This could result in high levels of commitment to the service process and in doing so provide Vietnamese joint-stock commercial banks with a competitive advantage. The finding is important for the banking service sector in general and the Vietnamese banking industry in particular.

Keywords: employee commitment, job satisfaction and external market orientation, vietnam, bank

Procedia PDF Downloads 382
1075 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

Abstract:

The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

Procedia PDF Downloads 61
1074 Joint Space Hybrid Force/Position Control of 6-DoF Robot Manipulator Using Neural Network

Authors: Habtemariam Alemu

Abstract:

It has been known that the performance of position and force control is highly affected by both robot dynamic and environment stiffness uncertainties. In this paper, joint space hybrid force and position control strategy with self-selecting matrix using artificial neural network compensator is proposed. The objective of the work is to improve controller robustness by applying a neural network technique in order to compensate the effect of uncertainties in the robot model. Simulation results for a 6 degree of freedom (6-DoF) manipulator and different types of environments showed the effectiveness of the suggested approach. 6-DoF Puma 560 family robot manipulator is chosen as industrial robot and its efficient dynamic model is designed using Matlab/SimMechanics library.

Keywords: robot manipulator, force/position control, artificial neural network, Matlab/Simulink

Procedia PDF Downloads 482
1073 A Survey on Quasi-Likelihood Estimation Approaches for Longitudinal Set-ups

Authors: Naushad Mamode Khan

Abstract:

The Com-Poisson (CMP) model is one of the most popular discrete generalized linear models (GLMS) that handles both equi-, over- and under-dispersed data. In longitudinal context, an integer-valued autoregressive (INAR(1)) process that incorporates covariate specification has been developed to model longitudinal CMP counts. However, the joint likelihood CMP function is difficult to specify and thus restricts the likelihood based estimating methodology. The joint generalized quasilikelihood approach (GQL-I) was instead considered but is rather computationally intensive and may not even estimate the regression effects due to a complex and frequently ill conditioned covariance structure. This paper proposes a new GQL approach for estimating the regression parameters (GQLIII) that are based on a single score vector representation. The performance of GQL-III is compared with GQL-I and separate marginal GQLs (GQL-II) through some simulation experiments and is proved to yield equally efficient estimates as GQL-I and is far more computationally stable.

Keywords: longitudinal, com-Poisson, ill-conditioned, INAR(1), GLMS, GQL

Procedia PDF Downloads 332
1072 Failure Mode Analysis of a Multiple Layer Explosion Bonded Cryogenic Transition Joint

Authors: Richard Colwell, Thomas Englert

Abstract:

In cryogenic liquefaction processes, brazed aluminum core heat exchangers are used to minimize surface area/volume of the exchanger. Aluminum alloy (5083-H321; UNS A95083) piping must transition to higher melting point 304L stainless steel piping outside of the heat exchanger kettle or cold box for safety reasons. Since aluminum alloys and austenitic stainless steel cannot be directly welded to together, a transition joint consisting of 5 layers of different metals explosively bonded are used. Failures of two of these joints resulted in process shut-down and loss of revenue. Failure analyses, FEA analysis, and mock-up testing were performed by multiple teams to gain a further understanding into the failure mechanisms involved.

Keywords: explosion bonding, intermetallic compound, thermal strain, titanium-nickel Interface

Procedia PDF Downloads 175
1071 Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients

Authors: Shreya Saxena

Abstract:

Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

Procedia PDF Downloads 74
1070 Effectiveness of Exercise and TENS in the Treatment of Temporomandibular Joint Disorders

Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

Abstract:

Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

Procedia PDF Downloads 205
1069 Temperature Evolution, Microstructure and Mechanical Properties of Heat-Treatable Aluminum Alloy Welded by Friction Stir Welding: Comparison with Tungsten Inert Gas

Authors: Saliha Gachi, Mouloud Aissani, Fouad Boubenider

Abstract:

Friction Stir Welding (FSW) is a solid-state welding technique that can join material without melting the plates to be welded. In this work, we are interested to demonstrate the potentiality of FSW for joining the heat-treatable aluminum alloy 2024-T3 which is reputed as difficult to be welded by fusion techniques. Thereafter, the FSW joint is compared with another one obtained from a conventional fusion process Tungsten Inert Gas (TIG). FSW welds are made up using an FSW tool mounted on a milling machine. Single pass welding was applied to fabricated TIG joint. The comparison between the two processes has been made on the temperature evolution, mechanical and microstructure behavior. The microstructural examination revealed that FSW weld is composed of four zones: Base metal (BM), Heat affected zone (HAZ), Thermo-mechanical affected zone (THAZ) and the nugget zone (NZ). The NZ exhibits a recrystallized equiaxed refined grains that induce better mechanical properties and good ductility compared to TIG joint where the grains have a larger size in the welded region compared with the BM due to the elevated heat input. The microhardness results show that, in FSW weld, the THAZ contains the lowest microhardness values and increase in the NZ; however, in TIG process, the lowest values are localized on the NZ.

Keywords: friction stir welding, tungsten inert gaz, aluminum, microstructure

Procedia PDF Downloads 249
1068 An Efficient Traceability Mechanism in the Audited Cloud Data Storage

Authors: Ramya P, Lino Abraham Varghese, S. Bose

Abstract:

By cloud storage services, the data can be stored in the cloud, and can be shared across multiple users. Due to the unexpected hardware/software failures and human errors, which make the data stored in the cloud be lost or corrupted easily it affected the integrity of data in cloud. Some mechanisms have been designed to allow both data owners and public verifiers to efficiently audit cloud data integrity without retrieving the entire data from the cloud server. But public auditing on the integrity of shared data with the existing mechanisms will unavoidably reveal confidential information such as identity of the person, to public verifiers. Here a privacy-preserving mechanism is proposed to support public auditing on shared data stored in the cloud. It uses group signatures to compute verification metadata needed to audit the correctness of shared data. The identity of the signer on each block in shared data is kept confidential from public verifiers, who are easily verifying shared data integrity without retrieving the entire file. But on demand, the signer of the each block is reveal to the owner alone. Group private key is generated once by the owner in the static group, where as in the dynamic group, the group private key is change when the users revoke from the group. When the users leave from the group the already signed blocks are resigned by cloud service provider instead of owner is efficiently handled by efficient proxy re-signature scheme.

Keywords: data integrity, dynamic group, group signature, public auditing

Procedia PDF Downloads 365
1067 Operational Advantages of Tungsten Inert Gas over Metal Inert Gas Welding Process

Authors: Emmanuel Ogundimu, Esther Akinlabi, Mutiu Erinosho

Abstract:

In this research, studies were done on the material characterization of type 304 austenitic stainless steel weld produced by TIG (Tungsten Inert Gas) and MIG (Metal Inert Gas) welding processes. This research is aimed to establish optimized process parameters that will result in a defect-free weld joint, homogenous distribution of the iron (Fe), chromium (Cr) and nickel (Ni) was observed at the welded joint of all the six samples. The welded sample produced at the current of 170 A by TIG welding process had the highest ultimate tensile strength (UTS) value of 621 MPa at the welds zone, and the welded sample produced by MIG process at the welding current of 150 A had the lowest UTS value of 568 MPa. However, it was established that TIG welding process is more appropriate for the welding of type 304 austenitic stainless steel compared to the MIG welding process.

Keywords: microhardness, microstructure, tensile, MIG welding, process, tensile, shear stress TIG welding, TIG-MIG welding

Procedia PDF Downloads 157
1066 Prescription of Maintenance Fluids in the Emergency Department

Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

Abstract:

The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

Procedia PDF Downloads 294
1065 Seismic Strengthening of Reinforced Concrete Beam-Column Joint by Reversible Mixed Technologies of FRP

Authors: Nasser-Eddine Attari

Abstract:

After the earthquake many structures were classified as slightly damaged and, being uneconomic to replace them, at least in the short term, suitable means of repairs of the beam column joint area are being studied. Furthermore, there exist a large number of buildings that need retrofitting of the joints before the next earthquake. The paper reports the results of the experimental programme, constituted of three beam-column reinforced concrete joints at a scale of one to three (1/3) tested under the effect of a pre-stressing axial load acting over the column. The beams were subjected at their ends to an alternate cyclic loading under displacement control to simulate a seismic action. Strain and cracking fields were monitored with the help a digital recording camera. Following the analysis of the results, a comparison can be made between the performances in terms of ductility, strength, and mode of failure of the different strengthening solution considered.

Keywords: fibre reinforced polymers, joints, reinforced concrete, beam columns

Procedia PDF Downloads 407
1064 Improvement of the Q-System Using the Rock Engineering System: A Case Study of Water Conveyor Tunnel of Azad Dam

Authors: Sahand Golmohammadi, Sana Hosseini Shirazi

Abstract:

Because the status and mechanical parameters of discontinuities in the rock mass are included in the calculations, various methods of rock engineering classification are often used as a starting point for the design of different types of structures. The Q-system is one of the most frequently used methods for stability analysis and determination of support systems of underground structures in rock, including tunnel. In this method, six main parameters of the rock mass, namely, the rock quality designation (RQD), joint set number (Jn), joint roughness number (Jr), joint alteration number (Ja), joint water parameter (Jw) and stress reduction factor (SRF) are required. In this regard, in order to achieve a reasonable and optimal design, identifying the effective parameters for the stability of the mentioned structures is one of the most important goals and the most necessary actions in rock engineering. Therefore, it is necessary to study the relationships between the parameters of a system and how they interact with each other and, ultimately, the whole system. In this research, it has attempted to determine the most effective parameters (key parameters) from the six parameters of rock mass in the Q-system using the rock engineering system (RES) method to improve the relationships between the parameters in the calculation of the Q value. The RES system is, in fact, a method by which one can determine the degree of cause and effect of a system's parameters by making an interaction matrix. In this research, the geomechanical data collected from the water conveyor tunnel of Azad Dam were used to make the interaction matrix of the Q-system. For this purpose, instead of using the conventional methods that are always accompanied by defects such as uncertainty, the Q-system interaction matrix is coded using a technique that is actually a statistical analysis of the data and determining the correlation coefficient between them. So, the effect of each parameter on the system is evaluated with greater certainty. The results of this study show that the formed interaction matrix provides a reasonable estimate of the effective parameters in the Q-system. Among the six parameters of the Q-system, the SRF and Jr parameters have the maximum and minimum impact on the system, respectively, and also the RQD and Jw parameters have the maximum and minimum impact on the system, respectively. Therefore, by developing this method, we can obtain a more accurate relation to the rock mass classification by weighting the required parameters in the Q-system.

Keywords: Q-system, rock engineering system, statistical analysis, rock mass, tunnel

Procedia PDF Downloads 40
1063 Numerical Modelling and Experiment of a Composite Single-Lap Joint Reinforced by Multifunctional Thermoplastic Composite Fastener

Authors: Wenhao Li, Shijun Guo

Abstract:

Carbon fibre reinforced composites are progressively replacing metal structures in modern civil aircraft. This is because composite materials have large potential of weight saving compared with metal. However, the achievement to date of weight saving in composite structure is far less than the theoretical potential due to many uncertainties in structural integrity and safety concern. Unlike the conventional metallic structure, composite components are bonded together along the joints where structural integrity is a major concern. To ensure the safety, metal fasteners are used to reinforce the composite bonded joints. One of the solutions for a significant weight saving of composite structure is to develop an effective technology of on-board Structural Health Monitoring (SHM) System. By monitoring the real-life stress status of composite structures during service, the safety margin set in the structure design can be reduced with confidence. It provides a means of safeguard to minimize the need for programmed inspections and allow for maintenance to be need-driven, rather than usage-driven. The aim of this paper is to develop smart composite joint. The key technology is a multifunctional thermoplastic composite fastener (MTCF). The MTCF will replace some of the existing metallic fasteners in the most concerned locations distributed over the aircraft composite structures to reinforce the joints and form an on-board SHM network system. Each of the MTCFs will work as a unit of the AU and AE technology. The proposed MTCF technology has been patented and developed by Prof. Guo in Cranfield University, UK in the past a few years. The manufactured MTCF has been successfully employed in the composite SLJ (Single-Lap Joint). In terms of the structure integrity, the hybrid SLJ reinforced by MTCF achieves 19.1% improvement in the ultimate failure strength in comparison to the bonded SLJ. By increasing the diameter or rearranging the lay-up sequence of MTCF, the hybrid SLJ reinforced by MTCF is able to achieve the equivalent ultimate strength as that reinforced by titanium fastener. The predicted ultimate strength in simulation is in good agreement with the test results. In terms of the structural health monitoring, a signal from the MTCF was measured well before the load of mechanical failure. This signal provides a warning of initial crack in the joint which could not be detected by the strain gauge until the final failure.

Keywords: composite single-lap joint, crack propagation, multifunctional composite fastener, structural health monitoring

Procedia PDF Downloads 131
1062 Experimental Investigation of the Static and Dynamic Behaviour of Double Lap Joints

Authors: H. I. Beloufa, M. Tarfaoui

Abstract:

For many applications, adhesively bonded assemblies have gained an increasing interest in the industry due to several advantages over welding, riveting and bolting, such as reduction of stress concentrations, lightness, low cost and easy manufacturing. This work is largely concerned to show the effects of the loading rate of the adhesively bonded joints under different speed rates. The tensile tests were conducted at four different rates; static (5mm/min, 50mm/min) and dynamic tests (1m/s, and 10m/s). An attempt was made to determine the damage kinetic and a comparison between the use of aluminium and composite laminate substrates is introduced. Aluminum T6082 and glass/vinylester laminated composite Substrates were used to construct aluminum/aluminum and laminate/laminate specimens. The adhesive used in this study was Araldite 2015. The results showed the effects of the loading rate évolution on the double joint strength. The comparison of the results of static and dynamic tests showed a raise of the strength of the specimens while the load velocity is elevated. In the case of composite substrates double joint lap, the stiffness increased by more than 60% between static and dynamic tests. However, in the case of aluminum substrates, the rigidity improved about 28% from static to moderately high velocity loading. For both aluminum and composite double joint lap, the strength increased by approximately 25% when the tensile velocity is increased from 5 mm/min to 50 mm/min (static tests). Nevertheless, the tensile velocity is extended to 1m/s the strength increased by 13% and 25% respectively for composite and aluminum substrates.

Keywords: adhesive, double lap joints, static and dynamic behavior, tensile tests

Procedia PDF Downloads 173
1061 Effect of Filler Metal Diameter on Weld Joint of Carbon Steel SA516 Gr 70 and Filler Metal SFA 5.17 in Submerged Arc Welding SAW

Authors: A. Nait Salah, M. Kaddami

Abstract:

This work describes an investigation on the effect of filler metals diameter to weld joint, and low alloy carbon steel A516 Grade 70 is the base metal. Commercially SA516 Grade70 is frequently used for the manufacturing of pressure vessels, boilers and storage tank, etc. In fabrication industry, the hardness of the weld joint is between the important parameters to check, after heat treatment of the weld. Submerged arc welding (SAW) is used with two filler metal diameters, and this solid wire electrode is used for SAW non-alloy and for fine grain steels (SFA 5.17). The different diameters were selected (Ø = 2.4 mm and Ø = 4 mm) to weld two specimens. Both specimens were subjected to the same preparation conditions, heat treatment, macrograph, metallurgy micrograph, and micro-hardness test. Samples show almost similar structure with highest hardness. It is important to indicate that the thickness used in the base metal is 22 mm, and all specifications, preparation and controls were according to the ASME section IX. It was observed that two different filler metal diameters performed on two similar specimens demonstrated that the mechanical property (hardness) increases with decreasing diameter. It means that even the heat treatment has the same effect with the same conditions, the filler metal diameter insures a depth weld penetration and better homogenization. Hence, the SAW welding technique mentioned in the present study is favorable to implicate for the industry using the small filler metal diameter.

Keywords: ASME, base metal, micro-hardness test, submerged arc welding

Procedia PDF Downloads 120
1060 The Curvature of Bending Analysis and Motion of Soft Robotic Fingers by Full 3D Printing with MC-Cells Technique for Hand Rehabilitation

Authors: Chaiyawat Musikapan, Ratchatin Chancharoen, Saknan Bongsebandhu-Phubhakdi

Abstract:

For many recent years, soft robotic fingers were used for supporting the patients who had survived the neurological diseases that resulted in muscular disorders and neural network damages, such as stroke and Parkinson’s disease, and inflammatory symptoms such as De Quervain and trigger finger. Generally, the major hand function is significant to manipulate objects in activities of daily living (ADL). In this work, we proposed the model of soft actuator that manufactured by full 3D printing without the molding process and one material for use. Furthermore, we designed the model with a technique of multi cavitation cells (MC-Cells). Then, we demonstrated the curvature bending, fluidic pressure and force that generated to the model for assistive finger flexor and hand grasping. Also, the soft actuators were characterized in mathematics solving by the length of chord and arc length. In addition, we used an adaptive push-button switch machine to measure the force in our experiment. Consequently, we evaluated biomechanics efficiency by the range of motion (ROM) that affected to metacarpophalangeal joint (MCP), proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP). Finally, the model achieved to exhibit the corresponding fluidic pressure with force and ROM to assist the finger flexor and hand grasping.

Keywords: biomechanics efficiency, curvature bending, hand functional assistance, multi cavitation cells (MC-Cells), range of motion (ROM)

Procedia PDF Downloads 203
1059 Wire Localization Procedures in Non-Palpable Breast Cancers: An Audit Report and Review of Literature

Authors: Waqas Ahmad, Eisha Tahir, Shahper Aqeel, Imran Khalid Niazi, Amjad Iqbal

Abstract:

Background: Breast conservation surgery applies a number of techniques for accurate localization of lesions. Wire localization remains the method of choice in non-palpable breast cancers post-neoadjuvant chemotherapy. Objective: The aim of our study was to determine the accuracy of wire localization procedures in our department and compare it with internationally set protocols as per the Royal College of Radiologists. Post wire mammography, as well as the margin status of the postoperative specimen, assessed the accuracy of the procedure. Methods: We retrospectively reviewed the data of 225 patients who presented to our department from May 2014 to June 2015 post neoadjuvant chemotherapy with non-palpable cancers. These patients are candidates for wire localized lumpectomies either under ultrasound or stereotactic guidance. Metallic marker was placed in all the patients at the time of biopsy. Post wire mammogram was performed in all the patients and the distance of the wire tip from the marker was calculated. The presence or absence of the metallic clip in the postoperative specimen, as well as the marginal status of the postoperative specimen, was noted. Results: 157 sonographic and 68 stereotactic wire localization procedures were performed. 95% of the wire tips were within 1 cm of the metallic marker. Marginal status was negative in 94% of the patients in histopathological specimen. Conclusion: Our audit report declares more than 95% accuracy of image guided wire localization in successful excision of non-palpable breast lesions.

Keywords: breast, cancer, non-palpable, wire localization

Procedia PDF Downloads 283
1058 Clinical and Structural Differences in Knee Osteoarthritis with/without Synovial Hypertrophy

Authors: Gi-Young Park, Dong Rak Kwon, Sung Cheol Cho

Abstract:

Objective: The synovium is known to be involved in many pathological characteristic processes. Also, synovitis is common in advanced osteoarthritis. We aimed to evaluate the clinical, radiographic, and ultrasound findings in patients with knee osteoarthritis and to compare the clinical and imaging findings between knee osteoarthritis with and without synovial hypertrophy confirmed by ultrasound. Methods: One hundred knees (54 left, 46 right) in 95 patients (64 women, 31 men; mean age, 65.9 years; range, 43-85 years) with knee osteoarthritis were recruited. The Visual Analogue Scale (VAS) was used to assess the intensity of knee pain. The severity of knee osteoarthritis was classified according to Kellgren and Lawrence's (K-L) grade on a radiograph. Ultrasound examination was performed by a physiatrist who had 24 years of experience in musculoskeletal ultrasound. Ultrasound findings, including the thickness of joint effusion in the suprapatellar pouch, synovial hypertrophy, infrapatellar tendinosis, meniscal tear or extrusion, and Baker cyst, were measured and detected. The thickness of knee joint effusion was measured at the maximal anterior-posterior diameter of fluid collection in the suprapatellar pouch. Synovial hypertrophy was identified as the soft tissue of variable echogenicity, which is poorly compressible and nondisplaceable by compression of an ultrasound transducer. The knees were divided into two groups according to the presence of synovial hypertrophy. The differences in clinical and imaging findings between the two groups were evaluated by independent t-test and chi-square test. Results: Synovial hypertrophy was detected in 48 knees of 100 knees on ultrasound. There were no significant differences in demographic parameters and VAS score except in sex between the two groups (P<0.05). Medial meniscal extrusion and tear were significantly more frequent in knees with synovial hypertrophy than those in knees without synovial hypertrophy. K-L grade and joint effusion thickness were greater in patients with synovial hypertrophy than those in patients without synovial hypertrophy (P<0.05). Conclusion: Synovial hypertrophy in knee osteoarthritis was associated with greater suprapatellar joint effusion and higher K-L grade and maybe a characteristic ultrasound feature of late knee osteoarthritis. These results suggest that synovial hypertrophy on ultrasound can be regarded as a predictor of rapid progression in patients with knee osteoarthritis.

Keywords: knee osteoarthritis, synovial hypertrophy, ultrasound, K-L grade

Procedia PDF Downloads 45
1057 Dynamic Analysis of Double Deck Tunnel

Authors: C. W. Kwak, I. J. Park, D. I. Jang

Abstract:

The importance of cost-wise effective application and construction is getting increase due to the surge of traffic volume in the metropolitan cities. Accordingly, the necessity of the tunnel has large section becomes more critical. Double deck tunnel can be one of the most appropriate solutions to the necessity. The dynamic stability of double deck tunnel is essential against seismic load since it has large section and connection between perimeter lining and interim slab. In this study, 3-dimensional dynamic numerical analysis was conducted based on the Finite Difference Method to investigate the seismic behavior of double deck tunnel. Seismic joint for dynamic stability and the mitigation of seismic impact on the lining was considered in the modeling and analysis. Consequently, the mitigation of acceleration, lining displacement and stress were verified successfully.

Keywords: double deck tunnel, interim slab, 3-dimensional dynamic numerical analysis, seismic joint

Procedia PDF Downloads 357
1056 Sustainable Management Practices of International Construction Joint Ventures: A Conceptual Model for Managing Barriers and Risks

Authors: Mershack O. Tetteh, Albert P. C. Chan, Amos Darko, Gabriel Nani

Abstract:

International construction joint ventures (ICJVs) have evolved as an effective approach to sustainable development, given their myriad socio-economic and environmental benefits. Yet, they are not free of barriers and risks. In many studies, it is termed as risks for convenience’s sake. While the barriers and risks continue to affect the success of ICJVs, a systematic and reliable approach for managing them has yet to be developed. This study aims to identify and classify the barriers and risks factors affecting ICJVs through a systematic literature review. Based on a critical review of 54 papers published in peer-reviewed journals from 1990 to 2019, a conceptual framework was proposed for managing the barriers and risks in ICJV operations. The review showed that the barriers can be grouped into six including inter-organizational differences, lack of expertise and confidence, lack of effective planning and strategies, lack of knowledge of ICJV’s fundamentals, conflicts among ICJV entities, and management difficulties. The risks were also categorized into six: policy and political risks, legal risks, financial risks, management risks, project and technical risks, and market risks. The developed model would help practitioners achieve more efficient resource allocation and bring new perspectives for managerial practices in ICJVs. Moreover, it is positioned to alleviate the negligence of previous studies that combined the barriers and risks factors as one checklist.

Keywords: barriers, construction, international construction joint venture, risks, sustainable development

Procedia PDF Downloads 214
1055 Optimal Policies in a Two-Level Supply Chain with Defective Product and Price Dependent Demand

Authors: Samira Mohabbatdar, Abbas Ahmadi, Mohsen S. Sajadieh

Abstract:

This paper deals with a two-level supply chain consisted of one manufacturer and one retailer for single-type product. The demand function of the customers depends on price. We consider an integrated production inventory system where the manufacturer processes raw materials in order to deliver finished product with imperfect quality to the retailer. Then retailer inspects the products and after that delivers perfect products to customers. The proposed model is based on the joint total profit of both the manufacturer and the retailer, and it determines the optimal ordering lot-size, number of shipment and selling price of the retailer. A numerical example is provided to analyse and illustrate the behaviour and application of the model. Finally, sensitivity analysis of the key parameters are presented to test feasibility of the model.

Keywords: supply chain, pricing policy, defective quality, joint economic lot sizing

Procedia PDF Downloads 307
1054 Specific Biomarker Level and Function Outcome Changes in Treatment of Patients with Frozen Shoulder Using Dextrose Prolotherapy Injection

Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

Abstract:

The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

Procedia PDF Downloads 83
1053 Comparative Analysis of Two Approaches to Joint Signal Detection, ToA and AoA Estimation in Multi-Element Antenna Arrays

Authors: Olesya Bolkhovskaya, Alexey Davydov, Alexander Maltsev

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In this paper two approaches to joint signal detection, time of arrival (ToA) and angle of arrival (AoA) estimation in multi-element antenna array are investigated. Two scenarios were considered: first one, when the waveform of the useful signal is known a priori and, second one, when the waveform of the desired signal is unknown. For first scenario, the antenna array signal processing based on multi-element matched filtering (MF) with the following non-coherent detection scheme and maximum likelihood (ML) parameter estimation blocks is exploited. For second scenario, the signal processing based on the antenna array elements covariance matrix estimation with the following eigenvector analysis and ML parameter estimation blocks is applied. The performance characteristics of both signal processing schemes are thoroughly investigated and compared for different useful signals and noise parameters.

Keywords: antenna array, signal detection, ToA, AoA estimation

Procedia PDF Downloads 463