Search results for: joint audit
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1384

Search results for: joint audit

934 Study of seum Tumor Necrosis Factor Alpha in Pediatric Patients with Hemophilia A

Authors: Sara Mohammad Atef Sabaika

Abstract:

Background: The development of factor VIII (FVIII) inhibitor and hemophilic arthropathy in patients with hemophilia A (PWHA) are a great challenge for hemophilia care. Both genetic and environmental factors led to complications in PWHA. The development of inhibitory antibodies is usually induced by the immune response. Tumor necrosis factor α (TNF-α), one of the cytokines, might contribute to its polymorphism. Aim: Study the association between tumor necrosis alpha level and genotypes in pediatric patients with hemophilia A and its relation to inhibitor development and joint status. Methods: A cross-sectional study was conducted among a sufficient number of PWHA attending the Pediatric Hematology and Oncology Unit, Pediatric department in Menoufia University hospital. The clinical parameters, FVIII, FVIII inhibitor, and serum TNF-α level were assessed. The genotyping of −380G > A TNF-α gene polymorphism was performed using real time polymerase chain reaction. Results: Among the 50 PWHA, 28 (56%) were identified as severe PWHA. The FVIII inhibitor was identified in 6/28 (21.5%) of severe PWHA. There was a significant correlation between serum TNF-α level and the development of inhibitor (p = 0:043). There was significant correlation between polymorphisms of −380G > A TNF-α gene and hemophilic arthropathy development (p = 0:645). Conclusion: The prevalence of FVIII inhibitor in severe PWHA in Menoufia was 21.5%. The frequency of replacement therapy is a risk factor for inhibitor development. Serum TNF-α level and its gene polymorphism might be used to predict inhibitor development and joint status in pediatric patients with hemophilia A.

Keywords: hemophilic arthropathy, TNF alpha., patients witb hemophilia A PWHA, inhibitor

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933 Tax Evasion in Brazil: The Case of Specialists

Authors: Felippe Clemente, Viviani S. Lírio

Abstract:

Brazilian tax evasion is very high. It causes many problems for economics as budget realization, income distribution and no allocation of productive resources. Therefore, the purpose of this article is to use the instrumental game theory to understand tax evasion agents and tax authority in Brazil (Federal Revenue and Federal Police). By means of Game Theory approaches, the main results from considering cases both with and without specialists show that, in a high dropout situation, penalizing taxpayers with either high fines or deprivations of liberty may not be very effective. The analysis also shows that audit and inspection costs play an important role in driving the equilibrium system. This would suggest that a policy of investing in tax inspectors would be a more effective tool in combating non-compliance with tax obligations than penalties or fines.

Keywords: tax evasion, Brazil, game theory, specialists

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932 From Responses of Macroinvertebrate Metrics to the Definition of Reference Thresholds

Authors: Hounyèmè Romuald, Mama Daouda, Argillier Christine

Abstract:

The present study focused on the use of benthic macrofauna to define the reference state of an anthropized lagoon (Nokoué-Benin) from the responses of relevant metrics to proxies. The approach used is a combination of a joint species distribution model and Bayesian networks. The joint species distribution model was used to select the relevant metrics and generate posterior probabilities that were then converted into posterior response probabilities for each of the quality classes (pressure levels), which will constitute the conditional probability tables allowing the establishment of the probabilistic graph representing the different causal relationships between metrics and pressure proxies. For the definition of the reference thresholds, the predicted responses for low-pressure levels were read via probability density diagrams. Observations collected during high and low water periods spanning 03 consecutive years (2004-2006), sampling 33 macroinvertebrate taxa present at all seasons and sampling points, and measurements of 14 environmental parameters were used as application data. The study demonstrated reliable inferences, selection of 07 relevant metrics and definition of quality thresholds for each environmental parameter. The relevance of the metrics as well as the reference thresholds for ecological assessment despite the small sample size, suggests the potential for wider applicability of the approach for aquatic ecosystem monitoring and assessment programs in developing countries generally characterized by a lack of monitoring data.

Keywords: pressure proxies, bayesian inference, bioindicators, acadjas, functional traits

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931 The Determinants of Corporate Social Responsibility Disclosure Extent and Quality: The Case of Jordan

Authors: Hani Alkayed, Belal Omar, Eileen Roddy

Abstract:

This study focuses on investigating the determinants of Corporate Social Responsibility Disclosure (CSRD) extent and quality in Jordan. The study examines factors that influence CSR disclosure extent and quality, such as corporate characteristics (size, gearing, firm’s age, and industry type), corporate governance (board size, number of meetings, non-executive directors, female directors in the board, family directors in the board, foreign members, audit committee, type of external auditors, and CEO duality) and ownership structure (government ownership, institutional ownership, and ownership concentration). Legitimacy theory is utilised as the main theory for our theoretical framework. A quantitative approach is adopted for this research and content analysis technique is used to gather CSR disclosure extent and quality from the annual reports. The sample is withdrawn from the annual reports of 118 Jordanian companies over the period of 2010-2015. A CSRD index is constructed, and includes the disclosures of the following categories; environmental, human resources, product and consumers, and community involvement. A 7 point-scale measurement was developed to examine the quality of disclosure, were 0= No Disclosures, 1= General disclosures, (Non-monetary), 2= General disclosures, (Non-monetary) with pictures, charts, and graphs 3= Descriptive/ qualitative disclosures, specific details (Non-monetary), 4= Descriptive/ qualitative disclosures, specific details with pictures, charts, and graphs, 5= Numeric disclosures, full descriptions with supporting numbers, 6= Numeric disclosures, full descriptions with supporting numbers, pictures, and Charts. This study fills the gap in the literature regarding CSRD in Jordan, and the fact that all the previous studies have ignored a clear categorisation as a measurement of quality. The result shows that the extent of CSRD is higher than the quality in Jordan. Regarding the determinants of CSR disclosures, the followings were found to have a significant relationship with both extent and quality of CSRD except non-executives, were the significant relationship was found just with the extent of CSRD: board size, non-executive directors, firm’s age, foreign members on the board, number of boards meetings, the presence of audit committees, big 4, government ownership, firm’s size, industry type.

Keywords: content analysis, corporate governance, corporate social responsibility disclosure, Jordan, quality of disclosure

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930 Cystic Ganglionosis in Child: Rare Entity

Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar

Abstract:

Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.

Keywords: radiology, rare, cystic ganglionosis, child

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929 A BIM-Based Approach to Assess COVID-19 Risk Management Regarding Indoor Air Ventilation and Pedestrian Dynamics

Authors: T. Delval, C. Sauvage, Q. Jullien, R. Viano, T. Diallo, B. Collignan, G. Picinbono

Abstract:

In the context of the international spread of COVID-19, the Centre Scientifique et Technique du Bâtiment (CSTB) has led a joint research with the French government authorities Hauts-de-Seine department, to analyse the risk in school spaces according to their configuration, ventilation system and spatial segmentation strategy. This paper describes the main results of this joint research. A multidisciplinary team involving experts in indoor air quality/ventilation, pedestrian movements and IT domains was established to develop a COVID risk analysis tool based on Building Information Model. The work started with specific analysis on two pilot schools in order to provide for the local administration specifications to minimize the spread of the virus. Different recommendations were published to optimize/validate the use of ventilation systems and the strategy of student occupancy and student flow segmentation within the building. This COVID expertise has been digitized in order to manage a quick risk analysis on the entire building that could be used by the public administration through an easy user interface implemented in a free BIM Management software. One of the most interesting results is to enable a dynamic comparison of different ventilation system scenarios and space occupation strategy inside the BIM model. This concurrent engineering approach provides users with the optimal solution according to both ventilation and pedestrian flow expertise.

Keywords: BIM, knowledge management, system expert, risk management, indoor ventilation, pedestrian movement, integrated design

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928 Preoperative Smoking Cessation Audit: A Single Centre Experience from Metropolitan Melbourne

Authors: Ya-Chu May Tsai, Ibrahim Yacoub, Eoin Casey

Abstract:

The Australian and New Zealand College of Anaesthetists (ANZCA) advises that smoking should not be permitted within 12 hours of surgery. There is little information in the medical literature regarding patients awareness of perioperative smoking cessation recommendations nor their appreciation of how smoking might negatively impact their perioperative course. The aim of the study is to assess the prevalence of current smokers presenting to Werribee Mercy Hospital (WMH) and to evaluate if pre-operative provision of both written and verbal pre-operative advice was, 1: Effective in improving patient awareness of the benefits of pre-operative smoking cessation, 2: Associated with an increase in the number of elective surgical patients who stop smoking at least 12 hours pre-operatively. Methods: The initial survey included all patients who presented to WMH for elective surgical procedures from 19 – 30 September 2016 using a standardized questionnaire focused on patients’ smoking history and their awareness of smoking cessation preoperatively. The intervention consisted of a standard pre-operative phone call to all patients advising them of the increased perioperative risks associated with smoking, and advised patients to cease 12 hours prior. In addition, written information on smoking cessation strategies were sent out in mail at least 1 week prior to planned procedure date to all patients. Questionnaire-based study after the intervention was conducted on day of elective procedure from 10 – 21 October 2016 inclusive. Primary outcomes measured were patient’s awareness of smoking cessation and proportion of smokers who quit >12 hours, considered a clinically meaning duration to reduce anaesthetics complications. Comparison of pre and post intervention results were made using SPSS 21.0. Results: In the pre-intervention group (n=156), 36 (22.4%) patients were current smokers, 46 were ex-smokers (29.5%) and 74 were non-smokers (48.1%). Of the smokers, 12 (33%) reported having been informed of smoking cessation prior to operation and 8 (22%) were aware of increased intra- and perioperative adverse events associated with smoking. In the post-intervention group n= 177, 38 (21.5%) patients were current smokers, 39 were ex-smokers (22.0%) and 100 were non-smokers (56.5%). Of the smokers, 32 (88.9%) reported having been informed of smoking cessation prior to operation and 35 (97.2%) reported being aware of increased intra- and perioperative adverse events associated with smoking. The median time since last smoke in the pre-intervention group was 5.5 hours (Q1-Q3 = 2-14) compared with 13 hours (Q1-Q3 = 5-24) in post intervention group. Amongst the smokers, smoking cessation at least 12 hours prior to surgery significantly increased from 27.8% pre-intervention to 52.6% post intervention (P=0.03). Conclusion: A standard preoperative phone call and written instruction on smoking cessation guidelines at time of waitlist placement increase preoperative smoking cessation rates by almost 2-fold.

Keywords: anaesthesia, audit, perioperative medicine, smoking cessation

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927 Development of Probability Distribution Models for Degree of Bending (DoB) in Chord Member of Tubular X-Joints under Bending Loads

Authors: Hamid Ahmadi, Amirreza Ghaffari

Abstract:

Fatigue life of tubular joints in offshore structures is not only dependent on the value of hot-spot stress, but is also significantly influenced by the through-the-thickness stress distribution characterized by the degree of bending (DoB). The DoB exhibits considerable scatter calling for greater emphasis in accurate determination of its governing probability distribution which is a key input for the fatigue reliability analysis of a tubular joint. Although the tubular X-joints are commonly found in offshore jacket structures, as far as the authors are aware, no comprehensive research has been carried out on the probability distribution of the DoB in tubular X-joints. What has been used so far as the probability distribution of the DoB in reliability analyses is mainly based on assumptions and limited observations, especially in terms of distribution parameters. In the present paper, results of parametric equations available for the calculation of the DoB have been used to develop probability distribution models for the DoB in the chord member of tubular X-joints subjected to four types of bending loads. Based on a parametric study, a set of samples was prepared and density histograms were generated for these samples using Freedman-Diaconis method. Twelve different probability density functions (PDFs) were fitted to these histograms. The maximum likelihood method was utilized to determine the parameters of fitted distributions. In each case, Kolmogorov-Smirnov test was used to evaluate the goodness of fit. Finally, after substituting the values of estimated parameters for each distribution, a set of fully defined PDFs have been proposed for the DoB in tubular X-joints subjected to bending loads.

Keywords: tubular X-joint, degree of bending (DoB), probability density function (PDF), Kolmogorov-Smirnov goodness-of-fit test

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926 Experimental Model of the Behaviour of Bolted Angles Connections with Stiffeners

Authors: Abdulkadir Cuneyt Aydin, Mahyar Maali, Mahmut Kılıç, Merve Sağıroğlu

Abstract:

The moment-rotation curves of semi-rigid connections are the visual expressions of the actual behaviour discovered in beam-to-column connections experiments. This research was to determine the behaviour of the connection using full-scale experiments under statically loaded. The stiffeners which are typically attached to beams web or flanges to control local buckling and to increase shear capacity in a beam web are almost always used in modern designs. They must also provide sufficient moment of inertia to control out of plane deformations. This study was undertaken to analyse the influence of stiffeners in the angles and beams on the behaviour of the beam-to-column joints. In addition, the aim was to provide necessary data to improve the Eurocode 3. The main parameters observed are the evolution of the resistance, the stiffness, the rotation capacity, the ductility of a joint and the Energy Dissipation. Experimental tests show that the plastic flexural resistance and the energy dissipation increased when thickness of stiffener beam, thickness of stiffener angles were increased in the test specimens. And also, while stiffness of joints, the bending moment capacity and the maximum bending moment increased with the increasing thickness of stiffener beam, these values decreased with the increasing thickness of stiffener angles. So, it is observed that the beam stiffener of angles are important in improving resistance moment of beam-to-column semi-rigid joints.

Keywords: bolted angles connection, semi-rigid joints, ductility of a joint, angles and beams stiffeners

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925 High-Temperature Corrosion of Weldment of Fe-2%Mn-0.5%Si Steel in N2/H2O/H2S-Mixed Gas

Authors: Sang Hwan Bak, Min Jung Kim, Dong Bok Lee

Abstract:

Fe-2%Mn-0.5%Si-0.2C steel was welded and corroded at 600, 700 and 800oC for 20 h in 1 atm of N2/H2S/H2O-mixed gas in order to characterize the high-temperature corrosion behavior of the welded joint. Corrosion proceeded fast and almost linearly. It increased with an increase in the corrosion temperature. H2S formed FeS owing to sulfur released from H2S. The scales were fragile and nonadherent.

Keywords: Fe-Mn-Si steel, corrosion, welding, sulfidation, H2S gas

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924 Death Due to Ulnar Artery Injury by Glassdoor: A Case Report

Authors: Ashok Kumar Rastogi

Abstract:

Glass is a material commonly used for Glassdoor, glass bottles, cookware, and containers. It can be harmful, as it is a hard and blunt object. Glass has been associated with severe injury and is a common cause of injuries warranting hospital visits to the emergency department (ED). These injuries can be accidental or intentionally inflicted. Broken glass injuries can be severe, even deadly. If broken glass shards fall out on your arm, it may cause fatal injuries. Case history: A 20-year-old male dead body was found aside the road, police informed, and a video recording ceased during an investigation. In the video recording, the person was in a drunken state (unable to walk and disoriented), wandering in the residential area road. He saw a barber shop, the shop door made of Glass. Suddenly, he hit the Glassdoor with his right hand forcefully. The Glassdoor broke into multiple pieces, and multiple injuries were seen over the right hand. Observations: Multiple small and large lacerations were seen over the right anterior part of the elbow. The main injury looked like an incised wound caused by a hard and sharp object. The main injury was noted as a laceration of size 13 x 06 cm bone deep, placed obliquely over the anteromedial aspect of the right elbow joint, its medial end at medial end of elbow joint while its anterior end was 04 cm below the elbow joint with laceration of underline brachialis muscles and complete transaction of ulnar artery and vein, skin margins looking sharply cut with irregular margins with tiny cuts at the medial lower border of laceration. Injuries were antemortem and fresh in nature, caused by hard and blunt objects but looking like hard and sharp objects. All organs were found pale, and the cause of death was shock and hemorrhage because of ulnar vessel injury. Conclusion: The findings of this case report highlight the potentially lethal consequences of glass injuries, especially those involving Glassdoors. The study underscores the importance of accurate interpretation and identification of wounds caused by Glass, as they may resemble injuries caused by other objects. It emphasizes the challenges faced by autopsy surgeons when determining the cause and manner of death in cases where visual evidence of injury is absent or when the weapon is not recovered. Ultimately, this case report serves as a reminder of the potential dangers posed by Glass and the importance of comprehensive forensic examinations.

Keywords: glassdoor, incised, wound, laceration, autopsy

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923 Importance of Flexibility Training for Older Adults: A Narrative Review

Authors: Andrej Kocjan

Abstract:

Introduction: Mobility has been shown to play an important role of health and quality of life among older adults. Falls, which are often related to decreased mobility, as well as to neuromuscular deficits, represent the most common injury among older adults. Fall risk has been shown to increase with reduced lower extremity flexibility. The aim of the paper is to assess the importance of flexibility training on joint range of motion and functional performance among elderly population. Methods: We performed literature research on PubMed and evaluated articles published until 2000. The articles found in the search strategy were also added. The population of interest included older adults (≥ 65 years of age). Results: Flexibility training programs still represent an important part of several rehabilitation programs. Static stretching and proprioceptive neuromuscular facilitation are the most frequently used techniques to improve the length of the muscle-tendon complex. Although the effectiveness of type of stretching seems to be related to age and gender, static stretching is a more appropriate technique to enhance shoulder, hip, and ankle range of motion in older adults. Stretching should be performed in multiple sets with holds of more than 60 seconds for a single muscle group. Conclusion: The literature suggests that flexibility training is an effective method to increase joint range of motion in older adults. In the light of increased functional outcome, activities such as strengthening, balance, and aerobic exercises should be incorporated into a training program for older people. Due to relatively little published literature, it is still not possible to prescribe detailed recommendations regarding flexibility training for older adults.

Keywords: elderly, exercise, flexibility, falls

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922 A Multi Objective Reliable Location-Inventory Capacitated Disruption Facility Problem with Penalty Cost Solve with Efficient Meta Historic Algorithms

Authors: Elham Taghizadeh, Mostafa Abedzadeh, Mostafa Setak

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Logistics network is expected that opened facilities work continuously for a long time horizon without any failure; but in real world problems, facilities may face disruptions. This paper studies a reliable joint inventory location problem to optimize cost of facility locations, customers’ assignment, and inventory management decisions when facilities face failure risks and doesn’t work. In our model we assume when a facility is out of work, its customers may be reassigned to other operational facilities otherwise they must endure high penalty costs associated with losing service. For defining the model closer to real world problems, the model is proposed based on p-median problem and the facilities are considered to have limited capacities. We define a new binary variable (Z_is) for showing that customers are not assigned to any facilities. Our problem involve a bi-objective model; the first one minimizes the sum of facility construction costs and expected inventory holding costs, the second one function that mention for the first one is minimizes maximum expected customer costs under normal and failure scenarios. For solving this model we use NSGAII and MOSS algorithms have been applied to find the pareto- archive solution. Also Response Surface Methodology (RSM) is applied for optimizing the NSGAII Algorithm Parameters. We compare performance of two algorithms with three metrics and the results show NSGAII is more suitable for our model.

Keywords: joint inventory-location problem, facility location, NSGAII, MOSS

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921 Design of Robust and Intelligent Controller for Active Removal of Space Debris

Authors: Shabadini Sampath, Jinglang Feng

Abstract:

With huge kinetic energy, space debris poses a major threat to astronauts’ space activities and spacecraft in orbit if a collision happens. The active removal of space debris is required in order to avoid frequent collisions that would occur. In addition, the amount of space debris will increase uncontrollably, posing a threat to the safety of the entire space system. But the safe and reliable removal of large-scale space debris has been a huge challenge to date. While capturing and deorbiting space debris, the space manipulator has to achieve high control precision. However, due to uncertainties and unknown disturbances, there is difficulty in coordinating the control of the space manipulator. To address this challenge, this paper focuses on developing a robust and intelligent control algorithm that controls joint movement and restricts it on the sliding manifold by reducing uncertainties. A neural network adaptive sliding mode controller (NNASMC) is applied with the objective of finding the control law such that the joint motions of the space manipulator follow the given trajectory. A computed torque control (CTC) is an effective motion control strategy that is used in this paper for computing space manipulator arm torque to generate the required motion. Based on the Lyapunov stability theorem, the proposed intelligent controller NNASMC and CTC guarantees the robustness and global asymptotic stability of the closed-loop control system. Finally, the controllers used in the paper are modeled and simulated using MATLAB Simulink. The results are presented to prove the effectiveness of the proposed controller approach.

Keywords: GNC, active removal of space debris, AI controllers, MatLabSimulink

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920 Effect of Self-Lubricating Carbon Materials on the Tribological Performance of Ultra-High Molecular Weight Polyethylene

Authors: Nayeli Camacho, Fernanda Lara-Perez, Carolina Ortega-Portilla, Diego G. Espinosa-Arbelaez, Juan M. Alvarado-Orozco, Guillermo C. Mondragon-Rodriguez

Abstract:

Ultra-high molecular weight polyethylene (UHMWPE) has been the gold standard material for total knee replacements for almost five decades. Wear damage to UHMWPE articulating surface is inevitable due to the natural sliding and rolling movements of the knee. This generates a considerable amount of wear debris, which results in mechanical instability of the joint, reduces joint mobility, increases pain with detrimental biologic responses, and causes component loosening. The presence of wear particles has been closely related to adverse reactions in the knee joint surrounding tissue, especially for particles in the range of 0.3 to 2 μm. Carbon-based materials possess excellent mechanical properties and have shown great promise in tribological applications. In this study, diamond-like carbon coatings (DLC) and carbon nanotubes (CNTs) were used to decrease the wear rate of ultra-high molecular weight polyethylene. A titanium doped DLC (Ti-DLC) was deposited by magnetron sputtering on stainless steel precision spheres while CNTs were used as a second phase reinforcement in UHMWPE at a concentration of 1.25 wt.%. A comparative tribological analysis of the wear of UHMWPE and UHMWPE-CNTs with a stainless steel counterpart with and without Ti-DLC coating is presented. The experimental wear testing was performed on a pin-on-disc tribometer under dry conditions, using a reciprocating movement with a load of 1 N at a frequency of 2 Hz for 100,000 and 200,000 cycles. The wear tracks were analyzed with high-resolution scanning electron microscopy to determine wear modes and observe the size and shape of the wear debris. Furthermore, profilometry was used to study the depth of the wear tracks and to map the wear of the articulating surface. The wear tracks at 100,000 and 200,000 cycles on all samples were relatively shallow, and they were in the range of average roughness. It was observed that the Ti-DLC coating decreases the mass loss in the UHMWPE and the depth of the wear track. The combination of both carbon-based materials decreased the material loss compared to the system of stainless steel and UHMWPE. Burnishing of the surface was the predominant wear mode observed with all the systems, more subtle for the systems with Ti-DLC coatings. Meanwhile, in the system composed of stainless steel-UHMWPE, the intrinsic surface roughness of the material was completely replaced by the wear tracks.

Keywords: CNT reinforcement, self-lubricating materials, Ti-DLC, UHMWPE tribological performance

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919 Effectiveness of Myofascial Release Technique in Treatment of Sacroiliac Joint Hypo-Mobility in Postnatal Women

Authors: Ahmed A. Abd El Rahim, Mohamed M. M. Essa, Magdy M. A. Shabana, Said A. Mohamed, Mohamed Ibrahim Mabrouk

Abstract:

Background: Sacroiliac joint (SIJ) dysfunction is considered the main cause of pregnancy-related back pain, which may continue to persist postnatally. Myofascial release technique (MFR) is an application of low-intensity, prolonged stretch to myofascial structures to improve function by increasing the sliding properties of restricted myofascial tissues. Purpose: This study was designed to investigate the effect of MFR on postnatal SIJ hypo-mobility. Materials and Methods: Fifty postnatal women complaining of SIJ hypo-mobility participated in this study. Their ages ranged from 26 to 35 yrs., and their body mass index (BMI) didn`t exceed 30 kg/m2. They were randomly assigned to two equal groups, group A (Gr. A) and group B (Gr. B). Both groups received three sessions per week for eight successive weeks. Gr. A received a traditional physical therapy program, while Gr. B received a traditional physical therapy program in addition to MFR. Doppler imaging of vibration was utilized to measure SIJ mobility pre- and post-intervention, and an electronic digital goniometer was used to measure back flexion and extension Range of motion. Results: Findings revealed a statistical improvement in post-intervention values of SIJ mobility in addition to trunk flexion and extension ROM in Gr. B compared to Gr. A (P<0.001). Conclusion: Adding MFR to traditional physical therapy programs is highly recommended in the treatment of SIJ hypo-mobility in postnatal women.

Keywords: sacroiliac hypo-mobility, sacroiliac dysfunction, myofascial release technique, traditional physical therapy, postnatal

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918 Effects of the Quality Construction of Public Construction in Taiwan to Implementation Three Levels Quality Management Institution

Authors: Hsin-Hung Lai, Wei Lo

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Whether it is in virtue or vice for a construction quality of public construction project, it is one of the important indicators for national economic development and overall construction, the impact on the quality of national life is very deep. In recent years, a number of scandal of public construction project occurred, the requirements of the government agencies and the public require the quality of construction of public construction project are getting stricter than ever, the three-level public construction project construction quality of quality control system implemented by the government has a profound impact. This study mainly aggregated the evolution of ISO 9000 quality control system, the difference between the practice of implementing management of construction quality by many countries and three-level quality control of our country, so we explored and found that almost all projects of enhancing construction quality are dominated by civil organizations in foreign countries, whereas, it is induced by the national power in our country and develop our three-level quality control system and audit mechanism based on IOS system and implement the works by legislation, we also explored its enhancement and relevance with construction quality of public construction project that are intervened by such system and national power, and it really presents the effectiveness of construction quality been enhanced by the audited result. The three-level quality control system of our country to promote the policy of public construction project is almost same with the quality control system of many developed countries; however our country mainly implements such system on public construction project only, we promote the three-level quality control system is for enhancing the quality of public construction project, for establishing effective quality management system, so as to urge, correct and prevent the defects of quality management by manufacturers, whereas, those developed countries is comprehensively promoting (both public construction project and civil construction) such system. Therefore, this study is to explore the scope for public construction project only; the most important is the quality recognition by the executor, either good quality or deterioration is not a single event, there is a certain procedure extends from the demand and feasibility analysis, design, tendering, contracting, construction performance, inspection, continuous improvement, completion and acceptance, transferring and meeting the needs of the users, all of mentioned above have a causal relationship and it is a systemic problems. So the best construction quality would be manufactured and managed by reasonable cost if it is by extensive thinking and be preventive. We aggregated the implemented results in the past 10 years (2005 to 2015), the audited results of both in central units and local ones were slightly increased in A-grade while those listed in B-grade were decreased, although the levels were not evidently upgraded, yet, such result presents that the construction quality of concept of manufacturers are improving, and the construction quality has been established in the design stage, thus it is relatively beneficial to the enhancement of construction quality of overall public construction project.

Keywords: ISO 9000, three-level quality control system, audit and review mechanism for construction implementation, quality of construction implementation

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917 Computational Analysis of Thermal Degradation in Wind Turbine Spars' Equipotential Bonding Subjected to Lightning Strikes

Authors: Antonio A. M. Laudani, Igor O. Golosnoy, Ole T. Thomsen

Abstract:

Rotor blades of large, modern wind turbines are highly susceptible to downward lightning strikes, as well as to triggering upward lightning; consequently, it is necessary to equip them with an effective lightning protection system (LPS) in order to avoid any damage. The performance of existing LPSs is affected by carbon fibre reinforced polymer (CFRP) structures, which lead to lightning-induced damage in the blades, e.g. via electrical sparks. A solution to prevent internal arcing would be to electrically bond the LPS and the composite structures such that to obtain the same electric potential. Nevertheless, elevated temperatures are achieved at the joint interfaces because of high contact resistance, which melts and vaporises some of the epoxy resin matrix around the bonding. The produced high-pressure gasses open up the bonding and can ignite thermal sparks. The objective of this paper is to predict the current density distribution and the temperature field in the adhesive joint cross-section, in order to check whether the resin pyrolysis temperature is achieved and any damage is expected. The finite element method has been employed to solve both the current and heat transfer problems, which are considered weakly coupled. The mathematical model for electric current includes Maxwell-Ampere equation for induced electric field solved together with current conservation, while the thermal field is found from heat diffusion equation. In this way, the current sub-model calculates Joule heat release for a chosen bonding configuration, whereas the thermal analysis allows to determining threshold values of voltage and current density not to be exceeded in order to maintain the temperature across the joint below the pyrolysis temperature, therefore preventing the occurrence of outgassing. In addition, it provides an indication of the minimal number of bonding points. It is worth to mention that the numerical procedures presented in this study can be tailored and applied to any type of joints other than adhesive ones for wind turbine blades. For instance, they can be applied for lightning protection of aerospace bolted joints. Furthermore, they can even be customized to predict the electromagnetic response under lightning strikes of other wind turbine systems, such as nacelle and hub components.

Keywords: carbon fibre reinforced polymer, equipotential bonding, finite element method, FEM, lightning protection system, LPS, wind turbine blades

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916 Low Students' Access to University Education in Nigeria: Causes and Remedy

Authors: Robert Ogbanje Okwori

Abstract:

The paper explained the causes low students’ access to university education in Nigeria and how it can be remedied. It is discovered that low students’ access to university education in Nigeria is evident despite these number of universities in the country. In 2006/2007 academic session, 806,089 sat for Joint Unified Matriculation Board Examination (JAMB) into Nigerian universities and only 123,626 (15.3%) were admitted while 2011/2012 academic session, a total of 1,493,604 candidates sat for Joint Unified Matriculation Board Examination (JAMB) into Nigerian universities and only 65,073 (43.57%) were admitted. This necessitates for the research. Therefore, the study posed the following research questions. What are causes of low students’ access to university education in Nigeria? What are the challenges of students’ access to university education in Nigeria? How can students’ access to university education in Nigeria be improved? Sample survey research design was adopted for the study. A structured questionnaire was used to gather data for the study. Six hundred and eighty (680) respondents which comprised of 100 level university students; JAMB Officers and University administrators (Vice Chancellors, Registrars and Admission Officers) were used for the study. Stratified random sampling was applied for adequate representation of respondents from universities in the six geopolitical zones of Nigeria. Mean was used to answer research questions while Kuder-Richardson formula 20 was used to check the internal consistency of the instrument. The correlation coefficient of the instrument was 0.87. The major findings include the carrying capacity of each university contributes to low students’ access to university education and academic staff were inadequate. From the analysis of the study, it is concluded that the rate of access to university education is low, therefore, every university should establish distance learning programme to reduce university admission crisis. The training infrastructure in the universities should be improved upon by the owners to increase the carrying capacity of each university.

Keywords: access, causes, low, university

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915 An Audit on the Role of Sentinel Node Biopsy in High-Risk Ductal Carcinoma in Situ and Intracystic Papillary Carcinoma

Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew

Abstract:

Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.

Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease

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914 Analysis and Design Modeling for Next Generation Network Intrusion Detection and Prevention System

Authors: Nareshkumar Harale, B. B. Meshram

Abstract:

The continued exponential growth of successful cyber intrusions against today’s businesses has made it abundantly clear that traditional perimeter security measures are no longer adequate and effective. We evolved the network trust architecture from trust-untrust to Zero-Trust, With Zero Trust, essential security capabilities are deployed in a way that provides policy enforcement and protection for all users, devices, applications, data resources, and the communications traffic between them, regardless of their location. Information exchange over the Internet, in spite of inclusion of advanced security controls, is always under innovative, inventive and prone to cyberattacks. TCP/IP protocol stack, the adapted standard for communication over network, suffers from inherent design vulnerabilities such as communication and session management protocols, routing protocols and security protocols are the major cause of major attacks. With the explosion of cyber security threats, such as viruses, worms, rootkits, malwares, Denial of Service attacks, accomplishing efficient and effective intrusion detection and prevention is become crucial and challenging too. In this paper, we propose a design and analysis model for next generation network intrusion detection and protection system as part of layered security strategy. The proposed system design provides intrusion detection for wide range of attacks with layered architecture and framework. The proposed network intrusion classification framework deals with cyberattacks on standard TCP/IP protocol, routing protocols and security protocols. It thereby forms the basis for detection of attack classes and applies signature based matching for known cyberattacks and data mining based machine learning approaches for unknown cyberattacks. Our proposed implemented software can effectively detect attacks even when malicious connections are hidden within normal events. The unsupervised learning algorithm applied to network audit data trails results in unknown intrusion detection. Association rule mining algorithms generate new rules from collected audit trail data resulting in increased intrusion prevention though integrated firewall systems. Intrusion response mechanisms can be initiated in real-time thereby minimizing the impact of network intrusions. Finally, we have shown that our approach can be validated and how the analysis results can be used for detecting and protection from the new network anomalies.

Keywords: network intrusion detection, network intrusion prevention, association rule mining, system analysis and design

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913 Effect of Pre-bonding Storage Period on Laser-treated Al Surfaces

Authors: Rio Hirakawa, Christian Gundlach, Sven Hartwig

Abstract:

In recent years, the use of aluminium has further expanded and is expected to replace steel in the future as vehicles become lighter and more recyclable in order to reduce greenhouse gas (GHG) emissions and improve fuel economy. In line with this, structures and components are becoming increasingly multi-material, with different materials, including aluminium, being used in combination to improve mechanical utility and performance. A common method of assembling dissimilar materials is mechanical fastening, but it has several drawbacks, such as increased manufacturing processes and the influence of substrate-specific mechanical properties. Adhesive bonding and fusion bonding are methods that overcome the above disadvantages. In these two joining methods, surface pre-treatment of the substrate is always necessary to ensure the strength and durability of the joint. Previous studies have shown that laser surface treatment improves the strength and durability of the joint. Yan et al. showed that laser surface treatment of aluminium alloys changes α-Al2O3 in the oxide layer to γ-Al2O3. As γ-Al2O3 has a large specific surface area, is very porous and chemically active, laser-treated aluminium surfaces are expected to undergo physico-chemical changes over time and adsorb moisture and organic substances from the air or storage atmosphere. The impurities accumulated on the laser-treated surface may be released at the adhesive and bonding interface by the heat input to the bonding system during the joining phase, affecting the strength and durability of the joint. However, only a few studies have discussed the effect of such storage periods on laser-treated surfaces. This paper, therefore, investigates the ageing of laser-treated aluminium alloy surfaces through thermal analysis, electrochemical analysis and microstructural observations.AlMg3 of 0.5 mm and 1.5 mm thickness was cut using a water-jet cutting machine, cleaned and degreased with isopropanol and surface pre-treated with a pulsed fibre laser at 1060 nm wavelength, 70 W maximum power and 55 kHz repetition frequency. The aluminium surface was then analysed using SEM, thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR) and cyclic voltammetry (CV) after storage in air for various periods ranging from one day to several months TGA and FTIR analysed impurities adsorbed on the aluminium surface, while CV revealed changes in the true electrochemically active surface area. SEM also revealed visual changes on the treated surface. In summary, the changes in the laser-treated aluminium surface with storage time were investigated, and the final results were used to determine the appropriate storage period.

Keywords: laser surface treatment, pre-treatment, adhesion, bonding, corrosion, durability, dissimilar material interface, automotive, aluminium alloys

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912 Supervised Machine Learning Approach for Studying the Effect of Different Joint Sets on Stability of Mine Pit Slopes Under the Presence of Different External Factors

Authors: Sudhir Kumar Singh, Debashish Chakravarty

Abstract:

Slope stability analysis is an important aspect in the field of geotechnical engineering. It is also important from safety, and economic point of view as any slope failure leads to loss of valuable lives and damage to property worth millions. This paper aims at mitigating the risk of slope failure by studying the effect of different joint sets on the stability of mine pit slopes under the influence of various external factors, namely degree of saturation, rainfall intensity, and seismic coefficients. Supervised machine learning approach has been utilized for making accurate and reliable predictions regarding the stability of slopes based on the value of Factor of Safety. Numerous cases have been studied for analyzing the stability of slopes using the popular Finite Element Method, and the data thus obtained has been used as training data for the supervised machine learning models. The input data has been trained on different supervised machine learning models, namely Random Forest, Decision Tree, Support vector Machine, and XGBoost. Distinct test data that is not present in training data has been used for measuring the performance and accuracy of different models. Although all models have performed well on the test dataset but Random Forest stands out from others due to its high accuracy of greater than 95%, thus helping us by providing a valuable tool at our disposition which is neither computationally expensive nor time consuming and in good accordance with the numerical analysis result.

Keywords: finite element method, geotechnical engineering, machine learning, slope stability

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911 An Audit of Climate Change and Sustainability Teaching in Medical School

Authors: M. Tiachachat, M. Mihoubi

Abstract:

The Bell polynomials are special polynomials in combinatorial analysis that have a wide range of applications in mathematics. They have interested many authors. The exponential partial Bell polynomials have been well reduced to some special combinatorial sequences. Numerous researchers had already been interested in the above polynomials, as evidenced by many articles in the literature. Inspired by this work, in this work, we propose a family of special polynomials named after the 2-successive partial Bell polynomials. Using the combinatorial approach, we prove the properties of these numbers, derive several identities, and discuss some special cases. This family includes well-known numbers and polynomials such as Stirling numbers, Bell numbers and polynomials, and so on. We investigate their properties by employing generating functions

Keywords: 2-associated r-Stirling numbers, the exponential partial Bell polynomials, generating function, combinatorial interpretation

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910 Evaluation of Current Methods in Modelling and Analysis of Track with Jointed Rails

Authors: Hossein Askarinejad, Manicka Dhanasekar

Abstract:

In railway tracks, two adjacent rails are either welded or connected using bolted jointbars. In recent years the number of bolted rail joints is reduced by introduction of longer rail sections and by welding the rails at location of some joints. However, significant number of bolted rail joints remains in railways around the world as they are required to allow for rail thermal expansion or to provide electrical insulation in some sections of track. Regardless of the quality and integrity of the jointbar and bolt connections, the bending stiffness of jointbars is much lower than the rail generating large deflections under the train wheels. In addition, the gap or surface discontinuity on the rail running surface leads to generation of high wheel-rail impact force at the joint gap. These fundamental weaknesses have caused high rate of failure in track components at location of rail joints resulting in significant economic and safety issues in railways. The mechanical behavior of railway track at location of joints has not been fully understood due to various structural and material complexities. Although there have been some improvements in the methods for analysis of track at jointed rails in recent years, there are still uncertainties concerning the accuracy and reliability of the current methods. In this paper the current methods in analysis of track with a rail joint are critically evaluated and the new advances and recent research outcomes in this area are discussed. This research is part of a large granted project on rail joints which was defined by Cooperative Research Centre (CRC) for Rail Innovation with supports from Australian Rail Track Corporation (ARTC) and Queensland Rail (QR).

Keywords: jointed rails, railway mechanics, track dynamics, wheel-rail interaction

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909 Microvoid Growth in the Interfaces during Aging

Authors: Jae-Yong Park, Gwancheol Seo, Young-Ho Kim

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Microvoids, sometimes called Kikendall voids, generally form in the interfaces between Sn-based solders and Cu and degrade the mechanical and electrical properties of the solder joints. The microvoid formation is known as the rapid interdiffusion between Sn and Cu and impurity content in the Cu. Cu electroplating from the acid solutions has been widely used by microelectronic packaging industry for both printed circuit board (PCB) and integrated circuit (IC) applications. The quality of electroplated Cu that can be optimized by the electroplating conditions is critical for the solder joint reliability. In this paper, the influence of electroplating conditions on the microvoid growth in the interfaces between Sn-3.0Ag-0.5Cu (SAC) solder and Cu layer was investigated during isothermal aging. The Cu layers were electroplated by controlling the additive of electroplating bath and current density to induce various microvoid densities. The electroplating bath consisted of sulfate, sulfuric acid, and additives and the current density of 5-15 mA/cm2 for each bath was used. After aging at 180 °C for up to 250 h, typical bi-layer of Cu6Sn5 and Cu3Sn intermetallic compounds (IMCs) was gradually growth at the SAC/Cu interface and microvoid density in the Cu3Sn showed disparities in the electroplating conditions. As the current density increased, the microvoid formation was accelerated in all electroplating baths. The higher current density induced, the higher impurity content in the electroplated Cu. When the polyethylene glycol (PEG) and Cl- ion were mixed in an electroplating bath, the microvoid formation was the highest compared to other electroplating baths. On the other hand, the overall IMC thickness was similar in all samples irrespective of the electroplating conditions. Impurity content in electroplated Cu influenced the microvoid growth, but the IMC growth was not affected by the impurity content. In conclusion, the electroplated conditions are properly optimized to avoid the excessive microvoid formation that results in brittle fracture of solder joint under high strain rate loading.

Keywords: electroplating, additive, microvoid, intermetallic compound

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908 Structural Damage Detection in a Steel Column-Beam Joint Using Piezoelectric Sensors

Authors: Carlos H. Cuadra, Nobuhiro Shimoi

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Application of piezoelectric sensors to detect structural damage due to seismic action on building structures is investigated. Plate-type piezoelectric sensor was developed and proposed for this task. A film-type piezoelectric sheet was attached on a steel plate and covered by a layer of glass. A special glue is used to fix the glass. This glue is a silicone that requires the application of ultraviolet rays for its hardening. Then, the steel plate was set up at a steel column-beam joint of a test specimen that was subjected to bending moment when test specimen is subjected to monotonic load and cyclic load. The structural behavior of test specimen during cyclic loading was verified using a finite element model, and it was found good agreement between both results on load-displacement characteristics. The cross section of steel elements (beam and column) is a box section of 100 mm×100 mm with a thin of 6 mm. This steel section is specified by the Japanese Industrial Standards as carbon steel square tube for general structure (STKR400). The column and beam elements are jointed perpendicularly using a fillet welding. The resulting test specimen has a T shape. When large deformation occurs the glass plate of the sensor device cracks and at that instant, the piezoelectric material emits a voltage signal which would be the indicator of a certain level of deformation or damage. Applicability of this piezoelectric sensor to detect structural damages was verified; however, additional analysis and experimental tests are required to establish standard parameters of the sensor system.

Keywords: piezoelectric sensor, static cyclic test, steel structure, seismic damages

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907 Effect of Shot Peening on the Mechanical Properties for Welded Joints of Aluminium Alloy 6061-T6

Authors: Muna Khethier Abbass, Khairia Salman Hussan, Huda Mohummed AbdudAlaziz

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This work aims to study the effect of shot peening on the mechanical properties of welded joints which performed by two different welding processes: Tungsten inert gas (TIG) welding and friction stir welding (FSW) processes of aluminum alloy 6061 T6. Arc welding process (TIG) was carried out on the sheet with dimensions of (100x50x6 mm) to obtain many welded joints with using electrode type ER4043 (AlSi5) as a filler metal and argon as shielding gas. While the friction stir welding process was carried out using CNC milling machine with a tool of rotational speed (1000 rpm) and welding speed of (20 mm/min) to obtain the same butt welded joints. The welded pieces were tested by X-ray radiography to detect the internal defects and faulty welded pieces were excluded. Tensile test specimens were prepared from welded joints and base alloy in the dimensions according to ASTM17500 and then subjected to shot peening process using steel ball of diameter 0.9 mm and for 15 min. All specimens were subjected to Vickers hardness test and micro structure examination to study the effect of welding process (TIG and FSW) on the micro structure of the weld zones. Results showed that a general decay of mechanical properties of TIG and FSW welded joints comparing with base alloy while the FSW welded joint gives better mechanical properties than that of TIG welded joint. This is due to the micro structure changes during the welding process. It has been found that the surface hardening by shot peening improved the mechanical properties of both welded joints, this is due to the compressive residual stress generation in the weld zones which was measured using X-Ray diffraction (XRD) inspection.

Keywords: friction stir welding, TIG welding, mechanical properties, shot peening

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906 Observational Study of Ionising Radiation Exposure in Orthopaedic Theatre

Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

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Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

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905 A Computational Framework for Load Mediated Patellar Ligaments Damage at the Tropocollagen Level

Authors: Fadi Al Khatib, Raouf Mbarki, Malek Adouni

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In various sport and recreational activities, the patellofemoral joint undergoes large forces and moments while accommodating the significant knee joint movement. In doing so, this joint is commonly the source of anterior knee pain related to instability in normal patellar tracking and excessive pressure syndrome. One well-observed explanation of the instability of the normal patellar tracking is the patellofemoral ligaments and patellar tendon damage. Improved knowledge of the damage mechanism mediating ligaments and tendon injuries can be a great help not only in rehabilitation and prevention procedures but also in the design of better reconstruction systems in the management of knee joint disorders. This damage mechanism, specifically due to excessive mechanical loading, has been linked to the micro level of the fibred structure precisely to the tropocollagen molecules and their connection density. We argue defining a clear frame starting from the bottom (micro level) to up (macro level) in the hierarchies of the soft tissue may elucidate the essential underpinning on the state of the ligaments damage. To do so, in this study a multiscale fibril reinforced hyper elastoplastic Finite Element model that accounts for the synergy between molecular and continuum syntheses was developed to determine the short-term stresses/strains patellofemoral ligaments and tendon response. The plasticity of the proposed model is associated only with the uniaxial deformation of the collagen fibril. The yield strength of the fibril is a function of the cross-link density between tropocollagen molecules, defined here by a density function. This function obtained through a Coarse-graining procedure linking nanoscale collagen features and the tissue level materials properties using molecular dynamics simulations. The hierarchies of the soft tissues were implemented using the rule of mixtures. Thereafter, the model was calibrated using a statistical calibration procedure. The model then implemented into a real structure of patellofemoral ligaments and patellar tendon (OpenKnee) and simulated under realistic loading conditions. With the calibrated material parameters the calculated axial stress lies well with the experimental measurement with a coefficient of determination (R2) equal to 0.91 and 0.92 for the patellofemoral ligaments and the patellar tendon respectively. The ‘best’ prediction of the yielding strength and strain as compared with the reported experimental data yielded when the cross-link density between the tropocollagen molecule of the fibril equal to 5.5 ± 0.5 (patellofemoral ligaments) and 12 (patellar tendon). Damage initiation of the patellofemoral ligaments was located at the femoral insertions while the damage of the patellar tendon happened in the middle of the structure. These predicted finding showed a meaningful correlation between the cross-link density of the tropocollagen molecules and the stiffness of the connective tissues of the extensor mechanism. Also, damage initiation and propagation were documented with this model, which were in satisfactory agreement with earlier observation. To the best of our knowledge, this is the first attempt to model ligaments from the bottom up, predicted depending to the tropocollagen cross-link density. This approach appears more meaningful towards a realistic simulation of a damaging process or repair attempt compared with certain published studies.

Keywords: tropocollagen, multiscale model, fibrils, knee ligaments

Procedia PDF Downloads 104