Search results for: lateral aberrant thyroid

Authors: Abdelaziz Rabhi, Mohamed Amrani, Abderrazek Ziane, Nabil Belkadi, Abdelraouf Hocini

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In this paper, a bedimensional simulation program of the electric characteristics of reverse biased lateral polysilicon PIN diode is presented. In this case we have numerically solved the system of partial differential equations formed by Poisson's equation and both continuity equations that take into account the effect of impact ionization. Therefore we will obtain the current-voltage characteristics (I-V) of the reverse-biased structure which may include the effect of breakdown.The geometrical model assumes that the polysilicon layer is composed by a succession of defined mean grain size crystallites, separated by lateral grain boundaries which are parallel to the metallurgic junction.

Keywords: breakdown, polycrystalline silicon, PIN, grain, impact ionization

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Authors: Mandeep Kamboj, Anand R. Katti

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The pile of 2.4 m diameter is subjected to lateral loads and moments. These lateral loads are caused due to wind/wave forces when used in foundations of various structures such as bridge piers and high rise towers exhibiting deflections with depth. The research scientist and developer has studied and developed various procedures to evaluate the coefficient of soil modulus variation (nh), using various methods. These are verified for slender piles in sand with various diameters up to 2.4 m. The subject explains about simplified approach of the theoretical values using IS procedure and Broms method and compared with actual field soil pressure/displacement distributions measured in mono-pile along its length and across the diameter.

Keywords: bridge pier, lateral loads, mono-pile, slender piles

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Authors: Christian Angerer, Markus Lienkamp

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Electric vehicles offer a high variety of possible drivetrain topologies with up to 4 motors. Multi-motor-designs can have several advantages regarding traction, vehicle dynamics, safety and even efficiency. With a rising number of motors, the whole drivetrain becomes more complex. All permutations of gearings, drivetrain-layouts, motor-types and –sizes lead up in a very large solution space. Single elements of this solution space can be analyzed by simulation methods. In addition to longitudinal vehicle behavior, which most optimization-approaches are restricted to, also lateral dynamics are important for vehicle dynamics, stability and efficiency. In order to compete large solution spaces and to find an optimal result, genetic algorithm based optimization is state-of-the-art. As lateral dynamics simulation is way more CPU-intensive, optimization takes much more time than in case of longitudinal-only simulation. Therefore, this paper shows an approach how to create meta-models from a 14-degree of freedom vehicle model in order to enable a numerically efficient drivetrain-layout optimization process under consideration of lateral dynamics. Different meta-modelling approaches such as neural networks or DoE are implemented and comparatively discussed.

Keywords: driving dynamics, drivetrain layout, genetic optimization, meta-modeling, lateral dynamicx

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Authors: Ibrahim Abdulla Labib, Medhat Mohamed Morsy, Gamal Hosny, Hanan Dawood Yassa, Gaber Hassan

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Amiodarone is a very effective drug, widely used for arrhythmia. Unfortunately it has many side effects involving many organs especially thyroid gland. The current work was conducted to elucidate the effect of amiodarone on the thyroid gland and the possible protective role of vitamin E. Fifty adult male albino rats weighed 200 – 250 grams were divided into five groups; ten rats each. Group I (Control): Five rats were sacrificed after three weeks and five rats were sacrificed after six weeks. Group II (Sham control): Each rat received sunflower oil orally; the solvent of vitamin E for three weeks. Group III (Amiodarone-treated): each rat received an oral dose of amiodarone; 150 mg/kg/day for three weeks. Group IV (Recovery): Each rat received amiodarone as group III then the drug was stopped for three weeks to evaluate recovery. Group V (Amiodarone + Vitamin E-treated): Each rat received amiodarone as group III followed by 100 mg/kg/day vitamin E orally for three weeks. Thyroid gland of the sacrificed animals were dissected out and prepared for light and electron microscopic studies. Amiodarone administration resulted in loss of normal follicular architecture as many follicles appeared either shrunken, empty or contained scanty pale colloid. Some follicles appeared lined by more than one layer of cells while others showed interruption of their membrane. Masson's Trichrome stained sections showed increased collagen fibers in between the thyroid follicles. Ultrastructurally, the apical border of the follicular cells showed few irregular detached microvilli. The nuclei of the follicular cells were almost irregular with chromatin condensation. The cytoplasm of most follicular cells revealed numerous dilated rough endoplasmic reticulum with numerous lysosomes. After three weeks of stopping amiodarone, the follicles were nearly regular in outline. Some follicles were filled with homogenous eosinophilic colloid and others had shrunken pale colloid or were empty. Some few follicles showed exfoliated cells in their lumina and others were still lined by more than one layer of follicular cells. Moderate amounts of collagen fibers were observed in-between thyroid follicles. Ultrastructurally, many follicular cells had rounded euchromatic nucleui, moderate number of lysosomes and moderately dilated rough endoplasmic reticulum. However, few follicular cells still showing irregular nucleui, dilated rough endoplasmic reticulum and many cytoplasmic vacuoles. Administration of vitamin E with amiodarone for three weeks resulted in obvious structural improvement. Most of the follicles were lined by a single layer of cuboidal cells and the lumina were filled with homogenous eosinophilic colloid with very few vacuolations. The majority of follicular cells had rounded nuclei with occasional detection of ballooned cells and dark nuclei. Scanty collagen fibers were detected among thyroid follicles. Ultrastructurally, most follicular cells exhibited rounded euchromatic nuclei with few short microvilli were projecting into the colloid. Few lysosomes were also noticed. It was concluded that amiodarone administration leads to many adverse histological changes in the thyroid gland. Some of these changes are reversible during the recovery period however concomitant vitamin E administration with amiodarone has a major protective role in preventing many of these changes.

Keywords: amiodarone, recovery, ultrastructure, vitamin E.

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Authors: Ahmed Rouili

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Cantilever L-shaped walls are known to be relatively economical as retaining solution. The design starts by proportioning the wall dimensions for which the stability is checked for. A ratio between the lengths of the base and the stem, falling between 0,5 to 0,7, ensure the stability requirements in most cases. However, the displacement pattern of the wall in terms of rotations and translations, and the lateral pressure profile, do not have the same figure for all wall’s proportioning, as it is usually assumed. In the present work, the results of a numerical analysis are presented, different wall geometries were considered. The results show that the proportioning governs the equilibrium between the instantaneous rotation and the translation of the wall-toe, also, the lateral pressure estimation based on the average value between the at-rest and the active pressure, recommended by most design standards, is found to be not applicable for all walls.

Keywords: cantilever wall, proportioning, numerical analysis, lateral pressure estimation

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Authors: V. K. Arora, Suraj Prakash

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Pile foundations are provided to transfer the vertical and horizontal loads of superstructures like high rise buildings, bridges, offshore structures etc. to the deep strata in the soil. These vertical and horizontal loads are due to the loads coming from the superstructure and wind, water thrust, earthquake, and earth pressure, respectively. In a pile foundation, piles are used in groups. Vertical piles in a group of piles are more efficient to take vertical loads as compared to horizontal loads and when the horizontal load per pile exceeds the bearing capacity of the vertical piles in that case batter piles are used with vertical piles because batter piles can take more lateral loads than vertical piles. In this paper, a model study was conducted on three vertical pile group with single positive and negative battered pile subjected to lateral loads. The batter angle for battered piles was ±35◦ with the vertical axis. Piles were spaced at 2.5d (d=diameter of pile) to each other. The soil used for model test was cohesionless soil. Lateral loads were applied in three stages on all the pile groups individually and it was found that under the repeated action of lateral loading, the deflection of the piles increased under the same loading. After comparing the results, it was found that the pile group with positive batter pile fails at 28 kgf and the pile group with negative batter pile fails at 24 kgf so it shows that positive battered piles are stronger than the negative battered piles.

Keywords: vertical piles, positive battered piles, negative battered piles, cohesionless soil, lateral loads, model test

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Authors: Nuha Alamro

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Besides achieving of weight loss, Bariatric surgery (BS) shown metabolic improvement including reduction of cardiovascular disease, insulin resistance and diabetes. This study aimed to measure BS effects on Framingham Risk Score (FRS) and metabolic syndrome (MetS) among patients who underwent BS. Additionally, to determine the effect of BS on TSH among euthyroid obese patients. A Retrospective follow-up study was conducted in King Abdullah Medical City. A total of 160 participants who underwent BS and completed one year of follow ups. Medical history, biochemical, anthropometric, and hormonal parameters were evaluated at baseline and 3-12 months after BS. International Diabetes Federation (IDF) criteria were used to diagnose MetS pre and postoperative. The mean age of participants was 41.9 ± 10.6 with Body Mass Index (BMI) of 48.8 ± 7.3. After 3 months, Systolic, Diastolic blood pressure (SBP, DBP), glycated haemoglobin (HBA1C), Low-density lipoprotein (LDL), cholesterol, triglycerides and Thyroid stimulating hormone (TSH) were significantly decrease (P < 0.001). Significant decrease was seen in Mets, BMI, FRS, SBP, DBP, HBA1C, LDL, triglycerides, cholesterol, liver enzyme, with significant increase in high-density lipoprotein (HDL) level 12 months post-op (P < 0.001). After 1 year, the prevalence of MetS, DM, HTN, FRS were significantly decrease from 72.5%, 43.1%, 78.1%, 11.4 to 16.3%, 9.4%, 22.5% and 5.4, respectively. Besides achieving substantial weight loss, MetS resolution was linked to improvement in cardiovascular risk profile.

Keywords: bariatric surgery, cardiovascular disease, metabolic syndrome, thyroid stimulating hormone

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Authors: Divya Dharshini Omprakash, Anjali Subramani

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Most of the tall structures are constructed using shear walls and tube systems in the recent decades. This makes the structure heavy and less resistant to lateral effects as the height of the structure goes up. This paper aims in the reduction of self-weight in tall structures by the use of Taper Cladding System (TCS) and also enumerates the construction techniques used in TCS. TCS has a tapering clad either fixed at the top or bottom of the structural core at the tapered end. This system eliminates the use of RC structural elements on the exterior of the structure and uses fewer columns only on the interior part to take up the gravity loads in order to reduce the self-weight of the structure. The self-weight reduction by TCS is 50% more compared to the present structural systems. The lateral loads on the hull will be taken care of by the tapered steel frame. Analysis were done to study the structural behaviour of taper cladded buildings subjected to lateral loads. TCS has a great impact in the construction of tall structures in seismic and dense urban areas. An effective construction management can be done by the use of Taper Cladding System. In this paper, sustainability, design considerations and implications of the system has also been discussed.

Keywords: Lateral Loads Resistance, reduction of self-weight, sustainable, taper clads

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Authors: Mathias M. L. Zarate, Erwin

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In the design of an H-shaped steel beam, lateral torsional buckling is one of the main considerations. The beam should be braced properly so that the plastic moment capacity can be well developed. Although the design guideline for lateral bracing has been available for decades ago, the design guideline was established based on past research which mostly used a very simple model to derive the proposed design equations provided. Most of the beam structures considered in the past research were simply supported beams subjected to transverse loading. Recalling that a simply supported beam is a kind of beam structure that is the most susceptible to lateral torsional buckling, the design requirements derived based on this structure may be too conservative for beams with other boundary conditions. As in the beams of a moment-resisting frame, both beam ends are rigidly connected to the column and thus have higher resistance against the lateral torsional buckling. On the other hand, the use of lateral bracing to support the bottom flange of the beams in building structures often becomes an obstacle. If the actual boundary condition of the beams in moment resisting is considered when analyzing the beam bracing requirements, the chance that a beam does not need to be braced at the bottom flange will become higher. Nowadays, by utilizing the power of computers to conduct numerical analysis, the buckling behavior of the beams with various kinds of boundary conditions and loading configurations can be explored conveniently as long as a reliable analysis model can be developed. In this study, finite element analysis is conducted to investigate the buckling behavior of H-shaped steel beams with various kinds of cross-sections and lengths subjected to seismic-type loading. The considered beam is laterally restrained along the top flange of the beam to account for the presence of floor slab, while no lateral bracing is provided to the bottom flange. The lateral torsional buckling of the beam is evaluated by observing the magnitude of the twist angle during the loading history. The main parameters that affect the buckling potential of the beam are found to be the beam length-to-beam depth ratio and the beam depth-to-flange width ratio. Higher values of these two parameters indicate a higher lateral torsional buckling potential in the beam. The limit values for the two design parameters are found to be related to the desired acceptance criteria which in this case is the magnitude of the twist angle considered as acceptable.

Keywords: H-shaped steel beam, lateral bracing design, lateral torsional buckling, seismic design

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Authors: Sandy Bao, Yankang Bao

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The understanding of information that is being processed in the brain, especially in the lateral geniculate nucleus (LGN), has been proven challenging for modern neuroscience and for researchers with a focus on how neurons process signals and images. In this paper, we are proposing a method to image process different colors within different layers of LGN, that is, green information in layers 4 & 6 and red & blue in layers 3 & 5 based on the surface dimension of layers. We take into consideration the images in LGN and visual cortex, and that the edge detected information from the visual cortex needs to be considered in order to return back to the layers of LGN, along with the image in LGN to form the new image, which will provide an improved image that is clearer, sharper, and making it easier to identify objects in the image. Matrix Laboratory (MATLAB) simulation is performed, and results show that the clarity of the output image has significant improvement.

Keywords: lateral geniculate nucleus, matrix laboratory, neuroscience, visual cortex

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Authors: Fereshteh Akbari, Farrokh Jalali Mosalam, Ali Hedayatifar, Amirreza Aminjavaheri

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The soil nailing is an effective method to stabilize slopes and retaining structures. Consequently, the lateral and vertical displacement of retaining walls are important criteria to evaluate the safety risks of adjacent structures. This paper is devoted to the optimization problems of retaining walls based on ABAQOUS Software. The various parameters such as nail length, orientation, arrangement, horizontal spacing, and bond skin friction, on lateral and vertical displacement of retaining walls are investigated. In order to ensure accuracy, the mobilized shear stress acting around the perimeter of the nail-soil interface is also modeled in ABAQOUS software. The observed trend of results is compared to the previous researches.

Keywords: retaining walls, soil nailing, ABAQOUS software, lateral displacement, vertical displacement

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Authors: L. Sun, O. Bloom, K. Anderson

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The medial and lateral sural artery perforator flaps (MSAP and LSAP, respectively) are two recently described flaps that are less commonly used in lower limb trauma reconstructive surgeries compared to flaps such as the anterolateral thigh (ALT) flap or the gastrocnemius flap. The LSAP flap has several theoretical benefits over the MSAP, including the ability to be sensate and being more easily manoeuvred into position as a local flap for coverage of lateral knee or leg defects. It is less commonly used in part due to a lack of documented studies of the anatomical reliability of the perforator, and an unquantified average length of the pedicle used for microsurgical anastomosis (if used as a free flap) or flap rotation (if used as a pedicled flap). It has been shown to have significantly lower donor site morbidity compared to other flaps such as the ALT, due to the decreased need for intramuscular dissection and resulting in less muscle loss at the donor site. 11 cadaveric lower limbs were dissected, with a mean of 1.6 perforators per leg, with an average pedicle length of 45mm to the sural artery and 70mm to the popliteal artery. While the majority of perforating arteries lay close to the midline (average of 19mm lateral to the midline), there were patients whose artery was significantly lateral and would have been likely injured by the initial incision during an operation. Adding to the literature base of documented LSAP dissections provides a greater understanding of the anatomical basis of these perforator flaps, and the authors hope this will establish them as a more commonly used and discussed option when managing complicated lower limb trauma requiring soft tissue reconstruction.

Keywords: cadaveric, dissection, lateral, perforator flap, sural artery, surface anatomy

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Authors: Nikita Sankhe

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A Frenum is a band or fold of mucous membrane, which is usually with enclosed muscle fibers, that attaches the lip and cheek to the alveolar mucosa or the gingiva and the underlying periosteum. It curbs or limits the movements of an organ. A frenum becomes a problem if its attachment is too close to the marginal or papillary gingiva, namely localized gingival recession and a midline diastema or it may pull the gingival margin away from the tooth allowing plaque accumulation and inhibit toothbrushing. Frenectomy is the complete removal of the frenum including its attachment to the underlying bone. Miller suggested a technique where by a closure was done across the midline by laterally positioned gingiva. Healing by primary intention resulted in aesthetically acceptable attached gingiva across the midline. This paper aims at showing how a lateral pedicle graft technique combined with frenectomy proves to be more advantageous than any other technique.

Keywords: frenum , frenectomy , lateral pedicle graft , classical frenectomy

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Authors: L. Dahmani, S. Drizi, M. Djemai, A. Boudjemia, M. O. Mechiche

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Channel sections are widely used in practice as beams. However, design rules for eccentrically loaded (not through shear center) beams with channel cross- sections are not available in Eurocode 3. This paper compares the ultimate loads based on the adjusted design rules for lateral torsional buckling of eccentrically loaded channel beams in bending to the ultimate loads obtained with Finite Element (FE) simulations on the basis of a parameter study. Based on the proposed design rule, this study has led to a new design rule which conforms to Eurocode 3.

Keywords: ANSYS, Eurocode 3, finite element method, lateral torsional buckling, steel channel beam

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Authors: Hema Lattupalli

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Introduction: A bony bridge extends from the lateral mass of the atlas to postero medial margin of vertebral artery groove, termed as a posterior bridge of atlas or posterior ponticulus. The foramen formed by the bridge is called as arcuate foramen or retroarticulare superior. Another bony bridge sometimes extends laterally from lateral mass to posterior root of transverse foramen forming and additional groove for vertebral artery, above and behind foramen transversarium called Lateral bridge or ponticulus lateralis. When both posterior and lateral are present together it is called as Posterolateral ponticuli. Aim and Objectives: The aim of the present study is to detect the presence of such Bridge or Ponticuli called as Lateral, Posterior and Posterolateral reported by earlier investigators in atlas vertebrae. Material and Methods: The study was done on 100 Atlas vertebrae from the Department of Anatomy Narayana Medical College Nellore, and also from SVIMS Tirupati was collected over a period of 2 years. The parameters that were studied include the presence of ponticuli, complete and incomplete and right and left side ponticuli. They were observed for all these parameters and the results were documented and photographed. Results: Ponticuli were observed in 25 (25%) of atlas vertebrae. Posterior ponticuli were found in 16 (16%), Lateral in 01 (01%) and Posterolateral in 08(08%) of the atlas vertebrae. Complete ponticuli were present in 09 (09%) and incomplete ponticuli in 16 (16%) of the atlas vertebrae. Bilateral ponticuli were seen in 10 (10%) and unilateral ponticuli were seen in 15 (15%) of the atlas vertebrae. Right side ponticuli were seen in 04 (04%) and Left side ponticuli in 05 (05%) of the atlas vertebrae respectively. Interpretation and Conclusion: In the present study posterior complete ponticuli were said to be more than the lateral complete ponticuli. The presence of Bilateral Incomplete Posterior ponticuli is higher and also Atlantic ponticuli. The present study is to say that knowledge of normal anatomy and variations in the atlas vertebra is very much essential to the neurosurgeons giving a message that utmost care is needed to perform surgeries related to craniovertebral regions. This is additional information to the Anatomists, Neurosurgeons and Radiologist. This adds an extra page to the literature.

Keywords: atlas vertebra, ponticuli, posterior arch, arcuate foramen

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Authors: Seraj Makkawi, Abdulaziz A. Alqarni, Himyan Alghaythee, Suzan Y. Alharbi, Anmar Fatani, Reem Adas, Ahmad R. Abuzinadah

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Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a neurodegenerative disease that involves both the upper and lower motor neurons. Familial ALS, including superoxide dismutase 1 (SOD1) mutation, accounts for 5-10% of all cases of ALS. Typically, the symptoms of ALS are purely motor, though coexistent sensory symptoms have been reported in rare cases. In this report, we describe the case of a 47- year-old man who presented with progressive bilateral lower limb weakness and numbness for the last four years. A nerve conduction study (NCS) showed evidence of coexistent axonal sensorimotor polyneuropathy in addition to the typical findings of ALS in needle electromyography. Genetic testing confirmed the diagnosis of familial ALS secondary to the SOD1 genetic mutation. This report highlights that the presence of sensory symptoms should not exclude the possibility of ALS in an appropriate clinical setting.

Keywords: Saudi Arabia, polyneuropathy, SOD1 gene mutation, familial amyotrophic lateral sclerosis, amyotrophic lateral sclerosis

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Authors: Dwitya Elvira, Eryati Darwin

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Background: Graves’ disease (GD) is an autoimmune thyroid disease. Imbalance of Th1/Th2 cells and T-regulatory (Treg)/Th17 cells was thought to play pivotal role in the pathogenesis of GD. Treg FoxP3 produced TGF-β to maintain regulatory function, and Th17 cells produced IL-17 as cytokines that were thought in mediating several autoimmune diseases. The aim of this study is to assess the role of IL-17 and TGF-β in the pathogenesis of GD and to investigate its correlation with Thyroid Stimulating Hormone Receptor Antibody (TRAb) and Treg FoxP3 expression. Method: 30 GD patients and 27 age and sex-matched controls were enrolled in this study. Diagnosis of GD was based on clinical and biochemical of GD. Serum IL-17, TGF-β, TRAb, and FoxP3 were measured by enzyme-linked immunosorbent assay (ELISA). Data were analyzed by using SPSS 21.0 (SPSS Inc.). Spearman rank correlation test was used for assessment of correlation. The statistical significance was accepted as P<0.05. Result: There was no significant correlation between IL-17 and TGF-β serum with expression of FoxP3 level in GD, but there was significant correlation between TGF-β and TRAb serum level (P<0.05). Serum levels of IL-17 and TGF-β were found to be elevated in patient group compared to control, where mean values of IL-17 were 14.43±2.15 pg/mL and TGF-β were 10.44±3.19 pg/mL in patients group; and in control group, level of IL-17 were 7.1±1.45 pg/mL and TGF-β were 4.95±1.35 pg/mL. Conclusion: Serum Il-17 and TGF-β were elevated in GD patients that reflect the role of inflammatory and regulatory cytokines activation in pathogenesis of GD. There was significant correlation between TGF-β and TRAb, revealing that Treg cytokines may play a role in pathogenesis of GD.

Keywords: IL-17, TGF-B, FoxP3, TRAb, Graves’ disease

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Authors: P. Kazymbet, G. Abildinova, K.Makhambetov, M. Bakhtin, D. Rybalkina, K. Zhumadilov

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Conducted cytogenetic research in workers Stepnogorsk Mining-Chemical Combine (Akmola region) with the study of 26341 chromosomal metaphase. Using a regression analysis with program DataFit, version 5.0, dependence between exposure dose and the following cytogenetic exponents has been studied: frequency of aberrant cells, frequency of chromosomal aberrations, frequency of the amounts of dicentric chromosomes, and centric rings. Experimental data on calibration curves "dose-effect" enabled the development of a mathematical model, allowing on data of the frequency of aberrant cells, chromosome aberrations, the amounts of dicentric chromosomes and centric rings calculate the absorbed dose at the time of the study. In the dose range of 0.1 Gy to 5.0 Gy dependence cytogenetic parameters on the dose had the following equation: Y = 0,0067е^0,3307х (R2 = 0,8206) – for frequency of chromosomal aberrations; Y = 0,0057е^0,3161х (R2 = 0,8832) –for frequency of cells with chromosomal aberrations; Y =5 Е-0,5е^0,6383 (R2 = 0,6321) – or frequency of the amounts of dicentric chromosomes and centric rings on cells. On the basis of cytogenetic parameters and regression equations calculated absorbed dose in workers of uranium production at the time of the study did not exceed 0.3 Gy.

Keywords: Stepnogorsk, mathematical modeling, cytogenetic, dicentric chromosomes

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Authors: Spandan Sahu, Amiya Kumar Pati, Kishanjit Kumar Khatua

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Rivers are the backbone of human civilization as well as one of the most important components of nature. In this paper, a method for predicting lateral depth-averaged velocity distribution in a two-flow braided compound channel is proposed. Experiments were conducted to study the boundary shear stress in the tip of the two flow path. The cross-section of the channel is divided into several panels to study the flow phenomenon on both the main channel and the flood plain. It can be inferred from the study that the flow coefficients get affected by boundary shear stress. In this study, the analytical solution of Shiono and knight (SKM) for lateral distributions of depth-averaged velocity and bed shear stress has been taken into account. The SKM is based on hydraulic parameters, which signify the bed friction factor (f), lateral eddy viscosity, and depth-averaged flow. While applying the SKM to different panels, the equations are solved considering the boundary conditions between panels. The boundary shear stress data, which are obtained from experimentation, are compared with CES software, which is based on quasi-one-dimensional Reynold's Averaged Navier-Stokes (RANS) approach.

Keywords: boundary shear stress, lateral depth-averaged velocity, two-flow braided compound channel, velocity distribution

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Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Nuo Duan, Yi Pik Cheng

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This paper presents the data of a series of two-dimensional Discrete Element Method (DEM) simulations of a large-diameter rigid monopile subjected to cyclic loading under a high gravitational force. At present, monopile foundations are widely used to support the tall and heavy wind turbines, which are also subjected to significant from wind and wave actions. A safe design must address issues such as rotations and changes in soil stiffness subject to these loadings conditions. Design guidance on the issue is limited, so are the availability of laboratory and field test data. The interpretation of these results in sand, such as the relation between loading and displacement, relies mainly on empirical correlations to pile properties. Regarding numerical models, most data from Finite Element Method (FEM) can be found. They are not comprehensive, and most of the FEM results are sensitive to input parameters. The micro scale behaviour could change the mechanism of the soil-structure interaction. A DEM model was used in this paper to study the cyclic lateral loads behaviour. A non-dimensional framework is presented and applied to interpret the simulation results. The DEM data compares well with various set of published experimental centrifuge model test data in terms of lateral deflection. The accumulated permanent pile lateral displacements induced by the cyclic lateral loads were found to be dependent on the characteristics of the applied cyclic load, such as the extent of the loading magnitudes and directions.

Keywords: cyclic loading, DEM, numerical modelling, sands

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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Authors: Ebrahim Zamani Beydokhti, Hashem Shariatmadar

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This paper presents an experimental and analytical investigation on the behavior of retrofitted beam-column joints subjected to reversed cyclic loading. The experimental program comprises 8 external beam–column joint connection subassemblages tested in 2 phases; one was the damaging phase and second was the repairing phase. The beam-column joints were no seismically designed, i.e. the joint, beam and column critical zones had no special transverse stirrups. The joins were tested under cyclic loading in previous research. The experiment had two phases named damage phase and retrofit phase. Then the experimental results compared with analytical results achieved from modeling in OpenSees software. The presence of lateral slab and the axial load amount were analytically investigated. The results showed that increasing the axial load and presence of lateral slab increased the joint capacity. The presence of lateral slab increased the dissipated energy, while the axial load had no significant effect on it.

Keywords: concrete beam-column joints, CFRP sheets, lateral slab, axial load

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Authors: Mohamad Amin Amini, Mehdi Poursha

Abstract:

Nonlinear response history analysis (NL-RHA) is a robust analytical tool for estimating the seismic demands of structures responding in the inelastic range. However, because of its conceptual and numerical complications, the nonlinear static procedure (NSP) is being increasingly used as a suitable tool for seismic performance evaluation of structures. The conventional pushover analysis methods presented in various codes (FEMA 356; Eurocode-8; ATC-40), are limited to the first-mode-dominated structures, and cannot take higher modes effect into consideration. Therefore, since more than a decade ago, researchers developed enhanced pushover analysis procedures to take higher modes effect into account. The main objective of this study is to propose an enhanced invariant lateral displacement distribution to take higher modes effect into consideration in performing a displacement-based pushover analysis, whereby a set of laterally applied displacements, rather than forces, is monotonically applied to the structure. For this purpose, the effect of different parameters such as the spectral displacement of ground motion, the modal participation factor, and the effective modal participating mass ratio on the lateral displacement distribution is investigated to find the best distribution. The major simplification of this procedure is that the effect of higher modes is concentrated into a single invariant lateral load distribution. Therefore, only one pushover analysis is sufficient without any need to utilize a modal combination rule for combining the responses. The invariant lateral displacement distribution for pushover analysis is then calculated by combining the modal story displacements using the modal combination rules. The seismic demands resulting from the different procedures are compared to those from the more accurate nonlinear response history analysis (NL-RHA) as a benchmark solution. Two structures of different heights including 10 and 20-story special steel moment resisting frames (MRFs) were selected and evaluated. Twenty ground motion records were used to conduct the NL-RHA. The results show that more accurate responses can be obtained in comparison with the conventional lateral loads when the enhanced modal lateral displacement distributions are used.

Keywords: displacement-based pushover, enhanced lateral load distribution, higher modes effect, nonlinear response history analysis (NL-RHA)

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Authors: Pushp Lata Sankhwar

Abstract:

INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Ami Nomura, Ken Imanishi, Etsuko Ueda, Tadahiro Wada, Shinichi Enoki

Abstract:

Recently, there have been a lot of earthquakes in Japan. It is necessary to promote seismic isolation devices for buildings. The devices have been hardly diffused in attached houses, because the devices are very expensive. We should develop a low-cost seismic isolation device for detached houses. We suggested a new seismic isolation device which uses a two-layer circular tube as a unit. If hysteresis is produced in the two-layer circular tube under lateral compression load, we think that the two-layer circular tube can have energy absorbing capacity. It is necessary to contact the outer layer and the inner layer to produce hysteresis. We have previously reported how the inner layer comes in contact with the outer layer from a perspective of analysis used mechanics of materials. We have clarified that the inner layer comes in contact with the outer layer under a lateral compression load. In this paper, we explored contact area between the outer layer and the inner layer under a lateral compression load by using FEA. We think that changing the inner layer’s thickness is effective in increase the contact area. In order to change the inner layer’s thickness, we changed the shape of the inner layer. As a result, the contact area changes depending on the inner layer’s thickness. Additionally, we experimented to check whether hysteresis occurs in fact. As a consequence, we can reveal hysteresis in the two-layer circular tube under the condition.

Keywords: contact area, energy absorbing capacity, hysteresis, seismic isolation device

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Authors: Vinci Mojamdar, Govind S. Gupta

Abstract:

Moving beds in the presence of gas flow are widely used in metallurgical and chemical industries like blast furnaces, catalyst reforming, drying, etc. Pressure drop studies in co- and counter – current conditions have been done by a few researchers. However, to the best of authours knowledge, proper pressure drop study with lateral gas injection lacks especially in the presence of cavity and nozzle protrusion inside the packed bed. The latter study is more useful for metallurgical industries for the processes such as blast furnaces, shaft reduction and, COREX. In this experimental work, a two dimensional cold model with slot type nozzle for lateral gas injection along with the plastic beads as packing material and dry air as gas have been used. The variation of pressure drop is recorded at various horizontal and vertical directions in the presence of cavity and nozzle protrusion. The study has been performed in both moving and stationary beds. Also, the experiments have been carried out in both increasing as well as decreasing gas flow conditions. Experiments have been performed at various gas flow rates and packed bed heights. Some interesting results have been reported such as there is no pressure variation in the moving bed for both the increasing and decreasing gas flow condition that is different from the stationary bed. Pressure hysteresis loop has been observed in a stationary bed.

Keywords: lateral gas injection, moving bed, pressure drop, pressure hysteresis, stationary bed

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Authors: T. Hirata, M. G. Silva, L. M. Rosa

Abstract:

The balance ability during task kick in soccer is a determining factor in the execution of functional movements that require a high-performance motor coordination. The current experiment explored it during an instep soccer kick and functional task kicking. Their kicking performance was measured in terms of the sway characteristics using lateral and antero-posterior balance of the center of pressure (COP) for the supporting leg and the kinematic data, the supporting leg’s knee angle. The motion was realized with one-legged stance of five male indoor soccer players and using the trigger device ball controller. The results showed large balance in antero-posterior direction than in lateral direction. However, each player adopts a different way to kick the ball, and the media-lateral displacement of the COP showed no correlation with the balance skill.

Keywords: kicking performance, center of pressure, one-legged stance, balance ability

Procedia PDF Downloads 589

Authors: Ami Nomura, Ken Imanishi, Yukinori Taniguchi, Etsuko Ueda, Tadahiro Wada, Shinichi Enoki

Abstract:

Recently, there have been a lot of earthquakes in Japan. It is necessary to promote seismic isolation devices for buildings. The devices have been hardly diffused in attached houses, because the devices are very expensive. We should develop a low-cost seismic isolation device for detached houses. We suggested a new seismic isolation device which uses a two-layer circular tube as a unit. If hysteresis is produced in the two-layer circular tube under lateral compression load, we think that the two-layer circular tube can have energy absorbing capacity. It is necessary to contact the outer layer and the inner layer to produce hysteresis. We have previously reported how the inner layer comes in contact with the outer layer from a perspective of analysis used mechanics of materials. We have clarified that the inner layer comes in contact with the outer layer under a lateral compression load. In this paper, we explored contact area between the outer layer and the inner layer under a lateral compression load by using FEA. We think that changing the inner layer’s thickness is effective in increase the contact area. In order to change the inner layer’s thickness, we changed the shape of the inner layer. As a result, the contact area changes depending on the inner layer’s thickness. Additionally, we experimented to check whether hysteresis occurs in fact. As a consequence, we can reveal hysteresis in the two-layer circular tube under the condition.

Keywords: contact area, energy absorbing capacity, hysteresis, seismic isolation device

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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