Search results for: lateral pedicle graft
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 894

Search results for: lateral pedicle graft

774 The Effect of Health Promoting Programs on Patient's Life Style after Coronary Artery Bypass Graft–Hospitalized in Shiraz Hospitals

Authors: Azizollah Arbabisarjou, Leila Safabakhsh, Mozhgan Jahantigh, Mahshid Nazemzadeh, Shahindokht Navabi

Abstract:

Background: Health promotion is an essential strategy for reduction of health disparities. Health promotion includes all activities that encourage optimum physical, spiritual, and mental function. The aim of this study was to determine the impact of a Health Promotion Program (HPP) on behavior in terms of the dimensions of the Health Promoting Lifestyle Profile (HPLP) in patients after Coronary Artery Bypass Graft (CABG). Methods and Materials: In this clinical trial study, 80 patients who had undergone CABG surgery (2011-2012) were selected and randomly divided in two groups: Experimental and Control that investigated by (HPLP II). Then the experimental group was educated about diet, walking and stress management. The program process was followed up for 3months and after that all variables were investigated again. The overall score and the scores for the six dimensions of the HPLP (self-actualization, health responsibility, exercise, nutrition, interpersonal support and stress management) were measured in the pre- and post-test periods. Statistical analysis was performed using Student's t-test and paired t-test. Results: Results showed that Score of stress management (p=.036), diet (p=.002), Spiritual Growth (p=.001) and interrelationship (p=002) increase in experimental group after intervention .Average scores after 3 months in the control group had no significant changes; except responsibility for health (p < .05). Results of the study revealed that comparison the scores of the experimental group were significantly different from the control group in all lifestyle aspects except for spiritual growth. Conclusion: This study showed that Health promoting program on lifestyle and health promotion in patients who suffer from CAD could enhance patient's awareness of healthy behaviors and improves the quality of life.

Keywords: coronary artery bypass graft, health promotion, lifestyle, education

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773 Stability Design by Geometrical Nonlinear Analysis Using Equivalent Geometric Imperfections

Authors: S. Fominow, C. Dobert

Abstract:

The present article describes the research that deals with the development of equivalent geometric imperfections for the stability design of steel members considering lateral-torsional buckling. The application of these equivalent imperfections takes into account the stiffness-reducing effects due to inelasticity and residual stresses, which lead to a reduction of the load carrying capacity of slender members and structures. This allows the application of a simplified design method, that is performed in three steps. Application of equivalent geometric imperfections, determination of internal forces using geometrical non-linear analysis (GNIA) and verification of the cross-section resistance at the most unfavourable location. All three verification steps are closely related and influence the results. The derivation of the equivalent imperfections was carried out in several steps. First, reference lateral-torsional buckling resistances for various rolled I-sections, slenderness grades, load shapes and steel grades were determined. This was done either with geometric and material non-linear analysis with geometrical imperfections and residual stresses (GMNIA) or for standard cases based on the equivalent member method. With the aim of obtaining identical lateral-torsional buckling resistances as the reference resistances from the application of the design method, the required sizes for equivalent imperfections were derived. For this purpose, a program based on the FEM method has been developed. Based on these results, several proposals for the specification of equivalent geometric imperfections have been developed. These differ in the shape of the applied equivalent geometric imperfection, the model of the cross-sectional resistance and the steel grade. The proposed design methods allow a wide range of applications and a reliable calculation of the lateral-torsional buckling resistances, as comparisons between the calculated resistances and the reference resistances have shown.

Keywords: equivalent geometric imperfections, GMNIA, lateral-torsional buckling, non-linear finite element analysis

Procedia PDF Downloads 130
772 Simulative Study of the Influence of Degraded Twin-Tube Shock Absorbers on the Lateral Forces of Vehicle Axles

Authors: Tobias Schramm, Günther Prokop

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Degraded vehicle shock absorbers represent a risk for road safety. The exact effect of degraded vehicle dampers on road safety is still the subject of research. This work is intended to contribute to estimating the effect of degraded twin-tube dampers of passenger cars on road safety. An axle model was built using a damper model to simulate different degradation levels. To parameterize the model, a realistic parameter space was estimated based on test rig measurements and database analyses, which is intended to represent the vehicle field in Germany. Within the parameter space, simulations of the axle model were carried out, which calculated the transmittable lateral forces of the various axle configurations as a function of vehicle speed, road surface, damper conditions and axle parameters. A degraded damper has the greatest effect on the transmittable lateral forces at high speeds and in poor road conditions. If a vehicle is traveling at a speed of 100 kph on a Class D road, a degraded damper reduces the transmissible lateral forces of an axle by 20 % on average. For individual parameter configurations, this value can rise to 50 %. The axle parameters that most influence the effect of a degraded damper are the vertical stiffness of the tire, the unsprung mass and the stabilizer stiffness of the axle.

Keywords: vehicle dynamics, vehicle simulation, vehicle component degradation, shock absorber model, shock absorber degradation

Procedia PDF Downloads 75
771 Plastic Deformation Behavior of a Pre-Bored Pile Filler Material Due to Lateral Cyclic Loading in Sandy Soil

Authors: A. Y. Purnama, N. Yasufuku

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The bridge structure is a building that has to be maintained, especially for the elastomeric bearing. The girder of the bridge needs to be lifted upward to maintain this elastomeric bearing, that needs high cost. Nowadays, integral abutment bridges are becoming popular. The integral abutment bridge is less costly because the elastomeric bearings are eliminated, which reduces the construction cost and maintenance costs. However, when this elastomeric bearing removed, the girder movement due to environmental thermal forces directly support by pile foundation, and it needs to be considered in the design. In case of pile foundation in a stiff soil, in the top area of the pile cannot move freely due to the fixed condition by soil stiffness. Pre-bored pile system can be used to increase the flexibility of pile foundation using a pre-bored hole that filled with elastic materials, but the behavior of soil-pile interaction and soil response due to this system is still rarely explained. In this paper, an experimental study using small-scale laboratory model test conducted in a half size model. Single flexible pile model embedded in sandy soil with the pre-bored ring, which filled with the filler material. The testing box made from an acrylic glass panel as observation area of the pile shaft to monitor the displacement of the pile during the lateral loading. The failure behavior of the soil inside the pre-bored ring and around the pile shaft was investigated to determine the point of pile rotation and the movement of this point due to the pre-bored ring system along the pile shaft. Digital images were used to capture the deformations of the soil and pile foundation during the loading from the acrylic glass on the side of the testing box. The results were presented in the form of lateral load resistance charts against the pile shaft displacement. The failure pattern result also established due to the cyclic lateral loading. The movement of the rotational point was measured due to the pre-bored system filled with appropriate filler material. Based on the findings, design considerations for pre-bored pile system due to cyclic lateral loading can be introduced.

Keywords: failure behavior, pre-bored pile system, cyclic lateral loading, sandy soil

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770 Effect of Colloid Versus Crystalloid Administration in Cardiopulmonary Bypass Prime Solution on Tissue and Organ Perfusionm

Authors: Mohammad Java Esmaeily

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Background: We evaluate the effects of tissue and organ perfusion during and after coronary artery bypass graft surgery with either colloid (Voluven) or crystalloid (Lactated ringers) as a prime solution. Materials and Methods: In this prospective randomized-controlled trial study, 70 patients undergoing on-pump coronary artery bypass graft surgery were randomly assigned to receive either colloid (Voluven) or crystalloid (Lactated ringer's) as a prime solution for initiation of cardiopulmonary bypass machine procedure. Tissue and organ perfusion markers, including lactate, troponin I, liver and renal function tests and electrolytes, were measured sequentially before induction (T1) to the second days after surgery (T5). Results: With the exception of chloride and potassium levels, no significant differences were detected in other measurements, and laboratory results were identical entirely in the two groups. Conclusion: Voluven® (hydroxyethyl starch, HES 130/0.4) has a not significant difference in comparison with crystalloid (Lactated ringer's) as priming solution on the basis of organ and tissue perfusion tests assessment.

Keywords: prime, colloid, crystalloid, lactate, troponin, hydroxyethyl starch

Procedia PDF Downloads 56
769 Xenografts: Successful Penetrating Keratoplasty Between Two Species

Authors: Francisco Alvarado, Luz Ramírez

Abstract:

Corneal diseases are one of the main causes of visual impairment and affect almost 4 million, and this study assesses the effects of deep anterior lamellar keratoplasty (DALK) with porcine corneal stroma and postoperative topical treatment with tacrolimus in patients with infectious keratitis. No patient was observed with clinical graft rejection. Among the cases: 2 were positive to fungal culture, 2 with Aspergillus and the other 8 cases were confirmed by bacteriological culture. Corneal diseases are one of the main causes of visual impairment and affect almost 4 million. This study assesses the effects of deep anterior lamellar keratoplasty (DALK) with porcine corneal stroma and postoperative topical treatment with tacrolimus in patients with infectious keratitis. Receiver bed diameters ranged from 7.00 to 9.00 mm. No incidents of Descemet's membrane perforation were observed during surgery. During the follow-up period, no corneal graft splitting, IOP increase, or intolerance to tacrolimus were observed. Deep anterior lamellar keratoplasty seems to be the best option to avoid xenograft rejection, and it could help new surgical techniques in humans.

Keywords: ophthalmology, cornea, corneal transplant, xenografts, surgical innovations

Procedia PDF Downloads 56
768 Seismic Considerations in Case Study of Kindergarten Building Design: Ensuring Safety and Structural Integrity

Authors: Al-Naqdi Ibtehal Abdulmonem, Hameed Reem Majeed

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Kindergarten buildings are essential for early childhood education, providing a secure environment for children's development. However, they are susceptible to seismic forces, which can endanger occupants during earthquakes. This article emphasizes the importance of conducting thorough seismic analysis and implementing proper structural design to protect the well-being of children, staff, and visitors. By prioritizing structural integrity and considering functional requirements, engineers can mitigate risks associated with seismic events. The use of specialized software like ETABS is crucial for designing earthquake-resistant kindergartens. An analysis using ETABS software compared the structural performance of a single-story kindergarten in Iraq's Ministry of Education, designed with and without seismic considerations. The analysis aimed to assess the impact of seismic design on structural integrity and safety. The kindergarten was designed with seismic considerations, including moment frames. In contrast, the same kindergarten was analyzed without seismic effects, revealing a lack of structural elements to resist lateral forces, rendering it vulnerable to structural failure during an earthquake. Maximum major shear increased over 4 times and over 5 times for bending moment in the kindergarten designed with seismic considerations induced by lateral loads and seismic forces. This component of shear force is vital for designing elements to resist lateral loads and ensure structural stability.

Keywords: seismic analysis, structural design, lateral loads, earthquake resistance, major shear, ETABS

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767 Variation in the Morphology of Soft Palate

Authors: Hema Lattupalli

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Introduction: The palate forms a partition between the oral cavity and nasal cavity. The palate is made up of two parts hard palate and soft palate. The Hard palate forms the anterior part of the palate, the soft palate forms a movable muscular fold covered by mucous membrane that is suspended from the posterior border of a hard palate. Aim and Objectives: Soft palate morphological variations have a great paucity in the literature. It’s also believed that the soft palate has no such important anatomical variations. There is a variable presentation of the soft palate morphology in the lateral cephalograms. The aim of this study is to identify the velar morphology. Materials and Methods: 100 normal subjects between the age group of 20 – 35 were taken for the study. Method: Lateral Cephalogram (radiologic study). Results: Different shapes of the soft palate were observed in the lateral cephalograms. The morphology of soft palate was classified into six types 1.Leaf like (50 cases) most common type, 2.Straight line (20 cases), 3.S shaped (4 cases) very rare, 4.Butt like (10 cases), 5. Rat tail (6 cases), 6. Hook shaped (10 cases). Conclusion: This classification helps us to understand the better diversity of the velar morphology in mid-sagittal plane. These findings help us to understand the etiology of OSAS.

Keywords: soft palate, cephalometric radiographs, morphology, cleft palate, obstructive sleep apnoea syndrome

Procedia PDF Downloads 335
766 A Study on the Coefficient of Transforming Relative Lateral Displacement under Linear Analysis of Structure to Its Real Relative Lateral Displacement

Authors: Abtin Farokhipanah

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In recent years, analysis of structures is based on ductility design in contradictory to strength design in surveying earthquake effects on structures. ASCE07-10 code offers to intensify relative drifts calculated from a linear analysis with Cd which is called (Deflection Amplification Factor) to obtain the real relative drifts which can be calculated using nonlinear analysis. This lateral drift should be limited to the code boundaries. Calculation of this amplification factor for different structures, comparing with ASCE07-10 code and offering the best coefficient are the purposes of this research. Following our target, short and tall building steel structures with various earthquake resistant systems in linear and nonlinear analysis should be surveyed, so these questions will be answered: 1. Does the Response Modification Coefficient (R) have a meaningful relation to Deflection Amplification Factor? 2. Does structure height, seismic zone, response spectrum and similar parameters have an effect on the conversion coefficient of linear analysis to real drift of structure? The procedure has used to conduct this research includes: (a) Study on earthquake resistant systems, (b) Selection of systems and modeling, (c) Analyzing modeled systems using linear and nonlinear methods, (d) Calculating conversion coefficient for each system and (e) Comparing conversion coefficients with the code offered ones and concluding results.

Keywords: ASCE07-10 code, deflection amplification factor, earthquake engineering, lateral displacement of structures, response modification coefficient

Procedia PDF Downloads 321
765 Developing and Evaluating Clinical Risk Prediction Models for Coronary Artery Bypass Graft Surgery

Authors: Mohammadreza Mohebbi, Masoumeh Sanagou

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The ability to predict clinical outcomes is of great importance to physicians and clinicians. A number of different methods have been used in an effort to accurately predict these outcomes. These methods include the development of scoring systems based on multivariate statistical modelling, and models involving the use of classification and regression trees. The process usually consists of two consecutive phases, namely model development and external validation. The model development phase consists of building a multivariate model and evaluating its predictive performance by examining calibration and discrimination, and internal validation. External validation tests the predictive performance of a model by assessing its calibration and discrimination in different but plausibly related patients. A motivate example focuses on prediction modeling using a sample of patients undergone coronary artery bypass graft (CABG) has been used for illustrative purpose and a set of primary considerations for evaluating prediction model studies using specific quality indicators as criteria to help stakeholders evaluate the quality of a prediction model study has been proposed.

Keywords: clinical prediction models, clinical decision rule, prognosis, external validation, model calibration, biostatistics

Procedia PDF Downloads 267
764 Normal Meniscal Extrusion Using Ultrasonography during the Different Range of Motion Running Head: Sonography for Meniscal Extrusion

Authors: Arash Sharafat Vaziri, Leila Aghaghazvini, Soodeh Jahangiri, Mohammad Tahami, Roham Borazjani, Mohammad Naghi Tahmasebi, Hamid Rabie, Hesan Jelodari Mamaghani, Fardis Vosoughi, Maryam Salimi

Abstract:

Aims: It is essential to know the normal extrusion measures in order to detect pathological ones. In this study, we aimed to define some normal reference values for meniscal extrusion in the normal knees during different ranges of motion. Methods: The amount of anterior and posterior portion of meniscal extrusion among twenty-one asymptomatic volunteers (42 knees) were tracked at 0, 45, and 90 degrees of knee flexion using an ultrasound machine. The repeated measures analysis of variance (ANOVA) was used to show the interaction between the amounts of meniscal extrusion and the different degrees of knee flexion. Result: The anterior portion of the lateral menisci at full knee extension (0.59±1.40) and the posterior portion of the medial menisci during 90° flexion (3.06±2.36) showed the smallest and the highest mean amount of extrusion, respectively. The normal average amounts of anterior extrusion were 1.12± 1.17 mm and 0.99± 1.34 mm for medial and lateral menisci, respectively. The posterior meniscal normal extrusions were significantly increasing in both medial and lateral menisci during the survey (F= 20.250 and 11.298; both P-values< 0.001) as they were measured at 2.37± 2.16 mm and 1.53± 2.18 mm in order. Conclusion: The medial meniscus can extrude 1.74± 1.84 mm normally, while this amount was 1.26± 1.82 mm for the lateral meniscus. These measures commonly increased with the rising of knee flexion motion. Likewise, the posterior portion showed more extrusion than the anterior portion on both sides. These measures commonly increased with higher knee flexion.

Keywords: meniscal extrusion, ultrasonography, knee

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763 Investigations into the in situ Enterococcus faecalis Biofilm Removal Efficacies of Passive and Active Sodium Hypochlorite Irrigant Delivered into Lateral Canal of a Simulated Root Canal Model

Authors: Saifalarab A. Mohmmed, Morgana E. Vianna, Jonathan C. Knowles

Abstract:

The issue of apical periodontitis has received considerable critical attention. Bacteria is integrated into communities, attached to surfaces and consequently form biofilm. The biofilm structure provides bacteria with a series protection skills against, antimicrobial agents and enhances pathogenicity (e.g. apical periodontitis). Sodium hypochlorite (NaOCl) has become the irrigant of choice for elimination of bacteria from the root canal system based on its antimicrobial findings. The aim of the study was to investigate the effect of different agitation techniques on the efficacy of 2.5% NaOCl to eliminate the biofilm from the surface of the lateral canal using the residual biofilm, and removal rate of biofilm as outcome measures. The effect of canal complexity (lateral canal) on the efficacy of the irrigation procedure was also assessed. Forty root canal models (n = 10 per group) were manufactured using 3D printing and resin materials. Each model consisted of two halves of an 18 mm length root canal with apical size 30 and taper 0.06, and a lateral canal of 3 mm length, 0.3 mm diameter located at 3 mm from the apical terminus. E. faecalis biofilms were grown on the apical 3 mm and lateral canal of the models for 10 days in Brain Heart Infusion broth. Biofilms were stained using crystal violet for visualisation. The model halves were reassembled, attached to an apparatus and tested under a fluorescence microscope. Syringe and needle irrigation protocol was performed using 9 mL of 2.5% NaOCl irrigant for 60 seconds. The irrigant was either left stagnant in the canal or activated for 30 seconds using manual (gutta-percha), sonic and ultrasonic methods. Images were then captured every second using an external camera. The percentages of residual biofilm were measured using image analysis software. The data were analysed using generalised linear mixed models. The greatest removal was associated with the ultrasonic group (66.76%) followed by sonic (45.49%), manual (43.97%), and passive irrigation group (control) (38.67%) respectively. No marked reduction in the efficiency of NaOCl to remove biofilm was found between the simple and complex anatomy models (p = 0.098). The removal efficacy of NaOCl on the biofilm was limited to the 1 mm level of the lateral canal. The agitation of NaOCl results in better penetration of the irrigant into the lateral canals. Ultrasonic agitation of NaOCl improved the removal of bacterial biofilm.

Keywords: 3D printing, biofilm, root canal irrigation, sodium hypochlorite

Procedia PDF Downloads 206
762 Stability of Concrete Moment Resisting Frames in View of Current Codes Requirements

Authors: Mahmoud A. Mahmoud, Ashraf Osman

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In this study, the different approaches currently followed by design codes to assess the stability of buildings utilizing concrete moment resisting frames structural system are evaluated. For such purpose, a parametric study was performed. It involved analyzing group of concrete moment resisting frames having different slenderness ratios (height/width ratios), designed for different lateral loads to vertical loads ratios and constructed using ordinary reinforced concrete and high strength concrete for stability check and overall buckling using code approaches and computer buckling analysis. The objectives were to examine the influence of such parameters that directly linked to frames’ lateral stiffness on the buildings’ stability and evaluates the code approach in view of buckling analysis results. Based on this study, it was concluded that, the most susceptible buildings to instability and magnification of second order effects are buildings having high aspect ratios (height/width ratio), having low lateral to vertical loads ratio and utilizing construction materials of high strength. In addition, the study showed that the instability limits imposed by codes are mainly mathematical to ensure reliable analysis not a physical ones and that they are in general conservative. Also, it has been shown that the upper limit set by one of the codes that second order moment for structural elements should be limited to 1.4 the first order moment is not justified, instead, the overall story check is more reliable.

Keywords: buckling, lateral stability, p-delta, second order

Procedia PDF Downloads 224
761 Non-Linear Static Analysis of Screwed Moment Connections in Cold-Formed Steel Frames

Authors: Jikhil Joseph, Satish Kumar S R.

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Cold-formed steel frames are preferable for framed constructions due to its low seismic weights and results into low seismic forces, but on the contrary, significant lateral deflections are expected under seismic/wind loading. The various factors affecting the lateral stiffness of steel frames are the stiffness of connections, beams and columns. So, by increasing the stiffness of beam, column and making the connections rigid will enhance the lateral stiffness. The present study focused on Structural elements made of rectangular hollow sections and fastened with screwed in-plane moment connections for the building frames. The self-drilling screws can be easily drilled on either side of the connection area with the help of gusset plates. The strength of screwed connections can be made 1.2 times the connecting elements. However, achieving high stiffness in connections is also a challenging job. Hence in addition to beam and column stiffness’s the connection stiffness are also going to be a governing parameter in the lateral deflections of the frames. SAP 2000 Non-linear static analysis has been planned to study the seismic behavior of steel frames. The SAP model will be consisting of nonlinear spring model for the connection to account the semi-rigid connections and the nonlinear hinges will be assigned for beam and column sections according to FEMA 273 guidelines. The reliable spring and hinge parameters will be assigned based on an experimental and analytical database. The non-linear static analysis is mainly focused on the identification of various hinge formations and the estimation of lateral deflection and these will contribute as an inputs for the direct displacement-based Seismic design. The research output from this study are the modelling techniques and suitable design guidelines for the performance-based seismic design of cold-formed steel frames.

Keywords: buckling, cold formed steel, nonlinear static analysis, screwed connections

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760 Ocular Complications, Adverse Effects of the Procedure, Side-effects of Medications Used for Graft Survival, and Preventable Vision Loss in Live-related Renal Transplant Recipients: Experience at a Transplant Centre in Pakistan

Authors: Fatema Ali Lanewala, Akhtar Jamal Khan

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The ocular complications in renal transplant recipients at the biggest transplant center in Pakistan were seen to be diverse, multiple, and sight-threatening. These complications could mainly be due to the primary disease causing renal failure, the process of transplantation, and/or the medications used pre and post-transplantation. A retrospective case series recently published in the Journal of Pakistan Medical Association highlights the common ocular pathologies encountered in renal transplant population. Majority of the patients suffered from cataract, which is a known side-effect of long-term steroids routinely used for graft survival. There was a unique finding in Pakistani population, never reported before from any other transplant centre world over; a large number of recipients was reported to be suffering from night blindness, which significantly improved on vitamin A supplementation. There were a variety of other ocular complications seen which emphasizes the necessity of ocular care and routine examination of transplant recipient’s eyes by an ophthalmologist in order to avoid visual compromise and improve the quality of life of the transplant recipient.

Keywords: cataract, night blindness, ocular complications, renal transplantation

Procedia PDF Downloads 67
759 Comparative Performance Study of Steel Plate Shear Wall with Reinforced Concrete Shear Wall

Authors: Amit S. Chauhan, S. Mandal

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The structural response of shear walls subjected to various types of loads is difficult to predict precisely. They are incorporated in buildings to resist lateral forces and support the gravity loads. The steel plate shear walls (SPSWs) are used as lateral load resisting systems for buildings and acts as an alternative to reinforced concrete shear walls (RCSWs). This paper compares the behavior of SPSW with the RCSW incorporated in a building frame having G+6 storey, located in Zone III, using the technique of Equivalent Static Method (ESM) as per Indian Standard Criteria For Earthquake Resistant Design of Structures IS 1893:2002. This paper intends to evaluate several parameters such as lateral displacement at tip, inter-storey drift, weight of steel and volume of concrete with the alteration of the shear wall with respect to different types viz., SPSW and RCSW. The strip model employed in this study is a widely accepted analytical tool for SPSW analysis. SPSW can be modelled as truss members by using a series of diagonal tension strips positioned at 45-degree angles. In this paper, by replacing the SPSWs with the tension strips, the G+6 building has been analyzed using STAAD.Pro V8i. Based on the present study, it can be concluded that structure with SPSWs is much better then structure with RCSWs.

Keywords: equivalent static method, inter-storey drift, lateral displacement, Steel plate shear wall, strip model

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758 Reconstruction of Complex Post Oncologic Maxillectomy Defects

Authors: Vinay Kant Shankhdhar

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Purpose: Maxillary defects are three dimensional and require complex bone and soft tissue reconstruction. Maxillary reconstruction using fibula osteocutaneous flaps in situation requiring orbital floor, orbital wall, palatal defects, and external skin, all at the same time require special planning and multiple osteotomies. We tried to improvise our reconstruction using multiple osteotomies and skin paddle designs for fibula and Flexor Hallucis Longus Muscle. This study aims at discussing the planning and outcome in complex maxillary reconstructions using fibula flaps and soft tissue flaps with or without bone grafts. Material and Methods: From 2011 to 2017 a total of 129 Free fibula flaps were done, 67 required two or more struts, 164 Anterolateral Thigh Flaps, 11 Deep Inferior Epigastric Artery perforator flaps and 3 vertical rectus abdominis muscle flaps with iliac crest bone graft. The age range was 2 to 70 years. The reconstruction was evaluated based on the post-operative rehabilitation including orbital support (prevention of diplopia), oral diet, speech and cosmetic appearance. Results: The follow- up is from 5 years to 1 year. In this series, we observed that the common complications were the de-vascularisation of most distal segment of osteotomised fibula and native skin necrosis. Commonest area of breakdown is the medial canthal region. Plate exposure occurs most commonly at the pyriform sinus. There was extrusion of one non-vascularized bone graft. All these complications were noticed post-radiotherapy. Conclusions: The use of free fibula osteocutaneous flap gives very good results when only alveolar reconstruction is required. The reconstruction of orbital floor with extensive skin loss with post operative radiotherapy has maximum complication rate in long term follow up. A soft tissue flap with non vascularized bone graft may be the best option in such cases.

Keywords: maxilla reconstruction, fibula maxilla, post cancer maxillary reconstruction

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757 Disturbance Observer for Lateral Trajectory Tracking Control for Autonomous and Cooperative Driving

Authors: Christian Rathgeber, Franz Winkler, Dirk Odenthal, Steffen Müller

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In this contribution a structure for high level lateral vehicle tracking control based on the disturbance observer is presented. The structure is characterized by stationary compensating side forces disturbances and guaranteeing a cooperative behavior at the same time. Driver inputs are not compensated by the disturbance observer. Moreover the structure is especially useful as it robustly stabilizes the vehicle. Therefore the parameters are selected using the Parameter Space Approach. The implemented algorithms are tested in real world scenarios.

Keywords: disturbance observer, trajectory tracking, robust control, autonomous driving, cooperative driving

Procedia PDF Downloads 527
756 Application of Flexi-Wall in Noise Barriers Renewal

Authors: B. Daee, H. M. El Naggar

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This paper presents an experimental study on structural performance of an innovative noise barrier consisting of poly-block, light polyurethane foam (LPF) and polyurea. This wall system (flexi-wall) is intended to be employed as a vertical extension to existing sound barriers in an accelerated construction method. To aid in the wall design, several mechanical tests were conducted on LPF specimens and two full-scale walls were then fabricated employing the same LPF material. The full-scale walls were subjected to lateral loading in order to establish their lateral resistance. A cyclic fatigue test was also performed on a full-scale flexi-wall in order to evaluate the performance of the wall under a repetitive loading condition. The result of the experiments indicated the suitability of flexi-wall in accelerated construction and confirmed that the structural performance of the wall system under lateral loading is satisfactory for the sound barrier application. The experimental results were discussed and a preliminary design procedure for application of flexi-wall in sound barrier applications was also developed.

Keywords: noise barrier, polyurethane foam, accelerated construction, full-scale experiment

Procedia PDF Downloads 260
755 Comparative Study of Dermal Regeneration Template Made by Bovine Collagen with and without Silicone Layer in the Treatment of Post-Burn Contracture

Authors: Elia Caldini, Cláudia N. Battlehner, Marcelo A. Ferreira, Rolf Gemperli, Nivaldo Alonso, Luiz P. Vana

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The advent of dermal regenerate templates has fostered major advances in the treatment of acute burns and their sequelae, in the last two decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are still lacking. The goal of this study was to prospectively analyze the outcome of patients treated with two of the existing templates, followed by thin skin autograft. They are both made of bovine collagen, one includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from burn sequelae (n = 12 per template). Negative pressure therapy was applied post-surgically; patients were monitored for 12 months. Data on scar skin quality (Vancouver and POSAS evaluation scales), rate of joint mobility recovery, and graft contraction were recorded. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The silicone-coupled template showed the best performance in all aspects.

Keywords: dermal regeneration template, artificial skin, skin quality, scar contracture

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754 Experimental Study on Single Bay RC Frame Designed Using EC8 under In-Plane Cyclic Loading

Authors: N. H. Hamid, M. S. Syaref, M. I. Adiyanto, M. Mohamed

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A one-half scale of single-bay two-storey RC frame together with foundation beam and mass concrete block is investigated. Moment resisting RC frame was designed using EC8 by including the provision for seismic loading and detailing of its connection. The objective of the experimental work is to determine seismic behaviour RC frame under in-plane lateral cyclic loading using displacement control method. A double actuator is placed at centre of the mass concrete block at top of frame to represent the seismic load. The percentage drifts are starting from ±0.01% until ±2.25% with increment of ±0.25% drift. The ultimate lateral load of 158.48 kN was recorded at +2.25% drift in pushing and -126.09 kN in pulling direction. From the experimental hysteresis loops, the parameters such as lateral strength capacity, stiffness, ductility and equivalent viscous damping can be obtained. RC frame behaves in the elastic manner followed by inelastic behaviour after reaches the yield limit. The ductility value for this type frame is 4 which lies between the limit 3 and 6. Therefore, it is recommended to build this RC frame for moderate seismic regions under Ductility Class Medium (DCM) such as in Sabah, East Malaysia.

Keywords: single bay, moment resisting RC frame, ductility class medium, inelastic behavior, seismic load

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753 Limitation of Parallel Flow in Three-Dimensional Elongated Porous Domain Subjected to Cross Heat and Mass Flux

Authors: Najwa Mimouni, Omar Rahli, Rachid Bennacer, Salah Chikh

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In the present work 2D and 3D numerical simulations of double diffusion natural convection in an elongated enclosure filled with a binary fluid saturating a porous medium are carried out. In the formulation of the problem, the Boussinesq approximation is considered and cross Neumann boundary conditions are specified for heat and mass walls conditions. The numerical method is based on the control volume approach with the third order QUICK scheme. Full approximation storage (FAS) with full multigrid (FMG) method is used to solve the problem. For the explored large range of the controlling parameters, we clearly evidenced that the increase in the depth of the cavity i.e. the lateral aspect ratio has an important effect on the flow patterns. The 2D perfect parallel flows obtained for a small lateral aspect ratio are drastically destabilized by increasing the cavity lateral dimension. This yields a 3D fluid motion with a much more complicated flow pattern and the classically studied 2D parallel flows are impossible.

Keywords: bifurcation, natural convection, heat and mass transfer, parallel flow, porous media

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752 The Effect of Main Factors on Forces during FSJ Processing of AA2024 Aluminum

Authors: Dunwen Zuo, Yongfang Deng, Bo Song

Abstract:

An attempt is made here to measure the forces of three directions, under conditions of different feed speeds, different tilt angles of tool and without or with the pin on the tool, by using octagonal ring dynamometer in the AA2024 aluminum FSJ (Friction Stir Joining) process, and investigate how four main factors influence forces in the FSJ process. It is found that, high feed speed lead to small feed force and small lateral force, but high feed speed leads to large feed force in the stable joining stage of process. As the rotational speed increasing, the time of axial force drop from the maximum to the minimum required increased in the push-up process. In the stable joining stage, the rotational speed has little effect on the feed force; large rotational speed leads to small lateral force and axial force. The maximum axial force increases as the tilt angle of tool increases at the downward movement stage. At the moment of start feeding, as tilt angle of tool increases, the amplitudes of the axial force increasing become large. In the stable joining stage, with the increase of tilt angle of tool, the axial force is increased, the lateral force is decreased, and the feed force almost unchanged. The tool with pin will decrease axial force in the downward movement stage. The feed force and lateral force will increase, but the axial force will reduced in the stable joining stage by using the tool with pin compare to by using the tool without pin.

Keywords: FSJ, force factor, AA2024 aluminum, friction stir joining

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751 The Confounding Role of Graft-versus-Host Disease in Animal Models of Cancer Immunotherapy: A Systematic Review

Authors: Hami Ashraf, Mohammad Heydarnejad

Abstract:

Introduction: The landscape of cancer treatment has been revolutionized by immunotherapy, offering novel therapeutic avenues for diverse cancer types. Animal models play a pivotal role in the development and elucidation of these therapeutic modalities. Nevertheless, the manifestation of Graft-versus-Host Disease (GVHD) in such models poses significant challenges, muddling the interpretation of experimental data within the ambit of cancer immunotherapy. This study is dedicated to scrutinizing the role of GVHD as a confounding factor in animal models used for cancer immunotherapy, alongside proposing viable strategies to mitigate this complication. Method: Employing a systematic review framework, this study undertakes a comprehensive literature survey including academic journals in PubMed, Embase, and Web of Science databases and conference proceedings to collate pertinent research that delves into the impact of GVHD on animal models in cancer immunotherapy. The acquired studies undergo rigorous analysis and synthesis, aiming to assess the influence of GVHD on experimental results while identifying strategies to alleviate its confounding effects. Results: Findings indicate that GVHD incidence significantly skews the reliability and applicability of experimental outcomes, occasionally leading to erroneous interpretations. The literature surveyed also sheds light on various methodologies under exploration to counteract the GVHD dilemma, thereby bolstering the experimental integrity in this domain. Conclusion: GVHD's presence critically affects both the interpretation and validity of experimental findings, underscoring the imperative for strategies to curtail its confounding impacts. Current research endeavors are oriented towards devising solutions to this issue, aiming to augment the dependability and pertinence of experimental results. It is incumbent upon researchers to diligently consider and adjust for GVHD's effects, thereby enhancing the translational potential of animal model findings to clinical applications and propelling progress in the arena of cancer immunotherapy.

Keywords: graft-versus-host disease, cancer immunotherapy, animal models, preclinical model

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750 Impact of Out-of-Plane Stiffness of the Diaphragm on Deflection of Wood Light-Frame Shear Walls

Authors: M. M. Bagheri, G. Doudak, M. Gong

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The in-plane rigidity of light frame diaphragms has been investigated by researchers due to the importance of this subsystem regarding lateral force distribution between the lateral force resisting system (LFRS). Where research has lacked is in evaluating the impact of out-of-plane raigidity of the diaphragm on the deflection of shear walls. This study aims at investigating the effect of the diaphragm on the behavior of wood light-frame shear walls, in particular its out-of-plane rigidity was simulated by modeling the floors as beam. The out of plane stiffness of the diaphragm was investigated for idealized (infinitely stiff or flexible) as well as “realistic”. The results showed reductions in the shear wall deflection in the magnitude of approximately 80% considering the out of plane rigidity of the diaphragm. It was also concluded that considering conservative estimates of out-of-plane stiffness might lead to a very significant reduction in deflection and that assuming the floor diaphragm to be infinitely rigid out of plan seems to be reasonable. For diaphragms supported on multiple panels, further reduction in the deflection was observed. More work, particularly at the experimental level, is needed to verify the finding obtained in the numerical investigation related to the effect of out of plane diaphragm stiffness.

Keywords: finite element analysis, lateral deflection, out-of-plane stiffness of the diaphragm, wood light-frame shear wall

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749 Teaching University Students Lateral Reading to Detect Disinformation and Misinformation

Authors: Diane Prorak, Perri Moreno

Abstract:

University students may have been born in the digital age, but they need to be taught the critical thinking skills to detect misinformation and social media manipulation online. In recent years, librarians have been active in designing instructional methods to help students learn information evaluation skills. At the University of Idaho Library (USA), librarians have developed new teaching methods for these skills. Last academic year, when classes were taught via Zoom, librarians taught these skills to an online session of each first-year rhetoric and composition course. In the Zoom sessions, students were placed in breakout groups where they practiced using an evaluation method known as lateral reading. Online collaborative software was used to give each group an evaluative task and break the task into steps. Groups reported back to the full class. Students learned to look at an information source, then search outside the source to find information about the organization, publisher or author, before evaluating the source itself. Class level pre-and post-test comparison results showed students learned better techniques for evaluation than they knew before instruction.

Keywords: critical thinking, information evaluation, information literacy instruction, lateral reading.

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748 Comparative Study between Mesenchymal Stem Cells and Regulatory T-Cells in Macrophage Polarization for Organ Transplant Tolerance: In Vitro Study

Authors: Vijaya Madhuri Devraj, Swarnalatha Guditi, Kiran Kumar Bokara, Gangadhar Taduri

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Cell-based strategies may open therapeutic approaches that promote tolerance through manipulation of macrophages to increase long-term transplant survival rates and minimize side effects of the current immune suppressive regimens. The aim of the present study was, therefore, to test and compare the therapeutic potential of MSC and Tregs on macrophage polarization to develop an alternate cell-based treatment option in kidney transplantation. In the current protocol, macrophages from kidney transplant recipients with graft dysfunction were co-cultured with MSCs and Treg cells with and without cell-cell contact on transwell plates, further to quantitatively assess macrophage polarization in response to MSC and Treg treatment over time, M1 and M2 cell surface markers were used. Additionally, multiple soluble analytes were analyzed in cell supernatant by using bead-based immunoassays. Furthermore, to confirm our findings, gene expression analysis was done. MSCs induced the formation of M2 macrophages more than Tregs when macrophages M0 were cultured in transwell without cell contact. From this, we deduced the mechanism that soluble factors present in the MSCs condition media are involved in skewing of macrophages towards type 2 macrophages; similarly, in co-culture with cell-cell contact, MSCs resulted in more M2 type macrophages than Tregs. And an important finding of this study is the combination of both MSC-Treg showed significantly effective and consistent results in both with and without cell contact setups. Hence, it is suggestive to prefer MSCs over Tregs for secretome-based therapy and a combination of both for either therapy for effective transplantation outcomes. Our findings underline a key role of Tregs and MSCs in promoting macrophage polarization towards anti-inflammatory type. The study has great importance in prolongation of allograft and patient survival without any rejection by cell-based therapy, which induce self-tolerance and controlling infection.

Keywords: graft rejection, graft tolerance, macrophage polarization, mesenchymal stem cells, regulatory T cells, transplant immunology

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747 Finite Element Analysis of the Anaconda Device: Efficiently Predicting the Location and Shape of a Deployed Stent

Authors: Faidon Kyriakou, William Dempster, David Nash

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Abdominal Aortic Aneurysm (AAA) is a major life-threatening pathology for which modern approaches reduce the need for open surgery through the use of stenting. The success of stenting though is sometimes jeopardized by the final position of the stent graft inside the human artery which may result in migration, endoleaks or blood flow occlusion. Herein, a finite element (FE) model of the commercial medical device AnacondaTM (Vascutek, Terumo) has been developed and validated in order to create a numerical tool able to provide useful clinical insight before the surgical procedure takes place. The AnacondaTM device consists of a series of NiTi rings sewn onto woven polyester fabric, a structure that despite its column stiffness is flexible enough to be used in very tortuous geometries. For the purposes of this study, a FE model of the device was built in Abaqus® (version 6.13-2) with the combination of beam, shell and surface elements; the choice of these building blocks was made to keep the computational cost to a minimum. The validation of the numerical model was performed by comparing the deployed position of a full stent graft device inside a constructed AAA with a duplicate set-up in Abaqus®. Specifically, an AAA geometry was built in CAD software and included regions of both high and low tortuosity. Subsequently, the CAD model was 3D printed into a transparent aneurysm, and a stent was deployed in the lab following the steps of the clinical procedure. Images on the frontal and sagittal planes of the experiment allowed the comparison with the results of the numerical model. By overlapping the experimental and computational images, the mean and maximum distances between the rings of the two models were measured in the longitudinal, and the transverse direction and, a 5mm upper bound was set as a limit commonly used by clinicians when working with simulations. The two models showed very good agreement of their spatial positioning, especially in the less tortuous regions. As a result, and despite the inherent uncertainties of a surgical procedure, the FE model allows confidence that the final position of the stent graft, when deployed in vivo, can also be predicted with significant accuracy. Moreover, the numerical model run in just a few hours, an encouraging result for applications in the clinical routine. In conclusion, the efficient modelling of a complicated structure which combines thin scaffolding and fabric has been demonstrated to be feasible. Furthermore, the prediction capabilities of the location of each stent ring, as well as the global shape of the graft, has been shown. This can allow surgeons to better plan their procedures and medical device manufacturers to optimize their designs. The current model can further be used as a starting point for patient specific CFD analysis.

Keywords: AAA, efficiency, finite element analysis, stent deployment

Procedia PDF Downloads 167
746 Effectiveness of Physiotherapy in Hand Dysfunction of Leukemia Patients with Chronic Musculoskeletal Graft versus Host Disease Post Bone Marrow Transplant

Authors: Mohua Chatterjee, Rajib De

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Introduction: Bone Marrow Transplant (BMT) is often performed to treat patients with various types of leukemia. A majority of these patients develop complications like chronic musculoskeletal GVHD post-BMT where patients get scleroderma, pain and restricted range of motion of joints of hand. If not treated early, it may cause permanent deformity of hand. This study was done to find the effectiveness of physiotherapy in hand dysfunction caused due to chronic musculoskeletal GVHD of leukemia patients after BMT. Methodology: 23 patients diagnosed with leukemia and having musculoskeletal GVHD were treated with a set of exercises including active exercises and stretching. The outcome was measured by Cochin Hand Function Scale (CHFS) at baseline and after four weeks of intervention. Results: Two patients were not able to carry out exercises beyond two weeks due to relapse of disease and one patient defaulted. It was found that all the patients who received physiotherapy had significant improvement in hand function. Mean CHFS decreased from 63.67 to 27.43 (P value < 0.001) indicating improvement in hand function after four weeks of physiotherapy. Conclusion: Early intervention of physiotherapy is effective in reducing hand dysfunction of leukemia patients with musculoskeletal GVHD post-BMT.

Keywords: bone marrow transplant, hand dysfunction, leukemia, musculoskeletal graft versus host disease, physiotherapy

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745 Lateral-Torsional Buckling of Steel Girder Systems Braced by Solid Web Crossbeams

Authors: Ruoyang Tang, Jianguo Nie

Abstract:

Lateral-torsional bracing members are critical to the stability of girder systems during the construction phase of steel-concrete composite bridges, and the interaction effect of multiple girders plays an essential role in the determination of buckling load. In this paper, an investigation is conducted on the lateral-torsional buckling behavior of the steel girder system which is composed of three or four I-shaped girders and braced by solid web crossbeams. The buckling load for such girder system is comprehensively analyzed and an analytical solution is developed for uniform pressure loading conditions. Furthermore, post-buckling analysis including initial geometric imperfections is performed and parametric studies in terms of bracing density, stiffness ratio as well as the number and spacing of girders are presented in order to find the optimal bracing plans for an arbitrary girder layout. The theoretical solution of critical load on account of local buckling mode shows good agreement with the numerical results in eigenvalue analysis. In addition, parametric analysis results show that both bracing density and stiffness ratio have a significant impact on the initial stiffness, global stability and failure mode of such girder system. Taking into consideration the effect of initial geometric imperfections, an increase in bracing density between adjacent girders can effectively improve the bearing capacity of the structure, and higher beam-girder stiffness ratio can result in a more ductile failure mode.

Keywords: bracing member, construction stage, lateral-torsional buckling, steel girder system

Procedia PDF Downloads 94