Search results for: lateral pedicle graft

Authors: J. Martin Leal-Graciano, Juan J. Pérez-Gavilán, A. Reyes-Salazar, J. H. Castorena, J. L. Rivera-Salas

Abstract:

The experimental results about the global behavior of twelve 1:2 scaled reinforced concrete frame subject to in-plane lateral load are presented. The main objective was to generate experimental evidence about the use of steel bars within mortar bed-joints as shear reinforcement in infill walls. Similar to the Canadian and New Zealand standards, the Mexican code includes specifications for this type of reinforcement. However, these specifications were obtained through experimental studies of load-bearing walls, mainly confined walls. Little information is found in the existing literature about the effects of joint reinforcement on the seismic behavior of infill masonry walls. Consequently, the Mexican code establishes the same equations to estimate the contribution of joint reinforcement for both confined walls and infill walls. A confined masonry construction and a reinforced concrete frame infilled with masonry walls have similar appearances. However, substantial differences exist between these two construction systems, which are mainly related to the sequence of construction and to how these structures support vertical and lateral loads. To achieve the objective established, ten reinforced concrete frames with masonry infill walls were built and tested in pairs, having both specimens in the pair identical characteristics except that one of them included joint reinforcement. The variables between pairs were the type of units, the size of the columns of the frame and the aspect ratio of the wall. All cases included tie-columns and tie-beams on the perimeter of the wall to anchor the joint reinforcement. Also, two bare frame with identical characteristic to the infilled frames were tested. The purpose was to investigate the effects of the infill wall on the behavior of the system to in-plane lateral load. In addition, the experimental results were compared with the prediction of the Mexican code. All the specimens were tested in cantilever under reversible cyclic lateral load. To simulate gravity load, constant vertical load was applied on the top of the columns. The results indicate that the contribution of the joint reinforcement to lateral strength depends on the size of the columns of the frame. Larger size columns produce a failure mode that is predominantly a sliding mode. Sliding inhibits the production of new inclined cracks, which are necessary to activate (deform) the joint reinforcement. Regarding the effects of joint reinforcement in the performance of confined masonry walls, many facts were confirmed for infill walls: this type of reinforcement increases the lateral strength of the wall, produces a more distributed cracking and reduces the width of the cracks. Moreover, it reduces the ductility demand of the system at maximum strength. The prediction of the lateral strength provided by the Mexican code is property in some cases; however, the effect of the size of the columns on the contribution of joint reinforcement needs to be better understood.

Keywords: experimental study, Infill wall, Infilled frame, masonry wall

Procedia PDF Downloads 53

Authors: Alaa T. Ali, Nevine H. Kheir El Din, Ehab S. Abdelhamid, Ahmed E. Amr

Abstract:

Objective: Severe alveolar bone resorption is usually associated with a deficient amount of soft tissues. soft tissue expansion is introduced to provide an adequate amount of soft tissue over the grafted area. This study aimed to assess the efficacy of sub-periosteal self-inflating osmotic tissue expanders used as preparatory surgery before horizontal alveolar ridge augmentation using autogenous onlay block bone graft. Methods: A prospective randomized controlled clinical trial was performed. Sixteen partially edentulous patients demanding horizontal bone augmentation in the anterior maxilla were randomly assigned to horizontal ridge augmentation with autogenous bone block grafts harvested from the mandibular symphysis. For the test group, soft tissue expanders were placed sub-periosteally before horizontal ridge augmentation. Impressions were taken before and after STE, and the cast models were optically scanned and superimposed to be used for volumetric analysis. Horizontal ridge augmentation was carried out after STE completion. For the control group, a periosteal releasing incision was performed during bone augmentation procedures. Implants were placed in both groups at re-entry surgery after six months period. A core biopsy was taken. Histomorphometric assessment for newly formed bone surface area, mature collagen area fraction, the osteoblasts count, and blood vessel count were performed. The change in alveolar ridge width was evaluated through bone caliper and CBCT. Results: Soft tissue expander successfully provides a Surplus amount of soft tissues in 5 out of 8 patients in the test group. Complications during the expansion period were perforation through oral mucosa occurred in two patients. Infection occurred in one patient. The mean soft tissue volume gain was 393.9 ± 322mm. After 6 months. The mean horizontal bone gains for the test and control groups were 3.14 mm and 3.69 mm, respectively. Conclusion: STE with a sub-periosteal approach is an applicable method to achieve an additional soft tissue and to reduce bone block graft exposure and wound dehiscence.

Keywords: soft tissue expander, ridge augmentation, block graft, symphysis bone block

Procedia PDF Downloads 96

Authors: J. Martin Leal-Graciano, Juan J. Pérez-Gavilán, A. Reyes-Salazar, J. H. Castorena, J. L. Rivera-Salas

Abstract:

The experimental results about the global behavior of twelve 1:2 scaled reinforced concrete frames subject to in-plane lateral load are presented. The main objective was to generate experimental evidence about the use of steel bars within mortar bed joints as shear reinforcement in infill walls. Similar to the Canadian and New Zealand standards, the Mexican code includes specifications for this type of reinforcement. However, these specifications were obtained through experimental studies of load-bearing walls, mainly confined walls. Little information is found in the existing literature about the effects of joint reinforcement on the seismic behavior of infill masonry walls. Consequently, the Mexican code establishes the same equations to estimate the contribution of joint reinforcement for both confined walls and infill walls. Confined masonry construction and a reinforced concrete frame infilled with masonry walls have similar appearances. However, substantial differences exist between these two construction systems, which are mainly related to the sequence of construction and to how these structures support vertical and lateral loads. To achieve the objective established, ten reinforced concrete frames with masonry infill walls were built and tested in pairs, having both specimens in the pair identical characteristics except that one of them included joint reinforcement. The variables between pairs were the type of units, the size of the columns of the frame, and the aspect ratio of the wall. All cases included tie columns and tie beams on the perimeter of the wall to anchor the joint reinforcement. Also, two bare frames with identical characteristics to the infilled frames were tested. The purpose was to investigate the effects of the infill wall on the behavior of the system to in-plane lateral load. In addition, the experimental results were compared with the prediction of the Mexican code. All the specimens were tested in a cantilever under reversible cyclic lateral load. To simulate gravity load, constant vertical load was applied on the top of the columns. The results indicate that the contribution of the joint reinforcement to lateral strength depends on the size of the columns of the frame. Larger size columns produce a failure mode that is predominantly a sliding mode. Sliding inhibits the production of new inclined cracks, which are necessary to activate (deform) the joint reinforcement. Regarding the effects of joint reinforcement in the performance of confined masonry walls, many facts were confirmed for infill walls. This type of reinforcement increases the lateral strength of the wall, produces a more distributed cracking, and reduces the width of the cracks. Moreover, it reduces the ductility demand of the system at maximum strength. The prediction of the lateral strength provided by the Mexican code is a property in some cases; however, the effect of the size of the columns on the contribution of joint reinforcement needs to be better understood.

Keywords: experimental study, infill wall, infilled frame, masonry wall

Procedia PDF Downloads 149

Authors: Shamik Hazra, Sushanta Mitra, Ashis Sen

Abstract:

Despite growing interest of microparticle manipulation in non-Newtonian fluids, combined effect of viscoelasticity and shear thinning on particle lateral position is not well understood. We performed experiments with rigid microparticles of 15 µm diamater in popular Shear thinning viscoelastic (STVE) liquid poyethylene oxide (PEO) of different molecular weights (MW) and concentrations (c), for Reynolds number (Re) < 1. Microparticles in an STVE liquid revealed four different migration regimes: original streamline (OS), bimodal (BM), centre migration (CM) and defocusing (DF), depending upon the Re and c and interplay of different forces is also elucidated. Our investigation will be helpful to select proper polymer concentration to achieve desired particle focusing inside microchannel.

Keywords: lateral migration, microparticle, polyethylene oxide, shear thinning, viscoelasticity

Procedia PDF Downloads 115

Authors: Nuruddin Mohammod Zahangir, Syed Tanvir Ahmady, Firoz Ahmed, Mainul Kabir, Tamjid Mohammad Najmus Sakib Khan, Nazmul Hossain, Niaz Ahmed, Madhava Janardhan Naik

Abstract:

The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas.The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and bilateral superficial femoral arteries. Operation was done on 11.03.14. The The Left Internal Mammary Artery (LIMA) and the Right Internal Mammary Artery (RIMA) were harvested in skeletonized manner. The free RIMA was then anastomosed with LIMA to make LIMA-RIMA Y. Cardio Pulmonary Bypass was then established and coronary artery bypass grafts performed. LIMA was anastomosed to the Left Anterior Descending artery. RIMA was anastomosed to Posterior Descending Artery, 1st and 2nd Obtuse Marginal arteries in a sequential manner. Abdomen was opened by midline incision. The infrarenal aorta exposed and was found to be severely diseased. A Vascular Clamp was applied infrarenally, aortotomy done and limited endarterectomy performed. An end-to-side anastomosis was done with upper end of PTFE synthetic Y-graft (14/7 mm) to the infarenal Aorta and the Clamp released. Good flow noted in both limbs of the graft. Patient was then slowly weaned off from Cardio Pulmonary Bypass without difficulty. The distal two limbs of the Y graft were passed to the groin through retroperitoneal tunnels and anastomosed end-to-side with the common femoral arteries. Saphenous vein was interposed between common femoral and popliteal arteries bilaterally through subfascial tunnels in both thigh. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 3 months of operation the patient is doing good and free of chest pain and claudication pain.

Keywords: total arterial, coronary revascularization, aorto-bifemoral bypass, bifemoro-bipopliteal bypass

Procedia PDF Downloads 437

Authors: Mohamed Eftal Bin Mohamed Ebrahim, Alexander Varey

Abstract:

Aim: Topical negative pressure has been shown to enhance angiogenesis during wound healing, both for open and closed wounds. Since angiogenesis is a key requirement for successful fat grafting, there may be a role for topical negative pressure as a means of enhancing the take rate during autologous fat grafting to breasts. Here we present a systematic review of the literature on this topic. Methods: Ovid and Embase were utilized, with searches ranging between 1960 – 2019. Terms (“Liposculpting” OR “Fat grafting” OR “Lipofilling” OR “Lipograft” OR “Fat transfer”) AND (“Negative Pressure” OR “Brava” OR “Kiwi”) AND (“Breast”) were merged as keywords. Inclusion criteria were females, autologous fat graft to breast with topical negative pressure prior to the procedure. Studies were excluded if there was no primary endpoint or non-original article. Results: Upon reviewing 219 articles, 2 met inclusion criteria. A total of 565 and 46 breasts in each article were treated respectively using the negative pressure device BRAVA®, with each cohort having different pre-and post-operative pressure settings. Khouri et al. cohort had higher graft survival (79%) compared to Del Vecchio et al. cohort (64%); however, the latter had fewer complications compared to Khouri’s cohort, e.g., fat necrosis, pneumothorax and infection. Conclusion: There is limited evidence regarding the use of topical negative pressure for fat grafting to the breasts. However, in the two studies published, the reported rates of success are high, suggesting there may be a benefit. Consequently, a randomized controlled trial on this area is required.

Keywords: fat grafting, lipograft, negative pressure, breast, breast augmentation, brava

Procedia PDF Downloads 168

Authors: Saul A. Torres Z., Eduardo Liceaga C., Alfredo Arias M.

Abstract:

We seek to develop a UAV for agricultural spraying at a maximum altitude of 5000 meters above sea level, with a payload of 100 liters of fumigant. For the developing the aerodynamic design of the aircraft is using computational tools such as the "Vortex Lattice Athena" software, "MATLAB", "ANSYS FLUENT", "XFoil" package among others. Also methods are being used structured programming, exhaustive analysis of optimization methods and search. The results have a very low margin of error, and the multi-objective problems can be helpful for future developments. Also we developed method for Stability Analysis (Lateral-Directional and Longitudinal).

Keywords: aerodynamics design, optimization, algorithm genetic, multi-objective problem, longitudinal stability, lateral-directional stability

Procedia PDF Downloads 563

Authors: Bin Mohamed Ebrahim, Aminesh Singla, Henry Pleass

Abstract:

Aim: There is an ongoing gap in renal transplantation between organs available for donation and recipients on the waiting list. Live donors with pre-existing or a history of renal calculi were thought to be a relative contraindication due to safety concerns for donors. We aim to review current literature assessing outcomes of donors who were found to have a history of renal calculi. Methods: Ovid and Embase were searched between 1960 to 2021 using key terms and Medical Subject Headings (MeSH) – nephrolithiasis, renal stones, renal transplantation and renal graft. Articles included conference proceedings and journal articles and were not excluded based on patient numbers. Studies were excluded if the specific organ was not identified, duplicated reports found or if post-transplant outcomes were not recorded. Outcomes were donor’s renal function or renal calculi recurrence postoperatively. Results: Upon reviewing 344 articles, 14 manuscripts met inclusion criteria. A total of 152 live donors were identified as having pre-existing or with a history of renal calculi at pre-operative workup. The mean stone size was 2.6 4mm (1 – 16) with a mean follow-up duration of 31.8 months (1 – 96). Seven studies had both outcomes. None showed renal complications or stone recurrence. The remaining studies contained 2 out of 84 patients having recurrent nephrolithiasis. Conclusion: Data suggests minimal morbidity involved for live renal donors with a history of nephrolithiasis. This should encourage surgeons to continue recruiting such donors for kidney transplantation.

Keywords: renal transplantation, renal graft, nephrolithiasis, renal calculi, live donor

Procedia PDF Downloads 157

Authors: Anasuya Ghosh, Subhramoy Chaudhury

Abstract:

During routine cadaveric dissection at gross anatomy lab of our institution, a radial artery was found with unusual origin and superficial course. Normally the radial artery takes its origin as one of the terminal branches of brachial artery at the level of the neck of radius. It usually lies along the lateral border of fore arm deep to the brachioradialis muscle. While dissecting a 72-year-old Caucasian female cadaver, it was found that the right sided radial artery originated from the upper part of brachial artery of arm, 2 cm below the lower border of teres major muscle, from the lateral aspect of brachial artery. Then the radial artery superficially crossed the brachial artery and median nerve from lateral to medial direction and rested superficially at the cubital fossa. Embryologically, it can be explained as a failure of disappearance, or abnormal persistence of some insignificant embryonic vessels may give rise to this kind of vascular anomalies. As radial artery is one of the most important upper limb arteries, its variation and related complications are clinically significant. This unusual origin and course of radial artery should be kept in mind by all healthcare providers including surgeons and radiologists during routine venipuncture, orthopedic and plastic surgeries of arm, coronary angiographic procedures in radial approach etc. to prevent unwanted complications.

Keywords: brachial artery anomalies, brachio-radial artery, high origin radial artery, superficial radial artery

Procedia PDF Downloads 302

Authors: Ashutosh Verma, Satyendra Mittal

Abstract:

Numerous geosynthetic reinforced soil (GRS) abutment failures over the years have been attributed to the loss of strength at the facing-reinforcement interface due to seasonal thermal expansion/contraction of the bridge deck. This causes excessive settlement below the bridge seat, causing bridge bumps along the approach road which reduces the design life of any abutment. Before designers while choosing the type of facing, a broad range of facing configurations are undoubtedly available. Generally speaking, these configurations can be divided into three groups: modular (panels/block), continuous, and full height rigid (FHR). The purpose of the current study is to use 1g physical model tests under serviceable cyclic lateral displacements to experimentally investigate the behaviour of these three facing classifications. To simulate field behaviour, a field instrumented GRS abutment prototype was modeled into a N scaled down 1g physical model (N = 5) with adjustable facing arrangements to represent these three facing classifications. For cyclic lateral displacement (d/H) of top facing at loading rate of 1mm/min, the peak earth pressure coefficient (K) on the facing and vertical settlement of the footing (s/B) at 25, 50, 75 and 100 cycles have been measured. For a constant footing offset of x/H = 0.1, three forms of cyclic displacements have been performed to simulate active condition (CA), passive condition (CP), and active-passive condition (CAP). The findings showed that when reinforcements are integrated into the wall along with presence of gravel gabions i.e. FHR design, a rather substantial earth pressure occurs over the facing. Despite this, the FHR facing's continuous nature works in conjunction with the reinforcements' membrane resilience to reduce footing settlement. On the other hand, the pressure over the wall is released upon lateral excitation by the relative displacement between the panels in modular facing reducing the connection strength at the interface and leading to greater settlements below footing. On the contrary, continuous facing do not exhibit relative displacement along the depth of facing rather fails through rotation about the base, which extends the zone of active failure in the backfill leading to large depressions in the backfill region around the bridge seat. Conservatively, FHR facing shows relatively stable responses under lateral cyclic excitations as compared to modular or continuous type of abutment facing.

Keywords: GRS abutments, 1g physical model, full height rigid, cyclic lateral displacement

Procedia PDF Downloads 46

Authors: Chang, Ya-Ju, Hsieh, Pei-Hsin, Wu, Jui-Chuang, Chen-Yang, Yui Whei

Abstract:

A mesoporous silica material was prepared to apply to the lateral-flow immunochromatography for detecting a model biosample. The probe antibody is immobilized on the silica surface as the test line to capture its affinity antigen, which laterally flows through the chromatography strips. The antigen is labeled with nano-gold particles, such that the detection can be visually read out from the test line without instrument aids. The result reveals that the mesoporous material provides a vast area for immobilizing the detection probes. Biosening surfaces corresponding with a positive proportion of detection signals is obtained with the biosample loading.

Keywords: mesoporous silica, immunochromatography, lateral-flow strips, biosensors, nano-gold particles

Procedia PDF Downloads 577

Authors: Fatma Mohamed Magdy Badr El Dine, Amr Mohamed Abd Allah

Abstract:

Introduction: Age estimation of individuals is one of the crucial steps in forensic practice. Different traditional methods rely on the length of the diaphysis of long bones of limbs, epiphyseal-diaphyseal union, fusion of the primary ossification centers as well as dental eruption. However, there is a growing need for the development of precise and reliable methods to estimate age, especially in cases where dismembered corpses, burnt bodies, purified or fragmented parts are recovered. Teeth are the hardest and indestructible structure in the human body. In recent years, assessment of pulp/tooth area ratio, as an indirect quantification of secondary dentine deposition has received a considerable attention. However, scanty work has been done in Egypt in terms of applicability of pulp/tooth ratio for age estimation. Aim of the Work: The present work was designed to assess the Cameriere’s method for age estimation from pulp/tooth ratio of maxillary canines, central and lateral incisors among a sample from Egyptian population. In addition, to formulate regression equations to be used as population-based standards for age determination. Material and Methods: The present study was conducted on 270 peri-apical X-rays of maxillary canines, central and lateral incisors (collected from 131 males and 139 females aged between 19 and 52 years). The pulp and tooth areas were measured using the Adobe Photoshop software program and the pulp/tooth area ratio was computed. Linear regression equations were determined separately for canines, central and lateral incisors. Results: A significant correlation was recorded between the pulp/tooth area ratio and the chronological age. The linear regression analysis revealed a coefficient of determination (R² = 0.824 for canine, 0.588 for central incisor and 0.737 for lateral incisor teeth). Three regression equations were derived. Conclusion: As a conclusion, the pulp/tooth ratio is a useful technique for estimating age among Egyptians. Additionally, the regression equation derived from canines gave better result than the incisors.

Keywords: age determination, canines, central incisors, Egypt, lateral incisors, pulp/tooth ratio

Procedia PDF Downloads 156

Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing

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Background: In lateral medullary strokes, hemiparesis doesn't typically manifest due to the distinct vascular supply to the corticospinal tract located within the medulla's tegmentum. Hemiparesis resulting from a medullary infarct would likely be attributable to a medial medullary stroke characterized by contralateral hemiparesis since the corticospinal tract fibers at this level have yet to cross over. This paper reports a unique case of a lateral medullary stroke variant that presented with ipsilateral hemiparesis. Objective: There have only been 23 other cases of reported Opalski syndrome, making this only the 24th and 25th case reported worldwide. Case Presentation: A 53-year-old male was admitted with slurring of speech with gait instability, numbness on the right face, Horner’s syndrome, and 4/5 motor strength on the right extremities. Hyperreflexia was noted on the right, together with a Babinski’s sign. Cranial magnetic resonance imaging (MRI) showed an infarct on the right dorsolateral medulla. A 48-year-old male was admitted complaining of dizziness, ataxic gait, veering to the left during ambulation, left facial numbness, left hemiplegia, crossed sensory disturbance, and right limb ataxia. MRI revealed an acute left lateral medullary infarction. Conclusion: A rare type of lateral medullary infarction, the Opalski Syndrome, is a weakness ipsilateral to the lesion of the infarct. The lesion involves the ipsilateral corticospinal tract below the pyramidal decussation. The considerable diversity in the posterior brain circulation serves as a contributing factor to the clinical observation of incomplete textbook syndromes, underscoring the significance of the neurological clinical approach and a solid foundation in neuroanatomy.

Keywords: Opalski syndrome, rare stroke, stroke, Wallenberg's syndrome

Procedia PDF Downloads 42

Authors: Mohammed Ali Hjaji, Magdi Mohareb

Abstract:

This paper develops the exact solutions for coupled flexural-lateral-torsional static response of thin-walled asymmetric open members subjected to general loading. Using the principle of stationary total potential energy, the governing differential equations of equilibrium are formulated as well as the associated boundary conditions. The formulation is based on a generalized Timoshenko-Vlasov beam theory and accounts for the effects of shear deformation due to bending and warping, and captures the effects of flexural–torsional coupling due to cross-section asymmetry. Closed-form solutions are developed for cantilever and simply supported beams under various forces. In order to demonstrate the validity and the accuracy of this solution, numerical examples are presented and compared with well-established ABAQUS finite element solutions and other numerical results available in the literature. In addition, the results are compared against non-shear deformable beam theories in order to demonstrate the shear deformation effects.

Keywords: asymmetric cross-section, flexural-lateral-torsional response, Vlasov-Timoshenko beam theory, closed form solution

Procedia PDF Downloads 444

Authors: Mark Osborn

Abstract:

Clustered, regularly interspaced short palindromic repeat (CRISPR/Cas) proteins can be designed to bind specified DNA and RNA sequences and hold great promise for the accurate detection of nucleic acids for diagnostics. Commercially available reagents were integrated into a CRISPR/Cas9-based lateral flow assay that can detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequences with single-base specificity. This approach requires minimal equipment and represents a simplified platform for field-based deployment. A rapid, multiplex fluorescence CRISPR/Cas9 nuclease cleavage assay capable of detecting and differentiating SARS-CoV-2, influenza A and B, and respiratory syncytial virus in a single reaction was also developed. These findings provide proof of principle for CRISPR/Cas9 point-of-care diagnosis that can detect specific SARS-CoV-2 strain(s). Further, Cas9 cleavage allows for a scalable fluorescent platform for identifying respiratory viral pathogens with overlapping symptomology. Collectively, this approach is a facile platform for diagnostics with broad application to user-defined sequence interrogation and detection.

Keywords: CRISPR/Cas9, lateral flow assay, SARS-Co-V2, single-nucleotide resolution

Procedia PDF Downloads 153

Authors: Alexandra Monteiro, K. Bousson, Fernando J. O. Moreira, Ricardo Reis

Abstract:

Fixed-wing flying vehicles are usually controlled by means of control surfaces such as elevators, ailerons, and rudders. The failure of these systems may lead to severe or even fatal crashes. These failures resulted in increased popularity for research activities on propulsion control in the last decades. The present work deals with a hybrid control architecture in which the propulsion-controlled vehicle maintains its traditional control surfaces, addressing the issue of robust lateral-directional dynamics control. The challenges stem from the parameter uncertainties in the stability and control derivatives and some unknown terms in the flight dynamics model. Two approaches are implemented and tested: linear quadratic regulation with robustness characteristics and H∞ control. The problem is centered on roll-yaw controller design with full state-feedback, which is able to deal with a standalone propulsion control mode as well as a hybrid mode combining both propulsion control and conventional control surface concepts while maintaining the original flight maneuverability characteristics. The results for both controllers emphasized very good control performances; however, the H∞ controller showed higher stabilization rates and robustness albeit with a slightly higher control magnitude than using the linear quadratic regulator.

Keywords: robust propulsion control, h-infinity control, lateral-directional flight dynamics, parameter uncertainties

Procedia PDF Downloads 116

Authors: Andrea Gatti, Federica Coppotelli, Ma Primavera, Laura Palmieri, Umberto Tarantino

Abstract:

Aim of study: Scientific literature is scarce of studies and reviews valuing the pros and cons of the paratricipital approach for the treatment of humeral shaft fractures; the lateral paratricipital approach is a valid alternative to the classical posterior approach to the humeral shaft as it preserves both the triceps muscle and the elbow extensor mechanisms; based on our experience, this retrospective analysis aims at analyzing outcome, risks and benefits of the lateral paratricipital approach for humeral shaft fractures. Methods: Our study includes 14 patients treated between 2018 and 2019 for unilateral humeral shaft fractures: 13 with a B1 or B2 and a patient with a C fracture type (according to the AO/ATO Classification); 6 of our patients identified as male while 8 as female; age average was 57.8 years old (range 21-73 years old). A lateral paratricipital approach was performed on all 14 patients, sparing the triceps muscle by avoiding the olecranon osteotomy and by assessing the integrity and the preservation of the radial nerve; the humeral shaft fracture osteosynthesis was performed by means of plates and screws. After surgery all patients have started elbow functional rehabilitation with acceptable pain management. Post-operative follow-up has been carried out by assessing radiographs, MEPS (Mayo Elbow Performance Score) and DASH (Disability of Arm Shoulder and Hand) functional assessment and ROM of the affected joint. Results: All 14 patients had an optimal post-operative follow-up with an adequate osteosynthesis and functional rehabilitations by entirely preserving the operated elbow joint; the mean elbow ROM was 0-118.6 degree (range of 0-130) while the average MEPS score was 86 (range75-100) and 79.9 for the DASH (range 21.7-86.1). Just 2 patients suffered of temporary radial nerve apraxia, healed in the subsequent follow-ups. CONCLUSION: The lateral paratricipital approach preserve both the integrity of the triceps muscle and the elbow biomechanism but we do strongly recommend additional studies to be carried out to highlight differences between it and the classical posterior approach in treating humeral shaft fractures.

Keywords: paratricepital approach, humerus shaft fracture, posterior approach humeral shaft, paratricipital postero-lateral approach

Procedia PDF Downloads 105

Authors: Seema Saini, Nidhi Chandra, Tushar Palekar

Abstract:

Objective: To determine the effect of Passive pectoralis minor muscle stretching on scapular kinematics in individuals with scapular dyskinesia. Design: A randomized controlled study was conducted in Pune. The sample size was 30 subjects, which were randomly allocated to either Group A, the experimental group in which passive pectoralis minor stretch was given, or Group B, the control group, in which conventional exercises were given for 3 days a week over 4 weeks. Pre and Post treatment readings of the outcome measures, pectoralis minor length, scapular upward rotation, and lateral scapular slide test were recorded. Results: The results obtained prove a significant difference between pre and post mean values of pectoralis minor length in group A (pre 21.91, post 22.87) and in group B (pre 23.55 post 23.99); scapular upward rotation in group A (pre 49.95, post 50.61) and group B (pre 52.64, post 53.51); lateral scapular slide test at 0° abduction in group A (pre 6.613, post 6.14) and group B (pre 6.84, post 6.22); lateral scapular slide test at 45° abduction in group A (pre 7.14 and post 7.12) and group B (pre 8.18, post 7.53). With an inter-group analysis, it was found that mean of pectoralis minor length, scapular upward rotation, and LSST at 0° abduction in group A was significant than group B (p<0.05). Conclusion: Passive pectoralis minor stretching along with conventional strengthening exercises was shown to be more effective in improving scapular kinematics among patients with scapular dyskinesia.

Keywords: scapulohumeral rhythm, scapular upward rotation, rounded shoulders, scapular strengthening

Procedia PDF Downloads 133

Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

Abstract:

We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

Procedia PDF Downloads 267

Authors: Miguel Limbert Ramos, Joseph Amado Galvez

Abstract:

Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

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Authors: T. Karech A. Noui, T. Bouzid

Abstract:

This article presents a comparative study by numerical analysis of the behavior of reinforcements of clayey soils by flexible columns (stone columns) and rigid columns (piles). The numerical simulation was carried out in 3D for an assembly of foundation, columns and a pile of a bridge. Particular attention has been paid to take into account the installation of the columns. Indeed, in practice, due to the compaction of the column, the soil around it sustains a lateral expansion and the horizontal stresses are increased. This lateral expansion of the column can be simulated numerically. This work represents a comparative study of the interaction between the soil on one side, and the two types of reinforcement on the other side, and their influence on the behavior of the soil and of the pile of a bridge.

Keywords: piles, stone columns, interaction, foundation, settlement, consolidation

Procedia PDF Downloads 244

Authors: M-M. Mohamed Ahmed, Nacer K. M’Sirdi, Aziz Naamane

Abstract:

In this paper, a longitudinal and lateral control approach based on a nonlinear observer is proposed for a convoy of autonomous vehicles to follow a desired trajectory. To authors best knowledge, this topic has not yet been sufficiently addressed in the literature for the control of multi vehicles. The modeling of the convoy of the vehicles is revisited using a robotic method for simulation purposes and control design. With these models, a sliding mode observer is proposed to estimate the states of each vehicle in the convoy from the available sensors, then a sliding mode control based on this observer is used to control the longitudinal and lateral movement. The validation and performance evaluation are done using the well-known driving simulator Scanner-Studio. The results are presented for different maneuvers of 5 vehicles.

Keywords: autonomous vehicles, convoy, non-linear control, non-linear observer, sliding mode

Procedia PDF Downloads 113

Authors: Athanasia Eirini Zarkadi, Despoina Balli, Olga Elpis Kolokitha

Abstract:

Objective: Impacted maxillary canines are a frequent condition and a common reason for patients seeking orthodontic treatment. Their simultaneous presence with dental anomalies raises a question about their possible connection. The aim of this study was to investigate the association of maxillary impacted canines with dental anomalies. Materials and Methods: Files of 874 patients from an orthodontic private practice in Greece were evaluated for the presence of maxillary impacted canines. From this sample, a group of 97 patients (39 males and 58 females) with at least one impacted maxillary canine were selected and consisted of the study group (canine impaction group) of this study. This group was compared to a control group of 97 patients (42 males and 55 females) that was created by random selection from the initial sample without maxillary canine impaction. The impaction diagnosis was made from the panoramic radiographs and confirmed from the surgery. The association between maxillary canine impaction and dental anomalies was examined with the chi-square test. A classification tree was created to further investigate the relations between impaction and dental anomalies. The reproducibility of diagnoses was assessed by re-examining the records of 25 patients two weeks after the first examination. Results: The found associated anomalies were cone-shaped upper lateral incisors and infraocclusion of deciduous molars. There is a significant increase in the prevalence of 12,4% of distal displacement of the unerupted mandibular second premolar in the canine impaction group compared to the control group that was 7,2%. The classification tree showed that the presence of a cone-shaped maxillary lateral incisor gave rise to the probability of an impacted canine to 83,3%. Conclusions: The presence of cone-shaped maxillary lateral incisors and infraocclusion of deciduous molars can be considered valuable early risk indicators for maxillary canine impaction.

Keywords: cone-shaped maxillary lateral incisors, dental anomalies, impacted canines, infraoccluded deciduous molars

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Authors: Hadi Rad

Abstract:

Unrestricted somatic stem cells (USSCs) loaded in nanofibrous PHBV scaffold can be used for skin regeneration when grafted into full-thickness skin defects of rats. Nanofibrous PHBV scaffolds were designed using electrospinning method and then, modified with the immobilized collagen via the plasma method. Afterward, the scaffolds were evaluated using scanning electron microscopy, physical and mechanical assays. In this study; nanofibrous PHBV scaffolds loaded with and without USSCs were grafted into the skin defects. The wounds were subsequently investigated at 21 days after grafting. Results of mechanical and physical analyses showed good resilience and compliance to movement as a skin graft. In animal models; all study groups excluding the control group exhibited the most pronounced effect on wound closure, with the statistically significant improvement in wound healing being seen on post-operative Day 21. Histological and immunostaining examinations of healed wounds from all groups, especially the groups treated with stem cells, showed a thin epidermis plus recovered skin appendages in the dermal layer. Thus, the graft of collagen-coated nanofibrous PHBV scaffold loaded with USSC showed better results during the healing process of skin defects in rat model.

Keywords: collagen, nanofibrous PHBV scaffold, unrestricted somatic stem cells, wound healing.

Procedia PDF Downloads 333

Authors: Reza Dinarvand, Mahdi Sadeghian, Somaye Sadeghian

Abstract:

Prediction of the ultimate bearing capacity of piles (Qu) is one of the basic issues in geotechnical engineering. So far, several methods have been used to estimate Qu, including the recently developed artificial intelligence methods. In recent years, optimization algorithms have been used to minimize artificial network errors, such as colony algorithms, genetic algorithms, imperialist competitive algorithms, and so on. In the present research, artificial neural networks based on colonial competition algorithm (ANN-ICA) were used, and their results were compared with other methods. The results of laboratory tests of short piles in clayey soils with parameters such as pile diameter, pile buried length, eccentricity of load and undrained shear resistance of soil were used for modeling and evaluation. The results showed that ICA-based artificial neural networks predicted lateral bearing capacity of short piles with a correlation coefficient of 0.9865 for training data and 0.975 for test data. Furthermore, the results of the model indicated the superiority of ICA-based artificial neural networks compared to back-propagation artificial neural networks as well as the Broms and Hansen methods.

Keywords: artificial neural network, clayey soil, imperialist competition algorithm, lateral bearing capacity, short pile

Procedia PDF Downloads 116

Authors: M. Naji, A. R. Khalim, M. Naji

Abstract:

Integral Abutment Bridges (IAB) are defined as simple or multiple span bridges in which the bridge deck is cast monolithically with the abutment walls. This kind of bridges are becoming very popular due to different aspects such as good response under seismic loading, low initial costs, elimination of bearings and less maintenance. However, the main issue related to the analysis of this type of structures is dealing with soil-structure interaction of the abutment walls and the supporting piles. A two-dimensional, non-linear finite element (FE) model of an integral abutment bridge has been developed to study the effect of lateral time history displacement loading on the soil system.

Keywords: integral abutment bridge, soil structure interaction, finite element modeling, soil-pile interaction

Procedia PDF Downloads 265

Authors: Halimah Al Hifzi, Waseem Al-Talalwah, Shorok Al Dorazi, Hassan Al Mousa, Zainab Al-Hashim, Roger Soames

Abstract:

The obturator artery is one branches of anterior division of the internal iliac artery. It passes on the lateral wall of pelvis to escape into thigh region via obturator foremen. Based on previous research studies, it found to be extremely variable in origin and course. It may arise from internal or external iliac artery. The current study includes 82 dissected specimens to investigate the origin of the obturator artery and explain the clinical importance. The obturator artery arises from the internal iliac artery in 75% either from its anterior or posterior division in 46.9% or 25% respectively. Further, it arises neither from the anterior nor posterior division of the internal iliac artery but it arises between them in 3.1%. In 25%, the obturator artery arises from the external iliac artery. In case of aneurysmectomy of posterior division, carries a high risk of insufficient of vascular supply for demand structures such as proximal adductors attachment and hip joint. Therefore, vascular surgeons have to pay attention to the posterior division being an origin of the obturator artery beside its usual three classical branches: superior gluteal, iliolumbar and lateral sacral arteries. Further, the obturator artery arising from the external iliac system is in great dangerous of laceration in case of anterior pelvic fracture. Therefore, it may lead to haemorrhagic shock threatening life.

Keywords: obturator artery, external iliac, internal iliac artery, anterior division, posterior division, superior gluteal, iliolumbar and lateral sacral, pubic fracture, aneurysm, shock

Procedia PDF Downloads 318

Authors: Mahmoud Samkan

Abstract:

Dispersed Generation (DG) is a promising solution to many power system problems such as voltage regulation and power loss. This paper proposes a heuristic two-step method to optimize the location and size of DG for reducing active power losses and, therefore, improve the voltage profile in radial distribution networks. In addition to a DG placed at the system load gravity center, this method consists in assigning a DG to each lateral of the network. After having determined the central DG placement, the location and size of each lateral DG are predetermined in the first step. The results are then refined in the second step. This method is tested for 33-bus system for 100% DG penetration. The results obtained are compared with those of other methods found in the literature.

Keywords: optimal location, optimal size, dispersed generation (DG), radial distribution networks, reducing losses

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Authors: Animesh Gupta

Abstract:

Objective: The purpose of this study is to evaluate the versatility and outcome of lateral supra malleolar flap (LSMF) in soft tissue reconstruction of the regions including the distal leg, ankle, dorsal foot and heel. Methods: From March 2021 to April 2023, 18 patients with soft tissue defects in the regions, including the distal leg, ankle, dorsal foot and heel, who underwent LSMF repair for lower limb wound reconstruction were analyzed. The location, size of the defects, etiology, outcome, complications, and other alternative options were studied and presented. Results: The follow-up period of the cases was 3-6 months after surgery. All flaps were successful; however, one flap was complicated by venous congestion and was managed by loosening a few sutures and the patient was required to elevate the affected limb to resolve the issue. Conclusion: The LSMF has numerous advantages in repairing soft tissue defects in areas involving the ankle, distal leg, heel and dorsum of the foot. In comparison to reverse sural flaps for repairing defects in the heel and lower leg, LSMF offers shorter operation time, shorter hospitalization, lower cost, and fewer postoperative complications.

Keywords: lateral supra malleolar flap, LSMF, soft tissue reconstruction, lower leg defect

Procedia PDF Downloads 49

Authors: Boris Kolev, Matt Kokan, Mohammad Deriszadeh, Farshid Bateni

Abstract:

Due to the increasing demand for real estate and the need for efficient land utilization in Greater Vancouver, developers have been increasingly considering the construction of high-rise structures with multiple below-grade parking. The temporary excavations required to allow for the construction of underground levels have recently reached up to 40 meters in depth. One of the challenges with deep excavations is the prediction of wall displacements and ground settlements due to their effect on the integrity of City utilities, infrastructure, and adjacent buildings. A large database of survey monitoring data has been collected for deep excavations in various soil conditions and shoring systems. The majority of the data collected is for tie-back anchors and shotcrete lagging systems. The data were categorized, analyzed and the results were evaluated to find a relationship between the most dominant parameters controlling the displacement, such as depth of excavation, soil properties, and the tie-back anchor loading and arrangement. For a select number of deep excavations, finite element modeling was considered for analyses. The lateral displacements from the simulation results were compared to the recorded survey monitoring data. The study concludes with a discussion and comparison of the available empirical and numerical modeling methodologies for evaluating lateral displacements in deep excavations.

Keywords: deep excavations, lateral displacements, numerical modeling, shoring walls, tieback anchors

Procedia PDF Downloads 149