Search results for: lateral supra malleolar flap

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

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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

Procedia PDF Downloads 122

Authors: Reza Dinarvand, Mahdi Sadeghian, Somaye Sadeghian

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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 118

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

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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

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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

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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

Procedia PDF Downloads 421

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

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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 153

Authors: W. T. A. Mohammed, M. Eltaeb, R. Kashani

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The first bending modes of tall asymmetric structures in the two lateral X and Y-directions have two different natural frequencies. To add tuned damping to these bending modes, one needs to either a) use two pendulum-tuned mass dampers (PTMDs) with one tuning frequency, each PTMD targeting one of the bending modes, or b) use one PTMD with two tuning frequencies (one in each lateral directions). Option (a), being more massive, requiring more space, and being more expensive, is less attractive than option (b). Considering that the tuning frequency of a pendulum depends mainly on the pendulum length, one way of realizing option (b) is by constraining the swinging length of the pendulum in one direction but not in the other; such PTMD is dubbed passive Bi-PTMD. Alternatively, option (b) can be realized by actively setting the tuning frequencies of the PTMD in the two directions. In this work, accurate physical models of passive Bi-PTMD and active PTMD are developed and incorporated into the numerical model of a tall asymmetric structure. The model of PTMDs plus structure is used for a)synthesizing such PTMDs for particular applications and b)evaluating their damping effectiveness in mitigating the dynamic lateral responses of their target asymmetric structures, perturbed by wind load in X and Y-directions. Depending on how elaborate the control scheme is, the active PTMD can either be made to yield the same damping effectiveness as the passive Bi-PTMD of the same size or the passive Bi-TMD twice as massive as the active PTMD.

Keywords: active tuned mass damper, high-rise building, multi-frequency tuning, vibration control

Procedia PDF Downloads 62

Authors: Berkant Coşkuner, Rahmi Aksoy

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The aim of this study is to present some preliminary stratigraphic and structural evidence for the Fethiye-Burdur fault zone between Kozluca and Burdur. The Fethiye-Burdur fault zone, the easternmost extension of the west Anatolian extensional province, extends from the Gulf of Fethiye northeastward through Burdur, a distance of about 300 km. The research area is located in the Burdur segment of the fault zone. Here, the fault zone includes several parallel to subparallel fault branching and en-echelon faults that lie within a linear belt, as much as 20 km in width. The direction of movement in the fault zone has been oblique-slip in the left lateral sense. The basement of the study area consists of the Triassic-Eocene Lycian Nappes, the Eocene-Oligocene molasse sediments and the lower Miocene marine rocks. The Burdur basin contains two basin infills. The ancient and deformed basin fill is composed of lacustrine sediments of the upper Miocene-lower Pliocene age. The younger and undeformed basin fill comprises Plio-Quaternary alluvial fan and recent basin-floor deposits and unconformably overlies the ancient basin infill. The Burdur basin is bounded by the NE-SW trending, left lateral oblique-slip normal faults, the Karakent fault on the northwest and the Burdur fault on the southeast. These faults played a key role in the development of the Burdur basin as a pull-apart basin.

Keywords: Burdur basin, Fethiye-Burdur fault zone, left lateral oblique-slip fault, Western Anatolia

Procedia PDF Downloads 385

Authors: Mohammad Hadi Jalali, Mostafa Ghayour, Saeed Ziaei-Rad, Behrooz Shahriari

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The vibration problems that can be occurred in the operational conditions of rotating machines may cause damage to the machine or even failure of the machine completely. Therefore, dynamic analysis of rotors is vital in the design and development stages of the rotating machines. In this study, the uncoupled torsional and lateral vibration analysis of a rotor-bearing system is carried out using transfer matrix method. The Campbell diagram, critical speed and the mode shape corresponding to the critical speed are obtained in order to evaluate the dynamic behavior of the rotor.

Keywords: transfer matrix method, rotor-bearing system, campbell diagram, critical speed

Procedia PDF Downloads 466

Authors: Wisam Ismail, Brendan Wooler, Penelope McManus

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Introduction: The public perception of implants has been damaged in the wake of recent negative publicity and increasingly we are finding patients wanting to avoid them. Planned lipo-modelling to enhance the volume of a Latissimus dorsi flap is a viable alternative to silicone implants and maintains a Totally Autologous Technique (TAT). Here we demonstrate that when compared to an Implant Assisted Technique (IAT), a TAT offers patients many benefits that offset the requirement of more operations initially, with reduced short and long term complications, reduced symmetrisation surgery and reduced revision rates. Methods. Data was collected prospectively over 7 years. The minimum follows up was 3 years. The technique was generally standardized in the hand of one surgeon. All flaps were extended LD flaps (ELD). Lipo-modelling was performed using standard techniques. Outcome measures were unplanned secondary procedures, complication rates, and contralateral symmetrisation surgery rates. Key Results Were: Lower complication rates in the TAT group (18.5% vs. 33.3%), despite higher radiotherapy rates (TAT=49%, IAT=36.8%), TAT was associated with lower subsequent symmetrisation rates (30.6% vs. 50.9%), IAT had a relative risk of 3.1 for subsequent unplanned procedure, Autologous patients required an average of 1.76 sessions of lipo-modelling, Conclusions: Using lipo-modelling to enable totally autologous LD reconstruction offers significant advantages over an implant assisted technique. We have shown a lower subsequent unplanned procedure rate, lower revision surgery, and less contralateral symmetrisation surgery. We anticipate that a TAT will be supported by patient satisfaction surveys and long-term patient-reported cosmetic outcome data and intended to study this.

Keywords: breast, Latissimus dorsi, lipomodelling, reconstruction

Procedia PDF Downloads 305

Authors: Boris Blostotsky, Elia Efraim

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The phenomenon of buckling of structural elements under compression is revealed in many cases of loading and found consideration in many structures and mechanisms. In the present work the method and results of dynamic test for buckling of bar loaded by a compression force directed towards the pole are considered. Experimental determination of critical force for such system has not been made previously. The tested object is a bar with semi-rigid connection to the base at one of its ends, and with a hinge moving along a circle at the other. The test includes measuring the natural frequency of the bar at different values of compression load. The lateral stiffness is calculated based on natural frequency and reduced mass on the bar's movable end. The critical load is determined by extrapolation the values of lateral stiffness up to zero value. For the experimental investigation the special test-bed was created that allows the stability testing at positive and negative curvature of the movable end's trajectory, as well as varying the rotational stiffness of the other end connection. Decreasing a friction at the movable end allows extend the diapason of applied compression force. The testing method includes: - Methodology of the experiment planning, that allows determine the required number of tests under various loads values in the defined range and the type of extrapolating function; - Methodology of experimental determination of reduced mass at the bar's movable end including its own mass; - Methodology of experimental determination of lateral stiffness of uncompressed bar rotational semi-rigid connection at the base. For planning the experiment and for comparison of the experimental results with the theoretical values of critical load, the analytical dependencies of lateral stiffness of the bar with defined end conditions on compression load. In the particular case of perfectly rigid connection of the bar to the base, the critical load value corresponds to solution by S.P. Timoshenko. Correspondence of the calculated and experimental values was obtained.

Keywords: non-destructive test, buckling, dynamic method, semi-rigid connections

Procedia PDF Downloads 334

Authors: Mohammad Raihan Mukhlis, M. Abdur Rahman Bhuiyan

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Bangladesh is a developing country in which a lot of multi-span simply/continuous supported flyovers are being constructed in its major cities. Being situated in a seismically active region, seismic safety evaluation of flyovers is essential for seismic risk reduction. Effects of site amplification on seismic safety evaluation of flyover piers are the main concern of this study. In this regard, failure mode, lateral strength and displacement ductility of piers of a typical multi-span simply supported flyover have been evaluated by Japan Road Association (JRA) recommended guidelines, with and without considering site amplification. Ultimate flexural strengths of piers have been computed using the pushover analysis results. Shear capacity of piers has been calculated using the guidelines of JRA. Lateral strengths have been determined depending on the failure modes of the piers. Displacement ductility of piers has been computed using yield and ultimate displacements of the piers obtained from the pushover analysis results. Selected earthquake time history is used in seismic safety evaluation of the flyover piers. Finally, the ductility design method is used to conduct the seismic safety evaluation of the piers with and without considering site amplification. From the numerical results, it has been revealed that the effects of site amplification on seismic safety evaluation of bridge structures should be carefully taken into account.

Keywords: displacement ductility, flyover pier, lateral strength, safety evaluation, site amplification

Procedia PDF Downloads 139

Authors: Maryam Solgi, Behzad Shahmohammadi, Morteza Raissi Dehkordi

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One of the main steps for seismic retrofitting of buildings is to determine the vulnerability of structures. While current procedures for evaluating existing buildings are complicated, and there is no limitation between short, middle-high, and tall buildings. This research utilizes a simplified method for assessing structures, which is adequate for existing reinforced concrete buildings. To approach this aim, Simple Lateral Mechanisms Analysis (SLaMA) procedure proposed by NZSEE (New Zealand Society for Earthquake Engineering) has been carried out. In this study, three RC moment-resisting frame buildings are determined. First, these buildings have been evaluated by inelastic static procedure (Pushover) based on acceptance criteria. Then, Park-Ang Damage Index is determined for the whole members of each building by Inelastic Time History Analysis. Next, the Simple Lateral Mechanisms Analysis procedure, a hand method, is carried out to define the capacity of structures. Ultimately, existing procedures are compared with Peak Ground Acceleration caused to fail (PGAfail). The results of this comparison emphasize that the Pushover procedure and SLaMA method define a greater value of PGAfail than the Park-Ang Damage model.

Keywords: peak ground acceleration caused to fail, reinforced concrete moment-frame buildings, seismic vulnerability analysis, simple lateral mechanisms analysis

Procedia PDF Downloads 61

Authors: Elia Efraim, Boris Blostotsky

Abstract:

The phenomenon of buckling of structural elements under compression is revealed in many cases of loading and found consideration in many structures and mechanisms. In the present work the method and results of dynamic test for buckling of bar loaded by a compression force directed towards the pole are considered. Experimental determination of critical force for such system has not been made previously. The tested object is a bar with semi-rigid connection to the base at one of its ends, and with a hinge moving along a circle at the other. The test includes measuring the natural frequency of the bar at different values of compression load. The lateral stiffness is calculated based on natural frequency and reduced mass on the bar's movable end. The critical load is determined by extrapolation the values of lateral stiffness up to zero value. For the experimental investigation the special test-bed was created that allows the stability testing at positive and negative curvature of the movable end's trajectory, as well as varying the rotational stiffness of the other end connection. Decreasing a friction at the movable end allows extend the diapason of applied compression force. The testing method includes : - methodology of the experiment planning, that allows determine the required number of tests under various loads values in the defined range and the type of extrapolating function; - methodology of experimental determination of reduced mass at the bar's movable end including its own mass; - methodology of experimental determination of lateral stiffness of uncompressed bar rotational semi-rigid connection at the base. For planning the experiment and for comparison of the experimental results with the theoretical values of critical load, the analytical dependencies of lateral stiffness of the bar with defined end conditions on compression load. In the particular case of perfectly rigid connection of the bar to the base, the critical load value corresponds to solution by S.P. Timoshenko. Correspondence of the calculated and experimental values was obtained.

Keywords: buckling, dynamic method, end-fixity factor, force directed towards a pole

Procedia PDF Downloads 325

Authors: Vera Wilden, Benno Hoffmeister, Markus Feldmann

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Glued laminated timber (glulam) is a preferred choice for long span girders, e.g., for gyms or storage halls. While the material provides sufficient strength to resist the bending moments, large spans lead to increased slenderness of such members and to a higher susceptibility to stability issues, in particular to lateral torsional buckling (LTB). Rules for the determination of the ultimate LTB resistance are provided by Eurocode 5. The verifications of the resistance may be performed using the so called equivalent member method or by means of theory 2nd order calculations (direct method), considering equivalent imperfections. Both methods have significant limitations concerning their applicability; the equivalent member method is limited to rather simple cases; the direct method is missing detailed provisions regarding imperfections and requirements for numerical modeling. In this paper, the results of a test series on slender glulam beams in three- and four-point bending are presented. The tests were performed in an innovative, newly developed testing rig, allowing for a very precise definition of loading and boundary conditions. The load was introduced by a hydraulic jack, which follows the lateral deformation of the beam by means of a servo-controller, coupled with the tested member and keeping the load direction vertically. The deformation-controlled tests allowed for the identification of the ultimate limit state (governed by elastic stability) and the corresponding deformations. Prior to the tests, the structural and geometrical imperfections were determined and used later in the numerical models. After the stability tests, the nearly undamaged members were tested again in pure bending until reaching the ultimate moment resistance of the cross-section. These results, accompanied by numerical studies, were compared to resistance values obtained using both methods according to Eurocode 5.

Keywords: experimental tests, glued laminated timber, lateral torsional buckling, numerical simulation

Procedia PDF Downloads 200

Authors: Wanwisa Deenin, Abdulhadee Yakoh, Chahya Kreangkaiwal, Orawon Chailapakul, Kanitha Patarakul, Sudkate Chaiyo

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LipL32 is an outer membrane protein present only on pathogenic Leptospira species, which are the causative agent of leptospirosis. Leptospirosis symptoms are often misdiagnosed with other febrile illnesses as the clinical manifestations are non-specific. Therefore, an accurate diagnostic tool for leptospirosis is indeed critical for proper and prompt treatment. Typical diagnosis via serological assays is generally performed to assess the antibodies produced against Leptospira. However, their delayed antibody response and complicated procedure are undoubtedly limited the practical utilization especially in primary care setting. Here, we demonstrate for the first time an early-stage detection of LipL32 by an integrated lateral-flow immunoassay with electrochemical readout (eLFIA). A ferrocene trace tag was monitored via differential pulse voltammetry operated on a smartphone-based device, thus allowing for on-field testing. Superior performance in terms of the lowest detectable limit of detection (LOD) of 8.53 pg/mL and broad linear dynamic range (5 orders of magnitude) among other sensors available thus far was established. Additionally, the developed test strip provided a straightforward yet sensitive approach for diagnosis of leptospirosis using the collected human sera from patients, in which the results were comparable to the real-time polymerase chain reaction technique.

Keywords: leptospirosis, electrochemical detection, lateral flow immunosensor, point-of-care testing, early-stage detection

Procedia PDF Downloads 57

Authors: Pattarachaya Preechakasedkit, Kota Osada, Koji Suzuki, Daniel Citterio, Orawon Chailapakul

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A paper-based lateral flow device for screening thyroid stimulating hormone (TSH) is reported. A sandwich immunoassay was performed using two mouse monoclonal TSH antibodies (anti-hTSH 5403 and 5404) as immobilized and labeled antibodies for capturing TSH samples. Test (anti-hTSH 5403) and control (goat anti-Mouse IgG) lines were fabricated on nitrocellulose membrane (NCM) using ballpoint pen printed with a speed of 3 cm/s and thickness setting of 1. The novel gold nanoparticles europium complex (AuNPs@Eu) was used as fluorescence label compared to conventional AuNPs label. The results obtained with this device can be visually assessed by the naked eyes and under UV hand lamps, and quantitative analysis can be performed using the ImageJ program. The limit of detection (LOD) under UV hand lamps (0.1 µIU/mL) provided 50-fold greater sensitivity than AuNPs (5 µIU/mL), which is suitable for both hypothyroidism and hyperthyroidism screening within 30 min. A linear relationship between the red intensity and the logarithmic concentrations of TSH was observed with a good correlation (R²=0.992). Furthermore, the device can be effectively applied for screening TSH in the spiked human serum with recovery range of 96.80-104.45% and RSD of 2.18-3.63%. Therefore, the developed device is an alternative method for TSH screening which provides a lot of advantages including low cost, short time analysis, ease of use, disposability, portability, and on-site measurement.

Keywords: thyroid stimulating hormone, paper-based lateral flow, hypothyroidism, hyperthyroidism

Procedia PDF Downloads 336

Authors: Vinay Kant Shankhdhar

Abstract:

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

Procedia PDF Downloads 101

Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

Procedia PDF Downloads 148

Authors: Teja Joshi

Abstract:

Laterality has shown to play a role in performance as well as injuries especially in unilateral sports disciplines. Uniquely, Artistic Gymnastics involves combination of unilateral, bilateral and complex multi-planer elements as well as gymnastics specific rotational preference. Therefore, this study was conducted to explore if any such preferences are associated with number of injuries in artistic gymnasts. To explore the association between lateral preferences, rotational preferences and injuries incidence in artistic gymnastics. Artistic gymnasts above 16 years of age, were invited to participate in an online survey. The survey included consent, lateral preference inventory, injury data collection according to anatomical locations and rotational preference for selected gymnastics elements performed on the floor exercise. SPSS version 24 was used to analyse Non-parametric data using Kruskal-Wallis (K- independent test) test. Multiple regression was performed to identify the predictor for injuries and their side in gymnasts. Total number of injuries per gymnast was associated with handedness (p value-0.049) and no significant association was noted for footdness (p value-0.207), eyedness (p value-0.491) and eardness (p value-0.798). Additionally, rotational preferences did not influence number of injuries (p value-0.521). In multiple regression, eyedness was identified as a predicting factor to determine the number of injuries. Rotational preferences were neither determined as a national strategy nor a product of lateral preference. Dominant hand had higher number of injuries in artistic gymnasts. Rotational preference is independent of laterality, number of injuries and nationality.

Keywords: sports injury, rotational preference, gymnastics, handedness

Procedia PDF Downloads 86

Authors: Ashutosh Verma, Satyendra MIttal

Abstract:

The loss of strength at the facing-reinforcement interface brought on by the seasonal thermal expansion/contraction of the bridge deck has been responsible for several geosynthetic reinforced soil abutment failures over the years. This results in excessive settlement below the bridge seat, which results in bridge bumps along the approach road and shortens abutment's design life. There are surely a wide variety of facing configurations available to designers when choosing the sort of facade. These layouts can generally be categorised into three groups: continuous, full height rigid (FHR) and modular (panels/block). The current work aims to experimentally explore the behavior of these three facing categories using 1g physical model testing under serviceable cyclic lateral displacements. With configurable facing arrangements to represent these three facing categories, a field instrumented GRS abutment prototype was modelled into a N scaled down 1g physical model (N = 5) to reproduce field behavior. Peak earth pressure coefficient (K) on the facing and vertical settlement of the footing (s/B) for footing offset (x/H) as 0.1, 0.2, 0.3, 0.4 and 0.5 at 100 cycles have been measured for cyclic lateral displacement of top of facing at loading rate of 1mm/min. Three types of cyclic displacements have been carried out to replicate active condition (CA), passive condition (CP), and active-passive condition (CAP) for each footing offset. The results demonstrated that a significant decrease in the earth pressure over the facing occurs when footing offset increases. It is worth noticing that the highest rate of increment in earth pressure and footing settlement were observed for each facing configuration at the nearest footing offset. Interestingly, for the farthest footing offset, similar responses of each facing type were observed, which indicates that the upon reaching a critical offset point presumably beyond the active region in the backfill, the lateral responses become independent of the stresses from the external footing load. Evidently, the footing load complements the stresses developed due to lateral excitation resulting in significant footing settlements for nearer footing offsets. The modular facing proved inefficient in resisting footing settlement due to significant buckling along the depth of facing. Instead of relative displacement along the depth of facing, continuous facing rotates around the base when it fails, especially for nearer footing offset causing significant depressions in the backfill area surrounding the footing. FHR facing, on the other hand, have been successful in confining the stresses in the soil domain itself reducing the footing settlement. It may be suitably concluded that increasing the footing offset may render stability to the GRS abutment with any facing configuration even for higher cycles of excitation.

Keywords: GRS abutments, 1g physical model, footing offset, cyclic lateral displacement

Procedia PDF Downloads 59

Authors: Sundaresan Soundararajan, George Ezekiel Silvananthan, Chor Ngee Tan

Abstract:

Introduction: Transforaminal Interbody Fusion (TLIF) has been adopted for many decades now, however, XLIF, still in relative infancy, has grown to be accepted as a new Minimally Invasive Surgery (MIS) option. There is a paucity of reports directly comparing lateral approach surgery to other MIS options such as TLIF in the treatment of lumbar degenerative disc diseases. Aims/Objectives: The objective of this study was to compare the efficacy and clinical outcomes between Minimally Invasive Transforaminal Interbody Fusion (TLIF) and Minimally Invasive Lateral Interbody Fusion (XLIF) in the treatment of patients with degenerative disc disease of the lumbar spine. Methods: A single center, retrospective cohort study involving a total of 38 patients undergoing surgical intervention between 2010 and 2013 for degenerative disc disease of lumbar spine at single L4/L5 level. 18 patients were treated with MIS TLIF, and 20 patients were treated with XLIF. Results: The XLIF group showed shorter duration of surgery compared to the TLIF group (176 mins vs. 208.3 mins, P = 0.03). Length of hospital stay was also significantly shorter in XLIF group (5.9 days vs. 9 days, p = 0.03). Intraoperative blood loss was favouring XLIF as 85% patients had blood loss less than 100cc compared to 58% in the TLIF group (P = 0.03). Radiologically, disc height was significantly improved post operatively in the XLIF group compared to the TLIF group (0.56mm vs. 0.39mm, P = 0.01). Foraminal height increment was also higher in the XLIF group (0.58mm vs. 0.45mm , P = 0.06). Clinically, back pain and leg pain improved in 85% of patients in the XLIF group and 78% in the TLIF group. Post op hip flexion weakness was more common in the XLIF group (40%) than in the TLIF group (0%). However, this weakness resolved within 6 months post operatively. There was one case of dural tear and surgical site infection in the TLIF group respectively and none in the XLIF group. Visual Analog Scale (VAS) score 6 months post operatively showed comparable reduction in both groups. TLIF group had Owsterty Disability Index (ODI) improvement on 67% while XLIF group showed improvement of 70% of its patients. Conclusions: Lateral approach surgery shows comparable clinical outcomes in resolution of back pain and radiculopathy to conventional MIS techniques such as TLIF. With significantly shorter duration of surgical time, minimal blood loss and shorter hospital stay, XLIF seems to be a reasonable MIS option compared to other MIS techniques in treating degenerative lumbar disc diseases.

Keywords: extreme lateral interbody fusion, lateral approach, minimally invasive, XLIF

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Authors: Saeed Rahjoo, Babak H. Mamaqani

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Concentric bracing systems have been in practice for many years because of their effectiveness in reducing seismic response. Depending on concept, seismic design codes provide various response modification factors (R), which itself consists of different terms, for different types of lateral load bearing systems but configuration of these systems are often ignored in the proposed values. This study aims at considering the effect of different x-bracing diagonal configuration on values of ductility dependent term in R computation. 51 models were created and nonlinear push over analysis has been performed. The main variables of this study were the suitable location of X–bracing diagonal configurations, which establishes better nonlinear behavior in concentric braced steel frames. Results show that some x-bracing diagonal configurations improve the seismic performance of CBF significantly and explicit consideration of lateral load bearing systems seems necessary.

Keywords: bracing configuration, concentrically braced frame (CBF), push over analyses, response reduction factor

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Authors: Yingyi Zhou, Tohru Kawabe

Abstract:

With the spread of EVs (electric Vehicles), the ride comfort has been gaining a lot of attention. The influence of the lateral acceleration is important for the improvement of ride comfort of EVs as well as the longitudinal acceleration, especially upon turning of the vehicle. Therefore, this paper proposes a practical optimal speed control method to greatly improve the ride comfort in the vehicle turning situation. For consturcting this method, effective criteria that can appropriately evaluate deterioration of ride comfort is derived. The method can reduce the influence of both the longitudinal and the lateral speed changes for providing a confortable ride. From several simulation results, we can see the fact that the method can prevent aggravation of the ride comfort by suppressing the influence of longitudinal speed change in the turning situation. Hence, the effectiveness of the method is recognized.

Keywords: electric vehicle, speed control, ride comfort, optimal control theory, driving support system

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Authors: V. T. Ngo, D. M. Xie

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Frequently, in the design of machines, some of parameters that directly affect the rotor dynamics of the machines are not accurately known. In particular, bearing stiffness support is one such parameter. One of the most basic principles to grasp in rotor dynamics is the influence of the bearing stiffness on the critical speeds and mode shapes associated with a rotor-bearing system. Taking a rig shafting as an example, this paper studies the lateral vibration of the rotor with multi-degree-of-freedom by using Finite Element Method (FEM). The FEM model is created and the eigenvalues and eigenvectors are calculated and analyzed to find natural frequencies, critical speeds, mode shapes. Then critical speeds and mode shapes are analyzed by set bearing stiffness changes. The model permitted to identify the critical speeds and bearings that have an important influence on the vibration behavior.

Keywords: lateral vibration, finite element method, rig shafting, critical speed

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Authors: Iman Zafarparandeh, Muzammil Mumtaz, Paniz Taherzadeh, Deniz Erbulut

Abstract:

The instability in the atlantoaxial joint may occur due to cervical surgery, congenital anomalies, and trauma. There are different types of fixation techniques proposed for restoring the stability and preventing harmful neurological deterioration. Application of the screw constructs has become a popular alternative to the older techniques for stabilizing the joint. The main difference between the various screw constructs is the type of the screw which can be lateral mass screw, pedicle screw, transarticular screw, and translaminar screw. The aim of this paper is to study the effect of three popular screw constructs fixation techniques on the biomechanics of the atlantoaxial joint using the finite element (FE) method. A three-dimensional FE model of the upper cervical spine including the skull, C1 and C2 vertebrae, and groups of the existing ligaments were developed. The accurate geometry of the model was obtained from the CT data of a 35-year old male. Three screw constructs were designed to compare; Magerl transarticular screw (TA-Screw), Goel-Harms lateral mass screw and pedicle screw (LM-Screw and Pedicle-Screw), and Wright lateral mass screw and translaminar screw (LM-Screw and TL-Screw). Pure moments were applied to the model in the three main planes; flexion (Flex), extension (Ext), axial rotation (AR) and lateral bending (LB). The range of motion (ROM) of C0-C1 and C1-C2 segments for the implanted FE models are compared to the intact FE model and the in vitro study of Panjabi (1988). The Magerl technique showed less effect on the ROM of C0-C1 than the other two techniques in sagittal plane. In lateral bending and axial rotation, the Goel-Harms and Wright techniques showed less effect on the ROM of C0-C1 than the Magerl technique. The Magerl technique has the highest fusion rate as 99% in all loading directions for the C1-C2 segment. The Wright technique has the lowest fusion rate in LB as 79%. The three techniques resulted in the same fusion rate in extension loading as 99%. The maximum stress for the Magerl technique is the lowest in all load direction compared to other two techniques. The maximum stress in all direction was 234 Mpa and occurred in flexion with the Wright technique. The maximum stress for the Goel-Harms and Wright techniques occurred in lateral mass screw. The ROM obtained from the FE results support this idea that the fusion rate of the Magerl is more than 99%. Moreover, the maximum stress occurred in each screw constructs proves the less failure possibility for the Magerl technique. Another advantage of the Magerl technique is the less number of components compared to other techniques using screw constructs. Despite the benefits of the Magerl technique, there are drawbacks to using this method such as reduction of the C1 and C2 before screw placement. Therefore, other fixation methods such as Goel-Harms and Wright techniques find the solution for the drawbacks of the Magerl technique by adding screws separately to C1 and C2. The FE model implanted with the Wright technique showed the highest maximum stress almost in all load direction.

Keywords: cervical spine, finite element model, atlantoaxial, fixation technique

Procedia PDF Downloads 356

Authors: Erwin, Cheng-Cheng Chen, Charles J. Salim

Abstract:

One of the method to solve the lateral torsional buckling (LTB) problem is by using side plates to increased the buckling resistance of the beam. Some modifications in designing the side plates are made in this study to simplify the construction in the field and reduce the cost. At certain region, side plates are not added: (1) At the beam end to preserve some spaces for bolt installation, but the beam is strengthened by adding cover plate at both flanges and (2) at the middle span of the beam where the moment is smaller. Three small scale full span beam specimens are tested under cyclic loading to investigate the LTB resistant and the ductility of the proposed design method. Test results show that the LTB deformation can be effectively suppressed and very high ductility level can be achieved. Following the test, a finite element analysis (FEA) model is established and is verified using the test results. An intensive parametric study is conducted using the established FEA model. The analysis reveals that the length of side plates is the most important parameter determining the performance of the beam and the required side plates length is determined by some parameters which are (1) beam depth to flange width ratio, (2) beam slenderness ratio (3) strength and thickness of the side plates, (4) compactness of beam web and flange, and (5) beam yield strength. At the end of the paper, a design formula to calculate the required side plate length is suggested.

Keywords: cover plate, earthquake resistant design, lateral torsional buckling, side plate, steel structure

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Authors: B. Kenny, M. Dixon, A. Boshell

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The use of alcoholic surgical prep was recently introduced into the Royal Newcastle Center for elective procedures. In the past 3 months there have been a significant number of burns believed to be related to ‘pooling’ of this surgical prep in patients undergoing procedures where they are placed in the lateral position with hip bolsters. The aim of the audit was to determine the reason for the burns, analyze what pre-existing factors may contribute to the development of the burns and what can be changed to prevent further burns occurring. All patients undergoing a procedure performed on the hip who were placed in the lateral position with sacral and anterior, superior iliac spine (ASIS) support with ‘bolsters’ were included in the audit. Patients who developed a ‘burn’ were recorded, details of the surgery, demographics, surgical prep used and length of surgery were obtained as well as photographs taken to document the burn. Measures were then taken to prevent further burns and the efficacy was documented. Overall 14 patients developed burns over the ipsilateral ASIS. Of these, 13 were Total Hip Arthroplasty (THA) and 1 was a removal of femoral nail. All patients had Chlorhexidine 0.5% in Alcohol 70% Tinted Red surgical preparation or Betadine Alcoholic Skin Prep (70% etoh). Patients were set up in the standard lateral decubitus position with sacral and bilateral ASIS bolsters with a valband covering. 86% of patients were found to have pre-existing hypersensitivities to various substances. There is very little literature besides a few case reports on surgical prep-related burns. The case reports that do exist are related to the use of tourniquet-related burns and there is no mention in the literature examining ‘bolster’ related burns. The burns are hypothesized to be caused by pooling of the alcoholic solution which is amplified by the use of Valband.

Keywords: arthroplasty, chemical burns, wounds, rehabilitation

Procedia PDF Downloads 275

Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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Authors: Zi-Ang Li, Mu-Xuan Tao

Abstract:

During the process of the industrialization of steel structure housing, a composite structural system with separated gravity and lateral resistant systems has been applied in engineering practices, which consists of composite frame with hinged beam-column joints, steel brace and RC shear wall. As an attempt in steel structural system area, seismic performance evaluation of the separated composite structure is important for further application in steel housing. This paper focuses on the seismic performance comparison of the separated composite structural system and traditional steel frame-shear wall system under the same inter-story drift ratio (IDR) provision limit. The same architectural layout of a high-rise building is designed as two different structural systems at the same IDR level, and finite element analysis using pushover method is carried out. Static pushover analysis implies that the separated structural system exhibits different lateral deformation mode and failure mechanism with traditional steel frame-shear wall system. Different indexes are adopted and discussed in seismic performance evaluation, including IDR, safe factor (SF), shear wall damage, etc. The performance under maximum considered earthquake (MCE) demand spectrum shows that the shear wall damage of two structural systems are similar; the separated composite structural system exhibits less plastic hinges; and the SF index value of the separated composite structural system is higher than the steel frame shear wall structural system.

Keywords: finite element analysis, new composite structural system, seismic performance evaluation, static pushover analysis

Procedia PDF Downloads 109