Search results for: lightning stroke

Authors: Hong Yu, Ion Matei

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Carbon fiber reinforced composites (CFRP) used as aircraft structure are subject to lightning strike, putting structural integrity under risk. Indirect damage may occur after a lightning strike where the internal structure can be damaged due to excessive heat induced by lightning current, while the surface of the structures remains intact. Three damage modes may be observed after a lightning strike: fiber breakage, inter-ply delamination and intra-ply cracks. The assessment of internal damage states in composite is challenging due to complicated microstructure, inherent uncertainties, and existence of multiple damage modes. In this work, a model based approach is adopted to diagnose faults in carbon composites after lighting strikes. A resistor network model is implemented to relate the overall electrical and thermal conduction behavior under simulated lightning current waveform to the intrinsic temperature dependent material properties, microstructure and degradation of materials. A fault detection and identification (FDI) module utilizes the physics based model and a particle filtering algorithm to identify damage mode as well as calculate the probability of structural failure. Extensive simulation results are provided to substantiate the proposed fault diagnosis methodology with both single fault and multiple faults cases. The approach is also demonstrated on transient resistance data collected from a IM7/Epoxy laminate under simulated lightning strike.

Keywords: carbon composite, fault detection, fault identification, particle filter

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Authors: Jayakrishnan U.

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A concept of adding two strokes to a four stroke Otto or Diesel engine cycle presented here for the waste heat recovery in a four stroke internal combustion engine. Four stroke Diesel cycle and Otto cycle engines have very low thermal efficiency due to high amount of energy loss in exhaust and also on the cooling of the engine. It is estimated about 35 percent of fuel energy is lost in exhaust of engine and 30 percent in cooling of engine. So by modifying a four-stroke Otto or Diesel engine by adding two-stroke heat recovery steam cycle is presented here. Water injection is used to get an additional power stroke by partial compression of the exhaust gases at the end of third stroke in a four stroke I.C.Engine. It is the conversion of a four-stroke cycle to a six-stroke cycle. By taking a four stroke petrol engine of known dimensions, an ideal thermodynamic model is used to analyse and calculate the events of exhaust gas compression and following two strokes of water injection. By changing the exhaust valve closing timing during exhaust stroke and analysing it on various points, an optimum amount of exhaust gas re-compression and amount of water injection can be found for maximizing efficiency and fuel economy. It is achieved by changing the exhaust valve timing and finding an optimum amount of exhaust re-compression, maximizing the net mean effective pressure of the steam expansion stroke (MEPsteam). Specific fuel consumption of the engine also decreases increasing the fuel economy. The valve closing timings for maximum MEPsteam is limited by either 1 bar or dew point temperature of expansion gas or moisture mixture to avoid moisture formation. By modifying the four-stroke Otto or Diesel cycle by adding two water injection stroke has the potential to significantly increase the engine efficiency and fuel economy.

Keywords: internal combustion engine, engine efficiency, six-stroke cycle, water injection, specific fuel consumption

Procedia PDF Downloads 275

Authors: Alain Rousseau, Alfred Aragones, Gilles Rougier

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The study is based on lightning and surge standards mainly the EN series 62305 for facility protection, EN series 61643 for Low Voltage Surge Protective Devices, High Voltage surge arrester standard en 60099-4 and the traction arrester standards namely EN 50526-1 and 50526-1 dealing respectively with railway applications fixed installations D.C. surge arresters and voltage limiting devices. The more severe stress for tramways installations is caused by direct lightning on the catenary line. In such case, the surge current propagates towards the various poles and sparkover the insulators leading to a lower stress. If the impact point is near enough, a significant surge current will flow towards the traction surge arrester that is installed on the catenary at the location the substation is connected. Another surge arrester can be installed at the entrance of the substation or even inside the rectifier to avoid insulation damages. In addition, surge arresters can be installed between + and – to avoid damaging sensitive circuits. Based on disturbances encountered in a substation following a lighting event, the engineering department of RATP has decided to investigate the cause of such damage and more generally to question the efficiency of the various possible protection means. Based on the example of a recent tramway line the paper present the result of a lightning study based on direct lightning strikes. As a matter of fact, the induced surges on the catenary are much more frequent but much less damaging. First, a lightning risk assessment is performed for the substations that takes into account direct lightning and induced lightning both on the substation and its connected lines such as the catenary. Then the paper deals with efficiency of the various surge arresters is discussed based on field experience and calculations. The efficiency of the earthing system used at the bottom of the pole is also addressed based on high frequency earthing measurement. As a conclusion, the paper is making recommendations for an enhanced efficiency of existing protection means.

Keywords: surge arrester, traction, lightning, risk, surge protective device

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Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Despite improvements in stroke management, it remains the leading cause of disability worldwide. It has been suggested that enhancing brain angiogenesis after stroke will improve stroke outcome. Promoting post stroke angiogenesis requires the upregulation of angiogenic factors with a simultaneous reduction of anti-angiogenic factors. Thrombospondin-1 is the main anti-angiogenic protein in the living cells. Counterintuitively, it has been shown that animals with Thrombospondin-1 knockdown will have better stroke outcome. Data about the clinical significance of Thrombspondin-1 levels at the time of admission is still lacking. The objective of this work is to assess the association between serum Thrombospondin-1 levels measured at the time of admission and baseline neurologic severity after stroke. Patients and Methods: Blood samples were collected from patients admitted to the King Abdullah University Hospital (KAUH) with ischemic stroke at the time of admission and serum Thrombopsondin-1 levels were measured using ELISA. Patients neurologic severity was evaluated using the National Institute of Health Stroke Scale (NIHSS). Results: Samples from 50 patients admitted between January 2016 and December 2016 were collected. The median age of participants was 68 years and the median NIHSS was 3. Multinomial regression identified serum Thrombospondin-1 as an independent predictor of stroke outcome (p=0.003). Baseline serum Thrombsopondin-1 was negatively associated with NIHSS at the time of admission (spearman rho correlation coefficient=0.272, p=0.032). Conclusion: Serum Thrombospondin-1 at the time of admission may be a useful marker of stroke severity that predicts more severe neurologic severity.

Keywords: thrombospondin, stroke, neuroprotection, biomarkers

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: Kasra Afsahi, Maryam Soheilifar

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COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year- old male who presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice CT (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him in August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from15 to 18). There were no adverse effects. This case with stroke post-COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation

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Authors: Yeaji Seok, Myung Kyung Lee

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Background: Even if patients survive after a stroke, stroke patients may experience disability in mobility, sensation, cognition, and speech and language. Stroke patients require rehabilitation for functional recovery and daily life for a considerable time. During rehabilitation, the role of caregivers is important. However, the stroke patients’ quality of life may deteriorate due to family caregivers’ non-preparedness and increased role burden. Purpose: To investigate the prediction of caregivers' preparedness and role burden on stroke patients’ quality of life. Methods: The target population was stroke patients who were hospitalized for rehabilitation and their family care providers. A total of 153 patient-family caregiver dyads were recruited from June to August 2021. Data were collected from self-reported questionnaires and analyzed using descriptive statistics, t-tests, chi-squared test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression with SPSS statistics 28 programs. Results: Family caregivers’ preparedness affected stroke patients’ mobility (β = .20, p < 0.05) and character (β = -.084, p < 0.05) and production activities (β = -.197, p < 0.05) in quality of life. The role burden of family caregivers affected language skills (β = .310, p<0.05), visual functions (β=-.357, p < 0.05), thinking skills (β = 0.443, p = 0.05), mood conditions (β = 0.565, p < 0.001), family roles (β = -0.361, p < 0.001), and social roles (β = -0.304, p < 0.001), while the caregivers’ burden of performing self-protection negatively affected patients’ social roles (β = .180, p=.048). In addition, caregivers’ role burden of personal life sacrifice affected patients’ mobility (β = .311, p < 0.05), self-care (β =.232, p < 0.05) and energy (β = .239, p < 0.05). Conclusion: This study indicated that family caregivers' preparedness and role burden affected stroke patients’ quality of life. The results of this study suggested that intervention to improve family caregivers’ preparedness and to reduce role burden should be required for quality of life in stroke patients.

Keywords: quality of life, preparedness, role burden, caregivers, stroke

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Authors: Hassan Abo Salem, Guo Feng, Xiaolin Huang

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The objective of this study is to determine the effectiveness of mirror therapy on motor recovery and functional abilities after stroke. The following databases were searched from inception to May 2014: Cochrane Stroke, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, and PEDro. Two reviewers independently screened and selected all randomized controlled trials that evaluate the effect of mirror therapy in stroke rehabilitation.12 randomized controlled trials studies met the inclusion criteria; 10 studies utilized the effect of mirror therapy for the upper limb and 2 studies for the lower limb. Mirror therapy had a positive effect on motor recover and function; however, we found no consistent influence on activity of daily living, Spasticity and balance. This meta-analysis suggests that, Mirror therapy has additional effect on motor recovery but has a small positive effect on functional abilities after stroke. Further high-quality studies with greater statistical power are required in order to accurately determine the effectiveness of mirror therapy following stroke.

Keywords: mirror therapy, motor recovery, stroke, balance

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Authors: Ehsan Kaviani, Azin Golmoradizade

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Introduction: Traditionally, tendons are considered to only contain tenocytes that are responsible for the maintenance, repair, and remodeling of tendons. Stem cells, which are termed tendon-derived stem cells, so this study we investigate the effect of transcranial direct current stimulation combined with swallowing training on post-stroke dysphagia. Methods: This review article is about effects of transcranial direct current stimulation (tDCS) on post-stroke dysphagia that were extracted from Science Direct, Pro quest, and Pub med Data Bases. 15 articles had been selected according to inclusion criteria from 2014 to 2019, and 6 of them had been deleted by exclusion criteria. Results: The results of our systematic review suggest that tDCS may represent a promising novel treatment for post-stroke dysphagia. However, to date, little is known about the optimal parameters of tDCS for relieving post-stroke dysphagia. Further studies are warranted to refine this promising intervention by exploring the optimal parameters of tDCS. Conclusion: anodal tDCS over the affected hemisphere may be as effective as cathodal tDCS on the unaffected hemisphere to enhance recovery after subacute ischemic stroke and anodal tdcs applied over the affected pharyngeal motor cortex can enhance the outcome of swallowing training in post-stroke dysphagia.

Keywords: dysphagia, stroke, cortical stimulation, transcranial direct current stimulation

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Authors: Fawwaz Eniola Fajingbesi, Nur Shahida Midia, Elsheikh M. A. Elsheikh, Siti Hajar Yusoff

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Empirical analysis of lightning related phenomena in real time is extremely dangerous due to the relatively high electric discharge involved. Hence, design and optimization of efficient grounding systems depending on real time empirical methods are impeded. Using numerical methods, the dynamics of complex systems could be modeled hence solved as sets of linear and non-linear systems . In this work, the induced current distribution as lightning strike traverses the soil have been numerically modeled in a 2D axial-symmetry and solved using finite element method (FEM) in COMSOL Multiphysics 5.2 AC/DC module. Stratified and non- stratified electrode system were considered in the solved model and soil conductivity (σ) varied between 10 – 58 mS/m. The result discussed therein were the electric field distribution, current distribution and soil ionization phenomena. It can be concluded that the electric field and current distribution is influenced by the injected electric potential and the non-linearity in soil conductivity. The result from numerical calculation also agrees with previously laboratory scale empirical results.

Keywords: current distribution, grounding systems, lightning discharge, numerical model, soil conductivity, soil ionization

Procedia PDF Downloads 286

Authors: Y. Mehdipour, S. Ebrahimi, A. Jahanpour, F. Seyedzaei, B. Sabayan, A. Karimi, H. Amirifard

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Ischemic stroke is one of the common reasons for disability and mortality. The fourth leading cause of death in the world and the third in some other sources. Only 1/3 of the patients with ischemic stroke fully recover, 1/3 of them end in permanent disability and 1/3 face death. Thus, the use of predictive models to predict stroke has a vital role in reducing the complications and costs related to this disease. Thus, the aim of this study was to specify the effective factors and predict ischemic stroke with the help of DM methods. The present study was a descriptive-analytic study. The population was 213 cases from among patients referring to Ali ibn Abi Talib (AS) Hospital in Zahedan. Data collection tool was a checklist with the validity and reliability confirmed. This study used DM algorithms of decision tree for modeling. Data analysis was performed using SPSS-19 and SPSS Modeler 14.2. The results of the comparison of algorithms showed that CHAID algorithm with 95.7% accuracy has the best performance. Moreover, based on the model created, factors such as anemia, diabetes mellitus, hyperlipidemia, transient ischemic attacks, coronary artery disease, and atherosclerosis are the most effective factors in stroke. Decision tree algorithms, especially CHAID algorithm, have acceptable precision and predictive ability to determine the factors affecting ischemic stroke. Thus, by creating predictive models through this algorithm, will play a significant role in decreasing the mortality and disability caused by ischemic stroke.

Keywords: data mining, ischemic stroke, decision tree, Bayesian network

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Authors: Zahra Hassani

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Background and Purpose: Poststroke depression (PSD) is one of the complications of a stroke that reduces the patient's chance of recovery, becomes irritable, and changes personality. Cognitive rehabilitation is one of the non-pharmacological methods that improve deficits such as attention, memory, and symptoms of depression. Therefore, the purpose of the present study is to evaluate the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke. Method: In this study, a systematic review of the databases Google Scholar, PubMed, Science Direct, Elsevier between the years 2015 and 2019 with the keywords cognitive rehabilitation therapy, post-stroke, depression Search is done. In this process, studies that examined the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke were included in the study. Results: Inclusion criteria were full-text availability, interventional study, and non-review articles. There was a significant difference between the articles in terms of the indices studied, sample number, method of implementation, and so on. A review of studies have shown that cognitive rehabilitation therapy has a significant role in reducing the symptoms of post-stroke depression. The use of these interventions is also effective in improving problem-solving skills, improving memory, and improving attention and concentration. Conclusion: This study emphasizes on the development of efficient and flexible adaptive skills through cognitive processes and its effect on reducing depression in patients after stroke.

Keywords: cognitive therapy, depression, stroke, rehabilitation

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Authors: John Rothrock

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Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.

Keywords: cardioembolic, cost-benefit, stroke, TTE

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Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

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

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

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

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Authors: Meida Laely Ramdani, Earmporn Thongkrajai, Dedy Purwito

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Lifestyle is one of the most important factors affecting health. Measurement of lifestyle behaviors is necessary for the identification of causal associations between unhealthy lifestyle and health outcomes. There was many instruments have been measured for lifestyle, but not specific for stroke recurrence. This study aimed to develop a new questionnaire of Lifestyle Adjustment Scale (LSAS) among recurrent stroke patients in Indonesia and to measure the reliability and validity of LSAS. The instrument consist of 33 items was developed from the responses of 30 recurrent stroke patients with the maximum age 60 years. Data was collected during October to November 2015. The properties of the instrument were evaluated by validity assessment and reliability measures. The content validity was judged adequate by a panel of five experts, with the result of I-CVI was 0.97. The Cronbach’s alpha analysis was carried out to measure the reliability of LSAS. The result showed that Cronbach’s alpha coefficient was 0.819. LSAS were classified under the domains of dietary habit, smoking habit, physical activity, and stress management. The results of Cronbach’s alpha coefficient for each subscale were 0.60, 0.39, 0.67, 0.65 and 0.76 respectively. LSAS instrument was valid and reliable therefore can be used as research tool among recurrent stroke patients. The development of this questionnaire has been adapted to the socio-cultural context in Indonesia.

Keywords: LSAS, recurrent stroke patients, lifestyle, Indonesia

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Authors: Navid Eghtedarpour, Mohammad Reza Hasani

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Since renewable wind power plants are usually installed in mountain regions and high-level lands, they are often prone to lightning strikes and their hazardous effects. Although the transmission line is protected using guard wires in order to prevent the lightning surges to strike the phase conductors, the back-flashover may also occur due to tower footing resistance. A combination of back-flashover corrective methods, tower-footing resistance reduction, insulation level improvement, and line arrester installation, are analyzed in this paper for back-flashover rate reduction of a double-circuit 63 kV line in the south region of Fars province. The line crosses a mountain region in some sections with a moderate keraunic level, whereas tower-footing resistance is substantially high at some towers. Consequently, an exceptionally high back-flashover rate is recorded. A new method for insulation improvement is studied and employed in the current study. The method consists of using a composite-type creepage extender in the string. The effectiveness of this method for insulation improvement of the string is evaluated through the experimental test. Simulation results besides monitoring the one-year operation of the 63-kV line show that due to technical, practical, and economic restrictions in operated sub-transmission lines, a combination of corrective methods can lead to an effective solution for the protection of transmission lines against lightning.

Keywords: lightning protection, BF rate, grounding system, insulation level, line surge arrester

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Authors: Azwadi Mohamad, Pauzi Yahaya, Nadiah Hudi

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Earthing system for high-voltage transmission tower is designed to protect the working personnel and equipments, and to maintain the quality of supply during fault. The existing earthing system for transmission towers in TNB’s system is purposely designed for normal power frequency (low-frequency) fault conditions that take into account the step and touch voltages. This earthing design is found to be inapt for lightning (transient) condition to a certain extent, which involves a high-frequency domain. The current earthing practice of laying the electrodes radially in straight 60 m horizontal lines under the ground, in order to achieve the specified impedance value of less than 10 Ω, was deemed ineffective in reducing the high-frequency impedance. This paper introduces a new earthing design that produces low impedance value at the high-frequency domain, without compromising the performance of low-frequency impedance. The performances of this new earthing design, as well as the existing design, are simulated for various soil resistivity values at varying frequency. The proposed concentrated earthing design is found to possess low TFR value at both low and high-frequency. A good earthing design should have a fine balance between compact and radial electrodes under the ground.

Keywords: earthing design, high-frequency, lightning, tower footing impedance

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Authors: Clara Oliver, Oibar Martinez, Jose Miguel Miranda

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This paper is devoted to the study of the most suitable protocols to verify the lightning protection and ground resistance quality in a large-scale scientific facility located in a harsh environment. We illustrate this work by reviewing a case study: the largest telescopes of the Northern Hemisphere Cherenkov Telescope Array, CTA-N. This array hosts sensitive and high-speed optoelectronics instrumentation and sits on a clear, free from obstacle terrain at around 2400 m above sea level. The site offers a top-quality sky but also features challenging conditions for a lightning protection system: the terrain is volcanic and has resistivities well above 1 kOhm·m. In addition, the environment often exhibits humidities well below 5%. On the other hand, the high complexity of a Cherenkov telescope structure does not allow a straightforward application of lightning protection standards. CTA-N has been conceived as an array of fourteen Cherenkov Telescopes of two different sizes, which will be constructed in La Palma Island, Spain. Cherenkov Telescopes can provide valuable information on different astrophysical sources from the gamma rays reaching the Earth’s atmosphere. The largest telescopes of CTA are called LST’s, and the construction of the first one was finished in October 2018. The LST has a shape which resembles a large parabolic antenna, with a 23-meter reflective surface supported by a tubular structure made of carbon fibers and steel tubes. The reflective surface has 400 square meters and is made of an array of segmented mirrors that can be controlled individually by a subsystem of actuators. This surface collects and focuses the Cherenkov photons into the camera, where 1855 photo-sensors convert the light in electrical signals that can be processed by dedicated electronics. We describe here how the risk assessment of direct strike impacts was made and how down conductors and ground system were both tested. The verification protocols which should be applied for the commissioning and operation phases are then explained. We stress our attention on the ground resistance quality assessment.

Keywords: grounding, large scale scientific instrument, lightning risk assessment, lightning standards and safety

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Authors: Jiewei Li, Hongyan Cui, Chunqi Chang, Yong Hu

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It was expected to benefit patient with hemiparesis after stroke by extensive arm rehabilitation, to partially regain forearm and hand function. This paper propose a robotic rehabilitation arm in assisting the hemiparetic patient to learn new ways of using and moving their weak arms. In this study, the robotic arm was driven by a somatosensory stimulated brain computer interface (BCI), which is a new modality BCI. The use of somatosensory stimulation is not only an input for BCI, but also a electrical stimulation for treatment of hemiparesis to strengthen the arm and improve its range of motion. A trial of this robotic rehabilitation arm was performed in a stroke patient with pure motor hemiparesis. The initial trial showed a promising result from the patient with great motivation and function improvement. It suggests that robotic rehabilitation arm driven by somatosensory BCI can enhance the rehabilitation performance and progress for hemiparetic patients after stroke.

Keywords: robotic rehabilitation arm, brain computer interface (BCI), hemiparesis, stroke, somatosensory stimulation

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Authors: Yuri A. Gruber, Matheus Rosendo, Ulisses G. A. Casemiro, Klaus de Geus, Rafael T. Bee

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Lightning strikes can cause severe negative impacts to the electrical sector causing direct damage to equipment as well as shutdowns, especially when occurring in power substations. In order to mitigate this problem, a meticulous planning of the power substation protection system is of vital importance. A critical part of this is the distribution of shielding wires through the substation, which creates a 3D imaginary protection mesh similar to a circus tarpaulin. Equipment enclosed in the volume defined by that 3D mesh is considered protected against lightning strikes. The use of traditional methods of longitudinal cutting analysis based on 2D CAD tools makes the process laborious and the results obtained may not guarantee satisfactory protection of electrical equipment. This work describes the application of a Game Engine to the problem of lightning protection of power substations providing the visualization of the 3D protection mesh, the amount of protected components and the highlight of equipment which remain unprotected. In addition, aspects regarding the implementation and the advantages of approaching the problem using Unreal® Engine 4 are described. In order to validate results, a comparison with traditional 2D methods is applied to the same case study to which the proposed technique has been applied. Finally, a comparative study involving different levels of protection using the technique developed in this work is presented, showing that modern game engines can be a powerful accessory for simulations in several areas of engineering.

Keywords: game engine, rolling spheres method, substation protection, UE4, Unreal Engine 4

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Authors: Chen-Sheng Chen, Tsung-Yi Huang, Pi-Chang Sun

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Chronic stroke patients often have complaints about hand dysfunction due to flexor hypertonia and extensor weakness, which makes it difficult to open their affected hand for functional grasp. Hand rehabilitation after stroke is essential for restoring functional independence. Constraint-induced movement therapy has shown to be a successful treatment for patients who have acquired certain level of wrist and finger extension. The goal of this study was to investigate the feasibility of task-oriented approach incorporating 3D-printed dynamic hand device by evaluating hand functional performance. This study manufactured a hand device using 3d printer for chronic stroke. The experimental group engaged task-oriented approach with dynamic hand device, but the control group only received task-oriented approach. Outcome measurements include palmar pinch force (PPF), lateral pinch force (LPF), grip force (GF), and Box and Blocks Test (BBT). The results of study revealed the improvement of PPF in experimental group but not in control group. Meanwhile, improvement in LPF, GF and BBT can be found in both groups. This study demonstrates that the 3D-printed dynamic hand device is an effective therapeutic assistive device to improve pinch force, grasp force, and dexterity and facilitate motivation during home program in individuals with chronic stroke.

Keywords: 3D printing, biomechanics, hand orthosis, stroke

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Authors: Yeasir Arafat Alve, Nazmun Nahar, Salma BeguM

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Introduction / Rationale: Caregivers of stroke survivors have experienced financial, emotional, physical and mental anxiety and have influence of family bonding and social customs, where 80% of caregivers were women and majority of the patients were cared for by immediate family members for example a spouse, son/daughter, son-in-law, daughter-in-law, siblings and they are significantly feel burden as a caregiver. In Bangladeshi context, there has a limitation of knowledge about the level of caregiver burden. This study could be suggested the health professional to focus on the care giving stress to provide a better support to them and also it will be advisable to provide equivalent services for caregivers and their families. Objectives: The study finds out the socio-demographic image of caregivers of stroke survivors in Bangladesh as well as discovers the level of burden of caregiver of stroke survivor in relation to general strain, isolation, disappointment, emotional involvement and environment. The study will find out the association between level of burden among caregivers and onset of stroke of survivors & duration of care giving. As well as to determine the association between level of burden among caregivers and caregiver’s age, gender, occupation and caregiver’s relationship with stroke survivors. Method / Approach: The study is a non experimental cross-sectional study design where 151 participants were selected through purposive comprehensive sampling. Data were selected from occupational therapy outdoor and stroke rehab unit, CRP (Savar & Mirpur) where using the Caregiver Burden Scale (a structured questionnaire) with face to face interview. Results: Most of the caregivers (78.8%) of stroke survivors faced moderate level of burden in general strain (37.7%), isolation (27.2%) but in case of disappointment (60.3%) feel higher burden and lower burden in emotional involvement (9.9%) and environment (0.7%). Caregiver burden level was significantly associated with caregivers’ age (P=0.006), sex (P=0.002), occupation (p= 0.04), relationship with stroke survivors (P=0.02), care giving duration (P=0.000), care giving hours (P=0.009), and onset of stroke (P=0.000) of stroke survivors. Conclusion: The study findings revealed that most of the caregivers faced moderate burden where no environmental burden for them, this is possibly in case of Bangladeshi culture where people hospitable. Through this study, it was also found that there is a possibility to have the higher burden. Finally, it is being also suggested that appropriate advice and support may preserve care giving which eventually enables the survivors to live a longer and more fulfilling life in the community.

Keywords: caregiver, level of caregiver burden, stroke survivor, stroke rehab unit

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Authors: Kumar Gular, Viswanathan S., Mastour Saeed Alshahrani, Ravi Shankar Reddy, Jaya Shanker Tedla, Snehil Dixit, Ajay Prasad Gautam, Venkata Nagaraj Kakaraparthi, Devika Rani Sangadala

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Background: Despite trunk control’s significant contribution to improving various functional activity components, the independent effect of trunk performance on quality of life is yet to be estimated in stroke survivors. Ascertaining the correlation between trunk control and self-reported quality of life while evaluating the effect of demographic and clinical characteristics on their relationship will guide concerned healthcare professionals in designing ideal rehabilitation protocols during the late sub-acute stroke stage of recovery. The aims of the present research were to (1) investigate the associations of trunk performance with self-rated quality of life and (2) evaluate if age, body mass index (BMI), and clinical characteristics mediate the relationship between trunk motor performance and perceived quality of life in the sub-acute stroke population. Methods: Trunk motor functions and quality of life among the late sub-acute stroke population aged 57.53 ± 6.42 years were evaluated through the trunk Impairment Scale (TIS) and Stroke specific quality of life (SSQOL) questionnaire, respectively. Pearson correlation coefficients and mediation analysis were performed to elucidate the relationship of trunk motor function with quality of life and determine the mediation impact of demographic and clinical characteristics on their association, respectively. Results: The current study observed significant correlations between trunk motor functions (TIS) and quality of life (SSQOL) with r=0.68 (p<0.001). Age, BMI, and type of stroke were detected as potential mediating factors in the association between trunk performance and quality of life. Conclusion: Validated associations between trunk motor functions and perceived quality of life among the late sub-acute stroke population emphasize the importance of comprehensive evaluation of trunk control. Rehabilitation specialists should focus on appropriate strategies to enhance trunk performance anticipating the potential effects of age, BMI, and type of stroke to improve health-related quality of life in stroke survivors.

Keywords: sub-acute stroke, quality of life, functional independence, trunk control

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Authors: Hassan Abo-Salem, Huang Xiaolin

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Background and Purpose: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantarflexor muscle tone by Modified Ashworth Scale. Results: Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05). Conclusions: Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and walking speed in chronic stroke patients.

Keywords: mirror therapy, stroke, MAS, walking speed

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Authors: Wi-Sun Ryu, Eun-Kee Bae

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Prior studies have shown that patients with right hemispheric stroke are likely to seek medical service compared with those with left hemispheric stroke. However, the underlying mechanism for this phenomenon is unknown. In the present study, we generated lesion probability maps in a patient with right and left middle cerebral artery infarct and statistically compared. We found that precentral gyrus-Brodmann area 44, a language area in the left hemisphere - involvement was significantly higher in patients with left hemispheric stroke. This finding suggests that a language dysfunction was more noticeable, thereby taking more patients to hospitals.

Keywords: cerebral infarct, brain MRI, statistical parametric mapping, middle cerebral infarct

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Authors: Marc Sebastián-Romagosa, Woosang Cho, Rupert Ortner, Christy Li, Christoph Guger

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Neurorehabilitation based on Brain-Computer Interfaces (BCIs) shows important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. For this publication, seven stroke patients in the chronic phase with hemiparesis in the lower extremity were recruited. All of them participated in 25 BCI sessions about 3 times a week. The BCI system was based on the Motor Imagery (MI) of the paretic ankle dorsiflexion and healthy wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes in motor improvement before, after and during the rehabilitation training. Our primary measures used for the assessment were the 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT fast velocity of 0.18 m/s IQR = [0.12 to 0.2], P = 0.016. The speed in the TUG was also significantly increased by 0.1 m/s IQR = [0.09 to 0.11], P = 0.031. The active ROM assessment increased 4.65º, and IQR = [ 1.67 - 7.4], after rehabilitation training, P = 0.029. These functional improvements persisted at least one month after the end of the therapy. These outcomes show the feasibility of this BCI approach for chronic stroke patients and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tools for stroke patients. However, the results are from only seven chronic stroke patients, so the authors believe that this approach should be further validated in broader randomized controlled studies involving more patients. MI and FES-based non-invasive BCIs are showing improvement in the gait rehabilitation of patients in the chronic stage after stroke. This could have an impact on the rehabilitation techniques used for these patients, especially when they are severely impaired and their mobility is limited.

Keywords: neuroscience, brain computer interfaces, rehabilitat, stroke

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Authors: Chiung-Hua Chan, Fang-Yuan Chang, Li-Chi Huang

Abstract:

Stroke patients received regular rehabilitation therapy have measurable advancement in muscle strength, balance, control upper and lower physical activity, walking speed and endurance. This study aimed to investigate the relationship between increases in bedside rehabilitation time and the function of activities and daily living (ADL) in stroke patients. The study was quasi-experimental research design and randomized sampling. The researcher collected 12 stroke patients of stroke patients transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. All participants then were assigned to case group and control group. Data collection was through direct observation of assessment ADL of stroke patients by researchers on Day 1. Case group received regular rehabilitation, exercises in increase of bedside rehabilitation schedules exercise programs by ward nurses. Bedside rehabilitation exercise content with physical, functional and linguistic frequency and time, Control group only give routine rehabilitation schedule care. This was a randomized study performed in 12 patients who were stroke patients and transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. First, the researcher explained the purpose and method of the study to the patients or the family members. All participants completed a consent informed before participation. Patients were randomly assigned to a ‘bedside rehabilitation program’ (BRP) group and a control (C) group. The BRP group received bedside rehabilitation schedules exercise programs by ward nurses. while the C group did not. Both groups received routine rehabilitation schedule. The Functional Independence Measure was used to measure outcome at the first, 14th and the 28th day of rehabilitation ward admitted. Data were analyzed using SPSS 22.0. After implementation of standardized ‘‘bedside rehabilitation program’, the results were: (1) the increasing of bedside rehabilitation had significant difference (p<.05) in promotion ADL function of stroke patients (2) the extend time of the bedside rehabilitation has significant difference (p<.05) in promotion ADL function of stroke patients compared with the control group. This study demonstrated that the ‘bedside rehabilitation program’ enhanced the ADL function in stroke patients. The nurses and rehabilitation ward managers need to understand that the extend time and frequency of rehabilitation provide a chance to enhanced the ADL function of stroke patients.

Keywords: stroke, bedside rehabilitation, functional activity, ADL

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Authors: A. Alzahrani, G. Arnold, W. Wang

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Background: Stroke commonly occurs in middle-aged and elderly populations, and the diagnosis of early stroke is still difficult. Patients who have suffered a stroke have different balance and gait patterns from healthy people. Advanced techniques of motion analysis have been routinely used in the clinical assessment of cerebral palsy. However, so far, little research has been done on the direct diagnosis of early stroke patients using motion analysis. Objectives: The aim of this study was to investigate whether patients with stroke have different balance and gait from healthy people and which biomechanical parameters could be used to predict and diagnose potential patients who are at a potential risk to stroke. Methods: Thirteen patients with stroke were recruited as subjects whose gait and balance was analysed. Twenty normal subjects at the matched age participated in this study as a control group. All subjects’ gait and balance were collected using Vicon Nexus® to obtain the gait parameters, kinetic, and kinematic parameters of the hip, knee, and ankle joints in three planes of both limbs. Participants stood on force platforms to perform a single leg balance test. Then, they were asked to walk along a 10 m walkway at their comfortable speed. Participants performed 6 trials of single-leg balance for each side and 10 trials of walking. From the recorded trials, three good ones were analysed using the Vicon Plug-in-Gait model to obtain gait parameters, e.g., walking speed, cadence, stride length, and joint parameters, e.g., joint angle, force, moments, etc. Result: The temporal-spatial variables of Stroke subjects were compared with the healthy subjects; it was found that there was a significant difference (p < 0.05) between the groups. The step length, speed, cadence were lower in stroke subjects as compared to the healthy groups. The stroke patients group showed significantly decreased in gait speed (mean and SD: 0.85 ± 0.33 m/s), cadence ( 96.71 ± 16.14 step/min), and step length (0.509 ± 017 m) in compared to healthy people group whereas the gait speed was 1.2 ± 0.11 m/s, cadence 112 ± 8.33 step/min, and step length 0.648 ± 0.43 m. Moreover, it was observed that patients with stroke have significant differences in the ankle, hip, and knee joints’ kinematics in the sagittal and coronal planes. Also, the result showed that there was a significant difference between groups in the single-leg balance test, e.g., maintaining single-leg stance time in the stroke patients showed shorter duration (5.97 ± 6.36 s) in compared to healthy people group (14.36 ± 10.20 s). Conclusion: Our result showed that there are significantly differences between stroke patients and healthy subjects in the various aspects of gait analysis and balance test, as a consequences of these findings some of the biomechanical parameters such as joints kinematics, gait parameters, and single-leg stance balance test could be used in clinical practice to predict and diagnose potential patients who are at a high risk of further stroke.

Keywords: gait analysis, kinetics, kinematics, single-leg stance, Stroke

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