Search results for: lower back

Authors: Vishal Mahale, Jayashree Bijwe, Sujeet K. Sinha

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Range of thermal conductivity (TC) of Friction Materials (FMs) is a critical issue since lower TC leads to accumulation of frictional heat on the working surface, which results in excessive fade while higher TC leads to excessive heat flow towards back-plate resulting in boiling of brake-fluid leading to ‘spongy brakes’. This phenomenon prohibits braking action, which is most undesirable. Therefore, TC of the FMs across the brake pads should not be high while along the brake pad, it should be high. To enhance TC, metals in the forms of powder and fibers are used in the FMs. Apart from TC improvement, metals provide strength and structural integrity to the composites. Due to higher TC Copper (Cu) powder/fiber is a most preferred metallic ingredient in FM industry. However, Cu powders/fibers are responsible for metallic wear debris generation, which has harmful effects on aquatic organisms. Hence to get rid of a problem of metallic wear debris generation and to keep the positive effect of TC improvement, incorporation of Cu fabric in NAO brake-pads can be an innovative solution. Keeping this in view, two realistic multi-ingredient FM composites with identical formulations were developed in the form of brake-pads. Out of which one composite series consisted of a single layer of Cu fabric in the body of brake-pad and designated as C1 while double layer of Cu fabric was incorporated in another brake-pad series with designation of C2. Distance of Cu fabric layer from the back-plate was kept constant for C1 and C2. One more composite (C0) was developed without Cu fabric for the sake of comparison. Developed composites were characterized for physical properties. Tribological performance was evaluated on full scale inertia dynamometer by following JASO C 406 testing standard. It was concluded that Cu fabric successfully improved fade resistance by increasing conductivity of the composite and also showed slight improvement in wear resistance. Worn surfaces of pads and disc were analyzed by SEM and EDAX to study wear mechanism.

Keywords: brake inertia dynamometer, copper fabric, non-asbestos organic (NAO) friction materials, thermal conductivity enhancement

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Authors: C. Bala Prashanth Reddy, B. Abhinay, C. Sreekar, D. V. Shobhana Priscilla

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The project aims in designing an emergency pacemaker which is capable of giving shocks to a human heart which has stopped working suddenly. A pacemaker is a machine commonly used by cardiologists. This machine is used in order to shock a human’s heart back into usage. The way the heart works is that there are small cells called pacemakers sending electrical pulses to cardiac muscles that tell the heart when to pump blood. When these electrical pulses stop, the heart stops beating. When this happens, a pacemaker is used to shock the heart muscles and the pacemakers back into action. The way this is achieved is by rubbing the two panels of the pacemaker together to create an adequate electrical current, and then the heart gets back to the normal state. The project aims in designing a system which is capable of continuously displaying the heart beat and blood pressure of a person on LCD. The concerned doctor gets the heart beat and also the blood pressure details continuously through the GSM Modem in the form of SMS alerts. In case of abnormal condition, the doctor sends message format regarding the amount of electric shock needed. Automatically the microcontroller gives the input to the pacemaker which in turn gives the shock to the patient. Heart beat monitor and display system is a portable and a best replacement for the old model stethoscope which is less efficient. The heart beat rate is calculated manually using stethoscope where the probability of error is high because the heart beat rate lies in the range of 70 to 90 per minute whose occurrence is less than 1 sec, so this device can be considered as a very good alternative instead of a stethoscope.

Keywords: missing R wave, PWM, demand pacemaker, heart

Procedia PDF Downloads 441

Authors: Pocholo Rodriguez, Anne Bernadine Ocampo, Ian Benedict Chan, Janric Micah Gray

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The state of an electric power system may be classified as either stable or unstable. The borderline of stability is at any condition for which a slight change in an unfavourable direction of any pertinent quantity will cause instability. Voltage instability in power distribution systems could lead to voltage collapse and thus power blackouts. The researchers will present an intelligent system using back propagation algorithm that can detect voltage instability and output voltage of a power distribution and classify it as stable or unstable. The researchers’ work is the use of parameters involved in voltage instability as input parameters to the neural network for training and testing purposes that can provide faster detection and monitoring of the power distribution system.

Keywords: back-propagation algorithm, load instability, neural network, power distribution system

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Authors: Benedicta Asante, Catherine Trask, Brenna Bath

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Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, there is the increase in reports of injuries, particularly for common and debilitating musculoskeletal disorders such as low back disorder (LBD). WCWs are likely exposed to diverse work-related hazards that could contribute to LBD. However, there is currently no summary of the state of knowledge on the prevalence and risk factors of LBD within this workforce. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back disorder’ and ‘waste collection workers’. Two reviewers screened articles at title, abstract, and full-text stages. Data were extracted on study design, sampling strategy, socio-demographics, geographical region, and exposure definition, the definition of LBD, response rate, statistical techniques, LBD prevalence and risk factors. The risk of bias was assessed with a standardized tool. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; only thirteen full-text articles met the study criteria and underwent data extraction. The majority of articles reported a 12-month prevalence of LBD between 16-74%. Although none of the included studies quantified relationships between risk factors and LBD, the suggested risk factors for LBD among WCWs included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Conclusion: LBD is a major occupational health issue among WCWs. In light of these risks and future growth in this industry, further research should focus on the investigation of risk factors, with more focus on ergonomic exposure assessment, and LBD prevention efforts.

Keywords: low back pain, scavenger, waste pickers, waste collection workers

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Authors: Yah-Ling Hung

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eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Keywords: eHealth, health intervention, health literacy, usability evaluation

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Authors: Yongjian Gu

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Ocean thermal energy is one of the ocean energy sources. It is a renewable, sustainable, and green energy source. Ocean thermal energy conversion (OTEC) applies the ocean temperature gradient between the warmer surface seawater and the cooler deep seawater to run a heat engine and produce a useful power output. Unfortunately, the ocean temperature gradient is not big. Even in the tropical and equatorial regions, the surface water temperature can only reach up to 28oC and the deep water temperature can be as low as 4oC. The thermal efficiency of the OTEC plants, therefore, is low. In order to improve the plant thermal efficiency by using the limited ocean temperature gradient, some OTEC plants use the method of adding more equipment for better heat recovery, such as heat exchangers, pumps, etc. Obviously, the method will increase the plant's complexity and cost. The more important impact of the method is the additional equipment needs to consume power too, which may have an adverse effect on the plant net power output, in turn, the plant thermal efficiency. In the paper, the author first describes varied OTEC plants and the practice of using the method of adding more equipment for improving the plant's thermal efficiency. Then the author proposes a parameter, plant back works ratio ϕ, for measuring if the added equipment is appropriate for the plant thermal efficiency improvement. Finally, in the paper, the author presents examples to illustrate the application of the back work ratio ϕ as a key parameter in the OTEC plant design and operation.

Keywords: ocean thermal energy, ocean thermal energy conversion (OTEC), OTEC plant, plant back work ratio ϕ

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Authors: Najebah Alsaleh, Nirpendra Singh, Udo Schwingenschlogl

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The electronic and transport properties of bulk and monolayer CuSbS2 and CuSbSe2 are determined by using density functional theory and semiclassical Boltzmann transport theory, in order to investigate the role of interlayer coupling for the thermoelectric properties. The calculated band gaps of the bulk compounds are in agreement with experiments and significantly higher than those of the monolayers, which thus show lower Seebeck coefficients. Since also the electrical conductivity is lower, the monolayers are characterized by lower power factors. Therefore, interlayer coupling is found to be essential for the excellent thermoelectric response of CuSbS2 and CuSbSe2, even though it is weak.

Keywords: density functional theory, thermoelectric, electronic properties, monolayer

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Authors: A. Ardianto, M. A. Putera Agung, S. Pramusandi

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Power waterway is one of dam structures and as an intake vertical tunnel or well function for hydroelectric power plants in Jatigede area, Sumedang, West Java. Gate shaft is also one of parts the power waterway system. The paper concerns some consideration in determining a critical state parameter on the back stability analysis of gate shaft or excavation wall stability during excavation. Study analysis was carried out using without and with reinforcement system. Results study showed that reinforcement shaft could reduce the total displacement and safety factor could increases significantly. Based on the back calculation results, it was recommended to install some reinforcement materials and drainage system to reduce pore water pressure.

Keywords: power waterway, reinforcement, displacement, safety

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Authors: Abdelhammid Chibane

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This study summarizes state-of-the-art knowledge in the seismic response of vertically irregular building frames. Criteria defining vertical irregularity as per the current building codes have been discussed. A review of studies on the seismic behaviour of vertically irregular structures along with their findings has been presented. It is observed that building codes provide criteria to classify the vertically irregular structures and suggest dynamic analysis to arrive at design lateral forces. Most of the studies agree on the increase in drift demand in the tower portion of set-back structures and on the increase in seismic demand for buildings with discontinuous distributions in mass, stiffness, and strength. The largest seismic demand is found for the combined-stiffness-and-strength irregularity.

Keywords: mass irregularity, set-back structure, stiffness irregularity, strength irregularity, vertical irregularity

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Authors: Andrzej Poszewiecki

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The presented paper contributes to the experimental current of research on privacy. The question of privacy is being discussed at length at present, primarily among lawyers and politicians. However, the matter of privacy has been of interest for economists for some time as well. The valuation of privacy by people is of great importance now. This article is about how people valuate their privacy. An experimental method has been utilised in the conducted research – the survey was carried out among customers of an online store, and the studied issue was whether their readiness to sell their data (WTA) was different from the willingness to buy data back (WTP). The basic aim of this article is to analyse whether people shopping on the Internet differentiate their privacy depending on whether they protect or sell it. The achieved results indicate the presence of major differences in this respect, which do not always come up with the original expectations. The obtained results have supported the hypothesis that people are more willing to sell their data than to repurchase them. However, the hypothesis that the value of proposed remuneration affects the willingness to sell/buy back personal data (one’s privacy) has not been supported.

Keywords: privacy, experimental economics, behavioural economics, internet

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Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite

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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.

Keywords: workplace exercise, paramedic health, strength training, flexibility training

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Authors: Abdul Salam Turkmani

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The Lower Cretaceous rocks are exposed only in the mountains regions of Syria, such as the Anti- Lebanon mountain on the western side of Damascus. The lower cretaceous sequences are made up of different rocks. The upper and middle parts of the section are composed mainly of carbonate sediments and, less frequently, gypsum and anhydrite. The lower beds are mainly composed of sandstone, conglomerate and clay. Clay samples were collected from the study area, which is located about 45 km west of the city of Damascus, near the border village of Kfer Yabous and to the left of the Damascus -Beirut International Road, within the lower Cretaceous upper Aptian deposits. The properties of clay were carried out by X-ray diffraction (XRD) and, X-ray fluorescence (XRF) and Thermal Analysis (DTA-TG-DSC) techniques. The studied samples of clay were mainly composed of kaolinite, quartz, illite. Chemical analysis shows the content of SiO₂ varied between 46.06 to 73 % Al₂O₃ 14.55-26.56%, about the staining oxides (Fe₂O₃ + TiO₂), the total content is about 4.3 to 12.5%. The physical properties were determined by studying the behavior of the body before and after firing, showed low bending strength values (22.5 kg/cm²) after drying, and (about 247 kg/cm²) after firing at 1180°C, water absorption value was about 10%. The cubic thermal expansion coefficient at 1140°C is 213.77 x 10-7 /°C. All of the presented results confirm the suitability of this clay for the ceramic industry.

Keywords: anti-Lebanon, Damascus, ceramic, clay, thermal analysis, thermal expansion coefficient

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Authors: Prerana Sharma

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Effect of relativistic nonlinearity on stimulated Raman scattering of the propagating laser beam carrying null intensity in center (hollow Gaussian beam) by excited plasma wave are studied in a collisionless plasma. The construction of the equations is done employing the fluid theory which is developed with partial differential equation and Maxwell’s equations. The analysis is done using eikonal method. The phenonmenon of Stimulated Raman scattering is shown along with the excitation of seed plasma wave. The power of plasma wave and back reflectivity is observed for higher order of hollow Gaussian beam. Back reflectivity is studied numerically for various orders of HGLB with different value of plasma density, laser power and beam radius. Numerical analysis shows that these parameters play vital role on reflectivity characteristics.

Keywords: Hollow Gaussian beam, relativistic nonlinearity, plasma physics, Raman scattering

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Authors: Eric Lacoste

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Laboratory animals are currently widely used as a model of human pathologies in dermatology such as atopic dermatitis (AD). These models provide a better understanding of the pathophysiology of this complex and multifactorial disease, the discovery of potential new therapeutic targets and the testing of the efficacy of new therapeutics. However, confirmation of the correct development of AD is mainly based on histology from skin biopsies requiring invasive surgery or euthanasia of the animals, plus slicing and staining protocols. However, there are currently accessible imaging technologies such as Optical Coherence Tomography (OCT), which allows non-invasive visualization of the main histological structures of the skin (like stratum corneum, epidermis, and dermis) and assessment of the dynamics of the pathology or efficacy of new treatments. Briefly, female immunocompetent hairless mice (SKH1 strain) were sensitized and challenged topically on back and ears for about 4 weeks. Back skin and ears thickness were measured using calliper at 3 occasions per week in complement to a macroscopic evaluation of atopic dermatitis lesions on back: erythema, scaling and excoriations scoring. In addition, OCT was performed on the back and ears of animals. OCT allows a virtual in-depth section (tomography) of the imaged organ to be made using a laser, a camera and image processing software allowing fast, non-contact and non-denaturing acquisitions of the explored tissues. To perform the imaging sessions, the animals were anesthetized with isoflurane, placed on a support under the OCT for a total examination time of 5 to 10 minutes. The results show a good correlation of the OCT technique with classical HES histology for skin lesions structures such as hyperkeratosis, epidermal hyperplasia, and dermis thickness. This OCT imaging technique can, therefore, be used in live animals at different times for longitudinal evaluation by repeated measurements of lesions in the same animals, in addition to the classical histological evaluation. Furthermore, this original imaging technique speeds up research protocols, reduces the number of animals and refines the use of the laboratory animal.

Keywords: atopic dermatitis, mouse model, oxzolone model, histology, imaging

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Authors: Martina Perinkova, Lenka Kolarcikova, Marketa Twrda

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Brownfields are one of the most important problems that must be solved by today's cities. The topic of this article is description of developing a comprehensive transformation of post-industrial area of the former iron factory national cultural heritage Lower Vítkovice. City of Ostrava used to be industrial superpower of the Czechoslovak Republic, especially in the area of coal mining and iron production, after declining industrial production and mining in the 80s left many unused areas of former factories generally brownfields and backfields. Since the late 90s we are observing how the city officials or private entities seeking to remedy this situation. Regeneration of brownfields is a very expensive and long-term process. The area is now rebuilt for tourists and residents of the city in the entertainment, cultural, and social center. It was necessary do the reconstruction of the industrial monuments. Equally important was the construction of new buildings, which helped reusing of the entire complex. This is a unique example of transformation of technical monuments and completion of necessary new objects, so that the area could start working again and reintegrate back into the urban system.

Keywords: brown fields, conversion, historical and industrial buildings, reconstruction

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Authors: Sakineh Tashakori, Terrence Lovat

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With the start of war in every part of the world, from the war between Russia and Ukraine to the unbelievable start of the war between Israel and Palestine, the number of war refugees is increasing day by day. They are all homeless dads, moms, and kids looking for a safe place to go back to their ordinary lives without the fear of being mistreated and misunderstood by others. The significance of this study is to help the education system make life easier for refugees by going to values pedagogy inspired by Habermasian epistemology. The study employs a literature review methodology, which involves gathering relevant sources from academic journals and books to answer how values pedagogy is going to help the education system in this regard. The collected literature will be critically analyzed and synthesized to draw meaningful conclusions and support the argument for the implementation of values pedagogy. The findings of the study illustrate that values pedagogy can have a role in peace education and softening discourse to give students a better sense of mutual cultural and religious understanding and respect.

Keywords: war, refugee, values pedagogy, Habermasian epistemology, peace education

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Authors: Riznaldi Akbar

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In this study, we compared the performance of the Artificial Neural Network (ANN) model with back-propagation algorithm in correctly predicting in-sample and out-of-sample external debt crisis in Indonesia. We found that exchange rate, foreign reserves, and exports are the major determinants to experiencing external debt crisis. The ANN in-sample performance provides relatively superior results. The ANN model is able to classify correctly crisis of 89.12 per cent with reasonably low false alarms of 7.01 per cent. In out-of-sample, the prediction performance fairly deteriorates compared to their in-sample performances. It could be explained as the ANN model tends to over-fit the data in the in-sample, but it could not fit the out-of-sample very well. The 10-fold cross-validation has been used to improve the out-of-sample prediction accuracy. The results also offer policy implications. The out-of-sample performance could be very sensitive to the size of the samples, as it could yield a higher total misclassification error and lower prediction accuracy. The ANN model could be used to identify past crisis episodes with some accuracy, but predicting crisis outside the estimation sample is much more challenging because of the presence of uncertainty.

Keywords: debt crisis, external debt, artificial neural network, ANN

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Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Namubiru Zula, Janice Desire Busingue

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Pro-active educational approaches have lately been adapted Globally in the Conservation of Natural Resources. This led to the introduction of the co-management system, which worked for some European Countries on the conservation of sharks and other Natural resources. However, this approach has drastically failed in the Fishery sector on Lake Victoria; and the punitive education approach has been re-instated. Literature is readily available about the punitive educational approaches and scanty with the pro-active one. This article analyses the pro-active approach adopted by the Department of Fisheries for the orientation of BMU leaders in a co-management system. The study is interpreted using the social constructivist lens for co-management of the fishery resource to ensure that fishers are also back to fishing sustainably. It highlights some of the education methods used, methodological challenges that included the power and skills gap of the facilitators and program designers, and some implications to practice.

Keywords: beach management units, fishers, education methods, proactive approach, punitive approach

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Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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Authors: Surapol Raadnui

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This paper describes an experimental investigation on a pair of gears in which wear and pitting were intentionally allowed to occur, namely, moisture corrosion pitting, acid-induced corrosion pitting, hard contaminant-related pitting and mechanical induced wear. A back-to-back spur gear test rig was used. The test samples of wear debris were collected and assessed through the utilization of an optical microscope in order to correlate and compare the debris morphology to pitting and wear degradation of the worn gears. In addition, weight loss from all test gear pairs was assessed with the utilization of the statistical design of the experiment. It can be deduced that wear debris characteristics exhibited a direct relationship with different pitting and wear modes. Thus, it should be possible to detect and diagnose gear pitting and wear utilization of worn surfaces, generated wear debris and quantitative measurement such as weight loss.

Keywords: tribology, spur gear wear, predictive maintenance, wear particle analysis

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Authors: Latifa Alenezi, Liz Croot, Janet Harris

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Chronic Low Back Pain (CLBP) is one of the most common and recurrent musculoskeletal problems that causes patients to access health care services frequently. The Bio-psychosocial Model emphasises that psychological, behavioural and social factors contribute to the development and persistence of CLBP. Cognitive behavioural therapy (CBT) is a psychological pain management strategy that can be used by physiotherapists treating chronic low back pain. However, evidence of the effectiveness of CBT for CLBP varies between different studies. The proposed study was preceded by a mixed methods systematic review that found that CBT has a beneficial effect for CLBP patients when compared to waiting list or other treatments; however, there is variation in effectiveness across different settings. Little is known about how CBT is applied by physiotherapists in physiotherapy settings. The interest of this study is directed towards generating an explanation and understanding of why, when, and how some physiotherapists make decisions and choose to apply CBT for CLBP patients, whereas others do not. Also, how and for what type of CLBP patients does CBT work, and for whom might CBT not work? Therefore, the study will take a qualitative approach to explore CLBP patients’, physiotherapists’ and managers’ perceptions of CBT and how it is used in physiotherapy to enable a deeper understanding and richer explanation of CBT effectiveness and help to inform research and practice. The study will use grounded theory approach to generate an explanatory theory of the clinical application of CBT for CLBP in physiotherapy settings. Physiotherapists, patients and managers of physiotherapy services will be interviewed. Grounded theory techniques will be used to analyse the data. The presentation will describe findings from the interviews and the emerging theory. This research will help to further inform RCTs about the effectiveness of CBT for CLBP in physiotherapy.

Keywords: CBT, CLBP, perception, physiotherapy, theory

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Authors: Makkhan Lal Meena, R. C. Bairwa, G. S. Dangayach, Rahul Jain

Abstract:

The current study looked at the frequency of chronic illness conditions, accidents, health complaints, and ergonomic issues among 100 conventional and 100 greenhouse farmers. Data related to the health symptoms and ergonomic problems were collected through questionnaires by conducting direct interviews of farmers. According to the findings, symptoms of heat exposure (skin rashes, headache, dizziness, and lack of appetite) were substantially higher among conventional farmers than greenhouse farmers. The greenhouse farmers reported much more pain, numbness, or weakness in wrists/hands, fingers, upper back, hips, and ankles/feet than conventional farmers. The findings of the study suggest that suitable ergonomic knowledge and awareness campaign programs concentrating on safety at work, particularly low back pain, should be implemented in workplaces to allow for earlier detection of symptoms among the greenhouse farmers.

Keywords: accident, conventional farmer, ergonomics, health symptoms, greenhouse farmers, pesticide

Procedia PDF Downloads 228

Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

Abstract:

Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: pilates, Mackenzie, preconception, low back pain, physical health

Procedia PDF Downloads 157

Authors: Antonis Constantinides, Christos Yiallouras, Christakis Damianou

Abstract:

The application of today's semiconductor transistors in high power UHF DVB-T linear amplifiers has evolved significantly by utilizing LDMOS technology. This fact provides engineers with the option to design a single transistor signal amplifier which enables output power and linearity that was unobtainable previously using bipolar junction transistors or later type first generation MOSFETS. The quiescent current stability in terms of thermal variations of the LDMOS guarantees a robust operation in any topology of DVB-T signal amplifiers. Otherwise, progressively uncontrolled heat dissipation enhancement on the LDMOS case can degrade the amplifier’s crucial parameters in regards to the gain, linearity, and RF stability, resulting in dysfunctional operation or a total destruction of the unit. This paper presents one more sophisticated approach from the traditional biasing circuits used so far in LDMOS DVB-T amplifiers. It utilizes a microprocessor control technology, providing stability in topologies where IDQ must be perfectly accurate.

Keywords: LDMOS, amplifier, back-off, bias circuit

Procedia PDF Downloads 308

Authors: Nadia Ben Si Ali, Nadia Benalia, Nora Zerzouri

Abstract:

Wind energy generation has attracted great interests in recent years. Doubly Fed Induction Generator (DFIG) for wind turbines are largely deployed because variable-speed wind turbines have many advantages over fixed-speed generation such as increased energy capture, operation at maximum power point, improved efficiency, and power quality. This paper presents the operation and vector control of a Doubly-fed Induction Generator (DFIG) system where the stator is connected directly to a stiff grid and the rotor is connected to the grid through bidirectional back-to-back AC-DC-AC converter. The basic operational characteristics, mathematical model of the aerodynamic system and vector control technique which is used to obtain decoupled control of powers are investigated using the software Mathlab/Simulink.

Keywords: wind turbine, Doubly Fed Induction Generator, wind speed controller, power system stability

Procedia PDF Downloads 347

Authors: Animesh Gupta

Abstract:

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

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

Procedia PDF Downloads 47

Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

Abstract:

Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

Procedia PDF Downloads 166

Authors: Ashwani Kumar

Abstract:

Use of NIR light for imaging the biological tissue and to quantify its optical properties is a good choice over other invasive methods. Optical tomography involves two steps. One is the forward problem and the other is the reconstruction problem. The forward problem consists of finding the measurements of transmitted light through the tissue from source to detector, given the spatial distribution of absorption and scattering properties. The second step is the reconstruction problem. In X-ray tomography, there is standard method for reconstruction called filtered back projection method or the algebraic reconstruction methods. But this method cannot be applied as such, in optical tomography due to highly scattering nature of biological tissue. A hybrid algorithm for reconstruction has been implemented in this work which takes into account the highly scattered path taken by photons while back projecting the forward data obtained during Monte Carlo simulation. The reconstructed image suffers from blurring due to point spread function.

Keywords: NIR light, tissue, blurring, Monte Carlo simulation

Procedia PDF Downloads 460

Authors: Alain Kusmoko, Druce Dunne, Huijun Li

Abstract:

Stellite 6 was deposited by laser cladding on a chromium bearing substrate (P91) with energy inputs of 1 kW (P91-1) and 1.8 kW (P91-1.8). The chemical compositions and microstructures of these coatings were characterized by atomic absorption spectroscopy, optical microscopy and scanning electron microscopy. The microhardness of the coatings was measured and the wear mechanism of the coatings was assessed using a pin-on-plate (reciprocating) wear testing machine. The results showed less cracking and pore development for Stellite 6 coatings applied to the P91 steel substrate with the lower heat input (P91-1). Further, the Stellite coating for P91-1 was significantly harder than that obtained for P91-1.8. The wear test results indicated that the weight loss for P91-1 was much lower than for P91-1.8. It is concluded that the lower hardness of the coating for P91-1.8, together with the softer underlying substrate structure, markedly reduced the wear resistance of the Stellite 6 coating.

Keywords: friction and wear, laser cladding, P91 steel, Stellite 6 coating

Procedia PDF Downloads 399