Search results for: orthopedic procedure

Authors: Md. Moinul Islam, N. M. Golam Zakaria

Abstract:

Seakeeping analysis of catamaran vessels in the earlier stages of design has become an important issue as it dictates the seakeeping characteristics, and it ensures safe navigation during the voyage. In the present paper, a 3D numerical method for the seakeeping prediction of catamaran vessel is presented using the 3D Green Function method. Both steady and unsteady potential flow problem is dealt with here. Using 3D linearized potential theory, the dynamic wave loads and the subsequent response of the vessel is computed. For validation of the numerical procedure catamaran vessel composed of twin, Wigley form demi-hull is used. The results of the present calculation are compared with the available experimental data and also with other calculations. The numerical procedure is also carried out for NPL-based round bilge catamaran, and hydrodynamic coefficients along with heave and pitch motion responses are presented for various Froude number. The results obtained by the present numerical method are found to be in fairly good agreement with the available data. This can be used as a design tool for predicting the seakeeping behavior of catamaran ships in waves.

Keywords: catamaran, hydrodynamic coefficients , motion response, 3D green function

Procedia PDF Downloads 185

Authors: Alena Skalon, Jennifer L. Beaudry

Abstract:

Eyewitness misidentifications can sometimes lead to wrongful convictions of innocent people. This occurs in part because jurors tend to believe confident eyewitnesses even when the identification took place under suggestive conditions. Empirical research demonstrated that jurors are often unaware of the factors that can influence the reliability of eyewitness identification. Most common legal safeguards that are designed to educate jurors about eyewitness evidence are judicial instructions and expert testimony. To date, very few studies assessed the effectiveness of judicial instructions and most of them found that judicial instructions make jurors more skeptical of eyewitness evidence or do not have any effect on jurors’ judgments. Similar results were obtained for expert testimony. However, none of the previous studies focused on the ability of legal safeguards to improve jurors’ assessment of evidence obtained from suggestive identification procedures—this is one of the gaps addressed by this paper. Furthermore, only three studies investigated whether legal safeguards improve the ultimate accuracy of jurors’ judgments—that is, whether after listening to judicial instructions or expert testimony jurors can differentiate between accurate and inaccurate eyewitnesses. This presentation includes two studies. Both studies used genuine eyewitnesses (i.e., eyewitnesses who watched the crime) and manipulated the suggestiveness of identification procedures. The first study manipulated the presence of judicial instructions; the second study manipulated the presence of one of two types of expert testimony: a traditional, verbal expert testimony or expert testimony accompanied by visual aids. All participant watched a video-recording of an identification procedure and of an eyewitness testimony. The results indicated that neither judicial instructions nor expert testimony affected jurors’ judgments. However, consistent with the previous findings, when the identification procedure was non-suggestive, jurors believed accurate eyewitnesses more often than inaccurate eyewitnesses. When the procedure was suggestive, jurors believed accurate and inaccurate eyewitnesses at the same rate. The paper will discuss the implications of these studies and directions for future research.

Keywords: expert testimony, eyewitness evidence, judicial instructions, jurors’ decision making, legal safeguards

Procedia PDF Downloads 148

Authors: A. Shashank Tiwari, S. P. Mahapatra

Abstract:

Scale-up is defined as the process of increasing batch size. Scale-up of a process viewed as a procedure for applying the same process to different output volumes. There is a subtle difference between these two definitions: batch size enlargement does not always translate into a size increase of the processing volume. In mixing applications, scale-up is indeed concerned with increasing the linear dimensions from the laboratory to the plant size. On the other hand, processes exist (e.g., tableting) where the term ‘scale-up’ simply means enlarging the output by increasing the speed. To complete the picture, one should point out special procedures where an increase of the scale is counterproductive and ‘scale-down’ is required to improve the quality of the product. In moving from Research and Development (R&D) to production scale, it is sometimes essential to have an intermediate batch scale. This is achieved at the so-called pilot scale, which is defined as the manufacturing of drug product by a procedure fully representative of and simulating that used for full manufacturing scale. This scale also makes it possible to produce enough products for clinical testing and to manufacture samples for marketing. However, inserting an intermediate step between R&D and production scales does not, in itself, guarantee a smooth transition. A well-defined process may generate a perfect product both in the laboratory and the pilot plant and then fail quality assurance tests in production.

Keywords: scale up, research, size, batch

Procedia PDF Downloads 376

Authors: Bachir Chemani, Rachid Halfaoui

Abstract:

The aim of study was to evaluate pressure distribution characteristics of the elastic textile bandages using two instrumental techniques: a prototype Instrument and a load Transference. The prototype instrument which simulates shape of real leg has pressure sensors which measure bandage pressure. Using this instrument, the results show that elastic textile bandages presents different pressure distribution characteristics and none produces a uniform distribution around lower limb. The load transference test procedure is used to determine whether a relationship exists between elastic textile bandage structure and pressure distribution characteristics. The test procedure assesses degree of load, directly transferred through a textile when loads series are applied to bandaging surface. A range of weave fabrics was produced using needle weaving machine and a sewing technique. A textile bandage was developed with optimal characteristics far superior pressure distribution than other bandages. From results, we find that theoretical pressure is not consistent exactly with practical pressure. It is important in this study to make a practical application for specialized nurses in order to verify the results and draw useful conclusions for predicting the use of this type of elastic band.

Keywords: textile, cotton, pressure, venous ulcers, elastic

Procedia PDF Downloads 336

Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

Abstract:

In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

Procedia PDF Downloads 117

Authors: Melissa Mattos, Camila Lima, Ibraim Castro, Augusto Carioca, Saulo Magalhães, Paula Freitas, Keciany Oliveira

Abstract:

Obesity is a chronic, multifactorial, relapsing disease that has increased dramatically over the years. Its control is considered a public health issue, and more and more treatments and interventions are being studied to reduce its prevalence. When interventions in lifestyle and the use of drugs do not generate lasting results, bariatric procedures emerge as a resource for obesity control. The main guidelines for the treatment of obesity emphasize the need for pre-procedure and post-procedure nutritional monitoring to avoid nutritional deficiencies that may occur. The individual who undergoes bariatric surgery needs to understand the changes that will be necessary for life in view of the intense anatomical and metabolic changes that result from surgical techniques. To assess the nutritional profile of patients who undergo bariatric surgery, we analyzed data from the medical records of all people who underwent sleeve-type bariatric surgery from January to June 2022 at a clinic in the City of Fortaleza. 38 patients were analyzed, 32 women and 6 men in the pre-surgical period, 6 and 12 months after surgery. The data showed an average weight loss of 24.45% at 6 months and 30.85% at 12 months, with a reduction of 21.32% and 30.41%, respectively, in the fat percentage, also indicating that 13.15% used drugs for weight loss during this period, leading to reflection on the isolated long-term efficacy of bariatric surgery, requiring multidisciplinary follow-up for a change in lifestyle. Only 12 individuals, corresponding to 31.57%, reached eutrophic BMI 12 months after surgery, 20 individuals remained overweight, corresponding to 52.63% of the sample, and 6 individuals (15.78%) remained in the BMI obese class I. As for body composition, there was a 52.39% reduction in fat mass and a 12.82% reduction in muscle mass, and 21% of individuals underwent cholecystectomy. Sleeve-type bariatric surgery promoted significant weight loss after 1 year of the procedure, with a reduction in body fat percentage and fat mass. Most patients were still overweight and had a significant reduction in muscle mass.

Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve

Procedia PDF Downloads 36

Authors: Amal A. Qedrah, Sofia A. Malik, Madiha Akbar

Abstract:

The aim of this article is to share a rare clinical case of pregnancy and surgical delivery in a patient who has undergone augmentation cystoplasty with mitrofanoff channel in the past. Methods: This case report is about a woman who conceived naturally at the age of 27, previously underwent augmentation cystoplasty at the age of 10 years with mitrofanoff procedure using self-clean intermittent catheterization. Furthermore, this pregnancy was complicated by the presence of preeclampsia diagnosed at term and PROM. Following the failure of induction for intrapartum preeclampsia, the patient delivered a healthy baby via low transverse cesarean section at 38 weeks done at Latifa Hospital, Dubai. Conclusion: The procedure is done at a pediatric or young age, after which most patients reach reproductive age. There is no contraindication to pregnancy vaginally or surgically; however, this case was complicated by preeclampsia, due to which this patient was taken for a cesarean section. It is advisable to consult a urologist frequently along with taking regular bacteriological urine samples and blood samples with renal ultrasonography for the evaluation of the kidney. Antibacterial treatment or prophylaxis should be used during pregnancy if necessary and intermittent self-catherization is mostly performed routinely. It is also important to have a urologist on standby during the surgery in order to avoid and/or fix any complications that might come forth.

Keywords: augmentation cystoplasty, cesarean section, delivery, mitrofanoff channel

Procedia PDF Downloads 120

Authors: Sie Long Kek, Wah June Leong, Kok Lay Teo

Abstract:

Linear quadratic Gaussian model is a standard mathematical model for the stochastic optimal control problem. The combination of the linear quadratic estimation and the linear quadratic regulator allows the state estimation and the optimal control policy to be designed separately. This is known as the separation principle. In this paper, an efficient computational method is proposed to solve the linear quadratic Gaussian problem. In our approach, the Hamiltonian function is defined, and the necessary conditions are derived. In addition to this, the output error is defined and the least-square optimization problem is introduced. By determining the first-order necessary condition, the gradient of the sum squares of output error is established. On this point of view, the stochastic approximation approach is employed such that the optimal control policy is updated. Within a given tolerance, the iteration procedure would be stopped and the optimal solution of the linear-quadratic Gaussian problem is obtained. For illustration, an example of the linear-quadratic Gaussian problem is studied. The result shows the efficiency of the approach proposed. In conclusion, the applicability of the approach proposed for solving the linear quadratic Gaussian problem is highly demonstrated.

Keywords: iteration procedure, least squares solution, linear quadratic Gaussian, output error, stochastic approximation

Procedia PDF Downloads 138

Authors: Mehran Naghizaderokni, Asscar Janalizadechobbasty

Abstract:

There are more probabilistic and deterministic liquefaction evaluation procedures in order to judge whether liquefaction will occur or not. A review of this approach reveals that there is a need for a comprehensive procedure that accounts for different sources of uncertainty in liquefaction evaluation. In fact, for the same set of input parameters, different methods provide different factors of safety and/or probabilities of liquefaction. To account for the different uncertainties, including both the model and measurement uncertainties, reliability analysis is necessary. This paper has obtained information from Standard Penetration Test (SPT) and some empirical approaches such as: Seed et al, Highway bridge of Japan approach to soil liquefaction, The Overseas Coastal Area Development Institute of Japan (OCDI) and reliability method to studying potential of liquefaction in soil of Babol city in the north of Iran are compared. Evaluation potential of liquefaction in soil of Babol city is an important issue since the soil of some area contains sand, seismic area, increasing level of underground waters and consequently saturation of soil; therefore, one of the most important goals of this paper is to gain suitable recognition of liquefaction potential and find the most appropriate procedure of evaluation liquefaction potential to decrease related damages.

Keywords: reliability analysis, liquefaction, Babol, civil, construction and geological engineering

Procedia PDF Downloads 478

Authors: Josef Fládr, Jiří Němeček, Veronika Koudelková, Petr Bílý

Abstract:

Mechanical parameters of cementitious composites differ quite significantly based on the composition of cement matrix. They are also influenced by mixing times and procedure. The research presented in this paper was aimed at identification of differences in microstructure of normal strength (NSC) and differently mixed high strength (HSC) cementitious composites. Scanning electron microscopy (SEM) investigation together with energy dispersive X-ray spectroscopy (EDX) phase analysis of NSC and HSC samples was conducted. Evaluation of interfacial transition zone (ITZ) between the aggregate and cement matrix was performed. Volume share, thickness, porosity and composition of ITZ were studied. In case of HSC, samples obtained by several different mixing procedures were compared in order to find the most suitable procedure. In case of NSC, ITZ was identified around 40-50% of aggregate grains and its thickness typically ranged between 10 and 40 µm. Higher porosity and lower share of clinker was observed in this area as a result of increased water-to-cement ratio (w/c) and the lack of fine particles improving the grading curve of the aggregate. Typical ITZ with lower content of Ca was observed only in one HSC sample, where it was developed around less than 15% of aggregate grains. The typical thickness of ITZ in this sample was similar to ITZ in NSC (between 5 and 40 µm). In the remaining four HSC samples, no ITZ was observed. In general, the share of ITZ in HSC samples was found to be significantly smaller than in NSC samples. As ITZ is the weakest part of the material, this result explains to large extent the improved mechanical properties of HSC compared to NSC. Based on the comparison of characteristics of ITZ in HSC samples prepared by different mixing procedures, the most suitable mixing procedure from the point of view of properties of ITZ was identified.

Keywords: electron diffraction spectroscopy, high strength concrete, interfacial transition zone, normal strength concrete, scanning electron microscopy

Procedia PDF Downloads 266

Authors: Chengzhu Liao, Jianbo Zhang, Haiou Wang, Jing Ming, Huili Li, Yanyan Li, Hua Cheng, Sie Chin Tjong

Abstract:

Since Bonfield’s group’s pioneer work, there has been growing interest amongst the materials scientists, biomedical engineers and surgeons in the use of novel biomaterials for the treatment of bone defects and injuries. This study focuses on the fabrication, mechanical characterization and biocompatibility evaluation of high density polyethylene (HDPE) reinforced with hydroxyapatite nanorods (HANR) and carbon nanofibers (CNF). HANRs of 20 wt% and CNFs of 0.5-2 wt% were incorporated into HDPE to form biocomposites using traditional melt-compounding and injection molding techniques. The mechanical measurements show that CNF additions greatly improve the tensile strength and Young’s modulus of HDPE and HDPE-20% nHA composites. Meanwhile, the nHA and CNF fillers were found to be effective to improve dimensional and thermal stability of HDPE. The results of osteoblast cell cultivation and dimethyl thiazolyl diphenyl thiazolyl tetrazolium (MTT) tests showed that the HDPE/ CNF-nHA nanocomposites are biocompatible. Such HDPE/ CNF-nHA hybrids are found to be potential biomaterials for making orthopedic joint/bone replacements.

Keywords: biocompatibility, biocomposite, carbon nanofiber, high density polyethylene, hydroxyapatite

Procedia PDF Downloads 269

Authors: E. Akpinar, A. Erol, M.F. Cakir

Abstract:

Precast reinforced concrete (RC) structures are excellent alternatives for construction world all over the globe, thanks to their rapid erection phase, ease mounting process, better quality and reasonable prices. Such structures are rather popular for industrial buildings. For the sake of economic importance of such industrial buildings as well as significance of safety, like every other type of structures, performance assessment and structural risk analysis are important. Fragility curves are powerful tools for damage projection and assessment for any sort of building as well as precast structures. In this study, a comparative review of current knowledge on fragility analysis of industrial precast RC structures were presented and findings in previous studies were compiled. Effects of different structural variables, parameters and building geometries as well as soil conditions on fragility analysis of precast structures are reviewed. It was aimed to briefly present the information in the literature about the procedure of damage probability prediction including fragility curves for such industrial facilities. It is found that determination of the aforementioned structural parameters as well as selecting analysis procedure are critically important for damage prediction of industrial precast RC structures using fragility curves.

Keywords: damage prediction, fragility curve, industrial buildings, precast reinforced concrete structures

Procedia PDF Downloads 150

Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

Abstract:

Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

Procedia PDF Downloads 412

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

Procedia PDF Downloads 77

Authors: Merrimi El Bekkaye, El Bikri Khalid, Benamar Rhali

Abstract:

In the present paper, the problem of geometrically non-linear free vibration of symmetrically and asymmetrically laminated composite beams (LCB) resting on nonlinear Pasternak elastic Foundation with immovable ends is studied. A homogenization procedure has been performed to reduce the problem under consideration to that of the isotropic homogeneous beams with effective bending stiffness and axial stiffness parameters. This simple formulation is developed using the governing axial equation of the beam in which the axial inertia and damping are ignored. The theoretical model is based on Hamilton’s principle and spectral analysis. Iterative form solutions are presented to calculate the fundamental nonlinear frequency parameters which are found to be in a good agreement with the published results. On the other hand, the influence of the foundation parameters on the nonlinear frequency to the linear frequency ratio of the LCB has been studied. The non-dimensional curvatures associated to the fundamental mode are also given in the case of clamped-clamped symmetrically and asymmetrically laminated composite beams.

Keywords: large vibration amplitudes, laminated composite beam, Pasternak foundation, composite beams

Procedia PDF Downloads 502

Authors: Krzysztof Buczak, Sonia Lachowska, Pawel Kucharski, Agnieszka Antonczyk

Abstract:

Tiletamine - zolazepam combination is increasingly used in veterinary anaesthesiology in wild animals, including snakes. The available literature shows a lack of information about anesthesia in this mixture in ovoviviparous snakes. The studies show the possibility of using the combination at a dose of 20 mg/kg or more for snake immobilization. This paper presents an anesthetic protocol with the use of a combination of tiletamine - zolazepam at the dose of 10 mg/kg intramuscularly and maintenance with inhalant anesthesia with isoflurane in pure oxygen. The objective of this study was to evaluate the usefulness of the anesthetic protocol to proceed with coeliotomy in Amazon Tree Boa. The patient was a five years old bicolor female Amazon Tree Boa (Corallus hortulanus) with dystocia. The clinical examination reveals significant emaciation (bodyweight 520g), high degree of dehydration, heart rate (HR = 60 / min), pale mucous membranes and poor reactivity. Meloxicam (1 mg/kg) and tramadol (10 mg/kg) were administered subcutaneously and the patient was placed in an incubator with access to fresh oxygen. Four hours later, the combination of tiletamine - zolazepam (10 mg/kg) was administered intramuscularly for induction of anesthesia. The snake was intubated and connected to inhalant anesthesia equipment. For maintenance, the anesthesia isoflurane in pure oxygen was used due to apnea, which occurs 30 minutes after the induction semi-closed system was attached and the ventilator was turned on (PCV system, four breaths per minute, 8 cm of H2O). Cardiopulmonary parameters (HR, RR, SPO2, ETCO2, ETISO) were assessed throughout the procedure. During the entire procedure, the operating room was heated to a temperature of 26 degrees Celsius. Additionally, the hose was placed on a heating mat, which maintained a temperature of 30 degrees Celsius. For 15 minutes after induction, the loss of muscle tone was observed from the head to the tail. Induction of general anesthesia was scored as good because of the possibility of intubation. During the whole procedure, the heart rate was at the rate of 58 beats per minute (bpm). Ventilation parameters were stable throughout the procedure. The recovery period lasts for about 4 hours after the end of general anesthesia. The muscle tension returned from tail to head. The snake started to breathe spontaneously within 1,5 hours after the end of general anesthesia. The protocol of general anesthesia with the combination of tiletamine- zolazepam with a dose of 10 mg/kg is useful for proceeding with the emergency coeliotomy in maintenance with isoflurane in oxygen. Further study about the impact of the combination of tiletamine- zolazepam for the recovery period is needed.

Keywords: anesthesia, corallus hortulanus, ovoviparous, snake, tiletamine, zolazepam

Procedia PDF Downloads 209

Authors: P.J. Jiji, B.V. Murlimanju, Latha V. Prabhu, Mangala M. Pai

Abstract:

Background: The lunate bone dislocation can lead to the compression of the median nerve and subsequent carpal tunnel syndrome. The dislocation can interrupt the vasculature and would cause avascular necrosis. The objective of the present study was to study the morphology and number of the nutrient foramina in the cadaveric dried lunate bones of the Indian population. Methods: The present study included 28 lunate bones (13 right sided and 15 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the lunate bones. The foramen ranged between 2 and 10. The foramina were more in number over the dorsal surface (average number 3.3) in comparison to the palmar surface (average number 2.4). Conclusion: We believe that the present study has provided important data about the nutrient foramina of the lunate bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the lunatomalacia and Kienbock’s disease.

Keywords: avascular necrosis, foramen, lunate, nutrient

Procedia PDF Downloads 221

Authors: Joseph Mouallem, Seyed Reza Amini Niaki, Norman Chavez-Cussy, Christian Costa Milioli, Fernando Eduardo Milioli

Abstract:

Sub-grid closures for filtered two-fluid models (fTFM) useful in large scale simulations (LSS) of riser flows can be derived from highly resolved simulations (HRS) with microscopic two-fluid modeling (mTFM). Accurate sub-grid closures require accurate mTFM formulations as well as accurate correlation of relevant filtered parameters to suitable independent variables. This article deals with both of those issues. The accuracy of mTFM is touched by assessing the impact of gas sub-grid turbulence over HRS filtered predictions. A gas turbulence alike effect is artificially inserted by means of a stochastic forcing procedure implemented in the physical space over the momentum conservation equation of the gas phase. The correlation issue is touched by introducing a three-filtered variable correlation analysis (three-marker analysis) performed under a variety of different macro-scale conditions typical or risers. While the more elaborated correlation procedure clearly improved accuracy, accounting for gas sub-grid turbulence had no significant impact over predictions.

Keywords: fluidization, gas-particle flow, two-fluid model, sub-grid models, filtered closures

Procedia PDF Downloads 96

Authors: M. S. Agha, A. M. Eshahiry, S. A. Aldabbar, Z. M. Alshahri

Abstract:

The propagation of microwave is affected by rain and dust particles by way of signal attenuation and de-polarization. Computations of these effects require knowledge of the propagation characteristics of microwave and millimeter wave energy in the climate conditions of the studied region. This paper presents the effect of wind and humidity on wireless communication such as microwave links in the west north region of Libya (Al-Khoms), experimental procedure to study the effects mentioned above. The experimental procedure is done on three selected antennae towers (Nagaza stations, Al-Khoms center stations, Al-Khoms gateway stations) to determining of the attenuation loss per unit length and cross-polarization discrimination (XPD) change which coverage in the studied region, it is required to collect the dust particles carried out by the wind, measure the particles size distribution (PSD), calculate the concentration, and carry chemical analysis of the contents, then the dielectric constant can be calculated. The result showed that effect of the humidity and dust, the antenna height, the visibility, on the complex permittivity effects both attenuation and phase shift, there is some consideration that has to be taken into account in the communication power budget.

Keywords: attenuation, de-polarization, scattering, transmission loss

Procedia PDF Downloads 125

Authors: Marcin Jakiel, Maria Kurek, Karolina Gutkowska, Sylwia Sanakiewicz, Dominika Stolarczyk, Jakub Batko, Rafał Jakiel, Mateusz K. Hołda

Abstract:

Proper imaging of the interventricular septum during endocavital lead implantation is essential for successful procedure. The interventricular septum is located oblique to the 3 main body planes and forms angles of 44.56° ± 7.81°, 45.44° ± 7.81°, 62.49° (IQR 58.84° - 68.39°) with the sagittal, frontal and transverse planes, respectively. The optimal left anterior oblique (LAO) projection is to have the septum aligned along the radiation beam and will be obtained for an angle of 53.24° ± 9,08°, while the best visualization of the septal surface in the right anterior oblique (RAO) projection is obtained by using an angle of 45.44° ± 7.81°. In addition, the RAO angle (p=0.003) and the septal slope to the transverse plane (p=0.002) are larger in the male group, but the LAO angle (p=0.003) and the dihedral angle that the septum forms with the sagittal plane (p=0.003) are smaller, compared to the female group. Analyzing the optimal RAO angle in cross-sections lying at the level of the connections of the septum with the free wall of the right ventricle from the front and back, we obtain slightly smaller angle values, i.e. 41.11° ± 8.51° and 43.94° ± 7.22°, respectively. As the septum is directed leftward in the apical region, the optimal RAO angle for this area decreases (16.49° ± 7,07°) and does not show significant differences between the male and female groups (p=0.23). Within the right ventricular apex, there is a cavity formed by the apical segment of the interventricular septum and the free wall of the right ventricle with a depth of 12.35mm (IQR 11.07mm - 13.51mm). The length of the septum measured in longitudinal section, containing 4 heart cavities, is 73.03mm ± 8.06mm. With the left ventricular septal wall formed by the interventricular septum in the apical region at a length of 10.06mm (IQR 8.86 - 11.07mm) already lies outside the right ventricle. Both mentioned lengths are significantly larger in the male group (p<0.001). For proper imaging of the septum from the right ventricular side, an oblique position of the visualization devices is necessary. Correct determination of the RAO and LAO angle during the procedure allows to improve the procedure performed, and possible modification of the visual field when moving in the anterior, posterior and apical directions of the septum will avoid complications. Overlooking the change in the direction of the interventricular septum in the apical region and a significant decrease in the RAO angle can result in implantation of the lead into the free wall of the right ventricle with less effective pacing and even complications such as wall perforation and cardiac tamponade. The demonstrated gender differences can also be helpful in setting the right projections. A necessary addition to the analysis will be a description of the area of the ventricular septum, which we are currently working on using autopsy material.

Keywords: anatomical variability, angle, electrocardiological procedure, intervetricular septum

Procedia PDF Downloads 73

Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed

Abstract:

The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.

Keywords: clinical outcomes, diet, exercises, teaching module

Procedia PDF Downloads 324

Authors: Madeleine Cox

Abstract:

Objective; analyse patient choices in management of first trimester miscarriage, rates of complications including repeat procedure. Design: all first trimester miscarriages from a tertiary institution on the Gold Coast in a 6 month time frame (July to December 2021) were reviewed, including choice of management, histopathology, any representations or admissions, and potential complications. Results: a total of 224 first trimester miscarriages were identified. Of these, 183 (81%) opted to have surgical management in the first instance. Of the remaining patients, 18 (8%) opted to have medical management, and 28 (12.5%) opted to have expectant management. In total, 33(15%) patients required a repeat treatment for retained products. 1 had medical management for a small volume PROC post suction curette. A significant number of these patients initially opted for medical management but then elected to have shorter follow up than usual and went on to have retained products noted. 5 women who had small volumes of RPOC post medical or surgical management had repeat suction curette, however, had very small volumes of products on scan and on curette and may have had a good result with repeated misoprostol administration. It is important to note that whilst a common procedure, suction curettes are not without risk. 2 women had significant blood loss of 1L and 1.5L. A third women had a uterine perforation, a rare but recognised complication, she went on to require a laparoscopy which identified a small serosal bowel injury which was closed by the colorectal team. Conclusion: Management of first trimester miscarriage should be guided by patient preference. It is important to be able to provide patients with their choice of management, however, it is also important to have a good understanding of the risks of each management choice, chances of repeated procedure, appropriate time frame for follow up. Women who choose to undertake medical or expectant management should be supported through this time, with appropriate time frame between taking misoprostol and repeat scan so that the true effects can be evaluated. Patients returning for scans within 2-3 days are more likely to be booked for further surgery, however, may reflect patients who did not have adequate counselling or simply changed their mind on their preferred management options.

Keywords: miscarriage, gynaecology, obstetrics, first trimester

Procedia PDF Downloads 78

Authors: Eugene Ivanov, Eduardo del-Rio, Igor Kapchenko, Maija Nystrӧm, Juha Kotila

Abstract:

Series of low modulus beta Ti alloy billets and powders can be produced in commercial quantities using a combination of electron beam melting (EBM) and EIGA atomization processes. In the present study, TNZT alloy powder was produced and processed in the EOSINT M290 laser sintering system to produce parts for mechanical testing. Post heat treatments such as diffusion annealing to reduce internal stresses or hot isostatic pressing to remove closed pores were not applied. The density can visually be estimated to be > 99,9 %. According to EDS study Nb, Zr, and Ta are distributed homogeneously throughout the printed sample. There are no indications for any segregation or chemical inhomogeneity, i.e. variation of the element distribution. These points to the fact that under the applied experimental conditions the melt generated by the laser rapidly cools down in the SLM (Selective Laser Melting) process. The selective laser sintering yielded dense structures with relatively good surface quality. The mechanical properties, especially the elongation (24%) along with tensile strength ( > 500MPa) and modulus of elasticity (~60GPa), were found to be promising compared to titanium alloys in general.

Keywords: beta titanium alloys, additive manufacturing, powder, implants

Procedia PDF Downloads 204

Authors: V. Durmus, M. Uydaci

Abstract:

In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

Procedia PDF Downloads 284

Authors: B. Soni, S. Biswas

Abstract:

Metal foams of Al find diverse applications in several industrial sectors such as in automotive and sports equipment industry as impact, acoustic and vibration absorbers, the aerospace industry as structural components in turbines and spatial cones, in the naval industry as low frequency vibration absorbers, and in construction industry as sound barriers inside tunnels, as fire proof materials and structure protection systems against explosions and even in heat exchangers, orthopedic components, and decorative items. Here, we report on the development of Al foams by a low cost and convenient technique of salt replication method with efficient control over size, geometry and distribution of the pores. Sodium bicarbonate was used as the foaming agent to form the porous refractory salt pattern. The mixed refractory salt slurry was microwave dried followed by sintering for selected time periods. Molten Al was infiltrated into the salt pattern in an inert atmosphere at a pressure of 2 bars. The final products were obtained by leaching out the refractory salt pattern. Mechanical properties of the derived samples were studied with a universal testing machine. The results were analyzed in correlation with their microstructural features evaluated with a scanning electron microscope (SEM).

Keywords: metal foam, Al, salt replication method, mechanical properties, SEM

Procedia PDF Downloads 333

Authors: Fariba Tadayon, Elmira Hassanlou, Hasan Bagheri, Mostafa Jafarian

Abstract:

Heavy metals are released into water, plants, soil, and food by natural and human activities. Lead has toxic roles in the human body and may cause serious problems even in low concentrations, since it may have several adverse effects on human. Therefore, determination of lead in different samples is an important procedure in the studies of environmental pollution. In this work, an ultrasonic assisted-ionic liquid based-liquid-liquid microextraction (UA-IL-DLLME) procedure for the determination of lead in zucchini, pomegranate, and lettuce has been established and developed by using flame atomic absorption spectrometer (FAAS). For UA-IL-DLLME procedure, 10 mL of the sample solution containing Pb2+ was adjusted to pH=5 in a glass test tube with a conical bottom; then, 120 μL of 1-Hexyl-3-methylimidazolium hexafluoro phosphate (CMIM)(PF6) was rapidly injected into the sample solution with a microsyringe. After that, the resulting cloudy mixture was treated by ultrasonic for 5 min, then the separation of two phases was obtained by centrifugation for 5 min at 3000 rpm and IL-phase diluted with 1 cc ethanol, and the analytes were determined by FAAS. The effect of different experimental parameters in the extraction step including: ionic liquid volume, sonication time and pH was studied and optimized simultaneously by using Response Surface Methodology (RSM) employing a central composite design (CCD). The optimal conditions were determined to be an ionic liquid volume of 120 μL, sonication time of 5 min, and pH=5. The linear ranges of the calibration curve for the determination by FAAS of lead were 0.1-4 ppm with R2=0.992. Under optimized conditions, the limit of detection (LOD) for lead was 0.062 μg.mL-1, the enrichment factor (EF) was 93, and the relative standard deviation (RSD) for lead was calculated as 2.29%. The levels of lead for pomegranate, zucchini, and lettuce were calculated as 2.88 μg.g-1, 1.54 μg.g-1, 2.18 μg.g-1, respectively. Therefore, this method has been successfully applied for the analysis of the content of lead in different food samples by FAAS.

Keywords: Dispersive liquid-liquid microextraction, Central composite design, Food samples, Flame atomic absorption spectrometry.

Procedia PDF Downloads 252

Authors: Anasuya Ghosh, Subhramoy Chaudhury

Abstract:

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

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

Procedia PDF Downloads 302

Authors: Paulo H. R. G. Reis, Joana P. Maia, Davi Neiva Alves, Mariana R. C. Aquino, Igor B. Guimaraes, Anderson Horta, Thiago Santiago, Mariana Volpini

Abstract:

Additive manufacturing is a manufacturing technique used in many fields as a tool for the production of complex parts accurately. This technique has a wide possibility of applications in bioengineering, mainly in the manufacture of orthopedic devices, thanks to the versatility of shapes and surface details. The present article aims to evaluate the mechanical viability of a wrist-hand orthosis made using additive manufacturing techniques with Nylon 12 polyamide and compare this device with the wrist-hand orthosis manufactured by the traditional process with thermoplastic Ezeform. The methodology used is based on the application of computational simulations of voltage and temperature, from finite element analysis, in order to evaluate the properties of displacement, mechanical stresses and thermal comfort in the two devices. The execution of this work was carried out through a case study with a 29-year-old male patient. The modeling software involved was Meshmixer from US manufacturer Autodesk and Fusion 360 from the same manufacturer. The results demonstrated that the orthosis developed by 3D printing, from Nylon 12, presents better thermal comfort and response to the mechanical stresses exerted on the orthosis.

Keywords: additive manufacturing, finite elements, hand orthosis, thermal comfort, neurorehabilitation

Procedia PDF Downloads 160

Authors: Roxana Maria Angelescu, Doina Răducanu, Mariana Lucia Angelescu, Ion Cincă, Vasile Dănuţ Cojocaru, Cosmin Cotruț, Şerban Nicolae

Abstract:

Titanium alloys are often used for biomedical applications as hard tissue replacements, such as: orthopedic implants, spinal fixation devices and dental implants. Their advantages are well known and demonstrated: excellent mechanical properties, biocompatibility and good corrosion resistance, but it is also known that the main disadvantage of the metallic materials is their tendency of corrosion in in-vivo environments. In 1987, titanium was found to be the only metallic biomaterial that osseointegrates. The aim of this study was to investigate the microstructure and the corrosion behavior of the Ti-20Nb-5Ta wt% alloy. In this case Nb stabilizes the β-Ti structure and Ta is a highly passivating metal. The as studied alloy was melt under argon protective atmosphere in a levitation induction melting furnace, type FIVE CELES - MP25, with a nominal power of 25 kW and a melting capacity of 30 cm3. The microstructure of the as studied alloy was analyzed by using the electronic microscope Tescan Vega II-XMU. The phase structure of the as studied alloy was determined, as well as the crystalline grain size (100-200µ). To determine the corrosion behavior of the as studied alloy, the technique used was the linear polarization, with the PARSTAT 4000 potentiostat, produced by Princeton Applied Research; potentiodynamic curves were obtained with the VeraStudio v.2.4.2 software.

Keywords: corrosion resistance, microstructure, titanium alloys

Procedia PDF Downloads 508

Authors: Victoria Siriaki Jorry, I. S. Mbalawata, Hayong Shin

Abstract:

The main objective in a change detection problem is to develop algorithms for efficient detection of gradual and/or abrupt changes in the parameter distribution of a process or time series data. In this paper, we present a modified cumulative (MCUSUM) algorithm to detect the start and end of a time-varying linear drift in mean value of a time series data based on likelihood ratio test procedure. The design, implementation and performance of the proposed algorithm for a linear drift detection is evaluated and compared to the existing CUSUM algorithm using different performance measures. An approach to accurately approximate the threshold of the MCUSUM is also provided. Performance of the MCUSUM for gradual change-point detection is compared to that of standard cumulative sum (CUSUM) control chart designed for abrupt shift detection using Monte Carlo Simulations. In terms of the expected time for detection, the MCUSUM procedure is found to have a better performance than a standard CUSUM chart for detection of the gradual change in mean. The algorithm is then applied and tested to a randomly generated time series data with a gradual linear trend in mean to demonstrate its usefulness.

Keywords: average run length, CUSUM control chart, gradual change detection, likelihood ratio test

Procedia PDF Downloads 262