Search results for: pressure injury
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4703

Search results for: pressure injury

4433 Instrumentation for Engine Start Cycle Characterization at Cold Weather High Altitude Condition

Authors: Amit Kumar Gupta, Rohit Vashistha, G. P. Ravishankar, Mahesh P. Padwale

Abstract:

A cold soaked gas turbine engine have known starting problems in high altitude and low temperature conditions. The high altitude results in lower ambient temperature, pressure, and density. Soaking at low temperature leads to higher oil viscosity, increasing the engine starter system torque requirement. Also, low temperature soaks results in a cold compressor rotor and casing. Since the thermal mass of rotor is higher than casing, casing expands faster, thereby, increasing the blade-casing tip clearance. The low pressure flow over the compressor blade coupled with the secondary flow through the compressor tip clearance during start result in stall inception. The present study discusses engine instrumentation required for capturing the stall inception event. The engine fan exit and combustion chamber were instrumented with dynamic pressure probes to capture the pressure characteristic and clamp-on current meter on primary igniter cable to capture ignition event during start cycle. The experiment was carried out at 10500 Ft. pressure altitude and -15°C ambient temperature. The high pressure compressor stall events were recorded during the starts.

Keywords: compressor inlet, dynamic pressure probe, engine start cycle, flight test instrumentation

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4432 Development of 3D Neck Muscle to Analyze the Effect of Active Muscle Contraction in Whiplash Injury

Authors: Nisha Nandlal Sharma, Julaluk Carmai, Saiprasit Koetniyom, Bernd Markert

Abstract:

Whiplash Injuries are mostly experienced in car accidents. Symptoms of whiplash are commonly reported in studies, neck pain and headaches are two most common symptoms observed. The whiplash Injury mechanism is poorly understood. In present study, hybrid neck muscle model were developed with a combination of solid tetrahedral elements and 1D beam elements. Solid tetrahedral elements represents passive part of the muscle whereas, 1D beam elements represents active part. To simulate the active behavior of the muscle, Hill-type muscle model was applied to beam elements. To simulate non-linear passive properties of muscle, solid elements were modeled with rubber/foam material model. Some important muscles were then inserted into THUMS (Total Human Model for Safety) THUMS was given a boundary conditions similar to experimental tests. The model was exposed to 4g and 7g rear impacts as these load impacts are close to low speed impacts causing whiplash. The effect of muscle activation level on occupant kinematics during whiplash was analyzed.

Keywords: finite element model, muscle activation, THUMS, whiplash injury mechanism

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4431 Cognitive Behaviour Hypnotherapy as an Effective Intervention for Nonsuicidal Self Injury Disorder

Authors: Halima Sadia Qureshi, Urooj Sadiq, Noshi Eram Zaman

Abstract:

The goal of this study was to see how cognitive behavior hypnotherapy affected nonsuicidal self-injury. DSM 5 invites the researchers to explore the newly added condition under the chapter of conditions under further study named Nonsuicidal self-injury disorder. To date, no empirical sound intervention has been proven effective for NSSI as given in DSM 5. Nonsuicidal self-injury is defined by DSM 5 as harming one's self physically, without suicidal intention. Around 7.6% of teenagers are expected to fulfill the NSSI disorder criteria. 3 Adolescents, particularly university students, account for around 87 percent of self-harm studies. Furthermore, one of the risks associated with NSSI is an increased chance of suicide attempts, and in most cases, the cycle repeats again. 6 The emotional and psychological components of the illness might lead to suicide, either intentionally or unintentionally. 7 According to a research done at a Pakistani military hospital, over 80% of participants had no intention of committing suicide. Furthermore, it has been determined that improvements in NSSI prevention and intervention are necessary as a stand-alone strategy. The quasi-experimental study took place in Islamabad and Rawalpindi, Pakistan, from May 2019 to April 2020 and included students aged 18 to 25 years old from several institutions and colleges in the twin cities. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, the individuals were assessed for >2 episodes without suicidal intent using the intentional self-harm questionnaire. The Clinician Administered Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess the individual for NSSI condition. Symptom checklist-90 (SCL-90) was used to screen the participants for differential diagnosis. Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to rule out the BPD cases. The selected participants, n=106 from the screening sample of 600, were selected. They were further screened to meet the inclusion and exclusion criteria, and the total of n=71 were split into two groups: intervention and control. The intervention group received cognitive behavior hypnotherapy for the next three months, whereas the control group received no treatment. After the period of three months, both the groups went through the post assessment, and after the three months’ period, follow-up assessment was conducted. The groups were evaluated, and SPSS 25 was used to analyse the data. The results showed that each of the two groups had 30 (50 percent) of the 60 participants. There were 41 males (68 percent) and 19 girls (32 percent) in all. The bulk of the participants were between the ages of 21 and 23. (48 percent). Self-harm events were reported by 48 (80 percent) of the pupils, and suicide ideation was found in 6 (ten percent). In terms of pre- and post-intervention values (d=4.90), post-intervention and follow-up assessment values (d=0.32), and pre-intervention and follow-up values (d=5.42), the study's effect size was good. The comparison of treatment and no-treatment groups revealed that treatment was more successful than no-treatment, F (1, 58) = 53.16, p.001. The results reveal that the treatment manual of CBH is effective for Nonsuicidal self-injury disorder.

Keywords: NSSI, nonsuicidal self injury disorder, self-harm, self-injury, Cognitive behaviour hypnotherapy, CBH

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4430 Response of Full-Scale Room Building Against Blast Loading

Authors: Eid Badshah, Amjad Naseer, Muhammad Ashraf

Abstract:

In this paper full-scale brick masonry room along with the veranda of a typical school building was subjected to eight successive blast tests with increasing charge weights ranging from 0.5kg to 16.02kg at 3.66m fixed stand-off distance. Pressure-time histories were obtained by data acquisition system from pressure sensors, installed on different points of room as well as veranda columns. The resulting damage pattern of different locations was observed during each test. Weak zones of masonry room were identified. Scaled distances for different damage levels in masonry room were experimentally obtained. The results provided a basis for determining the response of masonry room building against blast loading in a specific threat scenario.

Keywords: peak pressure, composition-B, TNT, pressure sensor, scaled distance, masonry

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4429 Effect of Endurance Exercise Training on Blood Pressure in Elderly Female Patients with Hypertension

Authors: Elham Ahmadi

Abstract:

This study is conducted with the aim of investigating the effect of moderate physical activity (60% of maximal heart rate-MHR) on blood pressure in an elderly female with hypertension. Hypertension is considered a modifiable risk factor for cardiovascular disease through physical activity. The purpose and significance of this study were to investigate the role of exercise as an alternative therapy since some patients exhibit sensitivity/intolerance to some drugs. Initially, 65 hypertensive females (average age = 49.7 years) (systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) and 25 hypertensive females as a control group (average age = 50.3 years and systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) were selected. The subjects were divided based on their age, duration of disease, physical activity, and drug consumption. Then, blood pressure and heart rate (HR) were measured in all of the patients using a sphygmomanometer (pre-test). The exercise sessions consisted of warm-up, aerobic activity, and cooling down (total duration of 20 minutes for the first session up to 55 minutes in the last session). At the end of the 12th session (mid-test) and final session (24th session), blood pressure was measured for the last time (post-test). The control group was without any exercise during the study. The results were analyzed using a t-test. Our results indicated that moderate physical activity was effective in lowering blood pressure by 6.4/5.6–mm Hg for SBP and 2.4/4.3mm Hg for DBP in hypertensive patients, irrespective of age, duration of disease, and drug consumption ( P<.005). The control group indicates no changes in BP. Physical activity programs with moderate intensity (approximately at 60% MHR), three days per week, can be used not only as a preventive measure for diastolic hypertension (DBP>90 mmHg high blood pressure) but also as an alternative to drug therapy in the treatment of hypertension, as well.

Keywords: endurance exercise, elderly female, hypertension, physical activity

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4428 Coping Strategies Used by Persons with Spinal Cord Injury: A Rehabilitation Hospital Based Qualitative Study

Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams

Abstract:

Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.

Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury

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4427 Structural Analysis of Multi-Pressure Integrated Vessel for Sport-Multi-Artificial Environment System

Authors: Joon-Ho Lee, Jeong-Hwan Yoon, Jung-Hwan Yoon, Sangmo Kang, Su-Yeon Hong, Hyun-Woo Jeong, Jaeick Chae

Abstract:

There are several dedicated individual chambers for sports that are supplied and used, but none of them are multi-pressured all-in-one chambers that can provide a sports multi-environment simultaneously. In this study, we design a multi-pressure (positive/atmospheric/negative pressure) integrated vessel that can be used for the sport-multi-artificial environment system. We presented additional vessel designs with enlarged space for the tall users; with reinforcement pads added to reduce the maximum stress in the joints of its shells, and then carried out numerical analysis for the structural analysis with maximum stress and structural safety. Under the targeted allowable pressure conditions, maximum stresses occurred at the joint of the shell, and the entrance, the safety of the structure was checked with the allowable stress of its material.

Keywords: structural analysis, multi-pressure, integrated vessel, sport-multi-artificial environment

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4426 CPT Pore Water Pressure Correlations with PDA to Identify Pile Drivability Problem

Authors: Fauzi Jarushi, Paul Cosentino, Edward Kalajian, Hadeel Dekhn

Abstract:

At certain depths during large diameter displacement pile driving, rebound well over 0.25 inches was experienced, followed by a small permanent set during each hammer blow. High pile rebound (HPR) soils may stop the pile driving and results in a limited pile capacity. In some cases, rebound leads to pile damage, delaying the construction project, and the requiring foundations redesign. HPR was evaluated at seven Florida sites, during driving of square precast, prestressed concrete piles driven into saturated, fine silty to clayey sands and sandy clays. Pile Driving Analyzer (PDA) deflection versus time data recorded during installation, was used to develop correlations between cone penetrometer (CPT) pore-water pressures, pile displacements and rebound. At five sites where piles experienced excessive HPR with minimal set, the pore pressure yielded very high positive values of greater than 20 tsf. However, at the site where the pile rebounded, followed by an acceptable permanent set, the measured pore pressure ranged between 5 and 20 tsf. The pore pressure exhibited values of less than 5 tsf at the site where no rebound was noticed. In summary, direct correlations between CPTu pore pressure and rebound were produced, allowing identification of soils that produce HPR.

Keywords: CPTU, pore water pressure, pile rebound

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4425 Investigation of Effects and Hazards of Wind Flow on Buildings in Multiple Arrangements Using CFD

Authors: S. C. Gupta

Abstract:

The wind flow over several buildings lying in close vicinity in urban areas generates flow interference effects causing problems related to pedestrian comfort and ventilation within the buildings. This promoted a lot of research interest in the recent years. Airflow over a building creates a positive pressure zone on the upstream side and negative pressure zones (cavities or eddy zones) on the roof and all other sides. Large eddy simulation model is used along with sub-grid-scale model to numerically simulate turbulence for this purpose. The basis of flow outside the building is the pressure difference (between the wind and building interior). Wind Tunnel models are fabricated and tested in the subsonic wind tunnel. Theoretical results are compared with the experimental data. Newer configuration is tried for favorable effects in recovering static pressure values. Results obtained are seen very encouraging. The proposed exhaustive research investigation through numerical simulations and the experimental work are described and some interesting findings are brought out.

Keywords: wind flow, buildings, static pressure wind tunnel testing, CFD

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4424 Appearance and Magnitude of Dynamic Pressure in Micro-Scale of Subsonic Airflow around Symmetric Objects

Authors: Shehret Tilvaldyev, Jorge Flores-Garay, Alfredo Villanueva, Erwin Martinez, Lazaro Rico

Abstract:

The efficiency of modern transportation is severely compromised by the prevalence of turbulent drag. The high level of turbulent skin-friction occurring, e.g., on the surface of an aircraft, automobiles or the carriage of a high-speed train, is responsible for excess fuel consumption and increased carbon emissions. The environmental, political, and economic pressure to improve fuel efficiency and reduce carbon emissions associated with transportation means that reducing turbulent skin-friction drag is a pressing engineering problem. The dynamic pressure of subsonic airflow around solid objects creates lift, but also induces drag force. This paper is presenting the results of laboratory experiments, investigating appearance and magnitude of dynamic pressure in micro scale of subsonic air flow around right cylinder and symmetrical airfoil.

Keywords: airflow, dynamic pressure, micro scale, symmetric object

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4423 Bayesian Networks Scoping the Climate Change Impact on Winter Wheat Freezing Injury Disasters in Hebei Province, China

Authors: Xiping Wang,Shuran Yao, Liqin Dai

Abstract:

Many studies report the winter is getting warmer and the minimum air temperature is obviously rising as the important climate warming evidences. The exacerbated air temperature fluctuation tending to bring more severe weather variation is another important consequence of recent climate change which induced more disasters to crop growth in quite a certain regions. Hebei Province is an important winter wheat growing province in North of China that recently endures more winter freezing injury influencing the local winter wheat crop management. A winter wheat freezing injury assessment Bayesian Network framework was established for the objectives of estimating, assessing and predicting winter wheat freezing disasters in Hebei Province. In this framework, the freezing disasters was classified as three severity degrees (SI) among all the three types of freezing, i.e., freezing caused by severe cold in anytime in the winter, long extremely cold duration in the winter and freeze-after-thaw in early season after winter. The factors influencing winter wheat freezing SI include time of freezing occurrence, growth status of seedlings, soil moisture, winter wheat variety, the longitude of target region and, the most variable climate factors. The climate factors included in this framework are daily mean and range of air temperature, extreme minimum temperature and number of days during a severe cold weather process, the number of days with the temperature lower than the critical temperature values, accumulated negative temperature in a potential freezing event. The Bayesian Network model was evaluated using actual weather data and crop records at selected sites in Hebei Province using real data. With the multi-stage influences from the various factors, the forecast and assessment of the event-based target variables, freezing injury occurrence and its damage to winter wheat production, were shown better scoped by Bayesian Network model.

Keywords: bayesian networks, climatic change, freezing Injury, winter wheat

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4422 The Current Ways of Thinking Mild Traumatic Brain Injury and Clinical Practice in a Trauma Hospital: A Pilot Study

Authors: P. Donnelly, G. Mitchell

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Traumatic Brain Injury (TBI) is a major contributor to the global burden of disease; despite its ubiquity, there is significant variation in diagnosis, prognosis, and treatment between clinicians. This study aims to examine the spectrum of approaches that currently exist at a Level 1 Trauma Centre in Australasia by surveying Emergency Physicians and Neurosurgeons on those aspects of mTBI. A pilot survey of 17 clinicians (Neurosurgeons, Emergency Physicians, and others who manage patients with mTBI) at a Level 1 Trauma Centre in Brisbane, Australia, was conducted. The objective of this study was to examine the importance these clinicians place on various elements in their approach to the diagnosis, prognostication, and treatment of mTBI. The data were summarised, and the descriptive statistics reported. Loss of consciousness and post-traumatic amnesia were rated as the most important signs or symptoms in diagnosing mTBI (median importance of 8). MRI was the most important imaging modality in diagnosing mTBI (median importance of 7). ‘Number of the Previous TBIs’ and Intracranial Injury on Imaging’ were rated as the most important elements for prognostication (median importance of 9). Education and reassurance were rated as the most important modality for treating mTBI (median importance of 7). There was a statistically insignificant variation between the specialties as to the importance they place on each of these components. In this Australian tertiary trauma center, there appears to be variation in how clinicians approach mTBI. This study is underpowered to state whether this is between clinicians within a specialty or a trend between specialties. This variation is worthwhile in investigating as a step toward a unified approach to diagnosing, prognosticating, and treating this common pathology.

Keywords: mild traumatic brain injury, adult, clinician, survey

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4421 Numerical Investigation and Optimization of the Effect of Number of Blade and Blade Type on the Suction Pressure and Outlet Mass Flow Rate of a Centrifugal Fan

Authors: Ogan Karabas, Suleyman Yigit

Abstract:

Number of blade and blade type of centrifugal fans are the most decisive factor on the field of application, noise level, suction pressure and outlet mass flow rate. Nowadays, in order to determine these effects on centrifugal fans, numerical studies are carried out in addition to experimental studies. In this study, it is aimed to numerically investigate the changes of suction pressure and outlet mass flow rate values of a centrifugal fan according to the number of blade and blade type. Centrifugal fans of the same size with forward, backward and straight blade type were analyzed by using a simulation program and compared with each other. This analysis was carried out under steady state condition by selecting k-Ɛ turbulence model and air is assumed incompressible. Then, 16, 32 and 48 blade centrifugal fans were again analyzed by using same simulation program, and the optimum number of blades was determined for the suction pressure and the outlet mass flow rate. According to the results of the analysis, it was obtained that the suction pressure in the 32 blade fan was twice the value obtained in the 16 blade fan. In addition, the outlet mass flow rate increased by 45% with the increase in the number of blade from 16 to 32. There is no significant change observed on the suction pressure and outlet mass flow rate when the number of blades increased from 32 to 48. In the light of the analysis results, the optimum blade number was determined as 32.

Keywords: blade type, centrifugal fan, cfd, outlet mass flow rate, suction pressure

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4420 An Image Processing Based Approach for Assessing Wheelchair Cushions

Authors: B. Farahani, R. Fadil, A. Aboonabi, B. Hoffmann, J. Loscheider, K. Tavakolian, S. Arzanpour

Abstract:

Wheelchair users spend long hours in a sitting position, and selecting the right cushion is highly critical in preventing pressure ulcers in that demographic. Pressure mapping systems (PMS) are typically used in clinical settings by therapists to identify the sitting profile and pressure points in the sitting area to select the cushion that fits the best for the users. A PMS is a flexible mat composed of arrays of distributed networks of flexible sensors. The output of the PMS systems is a color-coded image that shows the intensity of the pressure concentration. Therapists use the PMS images to compare different cushions fit for each user. This process is highly subjective and requires good visual memory for the best outcome. This paper aims to develop an image processing technique to analyze the images of PMS and provide an objective measure to assess the cushions based on their pressure distribution mappings. In this paper, we first reviewed the skeletal anatomy of the human sitting area and its relation to the PMS image. This knowledge is then used to identify the important features that must be considered in image processing. We then developed an algorithm based on those features to analyze the images and rank them according to their fit to the users' needs.

Keywords: dynamic cushion, image processing, pressure mapping system, wheelchair

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4419 Urine Neutrophil Gelatinase-Associated Lipocalin as an Early Marker of Acute Kidney Injury in Hematopoietic Stem Cell Transplantation Patients

Authors: Sara Ataei, Maryam Taghizadeh-Ghehi, Amir Sarayani, Asieh Ashouri, Amirhossein Moslehi, Molouk Hadjibabaie, Kheirollah Gholami

Abstract:

Background: Acute kidney injury (AKI) is common in hematopoietic stem cell transplantation (HSCT) patients with an incidence of 21–73%. Prevention and early diagnosis reduces the frequency and severity of this complication. Predictive biomarkers are of major importance to timely diagnosis. Neutrophil gelatinase associated lipocalin (NGAL) is a widely investigated novel biomarker for early diagnosis of AKI. However, no study assessed NGAL for AKI diagnosis in HSCT patients. Methods: We performed further analyses on gathered data from our recent trial to evaluate the performance of urine NGAL (uNGAL) as an indicator of AKI in 72 allogeneic HSCT patients. AKI diagnosis and severity were assessed using Risk–Injury–Failure–Loss–End-stage renal disease and AKI Network criteria. We assessed uNGAL on days -6, -3, +3, +9 and +15. Results: Time-dependent Cox regression analysis revealed a statistically significant relationship between uNGAL and AKI occurrence. (HR=1.04 (1.008-1.07), P=0.01). There was a relation between uNGAL day +9 to baseline ratio and incidence of AKI (unadjusted HR=.1.047(1.012-1.083), P<0.01). The area under the receiver-operating characteristic curve for day +9 to baseline ratio was 0.86 (0.74-0.99, P<0.01) and a cut-off value of 2.62 was 85% sensitive and 83% specific in predicting AKI. Conclusions: Our results indicated that increase in uNGAL augmented the risk of AKI and the changes of day +9 uNGAL concentrations from baseline could be of value for predicting AKI in HSCT patients. Additionally uNGAL changes preceded serum creatinine rises by nearly 2 days.

Keywords: acute kidney injury, hemtopoietic stem cell transplantation, neutrophil gelatinase-associated lipocalin, Receiver-operating characteristic curve

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4418 Effect of Knowledge of Bubble Point Pressure on Estimating PVT Properties from Correlations

Authors: Ahmed El-Banbi, Ahmed El-Maraghi

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PVT properties are needed as input data in all reservoir, production, and surface facilities engineering calculations. In the absence of PVT reports on valid reservoir fluid samples, engineers rely on PVT correlations to generate the required PVT data. The accuracy of PVT correlations varies, and no correlation group has been found to provide accurate results for all oil types. The effect of inaccurate PVT data can be significant in engineering calculations and is well documented in the literature. Bubble point pressure can sometimes be obtained from external sources. In this paper, we show how to utilize the known bubble point pressure to improve the accuracy of calculated PVT properties from correlations. We conducted a systematic study using around 250 reservoir oil samples to quantify the effect of pre-knowledge of bubble point pressure. The samples spanned a wide range of oils, from very volatile oils to black oils and all the way to low-GOR oils. A method for shifting both undersaturated and saturated sections of the PVT properties curves to the correct bubble point is explained. Seven PVT correlation families were used in this study. All PVT properties (e.g., solution gas-oil ratio, formation volume factor, density, viscosity, and compressibility) were calculated using the correct bubble point pressure and the correlation estimated bubble point pressure. Comparisons between the calculated PVT properties and actual laboratory-measured values were made. It was found that pre-knowledge of bubble point pressure and using the shifting technique presented in the paper improved the correlation-estimated values by 10% to more than 30%. The most improvement was seen in the solution gas-oil ratio and formation volume factor.

Keywords: PVT data, PVT properties, PVT correlations, bubble point pressure

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4417 Risking Injury: Exploring the Relationship between Risk Propensity and Injuries among an Australian Rules Football Team

Authors: Sarah A. Harris, Fleur L. McIntyre, Paola T. Chivers, Benjamin G. Piggott, Fiona H. Farringdon

Abstract:

Australian Rules Football (ARF) is an invasion based, contact field sport with over one million participants. The contact nature of the game increases exposure to all injuries, including head trauma. Evidence suggests that both concussion and sub-concussive traumas such as head knocks may damage the brain, in particular the prefrontal cortex. The prefrontal cortex may not reach full maturity until a person is in their early twenties with males taking longer to mature than females. Repeated trauma to the pre-frontal cortex during maturation may lead to negative social, cognitive and emotional effects. It is also during this period that males exhibit high levels of risk taking behaviours. Risk propensity and the incidence of injury is an unexplored area of research. Little research has considered if the level of player’s (especially younger players) risk propensity in everyday life places them at an increased risk of injury. Hence the current study, investigated if a relationship exists between risk propensity and self-reported injuries including diagnosed concussion and head knocks, among male ARF players aged 18 to 31 years. Method: The study was conducted over 22 weeks with one West Australian Football League (WAFL) club during the 2015 competition. Pre-season risk propensity was measured using the 7-item self-report Risk Propensity Scale. Possible scores ranged from 9 to 63, with higher scores indicating higher risk propensity. Players reported their self-perceived injuries (concussion, head knocks, upper body and lower body injuries) fortnightly using the WAFL Injury Report Survey (WIRS). A unique ID code was used to ensure player anonymity, which also enabled linkage of survey responses and injury data tracking over the season. A General Linear Model (GLM) was used to analyse whether there was a relationship between risk propensity score and total number of injuries for each injury type. Results: Seventy one players (N=71) with an age range of 18.40 to 30.48 years and a mean age of 21.92 years (±2.96 years) participated in the study. Player’s mean risk propensity score was 32.73, SD ±8.38. Four hundred and ninety five (495) injuries were reported. The most frequently reported injury was head knocks representing 39.19% of total reported injuries. The GLM identified a significant relationship between risk propensity and head knocks (F=4.17, p=.046). No other injury types were significantly related to risk propensity. Discussion: A positive relationship between risk propensity and head trauma in contact sports (specifically WAFL) was discovered. Assessing player’s risk propensity therefore, may identify those more at risk of head injuries. Potentially leading to greater monitoring and education of these players throughout the season, regarding self-identification of head knocks and symptoms that may indicate trauma to the brain. This is important because many players involved in WAFL are in their late teens or early 20’s hence, may be at greater risk of negative outcomes if they experience repeated head trauma. Continued education and research into the risks associated with head injuries has the potential to improve player well-being.

Keywords: football, head injuries, injury identification, risk

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4416 Construction of a Dynamic Migration Model of Extracellular Fluid in Brain for Future Integrated Control of Brain State

Authors: Tomohiko Utsuki, Kyoka Sato

Abstract:

In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.

Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control

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4415 Investigation of Time Pressure and Instinctive Reaction in Moral Dilemmas While Driving

Authors: Jacqueline Miller, Dongyuan Y. Wang, F. Dan Richard

Abstract:

Before trying to make an ethical machine that holds a higher ethical standard than humans, a better understanding of human moral standards that could be used as a guide is crucial. How humans make decisions in dangerous driving situations like moral dilemmas can contribute to developing acceptable ethical principles for autonomous vehicles (AVs). This study uses a driving simulator to investigate whether drivers make utilitarian choices (choices that maximize lives saved and minimize harm) in unavoidable automobile accidents (moral dilemmas) with time pressure manipulated. This study also investigates how impulsiveness influences drivers’ behavior in moral dilemmas. Manipulating time pressure results in collisions that occur at varying time intervals (4 s, 5 s, 7s). Manipulating time pressure helps investigate how time pressure may influence drivers’ response behavior. Thirty-one undergraduates participated in this study using a STISM driving simulator to respond to driving moral dilemmas. The results indicated that the percentage of utilitarian choices generally increased when given more time to respond (from 4 s to 7 s). Additionally, participants in vehicle scenarios preferred responding right over responding left. Impulsiveness did not influence utilitarian choices. However, as time pressure decreased, response time increased. Findings have potential implications and applications on the regulation of driver assistance technologies and AVs.

Keywords: time pressure, automobile moral dilemmas, impulsiveness, reaction time

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4414 Investigation of External Pressure Coefficients on Large Antenna Parabolic Reflector Using Computational Fluid Dynamics

Authors: Varun K, Pramod B. Balareddy

Abstract:

Estimation of wind forces plays a significant role in the in the design of large antenna parabolic reflectors. Reflector surface accuracies are very sensitive to the gain of the antenna system at higher frequencies. Hence accurate estimation of wind forces becomes important, which is primary input for design and analysis of the reflector system. In the present work, numerical simulation of wind flow using Computational Fluid Dynamics (CFD) software is used to investigate the external pressure coefficients. An extensive comparative study has been made between the CFD results and the published wind tunnel data for different wind angle of attacks (α) acting over concave to convex surfaces respectively. Flow simulations using CFD are carried out to estimate the coefficients of Drag, Lift and Moment for the parabolic reflector. Coefficients of pressures (Cp) over the front and the rear face of the reflector are extracted over surface of the reflector to study the net pressure variations. These resultant pressure variations are compared with the published wind tunnel data for different angle of attacks. It was observed from the CFD simulations, both convex and concave face of reflector system experience a band of pressure variations for the positive and negative angle of attacks respectively. In the published wind tunnel data, Pressure variations over convex surfaces are assumed to be uniform and vice versa. Chordwise and spanwise pressure variations were calculated and compared with the published experimental data. In the present work, it was observed that the maximum pressure coefficients for α ranging from +30° to -90° and α=+90° was lower. For α ranging from +45° to +75°, maximum pressure coefficients were higher as compared to wind tunnel data. This variation is due to non-uniform pressure distribution observed over front and back faces of reflector. Variations in Cd, Cl and Cm over α=+90° to α=-90° was in close resemblance with the experimental data.

Keywords: angle of attack, drag coefficient, lift coefficient, pressure coefficient

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4413 Yield Onset of Thermo-Mechanical Loading of FGM Thick Walled Cylindrical Pressure Vessels

Authors: S. Ansari Sadrabadi, G. H. Rahimi

Abstract:

In this paper, thick walled Cylindrical tanks or tubes made of functionally graded material under internal pressure and temperature gradient are studied. Material parameters have been considered as power functions. They play important role in the elastoplastic behavior of these materials. To clarify their role, different materials with different parameters have been used under temperature gradient. Finally, their effect and loading effect have been determined in first yield point. Also, the important role of temperature gradient was also shown. At the end the study has been results obtained from changes in the elastic modulus and yield stress. Also special attention is also given to the effects of this internal pressure and temperature gradient in the creation of tensile and compressive stresses.

Keywords: FGM, cylindrical pressure tubes, small deformation theory, yield onset, thermal loading

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4412 Addressing Sexual Health in Males with Spinal Cord Injury in Rural South India: Using the Knowledge to Action Framework to Evaluate an Education Manual on Improving Knowledge, Attitudes and Practices

Authors: Cassandra Maffei, Effie Pomaki, Salomé Deslauriers-Brouillard, Levana Dahan, Caroline Storr, Ramasubramanian Ponnusamy, Philippe S. Archambault

Abstract:

Sexual health education following spinal cord injury (SCI) remains poorly integrated into the rehabilitation process, especially in low-income countries where the topics of disability and sexuality are stigmatized. This research aimed to evaluate a sexual health manual that was created and distributed amongst males with SCI who had received rehabilitation services at Amar Seva Sangam (ASSA), a rehabilitation center located in rural South India. A service evaluation was completed to collect data from a convenience sample of 37 males with spinal cord injuries. Data were analyzed using descriptive statistics and content analysis. The service evaluation showed that the manual was well received by the sample and had positive impacts on secondary outcome measures, including relationship dynamics and quality of life. It can thus be used as an effective adjunct tool to support the improvement of sexual health knowledge, attitudes, and practices of individuals with SCI.

Keywords: spinal cord injury, sexual health, rehabilitation, India, education, service evaluation

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4411 A Lightning Strike Mimic: The Abusive Use of Dog Shock Collar Presents as Encephalopathy, Respiratory Arrest, Cardiogenic Shock, Severe Hypernatremia, Rhabdomyolysis, and Multiorgan Injury

Authors: Merrick Lopez, Aashish Abraham, Melissa Egge, Marissa Hood, Jui Shah

Abstract:

A 3 year old male with unknown medical history presented initially with encephalopathy, intubated for respiratory failure, and admitted to the pediatric intensive care unit (PICU) with refractory shock. During resuscitation in the emergency department, he was found to be in severe metabolic acidosis with a pH of 7.03 and escalated on vasopressor drips for hypotension. His initial sodium was 174. He was noted to have burn injuries to his scalp, forehead, right axilla, bilateral arm creases and lower legs. He had rhabdomyolysis (initial creatinine kinase 5,430 U/L with peak levels of 62,340 normal <335 U/L), cardiac injury (initial troponin 88 ng/L with peak at 145 ng/L, normal <15ng/L), hypernatremia (peak 174, normal 140), hypocalcemia, liver injury, acute kidney injury, and neuronal loss on magnetic resonance imaging (MRI). Soft restraints and a shock collar were found in the home. He was critically ill for 8 days, but was gradually weaned off drips, extubated, and started on feeds. Discussion Electrical injury, specifically lightning injury is an uncommon but devastating cause of injury in pediatric patients. This patient with suspected abusive use of a dog shock collar presented similar to a lightning strike. Common entrance points include the hands and head, similar to our patient with linear wounds on his forehead. When current enters, it passes through tissues with the least resistance. Nerves, blood vessels, and muscles, have high fluid and electrolyte content and are commonly affected. Exit points are extremities: our child who had circumferential burns around his arm creases and ankles. Linear burns preferentially follow areas of high sweat concentration, and are thought to be due to vaporization of water on the skin’s surface. The most common cause of death from a lightning strike is due to cardiopulmonary arrest. The massive depolarization of the myocardium can result in arrhythmias and myocardial necrosis. The patient presented in cardiogenic shock with evident cardiac damage. Electricity going through vessels can lead to vaporization of intravascular water. This can explain his severe hypernatremia. He also sustained other internal organ injuries (adrenal glands, pancreas, liver, and kidney). Electrical discharge also leads to direct skeletal muscle injury in addition to prolonged muscular spasm. Rhabdomyolysis, the acute damage of muscle, leads to release of potentially toxic components into the circulation which could lead to acute renal failure. The patient had severe rhabdomyolysis and renal injury. Early hypocalcemia has been consistently demonstrated in patients with rhabdomyolysis. This was present in the patient and led to increased vasopressor needs. Central nervous system injuries are also common which can include encephalopathy, hypoxic injury, and cerebral infarction. The patient had evidence of brain injury as seen on MRI. Conclusion Electrical injuries due to lightning strikes and abusive use of a dog shock collar are rare, but can both present in similar ways with respiratory failure, shock, hypernatremia, rhabdomyolysis, brain injury, and multiorgan damage. Although rare, it is essential for early identification and prompt management for acute and chronic complications in these children.

Keywords: cardiogenic shock, dog shock collar, lightning strike, rhabdomyolysis

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4410 A Preliminary Outcome of the Effect of an Accumulating 10,000 Daily Steps on Blood Pressure and Diabetes in Overweight Thai Participants

Authors: Kornanong Yuenyongchaiwat, Duangnate Pepatsitipong, Panthip Sangprasert

Abstract:

High blood pressure and diabetes have been suggested as being non-communicable disease (NCDs), and there is one of the components of the definition of metabolic syndrome. Therefore, the purpose of this study was to evaluate the effect of a 12-week pedometer based community walking intervention on change in resting blood pressure and blood glucose in participants with overweight in the community setting. Method: Participants were recruited both males and females who had a sedentary lifestyle aged 35-59 years (mean aged 49.67 years). A longitudinal quasi-experimental study was designed with 35 overweight participants who had body mass index ≥ 25 kg/m2. These volunteers were assigned to the 12-week pedometer-based walking program (an accumulated at least 10,000 steps a day). Blood pressure and blood glucose were measured initially before and after 12-week intervention. Results: Systolic blood pressure and heart rate were significantly lower in 30 individuals who had accumulated 10,000 steps d-1 in the intervention group at 12 week follow-up (-13.74 mmHg and 5.3 bpm, respectively). In addition, reduction in blood glucose (-14.89 mmol) in the intervention participants was statistically significant (p < .001). A regression analysis indicated that reductions in systolic blood pressure were significantly related to the increase in steps per day. Conclusion: The accumulation of least 10,000 steps d-1 resulted in decreased resting systolic blood pressure and blood glucose in overweight participants. This has also shown that an increase in physical activity in overweight participants with sedentary lifestyle by accumulating at least 10,000 steps a day can reduce the risk of cardiovascular disease (e.g., hypertension and diabetes).

Keywords: blood glucose, blood pressure, diabetes, hypertension, physical activity, walking

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4409 Evaluation of Resting Systolic and Diastolic Blood Pressure of Staff of Multi-National Petroleum Company in Warri, Nigeria

Authors: Ekpon Oghenetega Philip, Tayire Okabare Favour, Boye Ejobowah Thomas

Abstract:

The study evaluated the resting systolic blood pressure (RSBP) and resting diastolic blood pressure (RDBP) of staff of a multi-national petroleum company in Nigeria with the aim of helping the staff maintain optimal health which is necessary to carry out their secular work. Eleven healthy male (age 36.9±10.48 years, mean±S.D) and 38 healthy female (39.99±12.23 years, mean±S.D) staff of the multi-national petroleum company performed an incremental exercise on a treadmill and cycle ergometers to determine RSBP and RDBP. An assessment of the health status of the staff of the company was carried out using a physical activity readiness questionnaire (PAR-Q) to determine their suitability for the program. Analysis of the t-test for male staff of RSBP shows that it was statistically significant with a calculated t value of 2.19, α = 0.05 and t-calculated for RSBP of female staff was 1.897, α = 0.05 showing a significance. While the t-calculated RSBP for male staff of the multi-national company is 0.44 with α =0.05 and the female RDBP is 4.129, α = 0.05 and they are all significant. It was recommended that staff of the company should regularly visit the company gym during their leisure hours to maintain optimum health.

Keywords: systolic blood pressure, diastolic blood pressure, exercise, pressure staff

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4408 Uncommon Case of Falx Subdural Hematoma

Authors: Thu Nguyen, Jane Daugherty-Luck

Abstract:

Falx subdural hematoma is a life-threatening condition associated with high mortality. We present a patient case who had fallen with no head injury or loss of conspicuousness. She had tenderness along cervical and thoracic lumbar spine. CT head revealed falx subdural hematoma. The patient was managed medically. The pathophysiology of falx subdural hematoma is linked to laceration of bridging veins provoked by frontal or occipital impact. Posttraumatic subdural hematoma is commonly caused by inertia instead of facture or cerebral contusion resulting from direct impact. The theory is consistent with the lack of fracture in most cases in the literature. Our patient had neither contusion nor fracture.

Keywords: falx subdural hematoma, traumatic head injury, CT head scan, bridging veins, inertia

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4407 Optimization Parameters Using Response Surface Method on Biomechanical Analysis for Malaysian Soccer Players

Authors: M. F. M. Ali, A. R. Ismail, B. M. Deros

Abstract:

Soccer is very popular and ranked as the top sports in the world as well as in Malaysia. Although soccer sport in Malaysia is currently professionalized, but it’s plunging achievements within recent years continue and are not to be proud of. After review, the Malaysian soccer players are still weak in terms of kicking techniques. The instep kick is a technique, which is often used in soccer for the purpose of short passes and making a scoring. This study presents the 3D biomechanics analysis on a soccer player during performing instep kick. This study was conducted to determine the optimization value for approach angle, distance of supporting leg from the ball and ball internal pressure respect to the knee angular velocity of the ball on the kicking leg. Six subjects from different categories using dominant right leg and free from any injury were selected to take part in this study. Subjects were asked to perform one step instep kick according to the setting for the variables with different parameter. Data analysis was performed using 3 Dimensional “Qualisys Track Manager” system and will focused on the bottom of the body from the waist to the ankle. For this purpose, the marker will be attached to the bottom of the body before the kicking is perform by the subjects. Statistical analysis was conducted by using Minitab software using Response Surface Method through Box-Behnken design. The results of this study found the optimization values for all three parameters, namely the approach angle, 53.6º, distance of supporting leg from the ball, 8.84sm and ball internal pressure, 0.9bar with knee angular velocity, 779.27 degrees/sec have been produced.

Keywords: biomechanics, instep kick, soccer, optimization

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4406 Magnitude of Infection and Associated factor in Open Tibial Fractures Treated Operatively at Addis Ababa Burn Emergency and Trauma Center April, 2023

Authors: Tuji Mohammed Sani

Abstract:

Back ground: An open tibial fracture is an injury where the fractured bone directly communicates with the outside environment. Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. Objective: The main objective of the study was to determine Prevalence of infection and its associated factors in surgically treated open tibial fracture in Addis Ababa Burn Emergency and Trauma (AaBET) center. Method: A facility based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET center from September 2018 to September 2021. The data was collected from patient’s chart using structured data collection form, and Data was entered and analyzed using SPSS version 26. Bivariable and multiple binary logistic regression were fitted. Multicollinearity was checked among candidate variables using variance inflation factor and tolerance, which were less than 5 and greater than 0.2, respectively. Model adequacy were tested using Hosmer-Lemeshow goodness of fitness test (P=0.711). AOR at 95% CI was reported, and P-value < 0.05 was considered statistically significant. Result: This study found that 33.9% of the study participants had an infection. Initial IV antibiotic time (AOR=2.924, 95% CI:1.160- 7.370) and time of wound closure from injury (AOR=3.524, 95% CI: 1.798-6.908), injury to admission time (AOR=2.895, 95% CI: 1.402 – 5.977). and definitive fixation method (AOR=0.244, 95% CI: 0.113 – 0.4508) were the factors found to have a statistically significant association with the occurrence of infection. Conclusion: The rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fracture treated at AaBET center. Time from injury to admission, time from injury to first debridement, wound closure time, and initial Intra Venous antibiotic time from the injury are an important factor that can be readily amended to improve the infection rate. Whether wound closed before seven days or not were more important factor associated with occurrences of infection.

Keywords: infection, open tibia, fracture, magnitude

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4405 3D-Printed Collagen/Chitosan Scaffolds Loaded with Exosomes Derived from Neural Stem Cells Pretreated with Insulin Growth Factor-1 for Neural Regeneration after Traumatic Brain Injury

Authors: Xiao-Yin Liu, Liang-Xue Zhou

Abstract:

Traumatic brain injury (TBI), as a kind of nerve trauma caused by an external force, affects people all over the world and is a global public health problem. Although there are various clinical treatments for brain injury, including surgery, drug therapy, and rehabilitation therapy, the therapeutic effect is very limited. To improve the therapeutic effect of TBI, scaffolds combined with exosomes are a promising but challenging method for TBI repair. In this study, we examined whether a novel 3D-printed collagen/chitosan scaffold/exosomes derived from neural stem cells (NSCs) pretreated with insulin growth factor-1 (IGF-I) scaffolds (3D-CC-INExos) could be used to improve TBI repair and functional recovery after TBI. Our results showed that composite scaffolds of collagen-, chitosan- and exosomes derived from NSCs pretreated with IGF-I (INExos) could continuously release the exosomes for two weeks. In the rat TBI model, 3D-CC-INExos scaffold transplantation significantly improved motor and cognitive function after TBI, as assessed by the Morris water maze test and modified neurological severity scores. In addition, immunofluorescence staining and transmission electron microscopy showed that the recovery of damaged nerve tissue in the injured area was significantly improved by 3D-CC-INExos implantation. In conclusion, our data suggest that 3D-CC-INExos might provide a potential strategy for the treatment of TBI and lay a solid foundation for clinical translation.

Keywords: traumatic brain injury, exosomes, insulin growth factor-1, neural stem cells, collagen, chitosan, 3D printing, neural regeneration, angiogenesis, functional recovery

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4404 Injury Patterns and Outcomes in Alcohol Intoxicated Trauma Patients Admitted at Level I Apex Trauma Centre of a Developing Nation

Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

Abstract:

Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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