Search results for: shoulder ultrasound

Authors: Zecarias Zemichael Woldu

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Cultivation of professionalism and dispositional values in junior faculty members in institutions of higher education (IHE) is a global challenge. Junior faculty members complain of the managerial inefficiency and lack of modeling in their career development. This paper explored how Graduate Teaching Assistants (GTAs) are inducted into the system and mentored at work in the IHE in Eritrea. It assesses the institutional significance and challenges of mentoring junior faculty members in IHE. The research was conducted in 7 IHE involving 165 participants. Quantitative and qualitative data were gathered through Likert scale questionnaire and in-depth interviews. A One-Way ANOVA was used to assess the GTAs’ knowledge of assigned duties and responsibilities, access to institutional information and resources, the quality of guidance and support provided and above all the mentoring state of affairs across the colleges. Results revealed that junior faculty shoulder vital responsibilities but they receive poor induction and mentoring at individual and institutional levels. A large number of junior faculty members revealed a need of serious professional molding to effectively shoulder more responsibilities in the colleges.

Keywords: induction, mentoring, junior faculty members, Eritrea

Procedia PDF Downloads 255

Authors: Erika K. Méndez, Carlos E. Orrego, Diana L. Manrique, Juan D. Gonzalez, Doménica Vallejo

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High moisture content in fruits generates post-harvest problems such as mechanical, biochemical, microbial and physical losses. Dehydration, which is based on the reduction of water activity of the fruit, is a common option for overcoming such losses. However, regular hot air drying could affect negatively the quality properties of the fruit due to the long residence time at high temperature. Power ultrasound (US) application during the convective drying has been used as a novel method able to enhance drying rate and, consequently, to decrease drying time. In the present study, a new approach was tested to evaluate the effect of US on the drying time, the final antioxidant activity (AA) and the total polyphenol content (TPC) of banana slices (BS), mango slices (MS) and guava slices (GS). There were also studied the drying kinetics with nine different models from which water effective diffusivities (Deff) (with or without shrinkage corrections) were calculated. Compared with the corresponding control tests, US assisted drying for fruit slices showed reductions in drying time between 16.23 and 30.19%, 11.34 and 32.73%, and 19.25 and 47.51% for the MS, BS and GS respectively. Considering shrinkage effects, Deff calculated values ranged from 1.67*10-10 to 3.18*10-10 m2/s, 3.96*10-10 and 5.57*10-10 m2/s and 4.61*10-10 to 8.16*10-10 m2/s for the BS, MS and GS samples respectively. Reductions of TPC and AA (as DPPH) were observed compared with the original content in fresh fruit data in all kinds of drying assays.

Keywords: banana, drying, effective diffusivity, guava, mango, ultrasound

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Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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Authors: Paul Dunst, Ing. Tobias Hemsel, Ing. Habil. Walter Sextro

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The use of fine powders with high cohesive and adhesive properties leads to challenges during transport, mixing and dosing in industrial processes, which have not been satisfactorily solved so far. Due to the increased contact forces at the transporting parts (e. g. pipe-wall and transport screws), conventional transport systems and also vibratory conveyors reach their limits. Often, flowability increasing additives that need to be removed again in later process steps are the only option to achieve wanted transport results. A rather new ultrasound-assisted powder transport system showed to overcome some of the issues by manipulating the effective friction between powder and transport pipe. Within this contribution, the transport mechanism will be introduced shortly, together with preliminary transport results. As the tangential force of the transport pipe and the powder is the main influencing factor within the transport process, a test stand for measuring tangential forces of a powder-wall contact in the presence of an ultrasonic vibration orthogonal to the contact plane was built. Measurements for a sample powder show that the effective tangential force can already be significantly reduced at very low ultrasonic amplitude. As a result of the measurements, an empirical model for the relationship of tangential force, contact parameters and ultrasonic excitation is presented. This model was used to adjust the driving parameters of the powder transport system, resulting in better performance.

Keywords: powder transport, ultrasound, friction, friction manipulation, vibratory conveyor

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Authors: Ali Hamza

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Accurate segmentation of breast ultrasound images is of paramount importance in enhancing the diagnostic capabilities of breast cancer detection. This study presents an approach utilizing the U-Net architecture for segmenting breast ultrasound images aimed at improving the accuracy and reliability of mass identification within the breast tissue. The proposed method encompasses a multi-stage process. Initially, preprocessing techniques are employed to refine image quality and diminish noise interference. Subsequently, the U-Net architecture, a deep learning convolutional neural network (CNN), is employed for pixel-wise segmentation of regions of interest corresponding to potential breast masses. The U-Net's distinctive architecture, characterized by a contracting and expansive pathway, enables accurate boundary delineation and detailed feature extraction. To evaluate the effectiveness of the proposed approach, an extensive dataset of breast ultrasound images is employed, encompassing diverse cases. Quantitative performance metrics such as the Dice coefficient, Jaccard index, sensitivity, specificity, and Hausdorff distance are employed to comprehensively assess the segmentation accuracy. Comparative analyses against traditional segmentation methods showcase the superiority of the U-Net architecture in capturing intricate details and accurately segmenting breast masses. The outcomes of this study emphasize the potential of the U-Net-based segmentation approach in bolstering breast ultrasound image analysis. The method's ability to reliably pinpoint mass boundaries holds promise for aiding radiologists in precise diagnosis and treatment planning. However, further validation and integration within clinical workflows are necessary to ascertain their practical clinical utility and facilitate seamless adoption by healthcare professionals. In conclusion, leveraging the U-Net architecture for breast ultrasound image segmentation showcases a robust framework that can significantly enhance diagnostic accuracy and advance the field of breast cancer detection. This approach represents a pivotal step towards empowering medical professionals with a more potent tool for early and accurate breast cancer diagnosis.

Keywords: mage segmentation, U-Net, deep learning, breast cancer detection, diagnostic accuracy, mass identification, convolutional neural network

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Authors: Vojtech Stejskal, Hana Skalova, Petr Kvapil, George Hutchinson

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Algae growth has been an important issue in water management of water plants, ponds and lakes, swimming pools, aquaculture & fish farms, gardens or golf courses for last decades. There are solutions based on chemical or biological principles. Apart of these traditional principles for inhibition of algae growth and biofilm production there are also physical methods which are very competitive compared to the traditional ones. Ultrasonic technology is one of these alternatives. Ultrasonic emitter is able to eliminate the biofilm which behaves as a host and attachment point for algae and is original reason for the algae growth. The ultrasound waves prevent majority of the bacteria in planktonic form becoming strongly attached sessile bacteria that creates welcoming layer for the biofilm production. Biofilm creation is very fast – in the serene water it takes between 30 minutes to 4 hours, depending on temperature and other parameters. Ultrasound device is not killing bacteria. Ultrasound waves are passing through bacteria, which retract as if they were in very turbulent water even though the water is visually completely serene. In these conditions, bacteria does not excrete the polysaccharide glue they use to attach to the surface of the pool or pond, where ultrasonic technology is used. Ultrasonic waves decrease the production of biofilm on the surfaces in the selected area. In case there are already at the start of the application of ultrasonic technology in a pond or basin clean inner surfaces, the biofilm production is almost absolutely inhibited. This paper talks about two different pilot applications – one in Czech Republic and second in United States of America, where the used ultrasonic technology (AlgaeControl) is coming from. On both sites, there was used Mezzo Ultrasonic Algae Control System with very positive results not only on biofilm production, but also algae growth in the surrounding area. Technology has been successfully tested in two different environments. The poster describes the differences and their influence on the efficiency of ultrasonic technology application. Conclusions and lessons learned can be possibly applied also on other sites within Europe or even further.

Keywords: algae growth, biofilm production, ultrasonic solution, ultrasound

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Authors: Nabil Al-Zaqri

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Semiconductor photocatalysts with surface defects display incredible light absorption bandwidth, and these defects function as highly active sites for oxidation processes by interacting with the surface band structure. Accordingly, engineering the photocatalyst with surface oxygen vacancies will enhance the semiconductor nanostructure's photocatalytic efficiency. Herein, a CeO2₋ₓ nanostructure is designed under the influence of low-frequency ultrasonic waves to create surface oxygen vacancies. This approach enhances the photocatalytic efficiency compared to many heterostructures while keeping the intrinsiccrystal structure intact. Ultrasonic waves induce the acoustic cavitation effect leading to the dissemination of active elements on the surface, which results in vacancy formation in conjunction with larger surface area and smaller particle size. The structural analysis of CeO₂₋ₓ revealed higher crystallinity, as well as morphological optimization, and the presence of oxygen vacancies is verified through Raman, X-rayphotoelectron spectroscopy, temperature-programmed reduction, photoluminescence, and electron spinresonance analyses. Oxygen vacancies accelerate the redox cycle between Ce₄+ and Ce₃+ by prolongingphotogenerated charge recombination. The ultrasound-treated pristine CeO₂ sample achieved excellenthydrogen production showing a quantum efficiency of 1.125% and efficient organic degradation. Ourpromising findings demonstrated that ultrasonic treatment causes the formation of surface oxygenvacancies and improves photocatalytic hydrogen evolution and pollution degradation. Conclusion: Defect engineering of the ceria nanoparticles with oxygen vacancies was achieved for the first time using low-frequency ultrasound treatment. The U-CeO₂₋ₓsample showed high crystallinity, and morphological changes were observed. Due to the acoustic cavitation effect, a larger surface area and small particle size were observed. The ultrasound treatment causes particle aggregation and surface defects leading to oxygen vacancy formation. The XPS, Raman spectroscopy, PL spectroscopy, and ESR results confirm the presence of oxygen vacancies. The ultrasound-treated sample was also examined for pollutant degradation, where 1O₂was found to be the major active species. Hence, the ultrasound treatment influences efficient photocatalysts for superior hydrogen evolution and an excellent photocatalytic degradation of contaminants. The prepared nanostructure showed excellent stability and recyclability. This work could pave the way for a unique post-synthesis strategy intended for efficient photocatalytic nanostructures.

Keywords: surface defect, CeO₂₋ₓ, photocatalytic, water treatment, H₂ production

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Authors: Fares A. Mayia, Mahmoud A. Yamany, Mushabbab A. Asiri

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In recent years, non-invasive Focused Ultrasound (FU) has been utilized for generating bubbles (cavities) to ablate target tissue by mechanical fractionation. Intensities >10 kW/cm² are required to generate the inertial cavities. The generation, rapid growth, and collapse of these inertial cavities cause tissue fractionation and the process is called Histotripsy. The ability to fractionate tissue from outside the body has many clinical applications including the destruction of the tumor mass. The process of tissue fractionation leaves a void at the treated site, where all the affected tissue is liquefied to particles at sub-micron size. The liquefied tissue will eventually be absorbed by the body. Histotripsy is a promising non-invasive treatment modality. This paper presents a technique for generating inertial cavities at lower intensities (< 1 kW/cm²). The technique (patent pending) is based on amplitude modulation (AM), whereby a low frequency signal modulates the amplitude of a higher frequency FU wave. Cavitation threshold is lower at low frequencies; the intensity required to generate cavitation in water at 10 kHz is two orders of magnitude lower than the intensity at 1 MHz. The Amplitude Modulation technique can operate in both continuous wave (CW) and pulse wave (PW) modes, and the percentage modulation (modulation index) can be varied from 0 % (thermal effect) to 100 % (cavitation effect), thus allowing a range of ablating effects from Hyperthermia to Histotripsy. Furthermore, changing the frequency of the modulating signal allows controlling the size of the generated cavities. Results from in vitro work demonstrate the efficacy of the new technique in fractionating soft tissue and solid calcium carbonate (Chalk) material. The technique, when combined with MR or Ultrasound imaging, will present a precise treatment modality for ablating diseased tissue without affecting the surrounding healthy tissue.

Keywords: focused ultrasound therapy, histotripsy, inertial cavitation, mechanical tissue ablation

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Authors: Leonel Lipa Cusi, Enrique Nestor Pasquel Carbajal, Laura Marina Navarro Alvarado, José Del Álamo Carazas

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This research analyses the accuracy of the ultrasound and the pulse echo ultrasound technic to find voids and to measure thickness of concrete elements. These mentioned air voids are simulated by polystyrene expanded and hollow containers of thin thickness made of plastic or cardboard of different sizes and shapes. These targets are distributed strategically inside concrete at different depths. For this research, a shear wave pulse echo ultrasonic device of 50 KHz is used to scan the concrete elements. Despite the small measurements of the concrete elements and because of voids’ size are near the half of the wavelength, pre and post processing steps like voltage, gain, SAFT, envelope and time compensation were made in order to improve imaging results.

Keywords: ultrasonic, concrete, thickness, pulse echo, void

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Authors: Mahesh Hariharan, Rajan Balasubramaniam, Sharath Kumar Shetty, Shanthala Yadavalli, Mohammed Ahetasham, Sravya Devarapalli

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Acute abdomen is one of the most common clinical conditions requiring a radiological investigation. Ultrasound is the primary modality of choice which can diagnose some of the common causes of acute abdomen. However, sometimes the underlying cause for the pain is far more complicated than expected to mandate a high degree of suspicion to suggest further investigation with contrast-enhanced computed tomography or magnetic resonance imaging. Here, we have compiled a comprehensive series of selected cases to highlight the conditions which can be easily overlooked unless carefully sought for. This also emphasizes the importance of multimodality approach to arrive at the final diagnosis with an increased overall diagnostic accuracy which in turn improves patient management and prognosis.

Keywords: acute abdomen, contrast-enhanced computed tomography scan, magnetic resonance imaging, plain radiographs, ultrasound

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Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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Authors: Shima Behkami, Nor Shahirul Umirah Idris, Sharifuddin Md. Zain, Kah Hin Low, Mehrdad Gholami, Nima A. Behkami, Ahmad Firdaus Kamaruddin

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In this work, Inductively Coupled Plasma Mass Spectrometry (ICP-MS), Isotopic Ratio Mass Spectrometry (IRMS) and Ultrasound Milko Tester were used to study milk samples obtained from various geographical locations in Malaysia. ICP-MS was used to determine the concentration of trace elements in milk, water and soil samples obtained from seven dairy farms at different geographical locations in peninsular Malaysia. IRMS was used to analyze the milk samples for isotopic ratios of δ13C, 15N and 18O. Nutritional parameters in the milk samples were determined using an ultrasound milko tester. Data obtained from these measurements were evaluated by Principal Component Analysis (PCA) and Hierarchical Analysis (HA) as a preliminary step in determining geographical origin of these milk samples. It is observed that the isotopic ratios and a number of the nutritional parameters are responsible for the discrimination of the samples. It was also observed that it is possible to determine the geographical origin of these milk samples solely by the isotopic ratios of δ13C, 15N and 18O. The accuracy of the geographical discrimination is demonstrated when several milk samples from a milk factory taken from one of the regions under study were appropriately assigned to the correct PCA cluster.

Keywords: inductively coupled plasma mass spectroscopy ICP-MS, isotope ratio mass spectroscopy IRMS, ultrasound, principal component analysis, hierarchical analysis, geographical origin, milk

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Authors: Salah Gariani, Islam Shyha, Fawad Inam, Dehong Huo

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A controlled cutting fluid impinging supply system (CUT-LIST) was developed to deliver an accurate amount of cutting fluid into the machining zone via well-positioned coherent nozzles based on a calculation of the heat generated. The performance of the CUT-LIST was evaluated against a conventional flood cutting fluid supply system during step shoulder milling of Ti-6Al-4V using vegetable oil-based cutting fluid. In this paper, the micro-hardness of the machined surface was used as the main criterion to compare the two systems. CUT-LIST provided significant reductions in cutting fluid consumption (up to 42%). Both systems caused increased micro-hardness value at 100 µm from the machined surface, whereas a slight reduction in micro-hardness of 4.5% was measured when using CUL-LIST. It was noted that the first 50 µm is the soft sub-surface promoted by thermal softening, whereas down to 100 µm is the hard sub-surface caused by the cyclic internal work hardening and then gradually decreased until it reached the base material nominal hardness. It can be concluded that the CUT-LIST has always given lower micro-hardness values near the machined surfaces in all conditions investigated.

Keywords: impinging supply system, micro-hardness, shoulder milling, Ti-6Al-4V, vegetable oil-based cutting fluid

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Authors: Neerja Bharti, Drishya P.

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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.

Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption

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Authors: Thibaud Berthomier, Ali Mansour, Luc Bressollette, Frédéric Le Roy, Dominique Mottier, Léo Fréchier, Barthélémy Hermenault

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Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators.

Keywords: deep venous thrombosis, ultrasonography, elastography, scattering operator, wavelet, spectral clustering

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Authors: Abder-Rahman Ali, Adélaïde Albouy-Kissi, Manuel Grand-Brochier, Viviane Ladan-Marcus, Christine Hoeffl, Claude Marcus, Antoine Vacavant, Jean-Yves Boire

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In this paper, we present a new segmentation approach for focal liver lesions in contrast enhanced ultrasound imaging. This approach, based on a two-cluster Fuzzy C-Means methodology, considers type-II fuzzy sets to handle uncertainty due to the image modality (presence of speckle noise, low contrast, etc.), and to calculate the optimum inter-cluster threshold. Fine boundaries are detected by a local recursive merging of ambiguous pixels. The method has been tested on a representative database. Compared to both Otsu and type-I Fuzzy C-Means techniques, the proposed method significantly reduces the segmentation errors.

Keywords: defuzzification, fuzzy clustering, image segmentation, type-II fuzzy sets

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Authors: Dechen Tshering Vogel, Johannes T. Heverhagen, Bernard Kiss, Spyridon Arampatzis

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In addition to computed tomography (CT), contrast enhanced ultrasound (CEUS), and magnetic resonance imaging (MRI) are being increasingly used for imaging of renal lesions. The aim of this prospective study was to compare the classification of complex cystic renal lesions using the Bosniak classification with CEUS and MRI to CT. Forty-eight patients with 65 cystic renal lesions were included in this study. All participants signed written informed consent. The agreement between the Bosniak classifications of complex renal lesions ( ≥ BII-F) on CEUS and MRI were compared to that of CT and were tested using Cohen’s Kappa. Sensitivity, specificity, positive and negative predictive values (PPV/NPV) and the accuracy of CEUS and MRI compared to CT in the detection of complex renal lesions were calculated. Twenty-nine (45%) out of 65 cystic renal lesions were classified as complex using CT. The agreement between CEUS and CT in the classification of complex cysts was fair (agreement 50.8%, Kappa 0.31), and was excellent between MRI and CT (agreement 93.9%, Kappa 0.88). Compared to CT, MRI had a sensitivity of 96.6%, specificity of 91.7%, a PPV of 54.7%, and an NPV of 54.7% with an accuracy of 63.1%. The corresponding values for CEUS were sensitivity 100.0%, specificity 33.3%, PPV 90.3%, and NPV 97.1% with an accuracy 93.8%. The classification of complex renal cysts based on MRI and CT scans correlated well, and MRI can be used instead of CT for this purpose. CEUS can exclude complex lesions, but due to higher sensitivity, cystic lesions tend to be upgraded. However, it is useful for initial imaging, for follow up of lesions and in those patients with contraindications to CT and MRI.

Keywords: Bosniak classification, computed tomography, contrast enhanced ultrasound, cystic renal lesions, magnetic resonance imaging

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Authors: Mohammad D. H. Beg, John O. Akindoyo, Suriati Ghazali, Abdullah A. Mamun

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In this study, composites were fabricated from oil palm empty fruit bunch fiber and poly(lactic) acid by extrusion followed by injection moulding. Surface of the fiber was pre-treated by ultrasound in an alkali medium and treatment efficiency was investigated by scanning electron microscopy (SEM) analysis and Fourier transforms infrared spectrometer (FTIR). Effect of fiber treatment on composite was characterized by tensile strength (TS), tensile modulus (TM) and impact strength (IS). Furthermore, biostrong impact modifier was incorporated into the treated fiber composite to improve its impact properties. Mechanical testing showed an improvement of up to 23.5% and 33.6% respectively for TS and TM of treated fiber composite above untreated fiber composite. On the other hand incorporation of impact modifier led to enhancement of about 20% above the initial IS of the treated fiber composite.

Keywords: fiber treatment, impact modifier, natural fibers, ultrasound

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Authors: B. K. Umesh Kumar, Waleed Al Shukaili

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Air travel is one of the safest modes of travel. Inflight injuries occur due to various factors such as air turbulence, spillage of hot liquids, and fall of improperly stowed overhead baggage. Injuries occur not only to passengers but also to the flight attendants who are handling the passengers throughout the flight. A retrospective study of all records of crew safety report by the captain of the aircraft for all the flights from 01 Mar 2015 to 31 Mar 2019 in a National Carrier of Middle Eastern country, were analyzed. There was one injury to Flight attendant every 1200 flights. Commonest aircraft involved was Boeing. Inflight phase had 82% of all injuries. 63% of accidents involved female Attendants. Commonest age group involved was from 25-30 years. Cart and container injuries were the commonest and accounted for nearly 62% of the total injuries followed by turbulence. Back injuries were the commonest injuries followed by ankle, shoulder, and burns. Mean days of absence from work seen in shoulder injuries 40 days followed by injuries to back, which accounted for 38 Days. Reduction in injuries to flight attendants can be brought about by proper selection of crew, reduction in cart load. Proper maintenance of cart and container plays a major role in prevention of occupational accidents.

Keywords: flight attendants, in-flight injuries, types of injuries, work related injury prevention

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Authors: Mohammad Mirjalili, Maryam Mohammdi, Loghman Karimi

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In this study, synthesis of zinc oxide nanoparticles was carried out along with the hydrolysis of Polyethylene terephthalate using sodium hydroxide to increase the surface activity and enhance the nanoparticles adsorption. The polyester fabrics were treated with zinc acetate and sodium hydroxide at ultrasound bath, resulting in the formation of ZnO nanospheres. The presence of zinc oxide on the surface of the polyethylene terephthalate was confirmed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). The self-cleaning property of treated polyethylene terephthalate was evaluated through discoloring methylene blue stain under sunlight irradiation. The antibacterial activities of the samples against two common pathogenic bacteria including Escherichia coli and Staphylococcus aureus were also assessed. The results indicated that the photocatalytic and antibacterial activities of the ultrasound treated polyethylene terephthalate improved significantly.

Keywords: zinc oxide, polyethylene terephthalate, self-cleaning, antibacterial

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Authors: Gurmeet Singh Cheema, Gurjinder Singh, Amardeep Singh Kang

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Aluminium alloy 6061 is a medium to high strength heat-treatable alloy which has very good corrosion resistance and very good weldability. Friction Stir Welding was developed and this technique has attracted considerable interest from the aerospace and automotive industries since it is able to produce defect free joints particularly for light metals i.e aluminum alloy and magnesium alloy. In the friction stir welding process, welding parameters such as tool rotational speed, welding speed and tool shoulder diameter play a major role in deciding the weld quality. In this research work, an attempt has been made to understand the effect of tool rotational speed, welding speed and tool shoulder diameter on friction stir welded AA6061 aluminium alloy joints. Statistical tool such as central composite design is used to develop the mathematical relationships. The mathematical model was developed to predict mechanical properties of friction stir welded aluminium alloy joints at the 95% confidence level.

Keywords: aluminium alloy, friction stir welding, central composite design, mathematical relationship

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Authors: Armansyah, I. P. Almanar, M. Saiful Bahari Shaari, M. Shamil Jaffarullah, Nur’amirah Busu, M. Arif Fadzleen Zainal Abidin, M. Amlie A. Kasim

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Temperature distribution in Friction Stir Welding (FSW) of 6061-T6 Aluminum Alloy is modeled using the Finite Element Method (FEM). In order to obtain temperature distribution in the welded aluminum plates during welding operation, transient thermal finite element analyses are performed. Heat input from tool shoulder and tool pin are considered in the model. A moving heat source with a heat distribution simulating the heat generated by frictions between tool shoulder and workpiece is used in the analysis. Three-dimensional model for simulated process is carried out by using Altair HyperWork, a commercially available software. Transient thermal finite element analyses are performed in order to obtain the temperature distribution in the welded Aluminum plates during welding operation. The developed model was then used to show the effect of various input parameters such as total rate of welding speed and rotational speed on temperature distribution in the workpiece.

Keywords: frictions stir welding, temperature distribution, finite element method, altair hyperwork

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Authors: Aigul Abduldayeva, Gulnar Tuleshova

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Osteoporosis (OP) is a major socio-economic problem and is a major cause of disability, reduced quality of life and premature death of elderly people. In Astana, the study involved 93 respondents, of whom 17 were men (18.3%), and 76 were women (81.7%). Age distribution of the respondents is as follows: 40-59 (66.7%), 60-75 (29.0%), 75-90 (4.3%). In the city of Astana general breach of bone mass (CCM) was determined in 83.8% (nationwide figure - RRP - 79.0%) of the patients, and normal levels of ultrasound densitometry were detected in 16.1% (RRP 21.0%) of the patients. OP was diagnosed in 20.4% of people over 40 (RRP for citizens is 19.0%), 25.4% in the group older than 50 (23.4% PIU), 22,6% in the group older than 60 (RRP 32.6%), 25.0% in the group older than 70 (47.6% of RRP). OPN was detected in 63.4% (RRP 59.6%) of the surveyed population. These data indicate that, there is no sharp difference between Astana and other cities in the country regarding the incidence of OP, that is, the situation with the OP is not aggravated by any regional characteristics. In the distribution of respondents by clusters it was found that 80.0% of the respondents with CCM were in the "best urban cluster", 93.8% were in "average urban cluster", and 77.4% were in a "poor urban cluster". There is a high rate construction of new buildings in Astana, presumably, that the new settlers inhabit the outskirts of the city, and very difficult to trace the socio-economic differences there. Based on these data the following conclusions can be made: 1. According to the ultrasound densitometry of the calcaneus the prevalence rate of NCM among the residents of Astana is 83.3%, OP - 20.4%, which generally coincides with data elsewhere in the country. 2. The urban population of Astana is under a high degree of risk for low energetic fracture, 46.2% of the population had medium and high risks of fracture, while the nationwide index is 26.7%. 3. In the development of CCM residents of Akmola region play a significant role gender, age, ethnic factors. According to the ultrasound densitometry women are more prone to Astana OP - 22.4% of respondents than men - 11.8% of respondents.

Keywords: nutrition, osteoporosis, elderly, urban population

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Authors: Mustafa Kemal Bilici, Memduh Kurtulmuş, İlyas Kartal, Ahmet İrfan Yükler

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Friction stir welding is a solid-state joining process that has gained acceptable progress in recent years. This method which was first used for welding of aluminum and its alloys is now employed for welding of other materials such as polymers and composites. The aim of the present work is to investigate the mechanical properties of butt joints produced by friction stir welding (FSW) in high density polyethylene sheets of 4 mm thickness. The effects of critical welding parameters and tool design have affected on mechanical properties, weld surface and macrostructure of friction stir welded polyethylene. Experiments were performed at tool rotational speeds of 600, 900, 1200 and 1500 r/min and traverse speeds of 30, 45 and 60 mm/min, tool diameters (d) of 4, 5, 6 mm and tool shoulder diameters (D) 20, 25, 30 mm. A strength value of 80 % of the base material was achieved at the isolated optimum welding condition. According to the tool design, the welding parameters and the mechanical properties changed to a great extent. The highest tensile strength was achieved at low feed rates, high tool rotation speeds and shoulder diameters/pin diameters ratio.

Keywords: friction stir welding, mechanical properties, polyethylene, high density polyethylene, tool design

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Authors: Andrew Anis Fakhrey Mosaad

Abstract:

This Musculoskeletal (MSK) conditions are a major contributing factor in disability. This becomes more challenging as the world population is witnessing an increase in the geriatric population. Various treatment strategies are being researched to provide the most effective and non-invasive approach. To date, low-level laser therapy (LLLT) is one of the emerging modalities to treat different musculoskeletal conditions in physical therapy practice. Physical therapy practice uses different modalities to control pain and inflammation. LLLT has been under research for the last two decades and has shown varying results. This literature review focuses on the effectiveness of LLLT in different musculoskeletal conditions. Using search engines of PubMed and Google Scholar, a number of articles have been reviewed based on the inclusion and exclusion criteria. LLLT shows promising results in treating different musculoskeletal conditions. However, clinicians need to ensure to follow the recommended dosage parameters for specific musculoskeletal conditions.

Keywords: musculoskeletal conditions, low level laser therapy, ultrasound, wavelength, pain and inflammation

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Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

Abstract:

Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

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Authors: Naomi Sakamoto, Eisuke Fukuma, Mika Nashimoto, Yoshitomo Koshida

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Background: Selective localization of the metastatic lymph node with clip and removal of clipped nodes with sentinel lymph node (SLN), known as targeted axillary dissection (TAD), reduced false-negative rates (FNR) of SLN biopsy (SLNB) after neoadjuvant chemotherapy (NAC). For the patients who achieved nodal pathologic complete response (pCR), accurate staging of axilla by TAD lead to omit axillary lymph node dissection (ALND), decreasing postoperative arm morbidity without a negative effect on overall survival. This study aimed to investigate the ultrasound (US) identification rate and success removal rate of two kinds of ultrasound-visible clips placed in metastatic lymph nodes during TAD procedure. Methods: This prospective study was conducted using patients with clinically T1-3, N1, 2, M0 breast cancer undergoing NAC followed by surgery. A US-visible clip was placed in the suspicious lymph node under US guidance before neoadjuvant chemotherapy. Before surgery, US examination was performed to evaluate the detection rate of clipped node. During the surgery, the clipped node was removed using several localization techniques, including hook-wire localization, dye-injection, or fluorescence technique, followed by a dual-technique SLNB and resection of palpable nodes if present. For the fluorescence technique, after injection of 0.1-0.2 mL of indocyanine green dye (ICG) into the clipped node, ICG fluorescent imaging was performed using the Photodynamic Eye infrared camera (Hamamatsu Photonics k. k., Shizuoka, Japan). For the dye injection method, 0.1-0.2 mL of pyoktanin blue dye was injected into the clipped node. Results: A total of 29 patients were enrolled. Hydromark™ breast biopsy site markers (Hydromark, T3 shape; Devicor Medical Japan, Tokyo, Japan) was used in 15patients, whereas a UltraCor™ Twirl™ breast marker (Twirl; C.R. Bard, Inc, NJ, USA) was placed in 14 patients. US identified the clipped node marked with the UltraCore Twirl in 100% (14/14) and with the Hydromark in 93.3% (14/15, p = ns). Success removal of clipped node marked with the UltraCore Twirl was achieved in 100% (14/14), whereas the node marked with the Hydromark was removed in 80% (12/15) (p = ns). Conclusions: The ultrasound identification rate differed between the two types of ultrasound-visible clips, which also affected the success removal rate of clipped nodes. Labelling the positive node with a US-highly-visible clip allowed successful TAD.

Keywords: breast cancer, neoadjuvant chemotherapy, targeted axillary dissection, breast tissue marker, clip

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Authors: Peifei Zhu, Zisheng Li, Yasuki Kakishita, Mayumi Suzuki, Tomoaki Chono

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Segmentation of left ventricle (LV) from cardiac ultrasound images provides a quantitative functional analysis of the heart to diagnose disease. Active Shape Model (ASM) is a widely used approach for LV segmentation but suffers from the drawback that initialization of the shape model is not sufficiently close to the target, especially when dealing with abnormal shapes in disease. In this work, a two-step framework is proposed to improve the accuracy and speed of the model-based segmentation. Firstly, a robust and efficient detector based on Hough forest is proposed to localize cardiac feature points, and such points are used to predict the initial fitting of the LV shape model. Secondly, to achieve more accurate and detailed segmentation, ASM is applied to further fit the LV shape model to the cardiac ultrasound image. The performance of the proposed method is evaluated on a dataset of 800 cardiac ultrasound images that are mostly of abnormal shapes. The proposed method is compared to several combinations of ASM and existing initialization methods. The experiment results demonstrate that the accuracy of feature point detection for initialization was improved by 40% compared to the existing methods. Moreover, the proposed method significantly reduces the number of necessary ASM fitting loops, thus speeding up the whole segmentation process. Therefore, the proposed method is able to achieve more accurate and efficient segmentation results and is applicable to unusual shapes of heart with cardiac diseases, such as left atrial enlargement.

Keywords: hough forest, active shape model, segmentation, cardiac left ventricle

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Authors: Niloofar Zebarjad

Abstract:

This research aims at finding a tool to provide basketball players with real-time audio feedback on their shooting form in free throw shots. Free throws played a pivotal role in taking the lead in fierce competitions. The major problem in performing an accurate free throw seems to be improper training. Since the arm movement during the free throw shot is complex, the coach or the athlete might miss the movement details during practice. Hence, there is a necessity to create a system that measures arm movements' critical characteristics and control for improper kinematics. The proposed setup in this study quantifies arm kinematics and provides real-time feedback as an audio signal consisting of a gyroscope sensor. Spatial shoulder angle data are transmitted in a mobile application in real-time and can be saved and processed for statistical and analysis purposes. The proposed system is easy to use, inexpensive, portable, and real-time applicable. Objectives: This research aims to modify and control the free throw using audio feedback and determine if and to what extent the new setup reduces errors in arm formations during throws and finally assesses the successful throw rate. Methods: One group of elite basketball athletes and two novice athletes (control and study group) participated in this study. Each group contains 5 participants being studied in three separate sessions over a week. Results: Empirical results showed enhancements in the free throw shooting style, shot pocket (SP), and locked position (LP). The mean values of shoulder angle were controlled on 25° and 45° for SP and LP, respectively, recommended by valid FIBA references. Conclusion: Throughout the experiments, the system helped correct and control the shoulder angles toward the targeted pattern of shot pocket (SP) and locked position (LP). According to the desired results for arm motion, adding another sensor to measure and control the elbow angle is recommended.

Keywords: audio-feedback, basketball, free-throw, locked-position, motor-control, shot-pocket

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Authors: Silpa Mariyam John, S. Baburaj, Prajit Geevarghese

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Diabetes accelerates pregnancy and can cause adverse effects on the fetus. Studies have shown that fetal abdominal circumference measured in ultrasound is an early parameter for the assessment of macrosomia. The objective of the study is to compare the fetal abdominal circumferences between diabetes and non-diabetic mothers. It was a comparative cross-sectional study conducted in a tertiary care hospital in Trivandrum, Kerala, with a sample size calculated as 95 for each group. All mothers taking antenatal care and delivering at the hospital were included after obtaining consent. The mothers and their newborns were divided into 2 groups (diabetic and non-diabetic). Relevant fetal biometry values were collected from medical records, and birth weight was measured by a calibrated electronic weighing machine after birth. The data were entered in MS EXCEL and analyzed. It was found that there is a significant relationship between the fetal abdominal circumference and birthweight in diabetic mothers during the first and third trimesters.

Keywords: newborn, diabetes, abdominal circumference, ultrasound

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