Search results for: soft knee

Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea.The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic, biopsy, diabetic foot

Procedia PDF Downloads 63

Authors: Saraswati Verma, Ankit Batra

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In the modern day, structures are designed with a lot of complexities due to economical, aesthetical, and functional needs causing various levels of irregularities to be induced. In the past, several studies have repeatedly shown that irregular structures suffer more damage than regular structures during earthquakes. The present study makes an effort to study the contribution of the orientation of columns in the seismic behaviour of buildings with vertical irregularities namely, soft storey irregularity, mass irregularity and geometric irregularity. The response of the various models is analysed using sap2000 version 14. The parameters through which a comparative response is investigated are displacement, variation in the stiffness contribution, and inter-storey drift. Models with different configurations of column orientations were studied for each vertical irregularity and it was observed that column orientation contributed significantly in affecting a better seismic response. Square columns of the same cross-sectional area showed a good response as compared to that of rectangular columns. The study concludes that as displacement values for buildings with a soft storey and mass irregularity are very high, square columns could be used to minimise the effect of displacement in x and y-axis. In buildings with geometric irregularity, exterior column orientations can be played with to enhance the stiffness in the shorter direction to control the displacement and drift values in both x and y directions.

Keywords: soft storey, mass irregularity, geometric irregularity, column orientation, square column

Procedia PDF Downloads 354

Authors: Amal A. Mashali, Omar Eltaweel, Elerian Ekladious

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Stature of an individual has an important role in identification, which is often required in medico-legal practice. The estimation of stature is an important step in the identification of dismembered remains or when only a part of a skeleton is only available as in major disasters or with mutilation. There is no published data on anthropological data among Jordanian population. The present study was designed in order to find out relationship of stature to some anthropometric measures among a sample of Jordanian population and to determine the most accurate and reliable one in predicting the stature of an individual. A cross sectional study was conducted on 336 adult healthy volunteers , free of bone diseases, nutritional diseases and abnormalities in the extremities after taking their consent. Students of Faculty of Medicine, Mutah University helped in collecting the data. The anthropometric measurements (anatomically defined) were stature, humerus length, hand length and breadth, foot length and breadth, foot index and knee height on both right and left sides of the body. The measurements were typical on both sides of the bodies of the studied samples. All the anthropologic data showed significant relation with age except the knee height. There was a significant difference between male and female measurements except for the foot index where F= 0.269. There was a significant positive correlation between the different measures and the stature of the individuals. Three equations were developed for estimation of stature. The most sensitive measure for prediction of a stature was found to be the humerus length.

Keywords: foot index, foot length, hand length, humerus length, stature

Procedia PDF Downloads 264

Authors: Amin Davoudi

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Aim: New approaches have been introduced to improve soft tissue indices of the dental implants. This systematic review aimed to investigate the effect of computer-aided design and computer-assisted manufacture (CAD/CAM) zirconia (Zr) implant abutments on periodontal aspects. Materials and Methods: Five electronic databases were searched thoroughly based on prior defined MeSH and non-MeSH keywords. Clinical studies were collected via hand searches in English language journals up to September 2020. Interproximal papilla stability, papilla recession, pink and white esthetic score (PES, WES), bone and gingival margin levels, color, and contour of soft tissue were reviewed. Results: The initial literature search yielded 412 articles. After the evaluation of abstracts and full texts, six studies were eligible to be screened. The study design of the included studies was a prospective cohort (n=3) and randomized clinical trial (n=3). The outcome was found to be significantly better for Zr than titanium abutments, however, the studies did not show significant differences between stock and CAD/CAM abutments. Conclusion: Papilla fill, WES, PES, and the distance from the contact point to dental crest bone of adjacent tooth and inter-tooth–implant distance were not significantly different between Zr CAD/CAM and Zr stock abutments. However, soft tissue stability and recession index were better in Zr CAD/CAM abutments.

Keywords: zirconia, CADCAM, periodental, implant

Procedia PDF Downloads 73

Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

Abstract:

Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

Procedia PDF Downloads 72

Authors: Pim Terachinda, Witaya Wannasuphoprasit, Wasuwat Kitisomprayoonkul, Anan Srikiatkhachorn

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Restoration of hand function and dexterity remain challenges in rehabilitation after stroke. We have developed soft exoskeleton hand robot in which using tendon-driven mechanism. Finger flexion and extension can be triggered by a foot switch and force can be adjusted manually depending on patient’s grip strength. The objective of this study is to investigate feasibility and safety of this device. The study was done in 2 stroke patients with the strength of the finger flexors/extensors grade 1/0 and 3/1 on Medical Research Council scale, respectively. Grasp and release training was performed for 30 minutes. No complication was observed. Results demonstrated that the device is safe, and therapy can be tailored to individual patient’s need. However, further study is required to determine recovery and rehabilitation outcomes after training in patients after nervous system injury.

Keywords: hand, rehabilitation, robot, stroke

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Authors: Wahiba Mohguen, Raïs El’hadi Bekka

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This paper presents a denoising method called EMD-Custom that was based on Empirical Mode Decomposition (EMD) and the modified Customized Thresholding Function (Custom) algorithms. EMD was applied to decompose adaptively a noisy signal into intrinsic mode functions (IMFs). Then, all the noisy IMFs got threshold by applying the presented thresholding function to suppress noise and to improve the signal to noise ratio (SNR). The method was tested on simulated data and real ECG signal, and the results were compared to the EMD-Based signal denoising methods using the soft and hard thresholding. The results showed the superior performance of the proposed EMD-Custom denoising over the traditional approach. The performances were evaluated in terms of SNR in dB, and Mean Square Error (MSE).

Keywords: customized thresholding, ECG signal, EMD, hard thresholding, soft-thresholding

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Authors: Muzamir Hasan, Anas Bazirgan

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Granular columns is a technique that has the properties of improving bearing capacity, accelerating the dissipation of excess pore water pressure and reducing settlement in a weak soft soil. This research aims to investigate the role of Polypropylene column in improving the shear strength and compressibility of soft reconstituted kaolin clay by determining the effects of area replacement ratio, height penetrating ratio and volume replacement ratio of a singular Polypropylene column on the strength characteristics. Reinforced kaolin samples were subjected to Unconfined Compression (UCT) and Unconsolidated Undrained (UU) triaxial tests. The kaolin samples were 50 mm in diameter and 100 mm in height. Using the PP column reinforcement, with an area replacement ratio of 0.8, 0.5 and 0.3, shear strength increased approximately 5.27%, 26.22% and 64.28%, and 37.14%, 42.33% and 51.17%, for area replacement ratios of 25% and 10.24%. Meanwhile, UU testing showed an increase in shear strength of 24.01%, 23.17% and 23.49% and 28.79%, 27.29 and 30.81% for the same ratios. Based on the UCT results, the undrained shear strength generally increased with the decrease in height penetration ratio. However, based on the UU test results Mohr-Coulomb failure criteria, the installation of Polypropylene columns did not show any significant difference in effective friction angle. However, there was an increase in the apparent cohesion and undrained shear strength of the kaolin clay. In conclusion, Polypropylene column greatly improved the shear strength; and could therefore be implemented in reducing the cost of soil improvement as a replacement for non-renewable materials.

Keywords: polypropylene, UCT, UU test, Kaolin S300, ground improvement

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Authors: Magdi M. E. Zumrawi, Nehla Mansour

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This paper aims to assess the efficiency of using geogrid reinforcement for subgrade stabilization. The literature of applying geogrid reinforcement technique for pavements built on soft subgrades and the previous experiences were reviewed. Laboratory tests were conducted on soil reinforced with geogrids in one or several layers. The soil specimens were compacted in four layers with or without geogrid sheets. The California Bearing Ratio (CBR) test, in soaking condition, was performed on natural soil and soil-geogrid specimens. The test results revealed that the CBR value is much affected by the geogrid sheet location and the number of sheets used in the soil specimen. When a geogrid sheet was placed at the 1^st layer of the soil, there was an increment of 26% in the CBR value. Moreover, the CBR value was significantly increased by 62% when geogrid sheets were placed at all four layers. The high CBR value is attributed to interface friction and interlock involved in the geogrid/ soil interactions. It could be concluded that geogrid reinforcement is successful and more economical technique.

Keywords: geogrid, reinforcement, stabilization, subgrade

Procedia PDF Downloads 289

Authors: Afshin Jahangirzadeh, Shatirah Akib, Keyvan Kimiaei, Hossein Basser

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Coastal defense structures were built to protect part of shore from beach erosion and flooding by sea water. Effects of coastal defense structures can be negative or positive. Some of the effects are beneficial in socioeconomic aspect, but environment matters should be given more concerns because it can bring bad consequences to the earth landscape and make the ecosystem be unbalanced. This study concerns on the negative impacts as they are dominant. Coastal structures can extremely impact the shoreline configuration. Artificial structures can influence sediment transport, split the coastal space, etc. This can result in habitats loss and lead to noise and visual disturbance of birds. There are two types of coastal defense structures, hard coastal structure and soft coastal structure. Both coastal structures have their own impacts. The impacts are induced during the construction, maintaining, and operation of the structures.

Keywords: ecosystem, environmental impact, hard coastal structures, soft coastal structures

Procedia PDF Downloads 455

Authors: Le Quang Hanh

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Almost all big cities in Vietnam are often located in the river deltas. Therefore the ground condition on these cities is mostly soft soil. As a result, the soil strengthen works are mandatory in order to prevent the harmful to the third parties and tunnel structure itself in urban tunnel projects in Vietnam. This paper will particularly introduce the large diameter jet-grouted column technique that is recently being successfully applied in Ho Chi Minh City in Vietnam. The success application of this technique for protecting the historical sensitive building and for water cutoff objective of launching and arriving shafts in the urban tunnel project, will be analyzed from construction process, quality control and lessons learnt. From this situation, the large diameter jet-grouted column technique can extend to another urban tunnel projects in Vietnam and other countries which have similar soft soil conditions.

Keywords: large diameter, jet grouting, ground improvement, urban tunnel

Procedia PDF Downloads 181

Authors: Andrey Yatsun, Andrei Malchikov

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Exoskeletons are used to support and compensate for the load on the human musculoskeletal system. Elastomers are an important component of exoskeletons, providing additional support and compensating for the load. The algorithm of the active elastomer tension system provides the required auxiliary force depending on the angle of rotation and the tilt speed of the operator's torso. Feedback for the drive is provided by a force sensor integrated into the attachment of the exoskeleton vest. The use of direct force measurement ensures the required accuracy in all settings of the man-machine system. Non-adjustable elastic elements make it difficult to move without load, tilt forward and walk. A strategy for the organization of the auxiliary forces management system is proposed based on the allocation of 4 operating modes of the human-machine system.

Keywords: soft exoskeleton, mathematical modeling, pre-tension elastomer, human-machine interaction

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Authors: Shivani Singh, Shantanu Nakhare, Kalyani Nair, Rohan Shetty

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As social networking is growing at a rapid pace today it is vital that we work on improving its management. Research has shown that the content present in online social networks may have significant influence on impressionable minds. If such platforms are misused, it will lead to negative consequences. Detecting insults or inappropriate messages continues to be one of the most challenging aspects of Online Social Networks (OSNs) today. We address this problem through a Machine Learning Based Soft Text Classifier approach using Support Vector Machine algorithm. The proposed system acts as a screening mechanism the alerts the user about such messages. The messages are classified according to their subject matter and each comment is labeled for the presence of profanity and insults.

Keywords: machine learning, online social networks, soft text classifier, support vector machine

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

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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

Procedia PDF Downloads 203

Authors: Blessing C. Nwachukwu, Michael O. Taiwo, Wasiu A. Abibu, Isaac O. Ayodeji

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Milk is an important source of micro and macronutrients for humans. Soft Cheese (Wara) is an example of a by-product of milk. In addition, water is considered as one of the most vital resources in cattle farms. Due to the high consumption rate of milk and soft cheese and the traditional techniques involved in their production in Nigeria, there was a need for a microbiological assessment which will be of utmost public health importance. The study thus investigated microbial risk assessments associated with consumption of milk and soft cheese (Wara). It also investigated common pathogens present in dairy water in farms and antibiotic sensitivity profiling for implicated pathogens were conducted. Samples were collected from three different Fulani dairy herds in Ido local government, Ibadan, Oyo State, Nigeria and subjected to microbiological evaluation and antimicrobial susceptibility testing. Aspergillus flavus was the only isolated fungal isolate from Wara while Staphylococcus aureus, Vibro cholera, Hafnia alvei, Proteus mirabilis, Escherishia coli, Psuedomonas aeuroginosa, Citrobacter freundii, and Klebsiella pneumonia were the bacteria genera isolated from Wara, dairy milk and dairy drinking water. Bacterial counts from Wara from the three selected farms A, B and C were 3.5×105 CFU/ml, 4.0×105 CFU/ml and 5.3×105 CFU/ml respectively while the fungal count was 3CFU/100µl. The total bacteria count from dairy milk from the three selected farms A, B and C were Farms 2.0 ×105 CFU/ml, 3.5 × 105 CFU/ml and 6.5 × 105 CFU/ml respectively. 1.4×105 CFU/ml, 1.9×105 CFU/ml and 4.9×105 CFU/ml were the recorded bacterial counts from dairy water from farms A, B and C respectively. The highest antimicrobial resistance of 100% was recorded in Wara with Enrofloxacin, Gentamycin, Cefatriaxone and Colistin. The highest antimicrobial susceptibility of 100% was recorded in Raw milk with Enrofloxacin and Gentamicin. Highest antimicrobial intermediate response of 100% was recorded in Raw milk with Streptomycin. The study revealed that most of the cheeses sold at Ido local Government are contaminated with pathogens. Further research is needed on standardizing the production method to prevent pathogens from gaining access. The presence of bacteria in raw milk indicated contamination due to poor handling and unhygienic practices. Thus, drinking unpasteurized milk is hazardous as it increases the risk of zoonoses. Also, the Provision of quality drinking water is crucial for optimum productivity of dairy. Health education programs aiming at increasing awareness of the importance of clean water for animal health will be helpful.

Keywords: dairy, raw milk, soft cheese, Wara

Procedia PDF Downloads 143

Authors: Ting-Ting Wen, Jung-Ruey Tsai

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This paper reports a method for the replication of micro-scale structures. By using electromagnetic force-assisted imprinting system with magnetic soft stamp written square-microlens cavity, a photopolymer square-microlens structures can be rapidly fabricated. Under the proper processing conditions, the polymeric square-microlens structures with feature size of width 100.3um and height 15.2um across a large area can be successfully fabricated. Scanning electron microscopy (SEM) and surface profiler observations confirm that the micro-scale polymer structures are produced without defects or distortion and with good pattern fidelity over a 60x60mm2 area. This technique shows great potential for the efficient replication of the micro-scale structure array at room temperature and with high productivity and low cost.

Keywords: square-microlens structures, electromagnetic force-assisted imprinting, magnetic soft stamp

Procedia PDF Downloads 298

Authors: Riyadh Jamegh, Alla Eldin Kassam, Sawsan Sabih

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In order to overcome uncertainty conditions and inability to meet customers' requests due to these conditions, organizations tend to reserve a certain safety stock level (SSL). This level must be chosen carefully in order to avoid the increase in holding cost due to excess in SSL or shortage cost due to too low SSL. This paper used soft computing fuzzy logic to identify optimal SSL; this fuzzy model uses the dynamic concept to cope with high complexity environment status. The proposed model can deal with three input variables, i.e., demand stability level, raw material availability level, and on hand inventory level by using dynamic fuzzy logic to obtain the best SSL as an output. In this model, demand stability, raw material, and on hand inventory levels are described linguistically and then treated by inference rules of the fuzzy model to extract the best level of safety stock. The aim of this research is to provide dynamic approach which is used to identify safety stock level, and it can be implanted in different industries. Numerical case study in the dairy industry with Yogurt 200 gm cup product is explained to approve the validity of the proposed model. The obtained results are compared with the current level of safety stock which is calculated by using the traditional approach. The importance of the proposed model has been demonstrated by the significant reduction in safety stock level.

Keywords: inventory optimization, soft computing, safety stock optimization, dairy industries inventory optimization

Procedia PDF Downloads 101

Authors: Chiung-Yun Chang, Po-Chou Chen, Jiun-Shiang Tzeng, Ka-Wai Mac, Chia-Chi Hsiao, Jo-Chi Jao

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This study aimed to measure R2* relaxation rates in the liver of New Zealand White (NZW) rabbits. R2* relaxation rate has been widely used in various hepatic diseases for iron overload by quantifying iron contents in liver. R2* relaxation rate is defined as the reciprocal of T2* relaxation time and mainly depends on the composition of tissue. Different tissues would have different R2* relaxation rates. The signal intensity decay in Magnetic resonance imaging (MRI) may be characterized by R2* relaxation rates. In this study, a 1.5T GE Signa HDxt whole body MR scanner equipped with an 8-channel high resolution knee coil was used to observe R2* values in NZW rabbit’s liver and muscle. Eight healthy NZW rabbits weighted 2 ~ 2.5 kg were recruited. After anesthesia using Zoletil 50 and Rompun 2% mixture, the abdomen of rabbit was landmarked at the center of knee coil to perform 3-plane localizer scan using fast spoiled gradient echo (FSPGR) pulse sequence. Afterward, multi-planar fast gradient echo (MFGR) scans were performed with 8 various echo times (TEs) (2/4/6/8/10/12/14/16 ms) to acquire images for R2* calculations. Regions of interest (ROIs) at liver and muscle were measured using Advantage workstation. Finally, the R2* was obtained by a linear regression of ln(SI) on TE. The results showed that the longer the echo time, the smaller the signal intensity. The R2* values of liver and muscle were 44.8  10.9 s-1 and 37.4  9.5 s-1, respectively. It implies that the iron concentration of liver is higher than that of muscle. In conclusion, R2* is correlated with iron contents in tissue. The correlations between R2* and iron content in NZW rabbit might be valuable for further exploration.

Keywords: liver, magnetic resonance imaging, muscle, R2* relaxation rate

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Authors: Mahmoud Y. Shokry, Rami M. El-Sherbiny

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This paper aims to highlight the role of some parameters that may be of a noticeable impact on numerical analysis/design of embankments. It presents the results of a three-dimensional (3-D) finite element analysis of a monitored earth embankment that was constructed on soft clay formation stabilized by cast in-situ piles using software PLAXIS 3D. A comparison between the predicted and the monitored responses is presented to assess the adequacy of the adopted numerical model. The model was used in the targeted parametric study. Moreover, a comparison was performed between the results of the 3-D analyses and the analytical solutions. This paper concluded that the effect of using mono pile caps led to decrease both the total and differential settlement and increased the efficiency of the piled embankment system. The study of using geogrids revealed that it can contribute in decreasing the settlement and maximizing the part of the embankment load transferred to piles. Moreover, it was found that increasing the stiffness of the geogrids provides higher values of tensile forces and hence has more effective influence on embankment load carried by piles rather than using multi-number of layers with low values of geogrid stiffness. The efficiency of the piled embankments system was also found to be greater when higher embankments are used rather than the low height embankments. The comparison between the numerical 3-D model and the theoretical design methods revealed that many analytical solutions are conservative and non-accurate rather than the 3-D finite element numerical models.

Keywords: efficiency, embankment, geogrids, soft clay

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Authors: Derwin K. C. Chan, Alfred S. Y. Lee

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The integrated model of self-determination theory and the theory of planned behaviour has been successfully applied to explain individuals’ adherence to health behaviours, including behavioural adherence toward rehabilitation. This study was a randomised controlled trial that examined the effectiveness of an mHealth intervention (i.e., mobile application) developed based on this integrated model in promoting treatment adherence of patients of anterior cruciate ligament rupture during their post-surgery home-based rehabilitation period. Subjects were 67 outpatients (aged between 18 and 60) who undertook anterior cruciate ligament (ACL) reconstruction surgery for less than 2 months for this study. Participants were randomly assigned either into the treatment group (who received the smartphone application; N = 32) and control group (who receive standard treatment only; N = 35), and completed psychological measures relating to the theories (e.g., motivations, social cognitive factors, and behavioural adherence) and clinical outcome measures (e.g., subjective knee function (IKDC), laxity (KT-1000), muscle strength (Biodex)) relating to ACL recovery at baseline, 2-month, and 4-month. Generalise estimating equation showed the interaction between group and time was significant on intention was only significant for intention (Wald x² = 5.23, p = .02), that of perceived behavioural control (Wald x² = 3.19, p = .07), behavioural adherence (Wald x² = 3.08, p = .08, and subjective knee evaluation (Wald x² = 2.97, p = .09) were marginally significant. Post-hoc between-subject analysis showed that control group had significant drop of perceived behavioural control (p < .01), subjective norm (p < .01) and intention (p < .01), behavioural adherence (p < .01) from baseline to 4-month, but such pattern was not observed in the treatment group. The treatment group had a significant decrease of behavioural adherence (p < .05) in the 2-month, but such a decrease was not observed in 4-month (p > .05). Although the subjective knee evaluation in both group significantly improved at 2-month and 4-month from the baseline (p < .05), and the improvements in the control group (mean improvement at 4-month = 40.18) were slightly stronger than the treatment group (mean improvement at 4-month = 34.52). In conclusion, the findings showed that the theory driven mobile application ameliorated the decline of treatment intention of home-based rehabilitation. Patients in the treatment group also reported better muscle strength than control group at 4-month follow-up. Overall, the mobile application has shown promises on tackling the problem of orthopaedics outpatients’ non-adherence to medical treatment.

Keywords: self-determination theory, theory of planned behaviour, mobile health, orthopaedic patients

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Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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Authors: Afef Dridi, Salah Mezlini

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Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.

Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method

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Authors: Soumaya Sallem, Marc Olivas

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This contribution presents a method for detecting, locating, and characterizing soft faults in a complex wired network. The proposed method is based on multi-carrier reflectometry MCTDR (Multi-Carrier Time Domain Reflectometry) combined with a multi-objective genetic algorithm. In order to ensure complete network coverage and eliminate diagnosis ambiguities, the MCTDR test signal is injected at several points on the network, and the data is merged between different reflectometers (sensors) distributed on the network. An adapted multi-objective genetic algorithm is used to merge data in order to obtain more accurate faults location and characterization. The proposed method performances are evaluated from numerical and experimental results.

Keywords: wired network, reflectometry, network distributed diagnosis, multi-objective genetic algorithm

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Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

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Authors: Saidasanov Saidazal Shokhmurodovich, Topolnickiy Orest Zinovyevich, Afaunova Olga Arturovna

Abstract:

Relevance: Bilateral congenital cleft is one of the most complex forms of all clefts, which makes it difficult to choose a surgical method of treatment. During primary operations to close the hard and soft palate, there is a shortage of soft tissues and their lack during standard uranoplasty, and these factors aggravate the period of rehabilitation of patients. Materials and methods: The results of surgical treatment of children with bilateral cleft, who underwent uranoplasty using a flap from the tongue, were analyzed. The study used methods: clinical and statistical, which allowed us to solve the tasks, based on the principles of evidence-based medicine. Results and discussion: in our study, 15 patients were studied, who underwent surgical treatment in the following volume: uranoplasty using a flap from the tongue in two stages. Of these, 9 boys and 6 girls aged 2.5 to 6 years. The first stage was surgical treatment in the volume: veloplasty. The second stage was a surgical intervention in volume: uranoplasty using a flap from the tongue. In all patients, the width of the cleft ranged from 1.6-2.8 cm. All patients in this group were orthodontically prepared. Using this method, the surgeon can achieve the following results: maximum narrowing of the palatopharyngeal ring, long soft palate, complete closure of the hard palate, alveolar process, and the mucous membrane of the nasal cavity is also sutured, which creates good conditions for the next stage of osteoplastic surgery. Based on the result obtained, patients have positive results of working with a speech therapist. In all patients, the dynamics were positive without complications. Conclusions: Based on our observation, tongue flap uranoplasty is one of the effective techniques for patients with wide clefts of the hard and soft palate. The use of a flap from the tongue makes it possible to reduce the number of repeated reoperations and improve the quality of social adaptation of this group of patients, which is one of the important stages of rehabilitation. Upon completion of the stages of rehabilitation, all patients had the maximum improvement in functional, anatomical and social indicators.

Keywords: congenital cleft lips and palate, bilateral cleft, child surgery, maxillofacial surgery

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Authors: Nayeli Camacho, Fernanda Lara-Perez, Carolina Ortega-Portilla, Diego G. Espinosa-Arbelaez, Juan M. Alvarado-Orozco, Guillermo C. Mondragon-Rodriguez

Abstract:

Ultra-high molecular weight polyethylene (UHMWPE) has been the gold standard material for total knee replacements for almost five decades. Wear damage to UHMWPE articulating surface is inevitable due to the natural sliding and rolling movements of the knee. This generates a considerable amount of wear debris, which results in mechanical instability of the joint, reduces joint mobility, increases pain with detrimental biologic responses, and causes component loosening. The presence of wear particles has been closely related to adverse reactions in the knee joint surrounding tissue, especially for particles in the range of 0.3 to 2 μm. Carbon-based materials possess excellent mechanical properties and have shown great promise in tribological applications. In this study, diamond-like carbon coatings (DLC) and carbon nanotubes (CNTs) were used to decrease the wear rate of ultra-high molecular weight polyethylene. A titanium doped DLC (Ti-DLC) was deposited by magnetron sputtering on stainless steel precision spheres while CNTs were used as a second phase reinforcement in UHMWPE at a concentration of 1.25 wt.%. A comparative tribological analysis of the wear of UHMWPE and UHMWPE-CNTs with a stainless steel counterpart with and without Ti-DLC coating is presented. The experimental wear testing was performed on a pin-on-disc tribometer under dry conditions, using a reciprocating movement with a load of 1 N at a frequency of 2 Hz for 100,000 and 200,000 cycles. The wear tracks were analyzed with high-resolution scanning electron microscopy to determine wear modes and observe the size and shape of the wear debris. Furthermore, profilometry was used to study the depth of the wear tracks and to map the wear of the articulating surface. The wear tracks at 100,000 and 200,000 cycles on all samples were relatively shallow, and they were in the range of average roughness. It was observed that the Ti-DLC coating decreases the mass loss in the UHMWPE and the depth of the wear track. The combination of both carbon-based materials decreased the material loss compared to the system of stainless steel and UHMWPE. Burnishing of the surface was the predominant wear mode observed with all the systems, more subtle for the systems with Ti-DLC coatings. Meanwhile, in the system composed of stainless steel-UHMWPE, the intrinsic surface roughness of the material was completely replaced by the wear tracks.

Keywords: CNT reinforcement, self-lubricating materials, Ti-DLC, UHMWPE tribological performance

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Authors: V. K. Stalin, V. Paneerselvam, M. Bharath, M. Kirithika

Abstract:

In developing countries like India due to the rapid urbanization, large amount of waste materials are produced every year. These waste materials can be utilized in the improvement of problematic soils. Stone column is one of the best methods to improve soft clay deposits. In this study, load tests were conducted to ensure the suitability of waste as column materials. The variable parameters studied are material, number of column and encasement. The materials used for the study are stone aggregate, copper slag, construction waste, for one, two and three number of columns with geotextile and geogrid encasement. It was found that the performance of waste as column material are comparable to that of conventional stone column with and without encasement. Hence, it is concluded that the copper slag and construction waste may be used as a column material in place of conventional stone aggregate to improve the soft clay advantage being utilization of waste.

Keywords: stone column, geocomposite, construction waste, copper slag

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Authors: Ophir Segal, Daniel Weltsch, Shay Tenenbaum, Ran Thein

Abstract:

Purpose: Patients with lateral patellar dislocation (LPD) are not always referred to perform an MRI. This might be the case in first time LPD patients without surgical indications or in patients with recurrent LPD who had MRI in previous episodes. Unfortunately, in some cases, there are additional knee pathological findings, which include tearing of the collateral or cruciate ligaments and injury to the tendons or menisci. These findings might be overlooked during the physical examination or masked by nonspecific clinical findings like knee pain, effusion, or hemarthrosis. The prevalence of these findings, which can be revealed by MRI, is misreported in literature and is considered rare. In our practice, all patients with LPD are sent for MRI after LPD. Therefore, we have designed a retrospective comparative study to evaluate the prevalence of additional pathological findings in patients with acute traumatic LPD that had performed MRI, comparing different groups of patients according to age, sex, and Tibial Tuberosity-Trochlear Groove(TT-TG) distance. Methods: MRI of the knee in patients after traumatic LPD were evaluated for the presence of additional pathological findings such as injuries to ligaments: Anterior/Posterior cruciate ligament(ACL, PCL), Medial/Lateral collateral ligament(MCL, LCL), injuries to tendons(QUADICEPS, PATELLAR), menisci(Medial/Lateral meniscus(MM, LM)) and tibial plateau, by a fellowship-trained, senior musculoskeletal radiologist. A comparison between different groups of patients was performed according to age (age group < 25 years, age group > 25 years), sex (Male/Female group), and TT-TG distance (TT-TG<15 groups, TT-TG>15 groups). A descriptive and comparative statistical analysis was performed. Results: 150 patients were included in this study. All suffered from LPD between the years 2012-2017 (mean age 21.3( ± SD 8.9), 86 males). ACL, PCL, MCL, and LCL complete or partial tears were found in 17(11.3%), 3(2%), 22(14.6%), and 4(2.7%) of the patients, respectively. MM and LM tears were found in 10(6.7%) and 3(2%) of the patients, respectively. A higher prevalence of PCL injury, MM tear, and LM tear were found in the older age group compared to the younger group of patients (10.5% vs. 1.8%, 18.4% vs. 2.7%, and 7.9% vs. 0%, respectively, p<0.05). A higher prevalence of non-displaced MM tear and LCL injury was found in the male group compared to the female group (8.1% vs. 0% and 8.1% vs. 0% respectively, p<0.05). A higher prevalence of ACL injury was found in the normal TT-TG group compared to the pathologic TT-TG group (17.5% vs. 2.3%, p= 0.0184). Conclusions: Overall, 43 out of 150 (28.7%) of the patient's MRI’s were positive for additional pathological radiological findings. Interestingly, a higher prevalence of additional pathologies was found in the groups of patients with a lower risk for recurrent LPD, including males, patients older than 25, and patients with TT-TG lower than 15mm, and therefore might not be referred for an MRI scan. Thus, we recommend a strict physical examination, awareness to the high prevalence of additional pathological findings, and to consider performing an MRI in all patients after LPD.

Keywords: additional findings, lateral patellar dislocation (LPD), MRI scan, traumatic patellar dislocation, cruciate ligaments injuries, menisci injuries, collateral ligaments injuries

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Authors: Deepa Das, Susmita Das

Abstract:

Cognitive Radio (CR) is an emerging technology to combat the spectrum scarcity issues. This is achieved by consistently sensing the spectrum, and detecting the under-utilized frequency bands without causing undue interference to the primary user (PU). In soft decision fusion (SDF) based cooperative spectrum sensing, various evolutionary algorithms have been discussed, which optimize the weight coefficient vector for maximizing the detection performance. In this paper, we propose the hybrid invasive weed optimization and particle swarm optimization (IWO/PSO) algorithm as a fast and global optimization method, which improves the detection probability with a lesser sensing time. Then, the efficiency of this algorithm is compared with the standard invasive weed optimization (IWO), particle swarm optimization (PSO), genetic algorithm (GA) and other conventional SDF based methods on the basis of convergence and detection probability.

Keywords: cognitive radio, spectrum sensing, soft decision fusion, GA, PSO, IWO, hybrid IWO/PSO

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Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

Abstract:

Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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