Search results for: stance control knee joint

Authors: Mohammad Mehdi Bagheri, Tianying Ma, Meng Gong

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Nail laminated timber (NLT) is widely used for constructing timber bridge decks in North America. Butt joints usually exist due to the length limits of lumber, leading to concerns about the decrease of structural performance of NLT. This study aimed at investigating the provisions incorporated in Canadian highway bridge design code on the use of but joints in wooden bridge decks. Three and five layers NLT specimens with various configurations were tested under 3-point bending test. It was found that the standard equation is capable of predicting the bending stiffness reduction due to butt joints and 1-m band limit in which, one but joint in every three adjacent lamination is allowed, sounds reasonable. The strength reduction also followed a pattern similar to stiffness reduction. Also reinforcement of the butt joint through nails and steel side plates was attempted. It was found that nail reinforcement recovers the stiffness slightly. In contrast, reinforcing the butt joint through steel side plate improved the flexural performance significantly when compared to the nail reinforcement.

Keywords: nail laminated timber, butt joint, bending stiffness, reinforcement

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Authors: M. Zielinska, B. Daniels, J. Gabel, A. Paletko

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A common nickel based superalloy Inconel625 was brazed with Ni-base braze filler material (AMS4777) containing melting-point-depressants such as B and Si. Different braze gaps, brazing times and forms of braze filler material were tested. It was determined that the melting point depressants B and Si tend to form hard and brittle phases in the joint during the braze cycle. Brittle phases significantly reduce mechanical properties (e. g. tensile strength) of the joint. Therefore, it is important to define optimal process parameters to achieve high strength joints, free of brittle phases. High ultimate tensile strength (UTS) values can be obtained if the joint area is free of brittle phases, which is equivalent to a complete isothermal solidification of the joint. Isothermal solidification takes place only if the concentration of the melting point depressant in the braze filler material of the joint is continuously reduced by diffusion into the base material. For a given brazing temperature, long brazing times and small braze filler material volumes (small braze gaps) are beneficial for isothermal solidification. On the base of the obtained results it can be stated that the form of the braze filler material has an additional influence on the joint quality. Better properties can be achieved by the use of braze-filler-material in form of foil instead of braze-filler-material in form of paste due to a reduced amount of voids and a more homogeneous braze-filler-material-composition in the braze-gap by using foil.

Keywords: diffusion brazing, microstructure, superalloy, tensile strength

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Authors: Young-Doo Kwon, Seong-Hwa Jun, Dong-Jin Lee, Hyung-Seok Lee

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Ball joints support and guide certain automotive parts that move relative to the frame of the vehicle. Such ball joints are covered and protected from dust, mud, and other interfering materials by ball-joint boots made of rubber—a flexible and near-incompressible material. The boots may experience twisting and bending deformations because of the motion of the joint arm. Thus, environmental and endurance tests of ball-joint boots apply both bending and twisting deformations. In this study, environmental and endurance testing was simulated via the finite element method performed by using a commercial software package. The ranges of principal stress and principal strain values that are known to directly affect the fatigue lives of the parts were sought. By defining these ranges, the number of iterative tests and modifications of the materials and dimensions of the boot can be decreased. Therefore, instead of performing actual part tests, manufacturers can perform standard fatigue tests in trials of different materials by applying only the defined range of stress or strain values.

Keywords: boot, endurance tests, rubber, FEA

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Authors: Priya Kulkarni, Soumya Koppikar, Datta Shinde, Shantanu Deshpande, Narendrakumar Wagh, Abhay Harsulkar

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Osteoarthritis (OA) is associated with multiple and overlapping aetiologies. IL-1β is produced by stressed tissue and known to aggravate disease pathologies. We selected 10 patients with elevated IL-1β in their synovial fluids (SF). We hypothesized IL-1β as nodal-point connecting different pathologies. IL-1β was higher in all meniscal tear (MT) patients perhaps as the earliest response to injury. Since MT above age of 30 leads to OA in less than 5 years, it is attributed that IL-1β modulates OA pathology. Among all bilateral OA patients, an interesting case operated for Total-Knee-Replacement revealed differential cartilage degeneration demonstrating strong association with higher IL-1β. Symptoms like acute-pain, effusion and redness were correlated with higher IL-1β and NO (Nitric-oxide). However, higher IL-1β was also found without typical-inflammation characterized by infiltration of neutrophils and macrophages. Cultured synoviocytes responded to IL-1β by releasing NO. In conclusion, IL-1β in SF acquires central position influencing different OA pathologies and aetiologies.

Keywords: IL-1β, meniscal tear, osteoarthritis, synovial fluid

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Jiahe Liu, Hongyang Yu, Feng Qian, Miao Luo, Linhang Zhu

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This study proposed a 3D human body reconstruction method, which integrates multi-view joint information into a set of joints and processes it with a parametric human body template. Firstly, we obtained human body image information captured from multiple perspectives. The multi-view information can avoid self-occlusion and occlusion problems during the reconstruction process. Then, we used the MvP algorithm to integrate multi-view joint information into a set of joints. Next, we used the parametric human body template SMPL-X to obtain more accurate three-dimensional human body reconstruction results. Compared with the traditional single-view parametric human body template reconstruction, this method significantly improved the accuracy and stability of the reconstruction.

Keywords: parametric human body templates, reconstruction of the human body, multi-view, joint

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Hamid Ahmadi, Neda Azari-Dodaran

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A total of 270 nonlinear steady-state finite element (FE) analyses were performed on 54 FE models of two-planar circular hollow section (CHS) KK-joints subjected to axial loading at five different temperatures (20 ºC, 200 ºC, 400 ºC, 550 ºC, and 700 ºC). The primary goal was to investigate the effects of temperature and geometrical characteristics on the ultimate strength, modes of failure, and initial stiffness of the KK-joints. Results indicated that on an average basis, the ultimate load of a two-planar tubular KK-joint at 200 ºC, 400 ºC, 550 ºC, and 700 ºC is 90%, 75%, 45%, and 16% of the joint’s ultimate load at ambient temperature, respectively. Outcomes of the parametric study showed that replacing the yield stress at ambient temperature with the corresponding value at elevated temperature to apply the EN 1993-1-8 equations for the calculation of the joint’s ultimate load at elevated temperatures may lead to highly unconservative results that might endanger the safety of the structure. Results of the parametric study were then used to develop a set of design formulas, through nonlinear regression analyses, to calculate the ultimate load of two-planar tubular KK-joints subjected to axial loading at elevated temperatures.

Keywords: ultimate load, two-planar tubular KK-joint, axial loading, elevated temperature, parametric equation

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Authors: Mircea I. Pastrav, Cornelia Baera, Florea Dinu

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A different concept for designing and detailing of reinforced concrete precast frame structures is analyzed in this paper. The new detailing of the joints derives from the special hybrid moment frame joints. The special reinforcements of this alternative detailing, named modified special hybrid joint, are bondless with respect to both column and beams. Full scale tests were performed on a plan model, which represents a part of 5 story structure, cropped in the middle of the beams and columns spans. Theoretical approach was developed, based on testing results on twice repaired model, subjected to lateral seismic type loading. Discussion regarding the modified special hybrid joint behavior and further on widening research needed concludes the presentation.

Keywords: modified hybrid joint, repair, seismic loading type, acceptance criteria

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Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

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Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

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Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

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Authors: Jose Carlos Montemayor, Kendrick Thomas Angelo Santos

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Filipinos have been divided on President Rodrigo Duterte’s leadership ever since his election in 2016. This study aimed to gain a thorough, in-depth understanding of the opinions of Filipinos from different age and income brackets on these issues in order to address the lack of studies analysing the current Philippine political landscape. An interview tackling relevant national issues were conducted with twelve respondents from the intersections of four age groups and three income brackets. The government’s handling of some issues received mixed opinions, some had neutral viewpoints, while others had more unfavorable ones. The responses differed on three levels: (1) the general stance on an issue; (2) the strength of a stance; and (3) the factoring in of an issue in forming an overall perception on the administration’s performance. Contrary to previous studies on political thought, opinions varied greatly such that no unique set of viewpoints could be attributed to any of the defined age or income groups. These results will be most useful to political science researchers, political analysts, and candidates shaping their platforms for the upcoming elections. Future studies are recommended to tackle more national issues and to consider other factors that may affect political opinions and behavior.

Keywords: age groups, opinion formation, socioeconomic brackets, Philippine politics, Rodrigo Duterte

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Authors: V. Schmidt, L. Janovák, N. Wiegand, B. Patczai, K. Turzó

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Large bone defects are not able to heal spontaneously. Bioactive glasses seem to be appropriate (bio)materials for bone reconstruction. Bioactive glasses are osteoconductive and osteoinductive, therefore, play a useful role in bony regeneration and repair. Because of their not optimal mechanical properties (e.g., brittleness, low bending strength, and fracture toughness), their applications are limited. Bioactive glass can be used as a coating material applied on metal surfaces. In this way -when using them as implants- the excellent mechanical properties of metals and the biocompatibility and bioactivity of glasses will be utilized. Furthermore, ion release effects of bioactive glasses regarding osteogenic and angiogenic responses have been shown. Silicate bioactive glasses (45S5 Bioglass) induce the release and exchange of soluble Si, Ca, P, and Na ions on the material surface. This will lead to special cellular responses inducing bone formation, which is favorable in the biointegration of the orthopedic prosthesis. The incorporation of other additional elements in the silicate network such as fluorine, magnesium, iron, silver, potassium, or zinc has been shown, as the local delivery of these ions is able to enhance specific cell functions. Although hip and knee prostheses present a high success rate, bacterial infections -mainly implant associated- are serious and frequent complications. Infection can also develop after implantation of hip prostheses, the elimination of which means more surgeries for the patient and additional costs for the clinic. Prosthesis-related infection is a severe complication of orthopedic surgery, which often causes prolonged illness, pain, and functional loss. While international efforts are made to reduce the risk of these infections, orthopedic surgical infections (SSIs) continue to occur in high numbers. It is currently estimated that up to 2.5% of primary hip and knee surgeries and up to 20% of revision arthroplasties are complicated by periprosthetic joint infection (PJIs). According to some authors, these numbers are underestimated, and they are also increasing. Staphylococcus aureus is the leading cause of both SSIs and PJIs, and the prevalence of methicillin-resistant S. aureus (MRSA) is on the rise, particularly in the United States. These deep infections lead to implant removal and consequently increase morbidity and mortality. The study targets this clinical problem using our experience so far with the Ag-doped polymer coatings on Titanium implants. Non-modified or modified (e.g., doped with antibacterial agents, like Ag) bioactive glasses could play a role in the prevention of infections or the therapy of infected tissues. Bioactive glasses have excellent biocompatibility, proved by in vitro cell culture studies of human osteoblast-like MG-63 cells. Ag-doped bioactive glass-scaffold has a good antibacterial ability against Escherichia coli and other bacteria. It may be concluded that these scaffolds have great potential in the prevention and therapy of implant-associated bone infection.

Keywords: antibacterial agents, bioactive glass, hip and knee prosthesis, medical implants

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Authors: Stepanov Ivan, Musalimov Viktor, Monahov Uriy

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This report examines the current state of human gait simulator development based on the human hip joint model. This unit will create a database of human gait types, useful for setting up and calibrating mechano devices, as well as the creation of new systems of rehabilitation, exoskeletons and walking robots. The system has ample opportunity to configure the dimensions and stiffness, while maintaining relative simplicity.

Keywords: hip joint, human gait, physiotherapy, simulation

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Authors: SanXi Wu

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A priori argument is a kind of reductio ad absurdum provided by Colin McGinn on the premise of accepting the basic rules of Dummett. The core part of the theory is to analyze the three joint positions besides realism and make them invalid, thus proving the rationality of the stance of realism. However, this argument strategy is vulnerable to skepticism because it delays the skeptical problem. In addition to McGinn, John Searle offers a linguistic transcendental argument strategy, which regards realism as the comprehensible condition that all normal activities of understanding must assume, while skepticism does not enjoy the same status. However, Searle's transcendental argument does not solve the problem of the relationship between realist presupposition and representational presupposition. Strawson, Hume, Reid, Wittgenstein, and others provide a naturalistic argument for realism. In this argument, realism is either a priori commitment from nature, or our second nature, or even a background belief that is fundamentally immovable. The key to this argument is to provide a quietistic treatment that ultimately invalidates our anti-realist myths. In comparison, the naturalistic argument is a more promising one. In this paper, methods of theoretical analysis and comparative research are used in order to demonstrate that in the face of skepticism, McGinn's a priori strategy and Searle's transcendental strategy are untenable, while Strawson and others' naturalistic strategy may resist the pressure of skepticism and make realism possible.

Keywords: a priori argument, transcendental argument, naturalism, realism, skepticism

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Authors: Sandeep Santosh, O. P. Sahu

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We simulate an efficient multiple wideband and nonstationary source localization algorithm by exploiting both the non-stationarity of the signals and the array geometric information.This algorithm is based on joint diagonalization structure (JDS) of a set of short time power spectrum matrices at different time instants of each frequency bin. JDS can be used for quick and accurate multiple non-stationary source localization. The JDS algorithm is a one stage process i.e it directly searches the Direction of arrivals (DOAs) over the continuous location parameter space. The JDS method requires that the number of sensors is not less than the number of sources. By observing the simulation results, one can conclude that the JDS method can localize two sources when their difference is not less than 7 degree but the Wideband MUSIC is able to localize two sources for difference of 18 degree.

Keywords: joint diagonalization structure (JDS), wideband direction of arrival (DOA), wideband MUSIC

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Authors: Fadzel Wong Chee Ping, Chee Keong Chen, Foong Kiew Ooi, Mahaneem Mohamed

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Introduction: To date, information on the effects of bee bread supplementation on isokinetic muscular performance are lacking. Therefore, this study was carried out to investigate the effects of 8-week bee bread supplementation on isokinetic muscular strength and power in young athletes. Methodology: Twelve male athletes (age: 24.0±1.8 years; BMI: 22.3 ± 1.3 kg.m-2; VO2max: 52.0 ± 2.8 mL.kg-1.min-1) were recruited in this randomised double blind, placebo-controlled crossover study. Participants consumed either bee bread at a dosage of 20 g.d-1 or placebo for 8 weeks. An isokinetic dynamometer was used to measure participants’ lower limb muscular strength and power prior (pre-test) and post (post-test) 8 weeks of experimental period. Testing angular velocities were set at 180o.s-1 and 300o.s-1 to determine knee flexion and extension muscular peak torque (an indicator of muscular strength) and average power of the participants. Statistical analyses were performed using ANOVA with repeated measures. Results: Isokinetic knee extension peak torque and average power at 180o.s-1, and isokinetic knee flexion peak torque and average power at 180o.s-1 were significantly (p<0.05) higher at post-test compared to pre-test with bee bread supplementation. However, significant differences were not observed in the measured parameters between pre- and post-test with placebo supplementation. Conclusion: Supplementation of bee bread for 8 weeks at a dosage of 20 g daily increased some of the measured isokinetic muscular strength and power parameters in young athletes.

Keywords: bee bread, isokinetic, power, strength

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Authors: Alisha Gupta

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Osteoarthritis (OA) is the most common form of arthritis which is a degenerative joint disease causing joints to begin to break down and underlying bones to change. This “wear and tear” most frequently affects hands, hips, and knees. This is important because OA pain is considered to be a leading cause of mobility impairment in older adults, with hip and knee OA ranked 11th highest contributors to global disability. Bone tissue engineering utilizing polymer scaffolds and hydrogels is an emerging field for treating osteoarthritis. Polymer scaffolds provide a three-dimensional structure for tissue growth, and hydrogels can be used to deliver drugs and growth factors. The combination of the two materials creates a hybrid structure that can better withstand physiological and mechanical demands while also providing a more controlled environment for drug and nutrient delivery. I think using bone tissue engineering for making scaffold-hydrogel composites that are self-regenerating and vascularizing might be useful in solving this problem. Successful implementation can reconstruct healthy, simulated bone tissue on deficient applicants.

Keywords: tissue engineering, regenerative medicine, scaffold-hydrogel composites, osteoarthritis

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Authors: Lucas Paganin, Viliam Makis

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With the advent of globalization, the market competition has become a major issue for most companies. One of the main strategies to overcome this situation is the quality improvement of the product at a lower cost to meet customers’ expectations. In order to achieve the desired quality of products, it is important to control the process to meet the specifications, and to implement the optimal maintenance policy for the machines and the production lines. Thus, the overall objective is to reduce process variation and the production and maintenance costs. In this paper, an integrated model involving Statistical Process Control (SPC) and maintenance is developed to achieve this goal. Therefore, the main focus of this paper is to develop the jointly optimal maintenance and statistical process control policy minimizing the total long run expected average cost per unit time. In our model, the production process can go out of control due to either the deterioration of equipment or other assignable causes. The equipment is also subject to failures in any of the operating states due to deterioration and aging. Hence, the process mean is controlled by an Xbar control chart using equidistant sampling epochs. We assume that the machine inspection epochs are the times when the control chart signals an out-of-control condition, considering both true and false alarms. At these times, the production process will be stopped, and an investigation will be conducted not only to determine whether it is a true or false alarm, but also to identify the causes of the true alarm, whether it was caused by the change in the machine setting, by other assignable causes, or by both. If the system is out of control, the proper actions will be taken to bring it back to the in-control state. At these epochs, a maintenance action can be taken, which can be no action, or preventive replacement of the unit. When the equipment is in the failure state, a corrective maintenance action is performed, which can be minimal repair or replacement of the machine and the process is brought to the in-control state. SMDP framework is used to formulate and solve the joint control problem. Numerical example is developed to demonstrate the effectiveness of the control policy.

Keywords: maintenance, semi-Markov decision process, statistical process control, Xbar control chart

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Authors: Raymond E. Raguindin

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Objective: This research studied the teaching improvement of daycare workers in imitation, joint attention, and language activities using the play-based early intervention training program in Cabanatuan City, Nueva Ecija. Methods: Focus group discussions were developed to explore the attitude, beliefs, and practices of daycare workers. Results: Findings of the study revealed that daycare workers have existing knowledge and experience in teaching children with autism. Their workshops on managing inappropriate behaviors of children with autism resulting in a general positive perception of accepting and teaching children with autism in daycare centers. Play based activities were modelled and participated in by daycare workers. These include demonstration, modelling, prompting and providing social reinforcers as reward. Five lectures and five training days were done to implement the training program. Daycare workers’ levels of skill in teaching imitation, joint attention and language were gathered before and after the participation in the training program. Findings suggest significant differences between pre-test and post test scores. They have shown significant improvement in facilitating imitation, joint attention, and language children with autism after the play-based early intervention training. They were able to initiate and sustain imitation, joint attention, and language activities with adequate knowledge and confidence. Conclusions: 1. Existing attitudes and beliefs greatly influenced the positive delivery mode of instruction. 2. Teacher-directed approach to improve attention, imitation, joint attention, and language of children with autism can be acquired by daycare workers. 3. Teaching skills and experience can be used as reference and basis for identifying future training needs.

Keywords: early intervention, imitation, joint attention, language

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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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Authors: Cory Cannon

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In the current era of shrinking budgets, increasing amounts of worldwide natural disasters, state and non-state initiated conflicts within the world. The response has involved multinational coalitions to conduct effective military operations. The need for a Knowledge Management strategy when developing these coalitions have been overlooked in the past and the need for developing these accords early on will save time and help shape the way information and knowledge are transferred from the staff and action officers of the coalition to the decision-makers in order to make timely decisions within an ever changing environment. The aim of this paper is to show how Knowledge Management has developed within the United States military and how the transformation of working within a Combined/ Joint environment in both the Middle East and the Far East has improved relations between members of the coalitions as well as being more effective as a military force. These same principles could be applied to multinational corporations when dealing with cultures and decision-making processes.

Keywords: civil-military, culture, joint environment, knowledge management

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Authors: Le Nguyen Binh, Luong Xuan Binh, Le Van Tuan, Tran Binh Duong, Truong Nguyen Khanh Hung, Do Le Hoang Son, Pham Quang Vinh, Hoang Quoc Huy, Nguyen Bach, Nguyen Quoc Khanh Le, Jiunn Horng Kang

Abstract:

Introduction: Traumatic hip dislocation is an emergency in young adult which can cause avascular necrosis of femoral head or osteoarthritis of hip joint. The reasons for these may be the loose body of bony or chondral fragments, which are difficult to be detected on CT scan or MRI. In those cases, Hip arthroscopy may be the method of choice for diagnosis and treatment of loose bodies in hip joint after traumatic dislocation. Methods: A case report is performed. A 55-year-old male patient was under hip arthroscopy to retrieve the loose body in the right hip joint. Results: The patient’s hip was reduced under anesthesia in the opeation room. Xray and CT scan post-reduction showed that his right hip was wide and a small fragment of femoral head (< 5mm) locking inside the joint. A hip arthroscopy was done to take the fragment out. Post-operation, the patient went under rehabilition. After 6 months, he can walk with full-weight bearing; no further dislocaion was noted, and the Harris score was 84 points. Conclusions: Although acute traumatic injury of hip joint is usually treated with open surgeries, these methods have many drawbacks, such as soft tissue destruction, blood-loss,….Despite its technical requirement, hip arthroscopy is less invasive and effective treatment. Therefore, it may be an alternative treatment for a traumatic hip injury and can be applied frequently in the near future.

Keywords: hip dislocation, hip arthroscopy, hip osteoarthritis, acute hip trauma

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Authors: Youcef Faci, Djillali Allou, Ahmed Mebtouche, Badredine Maalem

Abstract:

The inclination of the bolt in a fastened joint of composite material during a tensile test can be influenced by several parameters, including material properties, bolt diameter and length, the type of composite material being used, the size and dimensions of the bolt, bolt preload, surface preparation, the design and configuration of the joint, and finally testing conditions. These parameters should be carefully considered and controlled to ensure accurate and reliable results during tensile testing of composite materials with fastened joints. Our work focuses on the effect of the stacking sequence and the geometry of specimens. An experimental test is carried out to obtain the inclination of a bolt during a tensile test of a composite material using acoustic emission and digital image correlation. Several types of damage were obtained during load. Digital image correlation techniques permit to obtain the inclination of bolt angle value during tensile test. We concluded that the inclination of the bolt during a tensile test of a composite material can be related to the damage that occurs in the material. It can cause stress concentrations and localized deformation in the material, leading to damage such as delamination, fiber breakage, matrix cracking, and other forms of failure.

Keywords: damage, digital image correlation, bolt inclination angle, joint

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Authors: Kaushikk Iyer, Richard M Hall, David Keeling

Abstract:

Hardware-in-the-loop (HIL) simulation is an advanced technique for developing and testing complex real-time control systems. This paper presents the benefits of HIL simulation and how it can be implemented and used effectively to develop, test, and validate advanced control algorithms used in a spinal joint Wear simulator for the Tribological testing of spinal disc prostheses. spinal wear simulator is technologically the most advanced machine currently employed For the in-vitro testing of newly developed spinal Discimplants. However, the existing control techniques, such as a simple position control Does not allow the simulator to test non-sinusoidal waveforms. Thus, there is a need for better and advanced control methods that can be developed and tested Rigorouslybut safely before deploying it into the real simulator. A benchtop HILsetupis was created for experimentation, controller verification, and validation purposes, allowing different control strategies to be tested rapidly in a safe environment. The HIL simulation aspect in this setup attempts to replicate similar spinal motion and loading conditions. The spinal joint wear simulator containsa four-Barlinkpowered by electromechanical actuators. LabVIEW software is used to design a kinematic model of the spinal wear Simulator to Validatehow each link contributes towards the final motion of the implant under test. As a result, the implant articulates with an angular motion specified in the international standards, ISO-18192-1, that define fixed, simplified, and sinusoid motion and load profiles for wear testing of cervical disc implants. Using a PID controller, a velocity-based position control algorithm was developed to interface with the benchtop setup that performs HIL simulation. In addition to PID, a fuzzy logic controller (FLC) was also developed that acts as a supervisory controller. FLC provides intelligence to the PID controller by By automatically tuning the controller for profiles that vary in amplitude, shape, and frequency. This combination of the fuzzy-PID controller is novel to the wear testing application for spinal simulators and demonstrated superior performance against PIDwhen tested for a spectrum of frequency. Kaushikk Iyer is a Ph.D. Student at the University of Leeds and an employee at Key Engineering Solutions, Leeds, United Kingdom, (e-mail: [email protected], phone: +44 740 541 5502). Richard M Hall is with the University of Leeds, the United Kingdom as a professor in the Mechanical Engineering Department (e-mail: [email protected]). David Keeling is the managing director of Key Engineering Solutions, Leeds, United Kingdom (e-mail: [email protected]). Results obtained are successfully validated against the load and motion tolerances specified by the ISO18192-1 standard and fall within limits, that is, ±0.5° at the maxima and minima of the motion and ±2 % of the complete cycle for phasing. The simulation results prove the efficacy of the test setup using HIL simulation to verify and validate the accuracy and robustness of the prospective controller before its deployment into the spinal wear simulator. This method of testing controllers enables a wide range of possibilities to test advanced control algorithms that can potentially test even profiles of patients performing various dailyliving activities.

Keywords: Fuzzy-PID controller, hardware-in-the-loop (HIL), real-time simulation, spinal wear simulator

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Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas

Abstract:

The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.

Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy

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Authors: P. T. Collett, M. Kershaw

Abstract:

Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

Procedia PDF Downloads 99

Authors: Bin Bian, Liang Wang

Abstract:

A hydraulic spherical motion mechanism (HSMM) is proposed. Unlike traditional systems using serial or parallel mechanisms for multi-DOF rotations, the HSMM is capable of implementing continuous 2-DOF rotational motions in a single joint without the intermediate transmission mechanisms. It has some advantages of compact structure, low inertia and high stiffness. However, as HSMM is a nonlinear and multivariable system, it is very complicate to realize accuracy control. Therefore, an augmented active disturbance rejection controller (ADRC) is proposed in this paper. Compared with the traditional PD control method, three compensation items, i.e., dynamics compensation term, disturbance compensation term and nonlinear error elimination term, are added into the proposed algorithm to improve the control performance. The ADRC algorithm aims at offsetting the effects of external disturbance and realizing accurate control. Euler angles are applied to describe the orientation of rotor. Lagrange equations are utilized to establish the dynamic model of the HSMM. The stability of this algorithm is validated with detailed derivation. Simulation model is formulated in Matlab/Simulink. The results show that the proposed control algorithm has better competence of trajectory tracking in the presence of uncertainties.

Keywords: hydraulic spherical motion mechanism, dynamic model, active disturbance rejection control, trajectory tracking

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Authors: Hamid Ahmadi, Shadi Asoodeh

Abstract:

The fatigue life of tubular joints commonly found in offshore industry is not only dependent on the value of hot-spot stress (HSS), but is also significantly influenced by the through-the-thickness stress distribution characterized by the degree of bending (DoB). The determination of DoB values in a tubular joint is essential for improving the accuracy of fatigue life estimation using the stress-life (S–N) method and particularly for predicting the fatigue crack growth based on the fracture mechanics (FM) approach. In the present paper, data extracted from finite element (FE) analyses of tubular KT-joints, verified against experimental data and parametric equations, was used to investigate the effects of geometrical parameters on DoB values at the crown 0˚, saddle, and crown 180˚ positions along the weld toe of central brace in tubular KT-joints subjected to axial loading. Parametric study was followed by a set of nonlinear regression analyses to derive DoB parametric formulas for the fatigue analysis of KT-joints under axial loads. The tubular KT-joint is a quite common joint type found in steel offshore structures. However, despite the crucial role of the DoB in evaluating the fatigue performance of tubular joints, this paper is the first attempt to study and formulate the DoB values in KT-joints.

Keywords: tubular KT-joint, fatigue, degree of bending (DoB), axial loading, parametric formula

Procedia PDF Downloads 337

Authors: Morteza Aien, Masoud Rashidinejad, Mahmud Fotuhi-Firuzabad

Abstract:

Power systems are innately uncertain systems. To face with such uncertain systems, robust uncertainty assessment tools are appealed. This paper inspects the uncertainty assessment formulation of the load flow (LF) problem considering different kinds of uncertainties, developed in its companion paper through some case studies. The proposed methodology is based on the evidence theory and joint propagation of possibilistic and probabilistic uncertainties. The load and wind power generation are considered as probabilistic uncertain variables and the electric vehicles (EVs) and gas turbine distributed generation (DG) units are considered as possibilistic uncertain variables. The cumulative distribution function (CDF) of the system output parameters obtained by the pure probabilistic method lies within the belief and plausibility functions obtained by the joint propagation approach. Furthermore, the imprecision in the DG parameters is explicitly reflected by the gap between the belief and plausibility functions. This gap, due to the epistemic uncertainty on the DG resources parameters grows as the penetration level increases.

Keywords: electric vehicles, joint possibilistic- probabilistic uncertainty modeling, uncertain load flow, wind turbine generator

Procedia PDF Downloads 406