Search results for: upper extremity reconstruction

Authors: Razieh Karimian, Kim Burton, Mohammad Mehdi Naghizadeh, Maryam Karimian

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Introduction: Habitual upper body postures are associated with online learning during the COVID-19 pandemic. This study explored whether adding an exercise routine to an ergonomic advice intervention improves these postures. Methods: In this randomized trial, 42 male adolescent students with a forward head posture were randomly divided into two equal groups, one allocated to ergonomic advice alone and the other to ergonomic advice plus an exercise routine. The angles of forward head, shoulder, and back postures were measured with a photogrammetric profile technique before and after the 8-week intervention period. Findings: During home quarantine, 76% of the students used their mobile phones, while 35% used a table-chair-computer for online learning. While significant reductions of the forward, shoulder, and back angles were found in both groups (P < 0.001), the effect was significantly greater in the exercise group (P < 0.001: forward head, shoulder, and back angles reduced by some 9, 6, and 5 degrees respectively, compared with 4 degrees in the forward head, and 2 degrees in the shoulder and back angles for ergonomic advice alone. Conclusion: The exercise routine produced a greater improvement in habitual upper body postures than ergonomic advice alone, a finding that may extend beyond online learning at home.

Keywords: randomized trial, online learning, adolescent, posture, exercise, ergonomic advice

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Authors: Karima Abdel Aty Hassan Mohamed, Manal Mohamed Ismail, Mona Hassan Gamal Eldein, Ahmed Hassan Hussein, Abdel Aziz Mohamed Elsingerg

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Background: Patellofemoral pain (PFP) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor, yet the relationships between pain, hip muscle strength and function are not known. Objective: The purpose of this study is to investigate the effects of strengthening hip abductors and lateral rotators on pain intensity, function and hip abductor and hip lateral rotator eccentric and concentric torques in patients with PFPS. Methods: Thirty patients had participated in this study; they were assigned into two experimental groups. With age ranged for eighty to thirty five years. Group A consisted of 15 patients (11females and 4 males) with mean age 20.8 (±2.73) years, received closed kinetic chain exercises program, stretching exercises for tight lower extremity soft tissues, and hip strengthening exercises .Group B consisted of 15 patients (12 females and 3 males) with mean age 21.2(±3.27) years, received closed kinetic chain exercises program and stretching exercises for tight lower extremity soft tissues. Treatment was given 2-3times/week, for 6 weeks. Patients were evaluated pre and post treatment for their pain severity, function of knee joint, hip abductors and external rotators concentric/eccentric peak torque. Result: the results revealed that there were significant differences in pain and function between both groups, while there was improvement for all values for both group. Conclusion: Six weeks rehabilitation program focusing on knee strengthening exercises either supplemented by hip strengthening exercises or not effective in improving function, reducing pain and improving hip muscles torque in patients with PFPS. However, adding hip abduction and lateral rotation strengthening exercises seem to reduce pain and improve function more efficiently.

Keywords: patellofemoral pain syndrome, hip muscles, rehabilitation, isokinetic

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Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

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Authors: Anshul, Rajni Kalia, Sachin Kumar

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Introduction: The costoclavicular approach, a modification to the infraclavicular approach, has been described for anesthesia for upper limb surgeries. Material And Methods: In this randomized and single-blind study, fourty patients undergoing emergency/elective upper limb surgery were allocated to two groups. Group C and S received ultrasound-guided Costoclavicular block and Supraclavicular block, respectively, with 20 ml 0.5 % ropivacaine with 8 mg dexamethasone under strict asepsis. The primary outcome assessed was the total duration of sensory and motor block in the postoperative period. Secondary outcomes were to compare the time taken to perform the procedure, block characteristics in terms of onset of motor and sensory blockade, the efficacy of analgesia with respect to the time of administration of the first rescue analgesic dose with both the blocks and note the side effects pertaining to either of the blocks. Results: The mean total duration of sensory and motor blockade was longer in group C vs. group S (p=0.002 and 0.024, respectively). The mean duration to perform a block in group S was more than in group C (p=0.012). The mean onset of sensory and motor Blockade Time in group S was more than in group C (p<0.001 and <0.001, respectively). The mean duration to perform a block in group S was more than in group C (p=0.012). Conclusion: The costoclavicular approach is better than supraclavicular in terms of rapid execution, faster onset of sensory-motor blockade, prolonged postoperative analgesia and similar PONV and safety profile.

Keywords: costoclavicular, supraclavicular, ropivacaine, dexamethasone

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Authors: Geum Yeon Sim, Tyler Pigott, Julio Vasquez

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A 38-year-old obese female with no apparent past medical history presented with left knee pain. Six months ago, she sustained a left knee dislocation in a motor vehicle accident that was managed with a skin graft over the left lower extremity without any reconstructive surgery. She developed persistent pain and stiffness in her left knee that worsened with walking and stair climbing. Examination revealed healed extensive skin graft over the left lower extremity, including the left knee. Palpation showed moderate tenderness along the superior border of the patella, exquisite tenderness over MCL, and mild tenderness on the tibial tuberosity. There was normal sensation, reflexes, and strength in her lower extremities. There was limited active and passive range of motion of her left knee during flexion. There was instability noted upon the valgus stress test of the left knee. Left knee magnetic resonance imaging showed high-grade (grade 2-3) injury of the proximal superficial fibers of the MCL and diffuse thickening and signal abnormality of the cruciate ligaments, as well as edema-like subchondral marrow signal change in the anterolateral aspect of the lateral femoral condyle weight-bearing surface. There was also notable extensive scarring and edema of the skin, subcutaneous soft tissues, and musculature surrounding the knee. The patient was managed with left knee immobilization for five months, which was complicated by limited knee flexion. Physical therapy consisting of quadriceps, hamstrings, gastrocnemius stretching and strengthening, range of motion exercises, scar/soft tissue mobilization, and gait training was given with marked improvement in pain and range of motion. The patient experienced a further reduction in pain as well as an improvement in function with home exercises consisting of continued strengthening and stretching.

Keywords: ligamentous injury, trauma, rehabilitation, knee pain

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Authors: Lise P. Labéjof, Ivna Mororó, Raquel G. Bastos, Maria Isabel G. Severo, Arno H. de Oliveira

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This work presents an alternative mode of intestine mucosa renewal that may allow to better understand the total loss of villi after irradiation. It was tested a morphological method of 3d reconstruction using micrographs of serial sections of rat duodenum. We used hundreds of sections of each specimen of duodenum placed on glass slides and examined under a light microscope. Those containing the detachment, approximately a dozen, were chosen for observation under a transmission electron microscope (TEM). Each of these sections was glued on a block of epon resin and recut into a hundred of 60 nm-thick sections. Ribbons of these ultrathin sections were distributed on a series of copper grids in the same order of appearance than during the process of microstomia. They were then stained by solutions of uranyl and lead salts and observed under a TEM. The sections were pictured and the electron micrographs showing signs of cells detachment were transferred into two softwares, ImageJ to align the cellular structures and Reconstruct to realize the 3d reconstruction. It has been detected epithelial cells that exhibited all signs of programmed cell death and localized at the villus-crypt junction. Their nucleus was irregular in shape with a condensed chromatin in clumps. Their cytoplasm was darker than that of neighboring cells, containing many swollen mitochondria. In some places of the sections, we could see intercellular spaces enlarged by the presence of shrunk cells which displayed a plasma membrane with an irregular shape in thermowell as if the cell interdigitations would distant from each other. The three-dimensional reconstruction of the crypts has allowed observe gradual loss of intercellular contacts of crypt cells in the longitudinal plan of the duodenal mucosa. In the transverse direction, there was a gradual increase of the intercellular space as if these cells moved away from one another. This observation allows assume that the gradual remoteness of the cells at the villus-crypt junction is the beginning of the mucosa detachment. Thus, the shrinking of cells due to apoptosis is the way that they detach from the mucosa and progressively the villi also. These results are in agreement with our initial hypothesis and thus have demonstrated that the villi become detached from the mucosa at the villus-crypt junction by the programmed cell death process. This type of loss of entire villus helps explain the rapid denudation of the intestinal mucosa in case of irradiation.

Keywords: 3dr, transmission electron microscopy, ionizing radiations, rat small intestine, apoptosis

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Authors: Babak Rezaei, Arash Zargar Shoushtari

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Kangan anticline is located in the Coastal Fars area, southwest of Nar and west of west Assaluyeh anticlines and north of Kangan harbor in Boushehr province. The Kangan anticline is nearly asymmetric and with 55Km long and 6Km wide base on structural map of Kangan Formation. The youngest and the oldest Formations on surface are Bakhtiyari (Pliocene) and Sarvak (Cenomanian) respectively. The highest dip angles of 30 and 40 degree were observed in north and south flanks of Kangan anticline respectively and two reverse faults cut these flanks parallel to structure strike. Existence of sweet gas in Kangan Fm. and Upper Dalan in this structure is confirmed with probable Silurian shales origin. Main facies belts in these formations include super tidal and intertidal flat, lagoon, oolitic-bioclastic shoals and open marine sub environments that expand in a homoclinal and shallow water carbonate ramp under the arid climates. Digenetic processes studies, indicates the influence of all digenetic environments (marine, meteoric, burial) in the reservoir succession. These processes sometimes has led to reservoir quality improvement (such as dolomitization and dissolution) but in many instances reservoir units has been destroyed (such as compaction, anhydrite and calcite cementation). In this study, petrophysical evaluation is made in Kangan and upper Dalan formations by using well log data of five selected wells. Probabilistic method is used for petrophysical evaluation by applying appropriate soft wares. According to this evaluation the lithology of Kangan and upper Dalan Formations mainly consist of limestone and dolomite with thin beds of Shale and evaporates. In these formations 11 Zones with different reservoir characteristic have been identified. Based on wire line data analyses, in some part of these formations, high porosity can be observed. The range of porosity (PHIE) and water saturation (Sw) are estimated around 10-20% and 20-30%, respectively.

Keywords: microfacies, electrofacies, petrophysics, diagenese, gas fields

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Authors: Jolanta Uszko, Tomasz Wloch, Aneta Pirowska, Roman Nowobilski

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Introduction: Phantom phenomena are often reported by subjects who have undergone limb amputation. Mostly, patients feel the amputated part of the limb as if it was still attached to the body. Two types of phantom phenomena: painless (phantom sensation) and painful (phantom pain) were described. Triggers of phantom sensations and phantom pain, as well as fully effective treatment, have not been clearly described yet. Purpose: To assess the influence of psychosocial factors and some clinical conditions on the occurrence of phantom phenomena in amputee athletes. Subjects: 21 men (age: 31 years, SD = 7.5 years) after lower or upper extremity amputation, who regularly performed high-intensity sports (Amp Football Team Players) were included to the study. Method and equipment: In the research, the following method and tools were used: Questionnaire [Pirowska] adapted for athletes with disabilities, Numerical Rating Scale (NRS) - for phantom pain assessment, McGill Pain Assessment Questionnaire (short version), Beck's Depression Inventory (BDI), State Trait Anxiety Inventory (STAI): X-1 and X-2, shortened version of The World Health Organization Quality of Life (WHOQOLBREFF). Results: In the study group, the lower leg amputations with traumatic etiology were predominant. Phantom sensations were present in all subjects. Half of the respondents claimed to experience phantom sensations at least once a day, paroxysmally. There was a prevalence of phantom sensations characterized as incomplete, immobile limb. Phantom pain was reported by over 85% of respondents. The nature of phantom pain was frequently described as stabbing, squeezing, shooting, pulsing, tiring. There was a significant correlation between phantom pain intensity and anxiety, quality of life, depressive tendencies, perception of phantom pain as the obstacle in daily functioning and intensity of the limb pain before amputation. Conclusions: The etiology of phantom phenomena is complex. Psychological factors seem to have a significant influence on the intensity of the phantom pain. Particular attention should be paid to patients who complain about persistent limb pain before the amputation. These are patients with an increased risk of the phantom pain of relatively high intensity.

Keywords: amputation, phantom pain, phantom sensations, adaptive sports

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Authors: Prem, Norhaya, Vwrene C., Mohammad Harris A., Amarjit, Fazir M.

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Upper limb surgery is a common orthopedic procedure. After surgery, it is necessary to raise the patient's arm to reduce limb swelling and promote recovery. After an injury or surgery, swelling (edema) in the limbs is common. This swelling can be painful, cause stiffness, and affect movement and ability to do daily activities. One of the easiest ways to manage swelling is to elevate the swollen limb. The goal is to elevate the swollen limb slightly above the level of the heart. This helps the extra fluid move back towards the heart for circulation to the rest of the body. Conventional arm sling or pillows are usually placed under the arm to raise it, but in this way the arm cannot be fixed well and easily slide down, without ideal raising effect. Conventional arm sling need experience to tie the sling and this delay in the application process. To reduce the waiting time and cost, modified Norhaya upper limb elevation sling was designed and made readily available. The sling is made from calico fabric, readily available in the ward. Measurements of patients’ arm lengths are obtained, and fabric sizes are cut into the average arm lengths, as well as 1 size above and below. The cut calico fabric is then sewn together with thick sewing threads. Its application is easy and junior most staff or doctor will be able to apply it on patient. The time taken to set up the sling is also reduced. Feedback gathered from ground staff regarding ease of setting up the sling was tremendous and patient also feel comfort in the modified Norhaya sling. The device can freely adjust the raising height of the affected limb and effectively fix the affected limb to reduce its swelling, thus promoting recovery. This device is worthy to be clinically popularized and applied. The Modified Norhaya upper limb elevation sling is the quickest to set up and the delay in elevating the patient’s hand is significantly reduced. Moreover, it is reproducible and there is also significant cost savings.

Keywords: elevate, effective, sling, timely

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Authors: Yueming Li

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This paper analyzes Lou Ye’s Summer Palace (2006), an autobiographical film of the Sixth Generation of Directors in Mainland China, from the approaches of inter-textual analysis and intellectual history. It highlights the film’s reconstruction of the June 4th Incident as an intermediary device for the revival and haunting of the 1980s’ New Enlightenment Movement. The paper demonstrates how the June 4th Incident unfolds as historical trauma and collective experience of the Generation through Lou’s flickering narrative in both plot organization and visual representation, under an individualized and internal viewpoint. It further proposes that these revenants of the June 4th Incident translate into “realms of memory,” which lend themselves for biographical and historical reconstruction of the June 4th Incident based on a politics of embodiment. Through this, Lou and his contemporaries acquire agency to actively respond to the June 4th Incident as an “intimate revolt.” In this sense, the film revisits the New Enlightenment Movement in that they similarly construct rebellious connotations in a seemingly depoliticized manner. As the paper examines how an autobiographical film reconstructs, revisits, and responds to a historical event and its absence, it answers how individuals’ agency intertwines with and counteracts their historical living contexts.

Keywords: new enlightenment movement, summer palace, the June 4th incident, the sixth generation of directors

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Authors: S. Haque, M. Kanapathy, E. Bollen, I. Younis, A. Mosahebi

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Background: Implant loss due to infection is the most devastating complication of implant-based breast reconstruction. The use of negative pressure wound therapy with instillation (NPWTi) for salvage of infected implant-based breast reconstructions has shown promising results to allow early reinsertion of a new implant as an alternative to current management of delayed reinsertion. This study compares the cost implication of NPWTi against current management of delayed reinsertion of infected breast implants. Methods: 20 cases of an infected breast implant treated with NPWTi (V.A.C. VERAFLO™ Therapy) followed by early re-insertion of a new implant were compared with 20 cases who had delayed reinsertion (non-NPWTi). Average cost per person was calculated using total operative expenses, cost of inpatient stay, cost of investigations, cost of antibiotics, and cost of outpatient visits. Results: Treatment with NPWTi allowed for earlier re-insertion of a new implant (NPWTi: 9.04 ± 2.92 days vs. non-NPWTi: 236.25 ± 123.89 days). The average cost per patient for NPWTi and non-NPWTi was £14,343.13 ± £2,786.70 and £8,920.31 ± £3,005.73 respectively. All patients treated with NPWTi had one admission and spent 11.9 ± 4.1days as an inpatient while non-NPWTi patients had 2.1 ± 0.3 admissions with total length of inpatient stay of 7.1 ± 5.8days. Patients treated with NPWTi had more surgeries (NPWTi: 3.35 ± 0.81 vs. non-NPWTi: 2.2 ± 0.41), however 3 non-NPWTi cases required flap reconstruction. Patients treated with NPWTi had fewer total outpatient visits (NPWTi: 12 ± 6 vs. non-NPWTi: 14.2 ± 6.3). Conclusion: Patients treated with NPWTi incurred higher average cost per patient, longer inpatient stay, and more procedures; however, had early re-insertion of new implants and fewer admissions and outpatient visits. A further study on patient-reported outcome is essential to compare cost against patient benefit.

Keywords: breast reconstruction, cost evaluation, infection, negative pressure wound therapy

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Authors: Hamdi Omar Omar, Hela Fakhfakh, Chokri Yaich

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This work reflects the integration of different techniques, such as field sampling and observations, magnetic susceptibility measurement, cyclostratigaraphy and sequence stratigraphy. The combination of these results allows us to reconstruct the environmental evolution of the Sidi Khalif Formation in the North-South Axis (NOSA), aged of Upper Tithonian, Berriasian and Lower Valanginian. Six sedimentary facies were identified and are primarily influenced by open marine sedimentation receiving increasing terrigenous influx. Spectral analysis, based on MS variation (for the outcropped section) and wireline logging gamma ray (GR) variation (for the sub-area section) show a pervasive dominance of 405-kyr eccentricity cycles with the expression of 100-kyr eccentricity, obliquity and precession. This study provides (for the first time) a precise duration of 2.4 myr for the outcropped Sidi Khalif Formation with a sedimentation rate of 5.4 cm/kyr and the sub-area section to 3.24 myr with a sedimentation rate of 7.64 cm/kyr. We outlined 27 5th-order depositional sequences, 8 Milankovitch depositional sequences and 2 major 3rd-order cycles for the outcropping section, controlled by the long eccentricity (405 kyr) cycles and the precession index cycles. This study has demonstrated the potential of MS and GR to be used as proxies to develop an astronomically calibrated time-scale for the Mesozoic era.

Keywords: Berriasian, magnetic susceptibility, orbital tuning, Sidi Khalif Formation

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Authors: Gopal Chandra Saha, Sumanta Daw

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Warm-up is an essential component for optimizing performance in various sports before a physical fitness training session. This study investigated the immediate comparative effect of Self-Myofascial Release through vibration rolling (VR), non-vibration rolling (NVR), and static stretching as a part of a warm-up treatment on the functional fitness of young adults. Functional fitness is a classification of training that prepares the body for real-life movements and activities. For the present study 20male physical education students were selected as subjects. The age of the subjects was ranged from 20-25 years. The functional fitness variables undertaken in the present study were flexibility, muscle strength, agility, static and dynamic balance of the lower extremity. Each of the three warm-up protocol was administered on consecutive days, i.e. 24 hr time gap and all tests were administered in the morning. The mean and SD were used as descriptive statistics. The significance of statistical differences among the groups was measured by applying ‘F’-test, and to find out the exact location of difference, Post Hoc Test (Least Significant Difference) was applied. It was found from the study that only flexibility showed significant difference among three types of warm-up exercise. The observed result depicted that VR has more impact on myofascial release in flexibility in comparison with NVR and stretching as a part of warm-up exercise as ‘p’ value was less than 0.05. In the present study, within the three means of warm-up exercises, vibration roller showed better mean difference in terms of NVR, and static stretching exercise on functional fitness of young physical education practitioners, although the results were found insignificant in case of muscle strength, agility, static and dynamic balance of the lower extremity. These findings suggest that sports professionals and coaches may take VR into account for designing more efficient and effective pre-performance routine for long term to improve exercise performances. VR has high potential to interpret into an on-field practical application means.

Keywords: self-myofascial release, functional fitness, foam roller, physical education

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Authors: Hebatullah Ali Abdel-Aleem Abdel-Hamid, Camellia Mousa Mohamed Elzean

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Knitted garments recently became a key component in wardrobes of the Egyptian woman. Many Egyptian women depend on garments made of knitted fabrics in their outer appearance because of its specific properties including flexibility. Through observation and application, it was noticed that knitwear blocks that used for knitted fabrics somehow does not fit the figures of the Egyptian women. Moreover, the pattern makers are usually confused and unable to choose the suitable blocks for different knitting fabrics taking into consideration its physical and mechanical properties. This study seeks to develop mathematical relationships for evaluation of the amount of added- or subtracted ease to Aldrich’s basic fitting blocks for some weft knitting fabrics and its fitting to the upper part of Egyptian women's bodies. To achieve this goal, 12 samples were used to evaluate fitting of Aldrich’s Basic Fitting Block to the upper part of Egyptian women's bodies. The samples were evaluated before and after alterations, through wear trials on the standard mannequins of size 48 and 56, and judged by experienced assessors using fit evaluation scale. The data obtained were statistically analyzed to identify the efficiency of the adjustments. The Aldrich’s Basic Fitting Block was selected because his method is known internationally and easy to use.

Keywords: Aldrich basic fitting block, clothing industry, knitted fabrics, pattern construction

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Authors: Hyejin Song, Jin Baek

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Based on the idea of bricolage that a new meaning beyond that of each of objects can be created through combination and juxtaposition of various objets, this study finds a way of morphological-recomposing of urban space through combination and juxtaposition of existing urban fabric and new fabric and suggests this idea as new direction of urban regeneration. This study sets concept of bricolage as a philosophical ground of interpreting contemporary urban situation. In this concept, urban objects such as buildings from various zeitgeists are positively considered as potential textures which can construct meaningful context. Seoul, as the city having long history and experiencing colonization and development, appears dynamic urban structure full of various objects from various periods. However, in contrast with successful plazas and streets in Europe, objects in Seoul do not make a meaningful context as public space due to thoughtless development. This study defines this situation as ‘disorgnized-fabric’. Following the concept of bricolage, to find the way for those existing scattered objects to be organized as a context of meaningful public space, this study firstly researches the case of successful public space by morphological analysis. Secondly, this study carefully explores urban space in Seoul, and draws figure-ground diagram to grasp the form of current urban fabric by various urban-objects. As a result of exploration, a lot of urban spaces from Myeong-dong, one of vibrant commercial district in Seoul, to declining residential area are judged as having potential fabric which can become meaningful context by just small adjustment of relationship between existing objects. This study also confirmed that by inserting a new object with consideration of form of existing fabric, it is possible to accord a new context as plaza to existing void which have broken as several parts. This study defines it as form-based urban reconstruction through the idea of bricolage, and suggests that it could be one of philosophical ground of successful urban regeneration.

Keywords: adjustment of relationship between existing objets, bricolage, morphological analysis of urban fabric, urban regeneration, urban reconstruction

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Authors: Wisam Ismail, Brendan Wooler, Penelope McManus

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Introduction: The public perception of implants has been damaged in the wake of recent negative publicity and increasingly we are finding patients wanting to avoid them. Planned lipo-modelling to enhance the volume of a Latissimus dorsi flap is a viable alternative to silicone implants and maintains a Totally Autologous Technique (TAT). Here we demonstrate that when compared to an Implant Assisted Technique (IAT), a TAT offers patients many benefits that offset the requirement of more operations initially, with reduced short and long term complications, reduced symmetrisation surgery and reduced revision rates. Methods. Data was collected prospectively over 7 years. The minimum follows up was 3 years. The technique was generally standardized in the hand of one surgeon. All flaps were extended LD flaps (ELD). Lipo-modelling was performed using standard techniques. Outcome measures were unplanned secondary procedures, complication rates, and contralateral symmetrisation surgery rates. Key Results Were: Lower complication rates in the TAT group (18.5% vs. 33.3%), despite higher radiotherapy rates (TAT=49%, IAT=36.8%), TAT was associated with lower subsequent symmetrisation rates (30.6% vs. 50.9%), IAT had a relative risk of 3.1 for subsequent unplanned procedure, Autologous patients required an average of 1.76 sessions of lipo-modelling, Conclusions: Using lipo-modelling to enable totally autologous LD reconstruction offers significant advantages over an implant assisted technique. We have shown a lower subsequent unplanned procedure rate, lower revision surgery, and less contralateral symmetrisation surgery. We anticipate that a TAT will be supported by patient satisfaction surveys and long-term patient-reported cosmetic outcome data and intended to study this.

Keywords: breast, Latissimus dorsi, lipomodelling, reconstruction

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Authors: Sweta Kandari

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Predominantly, the conventional role of an architect is to design and construct. However, in a post-disaster scenario, the prevalent role expands and includes many other responsibilities. Agencies collaborating in post-disaster reconstruction face the challenge of building back quickly while requiring them to listen, reflect, develop and deliver as per the needs and requirements of the people. The question of the role of an architect has been extensively discussed in the reconstruction field. Discourses about the role of an architect in post-disaster scenario revolve around the ignorance by the profession, their professional abilities and inabilities. Within this domain, this paper aims at analyzing and recognizing the roles, responsibilities, scope, limitations, skillsets applied and required by an architect while working in a post-disaster situation. Four projects rebuilt after the 2001 Bhuj earthquake in Gujarat, India were examined for this research. Based on the analysis of the case study, areas of intervention of an architect in the various stages of rebuilding were identified. It was reinforced that within the areas of intervention identified, there is a vast gap between the prescribed, the prevalent notion and the performed responsibilities of an architect. This paper brings forth the specific gaps in the rebuilding process while exploring and understanding the relationship between various stakeholders that influence the role of an architect.

Keywords: rebuilding, role of an architect, Bhuj, post-disaster

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Authors: Linyu Wang, Furui Huo, Jianhong Xiang

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The Doppler shift generated by high-speed movement and multipath effects in the channel are the main reasons for the generation of a time-frequency doubly-selective (DS) channel. There is severe inter-carrier interference (ICI) in the DS channel. Channel estimation for an orthogonal frequency division multiplexing (OFDM) system over a DS channel is very difficult. The simultaneous orthogonal matching pursuit algorithm under distributed compressive sensing theory (DCS-SOMP) has been used in channel estimation for OFDM systems over DS channels. However, the reconstruction accuracy of the DCS-SOMP algorithm is not high enough in the low SNR stage. To solve this problem, in this paper, we propose an improved DCS-SOMP algorithm based on the inner product difference comparison operation (DCS-DCSOMP). The reconstruction accuracy is improved by increasing the number of candidate indexes and designing the comparison conditions of inner product difference. We combine the DCS-DCSOMP algorithm with the basis expansion model (BEM) to reduce the complexity of channel estimation. Simulation results show the effectiveness of the proposed algorithm and its advantages over other algorithms.

Keywords: OFDM, doubly selective, channel estimation, compressed sensing

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Authors: Maged El Osta, Milad Masoud

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Al Jabal Al Akhdar in the north-eastern part of Libya represents a region with promising ecological underpinning for grazing and other agricultural developments. The groundwater potential of both Upper Cretaceous and Eocene aquifers was studied based the available literature and a complete database for about 112 water wells drilled in the period 2003-2009. In this research, the hydrogeological methods will be integrated with the Geographic Information System (GIS) that played a main role in highlighting the spatial characteristics of the groundwater system. The results indicate that the depth to water for the Upper Cretaceous aquifer ranges from 150 to 458 m, and the piezometric surface decreases from over 500 m (m.s.l) in the northern parts to -20 m (m.s.l) in southeastern part. Salinity ranges between 303 and 1329 mg/l indicating that groundwater belongs to the slightly fresh water class. In the Eocene aquifer, the depth to groundwater ranges from 120 to 290.5 m and the potentiometric level decreases gradually southwards from 220 to -51 m (m.s.l) and characterized by steep slope in the southeastern part of the study area, where the aquifer characterized by relatively high productivity (specific capacity ranges between 10.08 and 332.3 m2/day). The groundwater salinity within this aquifer ranges between 198 and 2800 mg/l (fresh to brackish water class). The annual average rainfall (from 280 to 500 mm) plays a significant role in the recharge of the two aquifers. The priority of groundwater quality and potentiality increases towards the central and northern portions of the concerned area.

Keywords: Eocene and Upper Cretaceous aquifers, rainfall, potentiality, Geographic Information System (GIS)

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Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

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Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

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Authors: Suzana Ramli, Wardah Tahir

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Estimation of surface runoff depth is a vital part in any rainfall-runoff modeling. It leads to stream flow calculation and later predicts flood occurrences. GIS (Geographic Information System) is an advanced and opposite tool used in simulating hydrological model due to its realistic application on topography. The paper discusses on calculation of surface runoff depth for two selected events by using GIS with Curve Number method for Upper Klang River basin. GIS enables maps intersection between soil type and land use that later produces curve number map. The results show good correlation between simulated and observed values with more than 0.7 of R2. Acceptable performance of statistical measurements namely mean error, absolute mean error, RMSE, and bias are also deduced in the paper.

Keywords: surface runoff, geographic information system, curve number method, environment

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Authors: Aileen F. Wang

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Mammography has been one of the most reliable methods for early detection and diagnosis of breast cancer. However, mammography misses about 17% and up to 30% of breast cancers due to the subtle and unstable appearances of breast cancer in their early stages. Recent computer-aided diagnosis (CADx) technology using Zernike moments has improved detection accuracy. However, it has several drawbacks: it uses manual segmentation, Zernike moments are not robust, and it still has a relatively high false negative rate (FNR)–17.6%. This project will focus on the development of a novel breast cancer detection algorithm to automatically segment the breast mass and further reduce FNR. The algorithm consists of automatic segmentation of a single breast mass using Point Region Growing Segmentation, reconstruction of the segmented breast mass using Pseudo-Zernike moments, and classification of the breast mass using the root mean square (RMS). A comparative study among the various algorithms on the segmentation and reconstruction of breast masses was performed on randomly selected mammographic images. The results demonstrated that the newly developed algorithm is the best in terms of accuracy and cost effectiveness. More importantly, the new classifier RMS has the lowest FNR–6%.

Keywords: computer aided diagnosis, mammography, point region growing segmentation, pseudo-zernike moments, root mean square

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Authors: Lyton Chithambo

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This paper reports the results of an investigation into the extent to which various stakeholder pressures influence voluntary disclosure of greenhouse-gas (GHG) emissions in the United Kingdom (UK). The study, which is grounded on institutional theory, also borrows from the insights of upper echelons theory and examines whether specific managerial (chief executive officer) characteristics explain and moderates various stakeholder pressures in explaining GHG voluntary disclosure. Data were obtained from the 2011 annual and sustainability reports of a sample of 216 UK companies on the FTSE350 index listed on the London Stock Exchange. Generally the results suggest that there is no substantial shareholder and employee pressure on a firm to disclose GHG information but there is significant positive pressure from the market status of a firm with those firms with more market share disclosing more GHG information. Consistent with the predictions of institutional theory, we found evidence that coercive pressure i.e. regulatory pressure and mimetic pressures emanating in some industries notably industrials and consumer services have a significant positive influence on firms’ GHG disclosure decisions. Besides, creditor pressure also had a significant negative relationship with GHG disclosure. While CEO age had a direct negative effect on GHG voluntary disclosure, its moderation effect on stakeholder pressure influence on GHG disclosure was only significant on regulatory pressure. The results have important implications for both policy makers and company boards strategizing to reign in their GHG emissions.

Keywords: greenhouse gases, voluntary disclosure, upper echelons theory, institution theory

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Authors: Dhiraj Kumar

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The paper attempts to argue that the regulation of the rural lower caste woman’s life-world is at the core of the reproduction of hierarchy in an Adivasi samaj (society). It has been established in studies on caste and Adivasi that the two societies are distinct and operate through different structures, norms, rituals, beliefs, etc. This is as opposed to the colonial and certain post-independence anthropology in/of India that collapsed the two into single categories for analysis. However, how the two seemingly different social structures affect each other has attracted little attention. The paper is inspired by an action-research at Gadh-Bansla, an Adivasi village in the Kanker district of Chhattisgarh that houses different caste groups – OBCs and SCs, as well as two different Adivasi groups: Gond and Halba. The action-research, taken place across a year, has worked with six families of the different groups present (i.e., Gond, Halba, OBCs, and SCs) in which inter-caste marriages have taken place. Through in-depth interviews and free association discussions with these six families, the paper presents the ways in which the samaj and caste society have interacted. It has been observed that there is a difference in treatment in marriages between a lower caste woman marrying into an upper caste or Halba household, and an upper caste or Halba woman marrying into a lower caste household. While the upper caste woman is easily accepted into the Adivasi samaj and the husband’s family, the same does not hold true for the lower caste woman. The lower caste woman has to face humiliation through untouchability, fine on the family, or in some cases excommunication of the couple. The paper concludes with a need to use caste as a central analytic to understand gender discrimination even in Adivasi contexts.

Keywords: caste, Adivasi, Samaj, humiliation, woman

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Authors: Mohammed Sulaiman, Hexu Liu, Mohamed Binalhaj, William W. Liou, Osama Abudayyeh

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Emerging technologies such as camera-equipped unmanned aerial vehicles (UAVs) are increasingly being applied in building fire rescue to provide real-time visualization and 3D reconstruction of the entire fireground. However, flight planning of camera-equipped UAVs is usually a manual process, which is not sufficient to fulfill the needs of emergency management. This research proposes a Geographic Information System (GIS)-based approach to automatic flight planning of camera-equipped UAVs for building fire emergency response. In this research, Haversine formula and lawn mowing patterns are employed to automate flight planning based on geometrical and spatial information from GIS. The resulting flight mission satisfies the requirements of 3D reconstruction purposes of the fireground, in consideration of flight execution safety and visibility of camera frames. The proposed approach is implemented within a GIS environment through an application programming interface. A case study is used to demonstrate the effectiveness of the proposed approach. The result shows that flight mission can be generated in a timely manner for application to fire emergency response.

Keywords: GIS, camera-equipped UAVs, automatic flight planning, fire emergency response

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Authors: Kajetan Deja, Katarzyna Draganska-Deja, Mateusz Ormanczyk, Michał Procajlo

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Two glaciated fjords on Spitsbergen (Hornsund 77°N) and Kongsfjorden (79°N) were studied for the occurrence of macroplankton (mostly euphausids, hyperiids, chaetognaths) with the use of drop down the camera. The underwater imagery demonstrates that closer to the glacier front, where turbid and freshwater occurs, most of the macroplankters leave the upper water column and descends to the bottom (about 100m depth). Concentrations of macroplankton in the immediate vicinity of the sediment reach over 500 specimens per m² - what corresponds to the biomass of 10g C/m³. Such concentrations of macroplankton are of prime interest for fish, seals and other carnivores. Conditions in the near-bottom waters are in many respects better than in the upper water column- better oxygenated, cold, fully saline and transparent waters with rich food deposited on the seabed from the surface (sinking microplankton). We suggest that near bottom occurrence of macroplankton is related to the increase of glacier melt and freshwater discharge intensity.

Keywords: arctic, ecosystem, fjords, Krill

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Authors: Yanqun Li, Hong Geng

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The occurrence of Wenchuan earthquake in 2008 has led to severe damage to the rural areas of Chengdu city, such as the rupture of the social network, the stagnation of economic production and the rupture of living space. The post-disaster reconstruction has become a sustainable issue. As an important link to maintain the order of rural social development, social network should be an important content of post-disaster reconstruction. Therefore, this paper takes rural reconstruction communities in earthquake-stricken areas of Chengdu as the research object and adopts sociological research methods such as field survey, observation and interview to try to understand the transformation of rural social relations network under the influence of earthquake and its impact on rural space. It has found that rural societies under the earthquake generally experienced three phases: the break of stable social relations, the transition of temporary non-normal state, and the reorganization of social networks. The connotation of phased rural social relations also changed accordingly: turn to a new division of labor on the social orientation, turn to a capital flow and redistribution in new production mode on the capital orientation, and turn to relative decentralization after concentration on the spatial dimension. Along with such changes, rural areas have emerged some social issues such as the alienation of competition in the new industry division, the low social connection, the significant redistribution of capital, and the lack of public space. Based on a comprehensive review of these issues, this paper proposes the corresponding response mechanism. First of all, a reasonable division of labor should be established within the villages to realize diversified commodity supply. Secondly, the villages should adjust the industrial type to promote the equitable participation of capital allocation groups. Finally, external public spaces should be added to strengthen the field of social interaction within the communities.

Keywords: social relations, social support networks, industrial division, capital allocation, public space

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Authors: Cecilia Estela Jiménez Pérez Campos

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Introduction: Amputation comes from a series of complications in diabetic persons; at that point, of the illness evolution they have a deplored aerobic capacity. Adding to that, cardiac rehabs programs are almost base in several activities in a standing position. The cardiac rehabilitation programs have to improve for them, based on scientific advice. Objective: Evaluation of aerobic capacity of diabetic amputee after an aerobic exercise program, with upper limb ergometer. Methodology: The design is longitudinal, prospective, comparative and no randomized. We include all diabetic pelvic limb amputees, who assist to the cardiac rehabilitation. We made 2 groups: an experimental and a control group. The patients did the exercise testing, with the author’s design protocol. The experimental group completed 24 exercise sessions (3 sessions/week), with an intensity determined with the training heart rate. At the end of 8 weeks period, the subjects did a second exercise test. Results: Both groups were a homogeneous sample in age (experimental n=15) 57.6+12.5 years old and (control n=8) 52.5+8.0 years old, sex, occupation, education and economic features. (square chi) (p=0.28). The initial aerobic capacity was similar in both groups. And the aerobic capacity accomplishes after the program was statistically greater in the experimental group than in the control one. The final media VO2peak (mlO2/kg/min) was experimental (17.1+3.8), control (10.5+3.8), p=0.001. (t student). Conclusions: The aerobic capacity improved after an arm ergometer exercise program and the quality of life improve too, in diabetic amputees. So this program is fundamental in diabetic amputee’s rehabilitation management.

Keywords: aerobic fitness, metabolic equivalent (MET), oxygen output, upper limb ergometer

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Authors: Marianna De Almeida

Abstract:

Greek secondary education is a highly selective system with regard to the access of students to Greek universities. Since access from elementary to lower secondary education and afterward to upper secondary education is rather liberal and almost free of selective mechanisms, the basic selection process comes after graduating from upper secondary school into play when students go through a highly selective process for university entry. This structure is responsible for the experience of extreme stress on the part of the candidates during a period of at least two years before the entrance examination leading to a radical change in students' everyday life routines. Instead of the school being an important agent for academic and psychological support, it seems that other agents, such as the informal private preparatory school and the student's families, take on the supportive role.

Keywords: stress, entrance examinations, family support, secondary education

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Authors: Surajit Chattopadhyay

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Accelerated expansion of the current universe is well-established in the literature. Dark energy and modified gravity are two approaches to account for this accelerated expansion. In the present work, we consider scalar field models of dark energy, namely, tachyon and DBI essence in the framework of chameleon Brans-Dicke cosmology. The equation of state parameter is reconstructed and the subsequent cosmological implications are studied. We examined the stability for the obtained solutions of the crossing of the phantom divide under a quantum correction of massless conformally invariant fields and we have seen that quantum correction could be small when the phantom crossing occurs and the obtained solutions of the phantom crossing could be stable under the quantum correction. In the subsequent phase, we have established a correspondence between the NHDE model and the quintessence, the DBI-essence and the tachyon scalar field models in the framework of chameleon Brans–Dicke cosmology. We reconstruct the potentials and the dynamics for these three scalar field models we have considered. The reconstructed potentials are found to increase with the evolution of the universe and in a very late stage they are observed to decay.

Keywords: dark energy, holographic principle, modified gravity, reconstruction

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