scholarly journals Hemodynamic Instability of the Closed Fractures Femur in Children

2021 ◽  
Author(s):  
Ahmed Alkhuzai
Keyword(s):  
Vital Sign ◽  
Hypovolemic Shock ◽  
Femoral Fractures ◽  
Hemodynamic Instability ◽  
High Energy ◽  
The Body ◽  
Associated Injury ◽  
Fracture Femur ◽  
Multiple Injured ◽  
Closed Fractures

Abstract Background: This is a prospective Study to assess the occurrence of hypovolemic shock in children with traumatic isolated closed fractures femur. This is common in children and adolescent as result of trivial to high energy trauma. Methods: A prospective descriptive study was performed on children with traumatic femoral fractures from the 20th of September 2015 to the 15th August 2018. Selection of 100 patients presented with isolated closed fracture femur in children, were admitted to the Sul. Emergency Hospital. Reason was to correct the old criteria of blood transfusion immediately, without suitable indication of replacement with real blood requirements. Depend on the children clinical parameters rather than on hemoglobin or hematocrit concentration; pulse rate. Systolic blood pressure, respiratory rate, Skin capillary refill time, and the mental status. Excluded open fractures and bilateral fracture femur in children, also excluded any fracture associated with trauma to the body organ as associated injury. Results: There was no evidence of hemodynamic instability in the 100 patients of these type fractures, selection inclusion criteria of the study when compared with internationally accepted normal vital sign parameters. No any patients in the study had hemoglobin less than 8.5 g/dl, the vital sign between these groups were similar, 2-6% incidence with hemodynamic instability has found among multiple injured children with femoral fractures, has excluded from the study. Conclusions: No evidence of hemodynamic instability was found in children with traumatic isolated femoral fractures bone. The Hemoglobin and hematocrit ratios early were non dependable, later on not significantly decreased or change to abnormal rate. Depending on vital signs parameters in the femur bone fractures patients after exclusion of bilateral fractures femur, and associated injury or patients with compound fractures, we confirmed that isolated closed femoral fractures are hemodynamically stable.

scholarly journals Treatment algorithms for high-energy traumas of lower extremities

2002 ◽  
Vol 55 (9-10) ◽  
pp. 437-442 ◽  
Author(s):  
Mladen Jovanovic ◽  
Zlata Janjic ◽  
Dusan Maric
Keyword(s):  
Soft Tissue ◽  
Surgical Approach ◽  
Specific Treatment ◽  
Injured Patient ◽  
High Energy ◽  
The Body ◽  
Soft Tissue Reconstruction ◽  
Treatment Algorithms ◽  
Multiple Injured ◽  
Life Threatening

Introduction High-energy traumas are open or closed injuries caused by force (missile, traffic injuries, crush or blust injuries, falling from heights), affecting the body surface and transferring high amount of kinetic energy inducing great damage to the tissue. Management of such lower extremity injuries has evolved over past several decades, but still remains a difficult task for every surgical team. Specific anatomic and functional characteristics combined with extensive injuries demands specific treatment protocols. Multiple injuries In a multiple injured patient the first priority is management of life-threatening trauma. Despite other injuries, surgical treatment of limb-threatening injuries must start as soon as life-threatening condition has been managed. Treatment algorithms Algorithms are especially beneficial in management of severely injured, but salvageable extremities and in making decision on amputation. Insight into mechanisms of injury, as well as systematic examination of the affected limb, should help us understand the extensiveness of trauma and make an adequate management plan. Prevention of infection and surgical approach Prevention of wound infection and surgical approach to high- energy limb trauma, which includes wound extension, wound excision, skeletal stabilization and if necessary muscle compartment release, should be done in the first 6 hours after injury. Methods of soft tissue reconstruction Commonly used methods for soft tissue defects must provide wound coverage in less than five days following injury. Rehabilitation Early passive and active mobilization and verticalization of patients is very important for successful treatment. Conclusion Good and timely evaluation of the injured and collaboration between plastic and orthopedic surgeons from the beginning of treatment, are crucial for final outcome.

Digestibility of nutrients and milk productivity of cows when using the concentrate mixture with the inclusion of rapeseed presscake

2020 ◽  
pp. 48-53
Author(s):  
L. Yarmots ◽  
G. Yarmots ◽  
A. Belenkaya
Keyword(s):  
Protein Digestibility ◽  
High Energy ◽  
Negative Influence ◽  
The Body ◽  
Milk Productivity ◽  
Lactating Cows ◽  
Low Protein ◽  
Concentrate Mixture ◽  
Almost All ◽  
Experimental Group

For ruminants, especially high-yielding animals in addition to the complete supply of animals with protein, its digestibility in the rumen is important. With low protein digestibility in the rumen, the released ammonia will be more effectively used by the rumen microflora, and the undigestible protein in the subsequent sections of the digestive tract can serve as a source of amino acids for the body. The use of concentrate mixtures with the inclusion of local, affordable and cheaper grain feeds, in particular a high-energy and protein ingredient- rapeseed presscake makes it possible to increase the milk productivity of cows throughout lactation. These presscakes are well balanced in their amino acid composition and belong to feeds whose protein has a low degree of digestibility in the rumen. The purpose of the researches was to study the digestibility of nutrients and milk productivity of cows when using the concentrate mixture with the inclusion of rapeseed presscake. In the scientific and economic experiment has been carried out on lactating cows, where the cows of the experimental group in the concentrate mixture of peas has been replaced with rapeseed presscake the digestibility of nutrients in the ration, energy metabolism and milk productivity have been studied. Studies have shown that almost all the nutrients were significantly better digested by the animals of the experimental group. Energy in milk was more allocated by cows of the experimental group by 6,29 MJ. From cows of the experimental group for 100 and 305 days of lactation has been obtained more milk by 6,27 and 7,06 %, respectively, than from control herdmates. The biochemical parameters of blood were within the limits of the physiological norm in animals of both groups. Thus, the replacement of peas with rapeseed presscake in the concentrate mixture did not have a negative influence on the metabolic processes and helped to increase the milk productivity of cows.

scholarly journals Innovative concepts for the usage of veneer-based hybrid materials in vehicle structures

2021 ◽  
pp. 146442072199839
Author(s):  
DB Heyner ◽  
G Piazza ◽  
E Beeh ◽  
G Seidel ◽  
HE Friedrich ◽  
...  
Keyword(s):  
Steel Strip ◽  
High Energy ◽  
The Body ◽  
Vehicle Body ◽  
Material System ◽  
Laminated Veneer Lumber ◽  
Hybrid Beam ◽  
Bending Load ◽  
The Impact ◽  
Very High

A promising approach for the development of sustainable and resource-saving alternatives to conventional material solutions in vehicle structures is the use of renewable raw materials. One group of materials that has particular potential for this application is wood. The specific material properties of wood in the longitudinal fiber direction are comparable to typical construction materials such as steel or aluminum. Due to its comparatively low density, there is a very high lightweight construction potential especially for bending load cases. Structural components of the vehicle body are exposed to very high mechanical loads in the case of crash impact. Depending on the component under consideration, energy has to be absorbed and the structural integrity of the body has to be ensured in order to protect the occupants. The use of natural materials such as wood poses particular challenges for such applications. The material characteristics of wood are dispersed, and depend on environmental factors such as humidity. The aim of the following considerations was to develop a material system to ensure the functional reliability of the component. The test boundary conditions for validation also play a key role in this context. The potential of wood–steel hybrid design based on laminated veneer lumber and steel was investigated for use in a component subjected to crash loads such as the door impact beam. The chosen solution involves a separation of functions. A laminated veneer lumber-based beam was hybridized with a steel strip on the tension side. The steel strip was designed to compensate the comparatively low elongation at fracture of the wood and to ensure the integrity of the beam. The wooden component was designed for high energy absorption due to delamination and controlled failure during the impact, while maintaining the surface moment of inertia, i.e. the bending stiffness of the entire component. This approach was chosen to ensure the functional safety of the component, avoid sudden component failure and utilize the high potential of both materials. The tests carried out provided initial functional proof of the chosen solution. The hybridization achieved significantly higher deformations without sudden failure of the beam. In addition, bending capabilities were increased significantly compared to a beam without hybridization. In comparison with a state-of-the-art steel beam, the hybrid beam was not able to achieve the maximum deformation and the target weight of the hybrid beam. Further optimization of the hybrid beam is therefore necessary.

Body Composition Modifications Due to the “Search, Rescue and Survival Training” in Male Military Firefighter Cadets

2021 ◽  
Author(s):  
Thiago Ramos de Barros ◽  
Verônica Pinto Salerno ◽  
Thalita Ponce ◽  
Míriam Raquel Meira Mainenti
Keyword(s):  
Body Composition ◽  
Body Weight ◽  
Repeated Measures ◽  
Food Restriction ◽  
Physical Exertion ◽  
High Energy ◽  
The Body ◽  
Fat Free Mass ◽  
Sleep Restriction ◽  
Fat Percentage

ABSTRACT Introduction To train and prepare cadets for a career as firefighters in Rio de Janeiro, the second-year students of the Officers Training Course are submitted to a Search, Rescue, and Survival Training (SRST) course, which is characterized by long periods of high physical exertion and sleep restriction during a 9-day instruction module, and food restriction during a 7-day survival module. The present study investigated changes in the body composition of 39 male cadets submitted to SRST during training and 4 weeks of recovery with no restrictions in food consumption. Materials and Methods Each cadet was evaluated by anthropometric measurements at six time points: pre-SRST; after the first module; after the second module; and after 1, 2, and 4 weeks of recovery. Measurements included body girths and skinfolds, to estimate trunk (chest and waist) and limbs (arm and thigh) dimensions, as well as body composition. Repeated measures ANOVA and Friedman test were applied (depending on each data distribution). Results Statistically significant decreases in body weight (76.2; 69.8-87.2 to 63.9; 58.9-73.5 kg) and fat free mass (FFM, 69.2; 63.7-77.2 to 60.1; 56.2-68.0 kg) were observed following the second module of SRST. Following a single week of recovery, the FFM returned to pre-SRST values. Body weight returned to pre-training levels in 2 weeks. Body fat percentage and mass also significantly decreased during SRST (9.0; 7.7-12.3 to 6.5; 5.1-9.3% and 6.9; 5.6-10.0 to 6.9; 5.6-10.0 kg, respectively), which showed a slower and more gradual recovery that reached pre-SRST values after 4 weeks. The girths of arm, thigh, chest and waist significantly decreased due to SRST. The girths of the limbs (arm and thigh) returned to pre-training values after one month of recovery, while the girths of the trunk (chest and waist) did not return to pre-SRST values during the study period. Conclusions The findings suggest that men who experience periods of high energy demands and sleep restriction followed by a period of food restriction will endure unavoidable physical consequences that can be mostly reversed by a 1-month recovery.

scholarly journals A Ten-Year Review of Primary School Flexible Learning Environments: Interior Design and IEQ Performance

Buildings ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 183
Author(s):  
Diksha Vijapur ◽  
Christhina Candido ◽  
Özgür Göçer ◽  
Shirley Wyver
Keyword(s):  
Primary School ◽  
Learning Environments ◽  
Interior Design ◽  
High Energy ◽  
The Body ◽  
Learning Activities ◽  
Indoor Environmental Quality ◽  
Flexible Learning ◽  
Physical Infrastructure ◽  
And Performance

Flexible Learning Environments (FLEs) arose as enablers for implementation of student-centric pedagogical approaches. Interior design is the key to the success of FLEs, providing the physical infrastructure needed for students to engage on several learning activities, from individual to group work, which take place in a variety of zones ranging from low to high energy. Therefore, a harmonious synergy between the interior design and subsequent Indoor Environmental Quality (IEQ) performance of FLEs’ physical configuration and learning activities is needed. The objective of this paper is to systematically review (in accordance with the PRISMA method) existing literature related to FLEs within primary school settings, typically catering to children aged 5–12 years old, to understand the body of work investigating the design and performance of FLEs over the last decade (2010–2020). Key findings suggest that the proximity and acoustic and visual permeability of zones found in FLEs may give rise to inadequate IEQ conditions delivered to students. In addition, it could be inferred from the results of the literature review that interior design and IEQ have not been sufficiently investigated in an integrated manner.

“FUNCTIONAL OUTCOME OF RETROGRADE NAILING IN THE MANAGEMENT OF SUPRACONDYLAR AND DISTAL FEMORAL FRACTURE”

2021 ◽  
pp. 107-109
Author(s):  
Avinash Kumar Choudhary ◽  
M.K Aseri ◽  
Sumit Machra ◽  
Devendra Singh
Keyword(s):  
Femoral Fracture ◽  
Distal Femur ◽  
Femoral Fractures ◽  
High Energy ◽  
Valgus Deformity ◽  
Minor Trauma ◽  
Rating Score ◽  
Joint Congruency ◽  
Distal Femoral Fractures

INTRODUCTION: Fractures of the Distal femur are complex injuries that pose a challenge to the orthopaedic surgeon. It constitutes about 6 % of all femoral fractures. It usually occurs during high energy trauma in younger patients and frequently are associated with concomitant injuries. In contrast, elderly patients with severe osteopenia might sustain solitary distal femoral fractures from minor trauma such as a simple fall. Proper diagnosis and treatment leads to early mobilization and rehabilitation of patients. MATERIAL AND METHODS :This prospective study was conducted in Department of Orthopedics at Dr. S. N. Medical College and Associated group of Hospital, Jodhpur ,Rajasthan ,India on 30 patients who underwent the surgery with retrograde intramedullary interlocking nail in the management of extra-articular supracondylar femoral fracture from August 2019 to November 2020. On follow up axial alignment was assessed and functional analysis was quantied using NEERS RATING SYSTEM, Radiographs was analyzed for correction, maintenance of position or loss of reduction. function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients. RESULTS: In our study 30 patients with supracondylar & distal femoral fractures based on AO Classication on MULLER ET AL underwent retrograde supracondylar nail, long term nal result were rated using NEER'S RATING SCORE , which gives point for pain, function, working, joint movement ,gross and radiological appearance. NEER'S RATING SCORE assigned for each patient after 24 weeks of follow up. After accessing this score out of total 30 patients, 10 have excellent score, 10 have good score, 8 have fair score and next 2 have poor score. Function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients,out of 30 patients 9 patients have an excellent result , 8 have good ,12 have fair and only 1 patient have poor result CONCLUSION:The retrograde intramedullary locked nail provides the surgeon with a different option in treatment of specic supracondylar fracture patterns. It offers a practical advantages of simple and efcient technique for patients with polytrauma, oating knee injuries and in elderly. this technique is very useful in distal femur fracture where antegrade nailing does not provide stability and also where plate xation is not suitable due to soft tissue condition.

scholarly journals Influence of Batch Mass on Formation of NiTi Shape Memory Alloy Produced by High-Energy Ball Milling

Metals ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1908
Author(s):  
Tomasz Goryczka ◽  
Piotr Salwa
Keyword(s):  
Ball Milling ◽  
Niti Alloy ◽  
Parent Phase ◽  
High Energy ◽  
High Energy Ball Milling ◽  
The Body ◽  
Niti Shape Memory Alloy ◽  
Scanning Calorimetry ◽  
Energy Ball ◽  
Grinding Time

A high-energy ball milling technique was used for production of the equiatomic NiTi alloy. The grinding batch was prepared in two quantities of 10 and 20 g. The alloy was produced using various grinding times. Scanning electron microscopy, X-ray diffraction, hardness measurement and differential scanning calorimetry were used for materials characterization at various milling stages. The produced alloy was studied by means of microstructure, chemical and phase composition, average grain and crystallite size, crystal lattice parameters and microstrains. Increasing the batch mass to 20 g and extending the grinding time to 140 h caused the increase in the average size of the agglomerates to 700 µm while the average crystallites size was reduced to a few nanometers. Microstrains were also reduced following elongation of milling time. Moreover, when the grinding time is extended, the amount of the monoclinic phase increases at the expense of the body-centered cubic one—precursors of crystalline, the B2 parent phase and the B19′ martensite. Crystallization takes place as a multistage process, however, at temperatures below 600 °C. After crystallization, the reversible martensitic transformation occurred with the highest enthalpy value—4 or 5 J/g after 120 and 140 h milling, respectively.

Contribution of monocarboxylate transporter 12 to blood supply of creatine on the sinusoidal membrane of the hepatocytes

2021 ◽  
Author(s):  
Ryuta Jomura ◽  
Yu Tanno ◽  
Shin-ichi Akanuma ◽  
Yoshiyuki Kubo ◽  
Masanori Tachikawa ◽  
...  
Keyword(s):  
Energy Homeostasis ◽  
Expression System ◽  
Circulatory System ◽  
Rat Hepatocytes ◽  
High Energy ◽  
The Body ◽  
Monocarboxylate Transporter ◽  
Xenopus Laevis Oocyte ◽  
Inflammatory Stress ◽  
Intracellular Energy

Creatine (Cr)/phosphocreatine has the ability to buffer the high-energy phosphate, thereby contributing to intracellular energy homeostasis. As Cr biosynthetic enzyme deficiency is reported to increase susceptibility to colitis under conditions of inflammatory stress, Cr is critical for maintaining intestinal homeostasis under inflammatory stress. Cr is mainly produced in the hepatocytes and then distributed to other organs of the body by the circulatory system. Since monocarboxylate transporter 9 (MCT9) and MCT12 have been reported to accept Cr as a substrate, these transporters are proposed as candidates for Cr efflux transporter in the liver. The aim of this study was to elucidate the transport mechanism on Cr supply from the hepatocytes. Immunohistochemical staining of the rat liver sections revealed that both MCT9 and MCT12 were localized on the sinusoidal membrane of the hepatocytes. In the transport studies using Xenopus laevis oocyte expression system, [14C]Cr efflux from MCT9- or MCT12-expressing oocytes was significantly greater than that from water-injected oocytes. [14C]Cr efflux from primary cultured hepatocytes was significantly decreased following MCT12 mRNA knockdown, whereas this efflux was not decreased after mRNA knockdown of MCT9. Based on the extent of MCT12 protein downregulation and Cr efflux after knockdown of MCT12 in primary cultured rat hepatocytes, the contribution ratio of MCT12 in Cr efflux was calculated as 76.4%. Our study suggests that MCT12 substantially contributes to the efflux of Cr at the sinusoidal membrane of the hepatocytes.

Radiotherapy dose calculations in high-Z materials: comprehensive comparison between experiment, Monte Carlo, and conventional planning algorithms (Preprint)

2021 ◽  
Author(s):  
Zhangkai Cheng ◽  
Regina Bromley ◽  
Brad Oborn ◽  
Jeremy Booth
Keyword(s):  
Monte Carlo ◽  
Radiation Therapy ◽  
Spinal Metastases ◽  
Dose Calculation ◽  
High Energy ◽  
The Body ◽  
Treatment Technique ◽  
Calculation Algorithms ◽  
Dose Calculation Algorithms ◽  
Ct Density

BACKGROUND Despite spinal metastases accounting for 10% to 30% of new tumors diagnoses annually, and radiation therapy is a standard treatment technique, the studies discussing the effects of small-size spinal prostheses on spinal radiation therapy are limited. OBJECTIVE To compare the accuracies of the AAA and AcurosXB dose calculation algorithms and to predict the change in the down-stream and lateral dose deposition of high energy photons in the presence of material with densities higher that commonly found in the body. METHODS Metal rods of titanium (d =4.5g/m2), stainless steel (d=8g/cm2) and tungsten (d=19.25 g/cm2) were positioned in a phantom. Film was position behind and laterally to the rods to measure the dose distribution for a 6 MV, 18 MV and 10 FFF photon beams. A DOSXYZnrc Monte Carlo simulation of the experimental setup was performed The AAA and AcurosXB dose calculation algorithms were used to predict the dose distributions. The dose from film and DOSXYZnrc were compared with the dose predicted by AAA and AcurosXB. RESULTS AAA overestimated the dose behind the rods by 15-25% and underestimated the dose laterally to the rods by 5-15% depending on the range of materials and energies investigated. AcurosXB overestimated the dose behind the rods by 1-18% and underestimated the dose laterally to the rods by up to 5% depending on the range of material and energies investigated. CONCLUSIONS AAA cannot deliver clinically acceptable dose calculation results at a distance less than 10 mm from metals, for a single field treatment. Acuros XB is able to handle metals of low atomic numbers (Z ≤ 26), but not tungsten (Z = 74). This can be due to the restriction of the CT-density table in EclipseTM TPS, which has an upper HU limit of 10501.

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