Bandcizer - A Tool to Assess Dosage of Elastic Band Exercises-Juniper Publishers

Journal of Head Neck & Spine Surgery

Introduction

Home based treatment or rehabilitation is one the most blooming and evolving trend among budding and established physiotherapists as it gives improvement in pain intensity, quality of life and muscle strength at the comfort of being at home. Home based exercises are often carried out by patients with help of home-based exercise equipment’s. Bandcizer is a sensor for resistance Training. It helps to assess the dosage of Thera band resistance and Intensity Figure 1.

What is the use of Bandcizer?

Elastic band or resistive exercise ropes are used by many now a day as it provides the sufficient resistance for doing strengthening exercises. The duration, method, repetition and technique of using such exercises are a matter of concern for the physios who recommend home based exercises. Recent studies are suggesting the fact that secondary injuries following the practice of home-based exercises have increased drastically. It’s unclear why such injuries happen and it’s a serious which has to be looked into at the earliest.

Founder

BandCizer ApS is founded by Anders S. Sørensen & Tim Bang. A new commercially available sensor has been developed which automatically records and stores exercise data into its memory card or directly send into the mobile phone. The University Southern Denmark and the national Danish jointly developed “BANDCIZER™”. This new sensor may help clinicians as well as researchers to monitor the Home-based exercise program with ease. The BandCizer is a small device (slightly larger than a quarter) that attaches to TheraBand resistance bands.

BandCizer is capable of automatically storing the data such as day, time and quantifying important aspects of exercise such as ROM and important details such as TUT (Time under tension). It measures the changes in thickness of the elastic band. It is equipped with a LSM3330 3D digital gyroscope with a sample rate of 20Hz. The data recorded by the sensor is sent to a computer directly in form of text files via Bluetooth.

How it Works

BandCizer ‘s 3D gyroscope measures rotation and angular velocity occurring around three axes: x, y and z. The positions of these axes are constant in the BandCizer and cannot be altered. For example: if rotation movement occurs around a vertical axis, the x-axis of the gyroscope will register and record this movement, under the condition that the x-axis of the gyroscope is always positioned on thera-band to point vertically.

BandCizer App guides you towards optimal performance, compliance and progression your training and also provide interactive supervision with live bio-feedback, tailored for the individual [1-5].

Advantages and Usage

a) To increase quality in rehabilitation, sport and fitness.

b) To boost motivation and provide interactive supervision.

c) To document compliance and visualise performance.

d) To share result with therapist (Figure 2).

 

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A Way to Enhance Hail Prevention Technique and to Increase the Efficiency of Anti-Hail Protection of Unlimited Agricultural Areas-Juniper Publishers

Agricultural Research & Technology: Open Access Journal

 

Abstract

In this article a new method and a station of anti-hail protection are described based on the early prevention of hail formation by significant shock waves, enriched by silver iodide or other reagents, allowing implement fully autonomous and automotive anti-hail protection of rural and urban areas of any size, restricted or unrestricted.

Introduction

Despite the best efforts of the authorities, farmers and researchers the protection of rural and urban areas from hail remains an actual problem for all countries subject to hailstorm, since every year, hail continues to cause irretrievable, great and severe damage to agriculture, rural and urban vegetation and properties, both, civil and state. To suppress hail power and to reduce damage from hail in agriculture and in the economy it is necessary to use anti-hail protection methods and stations that will be more efficient in application and chip in exploitation. At present the anti-hail protection of width areas is implemented by the following methods: seeding of clouds with silver iodide or other substances, which induce freezing to occur at warmer temperatures than otherwise, and the use of sonic cannons (gas-generators) or other kinds of explosive devices, which involves supersonic and significant shock waves generation and their direction upwardly to the sky, to transports positive ions from ground level to cloud level which disrupt formation of hail nuclei. Both described techniques are not efficient against already formed hailstones, so the most important requirement in their application remains their timely startup. A developed method of hail generative clouds early detection, based on the measuring of clouds intrinsic emission in radiofrequencies [1-10], allows interrupt hail formation in cumulonimbus and to implement fully autonomous and automotive anti-hail protection of any areas of any size. However, to increase efficiency of protection against hail, it is advisable to combine sometimes two described methods, and to enrich the ground level by reagents, which will then be moved to cloud level by shock waves. In this presentation will be described a new method and a station of anti-hail protection based on the early prevention of hail formation by significant shock waves, enriched by silver iodide or other reagents, allowing implement fully autonomous and automotive anti-hail protection of rural and urban areas of any size, restricted or unrestricted.

Clouds seeding by shock waves for hail prevention

In Figure 1 an option from [3] for implementation of fully autonomous and automatically functioning large-scale network of anti-hail protection is presented allowing to protect a vast (practically unrestricted) area (1) comprising M>>1 spatially distributed protected sites (2) 50-70 hectares each and hail trapping areas (2T). Each protected site (2) and hail trapping area (2T) is equipped with an anti-hail protection system (4) comprising a powerful supersonic cannon (gas-generator) and a local detector-alerter for early detection of impending hail or hail generative clouds, by measuring apparent temperature of the corresponding part of the sky just over the protected site or hail trapping area, and for timely starting-up the corresponding site’s and trapping area’s gas-generators (supersonic cannons). Detailed block diagrams of the corresponding site’s anti-hail protection system including a local detector-alerter and a gas-generator and initially described in [4-10] are presented in Figure 2.

The marginal sites of the protected area (1) in addition are equipped with a remote sensing complex of K far-detection (far-ranging) systems (3) spatially distributed along the edges of the protected area as shown in Figure 1. The remote sensing complex which serves the whole protected area (1) of M sites is used for far-ranging detection of hail or hail generative clouds over an adjacent land all around the protected area at a horizontal distance 4-6km far from the edge (boundary) of the protected area (1) and at the altitude 3-5km, as well as for warning the anti-hail protection systems of the protected sites of the protected area (1) by transmitting on the air the warning signals on impending hail danger from a certain adjacent land of the protected area of M sites. The number K depends on the type of spatial distribution of M sites and it can have a value from the interval [1M], e.g. if M sites are spatially distributed around a common center it will be possible to use only one (K=1) far detection system. If all M sites are located far apart as a long chain then for entire serving the protected area of M sites it will be necessary to use K=M far detection systems. Depending on the terrain relief, any of the far detection systems can be installed individually, near or at a distance from the corresponding detector-alerter, inside or outside the corresponding protection site, etc. Further actions of the chain are described in detail in [2,3]. A detailed block diagram of the far detection system is presented in [1-10].

When M=K=1 the option of Figure 1 is performed into the outline of a version of implementation of a local network of autonomous and automatically functioning anti-hail protection of the protected site (2) of a limited size, including a restricted area like one of the marginal sites of Figure 1 and one or more trapping areas (2T) [1]. Operation actions of the local network of an antihail protection of a locally restricted area are described in detail in [1]. Sometimes, some of marginal gas-generators of Figure 1 and gas-generators of the trapping areas can be equipped in addition by reagent injecting facilities, which can enhance hail trapping and can make hail to fall out in trapping areas and thereby quickly neutralize hail threat. A block diagram of the anti-hail protection system (4) including the local detector-alerter and the gasgenerator with reagent injecting facilities is presented in Figure 2.

When the far-range detector-alerter of any azimuth direction detects hail cloud or cumulonimbus coming from certain azimuth direction it warns detector-alerters of nearby located protected sites. Simultaneously it warns as well detector-alerters of the relevant trapping areas (2T) by transmitting on the air warning code-signals about impending hail danger from the certain direction. In a case if the far-range detector-alerter detects a cloud of severe hail the detector-alerters of nearby located protected sites turn-off their gas-generators to skip impending hail cloud. In opposite, the detector-alerters of the relevant trapping areas set the “alert mode” of operation for their gas-generators and start-up their gas-generators when the signals of sky brightness temperature (apparent temperatures) exceed the “alert” threshold level. Detector-alerters of the involved trapping areas turn-off their gas-generators when the corresponding far-range detectoralerters interrupt transmitting warning code signals on impending hail danger and when the levels of the signals of sky intrinsic microwave emission measured by their detector-alerters fall below the “alert” thresholds levels. During the first few explosions, a reagent is injected into the combustion chamber of the gasgenerator, which, as a result of an explosion leaves the combustion chamber through the conical barrel of the gas generator and enriching the ground level of the air with microscopic particles After that, due to the successions of significant shock waves the particles of the injected reagent, together with existed in the air positive ions are transported from ground level to cloud level. So, by this way it is possible to increase the probability of disruption of formation of hail nuclei and to implement fully autonomous and automatic trapping of hail and to enhance protection possibilities of the above described networks of locally restricted and wideranging anti-hail protections.

Conclusion

Despite the fact that joint application of reagents and shock waves can increase the cost of anti-hail protection and pollution level of agricultural fields and environment, however the combination of both techniques clouds seeding by reagents and impact on clouds by generated and directed upwardly to the sky supersonic and significant shock waves can enhance the probability of hail prevention and hail suppression 

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Geometric Simulation for 3D-Printed Soft Robots-Juniper Publishers

Robotics & Automation Engineering Journal

Introduction

Robots fabricated by soft materials can provide higher flexibility and thus better safety while interacting with natural objects with low stiffness such as food and human beings. With the growth of three-dimensional (3D) printing, it is even possible to directly fabricate soft robots [1,2] with complex structures and multiple materials realizing highly dexterous tasks like human-interactive grasping and confined area detection [3]. However, with such increased degrees of freedom (DoF), the design of soft robots becomes a very difficult task. It can be made possible by integrating simulation into the design phase. However, the shape deformation comes from many different and complex factors including manufacturing process, material properties, actuation, etc. Especially with the limited understanding of layer-based additive process in AM, it is challenging to formulate a complete mathematical model for the simulation.

SOFA [4] is one of the most widely used frameworks for physical simulation. It is also applied in the simulation of soft robots that supports interactive deformation [5]. However, it may suffer from the problem of numerical accuracy, particularly if there is large deformation. Unfortunately, one benefit of soft robot is its capability of adapting to highly curved contact by large deformation, which needs to be precisely simulated for many applications. There is another type of simulation methodology to simplify the simulation model of deformation to a geometry optimization problem [6]. It was originally developed in the computer graphics area for visualization, but it has been proved to work superbly in physical simulation like self-transformation structures [7] and the computational efficiency is remarkable [8]. This geometric simulation is particularly suitable for soft robots [9] (Figure 1), because the actuation of soft robots is commonly defined by geometry variations (e.g., cable shortening and pneumatic expansion), and it is actually indirect to first obtain apply them in the conventional deformation simulation. It is shown that the geometric simulation gives better convergence and accuracy than the conventional methods. Therefore, the aim of this review is to share this technique with a broader audience in the robotic community, and discuss the potentials capabilities, and future works of this technology.

Geometric Simulation

The common way of Finite Element Analysis (FEA) is to apply Hooke’s law to each element and then assemble the equations to compute the deformation with the applied force:

where 𝐹 is the global nodal force vector, 𝐾 is the global stiffness matrix, and 𝛷 is the global nodal displacement vector. In the geometric simulation, the formulation is developed by shape projection on the elements in terms of point positions:

where 𝐕 ∈ ℛ𝑛×3 stacks all the point positions of 𝑛 vertices, Ci ∈ ℛ𝑒×𝑛 is the centering matrix for the 𝑖-th element among 𝑒 elements, Pi ∈ ℛ 𝑒×3 is the variables defining the shape projections for the element, and 𝑤𝑖 is the weight for the element, which is commonly set as the volume. This minimization can be solved by taking derivative and thus a sparse symmetric positive definite system:

This geometric optimization is formulated to minimize the elastic energy with reference to shape variations similar to the physical phenomenon during deformation. To compare Eq. (3) with Eq. (1), they have the same form with:

Therefore, the geometric simulation actually has the benefits as the FEA, but it should be noted the force vector 𝐹 here is defined purely by the shape projections. As a result, this is a direct approach to take the geometric actuation as input and compute the deformed shape of soft robots by numerical optimization using a geometry-based algorithm. To complete the formulation, the shape projections should be carefully defined to model different actuations in the simulation and to model the material properties geometrically. In the state-of-the-art work [9], the geometric constraints of actuations are modeled as a type of element, e.g., aligning the cable with the edge of elements and shorten the edges, or scaling the size of elements for volume expansion in pneumatic actuations. In such way, the actuation can be directly integrated in the optimization without additional computation burdens. In terms of modeling the material properties geometrically in the framework, a calibration step is done to learn the relationship between material properties and shape parameters between hard and soft assignments. Should the element be rigid or preserve its volume is determined by the shape parameters and modeled by the shape projection. It is shown that the calibration method can be used to simulate the deformation of objects with two materials. Different from using constrained nonlinear optimization, the geometry optimization can converge in a few iterations, thanks to the shape projection operator.

Discussion

The development of geometric simulation was motivated by the observation that most actuations of soft robots such as length shortening of cable and volume changing of chamber are based on geometry variation. The geometric optimization tries to preserve shape during deformation with the function of representing actuations as different type of geometric constraints to be imposed on specially designed elements. It shows promising results in terms of accuracy and efficiency, and it is also shown to be possible in the dynamic models [10].

Conclusion

The preliminary results of the geometry-based framework are attractive, and its efficiency opens the opportunity of iterative design for soft robot. However, the current development is still limited with simple structures, materials, and actuations. Therefore, to make this simulation more practical and user friendly, the future works should include extending to different actuations such as thermo, magnetism or electro ones; multiple actuations acting together; multiple materials; non-linear material like hyperplastic material [11]; and multiple bodies with collision detections.

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The Use of Plastic Waste as Transition Materials in the Production of Pavement Blocks-Juniper Publishers

Civil Engineering Research Journal 

Abstract

Many developing countries are facing a lot of challenges with management of huge quantities of solid waste generated on daily basis. Plastic waste which is part of solid waste poses a menace to sustainable development due to its slow rate of degradability and the indiscriminate way it is disposed. To lessen the negative impacts on the environment and the associated effects on human health, plastic waste is being considered as materials in transition and are being used in the production of pavement blocks and other materials for construction purposes. The study reports some physical and mechanical properties of plastic waste pavement blocks produced by one company in Ghana which has taken a major lead in the direction of adding value to plastic waste for construction. Results are compared to two other pavement block types made from cement and fired clay pavement blocks and discussed. Using plastic waste as transition materials for pavement blocks may among other benefits listed, translate to reduction in construction cost and large quantities of plastic waste polluting the environment and may contribute to cleaner cities and towns.

Keywords: Plastic waste; Transition materials; Pavement blocks; Environment; Construction

Introduction

Economic growth and changing consumption patterns are resulting in rapid increase in the use of plastics in the world. Thus, consumption of plastic material has increased from 5 million tons in the 1950s to 100 million in the 2000s. In Ghana per capita generation of plastic waste has been reported to be between 0.0016- 0.035kg/person/day. And, plastics make up between 18-20% component materials in the waste stream [1]. There are however concerns about plastic waste disposal methods commonly employed in many developing countries as they do not deal effectively with the large tonnes of plastic waste generated. These disposal methods include dumping plastic waste in landfills, incineration and open littering. Since plastics take several years to degrade, there are challenges associated with their improper disposal which include:

i. Blocking drains and choking of gutters which may contribute to floods

ii. Release of toxic gases into the atmosphere when openly burnt. Some of these gases may be harmful to humans and cause greenhouse effects.

iii. Discarded bottles and containers may serve as breeding grounds for mosquitoes when filled with rainwater.

iv. Washing of the littered plastic materials into water bodies including oceans contributing to decline of ocean life.

Common pavement materials used in Ghana include the cement pavement blocks and the fired clay pavement bricks. Portland cement imported into the country is used in the production of cement pavement blocks and is associated with increasingly high cost due the unstable value of foreign exchange. Fired claypavers produced from available local clay materials are not very popular with a lot of people because they are perceived by many as expensive. The production of fired clay pavers currently in the country relies on firewood burnt at very high temperatures. This firing method is not sustainable and associated with consumption of a lot energy. In recent times, due to the ecological and environmental challenges associated with the disposal of plastic waste, there are a lot of interest in turning plastic waste into a resource in construction. Pavement blocks produced from waste plastic and other materials like sand, quarry dust etc., is recently being promoted in many developing countries as a more affordable and a sustainable material which may be used in construction and Ghana is no exception. Though it is generally known that these plastic waste pavement blocks are strong and durable, there is little scientific data in Ghana to support this claim. This paper therefore reports a study on three types of pavement blocks produced from plastic waste, fired clay, and cement with regards to some of their physical and mechanical properties.

Materials and Methods

Materials

The pavements samples under study were obtained from three different commercial paving factories in Ghana. The raw materials used in the production of these pavers comprised of cement, quarry dust and fine aggregates (sand), for the cement pavers, clay for the clay pavers, and waste plastics and sand for the plastic pavers. Six samples of each paver types were randomly selected and tested for each of the various physical and mechanical properties which include density, compressive strength, flexural strength, abrasive resistance, water of absorption and durability in sea water. Plastic pavement blocks were commercially produced in bigger sizes of 30cm by 30cm. They were cut into 4 equal part with half remaining. And test run on samples of dimension 20cm by 10cm with a thickness of 5cm. This is to make sure all types of pavement blocks have comparable sizes. Cement and fired clay pavement blocks are of hexagonal shape and with dimensions 23cm by 14cm with thickness 5m and 20m by 10.5 with thickness 6.5cm respectively. The samples were cured for more than 28 days to ensure maximum mechanical strength development before the various test were conducted.

Method

Antifungal resistance

Density: The density of the various paving bricks was determined using Archimedes principle of water displacement. Dry weights of various pavers were measured and fully immersed in a tank containing water. The volume of water displaced was measured for each pavement type, and the average volume of water displaced was recorded for five samples each of the various pavers. The densities of the various pavers were determined by dividing the dry weight by the volume of water displaced [2].

Compressive strength: The compressive strength is the most prioritized property to be achieved in the production of paving bricks in almost every factory that is actively involved in manufacturing of pavers [3]. Hydraulic universal testing machine which has a maximum capacity up to 2500KN was used to determine the compressive of the various pavers in this study. The load was applied to the nominal area of the cement, clay and rubberized pavers to determine the various compressive strengths. The corrected compressive strength was computed using correcting factors (BIS, 2006).

Flexural strength: Flexural strength is one of the tests performed on paver blocks which serves as a quality indicator and it is considered as a basis for comparison in terms of wearing resistance. Flexural strength test was performed by subjecting the various pavers to a thwartwise force which is perpendicular to its longitudinal axis. A center line was indicated on top of the pavers which is perpendicular to its length. The pavers were supported by two support rods over a span of 150mm and were tested under a central line load until failure occurred, using the INSTRON universal testing machine. The flexural strength values recorded are the average of five samples each for the various paver [4].

Water of absorption and durability in sea water: Water of absorption is the determination of the rate of absorption by measuring the increase in mass of the pavers resulting from absorption of water over a period. The pavers were fully immersed in a tank of fresh water for 24 hours and the weight measured to determine the percentage of water absorption. And, the pavements were fully immersed in a tank of sea water for four months to determine its durability by applying a load to determine the compressive strength using the universal testing machine. The percent water of absorption is determined using equation (1),

Results

Density

The density values of the various pavers are presented in Figure 1. The values range between 1.99g/cm3 to 2.04 g/cm3, with fired clay pavement block having the lowest and cement pavement block having the highest.

Compressive Strength

As shown in Figure 2 above, clay brick pavement blocks recorded the highest compressive strength followed by the plastic pavement blocks with the cement pavement blocks recording the least compressive strength.

Flexural Strength

Figure 3 shows the test results of flexural strength of plastic paver, cement paver and clay bricks to be 6.04MPa, 5.86MPa and 5.09MPa respectively.

Water of Absorption

Figure 4 shows the percentage water of absorption test results for clay bricks, cement blocks and plastic pavers as 11.82, 8.075 and 0.369 respectively

Abrasion Resistance

Abrasive resistance is a measure of the resistance of paving brick to the wearing action due to traffic and can be calculated using equation (2).

The maximum abrasion index for Type III i.e. pedestrian and light traffic pavement is 0.50 and the minimum abrasion limit for a 28day cured concrete paver is 1.20 for footpaths and car parks (ASTM C 902-15). The three types of pavers have abrasion index of 0.35, 0.14 and 0.014 for clay, cement and fired clay pavement blocks respectively Figure 5.

Durability in Sea water

Percentage of seawater absorbed by the three different pavement blocks are shown in Figure 6 above.

Discussion

The density of burnt brick pavers has been stated to be between 1.826g/cm3 and 1.985g/cm3, and specific gravity of special masonry varies between 1.20g/cm3 and 2.40g/cm3(ASTM C-902). From the results in Figure 1, Clay pavers had the minimum density value followed by the plastic and cement pavers of densities 2.04g/ cm3 and 2.10g/cm3 respectively. The 3 types however fall within the standard specification. Clay pavement blocks recorded higher average compressive strength, followed by plastic pavement blocks and then cement pavement blocks. Clay pavement blocks have highest thickness compared to plastic and cement pavement blocks and this may have contributed to the high compressive strength. Also, the compressive strength of the plastic pavement blocks was not determined on full blocks but on a cut-out section, may have caused a reduction in the compressive strength of plastic pavement blocks as noted by Vila et al. [5]. The production of clay bricks currently in Ghana relies on firewood and requires much energy during firing. Harmful gases such CO2 may also be released into the environment which is not eco-friendly. When firing is not well controlled, clay bricks can develop cracks which may lead to reduction in strength.

Cement pavers recorded the least compressive strength value as compared to the rubberized pavers. Poor compaction is a major factor that influence the strength of cement pavers which creates more pores to absorb water. Secondly, decreased strength in concrete pavers can be attributed to variation in the mix proportions in the batching process. Improper mixing proportions and insufficient compaction hinders the achievement of maximum density and creates voids which contributes to reducing the strength of the concrete pavers. Increasing void content and decreasing density decreases the compressive of the concrete pavers [6]. Plastic pavers recorded higher compressive value than cement pavers. Melting of plastics for plastic pavers requires less energy since plastics have low melting points and melting is done at low temperatures. The melting process does not release harmful gases into the environment, and it is cheaper to produce. Therefore, plastic pavers may be used commercially for non-traffic application. The high flexural strength average value obtained for plastic modified pavement block as compared to the concrete pavers and clay bricks may be due to good adhesion of molten plastic to the sand particles and low porosity. This is an indication that the plastic pavement blocks could withstand higher flexural stresses than the rest

Results obtained for water of absorption indicated that clay brick absorbed maximum water as compared to cement paver and plastic paver. The maximum water absorption by the clay bricks may have occurred as a result of the presence of pores and due to the hydrophilic nature of clay. Increased absorption of water may result in loss of bondage of clay particles hence reduced strength of clay pavement blocks in service. The cement pavers absorbed less water as compared to the clay bricks. This is because the cement creates stronger bonds between the particles, and this minimizes the pores through which water get absorbed by the concrete pavement block [7]. However average value obtained for both fired clay and cement pavement blocks are more than the minimum value of 5%. Thus, the use of these pavement blocks may not be durable especially in waterlogged areas. Water absorption values obtained for plastic pavers are within the specified standard of less than 5%. This may be due the low porosity of the rubberized paver and due to the hydrophobic nature of plastics. The water of absorption of plastic pavers have been found to further decrease when the proportion of plastic waste is increased. The low porosity of the plastic pavers may contribute to little or no damage under severe conditions such as heavy rains as compared to clay bricks and cement pavers. Clay bricks and cement pavers may absorb water under severe condition, and this has a tendency of weakening the bonds that exist between their structures which may lead to formation of micro cracks. Hence any load applied on clay bricks and cement pavers, may act on the stress concentration points because of the presence of micro cracks and this may cause decrease in strength. The very low abrasion resistance value recorded by the plastic pavers indicates that plastic pavers have high ability to withstand wearing action than clay bricks and cement pavers which may be as a result of the good adherence of the plastic with the sand aggregates. Seawater durability is the ability of pavers to resist permeability of saline solution and have improved strength to be serviceable. Four months durability in Sea water test results are shown in Figure 4 for the various types of pavers under study.

The permeability of sea water in pavers causes two main actions to occur; chemical reaction which usually occurs within the pavers resulting in softening and disruptive expansion of the pavement blocks, and crystallization of salts which occurs on the surface of the pavers. As pavers absorb sea water, the dissolved salts in the form of crystals are left within the joint and the pores of the pavers which may cause expansion and increases porosity thereby reducing the strength of pavers [8]. As indicated by results in Figure 6, plastic pavers absorbed less Sea water. This may be due to the low porosity exhibited and due to the structure of plastics, i.e. strong with close intermolecular links and so this type of pavers resists sea water [9-14] absorption as compared to the cement and clay pavers. Therefore, plastic pavers may remain stronger in terms of durability in high saline environment.

Conclusion

In this study clay pavement and plastic pavement blocks obtained higher average compressive strength than the cement pavement blocks. Durability studies suggested that plastic pavement blocks may perform better in areas prone to flooding and high saline content. Though the various pavement blocks may be used for footpath, light traffic, walkway etc., the plastic pavement blocks made from waste plastic and sand may be cheaper and represent an alternative way of turning waste material into useful product for a more sustained construction. Plastic waste use as transitional material in construction is a demonstration of how waste could be turned into a resource for cost effective, yet a durable and sustainable material for construction. Other advantages include minimizing plastic waste in the environment, the landfills and water bodies contributing to cleaner cities and towns and creation of more jobs.

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Intra-Thyroidal Thymic Tissue May Display Radiological Features Suggestive of Malignancy - A Case Report-Juniper Publishers

Journal of Head Neck & Spine Surgery

Abstract

Introduction: Thyroid “incidentalomas” are increasing in frequency, thought mainly to be a result of the enhanced sensitivity of ultrasonography and the increasing use of this imaging technique. We present two cases of thyroid nodules in paediatric patients which were found to be intrathyroidal thymic tissue.

Case report: The first case displayed ultrasonographic features that were highly suspicious for papillary thyroid cancer with microcalcification, however following diagnostic hemithyroidectomy the lesion was diagnosed as intra-thyroidal ectopic thymic tissue. Histologically, calcified Hassall’s corpuscles would account for the calcified appearance of the nodule on ultrasound scan. We describe a further case of intra-thyroidal ectopic thymic tissue in another paediatric patient who presented with a thyroid mass.

Discussion:It is important to consider thymic remnant tissue as a differential diagnosis for incidental thyroid nodules.

Keywords: Paediatric; Otolaryngology; Incidental finding; Endocrine gland neoplasms; Thyroid malignancy

Introduction

Thyroid nodules are less commonly found in children, affecting 0.2-1.5%, when compared to adult patients [1]. Paediatric thyroid lesions are however more likely to be malignant and must be carefully investigated [1,2]. There are sporadic reports of intra-thyroidal thymic tissue in the literature, however increasing ultrasound scan use and enhanced sensitivity of ultrasonographic images has resulted in a rise in incidentally found thyroid lesions, which is likely to increase further [3,4]. This has created a diagnostic dilemma for clinicians and lead to an increase in diagnostic thyroid surgeries and an increase in detection of microcarcinomas. Thymic tissue has a distinctive appearance on ultrasound with features that may be misinterpreted as a malignant thyroid nodule [3].

We report two cases of intra-thyroidal ectopic thymic tissue in paediatric patients, both presenting with a thyroid mass. One patient displayed radiological features that were suspicious of malignancy. Both patients underwent diagnostic hemi-thyroidectomy.

Case Report

Case 1

A 4-year-old girl with no co-morbidities presented with cervical lymphadenopathy following an upper respiratory tract infection. An ultrasound noted cervical lymphadenopathy and a solitary thyroid nodule with appearances suspicious of papillary thyroid cancer. There was no family history or other risk factors for thyroid malignancy. Blood tests revealed normal thyroid function, calcitonin and thyroid auto-antibodies.

A repeat ultrasound scan of the neck revealed a hypo-echoic nodule within the left lobe of the thyroid, displaying micro-calcification and was taller than wide leading to a U5 (malignant) diagnostic ultrasound grading (Figure 1). Following diagnostic hemi-thyroidectomy, the nodule was histologically found to be ectopic thymic tissue within the thyroid lobe, with calcification of Hassall’s corpuscles, which would account for the calcified appearance on ultrasound scan.

Case 2

A 12-year-old boy with no co-morbidities presented with a midline neck swelling that had appeared 6 weeks previously. Clinically he was found to have a 4.0 x 5.0cm, non-tender neck mass in the midline with no movement on tongue protrusion. Thyroid function, calcitonin and thyroid auto-antibodies were normal.

Ultrasound revealed a 4.0cm hyper-echoic thyroid lesion arising from the isthmus. Fine needle aspiration cytology (FNAC) was reassuring with morphological features consistent with a benign colloid nodule and classified as Thy 2, however due to the size of the mass the child underwent hemi-thyroidectomy which revealed nodular hyperplasia; ectopic intrathyroidal thymic tissue was also identified throughout the sample.

Discussion

Intra-thyroidal thymic tissue is an uncommon cause of neck swellings and has rarely been reported in the literature with published data from a small number of case reports [3,5]. The thymus is involved in adaptive immunity and T-cell function; it proliferates in the neonatal period and first decade of life and is vital for development of a mature immune system [6]. Embryologically, the thymus is derived from the endoderm of the third and fourth pharyngeal pouch during the 6th gestational week and as the thymo-pharyngeal duct elongates during the 7th week the thymus migrates inferiorly and medially towards the superior mediastinum [4,6]. Ectopic thyroid tissue can therefore be found anywhere from the angle of mouth to the superior mediastinum [5], meaning ectopic thymic tissue can easily be misinterpreted as a pathological neck lump, particularly in the paediatric population.

There are various reports of ectopic thymic tissue. Most commonly it is found as aberrant tissue within the neck, known as ectopic cervical thymic tissue [5]. There are only sporadic reports of in thyroidal thymic tissue, however it has previously been misdiagnosed as papillary thyroid cancer on ultrasound, similar to the case presented [3,5]. The exact epidemiology of intra-thyroidal thymic tissue remains unclear, however one study from Japan suggests that it is present in 1% of children [7]. Similar numbers were found in a study of perinatal thyroid glands [8]. With the increasing use and enhanced sensitivity of ultrasound, higher numbers of ectopic thymic tissue located within the thyroid gland may be detected and potentially misdiagnosed as malignancy, leading to diagnostic surgery, as in the two cases presented.

We present the cases of two children with intra-thyroidal thymic tissue who were referred to our paediatric head and neck tertiary referral service with thyroid masses. One child had a thyroid lesion that was radiologically suspicious for a papillary thyroid cancer with micro-calcifications and a mass that was taller than wide. Micro-calcifications are considered a highly suspicious feature on ultrasound, suggestive of papillary thyroid cancer and would result in a U5 grading on ultrasound according to the British Thyroid Association guidelines [9,10]. Hyperechoic foci within ectopic thymic tissue may be misinterpreted as micro-calcifications, which could mimic a malignant thyroid lesion. The other child had incidental thymic tissue identified throughout the thyroid gland in association with nodular hyperplasia.

The cases presented highlight the complexities of preoperative diagnosis of intra-thyroidal thymic tissue. However, with increasing usage of ultrasound imaging it is important to consider thymic remnant tissue as a differential diagnosis for thyroid nodules, especially as the imaging findings may mimic a malignant thyroid lesion. Unfortunately, due to the suspicious ultrasound features diagnostic thyroid surgery may still be inevitable.

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Effect of Police Confinement Training Period on Respiratory Muscle Power and Hemoglobin in Khartoum State, Sudan-Juniper Publishers

International Journal of Pulmonary & Respiratory Sciences

Abstract

Introduction: Adequate aerobic capacity and muscle strength are essential elements to perform the activities that are required from professional soldiers & officers to optimize their peak performance & maintain physically demanding tasks. The newly recruited police officers will be subjected to 6_8 week's confinement in which they will have a training program including exercise & initial police training. The objective of this study was to assess the respiratory muscle power, blood pressure and hemoglobin during this period.

Method: This was a cross sectional study conducted during the period from July to September 2017 in Soba, faculty of police science and law, Khartoum, Sudan. Eighty-one policemen trainee were randomly selected, aged between 20 and 30 years underwent evaluation before & after the confinement period (40 days). Maximal respiratory pressure (MEP and MIP) was measured using respiratory pressure meter for respiratory muscle power. Hemoglobin, pulse & blood pressure was also measured.

Results: The mean values of MEP & MIP were significantly higher after the end of the confinement period (P>0.05). Also there was significant change in the mean of hemoglobin before & after the confinement period (p= 0.03). There was no change in pulse & blood pressures.

Conclusion: Police training confinement improves respiratory muscle power & hemoglobin level.

Keywords: Police training; Respiratory muscle power; Hb level in police training

Introduction

Exercise is a stressful situation that produces marked changes in body functions including the respiratory system. The physical inactivity is directly related to morbidity and mortality from many diseases [1]. Therefore, physical training is one of the major bases for good health and wellbeing and currently globally recommended [2]. During exercise the body's demand for oxygen increases as the breathing must also rise. This requires numerous muscles surrounding the lungs to contract in a highly coordinated manner. As the intensity of exercise increases, the respiratory muscles contract more forcefully and quickly to keep pace with the increase in oxygen demand. Training of the respiratory muscles increases their strength and improves lung function and was found to reduce the severity of obstructive sleep apnea in cervical spinal cord injury and improves breathing pattern in patients with COPD [3,4].

Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) are useful indices for assessment of respiratory muscles performance in adults as well as in children [5]. Several cross-sectional and cohort studies have shown significant improvement of lung function as a result of exercise in both children and adolescents [6-9]. However, measurement of respiratory muscles strength has not been widely investigated in relation to physical training. In this context, the present study aimed at assessing pulmonary function as well as respiratory muscles strength among policewomen trainees compared to healthy untrained sedentary group of medical students.

The common physiological changes that alter the body during exercise are the cardiopulmonary changes; mainly they include increase in pulmonary ventilation (breathing) which directly proportionate to the intensity & metabolic needs of exercise. Breathing may increase from typical resting rate of 15 breaths per min up to 40-50 breath per minute. As the intensity of exercise continue to increase a person reaches a maximum point above which oxygen consumption will not increase any more. This point is known as VO2 MAX and can be improved by long term endurance by increasing aerobic enzyme activity & improving glycogen stores in muscle.

A previous study was done by Awad et al. [10] 2012 on the effect of police training on some cardiopulmonary & hematological parameters in Khartoum state, Sudan. The aim of their study was to investigate the effect of training of male police officers on the spirometeric lung function test parameters, respiratory muscle power, blood pressure, hemoglobin & white blood cells. A cross sectional study conducted during the period from October to December 2012, in which 59 policemen trainee were randomly selected with another 30 medical students as control. The maximum inspiratory and expiratory pressure (MIP&MEP) were found to be significantly higher in police trainee MIP 106.9+28.17 cmH2O (P=0.005) and MEP 137.51+ 31.68 cmH2O (P=0.000) compared to control MIP 88.13+30.96 cmH2o and MEP 103.57+ 29.9 cmH2O. There was significant increase in Hb value, the mean of Hb in policemen was 14.5g/dl compared to control group 13.7g/dl.

Another study done by Segizbaeva MO et al. [11] on the effect of inspiratory muscle training on resistance to fatigue of respiratory muscles during exhaustive exercise. Daily inspiratory muscle strength training was performed for 3 weeks in 10 male subjects .the study found that inspiratory muscle training results in a significant increase in MIP (+18%) [11]. A study done by Branch Rasht, Islamic Azad University 2011 on the effect of one period of training on hemoglobin, hematocrit and RBCs of athlete girls. In which13 athlete girls were selected none randomly for 8 weeks of training .They found that there was significant decrease in HB after the period of training (P=0.045) [12]. Some of the studies suggest that in endurance- trained athletes hematological parameters such as hematocrit, hemoglobin concentration, and red blood cell (RBC) count are reduced, mainly due to exercise-induced plasma volume expansion, which sets in within a few days of exercise training [13]. One of the studies suggests that the physical training itself has no significant effect on hematological variables in athletes compared with controls. The specific type of duration of training is of major importance in adaptation of the RBC system and the iron metabolism [14].

Some of the studies performed to assess the influence of duration of training on hematological parameters among runners and compared them with age- and sex-matched controls group. They found that there is an increase in the counts of RBC and hemoglobin concentration in the runners compared to controls group [15-18]. The aim of this study was to investigate the effects of police training during confinement period on respiratory muscle power, blood pressure, pulse and hemoglobin.

Methods

A cross sectional descriptive study was conducted during July to September 2017 in the faculty of police sciences and law, Soba, Khartoum state, Sudan. Study population included 81 newly recruited subjects. The subjects were healthy with no symptoms of present illness aged between 20_30 years. Any subject with a history of cardiorespiratory diseases & acute respiratory infection were excluded from the study. The students were informed by consent to get sociodemographic data. Their weight was recorded without shoes on a weighing scale. Pulse was counted & blood pressure measured in a sitting position with a sphygmomanometer. Respiratory muscle power was measured by respiratory pressure meter (RPM), in measuring the maximum expiratory pressure (MEP) the subject was asked to inhale to the total lung capacity (TLC) & then exhale with as much effort as possible through the controlled leak of the meter for at least 3 seconds. The reading displayed was the maximum average expiratory pressure over 1 second. While the maximum inspiratory effort (MIP) was conducted by having the subjects expire to a residual volume (RV) & then perform a maximum inspiratory maneuver. The reading displayed was the maximum average inspiratory pressure over one second. Blood sample was collected into a container tube containing K3_EDTA (anticoagulant), and HB was measured using sysmex KX-21 automated hematology.

Results

The average age of the studied subjects was 25.5. The mean weight of participants was 85+ 7 Kg before training and 75+7 Kg after confinement period. The mean length of the participant was 180 +9 cm before and after confinement period. Our study found that the respiratory muscle powers measured by MIP & MEP were significantly increased after the confinement period (Table 1 & Figure 1). There was significant change in mean blood hemoglobin level before & after confinement as the meanHB level was found to be 11.75 g/dl before confinement period compared to 11.88 g/dl after i. There was no change in pulse & blood pressure. After the end of confinement period (The systolic mean pressure =117.4 mmHg) (diastolic mean pressure = 80.74mmHg) (pulse mean=84.74 beat/min).

Discussion

This study showed that the mean value of respiratory muscle power (MIP & MEP) were significantly higher after the end of confinement period MIP (p=0.001) & MEP (P=0.02) these finding did not differ much from the previous studies. A study done by Kamal et al. [10] and Segizbaeva et al. [11]. Our study showed that there was increase in hemoglobin level after the end of confinement period could be due to good nutritional status, or exercise induced hemo concentration as a result of fluid transfer from the blood to interstitial space. This differ from a previous study done by Islamic Azad University 2011 [12] suggested aerobic training decrease HB, HTC and RBCs in athlete. In our study there was no change in systolic & diastolic blood pressure after the end of confinement period. This differed from a study done by Kamal et al. [10] they found significant decrease in systolic blood pressure (P=0.001) and diastolic blood pressure (P=0.007) in policemen.

Conclusion

Physical training and exercise during the confinement period improved the pulmonary function and respiratory muscle power in police trainees after 40 days of training.

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Design of A Roadmap for Implementing A Quality Approach At ONS-Algeria-Juniper Publishers

Biostatistics and Biometrics Open Access Journal

Abstract

The rapid changes in Algeria have had and continue to have a profound impact on infrastructure, economic agents and the population as a whole. These transformations have already turned the statistical landscape upside down and will continue to do so. In fact, the need for statistical data has changed and evolved in terms of the nature of the statistics, on one hand, and requirements regarding availability, quality and time, on the other hand. Starting from the context described above, the development of ONS-Algeria’s quality approach is essentially based on the capitalization of the work of cooperation with Eurostat on the principles of the European Quality Assurance Framework for Official Statistics (QAF), the option for a participatory and transparent process to enrich this approach and facilitate its appropriation and lastly, conducting the process in stages. In driving the process step by step, to optimize its management, our paper will address the issues related to the design of a roadmap for implementing the Code of Practice (CoP) for the ENP south countries.

Keywords: Code of practice; Implementation challenges; Quality management; ENP South countries
Abbrevations: QAF: Quality Assurance Framework for Official Statistics; Code of Practice; GSBPM: General Statistical Model of The Operational Process; METIS: Statistical Metadata; SAQ: Self-Assessment Questionnaire; CPI: Consumer Price Index

Introduction

The rapid changes in the country have had and continue to have a profound impact on infrastructure, economic agents and the population as a whole. These transformations have already turned the statistical landscape upside down and will continue to do so. In fact, the need for statistical data has changed and evolved in terms of the nature of the statistics, on one hand, and requirements regarding availability, quality and time, on the other hand [1-3]. Starting from the context described above, the development of our quality approach is essentially based on the following three principles:

a. The capitalization of cooperation initiatives with Eurostat on the principles of the European Quality Assurance Framework for Official Statistics (QAF);

b. The choice of a participatory and transparent process to enrich this approach and facilitate our making it our own;

c. And lastly, conducting the process step by step, in order to optimize its steering.

Approach

It should be noted that ONS takes into account quality guidelines in the performance of its processes according to international standards. Indeed, ONS participates in the work of the South Mediterranean Quality Working Group and contributed to the development of the Regional Code of Practice (CoP) (ENP-South) [4].

In tandem with the “classical” quality approach, which requires rapid and intense mobilization of resources, and referring to the QAF guidelines, the quality approach adopted by ONS, based on the CoP, is a step-by-step and progressive quality approach. It is organized around four levels of a step by step implementation:

I. Recurring surveys

II. Structural surveys

III. Major operations such as census

IV. The institution

As each survey phase is a potential source of errors, it is necessary to analyze the different processes within each phase, to determine the errors and to find the methods to eliminate them or to reduce them.

Even though ONS applies control actions in carrying out these surveys, a well-defined quality control system is needed and is part of the projects carried out by the quality unit. In fact, the control actions to be integrated into the production process to improve the quality of the data are:

a. Preventive control actions are put to practice to prevent errors from being verified: we act on the sources of errors.

b. Ongoing control actions are applied to monitor and correct errors while performing a survey. One can find tools and methods to identify errors when they are verified and to limit their effects on the survey results.

c. A posteriori evaluation actions are those operations that make it possible to measure errors directly or indirectly, and in particular control surveys carried out after data collection.

Therefore, all of these control actions represent the quality control system of a survey. For this reason, when designing and conducting a survey, part of the budget must be reserved for data quality control actions.

In addition, the use of the general statistical model of the operational process (GSBPM), developed by the UNECE/Eurostat/OECD working group on Statistical Metadata (METIS), to document our statistical operations. Indeed, the GSBPM has been developed to provide a standard framework for the operational processes required to produce official statistics. The GBSPM can also be used to integrate standards relating to data and metadata, as a model for process documentation for the harmonization of statistical IT infrastructure, and to provide a framework for assessing and improving the quality of data: it is a representation model of the statistical process. Quality being considered as an overarching process, this model highlights the principle that quality must be integrated at every stage, combined with the notion that quality is multidimensional. Hence, this model is defined by the aspects related, on the one hand, to the quality of the statistical data (relevance, accuracy, etc.) and, on the other hand, to the quality of the process (precision of needs, design, implementation, execution and evaluation) [5,6].

Implementation

In order to ensure that the implementation, of the quality approach at ONS, is rigorous; we base its framework on the following manuals:

i. Quality Assurance Framework (QAF): defining the principles of the quality system.

ii. Code of Practice (CoP): defining the indicators measuring the implementation of the quality system.

iii. The Self-Assessment Questionnaire (SAQ): measuring the implementation of the quality system at two levels:

• Institutional

• Process.

To achieve these objectives, the stages/actions of the gradual implementation of our quality approach could be broken down as follows (Table 1):

i. A clear display (website, notes to the technical and regional departments) of the Commitment on Quality by Top Management.

ii. The designation of the technical staff assigned to the unit in charge of quality support and communication with the technical departments.

iii. The presentation of quality tools and related documentation by the Quality Unit, under the control and with the support of Top Management, to the technical departments.

iv. The implementation of the GSBPM to document the collection processes for the Consumer Price Index (CPI) and the labor force surveys, and other surveys deemed appropriate by Top Management.

v. The implementation of the SAQ by the structures that applied the GSBPM.

vi. The implementation of the GSBPM and SAQ for the population census.

vii. A self-evaluation process through the implementation of the SAQ by the institution.

Conclusion

We should note that executives tend to have a relatively rosy view of how well-defined their culture is and how nicely it is performing. Those in quality management who are closer to where the rubber meets the road have a dimmer view. Without consensus on what’s broken and how bad it is, there will be disagreement on what to fix. Such discoveries shouldn’t be news to anyone who has lead or is aspiring to achieve a strong and sustainable culture of quality excellence.

Hence, at ONS we are aware that it would be especially helpful if suggestions were woven together to answer at least a few important questions and improve our approach:

a. Are there any details missing in the approach that must be understood for a successful culture of quality? b. Because understanding users is critical to guiding success, is there some intuitive framework or method accessible to management and quality practitioners alike?

c. Is there a quick, easy, and practical way to determine how well top management and the rest of the organization agrees on the cultural characteristics of excellence?

d. Would such a cultural assessment be enough to inspire consensus for action?

Furthermore, from the first stages of implementation, three guidelines that rise to the top and are strongly related to each other:

I. All employees must apply the key elements of any strategy for building a quality culture.

II. Closely understand user expectations so we can focus and give them what they want.

III. Develop a formal quality policy, common language, and leader behaviors as deployment mechanisms.

We do understand that changing our culture to integrate quality excellence is not an easy process. We’ll have good days and bad days, progress and setbacks. We have to keep going when change is hard as we are inspired by this Henry Ford’s quote: “One of the greatest discoveries a man makes, one of his great surprises, is to find he can do what he was afraid he couldn’t do.” 

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