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An investigation on the machinability of glass-fibre reinforced plastic (GFRP) fabricated using hand moulding was conducted on a vertical-milling centre (VMC) with solid K10 carbide and carbide-tipped K10 end mills having four flutes. This revealed that the machinability of GFRP depends on tool wear and delamination. Sensor-fusion techniques were used to measure tool wear and delamination and the tests were conducted utilising a Taguchi L8 orthogonal array that included the data from the sensors' output. These tests illustrated the suitability of the sensor technique for online monitoring of delamination and tool wear and for improving the machinability of composites for a wide variety of applications. The results showed that using solid carbide end mills leads to less delamination of materials during milling of GFRP and carbide-tipped end mills resulted in little tool wear or change in the depth of cut when used at high speeds along with an appropriate feed rate.

Purpose Correlation of body mass index (BMI) with clinical outcome in patients with glioblastoma is not well documented. Hence, we studied the association between survival and pretreatment BMI in glioblastoma patients. Methods and Materials In this retrospective study, only patients with histopathology-confirmed glioblastoma were included. Their BMIs were calculated from height and weight measurements and recorded in medical records at their first examination. Treatment plans for all patients consisted of concurrent radiation therapy and temozolomide, followed by maintenance therapy with temozolomide. The primary endpoint was overall survival (OS). Univariate and multivariate Cox proportional hazards models were used to estimate the mortality risk associated with BMI as a continuous and categorical variable. A BMI of 18.5 to 24.9 kg/m2 was classified as normal, 25.0 to 29.9 kg/m2 as overweight, and ≥30.0 kg/m2 as obese. Results Data from 392 patients treated from January 2008 through June 2016 were analyzed. At a median follow-up of 48.6 months, the median OS was 13.5 months in normal subjects, 15.4 months in overweight subjects, and 15.1 months in obese subjects. A total of 81% of the patients died. The hazard ratios for overweight and obese patients were 0.70 (95% confidence interval, 0.54-0.92; P = .009) and 0.66 (95% confidence interval, 0.45-0.98; P = .04), respectively, when adjusted for age, Karnofsky performance score, and extent of resection. Sex, diabetes, and hypertension had no significant interactions. Conclusions Patients with elevated BMIs had significantly better OS in our series of patients. The mechanism of this interaction needs to be explored further to understand this association.

In this paper, kinematics and dynamics modeling of a typical 3-Degree of freedom (DOF) translational Parallel kinematic machine (PKM) is carried out. The kinematic structure of PKM consists of three limbs, connecting the base and the tool platform. Each limb consists of an arm and a forearm with joints Prismatic-revolute-revolute-revolute (PRRR). The arrangement of joints are in such a way that the tool platform will have pure translational motion along the Cartesian axes. Inverse kinematic relations that are necessary to find the slider positions and joint angles for a given position of tool platform are derived. The dynamics model is then derived based on Natural orhogonal complement (NOC). The inverse dynamics equations presented are used to compute actuator forces. The actuator forces using NOC are validated with those obtained based on Lagrangian method. The effect of slider, arm, and forearm inertia on the actuator forces is studied to know whether to neglect the arm and forearm inertias while computing the actuator forces for PKM. Finally, an attempt is made to find the optimal location of a circular trajectory using Genetic algorithms (GA) with minimization of Grand total actuator force (GTAF) as objective function.

Background and Purpose Spasticity is a major disabling symptom in patients post stroke. Although studies have demonstrated that transcutaneous electrical nerve stimulation (TENS) can reduce spasticity, the duration of single session TENS is a subject of debate. The purpose of this study was to determine the sustainability of the effects of TENS applied over common peroneal nerve in the reduction of ankle plantar-flexor spasticity and improving gait speed in patients post stroke. Methods Thirty patients (11 women and 19 men) (mean age of 46.46 years) were randomly assigned to group 1 (task oriented exercises), group 2 (TENS for 30 min and task oriented exercises) and group 3 (TENS for 60 min and task oriented exercises) for a period of five sessions per week for 6 weeks. All patients were assessed for ankle plantar-flexor spasticity, passive ankle dorsi-flexion range of motion, clonus and timed up and go test at the time of recruitment to study, at 3 and 6 weeks of therapeutic intervention. Results The overall results of the study suggest that there was a decrease in ankle plantar flexor spasticity, ankle clonus and timed up and go score in all the groups. A greater reduction of spasticity was seen in TENS groups (groups 2 and 3) when compared to control. No significant improvement was found in timed up and go test (TUG) scores between groups. Conclusion Both 30 min and 60 min of application of TENS are effective in reducing spasticity of ankle plantar flexors, improving walking ability and increase the effectiveness of task related training. Based on the effect size, we would recommend a longer duration application for the reduction of spasticity. Copyright © 2015 John Wiley & Sons, Ltd.

Graphical abstractDisplay Omitted HighlightsGenerating circuits for accelerated life testing of field programmable gate arrays.The problem involves multi-variable optimization.Proposed a genetic algorithm for the purpose mentioned above.Proved empirically that particle swarm optimization can be used to enhance the quality of results yielded by a GA.Showed that GA aided by PSO not only reduces time (from months to hours) but can also yield better results than the hand-crafted SBC. Accelerated life testing (ALT) of a field programmable gate array (FPGA) requires it to be configured with a circuit that satisfies multiple criteria. Hand-crafting such a circuit is a herculean task as many components of the criteria are orthogonal to each other demanding a complex multivariate optimization. This paper presents an evolutionary algorithm aided by particle swarm optimization methodology to generate synthetic benchmark circuits (SBC) that can be used for ALT of FPGAs. The proposed algorithm was used to generate a SBC for ALT of a commercial FPGA. The generated SBC when compared with a hand-crafted one, demonstrated to be more suitable for ALT, measured in terms of meeting the multiple criteria. The SBC generated by the proposed technique utilizes 8.37% more resources; operates at a maximum frequency which is 40% higher; and has 7.75% higher switching activity than the hand-crafted one reported in the literature. The hand-crafted circuit is very specific to the particular device of that family of FPGAs, whereas the proposed algorithm is device-independent. In addition, it took several man months to hand-craft the SBC, whereas the proposed algorithm took less than half-a-day.

Polypill is a fixed-dose combination that contains three or more active ingredients used as a single daily pill to achieve a large effect in preventing cardiovascular disease with minimal adverse effects. A novel and accurate liquid chromatography tandem mass spectrometry method using electrospray ionization mode has been developed and validated for the simultaneous determination of amlodipine (AMD), valsartan (VAL) using losartan (LOS) as an internal standard (IS), and hydrochlorothiazide (HCT) using furosemide (FSD) as an IS. The separation was carried on Aquasil C18 (50 mmÃ2.1 mm, 5 µm) reversed phase column using acetonitrile and water containing 0.1% formic acid (50:50, v/v) as the mobile phase. The method was validated in terms of linearity, accuracy and precision over the concentration range of 1â1000 ng/mL. The intra and inter-day precision and accuracy, stability and extraction recoveries of all the analytes were in the acceptable range. This method can be successfully applied to the pharmacokinetic study of AMD, VAL and HCT when given as a polypill. Keywords: Amlodipine, Valsartan, Hydrochlorothiazide, Exforge HCT, Polypill

Background: Isocitrate dehydrogenase 1 (IDH1) mutant tumors represent a distinct subtype among diffuse gliomas, with improved prognosis compared to histological grade-matched IDH1 wild-type tumors. Here, we sought to identify factors associated with outcome exclusively within the glioma subgroup defined[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Rehabilitation interventions are expected to ensure best possible recovery and minimize functional disability in stroke survivors. However, not many studies have investigated patterns of recovery and outcomes after stroke in low-income countries. The objective of this study is to identify the biological, psychological, and social components associated with functioning over time in Indian stroke patients using the International Classification of Functioning, Disability and Health (ICF)-based tools and the Functional Independence Measure (FIM).The functioning profile of stroke survivors who received a standard multi-disciplinary rehabilitation was prospectively assessed using the ICF and the FIM at admission (baseline), at 1224 weeks. Descriptive analyses were performed to identify changes in the frequencies of ICF categories and qualifiers from admission to follow-up.One hundred and twenty-seven participants (mean age of 56 years) with mean FIM score 68 at baseline participated and completed the study. The mean FIM score at follow-up was 108. The numbers and frequency of ICF categories for activities and participation reduced after rehabilitation. More numbers of environmental factors were identified as barriers at follow-up (15 out of 33) compared to baseline. Within the components of Activities and Participation, significant improvement in functioning was found in 43 out of 51 categories.The results show a reduction in frequencies in ICF activities and participation categories corresponding to basic activities of daily living. Categories corresponding to employment and social integration showed little or no improvement.

While studies have looked into the effects of Maitland mobilization on symptom relief, to date, no work has specifically looked at the effects of Mulligan mobilization. The objective of this work was to compare the effectiveness of Maitland and Mulligan's mobilization and exercises on pain response, range of motion (ROM) and functional ability in patients with mechanical neck pain.A total sample of 60 subjects (21-45 years of age) with complaints of insidious onset of mechanical pain that has lasted for less than 12 weeks and reduced ROM were randomly assigned to: group I - Maitland mobilization and exercises; group - II Mulligan mobilization and exercises; and group-III exercises only, and assessed for dependent variables by a blinded examiner.Post measurement readings revealed statistical significance with time (p 0.00) and no significance between groups (p 0.05) indicating no group is superior to another after treatment and at follow-up. The effect sizes between the treatment groups were small.Our results showed that manual therapy interventions were no better than supervised exercises in reducing pain, improving ROM and neck disability.

In this paper, a typical 3-degree of freedom (3-DOF) translational parallel kinematic machine (PKM) is studied and analyzed whose tool platform has only translations along X-, Y- and Z-axes. It consists of three limbs, each of which have arm and forearm with prismatic-revolute-revolute-revolute (PRRR) joints. Inverse kinematics analysis is carried out to find the slider coordinates and joint angles for a given position of tool platform. Stiffness modeling is done based on the compliance matrices of arm and forearm of each limb. Using the stiffness modeling the variations of minimum and maximum translational stiffness in the workspace are analyzed. For various architectural parameters of the 3-DOF PKM the tendency of variations on the minimum and maximum stiffness over the entire workspace is studied; and also the deflections of the tool platform along X, Y, and Z directions with respect to various forces are presented.

General-purpose Graphics Processing Units (GPGPUs) are widely used for executing massively parallel workloads from various application domains. Feeding data to the hundreds to thousands of cores that current GPGPUs integrate places great demands on the memory hierarchy, fueling an ever-increasing demand for on-chip memory. In this work, we propose STAG, a high density, energy-efficient GPGPU cache hierarchy design using a new spintronic memory technology called Domain Wall Memory (DWM). DWMs inherently offer unprecedented benefits in density by storing multiple bits in the domains of a ferromagnetic nanowire, which logically resembles a bit-serial tape. However, this structure also leads to a unique challenge that the bits must be sequentially accessed by performing "shift" operations, resulting in variable and potentially higher access latencies. To address this challenge, STAG utilizes a number of architectural techniques : (i) a hybrid cache organization that employs different DWM bit-cells to realize the different memory arrays within the GPGPU cache hierarchy, (ii) a clustered, bit-interleaved organization, in which the bits in a cache block are spread across a cluster of DWM tapes, allowing parallel access, (iii) tape head management policies that predictively configure DWM arrays to reduce the expected number of shift operations for subsequent accesses, and (iv) a shift aware pro- motion buffer (SaPB), in which accesses to the DWM cache are predicted based on intra-warp locality, and locations that would incur a large shift penalty are promoted to a smaller buffer. Over a wide range of benchmarks from the Rodinia, IS- PASS and Parboil suites, STAG achieves significant benefits in performance (12.1% over SRAM and 5.8% over STT-MRAM) and energy (3.3X over SRAM and 2.6X over STT-MRAM)

In this paper, error modeling and analysis of a typical 3-degree of freedom translational Parallel Kinematic Machine is presented. This mechanism provides translational motion along the Cartesian X-, Y- and Z-axes. It consists of three limbs each having an arm and forearm with prismatic-revolute-revolute-revolute joints. The moving or tool platform maintains same orientation in the entire workspace due to its joint arrangement. From inverse kinematics, the joint angles for a given position of tool platform necessary for the error modeling and analysis are obtained. Error modeling is done based on the differentiation of the inverse kinematic equations. Variation of pose errors along X, Y and Z directions for a set of dimensions of the parallel kinematic machine is presented. A non-dimensional performance index, namely, global error transformation index is used to study the influence of dimensions and its corresponding global maximum pose error is reported. An attempt is made to find the optimal dimensions of the Parallel Kinematic Machine using Genetic Algorithms in MATLAB. The methodology presented and the results obtained are useful for predicting the performance capability of the Parallel Kinematic Machine under study.

Despite the popularity and an increased use of bone morphogenetic protein to improve bone healing in patients with congenital pseudoarthrosis of the tibia (CPT), no previous study has compared its efficacy against any other procedure. We randomised 20 consecutive patients (mean age 4.1 years) with CPT (Crawford type IV) associated with neurofibromatosis type 1(NF1) and no previous history of surgery into two groups. Group 1 received recombinant human bone morphogenetic protein-7 (rhBMP-7) along with intramedullary Kirschner (K)-wire fixation and autologous bone grafting; group 2 received only K wire and grafting. Outcome measures were time to achieve union, Johnston grade, tibial length and the American Orthopaedic Foot and Ankle Society (AOFAS) score, which were evaluated preoperatively and at five year follow-up. Study results showed that patients in group 1 achieved primary bone union at a mean of 14.5 months [standard error (SE) 5.2], whereas group 2 took a mean of 17.11 months (SE 5.0). However, the log-rank test showed no difference in healing times between groups at all time points (P = 0.636). There was a statistically significant pre- to post operative improvement (P

Introduction Spasticity occurs in disorders of the central nervous system such as stroke, spinal cord injury (SCI), multiple sclerosis and traumatic brain injury. The recently developed clinical measurement for the measurement of spasticity is the Modified Modified Ashworth Scale (MMAS) Purpose of study The purpose of this study is to determine the inter-rater reliability of the MMAS in the assessment of plantar flexor spasticity in patients with SCI. Methodology Thirty-eight subjects (32 males and six females, mean age 31.9 + 12.6 years) were recruited for the study. Excluded from the study were patients with contracture in the lower limb and where passive movements were contraindicated. Procedure Each patient was assessed by two raters in a single session. After the performance of the procedure by the first assessor and rating of the patient's muscle tone with the MMAS, the same procedure was repeated by the second assessor after 1 hour. The evaluation was carried out in side-lying position. The extent of agreement was analysed by non-weighted Cohen kappa. Results The agreement between the raters was good (soleus – ĸ: 0.75, SE = 0 .084, p

Fibular hemimelia is the most common lower extremity congenital longitudinal deficiency leading to cosmetic deformity, pain, and gait disturbance. Eight-plate hemiepiphysiodesis has proven to be successful in correcting angular deformity of the knee; it is an easy surgical technique and yields a more rapid rate of correction. The aim of this study was to determine the effectiveness of eight-plate hemiepiphysiodesis in bilateral genu valgum resulting from fibular hemimelia and overall height improvement in two girls and four boys with a mean age of 22 months who were followed up for a period of 18 months. The variables studied were arm span, the total height ratio, intermalleolar distance, tibiofemoral angle, and activity. All the parameters improved significantly. The mean improvement in the valgus was 7.41°. The mean intermalleolar distance reduced by 19.5 cm, and all patients achieved a significant improvement in lower limb function. Although there was significant improvement in total height, it still lagged behind arm span at the time of final follow-up. The results of eight-plate hemiepiphysiodesis were found to be satisfactory. We conclude that it is a reasonable treatment option for young patients with an adequate growth potential.

Kalina cycle system (KCS) operates at a heat source temperature up to 600?C with an improved heat recovery. The current work focuses on thermodynamic processes development and assessment of a KCS configuration to augment the power from a heat recovery of solar thermal collectors operating from 250?C to 600?C. There are three pressure levels in current cycle i.e. high pressure (HP), intermediate pressure (IP) and low pressure (LP). The superheated vapor expands from HP to LP and the separator is located at IP. The current work develops a new methodology for thermodynamic evaluation with more flexibility compared to the reported method in literature. Separator inlet condition (temperature and concentration), turbine inlet condition (pressure, temperature and concentration) and solar radiation have been identified as key parameters for the plant evaluation. The performance is improving with an increase in separator temperature, turbine inlet pressure, source temperature and solar radiation. But it is decreasing with an increase in separator and turbine inlet concentrations. The cycle efficiency, plant efficiency and specific power have been found as 23.5%, 7.5% and 675 kW at 0.3 separator concentration and 0.5 turbine concentration.

In this paper, stiffness modelling and analysis of a typical 3-DOF parallel kinematic machine (PKM) that provides translational motion along X, Y and Z axes is presented. The mechanism consists of three limbs each having an arm and a forearm with prismatic-revoluterevolute-revolute joints (PRRR). The joint arrangement is in such a way that the moving or tool platform maintains same orientation in the entire workspace. Through inverse kinematics, the joint angles for a given position of tool platform necessary for the stiffness modelling and analysis are obtained. The stiffness modelling is based on the compliance matrices of arm and forearm of each limb. Typical non-dimensional performance indices, namely, workspace volume index (WVI), global translational stiffness index (GTSI), and global rotational stiffness index (GRSI), are introduced and used to study the influence of dimensions. Attempts are also made to find the optimal dimensions of the translational PKM using multi-objective optimization based on the genetic algorithms (MOGA) in MATLAB. The methodology presented and the results obtained are useful for predicting the performance capability of the PKM under study.

Objectives The present study was aimed at investigating the effect of curcumin in combination with prednisolone for the effective treatment of arthritis with reduced side effects when glucocorticoids therapy is indicated. Methods Arthritis was induced in wistar rats by subplantar injection of Freund's complete adjuvant, and animals were observed for the symptoms of arthritis during the period of 21 days. Combined treatment of curcumin with various doses of prednisolone (1.25, 2.5 and 5 mg/kg) was evaluated in order to ascertain the efficacy and toxicity induced by steroid. Key findings Arthritic animals showed significant increase in tumour necrosis factor-α and IL-1β levels in paw tissue and IL-1β in serum. Combined therapy of curcumin with low doses of prednisolone showed pronounced beneficial effect on joint swelling, leucocyte count and biochemical parameters compared with prednisolone groups. Among the different doses used in the study, prednisolone at 1.25 mg/kg in combination with curcumin showed beneficial anti-arthritic activity and also reduced the steroid toxicity. This is evidenced by increase in body weight, low toxicity to immune organs, reduction in leucocyte count, increase in spleen anti-oxidant enzymes and potent inhibition of cytokines in combination group. Conclusion Therefore, combined treatment of curcumin with low doses of prednisolone may find therapeutic use in arthritis.

Presence of single umbilical persistent vitelline artery distinguishes sirenomelia from caudal regression syndrome. We report a case of a12-year-old boy who had bilateral umbilical arteries presented with fusion of both legs in the lower one third of leg. Both feet were rudimentary. The right foot had a valgus rocker-bottom deformity. All toes were present but rudimentary. The left foot showed absence of all toes. Physical examination showed left tibia vara. The chest evaluation in sitting revealed pigeon chest and elevated right shoulder. Posterior examination of the trunk showed thoracic scoliosis with convexity to right. The patient was operated and at 1 year followup the boy had two separate legs with a good aesthetic and functional results.

Kalina power plants have an efficient system of heat recovery compared with a single-fluid system because of a better temperature match between hot and cold fluids. The high-temperature reg...

BACKGROUND Studies have shown that farming is associated with many agricultural workers experiencing low back pain (LBP). The rehabilitation of these workers should facilitate their functioning, activities and level of participation in an adequate way. OBJECTIVE The objectives of this study were to identify the health components associated with LBP and to evaluate the effectiveness of the interventions in returning agricultural workers with LBP to their vocation using the International Classification of Function (ICF) -based tools. METHODS Thirty-one full time agricultural workers from 3 different Indian states were prospectively assessed using the ICF core set for LBP. ICF core sets permitted analysis of limitations of function from both the participant and rehabilitation team's perspectives. Each ICF category was rated using an ICF qualifier. The components identified were linked to the ICF categorical profile and assessment sheet. The clinicians identified the global, service program and cycle goals based on ICF. The participants' functioning was followed over a 4-month period. RESULTS After intervention, the participants were able to undergo their routine activities without increases in pain. However, on returning to active farming, participants noted few improvements in the components d410 (changing basic body position), d415 (maintaining body position), d430 (lifting and carrying objects), d465 (moving around using equipment), d850 (remunerative employment) and d859 (work and employment, other specified and unspecified). CONCLUSION The results of the study conclude that the current interventions for LBP are not effective in returning agriculture workers with LBP in India to pain-free farming. There is an urgent need to individualize the health needs of agriculture workers.

The incidence of flatfoot is approximately 5% in children and adults. The symptomatic form of a flexible flatfoot produces subjective and objective complaints, including gait disturbances. Surgical intervention is considered when conservative management fails. The arthroereisis procedure provides a stable foot and durable correction. However, to the best of our knowledge, no study has evaluated the effectiveness of this procedure on gait parameters.Fifteen children with painful flatfeet (10 males; 5 females) with a mean age of 12 years and 6 months underwent the calcaneo stop procedure. Radiographic, gait analysis and functional measures were evaluated to assess the changes pre- and post-operatively.All children were followed up for a mean period of 4 years and 6 months. The overall results of the study exhibited statistically significant improvement for all radiographic variables, functional measures and range of motion investigated in the study (Although there was no significant improvement in the kinematic and kinetic variables investigated, this study supports the calcaneo-stop procedure as a reliable and effective procedure for treating paediatric flexible flatfoot.إن نسبة الأقدام المسطحة في الأطفال والبالغين هي حوالي ٥٪. ويُنتج النوع المصحوب بالأعراض من الأقدام المسطحة المرنة شكاوى ذاتية وموضوعية مثل اضطرابات المشية. ويُلجأ إلى التدخل الجراحي عند فشل العلاج التحفظي. وقد بينت الأبحاث أن إجراءات التقييد المفصلي توفر قدما مستقرة وتصحيحا متينا٬ إلا أنه لم تقم أي من الدراسات بتقييم فاعلية هذا الإجراء على معالم المشية.أُجريت عملية “إيقاف عظمة العقب” على ١٥ طفلا لديهم أقداما مسطحة مؤلمة (١٠ أولاد و٥ بنات) بمتوسط عمر ١٢ سنة و٦ أشهر. وتم تقييم الأشعة وتحليل المشية والقياسات الوظيفية لمعرفة التغيرات قبل وبعد العملية.تمت متابعة جميع الأطفال لمدة متوسطها ٤ سنوات و٦ أشهر. وأظهرت النتائج العامة للدراسة تحسنا ذا قيمة إحصائية لجميع المتغيرات الإشعاعية والقياسات الوظيفية ومدى الحركة التي تم التحقق منها في الدراسة. على الرغم من أن الدراسة أظهرت تحسنا في جميع المعالم الزمنية التي تم قياسها عند تحليل المشية٬ إلا أن النتائج لم تُظهر أي اختلافات ذات قيمة إحصائية في المتغيرات الحركية القياسية والحركية قبل وبعد الجراحة.على الرغم من عدم وجود تحسن ذي قيمة في المتغيرات الحركية القياسية والحركية التي تم التحقيق فيها٬ نستنتج بأن عملية “إيقاف عظمة العقب” هي عملية فعالة ويمكن الاعتماد عليها في علاج القدم المسطحة المرنة لدى الأطفال.