Thyroid hormone profile in a population of Nigerian patients with traumatic brain injury

Summary: Traumatic brain injury (T.B.I.) has an annual incidence of 200/100000. There is little or no information on neuroendocrine sequelae following T.B.I. in the Nigerian population. The purpose of the study is to evaluate the effect of T.B.I on the thyroid axis and relate it to outcome by outlining the change in thyroid axis of head injured patients. One hundred and fifteen patients were recruited with 85% male and 15% female. Of these patients, 71.7% presented within 24 hours of injury. The head injury was mild in 53%, moderate in 16% and severe in 31% of the patients. Serum T3 was high in 52.2%, low in 7.8% and normal in 40%. Serum T4 was high in 4.3%, low in 68.7%, and normal in 27%. Serum TSH was high in 16.5% TSH levels, low in 6.1% and normal in 77.4%. There was no correlation between the severity of head injury measured by the Glasgow coma score and patterns observed in the thyroid function test. With respect to outcome of head injury, serum T4 was low in patients who died or had persistent vegetative state (p=0.012). Traumatic brain injury in Nigerian patients is associated with an elevation of T3, low levels of T4 and normal TSH values. Death and persistent vegetative state were associated with low T4.Keywords: Caffeine, ischaemia-reperfusion injury, cerebral ischaemia, neuro-inflammation, strokeNiger. J. Physiol. Sci. 33(December 2018) 159-16

Volume-aware design of composite molds

© 2019 Association for Computing Machinery. We propose a novel technique for the automatic design of molds to cast highly complex shapes. The technique generates composite, two-piece molds. Each mold piece is made up of a hard plastic shell and a flexible silicone part. Thanks to the thin, soft, and smartly shaped silicone part, which is kept in place by a hard plastic shell, we can cast objects of unprecedented complexity. An innovative algorithm based on a volumetric analysis defines the layout of the internal cuts in the silicone mold part. Our approach can robustly handle thin protruding features and intertwined topologies that have caused previous methods to fail. We compare our results with state of the art techniques, and we demonstrate the casting of shapes with extremely complex geometry

Influence of Various Light Timber Retrofit Layouts on the Dynamic Response of Typical Duch Masonry Terraced Houses

A majority of the residential building stock in Groningen (The Netherlands), which has been lately exposed to low intensity ground motions due to gas extraction, consists of unreinforced masonry (URM) structures not originally designed to withstand earthquakes. Amongst them, the terraced house building typology proved to be particularly vulnerable towards horizontal actions. Experimental results from a recently performed shake-table test on a full-scale terraced house prototype, characterised by the presence of a timber retrofitting system, seem to indicate that the dynamic response of these structures might be consistently improved through the employment of such a cost-effective light retrofitting solution. In this work, an advanced discontinuum-based model, implemented in the framework of the Applied Element Method (AEM), is developed to extend experimental results and to numerically investigate the influence of a number of additional timber retrofit layouts, characterised by different geometrical configurations, on the building behaviour. Each timber component was explicitly represented in the AEM models to represent the possible interaction among URM walls and the retrofitting system. First, the proposed modelling strategy is validated against experimental tests on both non-retrofitted and retrofitted URM panels subjected to cyclic shear compression loading. Then, calibrated mechanical parameters were directly implemented in the full-scale building model. Given the good agreement between numerical and experimental outcomes in terms of both damage evolution and hysteretic response, a comprehensive parametric study was undertaken. Numerical evidence seems to suggest that the employment of different retrofit layouts may have a significant influence on the dynamic behaviour of the selected building typology

Studies on the Physicochemical and Physico-Mechanical Properties of Activated Palm Kernel Shell blended with Carbon Black filled NR Vulcanizates

Palm kernel shell was activated using chemical activation of H3PO4 and KOH. Various amounts of activated palm kernel shell (APKS) couple with carbon black (CB) and other conventional ingredients were used to produce natural rubber vulcanizates (NR vulcanizates). The NR vulcanizates were compounded on a two-row mill and tested for its physico-mechanical properties. The results for characterization of physicochemical properties carried out on APKS  were ash content (2.06%), moisture content (8.06%), %carbon (54.41%), particle size (4.00, 3.35, 2.00, 1.18mm), bulk density (0.62g/ml) and pH (5.3).The results show significant values for all, the moisture and ash content were within the recommended standard of ASTM (3-10max) and (< or =8) respectively. The filler loading concentrations CB/APKS were labeled as mixes 1 to 7. The composition of CB/APKS filler loading ratios were 30:0, 25:5, 20:10, 15:15, 10:20, 5:25, and 0:30 samples 1,2,3,4,5,6 and 7 respectively. Results obtained showed that CB/APKS filled vulcanizates exhibited improvement in the physico-mechanical properties investigated. The results obtained for CB/APKS across the samples filler loading shows that CB composition possess higher UTS, EB and rubber fatigue test while APKS filler loading composition exhibited higher hardness and young modulus. Abrasion resistance was excellent for both CB and APKS filler loading composition.Keywords: Activated Palm Kernel Shell, filler, carbon black, Chemical Activation, Natural Rubber

Seismic Testing of Adjacent Interacting Masonry Structures

In many historical centres in Europe, stone masonry buildings are part of building aggregates, which developed when the layout of the city or village was densified. In these aggregates, adjacent buildings share structural walls to support floors and roofs. Meanwhile, the masonry walls of the façades of adjacent buildings are often connected by dry joints since adjacent buildings were constructed at different times. Observations after for example the recent Central Italy earthquakes showed that the dry joints between the building units were often the first elements to be damaged. As a result, the joints opened up leading to pounding between the building units and a complicated interaction at floor and roof beam supports. The analysis of such building aggregates is very challenging and modelling guidelines do not exist. Advances in the development of analysis methods have been impeded by the lack of experimental data on the seismic response of such aggregates. The objective of the project AIMS (Seismic Testing of Adjacent Interacting Masonry Structures), included in the H2020 project SERA, is to provide such experimental data by testing an aggregate of two buildings under two horizontal components of dynamic excitation. The test unit is built at half-scale, with a two-storey building and a one-storey building. The buildings share one common wall while the façade walls are connected by dry joints. The floors are at different heights leading to a complex dynamic response of this smallest possible building aggregate. The shake table test is conducted at the LNEC seismic testing facility. The testing sequence comprises four levels of shaking: 25%, 50%, 75% and 100% of nominal shaking table capacity. Extensive instrumentation, including accelerometers, displacement transducers and optical measurement systems, provides detailed information on the building aggregate response. Special attention is paid to the interface opening, the global behaviour in relation to the interface separation, interstorey drifts and out-of-plane displacements

A framework for intelligent policy decision making based on a government data hub

Author ProofThe e-Oman Integration Platform is a data hub that enables data exchanges across government in response to transactions. With millions of transactions weekly, and thereby data exchanges, we propose to investigate the potential of gathering intelligence from these linked sources to help government officials make more informed decisions. A key feature of this data is the richness and accuracy, which increases the value of the learning outcome when augmented by other big and open data sources. We consider a high-level framework within a government context, taking into account issues related to the definition of public policies, data privacy, and the potential benefits to society. A preliminary, qualitative validation of the framework in the context of e-Oman is presented. This paper lays out foundational work into an ongoing research to implement government decision-making based on big data.“SmartEGOV: Harnessing EGOV for Smart Governance (Foundations, Methods, Tools)/NORTE-01-0145-FEDER-000037”, supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (EFDR

Shake-table testing of a stone masonry building aggregate: overview of blind prediction study

City centres of Europe are often composed of unreinforced masonry structural aggregates, whose seismic response is challenging to predict. To advance the state of the art on the seismic response of these aggregates, the Adjacent Interacting Masonry Structures (AIMS) subproject from Horizon 2020 project Seismology and Earthquake Engineering Research Infrastructure Alliance for Europe (SERA) provides shake-table test data of a two-unit, double-leaf stone masonry aggregate subjected to two horizontal components of dynamic excitation. A blind prediction was organized with participants from academia and industry to test modelling approaches and assumptions and to learn about the extent of uncertainty in modelling for such masonry aggregates. The participants were provided with the full set of material and geometrical data, construction details and original seismic input and asked to predict prior to the test the expected seismic response in terms of damage mechanisms, base-shear forces, and roof displacements. The modelling approaches used differ significantly in the level of detail and the modelling assumptions. This paper provides an overview of the adopted modelling approaches and their subsequent predictions. It further discusses the range of assumptions made when modelling masonry walls, floors and connections, and aims at discovering how the common solutions regarding modelling masonry in general, and masonry aggregates in particular, affect the results. The results are evaluated both in terms of damage mechanisms, base shear forces, displacements and interface openings in both directions, and then compared with the experimental results. The modelling approaches featuring Discrete Element Method (DEM) led to the best predictions in terms of displacements, while a submission using rigid block limit analysis led to the best prediction in terms of damage mechanisms. Large coefficients of variation of predicted displacements and general underestimation of displacements in comparison with experimental results, except for DEM models, highlight the need for further consensus building on suitable modelling assumptions for such masonry aggregates

Evaluation of the safety of C-spine clearance by paramedics: design and methodology

<p>Abstract</p> <p>Background</p> <p>Canadian Emergency Medical Services annually transport 1.3 million patients with potential neck injuries to local emergency departments. Less than 1% of those patients have a c-spine fracture and even less (0.5%) have a spinal cord injury. Most injuries occur before the arrival of paramedics, not during transport to the hospital, yet most patients are transported in ambulances immobilized. They stay fully immobilized until a bed is available, or until physician assessment and/or X-rays are complete. The prolonged immobilization is often unnecessary and adds to the burden of already overtaxed emergency medical services systems and crowded emergency departments.</p> <p>Methods/Design</p> <p>The goal of this study is to evaluate the safety and potential impact of an active strategy that allows paramedics to assess very low-risk trauma patients using a validated clinical decision rule, the Canadian C-Spine Rule, in order to determine the need for immobilization during transport to the emergency department.</p> <p>This cohort study will be conducted in Ottawa, Canada with one emergency medical service. Paramedics with this service participated in an earlier validation study of the Canadian C-Spine Rule. Three thousand consecutive, alert, stable adult trauma patients with a potential c-spine injury will be enrolled in the study and evaluated using the Canadian C-Spine Rule to determine the need for immobilization. The outcomes that will be assessed include measures of safety (numbers of missed fractures and serious adverse outcomes), measures of clinical impact (proportion of patients transported without immobilization, key time intervals) and performance of the Rule.</p> <p>Discussion</p> <p>Approximately 40% of all very low-risk trauma patients could be transported safely, without c-spine immobilization, if paramedics were empowered to make clinical decisions using the Canadian C-Spine Rule. This safety study is an essential step before allowing all paramedics across Canada to selectively immobilize trauma victims before transport. Once safety and potential impact are established, we intend to implement a multi-centre study to study actual impact.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01188447">NCT01188447</a></p

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

Background Tranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI. Methods This randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding were eligible. The time window for eligibility was originally 8 h but in 2016 the protocol was changed to limit recruitment to patients within 3 h of injury. This change was made blind to the trial data, in response to external evidence suggesting that delayed treatment is unlikely to be effective. We randomly assigned (1:1) patients to receive tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was head injury-related death in hospital within 28 days of injury in patients treated within 3 h of injury. We prespecified a sensitivity analysis that excluded patients with a GCS score of 3 and those with bilateral unreactive pupils at baseline. All analyses were done by intention to treat. This trial was registered with ISRCTN (ISRCTN15088122), ClinicalTrials.gov (NCT01402882), EudraCT (2011-003669-14), and the Pan African Clinical Trial Registry (PACTR20121000441277). Results Between July 20, 2012, and Jan 31, 2019, we randomly allocated 12 737 patients with TBI to receive tranexamic acid (6406 [50·3%] or placebo [6331 [49·7%], of whom 9202 (72·2%) patients were treated within 3 h of injury. Among patients treated within 3 h of injury, the risk of head injury-related death was 18·5% in the tranexamic acid group versus 19·8% in the placebo group (855 vs 892 events; risk ratio [RR] 0·94 [95% CI 0·86-1·02]). In the prespecified sensitivity analysis that excluded patients with a GCS score of 3 or bilateral unreactive pupils at baseline, the risk of head injury-related death was 12·5% in the tranexamic acid group versus 14·0% in the placebo group (485 vs 525 events; RR 0·89 [95% CI 0·80-1·00]). The risk of head injury-related death reduced with tranexamic acid in patients with mild-to-moderate head injury (RR 0·78 [95% CI 0·64-0·95]) but not in patients with severe head injury (0·99 [95% CI 0·91-1·07]; p value for heterogeneity 0·030). Early treatment was more effective than was later treatment in patients with mild and moderate head injury (p=0·005) but time to treatment had no obvious effect in patients with severe head injury (p=0·73). The risk of vascular occlusive events was similar in the tranexamic acid and placebo groups (RR 0·98 (0·74-1·28). The risk of seizures was also similar between groups (1·09 [95% CI 0·90-1·33]). Interpretation Our results show that tranexamic acid is safe in patients with TBI and that treatment within 3 h of injury reduces head injury-related death. Patients should be treated as soon as possible after injury. Funding National Institute for Health Research Health Technology Assessment, JP Moulton Charitable Trust, Department of Health and Social Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and Wellcome Trust (Joint Global Health Trials scheme)