Synthesis of electrical networks interconnecting PZT actuators to damp mechanical vibrations

This paper proves that it is possible to damp mechanical vibrations of some beam frames by means of piezoelectric actuators interconnected via passive networks. We create a kind of electromechanical wave guide where the electrical velocity group equals the mechanical one thus enabling an electromechanical energy transfer. Numerical simulations are presented which prove the technical feasibility of proposed deviceComment: International Symposium on Applied Electromagnetics and Mechanics in honor of Professor K.Miya, Tokyo: 2000. 9 page

The bias-extension test for the analysis of in-plane shear properties of textile composite reinforcements and prepregs: a review

The bias-extension test is a rather simple experiment aiming to determine in-plane shear properties of textile composite reinforcements. However the mechanics during the test involves fibrous material at large shear strains and large rotations of the fibres. Several aspects are still being studied and are not yet modeled in a consensual manner. The standard analysis of the test is based on two assumptions: inextensibility of the fibers and rotations at the yarn crossovers without slippage. They lead to the development of zones with constant fibre orientations proper to the bias-extension test. Beyond the analysis of the test within these basic assumptions, the paper presents studies that have been carried out on the lack of verification of these hypothesis (slippage, tension in the yarns, effects of fibre bending). The effects of temperature, mesoscopic modeling and tension locking are also considered in the case of the bias-extension test

Equilibria determination of elastic articulated duoskelion beams in 2D via a Riks-type algorithm

The overall behavior of an articulated beam structure constituted by elements arranged according to a specific chirality is studied. The structure as a whole, due to its slenderness and geometry, is called duoskelion beam. The name duoskelion is a neologism which is inspired by the Greek word δύοσκέλιον (two-legged). A discrete model for shearable beams, formulated recently, is exploited to investigate its mechanics. A purposely designed numerical scheme, adapting the Riks rationale, is used to calculate large displacement and deformation equilibria of duoskelion beams. Aimed at computing the current step correction, the Riks arc-length method is modified and made more efficient by applying a specific orthogonality condition, defined via the stiffness matrix, to an adapted extrapolation step. The robustness of the resulting scheme and its capability to follow equilibrium branches allows, in principle, for the exploration of the whole set of local energy minima in the introduced space of configurations, by using suitably modulated perturbative external loads. The developed numerical tool can be used to understand the mechanics of duoskelion beams. It is proved that there exists a stable principal equilibrium branch in which only compression is observed for any compression load. Additional stable equilibrium branches are found in compression such that the clamped–clamped compressed beam assumes a characteristic S shape which, upon reaching a critical load, is significantly amplified. A mechanically relevant stable equilibrium is also found in extension, being observed the S-shaped configuration experimentally found in Misra et al. (2020)

Intestinal lymphangiectasia in a 3-month-old girl: A case report of Hennekam syndrome caused by CCBE1 mutation

RATIONAL: Intestinal lymphangiectasia (IL) is a rare disease characterized by dilatation and rupture of intestinal lymphatic channels leading to protein-losing enteropathy. IL is classified as primary and secondary types. PATIENT CONCERNS: A 3-month-old girl born at term from vaginal delivery with an APGAR score of 10/10 and birth weight of 4.310 g (>97° percentile) was admitted to our hospital because of increasing abdominal tenderness and diarrhea. At first examination, she presented an abdominal circumference of 60 cm, edema of the lower extremities and vulva, and facial dysmorphisms (hypertelorism, flat nasal bridge, flat mid-face). DIAGNOSIS: Once admitted, ultrasonography showed a large amount of ascites, while blood laboratory investigations revealed severe hypoproteinemia, hypoalbuminemia and hypogammaglobulinemia. Lymphoscintigraphy with 99m-Tc-nanocolloid demonstrated abnormal leakage of the tracer in the abdomen as evidence of IL. To detect a possible secondary, exams were performed and demonstrated positive antibody titres for CMV-IgM and IgG in blood and CMV-DNA positivity in blood, urine, saliva, maternal milk, and gastric and duodenal biopsies. Genetic investigations identified the genomic variant c.472C>T of the CCBE1 gene, coding for a protein variant (p.Arg158Cys), in homozygosity. INTERVENTIONS: Total parenteral nutrition was started and continued for a total of 18 days, then gradually bridged by enteral nutrition with a special formula. In addition, antiviral therapy for CMV infection was added first with intravenous ganciclovir for 14 days, resulting in the disappearance of blood viral load after 7 days of therapy and then with valganciclovir per os for another 30 days. OUTCOMES: The clinical course of the child gradually improved. A few days after starting treatments, lower extremities and vulvar edema disappeared, and abdominal circumference gradually decreased to a stable value of 38 cm, without any ultrasonographic signs of ascites left. Moreover, serum albumin and IgG rose to normal values after 3 months (4.3 g/dL and 501 mg/dL, respectively). LESSONS: This case suggests that in presence of IL both primary and secondary causes should be evaluated. On the other hand, genetic diagnosis is crucial not only for diagnosis but also for prognosis in HS. Life expectancy and quality could deeply vary among different gene mutations and protein variants of the same gene. Further studies and case reports are needed to better understand the clinical meaning of these genetic results and the role of CMV as trigger of IL

A nonlinear Lagrangian particle model for grains assemblies including grain relative rotations

International audienceWe formulate a discrete Lagrangian model for a set of interacting grains, which is purely elastic. The considered degrees of freedom for each grain include placement of barycenter and rotation. Further, we limit the study to the case of planar systems. A representative grain radius is introduced to express the deformation energy to be associated to relative displacements and rotations of interacting grains. We distinguish inter‐grains elongation/compression energy from inter‐grains shear and rotations energies, and we consider an exact finite kinematics in which grain rotations are independent of grain displacements. The equilibrium configurations of the grain assembly are calculated by minimization of deformation energy for selected imposed displacements and rotations at the boundaries. Behaviours of grain assemblies arranged in regular patterns, without and with defects, and similar mechanical properties are simulated. The values of shear, rotation, and compression elastic moduli are varied to investigate the shapes and thicknesses of the layers where deformation energy, relative displacement, and rotations are concentrated. It is found that these concentration bands are close to the boundaries and in correspondence of grain voids. The obtained results question the possibility of introducing a first gradient continuum models for granular media and justify the development of both numerical and theoretical methods for including frictional, plasticity, and damage phenomena in the proposed model

Factors associated with fatigue in hip and/or knee osteoarthritis: a systematic review and best evidence synthesis

Objective: The aim was systematically to identify and evaluate factors related to fatigue in individuals with hip and/or knee OA. Methods: A systematic literature search was conducted using AMED, CINAHL, MEDLINE, ProQuest and Web of Science Core Collections databases. Inclusion criteria comprised cross-sectional, case-control or longitudinal studies on patients with a diagnosis of hip and/or knee OA that included self-reported fatigue measures. Study quality was assessed using the National Heart, Lung and Blood Institute quality appraisal tool, and factors were synthesized within a bio-behavioural framework. Study designs and quality were combined to determine current evidence levels using best evidence synthesis grading. The full review protocol is available from PROSPERO (PROSPERO 2019: CRD42019138571). Results: Twenty-four studies were included, of which 19 were high, 4 moderate and 1 low quality. There was strong evidence of an association between poor self-reported physical function and high depressive symptoms with higher fatigue. Moderate evidence of an association was found between severe pain, high numbers of co-morbidities and low physical activity levels with higher fatigue. There was moderate or limited evidence of no association between most sociodemographic factors and radiographic OA severity with fatigue. Conclusion: Targets for fatigue management might include improving physical function, reducing depressive symptoms, pain and co-morbidities, and increasing physical activity levels. There is a need for more rigorous longitudinal studies to understand the causal effect of fatigue determinants within the hip and knee OA populations

Years of life that could be saved from prevention of hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) causes premature death and loss of life expectancy worldwide. Its primary and secondary prevention can result in a significant number of years of life saved. AIM: To assess how many years of life are lost after HCC diagnosis. METHODS: Data from 5346 patients with first HCC diagnosis were used to estimate lifespan and number of years of life lost after tumour onset, using a semi-parametric extrapolation having as reference an age-, sex- and year-of-onset-matched population derived from national life tables. RESULTS: Between 1986 and 2014, HCC lead to an average of 11.5 years-of-life lost for each patient. The youngest age-quartile group (18-61 years) had the highest number of years-of-life lost, representing approximately 41% of the overall benefit obtainable from prevention. Advancements in HCC management have progressively reduced the number of years-of-life lost from 12.6 years in 1986-1999, to 10.7 in 2000-2006 and 7.4 years in 2007-2014. Currently, an HCC diagnosis when a single tumour <2 cm results in 3.7 years-of-life lost while the diagnosis when a single tumour 65 2 cm or 2/3 nodules still within the Milan criteria, results in 5.0 years-of-life lost, representing the loss of only approximately 5.5% and 7.2%, respectively, of the entire lifespan from birth. CONCLUSIONS: Hepatocellular carcinoma occurrence results in the loss of a considerable number of years-of-life, especially for younger patients. In recent years, the increased possibility of effectively treating this tumour has improved life expectancy, thus reducing years-of-life lost

Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape