THE EPIDEMIOLOGY AND HEALTH ECONOMICS OF ANKLE INJURIES

The thesis focuses on a central theme of the epidemiology and health economics of ankle sprains to inform health policy and the provision of health services. It describes the burden, prognosis, resource utilization, and costs attributed to these injuries. The first manuscript systematically reviewed 34 studies on the direct and indirect costs of treating ankle and foot injuries. The overall costs per patient ranged from $2,075- $3,799 (2014 USD) for ankle sprains; $290-$20,132 for ankle fractures; and $6,345-$45,731 for foot fractures, reflecting differences in injury severity, treatment methods, and study characteristics. The second manuscript provided an epidemiological and economic profile of non-fracture ankle and foot injuries in Ontario using linked databases from the Institute for Clinical Evaluative Sciences. The incidence rate of ankle sprains was 16.9/1,000 person-years. Annually, ankle and foot injuries cost $21,685,876 (2015 CAD). The mean expenses per case were $99.98 (95% CI, $99.70-100.26) for any injury. Costs ranged from $133.78-$210.75 for ankle sprains and $1,497.12-$1,755.69 for dislocations. The third manuscript explored the impact of body mass index on recovery from medically attended grade 1 and 2 ankle sprains using the Foot and Ankle Outcome Score. Data came from a randomized controlled trial of a physiotherapy intervention in Kingston, Ontario. At six months, the odds ratio of recovery for participants with obesity was 0.60 (0.37-0.97) before adjustment and 0.74 (0.43-1.29) after adjustment compared to non-overweight participants. The fourth manuscript used trial data to examine the health-related quality of life among ankle sprain patients using the Health Utilities Index version 3 (HUI-3). The greatest improvements in scores were seen at one month post-injury (HUI-3: 0.88, 95% CI: 0.86-0.90). Individuals with grade 2 sprains had significantly lower ambulation scores than those with grade 1 sprains (0.70 vs. 0.84; p<0.05). The final manuscript used trial data to describe the financial burden (direct and indirect costs) of ankle sprains. The overall mean costs were $1,508 (SD: $1,452) at one month and increased to $2,206 (SD: $3,419) at six months. Individuals with more severe injuries at baseline had significantly higher (p<0.001) costs compared to individuals with less severe injuries, after controlling for confounders.

FE simulation and experimental tests of high-strength structural bolts under tension

Experimental tests have been completed for high-strength 8.8 bolts for studying their mechanical performance subjected to tensile loading. As observed from these tests, failure of structural bolts has been identified as in one of two ways: threads stripping and necking of the threaded portion of the bolt shank, which is possibly due to the degree of fit between internal and external threads. Following the experimental work, a numerical approach has been developed for demonstration of the tensile performance with proper consideration of tolerance class between bolts and nuts. The degree of fit between internal and external threads has been identified as a critical factor affecting failure mechanisms of high-strength structural bolts in tension, which is caused by the machining process. In addition, different constitutive material laws have been taken into account in the numerical simulation, demonstrating the entire failure mechanism for structural bolts with different tolerance classes in their threads. It is also observed that the bolt capacities are closely associated with their failure mechanisms.

Examination of stress and strain in glass structures during pressure treatment using FEM simulation and experimental tests

Otto-von-Guericke-Universität Magdeburg, Fakultät für Maschinenbau, Dissertation, 2016

Design and Experimental Investigation of a Hydroxyl Ammonium Nitrate Based Workhorse Microthruster

Thesis (Master's)--University of Washington, 2016-08

Analytical and Experimental Investigation of an Ammonia/Air Opposed Reacting Jet

The point-by-point properties of an ammonia/air opposed-reacting-jet flowfield are described by solving the governing partial differential elliptic equations. Analytical descriptions of the reacting flowfield are compared to experimentally measured profiles of temperature and composition. Calculated distributions of stream function, temperature and fuel mole fraction are also presented. © 1972, Taylor & Francis Group, LLC. All rights reserved.

Thermal analysis during bone drilling using rigid polyurethane foams: numerical and experimental methodologies

Osteotomy or bone cutting is a common procedure in orthopaedic surgery, mainly in the treatment of fractures and reconstructive surgery. However, the excessive heat produced during the bone drilling process is a problem that counters the benefits of this type of surgery, because it can result in thermal osteonecrosis, bone reabsorption and damage the osseointegration of implants. The analysis of different drilling parameters and materials can allow to decrease the temperature during the bone drilling process and contribute to a greater success of this kind of surgical interventions. The main goal of this study was to build a numerical three-dimensional model to simulate the drilling process considering the type of bone, the influence of cooling and the bone density of the different composite materials with similar mechanical properties to the human bone and generally used in experimental biomechanics. The numerical methodology was coupled with an experimental methodology. The use of cooling proved to be essential to decrease the material damage during the drilling process. It was concluded that the materials with less porosity and density present less damage in drilling process. The developed numerical model proved to be a great tool in this kind of analysis. © 2016, The Brazilian Society of Mechanical Sciences and Engineering.

Hamburg model basin : numerical and experimental investigations on the dependence of the fluctuations of thrust and torque on the blade area ratio of four-blade ship-propellers /

Contract no. N 62558-2223.

Computational and experimental study of the behavior of cyano-based ionic liquids in aqueous solution

The solvation of cyano- (CN-) based ionic liquids (ILs) and their capacity to establish hydrogen bonds (H-bonds) with water was studied by means of experimental and computational approaches. Experimentally, water activity data were measured for aqueous solutions of ILs based on 1-butyl-3-methylimidazolium ([BMIM](+)) cation combined with one of the following anions: thiocyanate ([SCN](-)), dicyanamide ([DCA](-)), or tricyanomethanide ([TCM](-)), and of 1-ethyl-3-methylimidazolium tetracyanoborate ([EMIM][TCB]). From the latter data, water activity coefficients were estimated showing that [BMIM][SCN] and [BMIM][DCA], unlike [BMIM][TCM] and [EMIM][TCB], are able to establish favorable interactions with water. Computationally, the conductor like screening model for real solvents (COSMO-RS) was used to estimate the water activity coefficients which compare well with the experimental ones. From the COSMO-RS results, it is suggested that the polarity of each ion composing the ILs has a strong effect on the solvation phenomena. Furthermore, classical molecular dynamics (MD) simulations were performed for obtaining an atomic level picture of the local molecular neighborhood of the different species. From the experimental and computational data it is showed that increasing the number of CN groups in the ILs' anions does not enhance their ability to establish H-bonds with water but decreases their polarities, being [BMIM][DCA] and [BMIM][SCN] the ones presenting higher propensity to interact.

Behavioral and neuroimaging research of reading: A case of Japanese

Behavioral studies showed that AS, an English-Japanese bilingual was a skilled reader in Japanese but was a phonological dyslexic in English. This behavioral dissociation was accounted for by the Hypothesis of Transparency and Granularity postulated by Wydell & Butterworth. However, a neuroimaging study using MEG (magnetoencephalography) revealed that AS has the same functional deficit in the left superior temporal gyrus (STG). This paper therefore offers an answer to this intriguing discrepancy between the behavioral dissociation and the neural unity in AS by reviewing existing behavioral and neuroimaging studies in alphabetic languages such as English, Finnish, French, and Italian, and nonalphabetic languages such as Japanese and Chinese.

A non-conventional five piston double.-acting Stirling Engine filling system CFD simulation and experimental validation

Análisis mediante CFD y validación experimental de un sistema de carga para un motor Stirling. Validado y analizado experimentalmente en un motor de 5 pistones de doble acción.

Arsenic Geochemitry in Warm Spring Ponds: New Field and Experimental Results

Silver Bow Creek (SBC) flows into the Warm Springs Ponds Operable Unit (WSPOU), where various containment cells are used to precipitate copper and other metals (e.g., Cd, Cu, Mn, Pb, Zn). Lime is added seasonally to increase the pH and assist in removal of metals from the water column. Although the WSPOU is effective at removing copper and other cationic trace metals, concentrations of dissolved arsenic exiting the facility are often above the site specific standard, 20 20 ug/L, during low-flow periods each summer and fall. This thesis is a continuation of arsenic geochemistry studies by Montana Tech in the WSPOU. Field work focused on Pond 3, the largest and first in the series of treatment ponds. Shallow groundwater was sampled from 8 PVC piezometers located near the south end of Pond 3. Three sediment pore-water diffusion samplers (“peepers”) were also deployed at the south end of Pond 3 to examine vertical gradients in chemistry in the top 25 cm of the pond sediment. In general, the pH and Eh values of the shallow groundwater and sediment pore-water were less than in the pond water. Concentrations of arsenic were generally higher in subsurface water, and tended to pass through a maximum (up to 530 g/L) about 10 cm below the sediment-water interface. In the peeper cells, there was a strong positive correlation between dissolved As and dissolved Fe, and an inverse correlation with sulfate. Therefore, the zone of arsenic release corresponds to a zone of bacterial Fe and sulfate reduction in the shallow, organic-rich sediment. Redox speciation of arsenic shows that arsenate (As(V)) is dominant in the pond, and arsenite (As(III)) is dominant in the subsurface water. A series of laboratory experiments with pH adjustment were completed using SBC water collected near the inlet to the WSPOU as well as water and shallow sediment collected from Pond 3. Water ± sediment mesocosms were set up in 1-L Nalgene bottles (closed system) or a 20-L aquarium (open system), both with continuous stirring. The pH of the mesocosm was adjusted by addition of NaOH or HNO3 acid. The closed system provided better pH control since the water was not in contact with the atmosphere, which prevented exchange of carbon dioxide. In both the closed and open systems, dissolved arsenic concentrations either decreased or stayed roughly the same with increase in pH to values > 11. Therefore, the release of dissolved As into the treatment ponds in low-flow periods is not due to changes in pH alone. All of these results support the hypothesis that the arsenic release in WSPOU is linked to microbial reduction of ferric oxide minerals in the organic-rich sediment. Upwards diffusion of dissolved As from the sediment pore-water into the pond water is the most likely explanation for the increase in As concentration of the WSPOU in low-flow periods.