The effects of compression use during exercise in women with breast cancer-related lymphoedema

Compelling evidence demonstrates the importance of regular exercise following breast cancer, and this is particularly important for those who develop breast cancer-related lymphoedema. However, fear of lymphoedema exacerbation and the need to wear compression while exercising present as significant barriers for these women. This Master's research evaluated the need for wearing compression during exercise in women with breast cancer-related lymphoedema. Findings demonstrated that exercise performed without compression does not exacerbate lymphoedema or related symptoms. These findings are clinically relevant as they highlight that compression use during exercise should be prescribed on an individual basis, taking into consideration patient preferences and adherence issues.

Systematic review and meta-analysis of the effects of exercise for those with cancer-related lymphedema

Objective: To evaluate the effects of exercise on cancer-related lymphedema and related symptoms, and to determine the need for those with lymphedema to wear compression during exercise. Data Sources: CINAHL, Cochrane, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, Science Direct and SPORTDiscus databases were searched for trials published prior to 1 January, 2015. Study Selection: Randomised and non-randomised, controlled trials, and single group pre-post studies published in English-language were included. Twenty-one (exercise) and four (compression and exercise) studies met inclusion criteria. Data Extraction: Data was extracted into tabular format using predefined data fields by one reviewer and assessed for accuracy by a second reviewer. Study quality was evaluated using the Effective Public Health Practice Project assessment tool. Data Synthesis: Data was pooled using a random effects model to assess the effects of acute and long-term exercise on lymphedema and lymphedema-associated symptoms, with subgroup analyses for exercise mode and intervention length. There was no effect of exercise (acute or intervention) on lymphedema or associated symptoms with standardised mean differences from all analyses ranging between −0.2 and 0.1 (p-values ≥0.22). Findings from subgroup analyses for exercise mode (aerobic, resistance, mixed, other) and intervention duration (>12 weeks or ≤12 weeks) were consistent with these findings; that is, no effect on lymphedema or associated symptoms. There were too few studies evaluating the effect of compression during regular exercise to conduct a meta-analysis. Conclusions: Individuals with secondary lymphedema can safely participate in progressive, regular exercise without experiencing a worsening of lymphedema or related-symptoms. However, the results also do not suggest any improvements will occur in lymphedema. At present, there is insufficient evidence to support or refute the current clinical recommendation to wear compression garments during regular exercise.

Study of surface evolution in the wheel-rail interface

This paper aims to trace surface evolution in the wheel-rail interface using data obtained from a twin-disc testing machine and the surface replication technique. Changes in the surface profile of the rail testing disc are explicitly analysed according to the wear mechanism, which helps elaborate a better understanding of the attrition of asperities during the wearing-in process of surface modification. The surface profile amplitude was seen to decrease during the initial running-in phase of the experiment cycle, and after reaching a saturation value, the profile amplitude then increased. Ultimately the results show that grinding will roughen the rail surface and the wheel-rail contact conditions will then remove this surface damage to some saturation value of the profile height. The variation in the rail surface profile beyond this point is then only dependant on the contact conditions which exist between the wheel and rail during normal operation.

Transcutaneous bone-anchoring prosthesis with knee replacement: A novel treatment for amputees

Background Over the last two decades, Transcutaneous Bone-Anchored Prosthesis (TCBAP) has proven to be an effective alternative for prosthetic attachment for amputees, particularly for individuals unable to wear a socket. [1-17] However, the load transmitted through a typical TCBAP to the residual tibia and knee joint can be unbearable for transtibial amputees with knee arthritis. Aim A. To describe the surgical procedure combining TKR with TCBAP for the first time; and B. To present preliminary data on potential risks and benefits with assessment of clinical and functional outcomes at follow up Method We used a TCBAP connected to the tibial base plate of a Total Knee Replacement (TKR) prosthesis enabling the tibial residuum and the knee joint to act as weight sharing structures by transferring the load directly to the femur. We performed a standard hinged TKR connected to a custom made TCBAP at the first stage followed by creating a skin implant interface as a second stage. We retrospectively reviewed four cases of trans-tibial amputations presenting with knee joint arthritis. Patients were assessed clinically and functionally including standard measures of health-related quality of life, amputee mobility predictor tool, ambulation tests and actual activity level. Progress was monitored for 6-24 months. Results Clinical outcomes including adverse events show no major complications but one case of superficial infection. Functional outcomes improved for all participants as early as 6 months follow up. Discussion & Conclusion TKR and TCBAP were combined for the first time in this proof-of-concept case series. The preliminary outcomes indicated that this procedure is potentially a safe and effective alternative for this patient group despite the theoretical increase in risk of ascending infection through the skin-implant interface to the external environment. We suggest larger comparative series to further validate these results.

Effect of ion nitriding on the microstructure and properties of Maraging steel (250 Grade)

In the present investigation, ion nitriding of Maraging steel (250 grade) has been carried out at three different temperatures i.e., at 435 degrees C, 450 degrees C and 465 degrees C for 10 h duration in order to achieve good wear resistance along with high strength required for the slat track component of aircraft. The microstructure of the base material and the nitrided layer was examined by optical and scanning electron microscope, and various phases present were determined by X-ray diffraction. Various properties, such as, hardness, case depth, tensile, impact, fatigue properties and corrosion resistance were investigated for both un-nitrided and ion-nitrided materials. It is observed that the microstructure of the core material remains unaltered and Fe4N is formed in the hardened surface layer after ion nitriding at all the three temperatures employed. Surface hardness increases substantially after ion nitriding. Surface hardness remains almost the same but case depth increases with the increase in ion nitriding temperature due to greater diffusivity at higher temperatures. Tensile strength, fatigue strength and corrosion resistance are improved but ductility and energy absorbed in impact test decrease on ion nitriding. These results are explained on the basis of microstructural observations. The properties obtained after ion nitriding at 450 degrees C for 10 h are found to be optimum when compared to the other two ion nitriding temperatures.

Genesis of workpiece roughness generated in surface grinding and polishing of metals

Assuming the grinding wheel surface to be fractal in nature, the maximum envelope profile of the wheel and contact deflections are estimated over a range of length scales. This gives an estimate of the 'no wear' roughness of a surface ground metal. Four test materials, aluminum, copper, titanium, and steel are surface ground and their surface power spectra were estimated. The departure of this power spectra from the 'no wear' estimates is studied in terms of the traction-induced wear damage of the surfaces. The surface power spectra in grinding are influenced by hardness and the power is enhanced by wear damage. No such correlation with hardness was found for the polished surface, the roughness of which is insensitive to mechanical properties and appears to be influenced by microstructure and physical properties of the material.

Finite Element Solution Of Surface-Tension Driven Flows In Laser Surface-Melting

Lasers are very efficient in heating localized regions and hence they find a wide application in surface treatment processes. The surface of a material can be selectively modified to give superior wear and corrosion resistance. In laser surface-melting and welding problems, the high temperature gradient prevailing in the free surface induces a surface-tension gradient which is the dominant driving force for convection (known as thermo-capillary or Marangoni convection). It has been reported that the surface-tension driven convection plays a dominant role in determining the melt pool shape. In most of the earlier works on laser-melting and related problems, the finite difference method (FDM) has been used to solve the Navier Stokes equations [1]. Since the Reynolds number is quite high in these cases, upwinding has been used. Though upwinding gives physically realistic solutions even on a coarse grid, the results are inaccurate. McLay and Carey have solved the thermo-capillary flow in welding problems by an implicit finite element method [2]. They used the conventional Galerkin finite element method (FEM) which requires that the pressure be interpolated by one order lower than velocity (mixed interpolation). This restricts the choice of elements to certain higher order elements which need numerical integration for evaluation of element matrices. The implicit algorithm yields a system of nonlinear, unsymmetric equations which are not positive definite. Computations would be possible only with large mainframe computers.Sluzalec [3] has modeled the pulsed laser-melting problem by an explicit method (FEM). He has used the six-node triangular element with mixed interpolation. Since he has considered the buoyancy induced flow only, the velocity values are small. In the present work, an equal order explicit FEM is used to compute the thermo-capillary flow in the laser surface-melting problem. As this method permits equal order interpolation, there is no restriction in the choice of elements. Even linear elements such as the three-node triangular elements can be used. As the governing equations are solved in a sequential manner, the computer memory requirement is less. The finite element formulation is discussed in this paper along with typical numerical results.

Use of physicochemical signatures to assess the sources of metals in urban road dust

Road deposited dust is a complex mixture of pollutants derived from a wide range of sources. Accurate identification of these sources is seminal for effective source-oriented control measures. A range of techniques such as enrichment factor analysis (EF), principal component analysis (PCA) and hierarchical cluster analysis (HCA) are available for identifying sources of complex mixtures. However, they have multiple deficiencies when applied individually. This study presents an approach for the effective utilisation of EF, PCA and HCA for source identification, so that their specific deficiencies on an individual basis are eliminated. EF analysis confirmed the non-soil origin of metals such as Na, Cu, Cd, Zn, Sn, K, Ca, Sb, Ba, Ti, Ni and Mo providing guidance in the identification of anthropogenic sources. PCA and HCA identified four sources, with soil and asphalt wear in combination being the most prominent sources. Other sources were tyre wear, brake wear and sea salt.

Uniformity in Bias Tilt for Nematics Oriented by Polyvinyl Alcohol Surface Layers

Uniformity in bias tilt, for the polyvinyl alcohol(PVA)surface layer induced orientation of nematic liquid crystals, could be achieved for large area display panels, if one of the transparent electrodes is first directionally rubbed with fine abrasive; then both the electrodes coated with PVA, followed by directionally buffing the chemisorbed layers in the same direction. Uniformity may be due to increased 'train' configuration of the adsorbed macromolecule by falling on to microgrooves and maintaining the same sense of asymmetry for the looped segments.

The National Road Safety Partnership Program providing a pathway for any business/organisation to create a positive road safety culture

The National Road Safety Partnership Program (NRSPP) is an industry-led collaborative network which aims to support Australian businesses in developing a positive road safety culture. It aims to help businesses to protect their employees and the public, not only during work hours, but also when their staff are ‘off-duty’. How do we engage and help an organisation minimise work-related vehicle crashes and their consequences both internally, and within the broader community? The first step is helping an organisation to understand the true cost of its road incidents. Larger organisations often wear the costs without knowing the true impact to their bottom line. All they perceive is the change in insurance or vehicle repairs. Understanding the true cost should help mobilise a business’s leadership to do more. The next step is ensuring the business undertakes an informed, structured, evidence-based pathway which will guide them around the costly pitfalls. A pathway based around the safe system approach with buy-in at the top which brings the workforce along. The final step, benchmarking, allows the organisation to measure and track its change. This symposium will explore the pathway steps for organisations using NRSPP resources to become engaged in road safety. The 'Total Cost of Risk' calculator has been developed by Zurich, tested in Europe by Nestle and modified by NRSPP for Australia. This provides the first crucial step. The next step is a structured approach through the Workplace Road Safety Guide using experts and industry to discuss the preferred safe system approach which can then link into the national Benchmarking Project. The outputs from the symposium can help frame a pathway for organisations to follow through the NRSPP website.

Laser surface cladding of MRI 153M magnesium alloy with (Al+Al2O3)

Laser surface cladding was carried out on a creep-resistant MRI 153M magnesium alloy with a mixture of Al and Al2O3 powders using a pulsed Nd:YAG laser at scan speeds of 21, 42, 63 and 84 mm/s. The Al2O3 particles partially or completely melted during laser irradiation and re-solidified with irregular shapes in the size range of 5–60 µm along with a few islands as large as 500 µm, within the grain-refined Mg-rich dendritic matrix. More than an order of magnitude improvement in wear resistance after cladding was attributed to the presence of ultra-hard Al2O3 particles, increased solid solubility of Al and other alloying elements, and a very fine dendritic microstructure as a result of rapid solidification in the cladded layer. However, corrosion resistance of the laser cladded alloy was reduced by almost an order of magnitude compared to that of the as-cast alloy mainly due to the presence of cracks and pores in the cladded layer.

Scanning electron microscopy study of worn Al-Si alloy surfaces

A pin-on-disc machine was used to wear Al-Si alloy pins under dry conditions. Unmodified and modified binary alloys and commercial multi-component alloys were tested. The surfaces of the worn alloys were examined by scanning electron microscopy to identify distinct topographical features to aid elucidation of the mechanisms of wear.

Kaukainen rakkaus : Saavuttamattomuuden semantiikka Kaija Saariahon oopperassa

L Amour de loin: The semantics of the unattainable in Kaija Saariaho s opera Kaija Saariaho (born 1952) is one of the most internationally successful Finnish composers there has ever been. Her first opera L Amour de loin (Love from afar, 1999-2000) has been staged all over the world and has won a number of important prizes. The libretto written for L Amour de loin by Amin Malouf (born 1949) sets the work firmly in the culture of courtly love and the troubadours, which flourished in Occitania in the South of France during the Middle Ages. The male lead in the opera is the troubadour Jaufré Rudel, who lived in the twelfth century and is known to have taken part in the Second Crusade in 1147-1148. This doctoral thesis L Amour de loin: The semantics of the unattainable in Kaija Saariaho s opera, which comes within the field of musicology and opera research, examines the dimensions of meaning contained in Kaija Saariaho s opera L Amour de loin. This hermeneutic-semiotic study is the first doctoral thesis dealing with Saariaho to be completed at the University of Helsinki. It is also the first thesis-level study of Saariaho s opera to be completed anywhere in the world. The study focuses on the libretto and music of the opera, that is to say the dramatic text (L Amour de loin 1980), and examines on the one hand the dimensions of meaning produced by the dramatic text and on the other, the way in which they fix the dramatic text in a historical and cultural context. Thus the study helps to answer questions about the dimensions of meaning contained in the dramatic text of the opera and how they can be interpreted. The most important procedural viewpoint is Lawrence Kramer s hermeneutic window (1990), supplemented by Raymond Monelle s semiotic theory of musical topics (2000, 2006) and the philosophical concept of Emmanuel Levinas (1996, 2002) in which the latter acts as an instrument for semantic interpretation to build up an analysis. The analytical section of the study is built around the three characters in the opera, Jaufré Rudel, Clémence the Countess of Tripoli, and the Pilgrim. The study shows that the music of Saariaho, who belongs to the third generation of Finnish modernists, has become distanced from the post-serial aesthetic towards a more diatonic form of expression. There is diatonicity, for instance, in the sonorous individuality of the male lead, which is based on the actual melodies of the historical Jaufré Rudel. The use of outside material in this context is exceptional in the work of Saariaho. At the same time, Saariaho s opera contains a wealth of expressive devices she has used in her earlier work. It became apparent during the study that, as a piece of music, L Amour de loin is a many layered and multi-dimensional work that does not unambiguously represent any single stylistic trend or aesthetic. Despite the composer s post-serial background and its abrasive relationship with opera, L Amour de loin is firmly attached to the tradition of western opera. The analysis based on the theory of musical topics that was carried out in the study, shows that topics referring to death and resurrection, used in opera since the seventeenth century, appear in L Amour de loin. The troubadour topic, mainly identified with the harp, also emerges in the work. The study also shows that the work is firmly attached to the tradition of western opera in other aspects, too, such as the travesti or trouser role played by the Pilgrim, and the idea of deus ex machina derived from Ancient Greek theatre. The study shows that the concept of love based on the medieval practices of courtly love, and the associated longing for another defined by almost 1,000 years of western culture, are both manifested in the semantics of Kaija Saariaho s opera which takes its place in the contemporary music genre.

Cavitation erosion characteristics of poly(methyl methacrylate) in a rotating disk device

Experimental results pertaining to the initiation, dynamics and mechanism of cavitation erosion on poly(methyl methacrylate) specimens tested in a rotating disk device are described in detail. Erosion normally starts at the location nearest to the center of rotation (CR). As the exposure time to cavitation increases, additional erosion areas or sites appear away from the CR and secondary erosion (induced by eroded pits) spreads upstream and merges with the main pit. The microcracks increase in density towards the end of the incubation period and transform into macrocracks in most cases. A study of light optical photographs and scanning electron micrographs of the eroded area shows that material particles are removed from the network of cracks because of crack joining and pits indicate particle debris. Optical degradation (loss of transmittance) is observed to be greater on the back of the specimen than on the front.

Flow of metal in constrained plane-strain extrusion forging- Part II

With many innovations in process technology, forging is establishing itself as a precision manufacturing process: as forging is used to produce complex shapes in difficult materials, it requires dies of complex configuration of high strength and of wear-resistant materials. Extensive research and development work is being undertaken, internationally, to analyse the stresses in forging dies and the flow of material in forged components. Identification of the location, size and shape of dead-metal zones is required for component design. Further, knowledge of the strain distribution in the flowing metal indicates the degree to which the component is being work hardened. Such information is helpful in the selection of process parameters such as dimensional allowances and interface lubrication, as well as in the determination of post-forging operations such as heat treatment and machining. In the presently reported work the effect of aperture width and initial specimen height on the strain distribution in the plane-strain extrusion forging of machined lead billets is observed: the distortion of grids inscribed on the face of the specimen gives the strain distribution. The stress-equilibrium approach is used to optimise a model of flow in extrusion forging, which model is found to be effective in estimating the size of the dead-metal zone. The work carried out so far indicates that the methodology of using the stress-equilibrium approach to develop models of flow in closed-die forging can be a useful tool in component, process and die design.