• Smart Structures and Systems
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• v.19 no.1
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• pp.39-46
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• 2017

Finite element model updating is very effective procedure to determine the uncertainty parameters in structural model and minimize the differences between experimentally and numerically identified dynamic characteristics. This procedure can be practiced with manual and automatic model updating procedures. The manual model updating involves manual changes of geometry and analyses parameters by trial and error, guided by engineering judgement. Besides, the automated updating is performed by constructing a series of loops based on optimization procedures. This paper addresses the ambient vibration based finite element model updating of long span reinforced concrete highway bridges using manual model updating procedure. Birecik Highway Bridge located on the $81^{st}km$ of Şanliurfa-Gaziantep state highway over Firat River in Turkey is selected as a case study. The structural carrier system of the bridge consists of two main parts: Arch and Beam Compartments. In this part of the paper, the arch compartment is investigated. Three dimensional finite element model of the arch compartment of the bridge is constructed using SAP2000 software to determine the dynamic characteristics, numerically. Operational Modal Analysis method is used to extract dynamic characteristics using Enhanced Frequency Domain Decomposition method. Numerically and experimentally identified dynamic characteristics are compared with each other and finite element model of the arch compartment of the bridge is updated manually by changing some uncertain parameters such as section properties, damages, boundary conditions and material properties to reduce the difference between the results. It is demonstrated that the ambient vibration measurements are enough to identify the most significant modes of long span highway bridges. Maximum differences between the natural frequencies are reduced averagely from %49.1 to %0.6 by model updating. Also, a good harmony is found between mode shapes after finite element model updating.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.1
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• pp.35-42
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• 2021

Objectives The objective of this study was to evaluate the effect of chuna manual therapy for rhinitis. Methods We performed a literature search using ten electronic databases (PubMed, Embase, Cochrane Library, Chinese Academic Journals(CAJ), Research Information Sharing Service(RISS), Dbpia, National Digital Science Library(NDSL), Koreanstudies Information Service System(KISS), Korean Medical database(KMbase), and Oriental Medicine Advanced Searching Integrated System(OASIS)) and two academic journals up to the end of April 2021. We included randomized controlled trials (RCTs) which appraised the effect of chuna manual therapy (CMT) in the treatment of rhinitis. The risk of bias was evaluated from the Cochrane Risk of Bias tool. Results 4 appropriate RCTs were included and analyzed. The efficacy rate of the CMT group was statistically higher compared to the control group treated with medicine[RR 1.14 (95%CI 1.06 1.22), P<0.01]. Conclusions Based on results, CMT could be effective in rhinitis. However, evidence were limited due to small number of studies, lack of well-designed RCT and regional bias. Further well-designed research should be required to obtain stronger evidence.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.117-128
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• 2022

Background: Moderate sedation is an integral part of dental care delivery. Target-controlled infusion (TCI) has the potential to improve patient safety and outcome. We compared the effects of using TCI to administer remifentanil/manual bolus midazolam with manual bolus fentanyl/midazolam administration on patient safety parameters, drug administration times, and patient recovery times. Methods: In this retrospective chart review, records of patients who underwent moderate intravenous sedation over 12 months in a private dental clinic were assessed. Patient indicators (pre-, intra-, and post-procedure noninvasive systolic and diastolic blood pressure, respiration, and heart rate) were compared using independent t-test analysis. Patient recovery time, procedure length, and midazolam dosage required were also compared between the two groups. Results: Eighty-five patient charts were included in the final analysis: 47 received TCI-remifentanil/midazolam sedation, and 38 received manual fentanyl/midazolam sedation. Among the physiological parameters, diastolic blood pressure showed slightly higher changes in the fentanyl group (P = 0.049), respiratory rate changes showed higher changes in the fentanyl group (P = 0.032), and the average EtCO₂ was slightly higher in the remifentanil group (P = 0.041). There was no significant difference in the minimum SpO₂ levels and average procedure length between the fentanyl and remifentanil TCI pump groups (P > 0.05). However, a significant difference was observed in the time required for discharge from the chair (P = 0.048), indicating that patients who received remifentanil required less time for discharge from the chair than those who received fentanyl. The dosage of midazolam used in the fentanyl group was 0.487 mg more than that in the remifentanil group; however, the difference was not significant (P > 0.05). Conclusion: The combination of TCI administered remifentanil combined with manual administered midazolam has the potential to shorten the recovery time and reduce respiration rate changes when compared to manual administration of fentanyl/midazolam. This is possibly due to either the lower midazolam dosage required with TCI remifentanil administration or achieving a stable, steady-state low dose remifentanil concentration for the duration of the procedure.

• Korean Journal of Radiology
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• v.21 no.6
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• pp.660-669
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• 2020

Objective: To evaluate the accuracy of a deep learning-based automated segmentation of the left ventricle (LV) myocardium using cardiac CT. Materials and Methods: To develop a fully automated algorithm, 100 subjects with coronary artery disease were randomly selected as a development set (50 training / 20 validation / 30 internal test). An experienced cardiac radiologist generated the manual segmentation of the development set. The trained model was evaluated using 1000 validation set generated by an experienced technician. Visual assessment was performed to compare the manual and automatic segmentations. In a quantitative analysis, sensitivity and specificity were calculated according to the number of pixels where two three-dimensional masks of the manual and deep learning segmentations overlapped. Similarity indices, such as the Dice similarity coefficient (DSC), were used to evaluate the margin of each segmented masks. Results: The sensitivity and specificity of automated segmentation for each segment (1-16 segments) were high (85.5-100.0%). The DSC was 88.3 ± 6.2%. Among randomly selected 100 cases, all manual segmentation and deep learning masks for visual analysis were classified as very accurate to mostly accurate and there were no inaccurate cases (manual vs. deep learning: very accurate, 31 vs. 53; accurate, 64 vs. 39; mostly accurate, 15 vs. 8). The number of very accurate cases for deep learning masks was greater than that for manually segmented masks. Conclusion: We present deep learning-based automatic segmentation of the LV myocardium and the results are comparable to manual segmentation data with high sensitivity, specificity, and high similarity scores.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.1
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• pp.1-11
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• 2019

Objectives : The purpose of this study is to review clinical studies about the effect of chuna manual therapy (CMT) for peripheral facial paralysis in children. Methods : In this review, we searched 11 electronic databases (Pubmed, Cochrane Library, EMBASE, CINAHL, CAJ, Oasis, NDSL, KISS, RISS, KISTI, Dbpia); We concluded our literature search in April 23, 2019. We included only randomized controlled trials (RCTs) of testing CMT for peripheral facial paralysis in children. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. The meta-analysis was performed by synthesizing outcome data of total efficacy rate (TER). Results : After screening papers, a total of 6 RCTs were selected and analyzed. In the 6 RCTs, patients(n=15-60 per study) were randomized into groups for treatment and control. Specifically, the treatment group received CMT, while the control group was concurrently given usual care, such as acupuncture and medicine. The meta-analysis showed that the treatment group receiving CMT alone showed significant improvement in TER, compared to the control group receiving acupuncture therapy alone(P<0.05). And the treatment group receiving CMT combined with usual care showed positive results, in terms of TER, compared to the control group receiving usual care, but was not statistically significant(P>0.05). Conclusions : Our analysis suggests that CMT has therapeutic effects for peripheral facial paralysis in children. However, to confirm this result, further investigation accompanied by high quality studies is required.

• Physical Therapy Rehabilitation Science
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• v.8 no.2
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• pp.79-85
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• 2019

Objective: The purpose of this study was to investigate the relationship between physical features, strength, function, and upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries. Design: Cross-sectional study. Methods: The degree and frequency of upper extremity musculoskeletal pain were measured in persons with spinal cord injuries using manual wheelchairs with the use of questionnaires. The pain scores of the hand, wrist, and shoulder joints were calculated by multiplying the seriousness and frequency of pain. We collected data on the manual muscle test, Spinal Cord Independent Measure-III, and the Body Mass Index. Statistical analysis was performed by descriptive analysis and Pearson's correlation analysis. Results: A total of 47 patients participated in this study and the neurological level of the injuries ranged from C2 to S5. Pain in the shoulder joints was the most common in persons with tetraplegia and paraplegia. Pain was experienced as mild to moderate, and occurred one or more times a week. Of the 32 persons with paraplegia, the most common area of complaint was the shoulder. Of the 15 persons with paraplegia, the shoulder joints were the most common site of pain. The independence levels of the persons with spinal cord injuries were highly correlated to muscle strength levels (p<0.05). Conclusions: This study investigated upper extremity musculoskeletal pain during rehabilitation of manual wheelchair users with spinal cord injuries and the relationship between physical features, strength, and function. In most persons with spinal cord injuries, pain and frequency of shoulder joints were high and pain levels were also related to functional levels.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.1
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• pp.25-34
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• 2021

Objectives This review was conducted to evaluate the effectiveness and clinical significance of Chuna manual therapy (CMT) in the treatment of pediatric cough. Methods Ten electronic databases (PubMed, EMBASE, Cochrane, CNKI [CAJ], KMBASE, KISS, KISTI, NDSL, RISS, and Oasis) were searched. Only randomized controlled trials (RCTs) using CMT for pediatric cough treatment were included. The methodological quality of each RCT was evaluated using the Cochrane risk-of-bias tool (v1.0). Results Nine RCTs met the inclusion criteria. The meta-analysis revealed positive effects of CMT in the treatment of pediatric cough. Both CMT alone and CMT combined with Chinese medication or Chinese medicine acupoint application (CMAA) were effective in treating pediatric cough. Conclusions This systematic review shows the reliability, effectiveness, and clinical significance of CMT in the treatment of pediatric cough. However, the evidence is limited due to the defective design of the included RCTs. More well-designed RCTs are required to provide clearer evidence for this claim.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.1
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• pp.43-52
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• 2021

Objectives The purpose of this study was to investigate the effectiveness of Chuna manual therapy (CMT) in the treatment of simple obesity. Methods We used seven databases to perform a literature search using the keywords "Chuna OR Tuina" AND "Obesity." We selected randomized clinical trials in which Chuna was used as the main method for treating simple obesity. The risk of bias was assessed by three independent researchers using the Cochrane risk of bias. Results A total of 14 RCTs were selected and analyzed. The results of the meta-analysis showed a significantly higher efficacy rate in the patient group treated with CMT as the main treatment than that in the control group. Conclusions The results of this systematic review suggest that CMT is effective in the treatment of simple obesity. However, given the limitations such as the small number of studies and the high risk of bias in the studies, additional research is needed to lend further support to this claim.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.9-19
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• 2021

Objectives This systematic review aimed to provide evidence for the effectiveness and safety of Chuna manual therapy (CMT) for carpal tunnel syndrome (CTS). Methods We searched 12 electronic databases (PubMed, Ovid-MEDLINE, EMBASE, The Cochrane Library, CNKI, CiNii, ScienceON, KMbase, KISS, OASIS, KMTANK, and RISS) up to the end of October 2021. We only included randomized controlled trials (RCTs) investigating CMT for the treatment of CTS. The methodological quality of the included RCTs was evaluated using the Cochrane Risk of Bias Tool 1.0. Results Six RCTs were eligible for inclusion in our study. A meta-analysis of four studies demonstrated positive results for the use of CMT when used in conjunction with Korean medicine treatment compared to those for Western conservative treatment for CTS. Conjunction treatment significantly improved the total efficacy rate compared to conservative treatment alone (P=0.0007, n=4). Conclusions There is reliable evidence for the use of CMT in treating CTS based on a published meta-analysis. To measure only the effect of Chuna, an experimental group should be designed with Chuna alone to evaluate its effectiveness. However, it should be noted that the studies included in this systematic review were heterogeneous and of low quality, thus warranting further investigation using well-designed RCTs.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2013.05a
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• pp.1181-1182
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• 2013