Search results for: extrapyramidal side effects/disorder

Authors: Kazuyoshi Mori

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Examples of parameterization of stabilizing controllers that require only one of right-/left-coprime factorizations are presented. One parameterization method requires one side coprime factorization. The other requires no coprime factorization. The methods are based on the factorization approach so that a number of models can be applied the method we use in this paper.

Keywords: parametrization, coprime factorization, factorization approach, linear systems

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Authors: Barış Ozluoymak, Emin Guzel, Ahmet İnce

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Since chemical fertilizers are used for meeting the deficiency of plant nutrients, its many harmful effects are not taken into consideration for the structure of the earth. These fertilizers are hampering the work of the organisms in the soil immediately after thrown to the ground. This interference is first started with a change of the soil pH and micro organismic balance is disrupted by reaction in the soil. Since there can be no fragmentation of plant residues, organic matter in the soil will be increasingly impoverished in the absence of micro organismic living. Biological activity reduction brings about a deterioration of the soil structure. If the chemical fertilization continues intensively, soils will get worse every year; plant growth will slow down and stop due to the intensity of chemical fertilizers, yield decline will be experienced and farmer will not receive an adequate return on his investment. In this research, a prototype of automatic farm manure spreading machine for orange orchards that not just manufactured in Turkey was designed, constructed, tested and eliminate the human drudgery involved in spreading of farm manure in the field. The machine comprised several components as a 5 m3 volume hopper, automatic controlled hydraulically driven chain conveyor device and side delivery conveyor belts. To spread the solid farm manure automatically, the machine was equipped with an electronic control system. The hopper and side delivery conveyor designs fitted between orange orchard tree row spacing. Test results showed that the control system has significant effects on reduction in the amount of unnecessary solid farm manure use and avoiding inefficient manual labor.

Keywords: automatic control system, conveyor belt application, orchard, solid farm manure

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Authors: Mohamed Almagsoudi

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The aim of this paper is to deal with two issues. One of them is about the theoretical side of codification, and the other is related to the practical side. At first, I have tried to criticize the debate running about codification of Islamic and Saudi Law, through observing and analyzing views of opponents and advocates. I tried to prove a hypothesis that both parties could not completely succeed in reviewing the theoretical base of this topic where discussion would not deal with irrelevant matters. It is a crucial shortcoming that made advocates unable to answer the critical questions addressed by those opponents.

Keywords: Codification, Saudi Law, Islamic law, Sharia

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Erin McKellar, Narelle Yeo

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Gender disparity can be found in the representation of the female characters in Leonard Bernstein’s musical West Side Story. As a postmodern composer, Bernstein was open about his social activism, yet did not consider his compositional portrayal of female characters as part of that activism. Using discretization as an analysis tool, this thesis explores the melodic contours of male and female songs in West Side Story to show differences in complexity between male and female characterisation. The analysis explores the intervallic relationship between the vocal line and melodic color in relation to the accompaniment harmony, taking into consideration the use of consonance and dissonance. West Side Story is commonly known for its distinct use of the tritone motif and its inherent dissonance. It is evident when reviewing the findings of this study that there is a distinct disparity between male-led and female-led music. The male-led numbers consistently adhere to a dissonant aesthetic with the tritone motif implemented in all of the extracted songs. By contrast, the female songs remain consonant with simple intervallic movements. By examining the results of this study through the lens of Equality Feminism, this thesis finds that Bernstein has simplified the characterisations of the female leads. The thesis further proposes that without cognisant consideration of the compositional portrayal of women, the musical theatre will continue to reinforce gender stereotypes, as evident through this study of Bernstein’s West Side Story.

Keywords: music theatre, gender bias, composition, Leonard Bernstein

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Authors: S. Alina Wang

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A Gibsonian approach is used to understand the existential dimensions of the human ecological niche. Then, this existential-Gibsonian framework is applied to rethinking Hacking’s historical analysis of multiple personality disorder. This research culminates in a generalized account of psychiatric illness from an enactivist lens. In conclusion, reflections on the implications of this account on approaches to psychiatric treatment are mentioned. J.J. Gibson’s theory of affordances centered on affordances of sensorimotor varieties, which guide basic behaviors relative to organisms’ vital needs and physiological capacities (1979). Later theorists, notably Neisser (1988) and Rietveld (2014), expanded on the theory of affordances to account for uniquely human activities relative to the emotional, intersubjective, cultural, and narrative aspects of the human ecological niche. This research shows that these affordances are structured by what Haugeland (1998) calls existential commitments, which draws on Heidegger’s notion of dasein (1927) and Merleau-Ponty’s account of existential freedom (1945). These commitments organize the existential affordances that fill an individual’s environment and guide their thoughts, emotions, and behaviors. This system of a priori existential commitments and a posteriori affordances is called existential enactivism. For humans, affordances do not only elicit motor responses and appear as objects with instrumental significance. Affordances also, and possibly primarily, determine so-called affective and cognitive activities and structure the wide range of kinds (e.g., instrumental, aesthetic, ethical) of significances of objects found in the world. Then existential enactivism is applied to understanding the psychiatric phenomenon of multiple personality disorder (precursor of the current diagnosis of dissociative identity disorder). A reinterpretation of Hacking’s (1998) insights into the history of this particular disorder and his generalizations on the constructed nature of most psychiatric illness is taken on. Enactivist approaches sensitive to existential phenomenology can provide a deeper understanding of these matters. Conceptualizing psychiatric illness as strictly a disorder in the head (whether parsed as a disorder of brain chemicals or meaning-making capacities encoded in psychological modules) is incomplete. Rather, psychiatric illness must also be understood as a disorder in the world, or in the interconnected networks of existential affordances that regulate one’s emotional, intersubjective, and narrative capacities. All of this suggests that an adequate account of psychiatric illness must involve (1) the affordances that are the sources of existential hindrance, (2) the existential commitments structuring these affordances, and (3) the conditions of these existential commitments. Approaches to treatment of psychiatric illness would be more effective by centering on the interruption of normalized behaviors corresponding to affordances targeted as sources of hindrance, the development of new existential commitments, and the practice of new behaviors that erect affordances relative to these reformed commitments.

Keywords: affordance, enaction, phenomenology, psychiatry, psychopathology

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Authors: Marios Loucas, Rafael Loucas, Oliver Muensterer

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Aim of the Study: Over the last two years, there has been a substantial rise of refugees entering Germany, of which approximately one-third are underage. Little is known about the general state of health such as nutrition, dental status and post-traumatic stress disorder among underage refugees. Our study assesses the general health status of underage refugees based on a large sample cohort. Methods: After ethics board approval, we used a structured questionnaire to collect demographic information and health-related elements in 3 large refugee accommodation centers, focusing on nutritional and dental status, as well as symptoms of posttraumatic stress disorder. Main results: A total of 461 minor refugees were included. The majority were boys (54.5%), average age was 8 years. Out of the 8 recorded countries of origin, most children came from Syria (33.6%), followed by Afghanistan (23.2%). Of the participants, 50.3% reported DSM-5 criteria of Posttraumatic stress disorder and presented mental health-related problems. The most frequently reported mental abnormalities were concentration disturbances (15.2%), sleep disorders (6.9%), unclear headaches (5.4%). The majority of the participants showed an unfavorable nutritional and dental status. According to the family, the majority of the children rarely eat healthy foods such as fruits, vegetables and fish. However, the majority of these children (over 90%) consume a large quantity of sugary foods and sweetened drinks such as soft drinks and confectionery at least daily. Caries was found in 63% of the minor children included in the study. A large proportion (47%) reported never brushing their teeth. According to the family, 78.3% of refugee children have never been evaluated by a dentist in Germany. The remainder visited a dentist mainly because of unbearable toothache. Conclusions: Minor refugees have specific psychological, nutritional and dental problems that must be considered in order to ensure appropriate medical care. Posttraumatic stress disorder is mainly caused by physical and emotional trauma suffered either during the flight or in the refugee camp in Germany. These data call for widespread screening of psychological, dental and nutritional problems in underage refugees. Dental care of this cohort is completely inadequate. Nutritional programs should focus on educating the families and providing the means to obtain healthy foods for these children.

Keywords: children, nutrition, posttraumatic stress disorder, refugee

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Authors: André Furtado, Rafael Mineiro, Isabel Gonçalves, Cecília Santos, Telma Quintela

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The development of therapies for central nervous system (CNS) disorders is one of the biggest challenges of current pharmacology, given the unique features of brain barriers, which limit drug delivery. Efflux transporters (ABC transporters) expressed at the blood-cerebrospinal fluid barrier (BCSFB), are the main obstacles for the delivery of therapeutic compounds into the CNS, compromising the effective treatment of brain cancer, brain metastasis from peripheral cancers, or even neurodegenerative disorders. It is thus extremely important to understand the regulation of these transporters for reducing their expression while treating a brain disorder or choosing the most appropriate conditions for drug administration. Based on the fact that the BCSFB have fine-tuned biological rhythms, studying the circadian variation of drug transport processes is critical for choosing the most appropriate time of the day for drug administration. In our study, using an in vitro model of the BCSFB, we characterized the circadian transport profile of methotrexate (MTX) and donepezil (DNPZ), two drugs involved in the treatment of cancer and Alzheimer’s Disease symptoms, respectively. We found that MTX is transported across the basal and apical membranes of the BCSFB in a circadian way. The circadian pattern of an ABC transporter, Abcc4, might be partially responsible for MTX circadian transport. Furthermore, regarding the DNPZ transport study, we observed that the regulation of Abcg2 expression by the circadian rhythm will impact the circadian-dependent transport of DNPZ across the BCSFB. Overall, our results will contribute to the current knowledge on brain pharmacoresistance at the BCSFB by disclosing how circadian rhythms control drug delivery to the brain, setting the grounds for a potential application of chronotherapy to brain diseases to enhance the efficacy of medications and minimize their side effects.

Keywords: blood-cerebrospinal fluid barrier, ABC transporters, drug transport, chronotherapy

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Authors: Shruti Govindarajan

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In-utero gene editing with CRISPR-Cas9 opens up new possibilities for treating genetic disorders during pregnancy while still in mother’s womb. By targeting genetic mutations in the early stages of fetal development, this approach could potentially prevent severe conditions—like cystic fibrosis, sickle cell anemia, and muscular dystrophy—from causing harm. CRISPR-Cas9, which allows precise DNA edits, could be delivered into fetal cells through vectors such as adeno-associated viruses (AAVs) or nanoparticles, correcting disease-causing mutations and possibly offering lifelong relief from these disorders. For families facing severe genetic diagnoses, in-utero gene editing could provide a transformative option. However, technical challenges remain, including ensuring that gene editing only targets the intended cells and verifying long-term safety. Ethical considerations are also at the forefront of this technology. The editing of a fetus's genes brings up difficult questions about consent, especially since these genetic changes will affect the child’s entire life without their input. There's also concern over possible unintended side effects, or changes passed down to future generations. Moreover, if used beyond therapeutic purposes, this technology could be misused for ‘enhancements,’ like selecting for certain physical or cognitive traits, raising concerns about inequality and social pressures. In this way, in-utero gene editing brings both exciting potential and complex moral questions. As research progresses, addressing these scientific and ethical concerns will be key to ensuring that this technology is used responsibly, prioritizing safety, fairness, and a focus on alleviating genetic disease. A cautious and inclusive approach, along with clear regulations, will be essential to realizing the benefits of in-utero gene editing while protecting against unintended consequences.

Keywords: in-utero gene editing, CRISPR, bioethics, genetic disorder

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Authors: Han-Jeong Hwang, Jae-Hyun Jo, Fatemeh Alimardani

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An accurate diagnosis of psychiatric diseases is a challenging issue, in particular when distinct symptoms for different diseases are overlapped, such as delusions appeared in bipolar mood disorder (BMD) and schizophrenia (SCH). In the present study, we propose a useful way to discriminate BMD and SCH using electroencephalography (EEG). A total of thirty BMD and SCH patients (15 vs. 15) took part in our experiment. EEG signals were measured with nineteen electrodes attached on the scalp using the international 10-20 system, while they were exposed to a visual stimulus flickering at 16 Hz for 95 s. The flickering visual stimulus induces a certain brain signal, known as steady-state visual evoked potential (SSVEP), which is differently observed in patients with BMD and SCH, respectively, in terms of SSVEP amplitude because they process the same visual information in own unique way. For classifying BDM and SCH patients, machine learning technique was employed in which leave-one-out-cross validation was performed. The SSVEPs induced at the fundamental (16 Hz) and second harmonic (32 Hz) stimulation frequencies were extracted using fast Fourier transformation (FFT), and they were used as features. The most discriminative feature was selected using the Fisher score, and support vector machine (SVM) was used as a classifier. From the analysis, we could obtain a classification accuracy of 83.33 %, showing the feasibility of discriminating patients with BMD and SCH using EEG. We expect that our approach can be utilized for psychiatrists to more accurately diagnose the psychiatric disorders, BMD and SCH.

Keywords: bipolar mood disorder, electroencephalography, schizophrenia, machine learning

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Authors: Yuji Fujino, Kazu Amimoto, Kazuhiro Fukata, Masahide Inoue, Hidetoshi Takahashi, Shigeru Makita

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Aim: Pusher behavior (PB) is a disorder in which stroke patients shift their body weight toward the affected side of the body (the hemiparetic side) and push away from the non-hemiparetic side. These patients often use further pushing to resist any attempts to correct their position to upright. It is known that the subcortical white matter lesion (SWML) usually correlates of gait or balance function in stroke patients. However, it is unclear whether the SWML influences PB. The purpose of this study was to investigate if the damage of SWML affects the severity of PB on acute stroke patients. Methods: Fourteen PB patients without thalamic or cortical lesions (mean age 73.4 years, 17.5 days from onset) participated in this study. Evaluation of PB was performed according to the Scale for Contraversive Pushing (SCP) for sitting and/or standing. We used modified criteria wherein the SCP subscale scores in each section of the scale were >0. As a clinical measurement, patients were evaluated by the Stroke Impairment Assessment Set (SIAS). For the depiction of SWML, we used T2-weighted fluid-attenuated inversion-recovery imaging. The degree of damage on SWML was assessed using the Fazekas scale. Patients were divided into two groups in the presence of SWML (SWML+ group; Fazekas scale grade 1-3, SWML- group; Fazekas scale grade 0). The independent t-test was used to compare the SCP and SIAS. This retrospective study was approved by the Ethics Committee. Results: In SWML+ group, the SCP was 3.7±1.0 points (mean±SD), the SIAS was 28.0 points (median). In SWML- group, the SCP was 2.0±0.2 points, and the SIAS was 31.5 points. The SCP was significantly higher in SWML+ group than in SWML- group (p<0.05). The SIAS was not significant in both groups (p>0.05). Discussion: It has been considered that the posterior thalamus is the neural structures that process the afferent sensory signals mediating graviceptive information about upright body orientation in humans. Therefore, many studies reported that PB was typically associated with unilateral lesions of the posterior thalamus. However, the result indicates that these extra-thalamic brain areas also contribute to the network controlling upright body posture. Therefore, SMWL might induce dysfunction through malperfusion in distant thalamic or other structurally intact neural structures. This study had a small sample size. Therefore, future studies should be performed with a large number of PB patients. Conclusion: The present study suggests that SWML can be definitely associated with PB. The patients with SWML may be severely incapacitating.

Keywords: pushing behavior, subcortical white matter lesion, acute phase, stroke

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Authors: Mathew Tran, Deepa Patel, Breann Prophete, Irandokht Khaki Najafabadi

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Status epilepticus is a neurological disorder requiring emergent control with medical therapy. Based on guideline recommendations for adults with status epilepticus, the first-line treatment is to start a benzodiazepine, as they are quick at seizure control. The second step is to initiate a non-benzodiazepine anti-epileptic drug to prevent refractory seizures. Studies show that the anti-epileptic drugs are approximately equivalent in status epilepticus control once a benzodiazepine has been given. This review provides a brief overview of the management of status epilepticus based on evidence from the literature and evidence-based guidelines.

Keywords: neurological disorder, seizure, status epilepticus, benzo diazepines, antiepileptic agents

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Authors: Claire P. Griffin

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The education provision for students with special educational needs, including students with Autism Spectrum Disorder (ASD), has undergone significant national and international changes in recent years. In particular, an increase in resource-based provision has occurred across educational settings in an effort to support inclusive practices. This paper seeks to explore the role of the Special Needs Assistant (SNA) in supporting children with ASD in Irish schools. This research stems from the second national evaluation of ‘Education Provision for Students with Autism Spectrum Disorder in Ireland’ (NCSE, 2016). This research was commissioned by the National Council for Special Education (NCSE) in Ireland and conducted by a team of researchers from Mary Immaculate College, Limerick from February to July 2014. This study involved a multiple case study research strategy across 24 educational sites, as selected through a stratified sampling process. Research strategies included semi-structured interviews, classroom observations, documentary review and child conversations. Data analysis was conducted electronically using Nvivo software, with use of an additional quantitative recording mechanism based on scaled weighting criteria for collected data. Based on such information, key findings from the NCSE national evaluation will be presented and critically reviewed, with particular reference to the role of the SNA in supporting pupils with ASD. Examples of positive practice inherent within the SNA role will be outlined and contrasted with discrete areas for development. Based on such findings, recommendations for the evolving role of the SNA will be presented, with the aim of informing both policy and best practice within the field.

Keywords: autism spectrum disorder, inclusive education , paraprofessional, special needs assistant

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Authors: J. Y Jang, C. Y. Tseng

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A three-dimensional numerical model of thermoelectric generator (TEG) modules attached to a large chimney plate is proposed and solved numerically using a control volume based finite difference formulation. The TEG module consists of a thermoelectric generator, an elliptical pin-fin heat sink, and a cold plate for water cooling. In the chimney, the temperature of flue gases is 450-650K. Therefore, the effects of convection and radiation heat transfer are considered. Although the TEG hot-side temperature and thus the electric power output can be increased by inserting an elliptical pin-fin heat sink into the chimney tunnel to increase the heat transfer area, the pin fin heat sink would cause extra pumping power at the same time. The main purpose of this study is to analyze the effects of geometrical parameters on the electric power output and chimney pressure drop characteristics. In addition, the effects of different operating conditions, including various inlet velocities (Vin = 1, 3, 5 m/s) and inlet temperatures (Tgas = 450, 550, 650K) are discussed in detail. The predicted numerical data for the power vs. current (P-I) curve are in good agreement (within 11%) with the experimental data.

Keywords: thermoelectric generator, waste heat recovery, pin-fin heat sink, experimental and numerical analysis

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Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

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Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa

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Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.

Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation

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Authors: Jaimala Ghambir, Tilak Thakur, Puneet Chawla

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As per the statistical data, the Doubly-fed Induction Generator (DFIG) based wind turbine with variable speed and variable pitch control is the most common wind turbine in the growing wind market. This machine is usually used on the grid connected wind energy conversion system to satisfy grid code requirements such as grid stability, fault ride through (FRT), power quality improvement, grid synchronization and power control etc. Though the requirements are not fulfilled directly by the machine, the control strategy is used in both the stator as well as rotor side along with power electronic converters to fulfil the requirements stated above. To satisfy the grid code requirements of wind turbine, usually grid side converter is playing a major role. So in order to improve the operation capacity of wind turbine under critical situation, the intensive study of both machine side converter control and grid side converter control is necessary In this paper DFIG is modeled using power components as variables and the performance of the DFIG system is analysed under grid voltage fluctuations. The voltage fluctuations are made by lowering and raising the voltage values in the utility grid intentionally for the purpose of simulation keeping in view of different grid disturbances.

Keywords: DFIG, dynamic modeling, DPC, sag, swell, voltage fluctuations, FRT

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Authors: J. O. Alvarez, L. Y. Rivera

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Physical activity can reduce symptomatology in children with autism spectrum disorder (ASD). The sport of soccer has been widely applied as a therapeutic method for ASD children. However, empirical results from soccer programs are not widely known. This paper presents the case study of Golitos, the only dedicated soccer program for children on the island of Puerto Rico, and analyzes its results in the reduction of ASD social and emotional symptoms. The paper shows evidence that suggests that program approach, content, and community-based elements can make a notable difference in the effectiveness of using soccer or sports as therapeutic methods for children with ASD.

Keywords: autism, soccer, program, community

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Authors: Shahriar Shahbazpanahi, Mohammad Hemen Jannaty, Alaleh Kamgar

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Shear strengthening can be carried out in concrete structures by external fibre reinforced polymer (FRP). In the present investigation, a new fracture mechanics model is developed to model side face of strengthened concrete beam by external FRP. Discrete crack is simulated by a spring element with softening behavior ahead of the crack tip to model the cohesive zone in concrete. A truss element is used, parallel to the spring element, to simulate the energy dissipation rate by the FRP. The strain energy release rate is calculated directly by using a virtual crack closure technique and then, the crack propagation criterion is presented. The results are found acceptable when compared to previous experimental results and ABAQUS software data. It is observed that the length of the fracture process zone (FPZ) increases with the application of FRP in side face at the same load in comparison with that of the control beam.

Keywords: FPZ, fracture, FRP, shear

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Authors: Shima Hashemi, Firoozeh Ghazanfari

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Introduction: Eating disorder is a psychiatric disorder that is increasingly growing. This study aimed to determine the relationship between eating disorders (anorexia and bulimia nervosa) with some of the demographic factors among Lorestan University of Medical Sciences students. Materials and Methods: This study is a cross-sectional and descriptive study that was done at Lorestan University of Medical Sciences in 2019. Four hundred fifty students were studied by stratified and cluster sampling methods. For gathering data, we use the standard questionnaire Eating Attitudes Test EAT (26). Data were analyzed using statistical software SPSS. Results: According to the results, 144 (32%) males and 305 (67.8%) females were studied. 88.7% were single, and 8.9% were married. In the anorexia nervosa group, the results showed that there was a significant meaning between demographic information, and the number of family members, marital status, BMI, level of education, family income, father and mother education, as well as in the bulimia nervosa group, there was no significant meaning with any demographic information (p>0.05). Conclusion: Anorexia and bulimia nervosa are two known types of eating disorders, and some demographic factors can be effective in causing or aggravating these disorders.

Keywords: eating disorder, anorexia nervosa, bulimia nervosa, students

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Authors: Stephanie Newman

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Niemann-Pick Type C disease is a rare, usually fatal lysosomal storage disorder. Although clinically characterized by progressive neurodegeneration, there is also evidence of altered innate immune responses such as neuroinflammation that promote disease progression. We have initiated an investigation into whether phagocytosis, an important innate immune activity and the process by which particles are ingested is defective in NPC. Using an in vitro assay, we have shown that NPC macrophages have a deficiency in the phagocytosis of different particles. We plan to investigate the mechanistic basis for impaired phagocytosis, the contribution that this deficiency makes to disease pathology, and whether therapies that have shown in vivo benefit are able to restore phagocytic activity.

Keywords: Niemann Pick Disease C, phagocytosis, innate immunity, lysosomal storage disorder

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Authors: Parvin Farzanegi

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Background: Diabetes is a metabolic disorder associated with increased free radicals and oxidative stress. The evidence indicates that physical inactivity is a modifiable behavioral risk factor for a wide range of chronic disorders such as diabetes mellitus. We investigated the effects of eight-week aerobic exercise on some antioxidant enzyme activities in postmenopausal women with type 2 diabetes mellitus (T2DM). Methods: sixteen sedentary postmenopausal women with T2DM were randomly assigned to the control (n=8; CG) and exercise group (n=8; EG). The exercise consisted of progressive aerobic training at a moderate intensity (50-70% of the maximum heart rate), for 25-60 min/day, and 3 days/week for 8 weeks. Age, sex, and body mass index were similar in the two groups. Antioxidant status was evaluated by measuring the superoxide dismutase (SOD) and catalase (CAT) activity. Also levels of malondialdehyde (MDA) as an index of lipid peroxidation and glucose in the plasma were measured before and after the intervention. Results: Following the 8 weeks of exercise training, the plasma MDA and glucose levels were significantly reduced in EG compared to CG (P=0.001 and P=0.011 respectively). However, SOD (P=0.017) and CAT (P=0.011) activities were increased in EG compared to CG. Conclusion: The present study suggests regular aerobic exercise appears can exert protective effects against oxidative stress due to its ability to increase antioxidant defense and glucose control in postmenopausal women with T2DM.

Keywords: aerobic exercise, antioxidant, diabetes mellitus, type 2

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Authors: P. Srisuruk, P. Narot

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The purpose of this research were 1) to develop the curriculum and instructional approach that are suitable for children with autism, attention deficit hyperactivity disorder and learning disability as well as to arrange the instructional approach that can be integrated into inclusive classroom 2) to increase the competency of the children in these group. The research processes were to a) study related documents, b) arrange workshops to clarify fundamental issues in developing core curriculum among the researchers and experts in curriculum development, c) arrange workshops to develop the curriculum, submit it to the experts for criticism and editing, d) implement the instructional approach to examine its effectiveness, e) select the schools to participate in the project and arrange training programs for teachers in the selected school, f) implement the instruction approach in the selected schools in different regions. The research results were 1) the core curriculum to enhance the competency of children with autism, attention deficit hyperactivity disorder and learning disability , and to be used as a guideline for teachers, and these group of children in order to arrange classrooms for students with special needs to study with normal students, 2) teaching and learning methods arranged for students with autism, attention deficit, hyperactivity disorder and learning disability to study with normal students can be used as a framework for writing plans to help students with parallel problems by developing teaching materials as part of the instructional approach. However, the details of how to help the students in each skill or content differ according to the demand of development as well as the problems of individual students or group of students. Furthermore; it was found that most of target teacher could implement the instructional approach based on the guideline model developed by the research team. School in each region does not have much difference in their implementation. The good point of the developed instructional model is that teacher can construct a parallel lesson plan. So teacher did not fell that they have to do extra work it was also shown that students in regular classroom enjoyed studying with the developed instructional model as well.

Keywords: instructional approach, autism, attention deficit hyperactivity disorder, learning disability

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Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

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Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

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Authors: Luo Lan, Huang Jingjing, Li Huafang

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Hypoactive sexual desire disorder (HSDD) was common in China, and Chinese women's sexual health-seeking behaviors were found to be mainly impeded by their psychological barriers. However, underlying mechanisms for such unhealthy sexual health attitudes and symptoms of HSDD were unknown. Many studies suggested the correlation between women's psychological barriers, HSDD and attachment style but had limitations, so this study further explored their relationship. Chinese women of childbearing age were recruited from May 2020 to December 2022 in Shanghai, China. The Revised Adult Attachment Scale (RAAS), the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO), a sexual health attitude questionnaire, and a psychiatric interview were administered. The analytic sample contained 279 women, of which 107 women were HSDD patients. Women with a fearful attachment style were found to be more likely to be unwilling to communicate sexual health (aOR 2.55, 95%CI 1.05-6.28) and feel ashamed of sexual health-related disorders (aOR 2.66, 95%CI 1.14-6.13). They are also linked with a higher risk of HSDD (aOR 3.25, 95%CI 1.35-8.12). Therefore, fearful attachment style should be given enough attention in the whole process of the diagnosis and treatment of HSDD and should be one of the focuses that guide sexual education.

Keywords: attachment style, hypoactive sexual desire disorder, attitude to health, sexual desire, sexual distress

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Authors: Masaki Yamaguchi, Daimei Sasayama, Shinsuke Washizuka

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The goal of this study was to examine the possibility of salivary cytokines for the screening of attention deficit hyperactivity disorder (ADHD) in children. We carried out a case-control study, including 19 children with ADHD and 17 healthy children (controls). A multiplex bead array immunoassay was used to conduct a multi-analysis of 27 different salivary cytokines. Six salivary cytokines (interleukin (IL)-1β, IL-8, IL12p70, granulocyte colony-stimulating factor (G-CSF), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF)) were significantly associated with the presence of ADHD (p < 0.05). An informative salivary cytokine panel was developed using VEGF by logistic regression analysis (odds ratio: 0.251). Receiver operating characteristic analysis revealed that assessment of a panel using VEGF showed “good” capability for discriminating between ADHD patients and controls (area under the curve: 0.778). ADHD has been hypothesized to be associated with reduced cerebral blood flow in the frontal cortex, due to reduced VEGF levels. Our study highlights the possibility of utilizing differential salivary cytokine levels for point-of-care testing (POCT) of biomarkers in children with ADHD.

Keywords: cytokine, saliva, attention deficit hyperactivity disorder, child

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Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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Authors: Joanna Estkowska

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Sensory integration methods are very useful and improve daily functioning autistic and mentally disabled children. Autism is a neurobiological disorder that impairs one's ability to communicate with and relate to others as well as their sensory system. Children with autism, even highly functioning kids, can find it difficult to process language with surrounding noise or smells. They are hypersensitive to things we can ignore such as sight, sounds and touch. Adolescents with highly functioning autism or Asperger Syndrome can study Science and Math but the social aspect is difficult for them. Nature science is an area of study that attracts many of these kids. It is a systematic field in which the children can focus on a small aspect. If you follow these rules you can come up with an expected result. Sensory integration program and systematic classroom observation are quantitative methods of measuring classroom functioning and behaviors from direct observations. These methods specify both the events and behaviors that are to be observed and how they are to be recorded. Our students with and without autism attended the lessons in the classroom of nature science in the school and in the laboratory of University of Science and Technology in Bydgoszcz. The aim of this study is investigation the effects of sensory integration methods in teaching to students with autism. They were observed during experimental lessons in the classroom and in the laboratory. Their physical characteristics, sensory dysfunction, and behavior in class were taken into consideration by comparing their similarities and differences. In the chemistry classroom, every autistic student is paired with a mentor from their school. In the laboratory, the children are expected to wear goggles, gloves and a lab coat. The chemistry classes in the laboratory were held for four hours with a lunch break, and according to the assistants, the children were engaged the whole time. In classroom of nature science, the students are encouraged to use the interactive exhibition of chemical, physical and mathematical models constructed by the author of this paper. Our students with and without autism attended the lessons in those laboratories. The teacher's goals are: to assist the child in inhibiting and modulating sensory information and support the child in processing a response to sensory stimulation.

Keywords: autism spectrum disorder, science education, sensory integration techniques, student with special educational needs

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Authors: Mariyam Arif, Ye Liu, Israr Ul Haq, Ahsan Ashfaq

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High cost of fossil fuels and intensifying installations of alternate energy generation sources are intimidating main challenges in power systems. Making accurate load forecasting an important and challenging task for optimal energy planning and management at both distribution and generation side. There are many techniques to forecast load but each technique comes with its own limitation and requires data to accurately predict the forecast load. Artificial Neural Network (ANN) is one such technique to efficiently forecast the load. Comparison between two different ranges of input datasets has been applied to dynamic ANN technique using MATLAB Neural Network Toolbox. It has been observed that selection of input data on training of a network has significant effects on forecasted results. Day-wise input data forecasted the load accurately as compared to year-wise input data. The forecasted load is then distributed among the six generators by using the linear programming to get the optimal point of generation. The algorithm is then verified by comparing the results of each generator with their respective generation limits.

Keywords: artificial neural networks, demand-side management, economic dispatch, linear programming, power generation dispatch

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Authors: M. S. Yalfani, J. Kohzadi, P. Ghadimi, S. Sobhani, M. Ghadimi

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The use of oil and water-soluble corrosion inhibitors has been established in Iranian oil and gas production systems for a long time. Imidazoline and its derivatives are being extensively used which are known as conventional corrosion inhibitors. This type of product has shown significant performance and low side effects, so that could monopolize the market of inhibitors in this region. However, the price growth of imidazolines, as well as the development of new lower-cost components with similar or even higher performance than imidazoline, have influenced the exclusive market of imidazoline-based products. During the latest years, pyridine and its derivatives have challenged imidazoline due to their remarkable anticorrosive properties and lower prices as well. Recently, we presented a formulated water-soluble inhibitor based on pyridine - an alkyl pyridine quaternary salt (APQS) - which could successfully pass all lab tests and eventually succeeded in being applied in an offshore sweet oil pipeline. The product was able to achieve high corrosion protection (> 90 %) with the LPR technique at low dosages of 15-25 ppm under severe corrosion conditions. Moreover, the lab test results showed that the APQS molecule is able to form a strong and persistent bond with the metal surface. The product was later nominated to be evaluated through a field trial in an offshore sweet oil pipeline where PH2S < 0.05 psi and CO2 is 6.4 mol%. The three-month trial - extended to six months- resulted in remarkable internal protection obtained by continuous injection of 10 ppm inhibitor, which was as low as 1 mpy measured by both weight loss corrosion coupons and online ER probes. In addition, no side effects, such as tight emulsion and stable foaming, were observed. The residual of the corrosion inhibitor was measured at the end of the pipeline to ensure the full coverage of the inhibitor throughout the pipeline. Eventually, these promising results were able to convince the end user to consider pyridine-based inhibitors as a reliable alternative to imidazoline.

Keywords: corrosion inhibitor, pyridine, sweet oil, pipeline, offshore

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