Search results for: non-pharmacological treatment methods
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 20782

Search results for: non-pharmacological treatment methods

16912 Identification of Crimean-Congo Hemorrhagic Fever Virus in Patients Referred to Ahvaz and Gilan Hospitals in Iran by real-time PCR Technique

Authors: Najmeh Jafari, Sona Rostampour Yasouri

Abstract:

Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

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16911 A Radiographic Superimposition in Orthognathic Surgery of Class III Skeletal Malocclusion

Authors: Albert Suryaprawira

Abstract:

Patients requiring correction of severe Class III skeletal discrepancy historically has been among the most challenging treatments for orthodontists. Correction of an aesthetic and functional problem is crucially important. This is a case report of an adult male aged 18 years who complained of difficulty in chewing and speaking. Patient has a prominent profile with mandibular excess. The pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. The panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, the pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, the post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition between those radiographs was performed to analyse the outcome. It includes the superimposition of the cranial base, maxilla, and mandible. Superimposition is important to describe the amount of hard and soft tissue movement. It is also important to predict the possibility of relapse after the surgery. The patient needs to understand all the surgical plan, outcome and relapse prevention. The surgery included mandibular set back by bilateral sagittal split osteotomies. Although the discrepancy was severe using this combination of treatment and the use of radiographic superimposition, an aesthetically pleasing and stable result was achieved.

Keywords: cephalometric, mandibular set back, orthognathic, superimposition

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16910 The Effect of Particulate Matter on Cardiomyocyte Apoptosis Through Mitochondrial Fission

Authors: Tsai-chun Lai, Szu-ju Fu, Tzu-lin Lee, Yuh-Lien Chen

Abstract:

There is much evidence that exposure to fine particulate matter (PM) from air pollution increases the risk of cardiovascular morbidity and mortality. According to previous reports, PM in the air enters the respiratory tract, contacts the alveoli, and enters the blood circulation, leading to the progression of cardiovascular disease. PM pollution may also lead to cardiometabolic disturbances, increasing the risk of cardiovascular disease. The effects of PM on cardiac function and mitochondrial damage are currently unknown. We used mice and rat cardiomyocytes (H9c2) as animal and in vitro cell models, respectively, to simulate an air pollution environment using PM. These results indicate that the apoptosis-related factor PUMA, a regulator of apoptosis upregulated by p53, is increased in mice treated with PM. Apoptosis was aggravated in cardiomyocytes treated with PM, as measured by TUNEL assay and Annexin V/PI. Western blot results showed that CASPASE3 was significantly increased and BCL2 (B-cell lymphoid 2) was significantly decreased under PM treatment. Concurrent exposure to PM increases mitochondrial reactive oxygen species (ROS) production by MitoSOX Red staining. Furthermore, using Mitotracker staining, PM treatment significantly shortened mitochondrial length, indicating mitochondrial fission. The expression of mitochondrial fission-related proteins p-DRP1 (phosphodynamics-related protein 1) and FIS1 (mitochondrial fission 1 protein) was significantly increased. Based on these results, the exposure to PM worsens mitochondrial function and leads to cardiomyocyte apoptosis.

Keywords: particulate matter, cardiomyocyte, apoptosis, mitochondria

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16909 A Method to Saturation Modeling of Synchronous Machines in d-q Axes

Authors: Mohamed Arbi Khlifi, Badr M. Alshammari

Abstract:

This paper discusses the general methods to saturation in the steady-state, two axis (d & q) frame models of synchronous machines. In particular, the important role of the magnetic coupling between the d-q axes (cross-magnetizing phenomenon), is demonstrated. For that purpose, distinct methods of saturation modeling of dumper synchronous machine with cross-saturation are identified, and detailed models synthesis in d-q axes. A number of models are given in the final developed form. The procedure and the novel models are verified by a critical application to prove the validity of the method and the equivalence between all developed models is reported. Advantages of some of the models over the existing ones and their applicability are discussed.

Keywords: cross-magnetizing, models synthesis, synchronous machine, saturated modeling, state-space vectors

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16908 Gene Prediction in DNA Sequences Using an Ensemble Algorithm Based on Goertzel Algorithm and Anti-Notch Filter

Authors: Hamidreza Saberkari, Mousa Shamsi, Hossein Ahmadi, Saeed Vaali, , MohammadHossein Sedaaghi

Abstract:

In the recent years, using signal processing tools for accurate identification of the protein coding regions has become a challenge in bioinformatics. Most of the genomic signal processing methods is based on the period-3 characteristics of the nucleoids in DNA strands and consequently, spectral analysis is applied to the numerical sequences of DNA to find the location of periodical components. In this paper, a novel ensemble algorithm for gene selection in DNA sequences has been presented which is based on the combination of Goertzel algorithm and anti-notch filter (ANF). The proposed algorithm has many advantages when compared to other conventional methods. Firstly, it leads to identify the coding protein regions more accurate due to using the Goertzel algorithm which is tuned at the desired frequency. Secondly, faster detection time is achieved. The proposed algorithm is applied on several genes, including genes available in databases BG570 and HMR195 and their results are compared to other methods based on the nucleotide level evaluation criteria. Implementation results show the excellent performance of the proposed algorithm in identifying protein coding regions, specifically in identification of small-scale gene areas.

Keywords: protein coding regions, period-3, anti-notch filter, Goertzel algorithm

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16907 Intervention Guide for Holistic Needs and Coping Strategies of Cancer Patients

Authors: Arvin Baes

Abstract:

This study was conducted to assess the holistic needs of cancer patients in terms of physiological, psychological, social, and spiritual needs and to determine how they respond through coping. It was conducted from January-April 2018 from various hospitals in Laguna, with 20 respondents. It utilized a survey descriptive type of research, a checklist type of questionnaire, and purposive sampling in selecting the respondents. It was found out that in terms of physiological needs, fatigue is the most common symptoms they experienced. In terms of psychological, social, and spiritual needs, most of the patients experienced a significant concern. Meanwhile, in coping, religion dominates among the 14 strategies followed by Use of Emotional Support and Positive Reframing, and Substance Use obtained the lowest response. Most of the respondents were female, and its significant relationship in terms of Positive Reframing agrees significantly. In coping and civil status, Positive Reframing and Humor are significant among married respondents. In coping and stage of cancer, 'Positive Reframing' and 'Humor' are significant with the stage of cancer. In coping and treatment modalities, Active Coping, Use of Emotional Support, and Religion are significantly related to patients’ treatment modalities. There is also a significant relationship between Active Coping and Physiological Needs, Religion and Psychological Needs, and Self-blaming and Psychological, Social, and Spiritual Needs. Thus, it is concluded that holistic needs and coping are essential to each other to meet the wholeness of cancer patients. A formulated care intervention program would be beneficial among this group of patients.

Keywords: coping strategies, cancer, cancer patients, holistic needs

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16906 Regulation on Macrophage and Insulin Resistance after Aerobic Exercise in High-Fat Diet Mice

Authors: Qiaofeng Guo

Abstract:

Aims: Obesity is often accompanied by insulin resistance (IR) and whole-body inflammation. Aerobic exercise is an effective treatment to improve insulin resistance and inflammation. However, the anti-inflammatory mechanisms of exercise on epididymal and subcutaneous adipose remain to be elucidated. Here, we compared the macrophage polarization between epididymal and subcutaneous adipose after aerobic exercise. Methods: Male C57BL/6 mice were fed a normal diet group or a high-fat diet group for 12 weeks and performed aerobic training on a treadmill at 55%~65% VO₂ max for eight weeks. Food intake, body weight, and fasting blood glucose levels were monitored weekly. The intraperitoneal glucose tolerance test was to evaluate the insulin resistance model. Fat mass, blood lipid profile, serum IL-1β, TNF-α levels, and CD31/CD206 rates were analysed after the intervention. Results: FBG (P<0.01), AUCIPGTT (P<0.01), and HOMA-IR (P<0.01) increased significantly for a high-fat diet and decreased significantly after the exercise. Eight weeks of aerobic exercise attenuated HFD-induced weight gain and glucose intolerance and improved insulin sensitivity. Serum IL-1β, TNF-α, CD11C/CD206 expression in subcutaneous adipose tissue were not changed before and after exercise, but not in epididymal adipose tissue (P<0.01). Conclusion: Insulin resistance is not accompanied by chronic inflammation and M1 polarization of subcutaneous adipose tissue macrophages in high-fat diet mice. Aerobic exercise effectively improved lipid metabolism and insulin sensitivity, which may be closely associated with reduced M1 polarization of epididymal adipose macrophages.

Keywords: aerobic exercise, insulin resistance, chronic inflammation, adipose, macrophage polarization

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16905 An Ethnobotanical Survey of Medicinal Plants for the Treatment of Infantile Diarrhea in the Eastern Cape Province of South Africa

Authors: Anela Lupuwana

Abstract:

The main objective of this paper is to develop an ethnobotanical survey that documents medicinal plants used to treat diarrhea among infants in the Eastern Cape province of South Africa. In South Africa’s pluralistic healthcare system, medicinal plants are an integral part of healing and treating an array of diseases. This is also the case in rural areas of South Africa, where healthcare facilities are hard to access. There is a lack of literature on the use of medicinal plants to cure ailments common to children, and this paper fills this gap. A total of 18 participants were interviewed using semi-structured interviews. A purposive approach was used to sample the study cohorts. A total of 28 medicinal plants representing 19 different families were recorded, with the family Asteraceae (11%) having the most medicinal plants. The remaining plants (82%) were distributed equally among the following families: Rubiaceae, Canellaceae, Aloaceae, Rutaceae, Thymeleaceae, Myrinaceae, Olinaceae, Iradeceae, Zingiberaceae, Capparaceae, Aizoaceae, Fabaceae, Geraniaceae, Cornaceae, Monimiaceae, Talinaceae, Chrysobalanaceae, and Icacinaceae. Oral administration was the most common mode of administration, with 82% of plants taken orally. Healing was proven to be holistic; it was more than just treating physical ailments as such; infants were protected from evil spirits that made them vulnerable to illnesses. There was also evidence of the assimilation of Dutch medicine and animal products into traditional healing methods. In order to mitigate the prevalence of disease and illness in South Africa, I recommend that diversity in healing practices should be acknowledged and appreciated.

Keywords: infants, traditional healers, primary care givers, traditional medicine

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16904 Service Flow in Multilayer Networks: A Method for Evaluating the Layout of Urban Medical Resources

Authors: Guanglin Song

Abstract:

(Objective) Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. (Methods) A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city.(Conclusion) The findings reveal that:1.there exists overall maldistribution and over-concentration of healthcare resources in Study Area, characterized by structural imbalance; 2.the low rate of primary care utilization in Study Area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem; 3.gradual optimization of the healthcare facility layout in Study Area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance.(Prospects) This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. Provide some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: flow of public services, urban networks, healthcare facilities, spatial planning, urban networks

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16903 MANIFEST-2, a Global, Phase 3, Randomized, Double-Blind, Active-Control Study of Pelabresib (CPI-0610) and Ruxolitinib vs. Placebo and Ruxolitinib in JAK Inhibitor-Naïve Myelofibrosis Patients

Authors: Claire Harrison, Raajit K. Rampal, Vikas Gupta, Srdan Verstovsek, Moshe Talpaz, Jean-Jacques Kiladjian, Ruben Mesa, Andrew Kuykendall, Alessandro Vannucchi, Francesca Palandri, Sebastian Grosicki, Timothy Devos, Eric Jourdan, Marielle J. Wondergem, Haifa Kathrin Al-Ali, Veronika Buxhofer-Ausch, Alberto Alvarez-Larrán, Sanjay Akhani, Rafael Muñoz-Carerras, Yury Sheykin, Gozde Colak, Morgan Harris, John Mascarenhas

Abstract:

Myelofibrosis (MF) is characterized by bone marrow fibrosis, anemia, splenomegaly and constitutional symptoms. Progressive bone marrow fibrosis results from aberrant megakaryopoeisis and expression of proinflammatory cytokines, both of which are heavily influenced by bromodomain and extraterminal domain (BET)-mediated gene regulation and lead to myeloproliferation and cytopenias. Pelabresib (CPI-0610) is an oral small-molecule investigational inhibitor of BET protein bromodomains currently being developed for the treatment of patients with MF. It is designed to downregulate BET target genes and modify nuclear factor kappa B (NF-κB) signaling. MANIFEST-2 was initiated based on data from Arm 3 of the ongoing Phase 2 MANIFEST study (NCT02158858), which is evaluating the combination of pelabresib and ruxolitinib in Janus kinase inhibitor (JAKi) treatment-naïve patients with MF. Primary endpoint analyses showed splenic and symptom responses in 68% and 56% of 84 enrolled patients, respectively. MANIFEST-2 (NCT04603495) is a global, Phase 3, randomized, double-blind, active-control study of pelabresib and ruxolitinib versus placebo and ruxolitinib in JAKi treatment-naïve patients with primary MF, post-polycythemia vera MF or post-essential thrombocythemia MF. The aim of this study is to evaluate the efficacy and safety of pelabresib in combination with ruxolitinib. Here we report updates from a recent protocol amendment. The MANIFEST-2 study schema is shown in Figure 1. Key eligibility criteria include a Dynamic International Prognostic Scoring System (DIPSS) score of Intermediate-1 or higher, platelet count ≥100 × 10^9/L, spleen volume ≥450 cc by computerized tomography or magnetic resonance imaging, ≥2 symptoms with an average score ≥3 or a Total Symptom Score (TSS) of ≥10 using the Myelofibrosis Symptom Assessment Form v4.0, peripheral blast count <5% and Eastern Cooperative Oncology Group performance status ≤2. Patient randomization will be stratified by DIPSS risk category (Intermediate-1 vs Intermediate-2 vs High), platelet count (>200 × 10^9/L vs 100–200 × 10^9/L) and spleen volume (≥1800 cm^3 vs <1800 cm^3). Double-blind treatment (pelabresib or matching placebo) will be administered once daily for 14 consecutive days, followed by a 7 day break, which is considered one cycle of treatment. Ruxolitinib will be administered twice daily for all 21 days of the cycle. The primary endpoint is SVR35 response (≥35% reduction in spleen volume from baseline) at Week 24, and the key secondary endpoint is TSS50 response (≥50% reduction in TSS from baseline) at Week 24. Other secondary endpoints include safety, pharmacokinetics, changes in bone marrow fibrosis, duration of SVR35 response, duration of TSS50 response, progression-free survival, overall survival, conversion from transfusion dependence to independence and rate of red blood cell transfusion for the first 24 weeks. Study recruitment is ongoing; 400 patients (200 per arm) from North America, Europe, Asia and Australia will be enrolled. The study opened for enrollment in November 2020. MANIFEST-2 was initiated based on data from the ongoing Phase 2 MANIFEST study with the aim of assessing the efficacy and safety of pelabresib and ruxolitinib in JAKi treatment-naïve patients with MF. MANIFEST-2 is currently open for enrollment.

Keywords: CPI-0610, JAKi treatment-naïve, MANIFEST-2, myelofibrosis, pelabresib

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16902 Improvement of Total Phenolic Contents and Anti-oxidative Properties of Ricegrass (Oryza sativa L.) using Selenium Bio-fortification

Authors: Rattanamanee Chomchan, Sunisa Siripongvutikorn, Panupong Puttarak

Abstract:

Ricegrass or young rice sprouts can be introduced as one of functional product since cereal sprouts have been much interested in this era due to their high nutritive values. Bio-fortification of selenium is one strategy to improve plant bioactive compounds. However, the level of selenium used are varied among species of plants, hence, the proper level need to be investigated. In this current study, influence of selenium bio-fortification hydroponically in the form of sodium selenite following the range 0, 10, 20, 30 and 40 mg Se/L on growth characteristics, selenium content, total extractable phenolic content (TPC) accumulation, lipid peroxidation and anti-oxidative properties of ricegrass were investigated. Results revealed that selenium bio-fortified exogenously increased the accumulation of selenium in ricegrass by 5.3 fold at 40 mg Se/L treatment without significant changes in leaves biomass at harvesting day while root part weight were slightly decreased when increased selenium level, respectively. Selenium at low concentration (10 and 20 mg Se/L) can stimulate the production of phenolic compounds and antioxidant activities in young ricegrass as measured by DPPH, ABTS and FRAP assay. Conversely, higher level of selenium fortification reduced the accumulation of phenolics in ricegrass afterward by acting as pro-oxidant. Moreover, highest significant reduction in oxidative stress, measured as malondialdehyde content was also observed at 20 mg Se/L treatment which in correlation to high TPC and antioxidant activities. In conclusion, selenium bio-fortification can be used as a technique to improve precious to ricegrass.

Keywords: antioxidant activities, bio-fortification, ricegrass, selenium

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16901 Lidocaine-Bupivacaine Block Improve Analgesia in Cats Undergoing Orchiectomy

Authors: T. C. Ng, R. Radzi, T. K. Ng, H. C. Chen

Abstract:

The analgesic effects of lidocaine-bupivacaine block in cats undergoing routine orchiectomy were determined in this controlled, randomized, and blinded study. Twelve cats were randomly assigned to two groups. Cats in local block group received subcutaneous infiltration of 1 mg/kg of 2% lidocaine and 1 mg/kg of 0.5% bupivacaine into the scrotal sac. Cats in control group received equivolume of saline. Both groups were induced with mixture of ketamine (15 mg/kg) and acepromazine (0.1 mg/kg) intramuscularly and maintained on sevoflurane via facemask. Non-invasive blood pressures (BP), heart (HR), and respiratory rate (RR) were measured intra-operatively at specific events. Post-operatively, all cats received meloxicam, 0.2 mg/kg subcutaneously. Pain scores were determined at 4, 8, and 24 hours postoperatively. Mechanical pressure thresholds (MPT) at the perineum and metatarsus were determined at 2, 4, 8, and 24 hours postoperatively. Intra-operatively, the BP and HR tended to be higher in the control group. The increment in HR peaked during traction and autoligation of the spermatic cord in the control group. There was no treatment difference in RR. Post-operatively, pain scores in the group given local blocks were lower than the control group at 4 hour post-operation. There was no treatment difference in the post-operative HR, RR, BP and MPT values. In conclusion, subcutaneous infiltration of lidocaine-bupivacaine into the scrotal sac before orchiectomy improved intra-operative hemodynamic stability and provided better analgesia up to 4 hours post-surgery.

Keywords: analgesia, bupivacaine, cat, lidocaine, local block, orchiectomy

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16900 Effects of Concomitant Use of Metformin and Powdered Moringa Oleifera Leaves on Glucose Tolerance in Sprague-Dawley Rats

Authors: Emielex M. Aguilar, Kristen Angela G. Cruz, Czarina Joie L. Rivera, Francis Dave C. Tan, Gavino Ivan N. Tanodra, Dianne Katrina G. Usana, Mary Grace T. Valentin, Nico Albert S. Vasquez, Edwin Monico C. Wee

Abstract:

The risk of diabetes mellitus is increasing in the Philippines, with Metformin and Insulin as drugs commonly used for its management. The use of herbal medicines has grown increasingly, especially among the elderly population. Moringa oleifera or malunggay is one of the most common plants in the country, and several studies have shown the plant to exhibit a hypoglycemic property with its flavonoid content. This study aims to investigate the possible effects of concomitant use of Metformin and powdered M. oleifera leaves (PMOL) on blood glucose levels. Twenty male Sprague-Dawley rats were equally distributed into four groups. Fasting blood glucose levels of the rats were measured prior to experimentation. The following treatments were administered to the four groups, respectively: glucose only 2 g/kg; glucose 2 g/kg + Metformin 100 mg/kg; glucose 2 g/kg + PMOL 200 mg/kg; and glucose 2 g/kg + PMOL 200 mg/kg and Metformin 100 mg/kg. Blood glucose levels were determined on the 1st, 2nd, 3rd, and 4th hour post-treatment and compared between groups. Statistical analysis showed that the type of intervention did not show significance in the reduction of blood glucose levels when compared with the other groups (p=0.378), while the effect of time exhibited significance (p=0.000). The interaction between the type of intervention and time of blood glucose measurement was shown to be significant (p=0.024). Within each group, the control and PMOL-treated groups showed significant reduction in blood glucose levels over time with p-values of 0.000 and 0.000, respectively, while the Metformin-treated and the combination groups had p-values of 0.062 and 0.093, respectively, which are not significant. The descriptive data also showed that the mean total reduction of blood glucose levels of the Metformin and PMOL combination treatment group was lower than the PMOL-treated group alone, while the mean total reduction of blood glucose levels of the combination group was higher than the Metformin-treated group alone. Based on the results obtained, the combination of Metformin and PMOL did not significantly lower the blood glucose levels of the rats as compared to the other groups. However, the concomitant use of Metformin and PMOL may affect each other’s blood glucose lowering activity. Additionally, prolonged time of exposure and delay in the first blood glucose measurement after treatment could exhibit a significant effect in the blood glucose levels. Further studies are recommended regarding the effects of the concomitant use of the two agents on blood glucose levels.

Keywords: blood glucose levels, concomitant use, metformin, Moringa oleifera

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16899 Sentiment Classification Using Enhanced Contextual Valence Shifters

Authors: Vo Ngoc Phu, Phan Thi Tuoi

Abstract:

We have explored different methods of improving the accuracy of sentiment classification. The sentiment orientation of a document can be positive (+), negative (-), or neutral (0). We combine five dictionaries from [2, 3, 4, 5, 6] into the new one with 21137 entries. The new dictionary has many verbs, adverbs, phrases and idioms, that are not in five ones before. The paper shows that our proposed method based on the combination of Term-Counting method and Enhanced Contextual Valence Shifters method has improved the accuracy of sentiment classification. The combined method has accuracy 68.984% on the testing dataset, and 69.224% on the training dataset. All of these methods are implemented to classify the reviews based on our new dictionary and the Internet Movie data set.

Keywords: sentiment classification, sentiment orientation, valence shifters, contextual, valence shifters, term counting

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16898 Modelling Biological Treatment of Dye Wastewater in SBR Systems Inoculated with Bacteria by Artificial Neural Network

Authors: Yasaman Sanayei, Alireza Bahiraie

Abstract:

This paper presents a systematic methodology based on the application of artificial neural networks for sequencing batch reactor (SBR). The SBR is a fill-and-draw biological wastewater technology, which is specially suited for nutrient removal. Employing reactive dye by Sphingomonas paucimobilis bacteria at sequence batch reactor is a novel approach of dye removal. The influent COD, MLVSS, and reaction time were selected as the process inputs and the effluent COD and BOD as the process outputs. The best possible result for the discrete pole parameter was a= 0.44. In orderto adjust the parameters of ANN, the Levenberg-Marquardt (LM) algorithm was employed. The results predicted by the model were compared to the experimental data and showed a high correlation with R2> 0.99 and a low mean absolute error (MAE). The results from this study reveal that the developed model is accurate and efficacious in predicting COD and BOD parameters of the dye-containing wastewater treated by SBR. The proposed modeling approach can be applied to other industrial wastewater treatment systems to predict effluent characteristics. Note that SBR are normally operated with constant predefined duration of the stages, thus, resulting in low efficient operation. Data obtained from the on-line electronic sensors installed in the SBR and from the control quality laboratory analysis have been used to develop the optimal architecture of two different ANN. The results have shown that the developed models can be used as efficient and cost-effective predictive tools for the system analysed.

Keywords: artificial neural network, COD removal, SBR, Sphingomonas paucimobilis

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16897 Oleuropein Ameliorates Palmitate-Induced Insulin Resistance by Increasing GLUT4 Translocation through Activation of AMP-Activated Protein Kinase in Rat Soleus Muscles

Authors: Hakam Alkhateeb

Abstract:

Oleuropein, the main constituent of leaves and fruits of the olive tree, has been demonstrated to exert beneficial effects on parameters relevant to the normal homeostatic mechanisms of glucose regulation in rat skeletal muscle. However, the antidiabetic effect of oleuropein, to our knowledge, has not been examined. Therefore, in this study, we examined whether oleuropein ameliorated palmitate-induced insulin resistance in skeletal muscle. To examine this question, insulin resistance was rapidly induced by incubating (12h) soleus muscle with a high concentration of palmitate(2mM). Subsequently, we attempted to restore insulin sensitivity by incubating (12h) muscles with oleuropien (1.5mM), while maintaining high concentrations of palmitate. Palmitate treatment for 12 h reduced insulin-stimulated glucose transport, GLUT4 translocationandAS160 phosphorylation. Oleuropein treatment (12 h) fully restoredinsulin-stimulated glucose transport, GLUT4translocationandAS160 phosphorylation. Inhibition of PI3K phosphorylation with wortmannin (1µM)did not affect the oleuropein-induced improvements in insulin-stimulated glucose transport, GLUT4 translocation, and AS160 phosphorylation. These results suggested that the improvements in these parameters cannot account for activating PI3K pathway. Taken altogether, it appears that oleuropein, through activation of another pathway like activated protein kinase (AMPK), may provide a possible strategy by which they ameliorate palmitate-induced insulin resistance in skeletal muscles.

Keywords: AS160, diabetes, GLUT4, oleuropein

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16896 In vitro Comparison Study of Biologically Synthesized Cupper-Disulfiram Nanoparticles with Its Free Corresponding Complex as Therapeutic Approach for Breast and Liver Cancer

Authors: Marwa M. Abu-Serie, Marwa M. Eltarahony

Abstract:

The search for reliable, effective, and safe nanoparticles (NPs) as a treatment for cancer is a pressing priority. In this study, Cu-NPs were fabricated by Streptomyces cyaneofuscatus through simultaneous bioreduction strategy of copper nitrate salt. The as-prepared Cu-NPs subjected to structural analysis; energy-dispersive X-ray spectroscopy, elemental mapping, X-ray diffraction, transmission electron microscopy, and ζ-potential. These biological synthesized Cu-NPs were mixed with disulfiram (DS), forming a nanocomplex of Cu-DS with a size of ~135 nm. The prepared nanocomplex (nanoCu-DS) exhibited higher anticancer activity than that of free complex of DS-Cu, Cu-NPs, and DS alone. This was illustrated by the lowest IC50 of nanoCu-DS (< 4 µM) against human breast and liver cancer cell lines comparing with DS-Cu, Cu-NPs, and DS (~8, 22.98-33.51 and 11.95-14.86, respectively). Moreover, flow cytometric analysis confirmed that higher apoptosis percentage range of nanoCu-DS-treated in MDA-MB 231, MCF-7, Huh-7, and HepG-2 cells (51.24-65.28%) than free complex of Cu-DS ( < 4.5%). Regarding inhibition potency of liver and breast cancer cell migration, no significant difference was recorded between free and nanocomplex. Furthermore, nanoCu-DS suppressed gene expression of β-catenine, Akt, and NF-κB and upregulated p53 expression (> 3, >15, > 5 and ≥ 3 folds, respectively) more efficiently than free complex (all ~ 1 fold) in MDA-MB 231 and Huh-7 cells. Our finding proved this prepared nano complex has a powerful anticancer activity relative to free complex, thereby offering a promising cancer treatment.

Keywords: biologically prepared Cu-NPs, breast cancer cell lines, liver cancer cell lines, nanoCu- disulfiram

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16895 Quintic Spline Solution of Fourth-Order Parabolic Equations Arising in Beam Theory

Authors: Reza Mohammadi, Mahdieh Sahebi

Abstract:

We develop a method based on polynomial quintic spline for numerical solution of fourth-order non-homogeneous parabolic partial differential equation with variable coefficient. By using polynomial quintic spline in off-step points in space and finite difference in time directions, we obtained two three level implicit methods. Stability analysis of the presented method has been carried out. We solve four test problems numerically to validate the derived method. Numerical comparison with other methods shows the superiority of presented scheme.

Keywords: fourth-order parabolic equation, variable coefficient, polynomial quintic spline, off-step points

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16894 The OverStitch and OverStitch SX Endoscopic Suturing System in Bariatric Surgery, Closing Perforations and Fistulas and Revision Procedures

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

Abstract:

Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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16893 Prevention and Treatment of Hay Fever Prevalence by Natural Products: A Phytochemistry Study on India and Iran

Authors: Tina Naser Torabi

Abstract:

Prevalence of allergy is affected by different factors according to its base and seasonal weather changes, and it also needs various treatments.Although reasons of allergy existence are not clear but generally, allergens cause reaction between antigen and antibody because of their antigenic traits. In this state, allergens cause immune system to make mistake and identify safe material as threat, therefore function of immune system impaired because of histamine secretion. There are different reasons for allergy, but herbal reasons are on top of the list, although animal causes cannot be ignored. Important point is that allergenic compounds, cause making dedicated antibody, so in general every kind of allergy is different from the other one. Therefore, most of the plants in herbal allergenic category can cause various allergies for human beings, such as respiratory allergies, nutritional allergies, injection allergies, infection allergies, touch allergies, that each of them show different symptoms based on the reason of allergy and also each of them requires different prevention and treatment. Geographical condition is another effective factor in allergy. Seasonal changes, weather condition, herbal coverage variety play important roles in different allergies. It goes without saying that humid climate and herbal coverage variety in different seasons especially spring cause most allergies in human beings in Iran and India that are discussed in this article. These two countries are good choices for allergy prevalence because of their condition, various herbal coverage, human and animal factors. Hay fever is one of the allergies, although the reasons of its prevalence are unknown yet. It is one of the most popular allergies in Iran and India because of geographical, human, animal and herbal factors. Hay fever is on top of the list in these two countries. Significant point about these two countries is that herbal factor is the most important factor in prevalence of hay fever. Variety of herbal coverage especially in spring during herbal pollination is the main reason of hay fever prevalence in these two countries. Based on the research result of Pharmacognosy and Phytochemistry, pollination of some plants in spring is major reason of hay fever prevalence in these countries. If airborne pollens in pollination season enter the human body through air, they will cause allergic reactions in eyes, nasal mucosa, lungs, and respiratory system, and if these particles enter the body of potential person through food, they will cause allergic reactions in mouth, stomach, and other digestive systems. Occasionally, chemical materials produced by human body such as Histamine cause problems like: developing of nasal polyps, nasal blockage, sleep disturbance, risk of asthma developing, blood vasodilation, sneezing, eye tears, itching and swelling of eyes and nasal mucosa, Urticaria, decrease in blood pressure, and rarely trauma, anesthesia, anaphylaxis and finally death. This article is going to study the reasons of hay fever prevalence in Iran and India and presents prevention and treatment Method from Phytochemistry and Pharmocognocy point of view by using local natural products in these two countries.

Keywords: hay fever, India, Iran, natural treatment, phytochemistry

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16892 Applying the Extreme-Based Teaching Model in Post-Secondary Online Classroom Setting: A Field Experiment

Authors: Leon Pan

Abstract:

The first programming course within post-secondary education has long been recognized as a challenging endeavor for both educators and students alike. Historically, these courses have exhibited high failure rates and a notable number of dropouts. Instructors often lament students' lack of effort in their coursework, and students often express frustration that the teaching methods employed are not effective. Drawing inspiration from the successful principles of Extreme Programming, this study introduces an approach—the Extremes-based teaching model — aimed at enhancing the teaching of introductory programming courses. To empirically determine the effectiveness of the model, a comparison was made between a section taught using the extreme-based model and another utilizing traditional teaching methods. Notably, the extreme-based teaching class required students to work collaboratively on projects while also demanding continuous assessment and performance enhancement within groups. This paper details the application of the extreme-based model within the post-secondary online classroom context and presents the compelling results that emphasize its effectiveness in advancing the teaching and learning experiences. The extreme-based model led to a significant increase of 13.46 points in the weighted total average and a commendable 10% reduction in the failure rate.

Keywords: extreme-based teaching model, innovative pedagogical methods, project-based learning, team-based learning

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16891 Isolation and Transplantation of Hepatocytes in an Experimental Model

Authors: Inas Raafat, Azza El Bassiouny, Waldemar L. Olszewsky, Nagui E. Mikhail, Mona Nossier, Nora E. I. El-Bassiouni, Mona Zoheiry, Houda Abou Taleb, Noha Abd El-Aal, Ali Baioumy, Shimaa Attia

Abstract:

Background: Orthotopic liver transplantation is an established treatment for patients with severe acute and end-stage chronic liver disease. The shortage of donor organs continues to be the rate-limiting factor for liver transplantation throughout the world. Hepatocyte transplantation is a promising treatment for several liver diseases and can, also, be used as a "bridge" to liver transplantation in cases of liver failure. Aim of the work: This study was designed to develop a highly efficient protocol for isolation and transplantation of hepatocytes in experimental Lewis rat model to provide satisfactory guidelines for future application on humans.Materials and Methods: Hepatocytes were isolated from the liver by double perfusion technique and bone marrow cells were isolated by centrifugation of shafts of tibia and femur of donor Lewis rats. Recipient rats were subjected to sub-lethal dose of irradiation 2 days before transplantation. In a laparotomy operation the spleen was injected by freshly isolated hepatocytes and bone marrow cells were injected intravenously. The animals were sacrificed 45 day latter and splenic sections were prepared and stained with H & E, PAS AFP and Prox1. Results: The data obtained from this study showed that the double perfusion technique is successful in separation of hepatocytes regarding cell number and viability. Also the method used for bone marrow cells separation gave excellent results regarding cell number and viability. Intrasplenic engraftment of hepatocytes and live tissue formation within the splenic tissue were found in 70% of cases. Hematoxylin and eosin stained splenic sections from 7 rats showed sheets and clusters of cells among the splenic tissues. Periodic Acid Schiff stained splenic sections from 7 rats showed clusters of hepatocytes with intensely stained pink cytoplasmic granules denoting the presence of glycogen. Splenic sections from 7 rats stained with anti-α-fetoprotein antibody showed brownish cytoplasmic staining of the hepatocytes denoting positive expression of AFP. Splenic sections from 7 rats stained with anti-Prox1 showed brownish nuclear staining of the hepatocytes denoting positive expression of Prox1 gene on these cells. Also, positive expression of Prox1 gene was detected on lymphocytes aggregations in the spleens. Conclusions: Isolation of liver cells by double perfusion technique using collagenase buffer is a reliable method that has a very satisfactory yield regarding cell number and viability. The intrasplenic route of transplantation of the freshly isolated liver cells in an immunocompromised model was found to give good results regarding cell engraftment and tissue formation. Further studies are needed to assess function of engrafted hepatocytes by measuring prothrombin time, serum albumin and bilirubin levels.

Keywords: Lewis rats, hepatocytes, BMCs, transplantation, AFP, Prox1

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16890 Examining Audiology Students: Clinical Reasoning Skills When Using Virtual Audiology Cases Aided With no Collaboration, Live Collaboration, and Virtual Collaboration

Authors: Ramy Shaaban

Abstract:

The purpose of this study was to examine the difference in clinical reasoning skills of students when using virtual audiology cases with and without collaborative assistance from major learning approaches important to clinical reasoning skills and computer-based learning models: Situated Learning Theory, Social Development Theory, Scaffolding, and Collaborative Learning. A quasi-experimental design was conducted at two United States universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computer-based audiology case simulations were developed, and participants were randomly placed into the three groups: no collaboration, virtual collaboration, and live collaboration. The clinical reasoning data were analyzed using One-Way ANOVA and Tukey posthoc analyses. The results show that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Collaboration, whether virtual or in person, has a positive effect on students’ clinical reasoning. These results with audiology students indicate that combining collaboration models with scaffolding and embedding situated learning and social development theories into the design of future virtual patients has the potential to improve students’ clinical reasoning skills.

Keywords: clinical reasoning, virtual patients, collaborative learning, scaffolding

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16889 Towards a Robust Patch Based Multi-View Stereo Technique for Textureless and Occluded 3D Reconstruction

Authors: Ben Haines, Li Bai

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Patch based reconstruction methods have been and still are one of the top performing approaches to 3D reconstruction to date. Their local approach to refining the position and orientation of a patch, free of global minimisation and independent of surface smoothness, make patch based methods extremely powerful in recovering fine grained detail of an objects surface. However, patch based approaches still fail to faithfully reconstruct textureless or highly occluded surface regions thus though performing well under lab conditions, deteriorate in industrial or real world situations. They are also computationally expensive. Current patch based methods generate point clouds with holes in texturesless or occluded regions that require expensive energy minimisation techniques to fill and interpolate a high fidelity reconstruction. Such shortcomings hinder the adaptation of the methods for industrial applications where object surfaces are often highly textureless and the speed of reconstruction is an important factor. This paper presents on-going work towards a multi-resolution approach to address the problems, utilizing particle swarm optimisation to reconstruct high fidelity geometry, and increasing robustness to textureless features through an adapted approach to the normalised cross correlation. The work also aims to speed up the reconstruction using advances in GPU technologies and remove the need for costly initialization and expansion. Through the combination of these enhancements, it is the intention of this work to create denser patch clouds even in textureless regions within a reasonable time. Initial results show the potential of such an approach to construct denser point clouds with a comparable accuracy to that of the current top-performing algorithms.

Keywords: 3D reconstruction, multiview stereo, particle swarm optimisation, photo consistency

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16888 Effects of Soaking of Maize on the Viscosity of Masa and Tortilla Physical Properties at Different Nixtamalization Times

Authors: Jorge Martínez-Rodríguez, Esther Pérez-Carrillo, Diana Laura Anchondo Álvarez, Julia Lucía Leal Villarreal, Mariana Juárez Dominguez, Luisa Fernanda Torres Hernández, Daniela Salinas Morales, Erick Heredia-Olea

Abstract:

Maize tortillas are a staple food in Mexico which are mostly made by nixtamalization, which includes the cooking and steeping of maize kernels in alkaline conditions. The cooking step in nixtamalization demands a lot of energy and also generates nejayote, a water pollutant, at the end of the process. The aim of this study was to reduce the cooking time by adding a maize soaking step before nixtamalization while maintaining the quality properties of masa and tortillas. Maize kernels were soaked for 36 h to increase moisture up to 36%. Then, the effect of different cooking times (0, 5, 10, 15, 20, 20, 25, 30, 35, 45-control and 50 minutes) was evaluated on viscosity profile (RVA) of masa to select the treatments with a profile similar or equal to control. All treatments were left steeping overnight and had the same milling conditions. Treatments selected were 20- and 25-min cooking times which had similar values for pasting temperature (79.23°C and 80.23°C), Maximum Viscosity (105.88 Cp and 96.25 Cp) and Final Viscosity (188.5 Cp and 174 Cp) to those of 45 min-control (77.65 °C, 110.08 Cp, and 186.70 Cp, respectively). Afterward, tortillas were produced with the chosen treatments (20 and 25 min) and for control, then were analyzed for texture, damage starch, colorimetry, thickness, and average diameter. Colorimetric analysis of tortillas only showed significant differences for yellow/blue coordinates (b* parameter) at 20 min (0.885), unlike the 25-minute treatment (1.122). Luminosity (L*) and red/green coordinates (a*) showed no significant differences from treatments with respect control (69.912 and 1.072, respectively); however, 25 minutes was closer in both parameters (73.390 and 1.122) than 20 minutes (74.08 and 0.884). For the color difference, (E), the 25 min value (3.84) was the most similar to the control. However, for tortilla thickness and diameter, the 20-minute with 1.57 mm and 13.12 cm respectively was closer to those of the control (1.69 mm and 13.86 cm) although smaller to it. On the other hand, the 25 min treatment tortilla was smaller than both 20 min and control with 1.51 mm thickness and 13.590 cm diameter. According to texture analyses, there was no difference in terms of stretchability (8.803-10.308 gf) and distance for the break (95.70-126.46 mm) among all treatments. However, for the breaking point, all treatments (317.1 gf and 276.5 gf for 25 and 20- min treatment, respectively) were significantly different from the control tortilla (392.2 gf). Results suggest that by adding a soaking step and reducing cooking time by 25 minutes, masa and tortillas obtained had similar functional and textural properties to the traditional nixtamalization process.

Keywords: tortilla, nixtamalization, corn, lime cooking, RVA, colorimetry, texture, masa rheology

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16887 A Comparison between Virtual Case-Based Learning and Traditional Learning: The Effect on Undergraduate Nursing Students’ Performance during Covid-19: A Pilot Study

Authors: Aya M. Aboudesouky

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Covid-19 has changed and affected the whole world dramatically in a new way that the entire world, even scientists, have not imagined before. The educational institutions around the world have been fighting since Covid-19 hit the world last December to keep the educational process unchanged for all students. E-learning was a must for almost all US universities during the pandemic. It was specifically more challenging to use online case-based learning instead of regular classes among nursing students who take practical education. This study aims to examine the difference in performance and satisfaction between nursing students taking traditional education and those who take virtual case-based education during their practical study. This study enrolls 40 last-year nursing undergraduates from a mid-sized university in Western Pennsylvania. The study uses a convenient sample. Students will be divided into two groups; a control group that is exposed to traditional teaching strategy and a treatment group that is exposed to a case-based teaching strategy. The module designed for this study is a total parenteral nutrition (TPN) module that will be taught for one month. The treatment group (n=20) utilizes the virtual simulation of the CBL method, while the control group (n=20) uses the traditional lecture-based teaching method. Student evaluations are collected after a month by using the survey to attain the students’ learning satisfaction and self-evaluation of the course. The post-test is used to assess the end of the course performance.

Keywords: virtual case-based learning, traditional education, nursing education, Covid-19 crisis, online practical education

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16886 Wastewater Treatment in the Abrasives Industry via Fenton and Photo-Fenton Oxidation Processes: A Case Study from Peru

Authors: Hernan Arturo Blas López, Gustavo Henndel Lopes, Antonio Carlos Silva Costa Teixeira, Carmen Elena Flores Barreda, Patricia Araujo Pantoja

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Phenols are toxic for life and the environment and may come from many sources. Uncured phenolic monomers present in phenolic resins used as binders in grinding wheels and emery paper can contaminate industrial wastewaters in abrasives manufacture plants. Furthermore, vestiges of resol and novolacs resins generated by wear and tear of abrasives are also possible sources of water contamination by phenolics in these facilities. Fortunately, advanced oxidation by dark Fenton and photo-Fenton techniques are capable of oxidizing phenols and their degradation products up to their mineralization into H₂O and CO₂. The maximal allowable concentrations for phenols in Peruvian waterbodies is very low, such that insufficiently treated effluents from the abrasives industry are a potential environmental noncompliance. The current case study highlights findings obtained during the lab-scale application of Fenton’s and photo-assisted Fenton’s chemistries to real industrial wastewater samples from an abrasives manufacture plant in Peru. The goal was to reduce the phenolic content and sample toxicity. For this purpose, two independent variables-reaction time and effect of ultraviolet radiation–were studied as for their impacts on the concentration of total phenols, total organic carbon (TOC), biological oxygen demand (BOD) and chemical oxygen demand (COD). In this study, diluted samples (1 L) of the industrial effluent were treated with Fenton’s reagent (H₂O₂ and Fe²⁺ from FeSO₄.H₂O) during 10 min in a photochemical batch reactor (Alphatec RFS-500, Brazil) at pH 2.92. In the case of photo-Fenton tests with ultraviolet lamps of 9 W, UV-A, UV-B and UV-C lamps were evaluated. All process conditions achieved 100% of phenols degraded within 5 minutes. TOC, BOD and COD decreased by 49%, 52% and 86% respectively (all processes together). However, Fenton treatment was not capable of reducing BOD, COD and TOC below a certain value even after 10 minutes, contrarily to photo-Fenton. It was also possible to conclude that the processes here studied degrade other compounds in addition to phenols, what is an advantage. In all cases, elevated effluent dilution factors and high amounts of oxidant agent impact negatively the overall economy of the processes here investigated.

Keywords: fenton oxidation, wastewater treatment, phenols, abrasives industry

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16885 The Effect of High-Pressure Processing on the Inactivation of Saccharomyces cerevisiae in Different Concentration of Manuka Honey and Its Relation with ° Brix

Authors: Noor Akhmazillah Fauzi, Mohammed Mehdi Farid, Filipa V. Silva

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The aim of this paper is to investigate if different concentration of Manuka honey (as a model food) has a major influence on the inactivation of Saccharomyces cerevisiae (as the testing microorganism) after subjecting it to HPP. Honey samples with different sugar concentrations (20, 30, 40, 50, 60 and 70 °Brix) were prepared aseptically using sterilized distilled water. No dilution of honey was made for the 80 °Brix sample. For the 0 °Brix sample (control), sterilized distilled water was used. Thermal treatment at 55 °C for 10 min (conventionally applied in honey pasteurisation in industry) was carried out for comparison purpose. S. cerevisiae cell numbers in honey samples were established before and after each HPP and thermal treatment. The number of surviving cells was determined after a proper dilution of the untreated and treated samples by the viable plate count method. S. cerevisiae cells, in different honey concentrations (0 to 80 °Brix), subjected to 600 MPa (at ambient temperature) showed an increasing resistance to inactivation with °Brix. A significant correlation (p < 0.05) between cell reduction and °Brix was found. Cell reduction in high pressure-treated samples varied linearly with °Brix (R2 > 0.9), confirming that the baroprotective effect of the food is due to sugar content. This study has practical implications in establishing efficient process design for commercial manufacturing of high sugar food products and on the potential use of HPP for such products.

Keywords: high pressure processing, honey, Saccharomyces cerevisiae, °Brix

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16884 Passive Solar Water Concepts for Human Comfort

Authors: Eyibo Ebengeobong Eddie

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Taking advantage of the sun's position to design buildings to ensure human comfort has always been an important aspect in an architectural design. Using cheap and less expensive methods and systems for gaining solar energy, heating and cooling has always been a great advantage to users and occupants of a building. As the years run by, daily techniques and methods have been created and more are being discovered to help reduce the energy demands of any building. Architects have made effective use of a buildings orientation, building materials and elements to achieve less energy demand. This paper talks about the various techniques used in solar heating and passive cooling of buildings and through water techniques and concepts to achieve thermal comfort.

Keywords: comfort, passive, solar, water

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16883 The Efficacy of Clobazam for Landau-Kleffner Syndrome

Authors: Nino Gogatishvili, Davit Kvernadze, Giorgi Japharidze

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Background and aims: Landau Kleffner syndrome (LKS) is a rare disorder with epileptic seizures and acquired aphasia. It usually starts in initially healthy children. The first symptoms are language regression and behavioral disturbances, and the sleep EEG reveals abnormal epileptiform activity. The aim was to discuss the efficacy of Clobazam for Landau Kleffner syndrome. Case report: We report a case of an 11-year-old boy with an uneventful pregnancy and delivery. He began to walk at 11 months and speak with simple phrases at the age of 2,5 years. At the age of 18 months, he had febrile convulsions; at the age of 5 years, the parents noticed language regression, stuttering, and serious behavioral dysfunction, including hyperactivity, temper outbursts. The epileptic seizure was not noticed. MRI was without any abnormality. Neuropsychological testing revealed verbal auditory agnosia. Sleep EEG showed abundant left fronto-temporal spikes, reaching over 85% during non-rapid eye movement sleep (non-REM sleep). Treatment was started with Clobazam. After ten weeks, EEG was improved. Stuttering and behavior also improved. Results: Since the start of Clobazam treatment, stuttering and behavior improved. Now, he is 11 years old, without antiseizure medication. Sleep EEG shows fronto-temporal spikes on the left side, over 10-49 % of non-REM sleep, bioccipital spikes, and slow-wave discharges and spike-waves. Conclusions: This case provides further support for the efficacy of Clobazam in patients with LKS.

Keywords: Landau-Kleffner syndrome, antiseizure medication, stuttering, aphasia

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