Search results for: complex pain

Authors: F. Saleh, F. Lyall, A. Abdulsid, L. Marks

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Background: Labour in human is a complex biological process that involves interactions of neurological, hormonal and inflammatory pathways, with the placenta being a key regulator of these pathways. It is known that uterine contractions and labour pain cause physiological changes in gene expression in maternal and fetal blood, and in placenta during labour. Oxidative and inflammatory stress pathways are implicated in labour and they may cause alteration of placental gene expression. Additionally, in placental tissues, labour increases the expression of genes involved in placental oxidative stress, inflammatory cytokines, angiogenic regulators and apoptosis. Recently, Hydrogen Sulphide (H2S) has been considered as an endogenous gaseous mediator which promotes vasodilation and exhibits cytoprotective anti-inflammatory properties. The endogenous H2S is synthesised predominantly by two enzymes: cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). As the H2S pathway has anti-oxidative and anti-inflammatory characteristics thus, we hypothesised that the expression of CBS and CSE in placental tissues would alter during labour. Methods: CBS and CSE expressions were examined in placentas using western blotting and RT-PCR in inner, middle and outer placental zones in placentas obtained from healthy non labouring women who delivered by caesarian section. These were compared with the equivalent zone of placentas obtained from women who had uncomplicated labour and delivered vaginally. Results: No differences in CBS and CSE mRNA or protein levels were found between the different sites within placentas in either the labour or non-labour group. There were no significant differences in either CBS or CSE expression between the two groups at the inner site and middle site. However, at the outer site there was a highly significant decrease in CBS protein expression in the labour group when compared to the non-labour group (p = 0.002). Conclusion: To the best of author’s knowledge, this is the first report to suggest that, CBS is expressed in a spatial manner within the human placenta. Further work is needed to clarify the precise function and mechanism of this spatial regulation although it is likely that inflammatory pathways regulation is a complex process in which this plays a role.

Keywords: anti-inflammatory, hydrogen sulphide, labour, oxidative stress

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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: Noureddine Seddari, Mohamed Belaoued, Salah Bougueroua

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The modeling of complex systems is generally based on the decomposition of their components into sub-systems easier to handle. This division has to be made in a methodical way. In this paper, we introduce an industrial control system modeling and simulation based on the Multi-Agent System (MAS) methodology AALAADIN and more particularly the underlying conceptual model Agent/Group/Role (AGR). Indeed, in this division using AGR model, the overall system is decomposed into sub-systems in order to improve the understanding of regulation and control systems, and to simplify the implementation of the obtained agents and their groups, which are implemented using the Multi-Agents Development KIT (MAD-KIT) platform. This approach appears to us to be the most appropriate for modeling of this type of systems because, due to the use of MAS, it is possible to model real systems in which very complex behaviors emerge from relatively simple and local interactions between many different individuals, therefore a MAS is well adapted to describe a system from the standpoint of the activity of its components, that is to say when the behavior of the individuals is complex (difficult to describe with equations). The main aim of this approach is the take advantage of the performance, the scalability and the robustness that are intuitively provided by MAS.

Keywords: complex systems, modeling and simulation, industrial control system, MAS, AALAADIN, AGR, MAD-KIT

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Authors: Carlos Escobar-del Pozo, César Ahumada-Monroy, Azael García-Rebolledo, Alberto Brambila-Solórzano, Gregorio Martínez-Sánchez, Luis Ortiz-Rincón

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Numerical simulations of flow in complex biological structures have gained considerable attention in the last years. However, the major issue is the validation of the results. The present work shows a Particle Image Velocimetry PIV flow visualization technique in complex biological structures, particularly in intracranial aneurysms. A methodology to reconstruct and generate a transparent model has been developed, as well as visualization and particle tracking techniques. The generated transparent models allow visualizing the flow patterns with a regular camera using the visualization techniques. The final goal is to use visualization as a tool to provide more information on the treatment and surgery decisions in aneurysms.

Keywords: aneurysms, PIV, flow visualization, particle tracking

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Authors: Nasrudin Andi Mappaware, Muh. Wirawan Harahap, Erlin Syahril, Farah Ekawati Mulyadi

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Cesarean section procedures are currently increasing, both for medical indications and without medical indications, better known as caesarean section on request. Cesarean section by self-request raises many dilemmas from the doctor's side regarding medical issues, professionalism, and bioethics. We report the case of a 27-year-old woman G1P0A0 gravid 38 weeks admitted to the hospital for a planned cesarean section on request for the reason that she could not tolerate pain and requested on a date that corresponded to the date and month of her mother's birth. Currently, there is no medical indication for a cesarean section. Anesthesia during cesarean section at self-request without medical indications is a dilemma for anesthesiologists considering the risks and complications of anesthesia for both the fetus and the mother. Cesarean section delivery without medical indications is still justified and does not conflict with ethics and professionalism. Because it fulfills the principle of autonomy which states that patients have the right to themselves. However, this medical procedure is still considered no safer and riskier even though medical technology has developed rapidly. The trend in increasing the number of cesarean sections is influenced by patient reasons such as: not being able to tolerate pain, trust factors and worry about damage to the birth canal.

Keywords: anesthesia, bioethics, medical, self-request, professionalism

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Authors: Nitin Kumar

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Purpose: The current research work focuses mainly on evolving a delivery system for ginseng extract (GE), which in turn will ameliorate the neuroprotective potential by means of enhancing the ginsenoside (Rb1) bio-availability (BA). For more noteworthy enhancement in oral bioavailability (OBA) along with pharmacological properties, the drug carriers’ performance can be strengthened by utilizing phytosomes-loaded microspheres (PM) delivery system. Methods: For preparing the disparate phytosome complexes (F1, F2, and F3), an aqueous extract of ginseng roots (GR) along with phospholipids were reacted in disparate ratio. Considering the outcomes, F3 formulation (spray-dried) was chosen for preparing the phytosomes powder (PP), PM, and extract microspheres (EM). PM was made by means of loading of F3 into Gum Arabic (GA) in addition to maltodextrin polymer mixture, whereas EM was prepared by means of the addition of extract directly into the same polymer mixture. For investigating the neuroprotective effect (NPE) in addition to their pharmacokinetic (PK) properties, PP, PM, and EM formulations were assessed. Results: F3 formulation gave enhanced entrapment efficiency (EE) (i.e., 50.61%) along with good homogeneity of spherical shaped particle size (PS) (42.58 ± 1.4 nm) with least polydispersity index (PDI) (i.e., 0.193 ± 0.01). The sustained release (up to 24 h) of ginsenoside Rb1 (GRb1) is revealed by the dissolution study of PM. A significantly (p < 0.05) greater anti-oxidant (AO) potential of PM can well be perceived as of the diminution in the lipid peroxidase level in addition to the rise in the glutathione superoxide dismutase (SOD) in addition to catalase levels. It also showed a greater neuroprotective potential exhibiting significant (p < 0.05) augmentation in the nociceptive threshold together with the diminution in damage to nerves. A noteworthy enhancement in the relative BA (157.94%) of GRb1 through the PM formulation can well be seen in the PK studies. Conclusion: It is exhibited that the PM system is an optimistic and feasible strategy to enhance the delivery of GE for the effectual treatment of neuropathic pain.

Keywords: ginseng, neuropathic, phytosome, pain

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Authors: Marzieh Yassin, Masoud Rashed, Soheil Mansour Sohani, Reza Salehi

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Background: Hip arthroplasty is one of the surgical methods to improve symptoms in patients with hip osteoarthritis. The use of electroacupuncture and TENS reduces pain, increases range of motion and improves performance. Methods: In this clinical trial study, 30 patients after hip arthroplasty were randomly divided into two groups: electroacupuncture (n=16) with exercise therapy and TENS with exercise therapy (n=14). Severity of pain, quality of life, range of motion, edema and function were evaluated in two groups before and after the interventions. Interventions of 10 sessions (three sessions per week) were conducted for two groups. The significance level in all tests was below 0.05. Results: The results showed that both groups improved all of the symptoms after the intervention (p≤0.05), although there was no statistically significant difference between the two groups in terms of effectiveness (p≥0.05). Conclusion: The results showed that both methods improve symptoms in patients after surgery. According to this study, electroacupuncture is suggested as a new method effective for the treatment of people with post-Total Hip Arthroplasty.

Keywords: electroacupuncture, physical performance, total hip arthroplasty, TENS

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Authors: Yoonjung An, Yongtae Park

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Offering a Product-Service System (PSS) is a well-accepted strategy that companies may adopt to provide a set of systemic solutions to customers. PSSs were initially provided in a simple form but now take diversified and complex forms involving multiple services, products and technologies. With the growing interest in the PSS, frameworks for the PSS development have been introduced by many researchers. However, most of the existing frameworks fail to examine various relations existing in a complex PSS. Since designing a complex PSS involves full integration of multiple products and services, it is essential to identify not only product-service relations but also product-product/ service-service relations. It is also equally important to specify how they are related for better understanding of the system. Moreover, as customers tend to view their purchase from a more holistic perspective, a PSS should be developed based on the whole system’s requirements, rather than focusing only on the product requirements or service requirements. Thus, we propose a framework to develop a complex PSS that is coordinated fully with the requirements of both worlds. Specifically, our approach adopts a multi-domain matrix (MDM). A MDM identifies not only inter-domain relations but also intra-domain relations so that it helps to design a PSS that includes highly desired and closely related core functions/ features. Also, various dependency types and rating schemes proposed in our approach would help the integration process.

Keywords: inter-domain relations, intra-domain relations, multi-domain matrix, product-service system design

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Authors: Liang Bai, Yandong Xiao, Haorang Wang, Songyang Lao

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The directedness of links is crucial to determine the controllability in complex networks. Even the edge directions can determine the controllability of complex networks. Obviously, for a given network, we wish to design its edge directions that make this network approach the optimal controllability. In this work, we firstly introduce two methods to enhance network by assigning edge directions. However, these two methods could not completely mitigate the negative effects of inaccessibility and dilations. Thus, to approach the optimal network controllability, the edge directions must mitigate the negative effects of inaccessibility and dilations as much as possible. Finally, we propose the edge direction for optimal controllability. The optimal method has been found to be successfully useful on real-world and synthetic networks.

Keywords: complex network, dynamics, network control, optimization

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Authors: Neslihan Beyazit, Sahin Bayraktar, Cahit Demetgul

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Transition metal ions have an important role in biochemistry and biomimetic systems and may provide the basis of models for active sites of biological targets. The presence of copper(II), iron(II) and zinc(II) is crucial in many biological processes. Tetradentate N2O2 donor Schiff base ligands are well known to form stable transition metal complexes and these complexes have also applications in clinical and analytical fields. In this study, we present salient structural features and the details of cathecholase activity of Fe(II) complex of a new Schiff Base ligand. A new asymmetrical N2O2 donor Schiff base ligand and its Fe(II) complex were synthesized by condensation of 4-nitro-1,2 phenylenediamine with 6-formyl-7-hydroxy-5-methoxy-2-methylbenzopyran-4-one and by using an appropriate Fe(II) salt, respectively. Schiff base ligand and its metal complex were characterized by using FT-IR, 1H NMR, 13C NMR, UV-Vis, elemental analysis and magnetic susceptibility. In order to determine the kinetics parameters of catechol oxidase-like activity of Schiff base Fe(II) complex, the oxidation of the 3,5-di-tert-butylcatechol (3,5-DTBC) was measured at 25°C by monitoring the increase of the absorption band at 390-400 nm of the product 3,5-di-tert-butylcatequinone (3,5-DTBQ). The compatibility of catalytic reaction with Michaelis-Menten kinetics also investigated by the method of initial rates by monitoring the growth of the 390–400 nm band of 3,5-DTBQ as a function of time. Kinetic studies showed that Fe(II) complex of the new N2O2 donor Schiff base ligand was capable of acting as a model compound for simulating the catecholase properties of type-3 copper proteins.

Keywords: catecholase activity, Michaelis-Menten kinetics, Schiff base, transition metals

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Authors: Manuel Meranza-Castillon, Rolando Diaz-Castillo, Adrian Arellano-Delgado, Cesar Cruz-Hernandez, Rosa Martha Lopez-Gutierrez

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In this work, we deal with experimental network synchronization of chaotic nodes with different topologies. Our approach is based on complex system theory, and we use a master-slave configuration to couple the nodes in the networks. In particular, we design and implement electronically complex dynamical networks composed by nine coupled chaotic Chua’s circuits with topologies: in nearest-neighbor, small-world, open ring, star, and global. Also, network synchronization is evaluated according to a particular coupling strength for each topology. This study is important by the possible applications to private transmission of information in a chaotic communication network of multiple users.

Keywords: complex networks, Chua's circuit, experimental synchronization, multiple users

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Authors: Fabrizio Iezzi, Claudio Valente

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The viscous damping in dynamic systems can be proportional or non-proportional. In the first case, the mode shapes are real whereas in the second case they are complex. From an engineering point of view, the complexity of the mode shapes is important in order to quantify the non-proportional damping. Different indices exist to provide estimates of the modal complexity. These indices are or not zero, depending whether the mode shapes are not or are complex. The modal density problem arises in the experimental identification when the dynamic systems have close modal frequencies. Depending on the entity of this closeness, the mode shapes can hold fictitious imaginary quantities that affect the values of the modal complexity indices. The results are the failing in the identification of the real or complex mode shapes and then of the proportional or non-proportional damping. The paper aims to show the influence of the modal density on the values of these indices in case of both proportional and non-proportional damping. Theoretical and pseudo-experimental solutions are compared to analyze the problem according to an appropriate mechanical system.

Keywords: complex mode shapes, dynamic systems identification, modal density, non-proportional damping

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Authors: N. Sateesh, C. S. P. Rao, K. Satyanarayana, C. Rajashekar

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This paper proposes a development of a CAD/CAM system for complex profiles of various machine members using a synthetic curve i.e. B-spline. Conventional methods in designing and manufacturing of complex profiles are tedious and time consuming. Even programming those on a computer numerical control (CNC) machine can be a difficult job because of the complexity of the profiles. The system developed provides graphical and numerical representation B-spline profile for any given input. In this paper, the system is applicable to represent a cam profile with B-spline and attempt is made to improve the follower motion.

Keywords: plate-cams, cam profile, b-spline, computer numerical control (CNC), computer aided design and computer aided manufacturing (CAD/CAM), R-D-R-D (rise-dwell-return-dwell)

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Authors: Rieski Prihastuti, Meliana Depo, Trisno A. Wibowo, Misinem

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On October 19, 2017, Yogyakarta Islamic Hospital reported 38 garment employees with nausea, vomiting, headache, abdominal pain, and diarrhea after they had lunch on October 18, 2017, to Sleman District Health Office. Objectives of this study were to ensure the outbreak and identify source and route of transmission. Case-control study was conducted to analyze food items that caused the outbreak. A case was defined as a person who got symptoms such as abdominal pain, diarrhea, nausea with/without vomiting, fever, and headache after they had lunch on October 18, 2017. Samples included leftover lunch box, vomit, tap water and drinking water had been sent to the laboratory. Data were analyzed descriptively as frequency table and analyzed by using chi-square in bivariate analysis. All of 196 garment employee was included in this study. The common symptoms of this outbreak were abdominal pain (84.4%), diarrhea (72.8%), nausea (61.6%), headache (52.8%), vomiting (12.8%), and fever (6.4%) with median incubation period 13 hours (range 1-34 hours). Highest attack rate and odds ratio was found in grilled chicken (Attack Rate 58,49%) with Odds Ratio 11,023 (Confidence Interval 95% 1.383 - 87.859; p value 0,005). Almost all samples showed mold, except drinking water. Based on its sign and symptoms, also incubation period, diarrheal Bacillus cereus and Clostridium perfringens were suspected to be the causative agent of the outbreak. Limitation of this study was improper sample handling and no sample of food handler and stools in the food caterer. Outbreak investigation training needed to be given to the hospital worker, and monitoring should be done to the food caterer to prevent another outbreak.

Keywords: disease outbreak, foodborne disease, food poisoning, outbreak

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Authors: Devam Sheth

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Nuclear imaging with stress myocardial perfusion (stress test) is the preferred first line investigation for noninvasive evaluation of ischaemic heart condition. The sensitivity of this test is close to 90 % making it a very reliable test. However, rarely it gives a false negative result which can be explained by the phenomenon termed as “balanced ischaemia”. We present the case of a 78 year Caucasian female without any significant past cardiac history, who presents with chest pain and shortness of breath since one day. The initial ECG and cardiac enzymes were non-impressive. Few hours later, she had some substernal chest pain along with some ST segment depression in the lateral leads. Stress test comes back negative for any significant perfusion defects. However, given her typical symptoms, she underwent a cardiac catheterization which revealed significant triple vessel disease mandating her to get a bypass surgery. This unusual phenomenon of false nuclear stress test in the setting of positive ECG changes can be explained only by balanced ischemia wherein due to global myocardial ischemia, the stress test fails to reveal relative perfusion defects in the affected segments.

Keywords: balanced, false positive, ischemia, myocardial perfusion imaging

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Authors: A. Oukaira, A. Lakhssassi, O. Ettahri

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To make a good thermal management in an ABDM (Adapter Board Detector Module) card, we must first control temperature and its gradient from the first step in the design of integrated circuits ASIC of our complex system. In this paper, our main goal is to develop and validate the thermal stability in order to get an idea of the flow of heat around the ASIC in transient and thus address the thermal issues for integrated circuits at the ABDM card. However, we need heat sources simulations for ABDM card to establish its thermal mapping. This led us to perform simulations at each ASIC that will allow us to understand the thermal ABDM map and find real solutions for each one of our complex system that contains 36 ABDM map, taking into account the different layers around ASIC. To do a transient simulation under NISA, we had to build a function of power modulation in time TIMEAMP. The maximum power generated in the ASIC is 0.6 W. We divided the power uniformly in the volume of the ASIC. This power was applied for 5 seconds to visualize the evolution and distribution of heat around the ASIC. The DBC (Dirichlet Boundary conditions) method was applied around the ABDM at 25°C and just after these simulations in NISA tool we will validate them by COMSOL tool, wich is a numerical calculation software for a modular finite element for modeling a wide variety of physical phenomena characterizing a real problem. It will also be a design tool with its ability to handle 3D geometries for complex systems.

Keywords: ABDM, APD, thermal mapping, complex system

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Authors: Rabia Korkmaz Tan, Şebnem Bora

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The major problem encountered when modeling complex systems with agent-based modeling and simulation techniques is the existence of large parameter spaces. A complex system model cannot be expected to reflect the whole of the real system, but by specifying the most appropriate parameters, the actual system can be represented by the model under certain conditions. When the studies conducted in recent years were reviewed, it has been observed that there are few studies for parameter tuning problem in agent based simulations, and these studies have focused on tuning parameters of a single model. In this study, an approach of parameter tuning is proposed by using metaheuristic algorithms such as Genetic Algorithm (GA), Particle Swarm Optimization (PSO), Artificial Bee Colonies (ABC), Firefly (FA) algorithms. With this hybrid structured study, the parameter tuning problems of the models in the different fields were solved. The new approach offered was tested in two different models, and its achievements in different problems were compared. The simulations and the results reveal that this proposed study is better than the existing parameter tuning studies.

Keywords: parameter tuning, agent based modeling and simulation, metaheuristic algorithms, complex systems

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Authors: M. D. Dogara, G. C. Afuwai, O. O. Esther, A. M. Dawai

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The geology of Northern Nigeria is under intense investigation particularly that of the northwest believed to be of the basement complex. The variability of the lithology is consistently inconsistent. Hence, the need for a close range study, it is, in view of the above that, two geophysical techniques, the vertical electrical sounding employing the Schlumberger array and seismic refraction methods, were used to delineate the geoelectric and geovelocity parameters of the basement complex of northwestern Nigeria. A total area of 400,000 m² was covered with sixty geoelectric stations established and sixty sets of seismic refraction data collected using the forward and reverse method. From the interpretation of the resistivity data, it is suggestive that the area is underlain by not more than five geoelectric layers of varying thicknesses and resistivities when a maximum half electrode spread of 100m was used. The result of the interpreted seismic data revealed two geovelocity layers, with velocities ranging between 478m/s to 1666m/s for the first layer and 1166m/s to 7141m/s for the second layer. The results of the two techniques, suggests that the area of study has an undulating bedrock topography with geoeletric and geovelocity layers composed of weathered rock materials.

Keywords: basement complex, delineation, geoelectric, geovelocity, Nigeria

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Authors: Ling Zhang, Feng Liu

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A matrix is called a ray pattern matrix if its entries are either 0 or a ray in complex plane which originates from 0. A ray pattern A of order n is called spectrally arbitrary if the complex matrices in the ray pattern class of A give rise to all possible nth degree complex polynomial. Otherwise, it is said to be spectrally non-arbitrary ray pattern. We call that a spectrally arbitrary ray pattern A of order n is minimally spectrally arbitrary if any nonzero entry of A is replaced, then A is not spectrally arbitrary. In this paper, we find that is not spectrally arbitrary when n equals to 4 for any θ which is greater than or equal to 0 and less than or equal to n. In this article, we give several ray patterns A(θ) of order n that are not spectrally arbitrary for some θ which is greater than or equal to 0 and less than or equal to n. by using the nilpotent-Jacobi method. One example is given in our paper.

Keywords: spectrally arbitrary, nilpotent matrix , ray patterns, sign patterns

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Authors: Hakan Akgul

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Purpose: The use of firecrackers (i.e., Ramadan Cannon) during the month of Ramadan is a traditional way of indicating that the fasting period is over in Muslim countries. Here, we report the rehabilitation of a case of hand injury with pluridigital fractures due to premature explosion of a Ramadan cannon. Materials and Methods: A 48-year old man admitted to the Emergency Department due to left hand injury as a result of a premature explosion of a Ramadan cannon. The patient was immediately taken to operation room because of the multiple fractures, tendon loss, and soft tissue loss in the left hand. Range of motion (ROM) of joints was measured with goniometer, pain and oedema were measured and splinting was performed. Results: Rehabilitation team took over the patient at postoperative 9th week. During the 3 month rehabilitation, range of motion increased, oedema was taken under control, pain was reduced, the colour of the skin turned to the normal tone. According to the visual analog scale (VAS), pain decreased from 9 to 4. Oedema, around the metacarpofalangeal (MCP) joints, decreased from 27,5 cm to 23,5 cm. Total active range of motion of the wrist increased from 5 degrees to 50 degrees.Total active range of motion of supination and pronation increased from 55 degrees to 70 degrees. Discussion: The rehabilitation of multiple hand injury is quite difficult. Different aspects of trauma should be taken into consideration when rehabilitation is planned. Factors such as waiting for the bone union, wound healing, and use of external fixators may delay rehabilitation process. Joint mobilization, massage for reducing oedema and preventing scar tissue, exercise within the range of motion are efficient measures. Poor patient compliance to treatment may lead to poor outcome. First of all, oedema and scar formation must be taken under control. Removing fixators should not be delayed depending on the bone union, and exercise within the range of motion should be started.

Keywords: explosion, fracture, hand, injury

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Authors: Mahmoud Ghazy, Ahmed R. Z. Baghdadi

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Background: With the perceived pain and poor function experienced following total hip Arthroplasty (THA), patients usually feel un-satisfied. Methods: Thirty patients with THA (group I) and thirty indicated for arthroplasty but weren’t operated on yet (group II) participated in the study. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and III respectively. The Berg Balance Scale (BBS), Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively and three months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs. Results: group I had significantly lower TUG and SC time compared with group II four weeks and three months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly four weeks and three months post-operatively compared with four weeks pre- operatively in group. But no significant differences in BBS scores four weeks and three months post-operatively in group I compared with group II. Interpretation/Conclusion : Patients with THA still have defects in proprioception, so they needs more concentration on proprioception training.

Keywords: dynamic balance, functional performance, hip arthroplasty, total

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Authors: Ishani Majumdar, Jaishree Paul

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Introduction: Ulcerative Colitis (UC) is an inflammatory disease of the colon resulting from an autoimmune response towards individual’s own microbiota. Excessive inflammation is characterized by hyper-activation of NFkB, a transcription factor regulating expression of various pro-inflammatory genes. The ubiquitin editing complex consisting of TNFAIP3, ITCH, RNF11 and TAX1BP1 maintains homeostatic levels of active NFkB through feedback inhibition and assembles in response to various stimuli that activate NFkB. TNFAIP3 deubiquitinates key signaling molecules involved in NFkB activation pathway. ITCH, RNF11 and TAX1BP1 provide substrate specificity, acting as adaptors for TNFAIP3 function. Aim: This study aimed to find expression of members of the ubiquitin editing complex at the transcript level in inflamed colon tissues of UC patients. Materials and Methods: Colonic biopsy samples were collected from 30 UC patients recruited at Department of Gastroenterology, AIIMS (New Delhi). Control group (n= 10) consisted of individuals undergoing examination for functional disorders. Real Time PCR was used to determine relative expression with GAPDH as housekeeping gene. Results: Expression of members of the ubiquitin editing complex was significantly altered during active disease. Expression of TNFAIP3 was upregulated while concomitant decrease in expression of ITCH, RNF11, TAX1BP1 was seen in UC patients. Discussion: This study reveals that increase in expression of TNFAIP3 was unable to control inflammation during active UC. Further, insufficient upregulation of ITCH, RNF11, TAX1BP1 may limit the formation of the ubiquitin complex and contribute to pathogenesis of UC.

Keywords: altered expression, inflammation, ubiquitin editing complex, ulcerative colitis

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Authors: Andrey Norov

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Based on the generalization of scientific and production experience and the latest developments of JSC “NIUIF”, the oldest (founded in September 1919) and the only Russian research institute for phosphorus-containing fertilizers, this paper shows the factors that determine the reasonable choice of a method for processing phosphate raw materials into complex fertilizers. These factors primarily include the composition of phosphate raw materials and the impurities contained in it, as well as some parameters of the process mode, wastelessness, ecofriendliness, energy saving, maximum use of the heat of chemical reactions, fire and explosion safety, efficiency, productive capacity, the required product range and the possibility of creating flexible technologies, compliance with BAT principles, etc. The presented data allow to choose the right technology for complex granular fertilizers, depending on the abovementioned factors.

Keywords: BAT, ecofriendliness, energy saving, phosphate raw materials, wastelessness

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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Authors: Maria Do Carmo Baracho De Alencar, Marciene Campos Fialho, Maria Do Carmo Vitório Ramos

Abstract:

The subjects affected by Repetitive Strain Injury/Work Related Musculoskeletal Disorder (RSI/WRMSD) face an everyday life marked by pain, feelings of worthlessness and incapacity caused by the disease, and aggravated often because of discrimination society. Aim: To investigate the experiences and feelings of workers affected by RSI/WRMSD in removal from work situations and to understand the repercussions on mental health. Methods: Clinical records of workers were consulted, opened from July 1, 2014, to July 1, 2015, at the Reference Center for Worker's Health, in Santos city-SP. Selection of workers affected by RSI /WRMSD and who had experienced the removal from work situation due to the disease, and invitation to participate in the study. Semi-structured and individual interviews were carried out based on a pre-elaborated script, and for thematic content analysis. Results: Of a total of 502 medical records, 157 were selected, and of these, 18 workers participated in the interviews, both gender, most of them with low education level, aged between 35 and 56 years, and from different professions. Diseases affected several physical body regions and some workers had more than one body region affected by chronic pain. In the testimonies emerged the psychic suffering by the process of illness at work, fear of dismissal, invisibility of pain, in medical expertise attendance, by the incapacity to perform tasks that were easily achievable, with feelings of uselessness, revolt, and injustice, among others. Conclusion: The workers need to be readapted to new life situations, and the study promotes reflections on the need for more interdisciplinary actions and of the Psychology to the workers affected by RSI/ WRMSD.

Keywords: repetitive strain injury, cumulative trauma disorder, absence from work, mental health, occupational health

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Authors: A. Chegenizadeh, M. Keramatikerman, H. Nikraz

Abstract:

Bitumen is one of the most applicable materials in pavement engineering. It is a binding material with unique viscoelastic properties, especially when it mixes with polymer. In this study, to figure out the viscoelastic behaviour of the polymer modified with bitumen (PMB), a series of dynamic shearing rheological (DSR) tests were conducted. Four percentages of lime (i.e. 1%, 2%, 4% and 5%) were mixed with PMB and tested under four different temperatures including 64ºC, 70ºC, 76ºC and 82ºC. The results indicated that complex shearing modulus (G*) increased by increasing the frequency due to raised resistance against deformation. The phase angle (δ) showed a decreasing trend by incrementing the frequency. The addition of lime percentages increased the complex modulus value and declined phase angle parameter. Increasing the temperature decreased the complex modulus and increased the phase angle until 70ºC. The decreasing trend of rutting factor with increasing temperature revealed that rutting factor improved by the addition of the lime to the PMB.

Keywords: rheological properties, DSR test, polymer mixed with bitumen (PMB), complex modulus, lime

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Authors: Daniel Suárez, Jesús Tomas, Sandra Sendra, Sandra Viciano-Tudela, Luis Felipe Calle, Javier Urios, Jaime Lloret

Abstract:

Our study is to develop a tool for the mobile phone to an assessment of body damage or determination of the degree of disability. This is a field of action of legal medicine and insurance with obvious economic implications. Those people who have suffered an accident or bodily harm demand a quantification of it. The assessment of bodily harm or disability by the expert medical professional is not exempt from complexity. Sometimes it is difficult to quantify pain; other times, the doctor faces simulators or exaggerators, and on many occasions, it is difficult to remember the extensive tables of scales whose details are complex to remember and apply. We present a tool, as a mobile application, that allows entering the sociodemographic date of the patient as well as the characteristics of the accident suffered by the person. With these preliminary data and introducing bodily damage, an approximate calculation of the compensation that the injured party should receive can be made. One of the results of this study is that it allows calculating joint mobility angles without the need to use a goniometer.

Keywords: mobile tool, body damage, personal injury and disability, telemedicine

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Authors: Olivier Mulisya, Guelord Barasima, Henry Mark Lugobe, Philémon Matumo, Bienfait Mumbere Vahwere, Hilaire Mutuka, Zawadi Léocadie, Wesley Lumika

Abstract:

Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in most poor-resource settings because of poor antenatal coverage, low socioeconomic status in most of the patients as well as lack of adequate medical resources. Clinical diagnosis can be very difficult and an ultrasound scan is very helpful during the early stages of gestation but can also be disappointing in the later stages. We report a case of a 25-year-old woman with severe abdominal pain not amended with any medication. A clinical picture of shock lead to an emergency laparotomy which confirmed the diagnosis of abdominal pregnancy. The ministry of health in developing countries should make an effort to make routine early ultrasounds accessible to pregnant women, and obstetricians should keep in mind the possibility of ectopic pregnancy, irrespective of the gestational age.

Keywords: abdominal pregnancy, live new bron, ultrasound imaging, abdominal pain

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Authors: Péter Restás, Andrea Czibor, Zsolt Péter Szabó

Abstract:

Purpose: This article aims to rethink the phenomena of employee behavior as a product of a system. Both organizational culture and Complex Adaptive Systems (CAS) theory emphasize that individual behavior depends on the specific system and the unique organizational culture. These two major theories are both represented in the field of organizational studies; however, they are rarely used together for the comprehensive understanding of workplace behavior. Methodology: By reviewing the literature we use key concepts stemming from organizational culture and CAS theory in order to show the similarities between these theories and create an enriched understanding of employee behavior. Findings: a) Workplace behavior is defined here as social cognition issue. b) Organizations are discussed here as complex systems, and cultures which drive and dictate the cognitive processes of agents in the system. c) Culture gives CAS theory a context which lets us see organizations not just as ever-changing and unpredictable, but as such systems that aim to create and maintain stability by recurring behavior. Conclusion: Applying the knowledge from culture and CAS theory sheds light on our present understanding of employee behavior, also emphasizes the importance of novel ways in organizational research and management.

Keywords: complex adaptive systems theory, employee behavior, organizational culture, stability

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Authors: Harriet Nalubega, Eddie Mwebesa

Abstract:

In Uganda, over 90% of people use herbal remedies. Herbal medicine use has been associated with delayed clinical appointments, presentation with advanced cancers, financial constraints, and misdiagnosis. This study aimed to evaluate the prevalence of herbal medicine use and practices amongst cancer patients receiving Palliative Care at Mobile Hospice Mbarara (MHM) and the associated challenges. This was a mixed-methods prospective study conducted in 2022 at MHM, where patients were interviewed, and a questionnaire was completed. 87% of the patients had used herbal medicine. Of these, 83% were female, and 59% had not received formal education. 27% of patients had used herbal remedies for a year or more. 51% of patients who were consuming herbs stopped using them after starting palliative care treatment. Motivations for herbal medicine use were in the hope for a cure in 59%, for pain relief in 30%, and peer influence in 10%. There is a high prevalence of herbal medicine use in Palliative Care. Female gender and lack of formal education were disproportionately associated with herbal remedy use. Most patients consume herbal remedies in search of a cure or to relieve severe pain. Education of cancer patients about herbal remedy use may improve treatment outcomes in Palliative Care.

Keywords: prevalence, herbal medicine, cancer patients, palliative care

Procedia PDF Downloads 114