Search results for: non-pharmacological treatment methods
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 20780

Search results for: non-pharmacological treatment methods

16100 A Real-World Evidence Analysis of Associations between Costs, Quality of Life and Disease-Severity Indicators of Alzheimer’s Disease in Thailand

Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

Abstract:

Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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16099 Dynamic Contrast-Enhanced Breast MRI Examinations: Clinical Use and Technical Challenges

Authors: Janet Wing-Chong Wai, Alex Chiu-Wing Lee, Hailey Hoi-Ching Tsang, Jeffrey Chiu, Kwok-Wing Tang

Abstract:

Background: Mammography has limited sensitivity and specificity though it is the primary imaging technique for detection of early breast cancer. Ultrasound imaging and contrast-enhanced MRI are useful adjunct tools to mammography. The advantage of breast MRI is high sensitivity for invasive breast cancer. Therefore, indications for and use of breast magnetic resonance imaging have increased over the past decade. Objectives: 1. Cases demonstration on different indications for breast MR imaging. 2. To review of the common artifacts and pitfalls in breast MR imaging. Materials and Methods: This is a retrospective study including all patients underwent dynamic contrast-enhanced breast MRI examination in our centre, performed from Jan 2011 to Dec 2017. The clinical data and radiological images were retrieved from the EPR (electronic patient record), RIS (Radiology Information System) and PACS (Picture Archiving and Communication System). Results and Discussion: Cases including (1) Screening of the contralateral breast in patient with a new breast malignancy (2) Breast augmentation with free injection of unknown foreign materials (3) Finding of axillary adenopathy with an unknown site of primary malignancy (4) Neo-adjuvant chemotherapy: before, during, and after chemotherapy to evaluate treatment response and extent of residual disease prior to operation. Relevant images will be included and illustrated in the presentation. As with other types of MR imaging, there are different artifacts and pitfalls that can potentially limit interpretation of the images. Because of the coils and software specific to breast MR imaging, there are some other technical considerations that are unique to MR imaging of breast regions. Case demonstration images will be available in presentation. Conclusion: Breast MR imaging is a highly sensitive and reasonably specific method for the detection of breast cancer. Adherent to appropriate clinical indications and technical optimization are crucial for achieving satisfactory images for interpretation.

Keywords: MRI, breast, clinical, cancer

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16098 Acute Respiratory Infections in a Rural Area of the Southwestern Region of Bangladesh: Perceptions, Practices and the Role of First-Time Mothers

Authors: Sonia Mannan

Abstract:

A qualitative study was conducted in a rural area of the southwestern region of Bangladesh to identify perceptions, practices, and the role of first-time mothers surrounding acute respiratory infections (ARI) in infants and children aged under four years. The study reveals that all mothers had knowledge of ARI and were able to identify a number of signs and symptoms. They also recognized pneumonia and thought it to be caused by exposure to cold or weather change, supernatural causes, evil influences, mothers’ negligence, and failure to observe ‘purdah’. They were able to identify chest retractions, difficult breathing, and inability to feed as signs of severe disease needing treatment outside the home. In these cases, spiritual healers were sought, and allopathic treatment was delayed or avoided. Home care practices involved massaging the child with oil and avoiding 'cooling' foods, including water. With the presence of fever and breathing difficulty, mothers tended to increase the number and diversity of medicines, although more concern was expressed about fever than about breathing difficulty. Effective medical care was more likely to be delayed for infants than for older children (they often waited 2-5 days after signs of illness appeared); infants were also more likely to be taken to a spiritual healer as the first-choice provider. The reasons for these perceptions and practices and their implications on the ARI of infants and young children are discussed. Community intervention is identified as viable, effective, and practical to address the body of local socio-cultural knowledge about family practices and the role of the mother regarding the mitigation of ARI in infants and young children.

Keywords: acute respiratory infections , public health, pneumonia, Bangladesh

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16097 Preservation of Sensitive Biological Products: An Insight into Conventional and Upcoming Drying Techniques

Authors: Jannika Dombrowski, Sabine Ambros, Ulrich Kulozik

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Several drying techniques are used to preserve sensitive substances such as probiotic lactic acid bacteria. With the aim to better understand differences between these processes, this work gives new insights into structural variations resulting from different preservation methods and their impact on product quality and storage stability. Industrially established methods (freeze drying, spray drying) were compared to upcoming vacuum, microwave-freeze, and microwave-vacuum drying. For freeze and microwave-freeze dried samples, survival and activity maintained 100%, whereas vacuum and microwave-vacuum dried cultures achieved 30-40% survival. Spray drying yielded in lowest viability. The results are directly related to temperature and oxygen content during drying. Interestingly, most storage stable products resulted from vacuum and microwave-vacuum drying due to denser product structures as determined by helium pycnometry and SEM images. Further, lower water adsorption velocities were responsible for lower inactivation rates. Concluding, resulting product structures as well as survival rates and storage stability mainly depend on the type of water removal instead of energy input. Microwave energy compared to conductive heating did not lead to significant differences regarding the examined factors. Correlations could be proven for three investigated microbial strains. The presentation will be completed by an overview on the energy efficiency of the presented methods.

Keywords: drying techniques, energy efficiency, lactic acid bacteria, probiotics, survival rates, structure characterization

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16096 Study of the Use of Artificial Neural Networks in Islamic Finance

Authors: Kaoutar Abbahaddou, Mohammed Salah Chiadmi

Abstract:

The need to find a relevant way to predict the next-day price of a stock index is a real concern for many financial stakeholders and researchers. We have known across years the proliferation of several methods. Nevertheless, among all these methods, the most controversial one is a machine learning algorithm that claims to be reliable, namely neural networks. Thus, the purpose of this article is to study the prediction power of neural networks in the particular case of Islamic finance as it is an under-looked area. In this article, we will first briefly present a review of the literature regarding neural networks and Islamic finance. Next, we present the architecture and principles of artificial neural networks most commonly used in finance. Then, we will show its empirical application on two Islamic stock indexes. The accuracy rate would be used to measure the performance of the algorithm in predicting the right price the next day. As a result, we can conclude that artificial neural networks are a reliable method to predict the next-day price for Islamic indices as it is claimed for conventional ones.

Keywords: Islamic finance, stock price prediction, artificial neural networks, machine learning

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16095 The Possibility to Assess the Industrial Enterprise Sustainability

Authors: G. Khasaev, S. Ashmarina , A. Zotova

Abstract:

The priority of Russian enterprises development has been given to the optimization process of industrial enterprise activity for their sustainable development in a long-term period. The assessment of sustainable development level as one of the most efficient instruments of sustainable development management at the industrial enterprise gives a complex view of its state. In order to perform accurate analysis of the current state of the industrial enterprise, it is necessary to perform the assessment of its sustainable development and using its results to elaborate the further tactic of enterprise functioning. The assessment of sustainable development level of the enterprise may help the effective management of strategy development only if the corresponding indicators system is created. The elaboration and usage the sustainable development indicators allows the enterprise to implement analysis of its activity results and monitoring of sustainable enterprise functioning. The authors’ methods are based on general aspects of the industrial enterprise functioning such as finance, customers, inner economic process, and staff system.

Keywords: assessment methods, indicators system, industrial enterprise, sustainable development

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16094 A Method for Precise Vertical Position of the Implant When Using Computerized Surgical Guides and Bone Reduction

Authors: Abraham Finkelman

Abstract:

Computerized Surgical Guides have been proven to be a predictable way to perform dental implants, with a relatively high accuracy in comparison to a treatment plan. When using the CSG Bone supported, it allows us to make the necessary changes of the hard tissue prior to the implant placement and after the implant placement. The CSG gives us an accurate position for the drilling, and during the implant placement it allows us to alter the vertical position of the implant altering the final position of the abutment and avoiding any risk of any damage to the adjacent anatomical structures. Any Changes required to the bone level can be done prior to the fixation of the CSG using a reduction guide, which incur extra surgical fees and the need of a second surgical guide. Any changes of the bone level after the implant placement are at the risk of damaging the implant neck surface. The technique consists of a universal system that allows us to remove the excess bone around the implant sockets prior to the implant placement which then enables us to place the implant in the vertical position with accuracy as planned with the CSG. The systems consist of a hollow pin of different sizes and diameters. Depending on the implant system that we are using. Length sizes are from 6mm-16mm and a diameter of 2.6mm-4.8mm. Upon the completion of the drilling, the pin is then inserted into the implant socket-using the insertion tool. Once the insertion tool has unscrewed the pin, we can continue with the bone reduction. The bone reduction can be done using conventional methods upon the removal of all the excess bone around the pin. The insertion tool is then screwed into the pin and the pin is then removed. We now, have the new bone level at the crest of the implant socket which is our mark for the vertical position of the implant. In some cases, when we are locating the implant very close to anatomical structures, any form of deviation to the vertical position of the implant during the surgery, can cause damage to such anatomical structures, creating irreversible damages such as paresthesia or dysesthesia of the mandibular nerve. If we are planning for immediate loading and we have done our temporary restauration in base of our computerized plan, deviation in the vertical position of the implant will affect the position of the abutment, affecting the accuracy of the temporary prosthesis, extending the working time till we adapt the prosthesis to the new position.

Keywords: bone reduction, computer aided navigation, dental implant placement, surgical guides

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16093 Gene Names Identity Recognition Using Siamese Network for Biomedical Publications

Authors: Micheal Olaolu Arowolo, Muhammad Azam, Fei He, Mihail Popescu, Dong Xu

Abstract:

As the quantity of biological articles rises, so does the number of biological route figures. Each route figure shows gene names and relationships. Annotating pathway diagrams manually is time-consuming. Advanced image understanding models could speed up curation, but they must be more precise. There is rich information in biological pathway figures. The first step to performing image understanding of these figures is to recognize gene names automatically. Classical optical character recognition methods have been employed for gene name recognition, but they are not optimized for literature mining data. This study devised a method to recognize an image bounding box of gene name as a photo using deep Siamese neural network models to outperform the existing methods using ResNet, DenseNet and Inception architectures, the results obtained about 84% accuracy.

Keywords: biological pathway, gene identification, object detection, Siamese network

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16092 Perception Towards Using E-learning with Stem Students Whose Programs Require Them to Attend Practical Sections in Laboratories during Covid-19

Authors: Youssef A. Yakoub, Ramy M. Shaaban

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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 eLearning instead of regular classes among students who take practical education. The aim of this study is to examine the perception of STEM students towards using eLearning instead of traditional methods during their practical study. Focus groups of STEM students studying at a western Pennsylavian, mid-size university were interviewed. Semi-structured interviews were designed to get an insight on students’ perception towards the alternative educational methods they used in the past seven months. Using convenient sampling, four students were chosen from different STEM fields: science of physics, technology, electrical engineering, and mathematics. The interview was primarily about the extent to which these students were satisfied, and their educational needs were met through distance education during the pandemic. The interviewed students were generally able to do a satisfactory performance during their virtual classes, but they were not satisfied enough with the learning methods. The main challenges they faced included the inability to have real practical experience, insufficient materials posted by the faculty, and some technical problems associated with their study. However, they reported they were satisfied with the simulation programs they had. They reported these simulations provided them with a good alternative to their traditional practical education. In conclusion, this study highlighted the challenges students face during the pandemic. It also highlighted the various learning tools students see as good alternatives to their traditional education.

Keywords: eLearning, STEM education, COVID-19 crisis, online practical training

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16091 Glenoid Osteotomy with Various Tendon Transfers for Brachial Plexus Birth Palsy: Clinical Outcomes

Authors: Ramin Zargarbashi, Hamid Rabie, Behnam Panjavi, Hooman Kamran, Seyedarad Mosalamiaghili, Zohre Erfani, Seyed Peyman Mirghaderi, Maryam Salimi

Abstract:

Background: Posterior shoulder dislocation is one of the disabling complications of brachial plexus birth injury (BPBI), and various treatment options, including capsule and surrounding muscles release for open reduction, humeral derotational osteotomy, and tendon transfers, have been recommended to manage it. In the present study, we aimed to determine the clinical outcome of open reduction with soft tissue release, tendon transfer, and glenoid osteotomy inpatients with BPBI and posterior shoulder dislocation or subluxation. Methods: From 2018 to 2020, 33 patients that underwent open reduction, glenoid osteotomy, and tendon transfer were included. The glenohumeral deformity was classified according to the Waters radiographic classification. Functional assessment was performed using the Mallet grading system before and at least two years after the surgery. Results: The patients were monitored for 26.88± 5.47 months. Their average age was 27.5±14 months. Significant improvement was seen in the overall Mallet score (from 13.5 to 18.91 points) and its segments, including hand to mouth, hand to the neck, global abduction, global external rotation, abduction degree, and external rotation degree. Hand-to-back score and the presence of trumpet sign were significantly decreased in the post-operation phase (all p values<0.001). The above-mentioned variables significantly changed for both infantile and non-infantile dislocations. Conclusion: Our study demonstrated that open reduction along with glenoid osteotomy improves retroversion, and muscle strengthening with different muscle transfers is an effective technique for BPBI.

Keywords: birth injuries, nerve injury, brachial plexus birth palsy, Erb palsy, tendon transfer

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16090 The Epidemiological Study on Prevalence of Giardia lamblia among Children in Esfahan City of Iran

Authors: Shahla Rostamirad

Abstract:

Purpose: Giardiasis is a widespread infection in humans caused by Giardia lamblia. The prevalence of this parasite among children in Isfahan of Iran is unknown. This study intended to estimate Giardia lamblia infection prevalence and identify possible associated risk factors in a healthy pediatric population living in the Isfahan, a metropolitan city of Iran. Methods: Between September 2010 and March 2012, 1448 stool sample from children with clinical manifestation that refer to clinical lab in Isfahan city for stool examination were collected and analyzed. About 1218 samples were positive for parasitic disease. All of samples were examined and diagnosed by direct examination and formalin-ether concentration of stools. Results: A total of 1218 positive cases were analyzed in this study. The findings showed that 92.5% of patients were infected by protozoa and 7.5 percent with helminth infection. The highest and lowest rate of infection belongs to Giardia lamblia and Entamoeba histolytica with 75% and 1.1%, respectively. Other infection cases were included of Blastocystys hominis 9.9%, E. coli 6.5%, H. nana 1.3%, Enterobious vermicolaris 4% and Ascaris lumbricoides 2.2% percent. The population studied revealed a gender distribution of 53.2% male and 46.8% female. Age distribution was 57.3% between 0-5 years and 42.7% between 6-15 years.The prevalence was higher among children aged 0-5 years (57.8%), than among older children (42.2%). Conclusion: The prevalence of protozoan parasite, especially Giardiasis, in children residing in the region of Isfahan is high. Several risk factors were associated with this prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between Giardia lamblia and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies. Other risk factor include presence of Helicobacter pylori infection, living in houses with own drainage system and reported household, pet contact, especially with cat and dog.

Keywords: Giardia duodenalis, prevalence, risk factors, children, Isfahan, Iran

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16089 Egg Yolk Peptide Stimulated Osteogenic Gene Expression

Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem

Abstract:

Postmenopausal osteoporosis is characterized by low bone density which leads to increased bone fragility and greater susceptibility to fracture. Current treatments for osteoporosis are dominated by drugs that inhibit bone resorption although they also suppress bone formation that may contribute to pathogenesis of osteonecrosis. To restore the extensive bone loss, there is a great need for anabolic treatments that induce osteoblasts to build new bone. Pre-osteoblastic cells produce proteins of the extra-cellular matrix, including type I collagen at first, and then to successively produce alkaline phosphatase (ALP) and osteocalcin during differentiation to osteoblasts. Finally, osteoblasts deposit calcium. Present study investigated the effects of egg yolk peptide (EYP) on osteogenic activities and bone matrix gene expressions in human osteoblastic MG-63 cells. The effects of EYP on cell proliferation, alkaline phosphatase (ALP) activity, collagen synthesis, and mineralization were measured. The expression of osteogenic genes including COL1A1 (collagen, type I, alpha 1), ALP, BGLAP (osteocalcin), and SPP1 (secreted phosphoprotein 1, osteopontin) were measured by quantitative realtime PCR. EYP dose-dependently increased MG-63 cell proliferation, ALP activity, collagen synthesis, and calcium deposition. Furthermore, COL1A1, ALP, and SPP1 gene expressions were increased by EYP treatment. Present study suggested that EYP treatment enhanced osteogenic activities and increased bone matrix osteogenicgenes. These results could provide a mechanistic explanation for the bone-strengthening effects of EYP.

Keywords: egg yolk peptide, osteoblastic MG-63 cells, alkaline phosphatase, collagen synthesis, osteogenic genes, COL1A1, osteocalcin, osteopontin

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16088 Urban Laboratory for Community Involvement in Urban Design Process

Authors: Anja Jutraz, Tadeja Zupancic

Abstract:

This article explores urban laboratory, which presents a combination of different physical and digital methods and tools for public participation in urban design. The city consists of built and unbuilt environments, which can be defined as a community of people, who live there. Communities should have the option to express opinions and decide about the future of their city, from the early stages of the design process onwards. In this paper, we presented the possibility of involving community into renewal of Banska Štiavnica in Slovakia (more exactly the old mining shaft and lake Michal Štolna) and the methods to promote the community building. As a case study we presented the eTHNo project, Education about Technical, Historical and Natural opportunities of Michal Štolna. Moreover, we discussed the possibility of using virtual digital tools for public participation in urban design, where we especially focused on Virtual Urban Laboratory, VuLab.

Keywords: community building, digital tools, public participation, urban design

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16087 Advancements in Predicting Diabetes Biomarkers: A Machine Learning Epigenetic Approach

Authors: James Ladzekpo

Abstract:

Background: The urgent need to identify new pharmacological targets for diabetes treatment and prevention has been amplified by the disease's extensive impact on individuals and healthcare systems. A deeper insight into the biological underpinnings of diabetes is crucial for the creation of therapeutic strategies aimed at these biological processes. Current predictive models based on genetic variations fall short of accurately forecasting diabetes. Objectives: Our study aims to pinpoint key epigenetic factors that predispose individuals to diabetes. These factors will inform the development of an advanced predictive model that estimates diabetes risk from genetic profiles, utilizing state-of-the-art statistical and data mining methods. Methodology: We have implemented a recursive feature elimination with cross-validation using the support vector machine (SVM) approach for refined feature selection. Building on this, we developed six machine learning models, including logistic regression, k-Nearest Neighbors (k-NN), Naive Bayes, Random Forest, Gradient Boosting, and Multilayer Perceptron Neural Network, to evaluate their performance. Findings: The Gradient Boosting Classifier excelled, achieving a median recall of 92.17% and outstanding metrics such as area under the receiver operating characteristics curve (AUC) with a median of 68%, alongside median accuracy and precision scores of 76%. Through our machine learning analysis, we identified 31 genes significantly associated with diabetes traits, highlighting their potential as biomarkers and targets for diabetes management strategies. Conclusion: Particularly noteworthy were the Gradient Boosting Classifier and Multilayer Perceptron Neural Network, which demonstrated potential in diabetes outcome prediction. We recommend future investigations to incorporate larger cohorts and a wider array of predictive variables to enhance the models' predictive capabilities.

Keywords: diabetes, machine learning, prediction, biomarkers

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16086 Effective Factors on Self-Care in Women with Osteoporosis: A Study with Content Analysis Approach

Authors: Arezoo Fallahi, Siamak Derakhshan, Parvaneh Taymoori, Babak Nematshahrbabaki

Abstract:

Background: Osteoporosis, the most common metabolic bone disease, is an important health care issue. Not only the cost of disease is high but also is one of the causes of disability and mortality and effect on quality of life. Although self-care is effective on disease, s control and treatment but still effective factors on self-care of patient, s viewpoint have not been survey. The aim of this study was to explore effective factors on self-care in women with osteoporosis. Materials and methods: This study was done by conventional content analysis approach in year 2014. Through purposeful sampling 15 women referred to bone mass densitometry centers participated in this study. Inclusion criteria were: Women older than 50 years old with osteoporosis, final diagnosis of osteoporosis for over six –month period, T-score index below -2.5 (lower back or hip), drug use by patients with a physician’s prescription, ability in speaking and attending to participate in the study. Data was collected by face to face and group semi-structure deep interviews and analyzed via content analysis method. To support of rigor of data, criteria credibility, confirmability and transferability were used. Results: during data analysis five categories developed: “hope and disability in the face of illness”, “mutual roles of physician”, “role of family” and “administrative centers and organizations”. To perform self-care behaviors, the participations of this study emphasized on pay attention to their own healthy, regarding patients' rights by physician, pay attention to women's health by men, and the role of media especially radio and television. Conclusion: the finding of the study showed that women’s responsibility with osteoporosis for their health is not a factor but it is multifactorial. Increasing life expectancy in patients, attention to patients needs by physician, increasing health promotion programs in the media and enhancing role of family may provide conditions and infrastructure to empowerment women in doing self-care behavior.

Keywords: women, osteoporosis, self-care, content analysis

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16085 Pathogenic Candida Biofilms Producers Involved in Healthcare Associated Infections

Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

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The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

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16084 Implementing 3D Printed Structures as the Newest Textile Form

Authors: Banu Hatice Gürcüm, Pınar Arslan, Mahmut Yalçın

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From the oldest production methods with yarns used to weave, knit, braid and knot to the newest production methods with fibres used to stitch, bond or structures of innovative technologies, laminates, nanoparticles, composites or 3D printing systems, textile industry advanced through materials, processes and context mostly within the last five decades. The creative momentum of fabric like 3D printed structures have come to the point of transforming as for the newest form of textile applications. Moreover, pioneering studies on the applications of 3D Printing Technology and Additive Manufacturing have been focusing on fashion and apparel sector from the last two decades beginning with fashion designers. After the advent of chain-mail like structures and flexible micro or meso structures created by SLS rapid manufacturing a more textile-like behavior is achieved. Thus, the primary aim of this paper is to discuss the most important properties of traditional fabrics that are to be expected of future fabrics. For this reason, this study deals primarily with the physical properties like softness, hand, flexibility, drapability and wearability of 3D Printed structures necessary to identify the possible ways in which it can be used instead of contemporary textile structures, namely knitted and woven fabrics. The aim of this study is to compare the physical properties of 3D printed fabrics regarding different rapid manufacturing methods (FDM and SLS). The implemented method was Material Driven Design (MDD), which comprise the use of innovative materials according to the production techniques such as 3D printing system. As a result, advanced textile processes and materials enable to the creation of new types of fabric structures and rapid solutions in the field of textiles and 3D fabrics on the other hand, are to be used in this regard.

Keywords: 3D printing technology, FDM, SLS, textile structure

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16083 The Effects of High-frequency rTMS Targeting the Mirror Neurons on Improving Social Awareness in ASD, the Preliminary Analysis of a Pilot Study

Authors: Mitra Assadi, Md. Faan

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Background: Autism Spectrum Disorder (ASD) in a common neurodevelopmental disorder with limited pharmacological interventions. Transcranial Magnetic Stimulation (rTMS) has produced promising results in ASD, although there is no consensus regarding optimal targets or stimulation paradigms. A prevailing theory in ASD attributes the core deficits to dysfunction of the mirror neurons located in the inferior parietal lobule (IPL) and inferior frontal gyrus (IFG). Methods: Thus far, 11 subjects with ASD, 10 boys and 1 girl with the mean age of 13.36 years have completed the study by receiving 10 session of high frequency rTMS to the IPL. The subjects were randomized to receive stimulation on the left or right IPL and sham stimulation to the opposite side. The outcome measures included the Social Responsiveness Scale – Second Edition (SRS-2) and Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency task. Results: None of the 11 subjects experienced any adverse effects. The rTMS did not produce any improvement in verbal fluency, nor there was any statistically significant difference between the right versus left sided stimulation. Analysis of social awareness on SRS-2 (SRS-AWR) indicated a close to significant effect of the treatment with a small to medium effect size. After removing a single subject with Level 3 ASD, we demonstrated a close to significant improvement on SRS-AWR with a large effect size. The analysis of the data 3-month post TMS demonstrated return of the SRS-AWR values to baseline. Conclusion: This preliminary analysis of the 11 subjects who have completed our study thus far shows a favorable response to high frequency rTMS stimulation of the mirror neurons/IPL on social awareness. While the decay of the response noted during the 3-month follow-up may be considered a limitation of rTMS, the presence of the improvement, especially the effect size despite the small sample size, is indicative of the efficacy of this technique.

Keywords: rTMS, autism, scoial cognition, mirror neurons

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16082 Simulation of Complex-Shaped Particle Breakage with a Bonded Particle Model Using the Discrete Element Method

Authors: Felix Platzer, Eric Fimbinger

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In Discrete Element Method (DEM) simulations, the breakage behavior of particles can be simulated based on different principles. In the case of large, complex-shaped particles that show various breakage patterns depending on the scenario leading to the failure and often only break locally instead of fracturing completely, some of these principles do not lead to realistic results. The reason for this is that in said cases, the methods in question, such as the Particle Replacement Method (PRM) or Voronoi Fracture, replace the initial particle (that is intended to break) into several sub-particles when certain breakage criteria are reached, such as exceeding the fracture energy. That is why those methods are commonly used for the simulation of materials that fracture completely instead of breaking locally. That being the case, when simulating local failure, it is advisable to pre-build the initial particle from sub-particles that are bonded together. The dimensions of these sub-particles consequently define the minimum size of the fracture results. This structure of bonded sub-particles enables the initial particle to break at the location of the highest local loads – due to the failure of the bonds in those areas – with several sub-particle clusters being the result of the fracture, which can again also break locally. In this project, different methods for the generation and calibration of complex-shaped particle conglomerates using bonded particle modeling (BPM) to enable the ability to depict more realistic fracture behavior were evaluated based on the example of filter cake. The method that proved suitable for this purpose and which furthermore allows efficient and realistic simulation of breakage behavior of complex-shaped particles applicable to industrial-sized simulations is presented in this paper.

Keywords: bonded particle model, DEM, filter cake, particle breakage

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16081 Influence of a Cationic Membrane in a Double Compartment Filter-Press Reactor on the Atenolol Electro-Oxidation

Authors: Alan N. A. Heberle, Salatiel W. Da Silva, Valentin Perez-Herranz, Andrea M. Bernardes

Abstract:

Contaminants of emerging concern are substances widely used, such as pharmaceutical products. These compounds represent risk for both wild and human life since they are not completely removed from wastewater by conventional wastewater treatment plants. In the environment, they can be harm even in low concentration (µ or ng/L), causing bacterial resistance, endocrine disruption, cancer, among other harmful effects. One of the most common taken medicine to treat cardiocirculatory diseases is the Atenolol (ATL), a β-Blocker, which is toxic to aquatic life. In this way, it is necessary to implement a methodology, which is capable to promote the degradation of the ATL, to avoid the environmental detriment. A very promising technology is the advanced electrochemical oxidation (AEO), which mechanisms are based on the electrogeneration of reactive radicals (mediated oxidation) and/or on the direct substance discharge by electron transfer from contaminant to electrode surface (direct oxidation). The hydroxyl (HO•) and sulfate (SO₄•⁻) radicals can be generated, depending on the reactional medium. Besides that, at some condition, the peroxydisulfate (S₂O₈²⁻) ion is also generated from the SO₄• reaction in pairs. Both radicals, ion, and the direct contaminant discharge can break down the molecule, resulting in the degradation and/or mineralization. However, ATL molecule and byproducts can still remain in the treated solution. On this wise, some efforts can be done to implement the AEO process, being one of them the use of a cationic membrane to separate the cathodic (reduction) from the anodic (oxidation) reactor compartment. The aim of this study is investigate the influence of the implementation of a cationic membrane (Nafion®-117) to separate both cathodic and anodic, AEO reactor compartments. The studied reactor was a filter-press, with bath recirculation mode, flow 60 L/h. The anode was an Nb/BDD2500 and the cathode a stainless steel, both bidimensional, geometric surface area 100 cm². The solution feeding the anodic compartment was prepared with ATL 100 mg/L using Na₂SO₄ 4 g/L as support electrolyte. In the cathodic compartment, it was used a solution containing Na₂SO₄ 71 g/L. Between both solutions was placed the membrane. The applied currents densities (iₐₚₚ) of 5, 20 and 40 mA/cm² were studied over 240 minutes treatment time. Besides that, the ATL decay was analyzed by ultraviolet spectroscopy (UV/Vis). The mineralization was determined performing total organic carbon (TOC) in TOC-L CPH Shimadzu. In the cases without membrane, the iₐₚₚ 5, 20 and 40 mA/cm² resulted in 55, 87 and 98 % ATL degradation at the end of treatment time, respectively. However, with membrane, the degradation, for the same iₐₚₚ, was 90, 100 and 100 %, spending 240, 120, 40 min for the maximum degradation, respectively. The mineralization, without membrane, for the same studied iₐₚₚ, was 40, 55 and 72 %, respectively at 240 min, but with membrane, all tested iₐₚₚ reached 80 % of mineralization, differing only in the time spent, 240, 150 and 120 min, for the maximum mineralization, respectively. The membrane increased the ATL oxidation, probably due to avoid oxidant ions (S₂O₈²⁻) reduction on the cathode surface.

Keywords: contaminants of emerging concern, advanced electrochemical oxidation, atenolol, cationic membrane, double compartment reactor

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16080 Full Fat Soybean Meal as a Substitute for Soybean Meal in Broiler Rations

Authors: R. M. K. S. Chandana, A. P. D. G. Pathirana, N. Priyankarage, W. A. D. Nayananjalie, S. S. P. Silva

Abstract:

Full fat soybean meal (FFSBM) has been used in many parts of the world together with solvent-extracted soybean meal (SBM) in livestock feeds. Although some local FFSBM is available, their use has not been assessed experimentally. This study was carried out to evaluate the use of local extruded FFSBM in broiler rations. Four treatment diets were formulated by incorporating locally produced FFSBM (0, 10, 20, and 30%) as a replacement for soybean meal (SBM) in a two-phase (starter and finisher) feeding program. Two hundred Hubbard F 15 day old broiler chicks were randomly assigned into four treatments with five replicates per each. Bodyweight gain (BWG), feed intakes (FI), and feed conversion ratio (FCR) were calculated for a period of 42 days. Nutrient utilization in the form of dry matter (DM), energy, nitrogen, and fat retention were estimated by the total collection method in three weeks old broilers. At the end of the experiment, carcass weight was measured, and the dressing percentage was calculated. Data were analyzed using one way analysis of variance (ANOVA) in SAS. There was no significant effect of FFSBM on feed intakes of chicks fed different diets (p > 0.05). Birds fed the control diet, and FF10 (10% FFSBM diet) gained significantly more than that of birds fed FF20 or FF30 diets (p > 0.05). In the finisher period, control birds gained more than all the other treatment birds. FCR was poorer in bird fed higher levels of FFSBM compared to the control or FF10 birds during their early life, but that was not evident in the latter part of the experiment. Treatments did not alter (p > 0.05) the retention of DM and nitrogen, but energy utilization was lowest (p < 0.05) in birds fed with 0% FFSBM, and the highest fat digestibility was observed in birds fed with 30% FFSBM diets. Thus, it can be concluded that FFSBM can be used as a substitute for SBM in broiler rations and could be incorporated up to 10% of the diet safely with no adverse effects on broiler performances.

Keywords: body weight, broiler, digestibility, full fat soybean meal, soybean meal

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16079 Using Biopolymer Materials to Enhance Sandy Soil Behavior

Authors: Mohamed Ayeldeen, Abdelazim Negm

Abstract:

Nowadays, strength characteristics of soils have more importance due to increasing building loads. In some projects, geotechnical properties of the soils are be improved using man-made materials varying from cement-based to chemical-based. These materials have proven successful in improving the engineering properties of the soil such as shear strength, compressibility, permeability, bearing capacity etc.. However, the use of these artificial injection formulas often modifies the pH level of soil, contaminates soil and groundwater. This is attributed to their toxic and hazardous characteristics. Recently, an environmentally friendly soil treatment method or Biological Treatment Method (BTM) was to bond particles of loose sandy soils. This research paper presents the preliminary results of using biopolymers for strengthening cohesionless soil. Xanthan gum was identified for further study over a range of concentrations varying from 0.25% to 2.00%. Xanthan gum is a polysaccharide secreted by the bacterium Xanthomonas campestris, used as a food additive and it is a nontoxic material. A series of direct shear, unconfined compressive strength, and permeability tests were carried out to investigate the behavior of sandy soil treated with Xanthan gum with different concentration ratios and at different curing times. Laser microscopy imaging was also conducted to study the microstructure of the treated sand. Experimental results demonstrated the compatibility of Xanthan gum to improve the geotechnical properties of sandy soil. Depending on the biopolymer concentration, it was observed that the biopolymers effectively increased the cohesion intercept and stiffness of the treated sand and reduced the permeability of sand. The microscopy imaging indicates that the cross-links of the biopolymers through and over the soil particles increase with the increase of the biopolymer concentration.

Keywords: biopolymer, direct shear, permeability, sand, shear strength, Xanthan gum

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16078 A Fluorescent Polymeric Boron Sensor

Authors: Soner Cubuk, Mirgul Kosif, M. Vezir Kahraman, Ece Kok Yetimoglu

Abstract:

Boron is an essential trace element for the completion of the life circle for organisms. Suitable methods for the determination of boron have been proposed, including acid - base titrimetric, inductively coupled plasma emission spectroscopy flame atomic absorption and spectrophotometric. However, the above methods have some disadvantages such as long analysis times, requirement of corrosive media such as concentrated sulphuric acid and multi-step sample preparation requirements and time-consuming procedures. In this study, a selective and reusable fluorescent sensor for boron based on glycosyloxyethyl methacrylate was prepared by photopolymerization. The response characteristics such as response time, pH, linear range, limit of detection were systematically investigated. The excitation/emission maxima of the membrane were at 378/423 nm, respectively. The approximate response time was measured as 50 sec. In addition, sensor had a very low limit of detection which was 0.3 ppb. The sensor was successfully used for the determination of boron in water samples with satisfactory results.

Keywords: boron, fluorescence, photopolymerization, polymeric sensor

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16077 Liquid Chromatography Microfluidics for Detection and Quantification of Urine Albumin Using Linear Regression Method

Authors: Patricia B. Cruz, Catrina Jean G. Valenzuela, Analyn N. Yumang

Abstract:

Nearly a hundred per million of the Filipino population is diagnosed with Chronic Kidney Disease (CKD). The early stage of CKD has no symptoms and can only be discovered once the patient undergoes urinalysis. Over the years, different methods were discovered and used for the quantification of the urinary albumin such as the immunochemical assays where most of these methods require large machinery that has a high cost in maintenance and resources, and a dipstick test which is yet to be proven and is still debated as a reliable method in detecting early stages of microalbuminuria. This research study involves the use of the liquid chromatography concept in microfluidic instruments with biosensor as a means of separation and detection respectively, and linear regression to quantify human urinary albumin. The researchers’ main objective was to create a miniature system that quantifies and detect patients’ urinary albumin while reducing the amount of volume used per five test samples. For this study, 30 urine samples of unknown albumin concentrations were tested using VITROS Analyzer and the microfluidic system for comparison. Based on the data shared by both methods, the actual vs. predicted regression were able to create a positive linear relationship with an R2 of 0.9995 and a linear equation of y = 1.09x + 0.07, indicating that the predicted values and actual values are approximately equal. Furthermore, the microfluidic instrument uses 75% less in total volume – sample and reagents combined, compared to the VITROS Analyzer per five test samples.

Keywords: Chronic Kidney Disease, Linear Regression, Microfluidics, Urinary Albumin

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16076 Generating Real-Time Visual Summaries from Located Sensor-Based Data with Chorems

Authors: Z. Bouattou, R. Laurini, H. Belbachir

Abstract:

This paper describes a new approach for the automatic generation of the visual summaries dealing with cartographic visualization methods and sensors real time data modeling. Hence, the concept of chorems seems an interesting candidate to visualize real time geographic database summaries. Chorems have been defined by Roger Brunet (1980) as schematized visual representations of territories. However, the time information is not yet handled in existing chorematic map approaches, issue has been discussed in this paper. Our approach is based on spatial analysis by interpolating the values recorded at the same time, by sensors available, so we have a number of distributed observations on study areas and used spatial interpolation methods to find the concentration fields, from these fields and by using some spatial data mining procedures on the fly, it is possible to extract important patterns as geographic rules. Then, those patterns are visualized as chorems.

Keywords: geovisualization, spatial analytics, real-time, geographic data streams, sensors, chorems

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16075 Comparative Analysis of DTC Based Switched Reluctance Motor Drive Using Torque Equation and FEA Models

Authors: P. Srinivas, P. V. N. Prasad

Abstract:

Since torque ripple is the main cause of noise and vibrations, the performance of Switched Reluctance Motor (SRM) can be improved by minimizing its torque ripple using a novel control technique called Direct Torque Control (DTC). In DTC technique, torque is controlled directly through control of magnitude of the flux and change in speed of the stator flux vector. The flux and torque are maintained within set hysteresis bands. The DTC of SRM is analysed by two methods. In one of the methods, the actual torque is computed by conducting Finite Element Analysis (FEA) on the design specifications of the motor. In the other method, the torque is computed by Simplified Torque Equation. The variation of peak current, average current, torque ripple and speed settling time with Simplified Torque Equation model is compared with FEA based model.

Keywords: direct toque control, simplified torque equation, finite element analysis, torque ripple

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16074 Effect of Biopesticide to Control Infestation of Whitefly Bemisia tabaci (Gennadius) on the Culantro Eryngium foetidum L.

Authors: Udomporn Pangnakorn, Sombat Chuenchooklin

Abstract:

Effect of the biopesticide from entomopathogenic nematode (Steinernema thailandensis n. sp.), bacteria ISR (Pseudomonas fluorescens), wood vinegar and fermented organic substances from plants: (neem Azadirachta indica + citronella grass Cymbopogon nardus Rendle + bitter bush Chromolaena odorata L.) were tested on culantro (Eryngium foetidum L.). The biopesticide was carried out for reduction infestation of the major insects pest (whitefly Bemisia tabaci (Gennadius)). The experimental plots were located at farmers’ farm in Tumbol Takhian Luean, Nakhon Sawan Province, Thailand. This study was undertaken during the drought season (lately November to May). The populations of whitefly were observed and recorded every hour up to 3 hours with insect net and yellow sticky traps after the treatments were applied. The results showed that bacteria ISR was the highest effectiveness for control whitefly infestation on culantro, the whitefly numbers on insect net were 12.5, 10.0, and 7.5 after spraying in 1hr, 2hr, and 3hr, respectively. While the whitefly on yellow sticky traps showed 15.0, 10.0, and 10.0 after spraying in 1hr, 2hr, and 3hr, respectively. Furthermore, overall the experiments showed that treatment of bacteria ISR found the average whitefly numbers only 8.06 and 11.0 on insect net and sticky tap respectively, followed by treatment of nematode found the average whitefly with 9.87 and 11.43 on the insect net and sticky tap, respectively. Therefore, the application of biopesticide from entomopathogenic nematodes, bacteria ISR, organic substances from plants and wood vinegar combined with natural enemies is the alternative method of Integrated Pest Management (IPM) for against infestation of whitefly.

Keywords: whitefly (Bemisia tabaci Gennadius), culantro (Eryngium foetidum L.), entomopathogenic nematode (Steinernema thailandensis n. sp.), bacteria ISR (Pseudomonas fluorescens), wood vinegar, fermented organic substances

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16073 An Investigation of the Relevant Factors of Unplanned Readmission within 14 Days of Discharge in a Regional Teaching Hospital in South Taiwan

Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

Abstract:

Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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16072 Lymphomas as Estrogen-Regulated Cancers

Authors: M. S. Hasni, J. Guan, K. Yakimchuk, M. Berglund, B. Sander, G. Enblad, R. M. Amini, S. Okret

Abstract:

Lymphomas are generally not considered as endocrine-related cancers. However, most lymphoid malignancies show gender differences in incidence and show prognosis with males being more affected. Furthermore, some epidemiological data indicate a protective role of estrogens against Non-Hodgkin lymphomas. Recent studies have demonstrated estrogen receptor β (ERβ) to be the major ER expressed in normal and malignant cells of lymphoid origin. We have analyzed the effects of estradiol and selective ERα and ERβ agonists on lymphoma growth in culture and in vivo. Treating lymphoma cells with estradiol or ERα selective agonist had minor or no effect on cell growth while selective ERβ agonist treatment showed an antiproliferative effect. When grafting mice with murine T lymphoma cells, male mice developed larger tumors compared to female mice, a difference that was abolished following ovariectomy, demonstrating estrogen-dependent growth in vivo. When subcutaneously grafting lymphoma cells to mice, so far growth of all tested human B lymphoma tumors (Raji and Ramos Burkitt lymphoma, SU.DHL4 (GC) and U2932 (ABC) DLBCL, Granta-519, Maver1 and Z138 MCL cells), were reduced following treatment with ERβ selective agonist (ref. 2 and unpublished). Moreover, the number and size of liver foci of disseminating Raji cells was reduced. We have identified target genes and mechanism that could explain the above effects of ERβ agonists. This included effects on angio and lymphangiogenesis. Now we have further analyzed effects of ERβ agonists on Ibrutinib-sensitive and -insensitive MCL cells in xenograft experiments as well as ERβ expression in primary lymphoma material (DLBCL). Preliminary statistical analysis has been done correlating ERβ expression to other biomarkers and clinical data.

Keywords: lymphomas, estrogen receptors, cancer, liver foci

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16071 Combined Tarsal Coalition Resection and Arthroereisis in Treatment of Symptomatic Rigid Flat Foot in Pediatric Population

Authors: Michael Zaidman, Naum Simanovsky

Abstract:

Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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