Search results for: intensive or adapted cognitive behavioural therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5876

Search results for: intensive or adapted cognitive behavioural therapy

5396 Responsive Integrative Therapeutic Method: Paradigm for Addressing Core Deficits in Autism by Balkibekova

Authors: Balkibekova Venera Serikpaevna

Abstract:

Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

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5395 Synergy and Complementarity in Technology-Intensive Manufacturing Networks

Authors: Daidai Shen, Jean Claude Thill, Wenjia Zhang

Abstract:

This study explores the dynamics of synergy and complementarity within city networks, specifically focusing on the headquarters-subsidiary relations of firms. We begin by defining these two types of networks and establishing their pivotal roles in shaping city network structures. Utilizing the mesoscale analytic approach of weighted stochastic block modeling, we discern relational patterns between city pairs and determine connection strengths through statistical inference. Furthermore, we introduce a community detection approach to uncover the underlying structure of these networks using advanced statistical methods. Our analysis, based on comprehensive network data up to 2017, reveals the coexistence of both complementarity and synergy networks within China’s technology-intensive manufacturing cities. Notably, firms in technology hardware and office & computing machinery predominantly contribute to the complementarity city networks. In contrast, a distinct synergy city network, underpinned by the cities of Suzhou and Dongguan, emerges amidst the expansive complementarity structures in technology hardware and equipment. These findings provide new insights into the relational dynamics and structural configurations of city networks in the context of technology-intensive manufacturing, highlighting the nuanced interplay between synergy and complementarity.

Keywords: city system, complementarity, synergy network, higher-order network

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5394 An Examination of Low Engagement in a Group-Based ACT Intervention for Chronic Pain Management: Highlighting the Need for User-Attainment Focused Digitalised Interventions

Authors: Orestis Kasinopoulos, Maria Karekla, Vasilis Vasiliou, Evangelos Karademas

Abstract:

Acceptance and Commitment Therapy (ACT) is an empirically supported intervention for treating Chronic Pain Patients, yet its effectiveness for some chronic conditions or when adapted to other languages, has not been explored. An ACT group intervention was designed to explore the effectiveness of treating a Greek speaking heterogeneous sample of Chronic Pain patients with the aim of increasing quality of life, acceptance of pain and functionality. Sixty-nine patients were assessed and randomly assigned to an ACT or control group (relaxation techniques) for eight, 90-minute, sessions. Results are currently being analysed and follow-ups (6 and 12 month) are being completed. Low adherence rates and high attrition rates observed in the study, however point to the direction of future modified interventions. Such modifications may include web-based and smartphone interventions and their benefits in being implemented in chronic pain patients.

Keywords: chronic pain, ACT, internet-delivered, digitalised intervention, adherence, attrition

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5393 Elements of Critical Event Management: A Qualitative Study of Trauma Teams

Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

Abstract:

Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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5392 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

Abstract:

Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

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5391 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia

Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

Abstract:

Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

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5390 Wound Healing Dressing and Some Composites Such as Zeolite, TiO2, Chitosan and PLGA as New Alternative for Melanoma Therapy: A Review

Authors: L. B. Naves, L. Almeida

Abstract:

The development of Drugs Delivery System (DDS), has been wildly investigated in the last decades. In this paper, first a general overview of traditional and modern wound dressing is presented. This is followed by a review of what scientist have done in the medical environment, focusing the possibility to develop a new alternative for DDS through transdermal pathway, aiming to treat melanoma skin cancer.

Keywords: cancer therapy, dressing polymers, melanoma, wound healing

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5389 Forced-Choice Measurement Models of Behavioural, Social, and Emotional Skills: Theory, Research, and Development

Authors: Richard Roberts, Anna Kravtcova

Abstract:

Introduction: The realisation that personality can change over the course of a lifetime has led to a new companion model to the Big Five, the behavioural, emotional, and social skills approach (BESSA). BESSA hypothesizes that this set of skills represents how the individual is thinking, feeling, and behaving when the situation calls for it, as opposed to traits, which represent how someone tends to think, feel, and behave averaged across situations. The five major skill domains share parallels with the Big Five Factor (BFF) model creativity and innovation (openness), self-management (conscientiousness), social engagement (extraversion), cooperation (agreeableness), and emotional resilience (emotional stability) skills. We point to noteworthy limitations in the current operationalisation of BESSA skills (i.e., via Likert-type items) and offer up a different measurement approach: forced choice. Method: In this forced-choice paradigm, individuals were given three skill items (e.g., managing my time) and asked to select one response they believed they were “worst at” and “best at”. The Thurstonian IRT models allow these to be placed on a normative scale. Two multivariate studies (N = 1178) were conducted with a 22-item forced-choice version of the BESSA, a published measure of the BFF, and various criteria. Findings: Confirmatory factor analysis of the forced-choice assessment showed acceptable model fit (RMSEA<0.06), while reliability estimates were reasonable (around 0.70 for each construct). Convergent validity evidence was as predicted (correlations between 0.40 and 0.60 for corresponding BFF and BESSA constructs). Notable was the extent the forced-choice BESSA assessment improved upon test-criterion relationships over and above the BFF. For example, typical regression models find BFF personality accounting for 25% of the variance in life satisfaction scores; both studies showed incremental gains over the BFF exceeding 6% (i.e., BFF and BESSA together accounted for over 31% of the variance in both studies). Discussion: Forced-choice measurement models offer up the promise of creating equated test forms that may unequivocally measure skill gains and are less prone to fakability and reference bias effects. Implications for practitioners are discussed, especially those interested in selection, succession planning, and training and development. We also discuss how the forced choice method can be applied to other constructs like emotional immunity, cross-cultural competence, and self-estimates of cognitive ability.

Keywords: Big Five, forced-choice method, BFF, methods of measurements

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5388 Children of Syria: Using Drawings for Diagnosing and Treating Trauma

Authors: Fatten F. Elkomy

Abstract:

The Syrian refugees are the largest refugee population since World War II. Mostly, children, these individuals were exposed to intense traumatic events in their homeland, throughout their journey, and during settlement in foreign lands. Art is a universal language to express feelings and tough human experiences. It is also a medium for healing and promoting creativity and resilience. Literature review was conducted to examine the use of art to facilitate psychiatric interviews, diagnosis, and therapy with traumatized children. Results show a severe impact of childhood trauma on the increased risk for abuse, neglect, and psychiatric disorders. Clinicians must recognize, evaluated and provide help for these children. In conclusion, drawings are used to tell a story, reflect deep emotions, and create a meaningful self-recognition and determination. Participants will understand art therapy using the expressive therapies continuum framework to evaluate drawings and to promote healing for refugee children.

Keywords: art therapy, children drawings, Syrian refugees, trauma in childhood

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5387 Possible Neuroprotective Mechanism of Remote Limb Ischemic Post Conditioning against Global Cerebral Ischemic Injury

Authors: Sruthi Ramagiri, Rajeev Taliyan

Abstract:

Background and purpose: Recent investigations on ischemia and reperfusion injury postulate that transient ischemia of remote organs after a prolonged ischemic insult confers neuroprotection. However, the molecular mechanisms of the remote limb ischemic post-conditioning (RIPOC) are yet to be elucidated. The current study was designed to investigate the protective mechanism of RIPOC against cerebral ischemic injury using global model of stroke. Materials and methods: Global ischemic reperfusion injury (IR) was achieved by 30 minutes ischemia of cerebral artery, followed by reperfusion for 24 hours. Induction of global ischemia was followed by 4 brief episodes (30 seconds each) of ischemia and reperfusion of femoral artery to accomplish RIPOC. 5-Hydroxy Decanoic acid (5-HD), a KATP channel blocker (20 mg/kg) was administered after induction of global ischemia and RIPOC intervention. Results: IR injury ensue significant behavioural deficits as manifested by rotarod performance and spontaneous locomotor activity when compared to sham control. Furthermore, IR injury significantly increased oxidonitrative stress and infarct volume as evidenced by biochemical parameters (MDA, GSH, Nitrite, SOD) and 2,3,5-triphenyltetrazolium chloride (TTC) staining respectively. Moreover, RIPOC intervention ameliorated the behavioural performance, attenuated the oxidative stress and infarct volume when compared to IR injury group. However, administration of 5-HD increased the oxidative stress and infarct size while deteriorating the behavioural parameters when compared to RIPOC group. Conclusions: In a nutshell, cerebral IR injury has significantly induced the neuronal damage, whereas RIPOC intervention decreased the neuronal injury. Moreover, 5-HD abolished the neuroprotection offered by RIPOC indicating the putative role of KATP channel opening in RIPOC against cerebral ischemic injury.

Keywords: RIPOC, cerebral injury, KATP channel, neuroprotection

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5386 Capacity Optimization in Cooperative Cognitive Radio Networks

Authors: Mahdi Pirmoradian, Olayinka Adigun, Christos Politis

Abstract:

Cooperative spectrum sensing is a crucial challenge in cognitive radio networks. Cooperative sensing can increase the reliability of spectrum hole detection, optimize sensing time and reduce delay in cooperative networks. In this paper, an efficient central capacity optimization algorithm is proposed to minimize cooperative sensing time in a homogenous sensor network using OR decision rule subject to the detection and false alarm probabilities constraints. The evaluation results reveal significant improvement in the sensing time and normalized capacity of the cognitive sensors.

Keywords: cooperative networks, normalized capacity, sensing time

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5385 Effects of Partial Sleep Deprivation on Prefrontal Cognitive Functions in Adolescents

Authors: Nurcihan Kiris

Abstract:

Restricted sleep is common in young adults and adolescents. The results of a few objective studies of sleep deprivation on cognitive performance were not clarified. In particular, the effect of sleep deprivation on the cognitive functions associated with frontal lobe such as attention, executive functions, working memory is not well known. The aim of this study is to investigate the effect of partial sleep deprivation experimentally in adolescents on the cognitive tasks of frontal lobe including working memory, strategic thinking, simple attention, continuous attention, executive functions, and cognitive flexibility. Subjects of the study were recruited from voluntary students of Cukurova University. Eighteen adolescents underwent four consecutive nights of monitored sleep restriction (6–6.5 hr/night) and four nights of sleep extension (10–10.5 hr/night), in counterbalanced order, and separated by a washout period. Following each sleep period, cognitive performance was assessed, at a fixed morning time, using a computerized neuropsychological battery based on frontal lobe functions task, a timed test providing both accuracy and reaction time outcome measures. Only the spatial working memory performance of cognitive tasks was found to be statistically lower in a restricted sleep condition than the extended sleep condition. On the other hand, there was no significant difference in the performance of cognitive tasks evaluating simple attention, constant attention, executive functions, and cognitive flexibility. It is thought that especially the spatial working memory and strategic thinking skills of adolescents may be susceptible to sleep deprivation. On the other hand, adolescents are predicted to be optimally successful in ideal sleep conditions, especially in the circumstances requiring for the short term storage of visual information, processing of stored information, and strategic thinking. The findings of this study may also be associated with possible negative functional effects on the processing of academic social and emotional inputs in adolescents for partial sleep deprivation. Acknowledgment: This research was supported by Cukurova University Scientific Research Projects Unit.

Keywords: attention, cognitive functions, sleep deprivation, working memory

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5384 Earnings-Related Information, Cognitive Bias, and the Disposition Effect

Authors: Chih-Hsiang Chang, Pei-Shan Kao

Abstract:

This paper discusses the reaction of investors in the Taiwan stock market to the most probable unknown earnings-related information and the most probable known earnings-related information. As compared with the previous literature regarding the effect of an official announcement of earnings forecast revision, this paper further analyzes investors’ cognitive bias toward the unknown and known earnings-related information, and the role of media during the investors' reactions to the foresaid information shocks. The empirical results show that both the unknown and known earnings-related information provides useful information content for a stock market. In addition, cognitive bias and disposition effect are the behavioral pitfalls that commonly occur in the process of the investors' reactions to the earnings-related information. Finally, media coverage has a remarkable influence upon the investors' trading decisions.

Keywords: cognitive bias, role of media, disposition effect, earnings-related information, behavioral pitfall

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5383 Effectiveness of Exercise and TENS in the Treatment of Temporomandibular Joint Disorders

Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

Abstract:

Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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5382 A Comparitive Study of the Effect of Stress on the Cognitive Parameters in Women with Increased Body Mass Index before and after Menopause

Authors: Ramesh Bhat, Ammu Somanath, A. K. Nayanatara

Abstract:

Background: The increasing prevalence of overweight and obesity is a critical public health problem for women. The negative effect of stress on memory and cognitive functions has been widely explored for decades in numerous research projects using a wide range of methodology. Deterioration of memory and other brain functions are hallmarks of Alzheimer’s disease. Estrogen fluctuations and withdrawal have myriad direct effects on the central nervous system that have the potential to influence cognitive functions. Aim: The present study aims to compare the effect of stress on the cognitive functions in overweight/obese women before and after menopause. Material and Methods: A total of 142 female subjects constituting women before menopause between the age group of 18–44 years and women after menopause between the age group of 45–60 years were included in the sample. Participants were categorized into overweight/obese groups based on the body mass index. The Perceived Stress Scale (PSS) the major tool was used for measuring the perception of stress. Based on the stress scale measurement each group was classified into with stress and without stress. Addenbrooke’s cognitive Examination-III was used for measuring the cognitive functions. Results: Premenopausal women with stress showed a significant (P<0.05) decrease in the cognitive parameters such as attention and orientation Fluency, language and visuospatial ability. Memory did not show any significant change in this group. Whereas, in the postmenopausal stressed women all the cognitive functions except fluency showed a significant (P<0.05) decrease after menopause stressed group. Conclusion: Stress is a significant factor on the cognitive functions of obese and overweight women before and after menopause. Practice of Yoga, Encouragement in activities like gardening, embroidery, games and relaxation techniques should be recommended to prevent stress. Insights into the neurobiology before and after menopause can be gained from future studies examining the effect on the HPA axis in relation to cognition and stress.

Keywords: cognition, stress, premenopausal, body mass index

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5381 Diagnosis and Treatment of Sleep Disorders

Authors: Andrew Anis Fakhrey Mosaad

Abstract:

Introduction: There are many different types of sleep disorders, each with serious implications for a person's health and a large financial burden on society. Method: This review offers a framework based on the International Classification of Sleep Disorders to aid in the diagnosis and treatment of sleep disorders. Differentiating between primary and secondary insomnia is covered, along with pharmacological and nonpharmacological therapy options. Common abnormalities of the circadian rhythm are mentioned along with their therapies, such as light therapy and chronotherapy. This article discusses the identification and management of periodic limb movement disorder and restless legs syndrome. The therapy of upper airway resistance syndrome and obstructive sleep apnea are the main topics of discussion. Conclusion: The range of narcolepsy symptoms and results, as well as diagnostic procedures and treatment, are discussed. The causes, outcomes, and treatments of many types of insomnias, such as sleep terrors, somnambulism, and rapid eye movement (REM) behavior sleep disorders, are discussed.

Keywords: diagnosis, treatment, sleep disorders, insomnia

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5380 Development of Generally Applicable Intravenous to Oral Antibiotic Switch Therapy Criteria

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

Abstract:

Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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5379 The Effect of Trans-Cranial Direct Current Stimulation (tDCS) on Cognitive Flexibility and Social Decision-Making in Football Players

Authors: Erfan Izadpanah

Abstract:

The present study was conducted to investigate the effect of the Trans-Cranial Direct Current Stimulation (tDCS) on cognitive flexibility and social decision-making in skilled, semi-skilled and novice football players. The present quasi-experimental pretest-posttest study was conducted on 60 randomly-selected subjects divided into trial and placebo groups (n=30 per group). The trial group received three 20-minute sessions of anodic stimulation at the intensity of 2 mA. The placebo group also received three sessions of sham anodic stimulation. Data were collected using the Wisconsin, Grant and Berg Card-Sorting Test (1948) and the ultimatum game and were then analyzed using the ANCOVA. The results showed significant differences between the skilled, semi-skilled and novice football players in the trial and placebo groups in terms of cognitive flexibility and social decision-making (P<0.01). TDCS appears to be able to improve cognitive flexibility and consequently social decision-making in football players and is recommended to sport psychologists and coaches as a useful intervention to increase cognitive flexibility and improve social decision-making in players.

Keywords: TDCS, cognitive flexibility, social decision-making, skilled, semi-skilled and novice football players

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5378 Successful Treatment of Multifocal XDR Tuberculosis Osteomyelitis

Authors: Abeer N. Alshukairi, Abdulrahman A. Alrajhi, Abdulfattah W. Alamri, Adel F. Alothman

Abstract:

We described the nosocomial transmission of a pre-XDR or an MDR case of pulmonary tuberculosis in a HIV negative health care worker in an area endemic for MDR & XDR tuberculosis. With inadequate therapy and non-compliance, his strain developed acquired resistance and he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after 2 years of therapy with various anti-tuberculous drugs in addition to interferon gamma.

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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5377 Reproduction Characteristics of Saanen Goats Raised under Intensive Conditions in Konya Province

Authors: Vahdettin Sariyel, Birol Dag

Abstract:

In this research, it is aimed to determine the effects of several environmental factors on adaptation and some yield parameters of Saanen goats reared under intensive conditions at a private farm in Konya province. Gestation rate, twins rate and litter size were evaluated as reproductive traits. Gestation rate was determined as 93.8% and 90.5% for 2011 and 2012 years respectively. Twins rate was determined as 59.35 % and 70.00 % for 2011 and 2012 years respectively. Litter size was 1.49 and 1.46 for 2011 and 2012 years respectively. Survival rates of kids from birth to weaning at three months of age were found as 87.74 % and 98.54 % for 2011 and 2012 years respectively.

Keywords: gestation rate, reproduction, saanen, twins rate, vitality

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5376 A Generic Middleware to Instantly Sync Intensive Writes of Heterogeneous Massive Data via Internet

Authors: Haitao Yang, Zhenjiang Ruan, Fei Xu, Lanting Xia

Abstract:

Industry data centers often need to sync data changes reliably and instantly from a large-scale of heterogeneous autonomous relational databases accessed via the not-so-reliable Internet, for which a practical universal sync middle of low maintenance and operation costs is most wanted, but developing such a product and adapting it for various scenarios are a very sophisticated and continuous practice. The authors have been devising, applying, and optimizing a generic sync middleware system, named GSMS since 2006, holding the principles or advantages that the middleware must be SyncML-compliant and transparent to data application layer logic, need not refer to implementation details of databases synced, does not rely on host computer operating systems deployed, and its construction is light weighted and hence, of low cost. A series of ultimate experiments with GSMS sync performance were conducted for a persuasive example of a source relational database that underwent a broad range of write loads, say, from one thousand to one million intensive writes within a few minutes. The tests proved that GSMS has achieved an instant sync level of well below a fraction of millisecond per record sync, and GSMS’ smooth performances under ultimate write loads also showed it is feasible and competent.

Keywords: heterogeneous massive data, instantly sync intensive writes, Internet generic middleware design, optimization

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5375 Atwood's Canadianisms and Neologisms: A Cognitive Approach to Literature

Authors: Eleonora Sasso

Abstract:

This paper takes as its starting point the notions of cognitive linguistics and lexical blending, and uses both these theoretical concepts to advance a new reading of Margaret Atwood’s latest writings, one which sees them as paramount literary examples of norm and usage in bilingual Canadian lexicography. Atwood’s prose seems to be imbued with Canadianisms and neologisms, lexical blends of zoomorphic forms, a kind of meeting-point between two conceptual structures which follow the principles of lexical economy and asyntactic relation. Atwood’s neologisms also attest to the undeniable impact on language exerted by Canada’s aboriginal peoples. This paper aims to track through these references and with the aid of the Eskimo-English dictionary look at the linguistic issues – attitudes to contaminations and hybridisations, questions of lexical blending in literary examples, etc – which they raise. Atwood’s fiction, whose cognitive linguistic strategy employs ‘the virtues of scissors and matches’, always strives to achieve isomorphism between word form and concept.

Keywords: Atwood, Canadianisms, cognitive science, Eskimo/English dictionary

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5374 Vital Pulp Therapy: The Minimally Invasive Endodontic Therapy for Mature Permanent Teeth

Authors: Fadwa Chtioui

Abstract:

Vital Pulp Therapy (VPT) is nowadays challenging the deep-rooted dogma of root canal treatment, being the only therapeutic option for permanent teeth diagnosed with irreversible pulpitis or carious pulp exposure. Histologic and clinical research has shown that compromised dental pulp can be treated without the full removal or excavation of all healthy pulp, and the outcome of the partial or full pulpotomy followed by a Tricalcium-Silicate-based dressing seems to show promising results in maintaining pulp vitality and preserving affected teeth in the long term. By reviewing recent advances in the techniques of VPT and their clinical effectiveness and safety in permanent teeth with irreversible Pulpitis, this work provides a new understanding of pulp pathophysiology and defense mechanisms and will reform dental practitioners' decision-making in treating irreversible pulpits from root canal therapy to vital pulp therapy by taking advantage of the biological effects of Tricalcium Silicate materials. Biography of presenting author: Fadwa Chitoui graduated from the school of Dental Medicine of Monastir, Tunisia, in 2015. After getting her DDS degree with honors, she earned her Postgraduate master's Degree in Endodontics and Restorative Dentistry from her Faculty. Since 2021, she has Started her own private and specialized practice based in the capital Tunis. She enjoys the sphere of associative life, worked with national and international associations, and got engaged in scientific dental research, whereby she tailored her passion for her field of specialty towards broadening her knowledge and ambitions, holding conferences and workshops nationally and internationally and publishing scientific articles in several journals.

Keywords: irreversible pulpitis, permanenet teeth, vital pulp therapy, pulpotomy

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5373 The Impact of Upward Social Media Comparisons on Body Image and the Role of Physical Appearance Perfectionism and Cognitive Coping

Authors: Lauren Currell, Gemma Hurst

Abstract:

Introduction: The present study experimentally investigated the impact of attractive Instagram images on female’s body image. It also examined whether physical appearance perfectionism and cognitive coping predicted body image following upward comparisons to idealised bodies on Instagram. Methods: One-hundred and fifty-eight females (mean age 24.35 years) were randomly assigned to an experimental (where they compared their bodies to those of Instagram models) or control condition (where they critiqued landscape painting). All participants completed measures on physical appearance perfectionism, cognitive coping, and pre- and post-measures of body image. Results: Comparing one’s body to idealised bodies on Instagram resulted in increased appearance and weight dissatisfaction and decreased confidence, compared to the control condition. Physical appearance perfectionism and cognitive coping both predicted body image outcomes for the experimental condition. Discussion: Clinical implications, such as the prevention and treatment of body dissatisfaction, are discussed. Strengths and limitations of the current study are also noted, and suggestions for future research are provided.

Keywords: perfectionism, cognitive coping, body image, social media

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5372 Palliative Orthovoltage Radiotherapy and Subcutaneous Infusion of Carboplatin for Treatment of Appendicular Osteosarcoma in Dogs

Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock

Abstract:

Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.

Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma

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5371 Disperse Innovation in the Turning German Energy Market

Authors: J. Gochermann

Abstract:

German energy market is under historical change. Turning-off the nuclear power plants and intensive subsidization of the renewable energies causes a paradigm change from big central energy production and distribution to more local structures, bringing the energy production near to the consumption. The formerly big energy market with only a few big energy plants and grid operating companies is changing into a disperse market with growing numbers of small and medium size companies (SME) generating new value-added products and services. This change in then energy market, in Germany called the “Energiewende”, inverts also the previous innovation system. Big power plants and large grids required also big operating companies. Innovations in the energy market focused mainly on big projects and complex energy technologies. Innovation in the new energy market structure is much more dispersed. Increasing number of SME is now able to develop energy production and storage technologies, smart technologies to control the grids, and numerous new energy related services. Innovation is now regional distributed, which is a remarkable problem for the old big energy companies. The paper will explain the change in the German energy market and the paradigm change as well as the consequences for the innovation structure in the German energy market. It will show examples how SME participate from this change and how innovation systems, as well for the big companies and for SME, can be adapted.

Keywords: changing energy markets, disperse innovation, new value-added products and services, SME

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5370 Trauma-Informed Applied Theatre: Using Performance to Connect with Mental Dysfunction Using Physical Embodiment Begins with Ancient Civilizations

Authors: Stephanie Elizabeth Talder

Abstract:

Art therapy is a field that is growing exponentially with new groundbreaking discoveries that allow for embodying trauma and mental healing. Applied theatre and performance is a continuously growing and developing field that can help people who are struggling to work through traumatic experiences plaguing their life. By using performance, there is an ability to target sensitive topics in a manner that does not lead to re-traumatization. The use of theatre as a healing agent has been going on for centuries, with clear applications beginning in Greek theatre and tragedy. When working with complex mental illness, issues such as PTSD, anxiety, and depression can be managed and worked through. A central component of drama therapy is the connection to community and self. The ability to connect mind-body to stories as well as to other people allows for healing to occur. There is the opportunity for healing through emotional catharsis and community building. Applied theatre in connection to the medical field can allow for there to be a meaningful impact made on mental health. Though there is still a significant amount of progress to be made within the stigmatization of mental health problems, bringing in a varying option that allows for there to be movement and community building possesses a strong ability to impact people in a positive way.

Keywords: applied theatre, drama therapy, art therapy, performance, theatre

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5369 Examining the Links between Fish Behaviour and Physiology for Resilience in the Anthropocene

Authors: Lauren A. Bailey, Amber R. Childs, Nicola C. James, Murray I. Duncan, Alexander Winkler, Warren M. Potts

Abstract:

Changes in behaviour and physiology are the most important responses of marine life to anthropogenic impacts such as climate change and over-fishing. Behavioural changes (such as a shift in distribution or changes in phenology) can ensure that a species remains in an environment suited for its optimal physiological performance. However, if marine life is unable to shift their distribution, they are reliant on physiological adaptation (either by broadening their metabolic curves to tolerate a range of stressors or by shifting their metabolic curves to maximize their performance at extreme stressors). However, since there are links between fish physiology and behaviour, changes to either of these traits may have reciprocal interactions. This paper reviews the current knowledge of the links between the behaviour and physiology of fishes, discusses these in the context of exploitation and climate change, and makes recommendations for future research needs. The review revealed that our understanding of the links between fish behaviour and physiology is rudimentary. However, both are hypothesized to be linked to stress responses along the hypothalamic pituitary axis. The link between physiological capacity and behaviour is particularly important as both determine the response of an individual to a changing climate and are under selection by fisheries. While it appears that all types of capture fisheries are likely to reduce the adaptive potential of fished populations to climate stressors, angling, which is primarily associated with recreational fishing, may induce fission of natural populations by removing individuals with bold behavioural traits and potentially the physiological traits required to facilitate behavioural change. Future research should focus on assessing how the links between physiological capacity and behaviour influence catchability, the response to climate change drivers, and post-release recovery. The plasticity of phenotypic traits should be examined under a range of stressors of differing intensity in several species and life history stages. Future studies should also assess plasticity (fission or fusion) in the phenotypic structuring of social hierarchy and how this influences habitat selection. Ultimately, to fully understand how physiology is influenced by the selective processes driven by fisheries, long-term monitoring of the physiological and behavioural structure of fished populations, their fitness, and catch rates are required.

Keywords: climate change, metabolic shifts, over-fishing, phenotypic plasticity, stress response

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5368 Spectrum Allocation Using Cognitive Radio in Wireless Mesh Networks

Authors: Ayoub Alsarhan, Ahmed Otoom, Yousef Kilani, Abdel-Rahman al-GHuwairi

Abstract:

Wireless mesh networks (WMNs) have emerged recently to improve internet access and other networking services. WMNs provide network access to the clients and other networking functions such as routing, and packet forwarding. Spectrum scarcity is the main challenge that limits the performance of WMNs. Cognitive radio is proposed to solve spectrum scarcity problem. In this paper, we consider a cognitive wireless mesh network where unlicensed users (secondary users, SUs) can access free spectrum that is allocated to spectrum owners (primary users, PUs). Although considerable research has been conducted on spectrum allocation, spectrum assignment is still considered an important challenging problem. This problem can be solved using cognitive radio technology that allows SUs to intelligently locate free bands and access them without interfering with PUs. Our scheme considers several heuristics for spectrum allocation. These heuristics include: channel error rate, PUs activities, channel capacity and channel switching time. Performance evaluation of the proposed scheme shows that the scheme is able to allocate the unused spectrum for SUs efficiently.

Keywords: cognitive radio, dynamic spectrum access, spectrum management, spectrum sharing, wireless mesh networks

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5367 Frequency of Gastrointestinal Manifestations in Systemic Sclerosis and Impact of Rituximab Treatment

Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova

Abstract:

Objectives. Gastrointestinal involvement is one of the most common manifestations of systemic sclerosis (SSc). The aim of our study was to assess the frequency of gastrointestinal manifestations in SSc patients (pts) with interstitial lung disease (ILD) and their changes to rituximab (RTX) therapy. Methods. There were 103 pts with SSc in this study. The mean follow-up period was 12.6±10.7 months. The mean age was 47±12.9 years, females - 87 pts (84%), and the diffuse cutaneous subset of the disease 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had ILD and were positive for ANA. 67% of them were positive for anti-topoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, and immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. 90% of pts received omeprazole at a dose of 20-40 mg/day. Results. At inclusion, dysphagia was observed in 76 pts (74%), early satiety or vomiting in 32 pts (31%), and diarrhea in 20 pts (19%). We didn't observe any changes in gastrointestinal manifestation during RTX therapy. There was a decrease in the number of pts with dysphagia from 76 (74%) to 66 (64%), but it was insignificant. The number of pts with early satiety or vomiting and diarrhea didn't change. Conclusion. In our study, gastrointestinal involvement was observed in most of the pts with SSc-ILD. We didn't find any significant changes in gastrointestinal manifestations during RTX therapy. RXT does not worsen gastrointestinal manifestations in SSc-ILD.

Keywords: systemic sclerosis, dysphagia, rituximab, gastrointestinal manifestations

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