Search results for: analyzing initial efficacy

Authors: Pitsanu Poonpetpun

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This research aimed to study opinions of Suan Sunandha Rajabhat University administrative personnel towards performance of the university council committee by addressing (1) personal characteristics of the committees; (2) duties designated by the university council; and (3) relationship between university council and university administrative personnel. The population of this study including the president, vice presidents, faculty deans, deputy deans, office heads, director of office of president, directors, deputy directors, division directors, made a total of 118 respondents. Frequency, percentage, mean, and standard deviation were utilized in analyzing the data. The finding on opinions of the administrative personnel towards personal characteristics of the university council committees was averagely at a high level. The characteristic items were rated and revealed that the item gaining the highest mean score was the item stating that the university council committees obtained overall appropriate qualification. The items stating that the president of the teachers’ council acting as the university council committee had impartiality and good governance reported the lowest mean score. The opinions of the administrative personnel towards duty performance of the university council committees was averagely in a high level, in which the item gaining the highest mean score was the item stating that formulating rules and regulations or assigning governmental offices to do so was practiced with governance or fairness to all stakeholders, and the item stating that the president of the teachers’ council acting as the university council committee had impartiality good governance reported the lowest mean score. Moreover, the study found that the rating of opinions of the administrative personnel towards relationship between university council and university administrative personnel was averagely high. Relationship items were rated and revealed that the highest mean score was rated for the fact that the university president was empowered by the university council to manage the university with no violation of the policies. The fact that there was the integrity of policy between the university council and the university administrative personnel was rated the lowest score.

Keywords: performance, university council, education, university administrative personnel

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Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

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Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

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Authors: Karl D. Humm

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The United Nations’ Community-based REDD+ (Reducing Emissions from Deforestation and forest Degradation) (CBR+) is a programme that directly finances grassroots climate change mitigation strategies that uplift Indigenous Peoples (IPs) and other marginalised groups. A pilot for it in six countries was developed in response to criticism of the REDD+ programme for excluding IPs from dialogues about climate change mitigation strategies affecting their lands and livelihoods. Despite the pilot’s conclusion in 2017, no complete report has yet been produced on the results of CBR+. To fill this gap, this study investigated the experiences with involving IPs in the CBR+ programmes and local projects across all six pilot countries. A literature review of official UN reports and academic articles identified challenges and successes with IP participation in REDD+ which became the basis for a framework guiding data collection. A mixed methods approach was used to collect and analyse qualitative and quantitative data from CBR+ documents and written interviews with CBR+ National Coordinators in each country for a cross-country comparative analysis. The study found that the most frequent challenges were lack of organisational capacity, illegal forest activities, and historically-based contentious relationships in IP and forest-dependent communities. Successful programmes included IPs and incorporated respect and recognition of IPs as major stakeholders in managing sustainable forests. Findings are summarized and shared with a set of recommendations for improvement of future projects.

Keywords: climate change, forests, indigenous peoples, REDD+

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Authors: Sridara Tipian, Henry Skates Jr., Antika Sawadsri

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It is widely recognized that universal design should be implemented as broadly as possible to benefit as many groups and sub groups of people within a society. In Thailand, public buildings such as public universities are obvious places where the benefits of universal design principles are easily appreciated and applied, but there are other building types such as private universities where the benefits may not be just as obvious. In these buildings, the implementation of universal design is not always achieved. There are many reasons given for this among which is the perceived additional cost of implementation. This paper argues that social capital should be taken into consideration when such decisions are being made. The paper investigates the background, principles and theories pertaining to universal design and using a case study of a private university, investigates the implementation of universal design against the background of current legislation and the perceptions of the private university administrators. The study examines the physical facilities of the case study university in the context of current theories and principles of universal design alongside the legal requirements for same. A survey of building users evaluates knowledge of and attitudes to universal design. The research shows that although administrators perceive the initial cost of investment to be prohibitive in the short term, in the long term, changes in societal values in relation to social inclusiveness are changing and that the social capital of investing in universal design should not be underestimated. The results of this study should provide greater incentive for the enforcement of the legal requirements for universal design in Thailand.

Keywords: public buildings, physical facilities, social capital private university, investment, decision making, value, enforcement, legal requirements

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Authors: Nargiza Nuralieva

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The study delves into assessing the influence of mindfulness and mental resilience training on the cognitive performance and stress management of pilots. Employing a meticulous literature search across databases such as Medline and Google Scholar, the study used specific keywords to target a wide array of studies. Inclusion criteria were stringent, focusing on peer-reviewed studies in English that utilized designs like randomized controlled trials, with a specific interest in interventions related to mindfulness or mental resilience training for pilots and measured outcomes pertaining to cognitive performance and stress management. The initial literature search identified a pool of 123 articles, with subsequent screening resulting in the exclusion of 77 based on title and abstract. The remaining 54 articles underwent a more rigorous full-text screening, leading to the exclusion of 41. Additionally, five studies were selected from the World Health Organization's clinical trials database. A total of 11 articles from meta-analyses were retained for examination, underscoring the study's dedication to a meticulous and robust inclusion process. The interventions varied widely, incorporating mixed approaches, Cognitive behavioral Therapy (CBT)-based, and mindfulness-based techniques. The analysis uncovered positive effects across these interventions. Specifically, mixed interventions demonstrated a Standardized Mean Difference (SMD) of 0.54, CBT-based interventions showed an SMD of 0.29, and mindfulness-based interventions exhibited an SMD of 0.43. Long-term effects at a 6-month follow-up suggested sustained impacts for both mindfulness-based (SMD: 0.63) and CBT-based interventions (SMD: 0.73), albeit with notable heterogeneity.

Keywords: mindfulness, mental resilience, pilots, cognitive performance, stress management

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Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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Authors: Monica M. Marcos

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In the framework of Archaeological Research, Heritage Conservation and Restoration, the object of study is metrology applied in composition of religious architecture in ancient Egypt, and usefulness in Archaology. The objective is the determination of the geometric and metrological relations in architectural models and the module used in the initial project of the buildings. The study and data collection of religious buildings, tombs and temples of the ancient Egypt, is completed with plans. The measurements systematization and buildings modulation makes possible to establish common compositional parameters, with a module determined by the measurement unit used. The measurement system corresponding to the main period of egyptian history, was the Egyptian royal cubit. The analysis of units measurements, used in architectural design, provides exact numbers on buildable spaces dimensions. It allows establishing proportional relationships between them, and finding a geometric composition module, on which the original project was based. This responds to a philosophical and functional concept of projected spaces. In the heritage rehabilitation and restoration field, knowledge of metrology helps in excavation, reconstruction and restoration of construction elements. The correct use of metrology contributes to the identification of possible work areas, helping to locate where the damaged or missing areas are. Also in restoration projects, metrology is useful for reordering and locating decontextualized parts of buildings. The conversion of measurements taken in the current International System to the ancient egyptian measurements, allows understand its conceptual purpose and its functionality, which makes easier to carry out archaeological intervention. In the work carried out in archaeological excavations, metrology is an essential tool for locating sites and establishing work zones.

Keywords: egyptology, metrology, archaeology, measurements, Egyptian cubit

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Authors: Muhammad Awais Kiani, Maryam Kiani

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This abstract explores the confluence of these two domains and highlights the key factors driving success in sales marketing for electronics. The abstract begins by digging into the ever-evolving landscape of consumer electronics, emphasizing how technological advancements and the growth of smart devices have revolutionized the way people interact with electronics. This paradigm shift has created tremendous opportunities for sales and marketing professionals to engage with consumers on various platforms and channels. Next, the abstract discusses the pivotal role of effective sales marketing strategies in the electronics industry. It highlights the importance of understanding consumer behavior, market trends, and competitive landscapes and how this knowledge enables businesses to tailor their marketing efforts to specific target audiences. Furthermore, the abstract explores the significance of leveraging digital marketing techniques, such as social media advertising, search engine optimization, and influencer partnerships, to establish brand identity and drive sales in the electronics market. It emphasizes the power of storytelling and creating captivating content to engage with tech-savvy consumers. Additionally, the abstract emphasizes the role of customer relationship management (CRM) systems and data analytics in optimizing sales marketing efforts. It highlights the importance of leveraging customer insights and analyzing data to personalize marketing campaigns, enhance customer experience, and ultimately drive sales growth. Lastly, the abstract concludes by underlining the importance of adapting to the ever-changing landscape of the electronics industry. It encourages businesses to embrace innovation, stay informed about emerging technologies, and continuously evolve their sales marketing strategies to meet the evolving needs and expectations of consumers. Overall, this abstract sheds light on the captivating realm of sales marketing in the electronics industry, emphasizing the need for creativity, adaptability, and a deep understanding of consumers to succeed in this rapidly evolving market.

Keywords: marketing industry, electronics, sales impact, e-commerce

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Authors: Olivera Lupescu, Taina Elena Avramescu, Mihail Nagea, Alexandru Dimitriu

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Acetabular fractures represent a real challenge due to their impact upon the long term function of the hip joint, and due to the risk of intra- and peri-operative complications especially that they affect young, active people. That is why treating these fractures require certain skills which must be exercised, regarding the pre-operative planning, as well as the execution of surgery.The authors retrospectively analyse 38 cases with acetabular fractures operated using the posterior approach in our hospital between 01.01.2013- 01.01.2015 for which complete medical records ensure a follow-up of 24 months, in order to establish the main causes of potential errors and to underline the methods for preventing them. This target is included in the Erasmus + project ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery COR-skills’. This paper analyses the pitfalls revealed by these cases, as well as the measures necessary to enhance the practical skills of the surgeons who perform acetabular surgery. Pre-op planning matched the intra and post-operative outcome in 88% of the analyzed points, from 72% at the beginning to 94% in the last case, meaning that experience is very important in treating this injury. The main problems detected for the posterior approach were: nervous complications - 3 cases, 1 of them a complete paralysis of the sciatic nerve, which recovered 6 months after surgery, and in other 2 cases intra-articular position of the screws was demonstrated by post-operative CT scans, so secondary screw removal was necessary in these cases. We analysed this incident, too, due to lack of information about the relationship between the screws and the joint secondary to this approach. Septic complications appeared in 3 cases, 2 superficial and 1 profound (requiring implant removal). The most important problems were the reduction of the fractures and the positioning of the screws so as not to interfere with the the articular space. In posterior acetabular fractures, pre-op complex planning is important in order to achieve maximum treatment efficacy with minimum of risk; an optimal training of the surgeons insisting on the main points of potential mistakes ensure the success of the procedure, as well as a favorable outcome for the patient.

Keywords: acetabular fractures, articular congruency, surgical skills, vocational training

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Authors: Sharjeel Abid, Tanveer Hussain, Ahsan Nazir, Abdul Zahir, Nabyl Khenoussi

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Localized application of drug has various advantages and fewer side effects as compared with other methods. Burn patients suffer from swear pain and the major aspects that are considered for burn victims include pain and infection management. Nano-fibers (NFs) loaded with drug, applied on local wound area, can solve these problems. Therefore, this study dealt with the fabrication of drug loaded NFs for better pain management. Two layers of NFs were fabricated with different drugs. Contact layer was loaded with Gabapentin (a nerve painkiller) and the second layer with acetaminophen. The fabricated dressing was characterized using scanning electron microscope, Fourier Transform Infrared Spectroscopy, X-Ray Diffraction and UV-Vis Spectroscopy. The double layered based NFs dressing was designed to have both initial burst release followed by slow release to cope with pain for two days. The fabricated nanofibers showed diameter < 300 nm. The liquid absorption capacity of the NFs was also checked to deal with the exudate. The fabricated double layered dressing with dual drug loading and release showed promising results that could be used for dealing pain in burn victims. It was observed that by the addition of drug, the size of nanofibers was reduced, on the other hand, the crystallinity %age was increased, and liquid absorption decreased. The combination of fast nerve pain killer release followed by slow release of non-steroidal anti-inflammatory drug could be a good tool to reduce pain in a more secure manner with fewer side effects.

Keywords: pain management, burn wounds, nano-fibers, controlled drug release

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Authors: Luiz G. Véras, Felipe L. Medeiros, Lamartine F. Guimarães

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This work approaches the automatic planning of paths for Unmanned Aerial Vehicles (UAVs) through the application of the Rapidly Exploring Random Tree Star-Smart (RRT*-Smart) algorithm. RRT*-Smart is a sampling process of positions of a navigation environment through a tree-type graph. The algorithm consists of randomly expanding a tree from an initial position (root node) until one of its branches reaches the final position of the path to be planned. The algorithm ensures the planning of the shortest path, considering the number of iterations tending to infinity. When a new node is inserted into the tree, each neighbor node of the new node is connected to it, if and only if the extension of the path between the root node and that neighbor node, with this new connection, is less than the current extension of the path between those two nodes. RRT*-smart uses an intelligent sampling strategy to plan less extensive routes by spending a smaller number of iterations. This strategy is based on the creation of samples/nodes near to the convex vertices of the navigation environment obstacles. The planned paths are smoothed through the application of the method called quintic pythagorean hodograph curves. The smoothing process converts a route into a dynamically-viable one based on the kinematic constraints of the vehicle. This smoothing method models the hodograph components of a curve with polynomials that obey the Pythagorean Theorem. Its advantage is that the obtained structure allows computation of the curve length in an exact way, without the need for quadratural techniques for the resolution of integrals.

Keywords: path planning, path smoothing, Pythagorean hodograph curve, RRT*-Smart

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Authors: Gi-Hoon Yang, JongHan Ha, MyungGu Yeo, JaeYoon Lee, SeungHyun Ahn, Hyeongjin Lee, HoJun Jeon, YongBok Kim, Minseong Kim, GeunHyung Kim

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Tissue engineering scaffolds must be biocompatible and biodegradable, provide adequate mechanical strength and cell attachment site for proliferation and differentiation. Furthermore, the scaffold morphology (such as pore size, porosity and pore interconnectivity) plays an important role. The electrospinning process has been widely used to fabricate micro/nano-sized fibres. Electrospinning allows for the fabrication of non-woven meshes containing micro- to nano-sized fibers providing high surface-to-volume area for cell attachment. Due to its advantageous characteristics, electrospinning is a useful method for skin, cartilage, bone, and nerve regeneration. In this study, we fabricated PCL scaffolds (SP) consisting of spiral-like struts using 3D melt-plotting system and micro/nanofibers using direct electrospinning writing. By altering the conditions of the conventional melt-plotting method, spiral-like struts were generated. Then, micro/nanofibers were deposited selectively. The control scaffold composed of perpendicular PCL struts was fabricated using the conventional melt-plotting method to compare the cellular activities. The effect on the attached cells (osteoblast-like cells (MG63)) was evaluated depending on the bending instability of the struts. The SP scaffolds showed enhanced biological properties such as initial cell attachment, proliferation and osteogenic differentiation. These results suggest that the SP scaffolds has potential as a bioengineered substitute for soft and hard tissue regeneration.

Keywords: cell attachment, electrospinning, mechanical strength, melt-plotting

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Authors: Zahid Ullah, Atlas Khan

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In today's data-driven world, the role of mathematics in bridging the gap between theory and applications is becoming increasingly vital. This abstract highlights the significance of mathematics as a powerful tool for analyzing, interpreting, and extracting meaningful insights from vast amounts of data. By integrating mathematical principles with real-world applications, researchers can unlock the full potential of data-driven decision-making processes. This abstract delves into the various ways mathematics acts as a bridge connecting theoretical frameworks to practical applications. It explores the utilization of mathematical models, algorithms, and statistical techniques to uncover hidden patterns, trends, and correlations within complex datasets. Furthermore, it investigates the role of mathematics in enhancing predictive modeling, optimization, and risk assessment methodologies for improved decision-making in diverse fields such as finance, healthcare, engineering, and social sciences. The abstract also emphasizes the need for interdisciplinary collaboration between mathematicians, statisticians, computer scientists, and domain experts to tackle the challenges posed by the data-driven landscape. By fostering synergies between these disciplines, novel approaches can be developed to address complex problems and make data-driven insights accessible and actionable. Moreover, this abstract underscores the importance of robust mathematical foundations for ensuring the reliability and validity of data analysis. Rigorous mathematical frameworks not only provide a solid basis for understanding and interpreting results but also contribute to the development of innovative methodologies and techniques. In summary, this abstract advocates for the pivotal role of mathematics in bridging theory and applications in a data-driven world. By harnessing mathematical principles, researchers can unlock the transformative potential of data analysis, paving the way for evidence-based decision-making, optimized processes, and innovative solutions to the challenges of our rapidly evolving society.

Keywords: mathematics, bridging theory and applications, data-driven world, mathematical models

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Authors: Judith Stein, Elfriede Friedmann

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The injection of a drug into the vitreous body for the treatment of retinal diseases like wet aged-related macular degeneration (AMD) is the most common medical intervention worldwide. We develop mathematical models for drug transport in the vitreous body of a human eye to analyse the impact of different rheological models of the vitreous on drug distribution. In addition to the convection diffusion equation characterizing the drug spreading, we use porous media modeling for the healthy vitreous with a dense collagen network and include the steady permeating flow of the aqueous humor described by Darcy's law driven by a pressure drop. Additionally, the vitreous body in a healthy human eye behaves like a viscoelastic gel through the collagen fibers suspended in the network of hyaluronic acid and acts as a drug depot for the treatment of retinal diseases. In a completely liquefied vitreous, we couple the drug diffusion with the classical Navier-Stokes flow equations. We prove the global existence and uniqueness of the weak solution of the developed initial-boundary value problem describing the drug distribution in the healthy vitreous considering the permeating aqueous humor flow in the realistic three-dimensional setting. In particular, for the drug diffusion equation, results from the literature are extended from homogeneous Dirichlet boundary conditions to our mixed boundary conditions that describe the eye with the Galerkin's method using Cauchy-Schwarz inequality and trace theorem. Because there is only a small effective drug concentration range and higher concentrations may be toxic, the ability to model the drug transport could improve the therapy by considering patient individual differences and give a better understanding of the physiological and pathological processes in the vitreous.

Keywords: coupled PDE systems, drug diffusion, mixed boundary conditions, vitreous body

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Authors: Nita Nurlaila Kadarwaty

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Purpose: This study presents a rare case of bilateral Acute Primary Angle Closure Glaucoma (PACG). Method: A case report of a 64-year-old woman with a good outcome Acute PACG in both eyes who underwent phacotrabeculectomy surgery. Result: A 64-year-old woman complained of acute pain in both eyes, accompanied by decreased vision, photophobia, and seeing halos for three weeks. There was no history of trauma, steroid or other systemic drugs used, or intraocular surgery before. Ophthalmologic examination revealed a right eye (RE) visual acuity of 0.1, left eye (LE) 0.2. RE intraocular pressure (IOP) was 12 mmhg and LE: 36.4 mmHg in medication of timolol maleat ED and acetazolamide oral. Both eyes' anterior segments revealed mixed injection, corneal edema, shallow anterior chamber, posterior synechiae, mid-dilatation pupil with negative pupillary reflection, and cloudy lens without intumescent. There was a glaucomatous optic and closed iridocorneal angle on the gonioscopy. Initial treatments included oral acetazolamide and potassium aspartate 250 mg three times a day, timolol maleate ED 0.5% twice a day, and prednisolone acetate ED 1% four times a day. This patient underwent trabeculectomy, phacoemulsification, and implantation of IOL in both eyes. One week after the surgeries, both eyes showed decreased IOP and good visual improvement. Conclusion: Bilateral simultaneous Acute PACG is generally severe and results in a poor outcome. It causes rapidly progressive visual loss and is often irreversible. Phacotrabeculectomy has more benefits compared to only phacoemulsification for the intervention regarding the reduced IOP post-surgical.

Keywords: acute primary angle closure glaucoma, intraocular pressure, phacotrabeculectomy, glaucoma

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Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

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Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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Authors: Samain Sabrin, Joshua Pratt, Joshua Bryk, Maryam Karimi

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Globally, extreme heat events have led to a surge in the number of heat-related moralities. These incidents are further exacerbated in high-density population centers due to the Urban Heat Island (UHI) effect. Varieties of anthropogenic activities such as unsupervised land surface modifications, expansion of impervious areas, and lack of use of vegetation are all contributors to an increase in the amount of heat flux trapped by an urban canopy which intensifies the UHI effect. This project aims to propose a systematic approach to measure the impact of air quality and increased temperature based on urban morphology in the selected metropolitan cities. This project will measure the impact of build environment for urban and regional planning using human biometeorological evaluations (mean radiant temperature, Tmrt). We utilized the Rayman model (capable of calculating short and long wave radiation fluxes affecting the human body) to estimate the Tmrt in an urban environment incorporating location and height of buildings and trees as a supplemental tool in urban planning, and street design. Our current results suggest a strong correlation between building height and increased surface temperature in megacities. This model will help with; 1. Quantify the impacts of the built environment and surface properties on surrounding temperature, 2. Identify priority urban neighborhoods by analyzing Tmrt and air quality data at pedestrian level, 3. Characterizing the need for urban green infrastructure or better urban planning- maximizing the cooling benefit from existing Urban Green Infrastructure (UGI), and 4. Developing a hierarchy of streets for new UGI integration and propose new UGI based on site characteristics and cooling potential.

Keywords: air quality, heat mitigation, human-biometeorological indices, increased temperature, mean radiant temperature, radiation flux, sustainable development, thermal comfort, urban canopy, urban planning

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Authors: Thelma Mort

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This empirical, qualitative research uses interviews of four intermediate phase English language student teachers at one university in South Africa and is an exploration of student teacher learning on their teaching practicum in their penultimate year of the initial teacher education course. The country’s post-apartheid language in education policy provides a context to this study in that children move from mother tongue language of instruction in foundation phase to English as a language of instruction in Intermediate phase. There is another layer of context informing this study which is the school context; the student teachers’ reflections are from their teaching practicum in resource constrained schools, which make up more than 75% of schools in South Africa. The findings were that in these schools, deep biases existed to local languages, that language was being used as a proxy for social class, and that conditions necessary for language acquisition were absent. The student teachers’ attitudes were in contrast to those found in the schools, namely that they had various pragmatic approaches to overcoming obstacles and that they saw language as enabling interdisciplinary work. This study describes language issues, tensions created by policy in South African schools and also supplies a regional account of learning to teach in resource constrained schools in Cape Town, where such language tensions are more inflated. The central findings in this research illuminate attitudes to language and language education in these teaching practicum schools and the complexity of learning to be a language teacher in these contexts. This study is one of the few local empirical studies regarding language teaching in the classroom and language teacher education; as such it offers some background to the country’s poor performance in both international and national literacy assessments.

Keywords: language teaching, narrative, post apartheid, South Africa, student teacher

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Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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Authors: Tayyaba Bari, Muhammad Hamza Anjum, Samra Kanwal, Fakhera Ikram

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Osteoarthritis, a degenerative condition, affects more than 213 million individuals globally. Since articular cartilage has no or limited vessels, therefore, after deteriorating, it is unable to rejuvenate. Traditional approaches for cartilage repair, like autologous chondrocyte implantation, microfracture and cartilage transplantation are often associated with postoperative complications and lead to further degradation. Decellularized human umbilical cord has gained interest as a viable treatment for cartilage repair. Decellularization removes all cellular contents as well as debris, leaving a biologically active 3D network known as extracellular matrix (ECM). This matrix is biodegradable, non-immunogenic and provides a microenvironment for homeostasis, growth and repair. UC derived bioink function as 3D scaffolding material, not only mediates cell-matrix interactions but also adherence, proliferation and propagation of cells for 3D organoids. This study comprises different physical, chemical and biological approaches to optimize the decellularization of human umbilical cord (UC) tissues followed by the solubilization of these tissues to bioink formation. The decellularization process consisted of two cycles of freeze thaw where the umbilical cord at -20˚C was thawed at room temperature followed by dissection in small sections from 0.5 to 1cm. Similarly decellularization with ionic and non-ionic detergents Sodium dodecyl sulfate (SDS) and Triton-X 100 revealed that both concentrations of SDS i.e 0.1% and 1% were effective in complete removal of cells from the small UC tissues. The results of decellularization was further confirmed by running them on 1% agarose gel. Histological analysis revealed the efficacy of decellularization, which involves paraffin embedded samples of 4μm processed for Hematoxylin-eosin-safran and 4,6-diamidino-2-phenylindole (DAPI). ECM preservation was confirmed by Alcian Blue, and Masson’s trichrome staining on consecutive sections and images were obtained. Sulfated GAG’s content were determined by 1,9-dimethyl-methylene blue (DMMB) assay, similarly collagen quantification was done by hydroxy proline assay. This 3D bioengineered scaffold will provide a typical atmosphere as in the extracellular matrix of the tissue, which would be seeded with the mesenchymal cells to generate the desired 3D ink for in vitro and in vivo cartilage regeneration applications.

Keywords: umbilical cord, 3d printing, bioink, tissue engineering, cartilage regeneration

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Authors: Umbreen Javaid

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Pakistan’s experience with nascent, yet to be evolved democratic institutions inherited from the British Empire, has not been a pleasant one when evaluated in terms of good governance, development, and success of anti-corruption mechanisms. The country has remained entangled in a vicious circle of accumulating large budget deficits, dwindling economy, low foreign direct investment, political instability, and rising terrorism. It is thus not surprising that no account of the state aimed at analyzing the six-decade journey since her inception is replete with negative connotations like dysfunctional, failed, fragile or weak state. The limited pool of experience of handling democratic institutions and lack of political will be on the part of country’s political elite to transform the society on democratic footings have left Pakistan as a “limited access order” state. The widespread illiteracy becomes a double edge sword when a largely illiterate electorate elects representatives who mostly come from a semi-educated background with the limited understanding of democratic minutiae and little or no proclivity to resist monetary allures. The prevalence of culture of patronage with widespread poverty coupled with absence of a comprehensive system of investigating, prosecuting and adjudicating cases of corruption encourage the practice that has been eroding the state’s foundations since her inception owing to the unwillingness of the traditional elites who have been strongly resistant towards any attempts aimed at disseminating powers. An analytical study of the historical, political, cultural, economic and administrative hurdles that have been at work in impeding Pakistan’s transition to a democratic, accountable society would be instrumental in understanding the issue of widespread plague of corruption and state’s inefficiency to cope with it effectively. The issue of corruption in Pakistan becomes more important when seen in the context of her vulnerability to terrorism and religious extremism. In this regard, Pakistan needs to learn a lot from developed countries in order to evolve a comprehensive strategy for combating and preventing this pressing issue.

Keywords: Pakistan, corruption, anti-corruption, limited access order

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Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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Authors: Maria Altamirano, Alfonso Duran

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Biostimulation has recently become important in order to improve the stability and performance of the anaerobic digestion (AD) process. This strategy involves the addition of nutrients or supplements to improve the rate of degradation of a native microbial consortium. With the aim of biostimulate sytrophism between secondary fermenting bacteria and methanogenic archaea, improving metabolite degradation and efficient conversion to methane, the addition of conductive materials, mainly carbon based have been studied. This research seeks to highlight the effect that coconut biochar (CBC) has on the metanogenic conversion of the organic fraction of municipal solid waste (OFMSW), analyzing the surface chemistry properties that give biochar its capacity to serve as a redox mediator in the anaerobic digestion process. The biochar characterization techniques were electrical conductivity (EC) scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), Fourier Transform Infrared Transmission Spectroscopy (FTIR) and Cyclic Voltammetry (CV). Effect of coconut biochar addition was studied using Authomatic Methane Potential Test System (AMPTS II) applying a one-way variance analysis to determine the dose that leads to higher methane performance. The surface chemistry of the CBC could confer properties that enhance the AD process, such as the presence of alkaline and alkaline earth metals and their hydrophobicity that may be related to their buffering capacity and the adsorption of polar and non-polar compounds, such as NH4+ and CO2. It also has aromatic functional groups, just as quinones, whose potential as a redox mediator has been demonstrated and its morphology allows it to form an immobilizing matrix that favors a closer activity among the syntrophic microorganisms, which directly contributed in the oxidation of secondary metabolites and the final reduction to methane, whose yield is increased by 39% compared to controls, with a CBC dose of 1 g/L.

Keywords: anaerobic digestion, biochar, biostimulation, syntrophic metabolism

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Authors: Tingke Wu, Man Yuan

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“National Territorial Planning (2016-2030)” was issued by the State Council of China in 2017. As an important initiative of putting it into effect, territorial planning at provincial level makes overall arrangement of territorial development, resources and environment protection, comprehensive renovation and security system construction. Hubei province, as the pivot of the “Rise of Central China” national strategy, is now confronted with great opportunities and challenges in territorial development, protection, and renovation. Territorial spatial pattern experiences long time evolution, influenced by multiple internal and external driving forces. It is not clear what are the main causes of its formation and what are effective ways of optimizing it. By analyzing land use data in 2016, this paper reveals present status of territory in Hubei. Combined with economic and social data and construction information, driving forces of territorial spatial pattern are then analyzed. Research demonstrates that the three types of territorial space aggregate distinctively. The four aspects of driving forces include natural background which sets the stage for main functions, population and economic factors which generate agglomeration effect, transportation infrastructure construction which leads to axial expansion and significant provincial strategies which encourage the established path. On this basis, targeted strategies for optimizing territory spatial pattern are then put forward. Hierarchical protection pattern should be established based on development intensity control as respect for nature. By optimizing the layout of population and industry and improving the transportation network, polycentric network-based development pattern could be established. These findings provide basis for Hubei Territorial Planning, and reference for future territorial planning in other provinces.

Keywords: driving forces, Hubei, optimizing strategies, spatial pattern, territory

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Authors: Zsolt Szabolcsi

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Political communication in Hungary has undergone a significant change in the 2010s. One element of the transformation is the Flashnews. This media product was launched in March 2015 and since then 40-50 blocks are broadcasted, daily, on 5 channels. Flashnews blocks are condensed news sessions, containing the summary of political narratives. It starts with the introduction of the narrator, then, usually four news topics are presented and, finally, the narrator concludes the block. The block lasts only one minute and, therefore, it provides a blink session into the main narratives of political communication at the time. Beyond its rapid pace, what makes its avoidance difficult is that these blocks are always in the first position in the commercial break of a non-political media product. Although it is only one minute long, its significance is high. The content of the Flashnews reflects the main governmental narratives and, therefore, the Flashnews is part of the agenda-setting capacity of political communication. It reaches media consumers who have limited knowledge and interest in politics, and their use of media products is not politically related. For this audience, the Flashnews pops up in the same way as commercials. Due to its structure and appearance, the impact of Flashnews seems to be similar to commercials, imbedded into the break of media products. It activates existing knowledge constructs, builds up associational links and maintains their presence in a way that the recipient is not aware of the phenomenon. The research aims to examine the extent to which the Flashnews and the main news narratives are identical in their content. This aim is realized with the content analysis of the two news products by examining the Flashnews and the evening news during main sport events from 2016 to 2018. The initial hypothesis of the research is that Flashnews is a contribution to the news management technique for an effective articulation of political narratives in public service media channels.

Keywords: flashnews, political communication, political marketing, news management

Procedia PDF Downloads 133

Authors: Angelika Dierolf, K. Rischer, A. Gonzalez-Roldan, P. Montoya, F. Anton, M. Van der Meulen

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Placebo analgesia is a powerful cognitive endogenous pain modulation mechanism with high relevance in pain treatment. Older people would benefit, especially from non-pharmacologic pain interventions, since this age group is disproportionately affected by acute and chronic pain, while pharmacological treatments are less suitable due to polypharmacy and age-related changes in drug metabolism. Although aging is known to affect neurobiological and physiological aspects of pain perception, as for example, changes in pain threshold and pain tolerance, its effects on cognitive pain modulation strategies, including placebo analgesia, have hardly been investigated so far. In the present study, we are assessing placebo analgesia in 35 older adults (60 years and older) and 35 younger adults (between 18 and 35 years). Acute pain was induced with short transdermal electrical pulses to the inner forearm, using a concentric stimulating electrode. Stimulation intensities were individually adjusted to the participant’s threshold. Next to the stimulation site, we applied sham transcutaneous electrical nerve stimulation (TENS). Participants were informed that sometimes the TENS device would be switched on (placebo condition), and sometimes it would be switched off (control condition). In reality, it was always switched off. Participants received alternating blocks of painful stimuli in the placebo and control condition and were asked to rate the intensity and unpleasantness of each stimulus on a visual analog scale (VAS). Pain-related evoked potentials were recorded with a 64-channel EEG. Preliminary results show a reduced placebo effect in older compared to younger adults in both behavioral and neurophysiological data. Older people experienced less subjective pain reduction under sham TENS treatment compared to younger adults, as evidenced by the VAS ratings. The N1 and P2 event-related potential components were generally reduced in the older group. While younger adults showed a reduced N1 and P2 under sham TENS treatment, this reduction was considerably smaller in older people. This reduced placebo effect in the older group suggests that cognitive pain modulation is altered in aging and may at least partly explain why older adults experience more pain. Our results highlight the need for a better understanding of the efficacy of non-pharmacological pain treatments in older adults and how these can be optimized to meet the specific requirements of this population.

Keywords: placebo analgesia, aging, acute pain, TENS, EEG

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Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

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Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

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Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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Authors: Peter Pomlenyi, Orsolya Semperger, Gergely Hegedus

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The purpose of the project is to develop a complex composite component with visible class ‘A’ surface. It is going to integrate more functions, including continuous fiber reinforcement, foam core, injection molded ribs, and metal inserts. Therefore we are going to produce recyclable structural composite part from thermoplastic polymer in serial production with short cycle time for automotive applications. Our design of the process line is determined by the principles of Industry 4.0. Accordingly, our goal is to map in details the properties of the final product including the mechanical properties in order to replace metal elements used in automotive industry, with special regard to the effect of each manufacturing process step on the afore mentioned properties. Period of the project is 3 years, which lasts from the 1st of December 2016 to the 30th November 2019. There are four consortium members in the R&D project evopro systems engineering Ltd., Department of Polymer Engineering of the Budapest University of Technology and Economics, Research Centre for Natural Sciences of Hungarian Academy of Sciences and eCon Engineering Ltd. One of the most important result that we can obtain short cycle time (up to 2-3 min) with in-situ polymerization method, which is an innovation in the field of thermoplastic composite production. Because of the mentioned method, our fully automated production line is able to manufacture complex thermoplastic composite parts and satisfies the short cycle time required by the automotive industry. In addition to the innovative technology, we are able to design, analyze complex composite parts with finite element method, and validate our results. We are continuously collecting all the information, knowledge and experience to improve our technology and obtain even more accurate results with respect to the quality and complexity of the composite parts, the cycle time of the production, and the design and analyzing method of the composite parts.

Keywords: T-RTM technology, composite, automotive, class A surface

Procedia PDF Downloads 138

Authors: Surabhi Gautam, Uma Kumar, Rima Dada

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A sustained acute-phase response in Rheumatoid Arthritis (RA) is associated with increased joint damage and inflammation leading to progressive disability. It is induced continuously by consecutive stimuli of proinflammatory cytokines, following a wide range of pathophysiological reactions, leading to increased synthesis of acute phase proteins like C - reactive protein (CRP) and dysregulation in levels of immunomodulatory soluble Human Leukocyte Antigen-G (HLA-G) molecule. This study was designed to explore the effect of yoga and meditation based lifestyle intervention (YMLI) on inflammatory markers in RA patients. Blood samples of 50 patients were collected at baseline (day 0) and after 30 days of YMLI. Patients underwent a pretested YMLI under the supervision of a certified yoga instructor for 30 days including different Asanas (physical postures), Pranayama (breathing exercises), and Dhayna (meditation). Levels of CRP, IL-6, IL-17A, soluble HLA-G and erythrocyte sedimentation rate (ESR) were measured at day 0 and 30 interval. Parameters of disease activity, disability quotient, pain acuity and quality of life were also assessed by disease activity score (DAS28), health assessment questionnaire (HAQ), visual analogue scale (VAS), and World Health Organization Quality of Life (WHOQOL-BREF) respectively. There was reduction in mean levels of CRP (p < 0.05), IL-6 (interleukin-6) (p < 0.05), IL-17A (interleukin-17A) (p < 0.05) and ESR (p < 0.05) and elevation in soluble HLA-G (p < 0.05) at 30 days compared to baseline level (day 0). There was reduction seen in DAS28-ESR (p < 0.05), VAS (p < 0.05) and HAQ (p < 0.05) after 30 days with respect to the base line levels (day 0) and significant increase in WHOQOL-BREF scale (p < 0.05) in all 4 domains of physical health, psychological health, social relationships, and environmental health. The present study has demonstrated that yoga practices are associated with regression of inflammatory processes by reducing inflammatory parameters and regulating the levels of soluble HLA-G significantly in active RA patients. Short term YMLI has significantly improved pain perception, disability quotient, disease activity and quality of life. Thus this simple life style intervention can reduce disease severity and dose of drugs used in the treatment of RA.

Keywords: inflammation, quality of life, rheumatoid arthritis, yoga and meditation

Procedia PDF Downloads 166