Search results for: intra operative radiotherapy

Authors: Carolyn Whyte, Tina Halai, Sonita Koshal

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Aim: There are many methods available to assess the potential difficulty of third molar surgery. This study investigated various factors to assess whether they had a bearing on the difficulties encountered. Study design: A retrospective study was completed of 62 single mandibular third molar teeth removed under day case general anaesthesia between May 2016 and August 2016 by 3 consultant oral surgeons. Method: Data collection was by examining the OPG radiographs of each tooth and recording the necessary data. This was depth of impaction, angulation, bony impaction, point of application in relation to second molar, root morphology, Pell and Gregory classification and Winters Lines. This was completed by one assessor and verified by another. Information on medical history, anxiety, ethnicity and age were recorded. Case notes and surgical entries were examined for any difficulties encountered. Results: There were 5 cases which encountered surgical difficulties which included fracture of root apices (3) which were left in situ, prolonged bleeding (1) and post-operative numbness >6 months(1). Four of the 5 cases had Pell and Gregory classification as (B) where the occlusal plane of the impacted tooth is between the occlusal plane and the cervical line of the adjacent tooth. 80% of cases had the point of application as either coronal or apical one third (1/3) in relation to the second molar. However, there was variability in all other aspects of assessment in predicting difficulty of removal. Conclusions: Of the cases which encountered difficulties they all had at least one predictor of potential complexity but these varied case by case.

Keywords: impaction, mandibular third molar, radiographic assessment, surgical removal

Procedia PDF Downloads 181

Authors: B. Sathyanarayana

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As per the report of World Health Organization, more than 80% of world population uses medicines made from herbal and natural materials. They have stood the test of time for their safety, efficacy, cultural acceptability and lesser side effects. Quality assurance and control measures, such as national quality specification and standards for herbal materials, good manufacturing practices (GMP) for herbal medicines, labelling, and licensing schemes for manufacturing, imports and marketing, should be in place in every country where herbal medicines are regulated. These measures are vital for ensuring the safety and efficacy of herbal medicines. In the case of herbal products challenge begins at the stage of designing itself except the classical products. Selection of herbal ingredients, officinal parts to be used, proportions are vital. Once the formulation is designed one should take utmost care to produce the standardized product of assured quality and safety. Quality control measures should cover the validation of quality and identity of raw materials, in process control (as per SOP and GMP norms) and at the level of final product. Quality testing, safety and efficacy studies of the final product are required to ensure the safe and effective use of the herbal products in human beings. Medicinal plants being the materials of natural resource are subjected to great variation making it really difficult to fix quality standards especially in the case of polyherbal preparations. Manufacturing also needs modification according to the type of ingredients present. Hence, it becomes essential to develop Standard operative Procedure for a specific herbal product. Present paper throws a light on the challenges that are encountered during the design and development of herbal products.

Keywords: herbal product, challenges, quality, safety, efficacy

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Authors: Marcela de Oliveira, Guilherme Giacomini, Allan Felipe Fattori Alves, Ana Luiza Menegatti Pavan, Maria Eugenia Dela Rosa, Fernando Antonio Bacchim Neto, Diana Rodrigues de Pina

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It is estimated that each year one death every 10 seconds (about 2 million deaths) in the world is attributed to tuberculosis (TB). Even after effective treatment, TB leaves sequelae such as, for example, pulmonary fibrosis, compromising the quality of life of patients. Evaluations of the aforementioned sequel are usually performed subjectively by radiology specialists. Subjective evaluation may indicate variations inter and intra observers. The examination of x-rays is the diagnostic imaging method most accomplished in the monitoring of patients diagnosed with TB and of least cost to the institution. The application of computational algorithms is of utmost importance to make a more objective quantification of pulmonary impairment in individuals with tuberculosis. The purpose of this research is the use of computer algorithms to quantify the pulmonary impairment pre and post-treatment of patients with pulmonary TB. The x-ray images of 10 patients with TB diagnosis confirmed by examination of sputum smears were studied. Initially the segmentation of the total lung area was performed (posteroanterior and lateral views) then targeted to the compromised region by pulmonary sequel. Through morphological operators and the application of signal noise tool, it was possible to determine the compromised lung volume. The largest difference found pre- and post-treatment was 85.85% and the smallest was 54.08%.

Keywords: algorithm, radiology, tuberculosis, x-rays exam

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Authors: Novie Nuraini, Sari Hanifa, Yetty Ramli

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Chronic subdural hematoma (cSDH) is a common condition after head trauma. Although the size of the thickness of cSDH has an important role in the decision to perform surgery, but the size limit of the thickness is not absolute. In this serial case report, we evaluate three case report of cSDH that indicated to get the surgical procedure because of deficit neurologic and neuroimaging finding with subfalcine herniation more than 0.5 cm and hematoma thickness more than one cm. On the first case, the patient got evacuation hematoma procedure, but the second and third case, we did nonsurgical treatment because the patient and family refused to do the operation. We did the conservative treatment with bed rest and mannitol. Serial radiologic evaluation is done when we found worsening condition. We also reevaluated radiologic examination two weeks after the treatment. The results in this serial case report, the first and second case have a good outcome. On the third case, there was a worsening condition, which in this patient there was a comorbid with type two diabetic mellitus, pneumonie and chronic kidney disease. Some conservative treatment such as bed rest, corticosteroid, mannitol or the other hyperosmolar has a good outcome in patient without neurologic deficits, small hematoma, and or patient without comorbid disease. Evacuate hematome is the best choice in cSDH treatment with deficit neurologic finding. Afterall, there is some condition that we can not do the surgical procedure. Serial radiologic examination needed after two weeks to evaluate the treatment or if there is any worsening condition.

Keywords: chronic subdural hematoma, traumatic brain injury, surgical treatment, nonsurgical treatment, outcome

Procedia PDF Downloads 332

Authors: Meltem Koray, Arda Ozgon, Duygu Ofluoglu, Mehmet Yaltirik

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Oral ulcerations can be seen as a side effect of different drugs. These ulcers usually appear within a few weeks following drug treatment. In most of cases, these ulcers resist to conventional treatments, such as anesthetics, antiseptics, anti-inflammatory agents, cauterization, topical tetracycline and corticosteroid treatment. The diagnosis is usually difficult, especially in patients receiving multiple drug therapies. Hyaluronan or hyaluronic acid (HA) is a biomaterial that has been introduced as an alternative approach to enhance wound healing and also used for oral ulcer treatment. The aim of this report is to present the treatment of drug-induced oral ulceration on maxillary mucosa with HA gel. 60-year-old male patient was referred to Department of Oral and Maxillofacial Surgery complaining of oral ulcerations during few weeks. He had received chemotherapy and radiotherapy in 2014 with the diagnosis of nasopharyngeal carcinoma, and he has accompanying systemic diseases such as; cardiological, neurological diseases and gout. He is medicated with Escitalopram (Cipralex® 20mg), Quetiapine (Seroquel® 100mg), Mirtazapine (Zestat® 15mg), Acetylsalicylic acid (Coraspin® 100mg), Ramipril-hydrochlorothiazide (Delix® 2.5mg), Theophylline anhydrous (Teokap Sr® 200mg), Colchicine (Colchicum Dispert® 0.5mg), Spironolactone (Aldactone® 100mg), Levothyroxine sodium (Levotiron® 50mg). He had painful oral ulceration on the right side of maxillary mucosa. The diagnosis was 'drug-induced oral ulceration' and HA oral gel (Aftamed® Oral gel) was prescribed 3 times a day for 2 weeks. Complete healing was achieved within 3 weeks without any side effect and discomfort. We suggest that HA oral gel is a potentially useful local drug which can be an alternative for management of drug-induced oral ulcerations.

Keywords: drug-induced, hyaluronic acid, oral ulceration, maxillary mucosa

Procedia PDF Downloads 268

Authors: Zhou Yang, Heli Sun, Jianbin Huang, Jizhong Zhao, Shaojie Qiao

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Traffic prediction is essential in a multitude of ways in modern urban life. The researchers of earlier work in this domain carry out the investigation chiefly with two major focuses: (1) the accurate forecast of future values in multiple time series and (2) knowledge extraction from spatial-temporal correlations. However, two key considerations for traffic prediction are often missed: the completeness of raw data and the full context of the prediction timestamp. Concentrating on the two drawbacks of earlier work, we devise an approach that can address these issues in a two-phase framework. First, we utilize the raw trajectories to a greater extent through building a VLA table and data compression. We obtain the intra-trajectory features with graph-based encoding and the intertrajectory ones with a grid-based model and the technique of back projection that restore their surrounding high-resolution spatial-temporal environment. To the best of our knowledge, we are the first to study direct feature extraction from raw trajectories for traffic prediction and attempt the use of raw data with the least degree of reduction. In the prediction phase, we provide a broader context for the prediction timestamp by taking into account the information that are around it in the training dataset. Extensive experiments on several well-known datasets have verified the effectiveness of our solution that combines the strength of raw trajectory data and prediction context. In terms of performance, our approach surpasses several state-of-the-art methods for traffic prediction.

Keywords: traffic prediction, raw data utilization, context building, data reduction

Procedia PDF Downloads 127

Authors: Didem Venus Yildiz, Murat Hocaoglu, Murat Dursun, Taner Akkan

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The shoulder joint is a more complex structure than the hip or knee joints. In addition to the overall complexity of the shoulder joint, two different factors influence the insufficient outcome of shoulder replacement: the shoulder prosthesis design is far from fully developed and it is difficult to place these shoulder prosthesis due to shoulder anatomy. The glenohumeral joint is the most complex joint of the human shoulder. There are various treatments for shoulder failures such as total shoulder arthroplasty, reverse total shoulder arthroplasty. Due to its reverse design than normal shoulder anatomy, reverse total shoulder arthroplasty has different physiological and biomechanical properties. Post-operative achievement of this arthroplasty is depend on improved design of reverse total shoulder prosthesis. Designation achievement can be increased by several biomechanical and computational analysis. In this study, data of human both shoulders with right side fracture was collected by 3D Computer Tomography (CT) machine in dicom format. This data transferred to 3D medical image processing software (Mimics Materilise, Leuven, Belgium) to reconstruct patient’s left and right shoulders’ bones geometry. Provided 3D geometry model of the fractured shoulder was used to constitute of reverse total shoulder prosthesis by 3-matic software. Finite element (FE) analysis was conducted for comparison of intact shoulder and prosthetic shoulder in terms of stress distribution and displacements. Body weight physiological reaction force of 800 N loads was applied. Resultant values of FE analysis was compared for both shoulders. The analysis of the performance of the reverse shoulder prosthesis could enhance the knowledge of the prosthetic design.

Keywords: reverse shoulder prosthesis, biomechanics, finite element analysis, 3D printing

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Authors: Csilla Marianna Szabó

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In Hungary, the society has changes a lot for the past 25 years, and these changes could be detected in educational situations as well. The number and the intensity of conflicts have been increased in most fields of life, as well as at schools. Teachers have difficulties to be able to handle school conflicts. What is more, the new net generation, generation Z has values and behavioural patterns different from those of the previous one, which might generate more serious conflicts at school, especially with teachers who were mainly socialising in a traditional teacher – student relationships. In Hungary, the bill CCIV, 2011 declared the foundation of Institutes of Teacher Training in higher education institutes. One of the tasks of the Institutes is to survey the competences and needs of teachers working in public education and to provide further trainings and services for them according to their needs and requirements. This job is supported by the Social Renewal Operative Programs 4.1.2.B. The Institute of Teacher Training at the College of Dunaújváros, Hungary carried out a questionnaire and surveyed the needs and the requirements of teachers working in the Central Transdanubian region. Based on the results, the professors of the Institute of Teacher Training decided to meet the requirements of teachers and launch short courses in spring 2015. One of the courses is going to focus on school conflict management through mediation. The aim of the pilot course is to provide conflict management techniques for teachers presenting different mediation techniques to them. The theoretical part of the course (5 hours) will enable participants to understand the main points and the advantages of mediation, while the practical part (10 hours) will involve teachers in role plays to learn how to cope with conflict situations applying mediation. We hope if conflicts could be reduced, it would influence school atmosphere in a positive way and the teaching – learning process could be more successful and effective.

Keywords: conflict resolution, generation Z, mediation, teacher training

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Authors: Sylwia K. Naliwajko, Renata Markiewicz-Zukowska, Justyna Moskwa, Krystyna Gromkowska-Kepka, Konrad Mielcarek, Patryk Nowakowski, Katarzyna Socha, Anna Puscion-Jakubik, Maria H. Borawska

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Glioblastoma (grade IV WHO) is a rapidly progressive brain tumor with very high morbidity and mortality. The vast malignant gliomas are not curable despite the therapy (surgical, radiotherapy, chemotherapy) and patients seek alternative or complementary treatments. Patients often use cannabidiol (CBD) oil as an alternative therapy of glioblastoma. CBD is one of the cannabinoids, an active component of Cannabis sativa. THC (Δ9-tetrahydrocannabinol) can be addictive, and in many countries CBD oil without THC ( < 0,2%) is available. Propolis produced by bees from the resin collected from trees has antiglioma properties in vitro and can be used as a supplement in complementary therapy of gliomas. The aim of this study was to examine the influence of extract from CBD oil in combination with propolis extract on two glioblastoma cell lines. The MTT (Thiazolyl Blue Tetrazolium Bromide) test was used to determine the influence of CBD oil extract and polish propolis extract (PPE) on the viability of glioblastoma cell lines – U87MG and LN18. The cells were incubated (24, 48 and 72 h) with CBD oil extract and PPE. CBD extract was used in concentration 1, 1.5 and 3 µM and PPE in 30 µg/mL. The data were presented compared to the control. The statistical analysis was performed using Statistica v. 13.0 software. CBD oil extract in concentrations 1, 1.5 and 3 µM did not inhibit the viability of U87MG and LN18 cells (viability more than 90% cells compared to the control). There was no dose-response viability, and IC50 value was not recognized. PPE in the concentration of 30 µg/mL time-dependently inhibited the viability of U87MG and LN18 cell line (after 48 h the viability as a percent of the control was 59,7±6% and 57,8±7%, respectively). In a combination of CBD with PPE, the viability of the treated cells was similar to PPE used alone (58,2±7% and 56,5±9%, respectively). CBD oil extract did not show anti-glioma activity and in combination with PPE did not change the activity of PPE.

Keywords: anticancer, cannabidiol, cell line, glioblastoma

Procedia PDF Downloads 246

Authors: Sopian Brahim, Mohd Suhaimi Mohamad, Ezarina Zakaria, Norulhuda Sarnon

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This study aims to explore the practical experience of child welfare case workers and professionalism in the child case management in Malaysia. This paper discusses the specific social work practice competency and challenges faced by child caseworkers in the fieldwork. This research is qualitative with Grounded Theory approach. Four sessions of Focused Group Discussion (FGD) have been conducted involving a total of 27 caseworkers (child protector and probation officers) in the Klang Valley. The study found that the four basic principles of knowledge in child case management namely: 1. Knowledge in child case management, 2. Professional values of caseworkers towards children, 3. skills in managing cases, and 4. Culturally competence practice in child case managemenr. In addition, major challenges faced in the child case management are the capacity and commitment of the family in children's rehabilitation program, the credibility of the case worker are being challenge and challenges in support system from intra and inter-agency. This study is important for policy makers to take into account the capacity and needs of the child's case worker in accordance with national social work competency framework thereby improving case management services for children more systematically in line with national standards.

Keywords: social work practice, child case management, competency-based knowledge, professionalism

Procedia PDF Downloads 335

Authors: S. Mohammad Reza Khatibi

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Statistics on urbanization in Iran and around the world show that urbanization rate and urban population had had an increasing growth and, during five decades, this trend shows the fact that growth will still continue for a long time. Therefore, instead of an irregular horizontal city development and growth, a sustainable development is achievable by filling the existing city fabric, organizing the density and changing the use of incompatible old or urban buildings. One approach is the infill development. Infill development is the development of vacant land or wasteland abandoned within built areas or where there already exist facilities and equipment. Simply put, infill development is the use of empty spaces or those lacking intra-city use for city development. Additionally, fulfillment of social justice and creating a safe, secure and desirable atmosphere for citizens to live and stay active along with acquiring equal life opportunities, are among the goals of vision plan of Iran in conflict with which, certain environments have been created by city neighborhoods having physical, social, economic, etc. problems. Accordingly, in order to meet the extensive need of many cities for openness to growing population, this paper aims to investigate the relationship between infill development indicators and life quality in urban neighborhoods, using descriptive-analytical research method. Findings show that infill development indicators in three physical, social and economic categories can be adapted with quality components of urban environments, especially urban neighborhoods, and related guidelines can be offered.

Keywords: infill development, life quality, urban neighborhoods, indicator

Procedia PDF Downloads 359

Authors: Isabella Schwartz, Ori Safran, Naama Karniel, Michal Abel, Adina Berko, Martin Seyres, Tamir Tsoar, Sigal Portnoy

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Virtual Reality allows to manipulate the patient’s perception, thereby providing a motivational addition to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive Range of Motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; N=6) and a manipulated feedback group (M-group; N=7). The shoulder ROM, pain, and the Disabilities of the Arm, Shoulder and Hand (DASH) scores were tested at baseline and after the 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle and the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM, with median and interquartile range of 197.1 (140.5-425.0) compared to 142.5 (139.1-151.3) for the NM-group (p=.046). Also, the M-group showed greater improvement in the DASH scores, with median and interquartile range of 67.7 (52.8-86.2) compared to 89.7 (83.8-98.3) for the NM-group (p=.022). Manipulated intervention is beneficial in individuals with traumatic stiff shoulder and should be further tested for other populations with orthopedic injuries.

Keywords: virtual reality, biofeedback, shoulder pain, range of motion

Procedia PDF Downloads 125

Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Omaimah Algohary

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Kaolin is one of the principle intestinal adsorbents, has traditionally been used internally in the treatment of various enteric disorders, colitis, enteritis, dysentery, and diarrhea associated with food and alkaloidal poisoning and in traveler’s diarrhea. It binds to and traps bacteria and its toxins and gases in the gut. It also binds to water in the gut, which helps to make the stools firmer, hence giving symptomatic relief. Metronidazole is a synthetic antibacterial agent that is used primarily in the treatment of various anaerobic infections such as intra-abdominal infections, antiprotozoal, and as amebicidal. The need for safe, therapeutically effective antidiarrheal combination continuously lead to effective treatment. Metronidazol used for treatment of anaerobic bacteria and kaolin , when administered simultaneously, Metronidazole–Kaolin interactions have been reported by FDA but not studied. This project is the first to study the effect of Metronidazole–Kaolin interactions on the antimicrobial activity of metronidazole. Agar diffusion method performed to test the antimicrobial activity of metronidazole–kaolin antidiarrheal combination from aqueous solutions at an in-vivo simulated pHs conditions that obtained at 37+0.5 °C on Helicobacter pylori as anaerobic bacteria and E.coli as aerobic bacteria and used as a control for the technique. The antimicrobial activity of metronidazole combination as 1:1 and 1:2 with kaolin was abolished in acidic media as no zones of inhibition shown compared to only metronidazole that used as a control. In alkaline media metronidazole combination as 1:1 and 1:2 with kaolin showed diminutive activity compared to the control. These results proved that the kaolin adsorb metronidazole and abolish its antimicrobial activity and such combination should be avoided.

Keywords: kaolin, metronidazole, interaction, Helicobacter pylori. E. coli, antimicrobial activity

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Authors: Ranojoy Dutta, Adam Barker

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Multifamily residential buildings are increasingly being built with large glazed areas to provide tenants with greater daylight and outdoor views. However, traditional double-glazed window assemblies can lead to significant thermal discomfort from high radiant temperatures as well as increased cooling energy use to address solar gains. Dynamic glazing provides an effective solution by actively controlling solar transmission to maintain indoor thermal comfort, without compromising the visual connection to outdoors. This study uses thermal simulations across three Canadian cities (Toronto, Vancouver and Montreal) to verify if dynamic glazing along with operable windows and ceiling fans can maintain the indoor operative temperature of a prototype southwest facing high-rise apartment unit within the ASHRAE 55 adaptive comfort range for a majority of the year, without any mechanical cooling. Since this study proposes the use of natural ventilation for cooling and the typical building life cycle is 30-40 years, the typical weather files have been modified based on accepted global warming projections for increased air temperatures by 2050. Results for the prototype apartment confirm that thermal discomfort with dynamic glazing occurs only for less than 0.7% of the year. However, in the baseline scenario with low-E glass there are up to 7% annual hours of discomfort despite natural ventilation with operable windows and improved air movement with ceiling fans.

Keywords: electrochromic glazing, multi-family housing, passive cooling, thermal comfort, natural ventilation

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Authors: Mohamed Khaled Ahmed Azzam

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Complete dentures, a non biological appliance, were and are still used to replace missing teeth and surrounding structures. Its main objectives are esthetics, speech, function and psychological state improvement. Dentists must realize that, just as dentate patients vary in their dental treatment complexity; edentulous patients also vary in the difficulty of their treatment plan. There are two main problems facing the removable Prosthodontist which harden his/her task how to please his patient with their new dentures being: Denture construction which however its fabrication is at the highest standards still is an unpleasant experience to all patients in the beginning and improves by time. This varies from one to several years according to the patient’s attitude, age, gender, socio-economical level and culture. The second problem of edentulous patients is both physical and psychological. Good interview, communication and note how patients present themselves for the concerns of their appearance, overall attitude and expectations concerning treatment is very important physically. On the psychological aspect patients have great difficulty to cope with new dentures to the extent of not using them at all. Hence their mind preparation should be commenced from day one by more than one method. This had a great impact on the acceptance which led to habituation to their dentures and patients were appreciative and pleased. In conclusion to successfully treat edentulous patients a great deal of information is required to complete a proper diagnosis, including patient mental attitude, past and present medical and dental conditions, and extra and intra-oral examinations. In addition to the clinical experience and skill of the whole dental team.

Keywords: complete dentures, edentulous patients, management of denture, psychological mind preparation

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Waleed Jarjoura

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In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in braille, basic Math competencies, braille printing which suggest Gerstmann syndrome in the blind. In addition, significant difficultiesorientation and mobility skills using the Cane, in general, organizational skills, and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctionsin blind individuals due to V/P shunt surgeries.

Keywords: congenital blindness, hydrocephalus, shunt surgery, spatial orientation

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Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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Authors: Reni Francis

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Learning has transcended the classroom boundaries to create a learner centric, interactive, and integrative teaching learning environment. This study analysed the impact of iLearn on the teaching, learning, and evaluation among 100 teacher trainees. The objectives were to cater to the different learning styles of the teacher trainees, to incorporate innovative teaching learning activities, to assist in peer tutoring, to implement different evaluation processes. i: Identifying the learning styles among the teacher trainees through VARK Learning style checklist was followed by planning the teaching-learning process to meet the learning styles of the teacher trainees. L: Leveraging innovations in teaching- learning by planning and creating modules incorporating innovative teaching learning and hence the concept based year plan was prepared. E: Engage learning through constructivism using different teaching methodology to engage the teacher trainees in the learning process through Workshop, Round Robin, Gallery walk, Co-Operative learning, Think-Pair-Share, EDMODO, Course Networking, Concept Map, Brainstorming Sessions, Video Clippings. A: Assessing the learning through an Open Book assignment, Closed book assignment, and Multiple Choice Questions and Seminar presentation. R: Remediation through peer tutoring through Mentor-mentee approach in the tutorial groups, Group work, Library Hours. N: Norming new standards. This was done in the form of extended remediation and tutorials to understand the need of the teacher trainee and support them for further achievements in learning through Face to face interaction, Supervised Study Circle, Mobile (Device) learning. The findings of the study revealed the positive impact of iLearn towards student achievement and enhanced social skills.

Keywords: academic achievement, innovative strategy, learning styles, social skills

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Authors: Monika Bansal

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Background: Placement of dental implant in narrow alveolar ridge is challenging to be treated. GBR procedure is currently most widely used to augment the deficient alveolar ridges and to treat the fenestration and dehiscence around dental implants. Thus, the objectives of the present study were to evaluate as well as compare the clinical performance of collagen membrane and titanium mesh for horizontal bone augmentation at dehisced implant sites. Methods and material: Total 12 single edentulous implant sites with buccal bone deficiency in 8 subjects were equally divided and treated simultaneously with either of the two membranes and DBBM(Bio-Oss) bone graft. Primary outcome measurements in terms of defect height and defect width were made using a calibrated plastic periodontal probe. Re-entry surgery was performed to remeasure the augmented site and to remove Ti-mesh at 6th month. Independent paired t-tests for the inter-group comparison and student-paired t-tests for the intra-group comparison were performed. The differences were considered to be significant at p ≤ 0.05. Results: Mean defect fill with respect to height and width was 3.50 ± 0.54 mm (87%) and 2.33 ± 0.51 mm (82%) for collagen membrane and 3.83 ± 0.75 mm (92%) and 2.50 ± 0.54 mm (88%) for Ti-mesh group respectively. Conclusions: Within the limitation of the study, it was concluded that mean defect height and width after 6 months were statistically significant within the group without significant difference between them, although defect resolution was better in Ti-mesh.

Keywords: collagen membrane, dehiscence, dental implant, horizontal bone, augmentation, ti-mesh

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Authors: Leema Jacob

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The concept of psychological well-being is complex and has familiar use not only in psychology but also in the area of lifespan development. Eudaimonic well-being is finding a purpose and meaning in life, and this depends on both the individual and society, especially during adolescence; the social-cognitive environment can be decisive. The social environment of adolescents, including family, school, and friends, is recognized as an essential context for successful human life. The development of mature social relationships is also undoubtedly important. Theory of Mind is an emerging domain in cognitive neuroscience that involves the ability to attribute mental states to oneself and others. ToM skills training constitutes a new aspect of the adolescent’s social development, including four domains: cognitive ToM, affective ToM, and an inter-intra-personal understanding of social norms. Still, little effort has been made to promote this training as a modality to foster their psychological well-being. This study aims to use the eudaimonic approach to evaluate psychological well-being with a quasi-experimental research design (pre-post-test). The major objective of the study was to identify the effect of ToM skills training on the eudaimonic well-being of adolescents with low social cognition. The data was analyzed to find their effect size from a sample of 74 adolescents from India between 17 and 19 years old. The result revealed that ToM skills training has a positive outcome on the well-being of adolescents post-training. The results are discussed based on the effect of ToM skills training on psychological well-being during adolescence, as well as on the importance of focusing on mental health as a developmental asset that can potentially influence mental well-being in the future.

Keywords: ToM training, adolescents, eudaimonic well-being, social cognition

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Authors: Meliani Samiha, Hassaine Sarah

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Figs are so much consumed in the Mediterranean region; they present a high nutritional value and also multiple therapeutic virtues. Our work contributes to the study of the antidiabetic activity of the common fig of the region of El Amra (AinDefla) Algeria. To do this, 20 Wistar rats female, divided into 4 lots, were used: Lot 1: 5 normal controls; Lot 2: 5 normal controls treated with dry fig juice at 20%; Lot 3: 5 diabetic controls; Lot 4: 5 diabetic controls treated with dry fig juice at 20%. The rats are rendered diabetic by intra-peritoneal injection of a streptozotocin solution. The blood glucose is measured after 1 hour, 2 hours, 3 hours and after 4 hours of the administration of the fig juice; it’s measured also on the 5th day, 8th day and 9th day of the beginning of the experiment. The determination of cholesterol and triglycerides blood is carried out at the beginning and the end of the study. On the 9th day, we recorded a very significant decrease of the blood sugar level of diabetic rats treated with dry fig juice. This blood glucose level normalized for 3 rats/5rats, we also recorded a decrease, but not significant, of cholesterol and triglycerides blood levels. In the short term (for 4 hours), an increase of blood sugar level, one hour after administration, for normal and diabetic rats. This increase is probably due to the high level of sugar content in the preparation. The blood glucose level is then corrected, four hours later. This may be the result of anti hyperglycemic effect of the active ingredients contained in the figs.

Keywords: antidiabetic, figs, hypoglycemia, streptozotocin

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Authors: Saad M. Darwish, Mohamed A. El-Iskandarani, Guitar M. Shawkat

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Nowadays, the amount of available multimedia data is continuously on the rise. The need to find a required image for an ordinary user is a challenging task. Content based image retrieval (CBIR) computes relevance based on the visual similarity of low-level image features such as color, textures, etc. However, there is a gap between low-level visual features and semantic meanings required by applications. The typical method of bridging the semantic gap is through the automatic image annotation (AIA) that extracts semantic features using machine learning techniques. In this paper, a multi-label image annotation system guided by Firefly and Bayesian method is proposed. Firstly, images are segmented using the maximum variance intra cluster and Firefly algorithm, which is a swarm-based approach with high convergence speed, less computation rate and search for the optimal multiple threshold. Feature extraction techniques based on color features and region properties are applied to obtain the representative features. After that, the images are annotated using translation model based on the Net Bayes system, which is efficient for multi-label learning with high precision and less complexity. Experiments are performed using Corel Database. The results show that the proposed system is better than traditional ones for automatic image annotation and retrieval.

Keywords: feature extraction, feature selection, image annotation, classification

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Authors: Nattawadee Sinpattanawong

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Oral presentation has been used mostly in business communication. The business presentation is carrying out through an audio and visual presentation material such as statistical documents, projectors, etc. Common examples of business presentation are intra-organization and sales presentations. The study aims at investigating functions, strategies and contents of assessors’ verbal feedback on presenters’ oral presentations and exploring presenters’ learning process and specific views and expectations concerning assessors’ verbal feedback related to the delivery of the oral presentation. This study is designed as a descriptive qualitative research; four master students and one teacher in English for Business and Industry Presentation Techniques class of public university will be selected. The researcher hopes that any understanding how assessors’ verbal feedback on oral presentations and learning process may illuminate issues for other people. The data from this research may help to expand and facilitate the readers’ understanding of assessors’ verbal feedback on oral presentations and learning process in their own situations. The research instruments include an audio recorder, video recorder and an interview. The students will be interviewing in order to ask for their views and expectations concerning assessors’ verbal feedback related to the delivery of the oral presentation. After finishing data collection, the data will be analyzed and transcribed. The findings of this study are significant because it can provide presenters knowledge to enhance their learning process and provide teachers knowledge about providing verbal feedback on student’s oral presentations on a business context.

Keywords: business context, learning process, oral presentation, verbal feedback

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Authors: Alhassan Dramani Yakubu

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The primary purpose of this study was to analyze effects that participating in sporting activities has on academic performance among students at Yaa Asantewaa Girls’ Senior High School. To dig out the main objective of the study, descriptive survey design was employed. The study used 45 respondents comprising of 25 student – athletes and 20 non-student – athletes. The purposive sampling and stratified random sampling technique were used to sample population of 455 students involved. The academic performance of sports participants is compared with those of non – participants in terms of their outcomes in the form of grades from mathematics. Data was obtained from the sample by the use of questionnaire which was self - administered. The questionnaire sought information on level of student’s participation in sports and importance of sports participation to students. Results revealed that participation in sporting activities is associated with higher grades among students. The analysis reinforces the idea that apart from their health benefits for participants, sporting activities lead to the attainment of the performance goals to which higher institutions aspire. The findings also implies that, mathematics teachers and other subject teachers should not fend off students from participating in sporting activities with the trepidation that participating in sports inflame academic performance. This study recommend that, educational programs about sports should be provided for students’ through the educational system to bring about positive academic performance.

Keywords: physical activity, physical education, intra mural, extra mural

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Authors: H. M. Haytham, E. A. Azza, E.S. Mohamed, E. G. Nesreen

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Thoracotomy is a great surgery that has serious pulmonary complications, so purpose of this study was to determine the response of diaphragmatic excursion to inspiratory muscle trainer post thoracotomy. Thirty patients of both sexes (16 men and 14 women) with age ranged from 20 to 40 years old had done thoracotomy participated in this study. The practical work was done in cardiothoracic department, Kasr-El-Aini hospital at faculty of medicine for individuals 3 days Post operatively. Patients were assigned into two groups: group A (study group) included 15 patients (8 men and 7 women) who received inspiratory muscle training by using inspiratory muscle trainer for 20 minutes and routine chest physiotherapy (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Group B (control group) included 15 patients (8 men and 7 women) who received the routine chest physiotherapy only (deep breathing, cough and early ambulation) twice daily, 3 days per week for one month. Ultrasonography was used to evaluate the changes in diaphragmatic excursion before and after training program. Statistical analysis revealed a significant increase in diaphragmatic excursion in the study group (59.52%) more than control group (18.66%) after using inspiratory muscle trainer post operatively in patients post thoracotomy. It was concluded that the inspiratory muscle training device increases diaphragmatic excursion in patients post thoracotomy through improving inspiratory muscle strength and improving mechanics of breathing and using of inspiratory muscle trainer as a method of physical therapy rehabilitation to reduce post-operative pulmonary complications post thoracotomy.

Keywords: diaphragmatic excursion, inspiratory muscle trainer, ultrasonography, thoracotomy

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Authors: Kuan-Wei Chen, Chien-Wei Chen, Tai-Ling Chang, Nan-Cheng Chen, Ching-Lin Hsieh, Gong-Hong Lin

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Background and Purposes: Deficits in sustained attention are common in patients with schizophrenia. Such impairment can limit patients to effectively execute daily activities and affect the efficacy of rehabilitation. The aims of this study were to examine the test-retest agreement, random measurement error, and practice effect of the Continuous Performance Test-Identical Pairs (CPT-IP) (a commonly used sustained attention test) in patients with schizophrenia. The results can provide empirical evidence for clinicians and researchers to apply a sustained attention test with sound psychometric properties in schizophrenia patients. Methods: We recruited patients with chronic schizophrenia to be assessed twice with 1 week interval using CPT-IP. The intra-class correlation coefficient (ICC) was used to examine the test-retest agreement. The percentage of minimal detectable change (MDC%) was used to examine the random measurement error. Moreover, the standardized response mean (SRM) was used to examine the practice effect. Results: A total of 56 patients participated in this study. Our results showed that the ICC was 0.82, MDC% was 47.4%, and SRMs were 0.36 for the CPT-IP. Conclusion: Our results indicate that CPT-IP has acceptable test-retests agreement, substantial random measurement error, and small practice effect in patients with schizophrenia. Therefore, to avoid overestimating patients’ changes in sustained attention, we suggest that clinicians interpret the change scores of CPT-IP conservatively in their routine repeated assessments.

Keywords: schizophrenia, sustained attention, CPT-IP, reliability

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Authors: Chutamas Thepmalee, Aussara Panya, Mutita Junking, Jatuporn Sujjitjoon, Nunghathai Sawasdee, Pa-Thai Yenchitsomanus

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Cholangiocarcinoma (CCA) is an aggressive malignancy of bile duct epithelial cells in which the standard treatments, including surgery, radiotherapy, chemotherapy, and targeted therapy are partially effective. Many solid tumors including CCA escape host immune responses by creating tumor microenvironment and generating immunosuppressive cytokines such as interleukin-10 (IL-10) and transforming growth factor-β (TGF-β). These cytokines can inhibit dendritic cell (DC) differentiation and function, leading to decreased activation and response of effector CD4+ and CD8+ T cells for cancer cell elimination. To overcome the effects of these immunosuppressive cytokines and to increase ability of DC to activate effector CD4+ and CD8+ T cells, we generated self-differentiated DCs (SD-DCs) with down-regulation of IL-10 and TGF-β receptors for activation of effector CD4+ and CD8+ T cells. Human peripheral blood monocytes were initially transduced with lentiviral particles containing the genes encoding GM-CSF and IL-4 and then secondly transduced with lentiviral particles containing short-hairpin RNAs (shRNAs) to knock-down mRNAs of IL-10 and TGF-β receptors. The generated SD-DCs showed up-regulation of MHC class II (HLA-DR) and co-stimulatory molecules (CD40 and CD86), comparable to those of DCs generated by convention method. Suppression of IL-10 and TGF-β receptors on SD-DCs by specific shRNAs significantly increased levels of IFN-γ and also increased cytolytic activity of DC-activated effector T cells against CCA cell lines (KKU-213 and KKU-100), but it had little effect to immortalized cholangiocytes (MMNK-1). Thus, SD-DCs with down-regulation of IL-10 and TGF-β receptors increased activation of effector T cells, which is a recommended method to improve DC function for the preparation of DC-activated effector T cells for adoptive T-cell therapy.

Keywords: cholangiocarcinoma, IL-10 receptor, self-differentiated dendritic cells, TGF-β receptor

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Authors: Shradha S. Binani, P. S. Bodke, R. V. Joat

Abstract:

Recent decades have witnessed an exponential growth in the field of acoustical parameters and ultrasound on solid, liquid and gases. Ultrasonic propagation parameters yield valuable information regarding the behavior of liquid systems because intra and intermolecular association, dipolar interaction, complex formation and related structural changes affecting the compressibility of the system which in turn produces variations in the ultrasonic velocity. The acoustic and thermo dynamical parameters obtained in ultrasonic study show that ion-solvation is accompanied by the destruction or enhancement of the solvent structure. In the present paper the ultrasonic velocity (v), density (ρ), viscosity(η) have been measured for the pharmacological important compound 2-hydroxy substituted phenyl pyrimidine derivative (2-hydroxy-4-(4’-methoxy phenyl)-6-(2’-hydroxy-4’-methyl-5’-chlorophenyl)pyrimidine) in ethanol as a solvent by using different concentration at constant room temperature. These experimental data have been used to estimate physical parameter like adiabatic compressibility, intermolecular free length, relaxation time, free volume, specific acoustic impedance, relative association, Wada’s constant, Rao’s constant etc. The above parameters provide information in understanding the structural and molecular interaction between solute-solvent in the drug solution with respect to change in concentration.

Keywords: acoustical parameters, ultrasonic velocity, density, viscosity, 2-hydroxy substituted phenyl pyrimidine derivative

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