Search results for: conventional therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5480

Search results for: conventional therapy

4850 Adaptive Cooperative Scheme Considering the User Location

Authors: Bit-Na Kwon, Hyun-Jee Yang, Dong-Hyun Ha, Hyoung-Kyu Song

Abstract:

In this paper, an adaptive cooperative scheme in the cell edge is proposed. The proposed scheme considers the location of a user and applies the suitable cooperative scheme. In cellular systems, the performance of communication is degraded if the user is located in the cell edge. In conventional scheme, two base stations are used in order to obtain diversity gain. However, the performance of communication is not sufficiently improved since the distance between each base station and a user is still distant. Therefore, we propose a scheme that the relays are used and the cooperative scheme is adaptively applied according to the user location. Through simulation results, it is confirmed that the proposed scheme has better performance than the conventional scheme.

Keywords: adaptive transmission, cooperative communication, diversity gain, OFDM

Procedia PDF Downloads 572
4849 Synthesis of PVA/γ-Fe2O3 Used in Cancer Treatment by Hyperthermia

Authors: Sajjad Seifi Mofarah, S. K. Sadrnezhaad, Shokooh Moghadam, Javad Tavakoli

Abstract:

In recent years a new method of combination treatment for cancer has been developed and studied that has led to significant advancements in the field of cancer therapy. Hyperthermia is a traditional therapy that, along with a creation of a medically approved level of heat with the help of an alternating magnetic AC current, results in the destruction of cancer cells by heat. This paper gives details regarding the production of the spherical nanocomposite PVA/γ-Fe2O3 in order to be used for medical purposes such as tumor treatment by hyperthermia. To reach a suitable and evenly distributed temperature, the nanocomposite with core-shell morphology and spherical form within a 100 to 200 nanometer size was created using phase separation emulsion, in which the magnetic nano-particles γ-Fe2O3 with an average particle size of 20 nano-meters and with different percentages of 0.2, 0.4, 0.5, and 0.6 were covered by polyvinyl alcohol. The main concern in hyperthermia and heat treatment is achieving desirable specific absorption rate (SAR) and one of the most critical factors in SAR is particle size. In this project all attempts has been done to reach minimal size and consequently maximum SAR. The morphological analysis of the spherical structure of the nanocomposite PVA/γ-Fe2O3 was achieved by SEM analyses and the study of the chemical bonds created was made possible by FTIR analysis. To investigate the manner of magnetic nanocomposite particle size distribution a DLS experiment was conducted. Moreover, to determine the magnetic behavior of the γ-Fe2O3 particle and the nanocomposite PVA/γ-Fe2O3 in different concentrations a VSM test was conducted. To sum up, creating magnetic nanocomposites with a spherical morphology that would be employed for drug loading opens doors to new approaches in developing nanocomposites that provide efficient heat and a controlled release of drug simultaneously inside the magnetic field, which are among their positive characteristics that could significantly improve the recovery process in patients.

Keywords: nanocomposite, hyperthermia, cancer therapy, drug releasing

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4848 Construction of Green Aggregates from Waste Processing

Authors: Fahad K. Alqahtani

Abstract:

Nowadays construction industry is developing means to incorporate waste products in concrete to ensure sustainability. To meet the need of construction industry, a synthetic aggregate was developed using optimized technique called compression moulding press technique. The manufactured aggregate comprises mixture of plastic, waste which acts as binder, together with by-product waste which acts as fillers. The physical properties and microstructures of the inert materials and the manufactured aggregate were examined and compared with the conventional available aggregates. The outcomes suggest that the developed aggregate has potential to be used as substitution of conventional aggregate due to its less weight and water absorption. The microstructure analysis confirmed the efficiency of the manufacturing process where the final product has the same mixture of binder and filler.

Keywords: fly ash, plastic waste, quarry fine, red sand, synthetic aggregate

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4847 NOx Emission and Computational Analysis of Jatropha Curcus Fuel and Crude Oil

Authors: Vipan Kumar Sohpal, Rajesh K Sharma

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Diminishing of conventional fuels and hysterical vehicles emission leads to deterioration of the environment, which emphasize the research to work on biofuels. Biofuels from different sources attract the attention of research due to low emission and biodegradability. Emission of carbon monoxide, carbon dioxide and H-C reduced drastically using Biofuels (B-20) combustion. Contrary to the conventional fuel, engine emission results indicated that nitrous oxide emission is higher in Biofuels. So this paper examines and compares the nitrogen oxide emission of Jatropha Curcus (JCO) B-20% blends with the vegetable oil. In addition to that computational analysis of crude non edible oil performed to assess the impact of composition on emission quality. In conclusion, JCO have the potential feedstock for the biodiesel production after the genetic modification in the plant.

Keywords: jatropha curcus, computational analysis, emissions, NOx biofuels

Procedia PDF Downloads 589
4846 A Weighted Sum Particle Swarm Approach (WPSO) Combined with a Novel Feasibility-Based Ranking Strategy for Constrained Multi-Objective Optimization of Compact Heat Exchangers

Authors: Milad Yousefi, Moslem Yousefi, Ricarpo Poley, Amer Nordin Darus

Abstract:

Design optimization of heat exchangers is a very complicated task that has been traditionally carried out based on a trial-and-error procedure. To overcome the difficulties of the conventional design approaches especially when a large number of variables, constraints and objectives are involved, a new method based on a well-stablished evolutionary algorithm, particle swarm optimization (PSO), weighted sum approach and a novel constraint handling strategy is presented in this study. Since, the conventional constraint handling strategies are not effective and easy-to-implement in multi-objective algorithms, a novel feasibility-based ranking strategy is introduced which is both extremely user-friendly and effective. A case study from industry has been investigated to illustrate the performance of the presented approach. The results show that the proposed algorithm can find the near pareto-optimal with higher accuracy when it is compared to conventional non-dominated sorting genetic algorithm II (NSGA-II). Moreover, the difficulties of a trial-and-error process for setting the penalty parameters is solved in this algorithm.

Keywords: Heat exchanger, Multi-objective optimization, Particle swarm optimization, NSGA-II Constraints handling.

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4845 Targeted Photodynamic Therapy for Intraperitoneal Ovarian Cancer, A Way to Stimulate Anti-Tumoral Immune Response

Authors: Lea Boidin, Martha Baydoun, Bertrand Leroux, Olivier Morales, Samir Acherar, Celine Frochot, Nadira Delhem

Abstract:

Ovarian cancer (OC) is one of the most defying diseases in gynecologic oncology. Even though surgery remains crucial in the therapy of patients with primary ovarian cancer, recurrent recidivism calls for the development of new therapy protocols to propose for patients dealing with this cancer. FRα is described as a tumor‐associated antigen in OC, where FRα expression is usually linked with more poorly differentiated, aggressive tumors. The Photodynamic treatment (PDT) available data have shown improvements in the uptake of small tumors and in the induction of a proper anti-tumoral immune response. In order to target specifically peritoneal metastatis, which overexpress FRα, a new-patented PS coupled with folic acid has been developed in our team. Herein we propose PDT using this new patented PS for PDT applied in an in vivo mice model. The efficacy of the treatment was evaluated in mice without and with PBMC reconstitution. Mice were divided into four groups: Non-Treated, PS, Light Only, and PDT Treated and subjected to illumination by laser set at 668nm with a duration of illumination of 45 minutes (or 1 min of illumination followed by 2 minutes of pause repeated 45 times). When mice were not reconstituted and after fractionized PDT protocol, a significant decrease in the tumor volume was noticed. An induction in the anti-tumoral cytokine IFNγ chaperoned this decrease while a subsequent inhibition in the cytokine TGFβ. Even more crucial, when mice were reconstituted and upon PDT, the fold of tumor decrease was even higher. An immune response was activated decoded with an increase in NK, CD3 +, LT helper and Cytotoxic T cells. Thereafter, an increase in the expression of the cytokines IFNγ and TNFα were noticed while an inhibition in TGFβ, IL8 and IL10 accompanied this immune response activation. Therefore, our work has shown for the first time that a fractionized PDT protocol using a folate-targeted PDT is effective for treatment of ovarian cancer. The interest in using PDT in this case, goes beyond the local induction of tumor apoptosis only, but can promote subsequent anti-tumor response. Most of the therapies currently used to treat ovarian cancer, have an uncooperative outcomes on the host immune response. The readiness of a tumor adjuvant treatment like PDT adequate in eliminating the tumor and in concert stimulating anti-tumor immunity would be weighty.

Keywords: folate receptor, ovarian cancer, photodynamic therapy, humanized mice model

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4844 Potentials of Additive Manufacturing: An Approach to Increase the Flexibility of Production Systems

Authors: A. Luft, S. Bremen, N. Balc

Abstract:

The task of flexibility planning and design, just like factory planning, for example, is to create the long-term systemic framework that constitutes the restriction for short-term operational management. This is a strategic challenge since, due to the decision defect character of the underlying flexibility problem, multiple types of flexibility need to be considered over the course of various scenarios, production programs, and production system configurations. In this context, an evaluation model has been developed that integrates both conventional and additive resources on a basic task level and allows the quantification of flexibility enhancement in terms of mix and volume flexibility, complexity reduction, and machine capacity. The model helps companies to decide in early decision-making processes about the potential gains of implementing additive manufacturing technologies on a strategic level. For companies, it is essential to consider both additive and conventional manufacturing beyond pure unit costs. It is necessary to achieve an integrative view of manufacturing that incorporates both additive and conventional manufacturing resources and quantifies their potential with regard to flexibility and manufacturing complexity. This also requires a structured process for the strategic production systems design that spans the design of various scenarios and allows for multi-dimensional and comparative analysis. A respective guideline for the planning of additive resources on a strategic level is being laid out in this paper.

Keywords: additive manufacturing, production system design, flexibility enhancement, strategic guideline

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4843 The Effect of Problem-Based Mobile-Assisted Tasks on Spoken Intelligibility of English as a Foreign Language Learners

Authors: Loghman Ansarian, Teoh Mei Lin

Abstract:

In an attempt to increase oral proficiency of Iranian EFL learners, the researchers compared the effect of problem-based mobile-assisted language learning with the conventional language learning approach (Communicative Language Teaching) in Iran. The experimental group (n=37) went through PBL instruction and the control group (n=33) went through conventional instruction. The results of quantitative data analysis after 26 sessions of treatment revealed that PBL could positively affect participants' knowledge of grammar, vocabulary, spoken fluency, and pronunciation; however, in terms of task achievement, no significant effect was found. This study can have pedagogical implications for language teachers, and material developers.

Keywords: problem-based learning, spoken intelligibility, Iranian EFL context, cognitive learning

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4842 Sensory Interventions for Dementia: A Review

Authors: Leigh G. Hayden, Susan E. Shepley, Cristina Passarelli, William Tingo

Abstract:

Introduction: Sensory interventions are popular therapeutic and recreational approaches for people living with all stages of dementia. However, it is unknown which sensory interventions are used to achieve which outcomes across all subtypes of dementia. Methods: To address this gap, we conducted a scoping review of sensory interventions for people living with dementia. We conducted a search of the literature for any article published in English from 1 January 1990 to 1 June 2019, on any sensory or multisensory intervention targeted to people living with any kind of dementia, which reported on patient health outcomes. We did not include complex interventions where only a small aspect was related to sensory stimulation. We searched the databases Medline, CINHAL, and Psych Articles using our institutional discovery layer. We conducted all screening in duplicate to reduce Type 1 and Type 2 errors. The data from all included papers were extracted by one team member, and audited by another, to ensure consistency of extraction and completeness of data. Results: Our initial search captured 7654 articles, and the removal of duplicates (n=5329), those that didn’t pass title and abstract screening (n=1840) and those that didn’t pass full-text screening (n=281) resulted in 174 articles included. The countries with the highest publication in this area were the United States (n=59), the United Kingdom (n=26) and Australia (n=15). The most common type of interventions were music therapy (n=36), multisensory rooms (n=27) and multisensory therapies (n=25). Seven articles were published in the 1990’s, 55 in the 2000’s, and the remainder since 2010 (n=112). Discussion: Multisensory rooms have been present in the literature since the early 1990’s. However, more recently, nature/garden therapy, art therapy, and light therapy have emerged since 2008 in the literature, an indication of the increasingly diverse scholarship in the area. The least popular type of intervention is a traditional food intervention. Taste as a sensory intervention is generally avoided for safety reasons, however it shows potential for increasing quality of life. Agitation, behavior, and mood are common outcomes for all sensory interventions. However, light therapy commonly targets sleep. The majority (n=110) of studies have very small sample sizes (n=20 or less), an indicator of the lack of robust data in the field. Additional small-scale studies of the known sensory interventions will likely do little to advance the field. However, there is a need for multi-armed studies which directly compare sensory interventions, and more studies which investigate the use of layering sensory interventions (for example, adding an aromatherapy component to a lighting intervention). In addition, large scale studies which enroll people at early stages of dementia will help us better understand the potential of sensory and multisensory interventions to slow the progression of the disease.

Keywords: sensory interventions, dementia, scoping review

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4841 Study of White Salted Noodles Air Dehydration Assisted by Microwave as Compared to Conventional Air Dried Process

Authors: Chiun-C. R. Wang, I-Yu Chiu

Abstract:

Drying is the most difficult and critical step to control in the dried salted noodles production. Microwave drying has the specific advantage of rapid and uniform heating due to the penetration of microwaves into the body of the product. Microwave-assisted facility offers a quick and energy saving method during food dehydration as compares to the conventional air-dried method for the noodle preparation. Recently, numerous studies in the rheological characteristics of pasta or spaghetti were carried out with microwave–assisted and conventional air driers and many agricultural products were dried successfully. There is very few research associated with the evaluation of physicochemical characteristics and cooking quality of microwave-assisted air dried salted noodles. The purposes of this study were to compare the difference between conventional air and microwave-assisted air drying method on the physicochemical properties and eating quality of rice bran noodles. Three different microwave power including 0.5 KW, 0.75 KW and 1.0 KW installing with 50℃ hot air were applied for dehydration of rice bran noodles in this study. Three proportion of rice bran ranging in 0-20% were incorporated into salted noodles processing. The appearance, optimum cooking time, cooking yield and losses, textural profiles analysis, and sensory evaluation of rice bran noodles were measured in this study. The results indicated that high power (1.0 KW) microwave facility caused partially burnt and porous on the surface of rice bran noodles. However, no significant difference of noodle was appeared on the surface of noodles between low power (0.5 KW) microwave-assisted salted noodles and control set. The optimum cooking time of noodles was decreased as higher power microwave was applied or higher proportion of rice bran was incorporated in the preparation of salted noodles. The higher proportion of rice bran (20%) or higher power of microwave-assisted dried noodles obtained the higher color intensity and the higher cooking losses as compared with conventional air dried noodles. Meanwhile, the higher power of microwave-assisted air dried noodles indicated the larger air cell inside the noodles and appeared little burnt stripe on the surface of noodles. The firmness of cooked rice bran noodles slightly decreased in the cooked noodles which were dried by high power microwave-assisted method. The shearing force, tensile strength, elasticity and texture profiles of cooked rice noodles decreased with the progress of the proportion of rice bran. The results of sensory evaluation indicated conventional dried noodles obtained the higher springiness, cohesiveness and overall acceptability of cooked noodles than high power (1.0 KW) microwave-assisted dried noodles. However, low power (0.5 KW) microwave-assisted dried noodles showed the comparable sensory attributes and acceptability with conventional dried noodles. Moreover, the sensory attributes including firmness, springiness, cohesiveness decreased, but stickiness increased with the increases of rice bran proportion in the salted noodles. These results inferred that incorporation of lower proportion of rice bran and lower power microwave-assisted dried noodles processing could produce faster cooking time and more acceptable quality of cooked noodles as compared to conventional dried noodles.

Keywords: white salted noodles, microwave-assisted air drying processing, cooking yield, appearance, texture profiles, scanning electrical microscopy, sensory evaluation

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4840 Human Mesenchymal Stem Cells as a Potential Source for Cell Therapy in Liver Disorders

Authors: Laila Montaser, Hala Gabr, Maha El-Bassuony, Gehan Tawfeek

Abstract:

Orthotropic liver transplantation (OLT) is the final procedure of both end stage and metabolic liver diseases. Hepatocyte transplantation is an alternative for OLT, but the sources of hepatocytes are limited. Bone marrow mesenchymal stem cells (BM-MSCs) can differentiate into hepatocyte-like cells and are a potential alternative source for hepatocytes. The MSCs from bone marrow are a promising target population as they are capable of differentiating along multiple lineages and, at least in vitro, have significant expansion capability. MSCs from bone marrow may have the potential to differentiate in vitro and in vivo into hepatocytes. Our study examined whether mesenchymal stem cells (MSCs), which are stem cells originated from human bone marrow, are able to differentiate into functional hepatocyte-like cells in vitro. Our aim was to investigate the differentiation potential of BM-MSCs into hepatocyte-like cells. Adult stem cell therapy could solve the problem of degenerative disorders, including liver disease.

Keywords: bone marrow, differentiation, hepatocyte, stem cells

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4839 Studies on the Feasibility of Cow’s Urine as Non-Conventional Energy Sources

Authors: Raj Kumar Rajak, Bharat Mishra

Abstract:

Bio-batteries represent an entirely new long-term, reasonable, reachable, and eco-friendly approach to generation of sustainable energy. In the present experimental work, we have studied the effect of the generation of power by bio-battery using different electrode pairs. The tests show that it is possible to generate electricity using cow’s urine as an electrolyte. C-Mg electrode pair shows maximum Voltage and Short Circuit Current (SCC), while C-Zn electrode pair shows less Open Circuit Voltage (OCV) and SCC. By the studies of cow urine and different electrodes, it is found that C-Zn electrode battery is more economical. The cow urine battery with C-Zn electrode provides maximum power (707.4 mW) and durability (up to 145 h). This result shows that the bio-batteries have the potency to full fill the need of electricity demand for lower energy equipment.

Keywords: bio-batteries, cow's urine, electrodes, non-conventional

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4838 Social Business: Opportunities and Challenges

Authors: Muhammad Mustafizur Rahaman

Abstract:

Social business is a new concept in the field of Business Economics and Capitalist Economy. It has increased the importance in economic and social development in emerging economies. Professor Muhammad Yunus is the founding father of the notion. While conventional business underscores profit maximization as a core business principle, social business calls for addressing social problems at the expense of profit. This underlying principle gives social business advantageous position over conventional businesses to serve those who live at the bottom of the pyramid. It also poses grave challenges to the social business because social business sacrifices profit at one hand and seeks financial sustainability on the other. For the sake of its financial sustainability, the social business might increase the price of its product or service which might lower its social impact, thus, makes the business self-defeating. Therefore, social business should be more innovative in every business process including production, marketing, and management. Otherwise, the business is unlikely to be driven out from the society.

Keywords: innovativeness, self-defeat, social business, social problem

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4837 Secondary Charged Fragments Tracking for On-Line Beam Range Monitoring in Particle Therapy

Authors: G. Traini, G. Battistoni, F. Collamati, E. De Lucia, R. Faccini, C. Mancini-Terracciano, M. Marafini, I. Mattei, S. Muraro, A. Sarti, A. Sciubba, E. Solfaroli Camillocci, M. Toppi, S. M. Valle, C. Voena, V. Patera

Abstract:

In Particle Therapy (PT) treatments a large amount of secondary particles, whose emission point is correlated to the dose released in the crossed tissues, is produced. The measurement of the secondary charged fragments component could represent a valid technique to monitor the beam range during the PT treatments, that is a still missing item in the clinical practice. A sub-millimetrical precision on the beam range measurement is required to significantly optimise the technique and to improve the treatment quality. In this contribution, a detector, named Dose Profiler (DP), is presented. It is specifically planned to monitor on-line the beam range exploiting the secondary charged particles produced in PT Carbon ions treatment. In particular, the DP is designed to track the secondary fragments emitted at large angles with respect to the beam direction (mainly protons), with the aim to reconstruct the spatial coordinates of the fragment emission point extrapolating the measured track toward the beam axis. The DP is currently under development within of the INSIDE collaboration (Innovative Solutions for In-beam Dosimetry in hadrontherapy). The tracker is made by six layers (20 × 20 cm²) of BCF-12 square scintillating fibres (500 μm) coupled to Silicon Photo-Multipliers, followed by two plastic scintillator layers of 6 mm thickness. A system of front-end boards based on FPGAs arranged around the detector provides the data acquisition. The detector characterization with cosmic rays is currently undergoing, and a data taking campaign with protons will take place in May 2017. The DP design and the performances measured with using MIPs and protons beam will be reviewed.

Keywords: fragmentation, monitoring, particle therapy, tracking

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4836 Nanosilver Containing Biodegradable Bionanocomposites for Antimicrobial Application: Design, Preparation and Study

Authors: Nino Kupatadze, Shorena Tskhadadze, Mzevinar Bedinashvili, David Tugushi, Ramaz Katsarava

Abstract:

Surgical device-associated infection and biofilm formation are some of the major problems in biomedicine for today. The losing protection ability of conventional antimicrobial-drugs leads to the challenges in the current antibiotic therapy, the most serious of which is antibiotic resistance. Our strategy to overcome the biofilm formation consists in coating devices with polymeric film containing nanosilver(AgNPs) as a bactericidal agent. Such bionanocomposites are also promising as wound dressing materials. For this purpose, we have developed a new generation of AgNPs containing polymeric composites in which amino acid based biodegradable poly(ester amide)s (PEAs) were served as both matrices and AgNPs stabilizers. The AgNPs were formed by photochemical (daylight) reduction of AgNO3 in ethanol solution. The formation of AgNPs was monitored by coloring the solution in brownish-red and appearance of the absorption maximum at 420-430 nm in UV spectrum. Comparative studies of PEAs with polyvinylpyrrolidone (PVP) as particle stabilizers were carried out. It was found that PVP is better stabilizer in terms of particles yield and stability. Therefore, in subsequent experiments blends of PEAs and PVP were used as stabilizers for fabricating AgNPs. As expected, PVP increased the stabilizing effect and this apparently observed in the UV spectrum of the samples after 7 h daylight irradiation: for pure PVP λmax = 430 nm, D = 2.03, for pure PEA λmax= 420 nm, D = 0.65, and for the blend of PVP and PEA λmax = 435 nm, D = 1.88. Further study of the obtained nanobiocomposites is in progress now.

Keywords: biodegradation, bionanocompositions, polymer, nanosilver

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4835 Expression of Fibrogenesis Markers after Mesenchymal Stem Cells Therapy for Experimental Liver Cirrhosis

Authors: Tatsiana Ihnatovich, Darya Nizheharodava, Mikalai Halabarodzka, Tatsiana Savitskaya, Marina Zafranskaya

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Liver fibrosis is a complex of histological changes resulting from chronic liver disease accompanied by an excessive production and deposition of extracellular matrix components in the hepatic parenchyma. Liver fibrosis is a serious medical and social problem. Hepatic stellate cells (HSCs) make a significant contribution to the extracellular matrix deposition due to liver injury. Mesenchymal stem cells (MSCs) have a pronounced anti-inflammatory, regenerative and immunomodulatory effect; they are able to differentiate into hepatocytes and induce apoptosis of activated HSCs that opens the prospect of their use for preventing the excessive fibro-formation and the development of liver cirrhosis. The aim of the study is to evaluate the effect of MSCs therapy on the expression of fibrogenesis markers genes in liver tissue and HSCs cultures of rats with experimental liver cirrhosis (ELC). Materials and methods: ELC was induced by the common bile duct ligation (CBDL) in female Wistar rats (n = 19) with an average body weight of 250 (220 ÷ 270) g. Animals from the control group (n = 10) were sham-operated. On the 56th day after the CBDL, the rats of the experimental (n = 12) and the control (n = 5) groups received intraportal MSCs in concentration of 1×106 cells/animal (previously obtained from rat’s bone marrow) or saline, respectively. The animals were taken out of the experiment on the 21st day. HSCs were isolated by sequential liver perfusion in situ with following disaggregation, enzymatic treatment and centrifugation of cell suspension on a two-stage density gradient. The expression of collagen type I (Col1a1) and type III (Col3a1), matrix metalloproteinase type 2 (MMP2) and type 9 (MMP9), tissue inhibitor of matrix metalloproteinases type 1 (TIMP1), transforming growth factor β type 1 (TGFβ1) and type 3 (TGFβ3) was determined by real-time polymerase chain reaction. Statistical analysis was performed using Statistica 10.0. Results: In ELC rats compared to sham-operated animals, a significant increase of all studied markers expression was observed. The administration of MSCs led to a significant decrease of all detectable markers in the experimental group compared to rats without cell therapy. In ELC rats, an increased MMP9/TIMP1 ratio after cell therapy was also detected. The infusion of MSCs in the sham-operated animals did not lead to any changes. In the HSCs from ELC animals, the expression of Col1a1 and Col3a1 exceeded the similar parameters of the control group (p <0.05) and statistically decreased after the MSCs administration. The correlation between Col3a1 (Rs = 0.51, p <0.05), TGFβ1 (Rs = 0.6, p <0.01), and TGFβ3 (Rs = 0.75, p <0.001) expression in HSCs cultures and liver tissue has been found. Conclusion: Intraportal administration of MSCs to rats with ELC leads to a decreased Col1a1 and Col3a1, MMP2 and MMP9, TIMP1, TGFβ1 and TGFβ3 expression. The correlation between the expression of Col3a1, TGFβ1 and TGFβ3 in liver tissue and in HSCs cultures indicates the involvement of activated HSCs in the fibrogenesis that allows considering HSCs to be the main cell therapy target in ELC.

Keywords: cell therapy, experimental liver cirrhosis, hepatic stellate cells, mesenchymal stem cells

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4834 Endocrine Therapy-Induced Alopecia in Patients with Breast Cancer in Tunisia

Authors: Aref Zribi, Sonia Ben Nasr, Sana Fendri, Mahdi Balti, Abderazzek Haddaoui

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Background: Despite their benefit, Endocrine therapies (ET) are known to have substantial adverse events (AEs) such as hot flashes, mood disorders and osteoarticular pain. ET induced alopecia(EIA) is less frequently noted by patients and is less reported in the literature. The aim of our study was to report ET alopecia characteristics and their influence on patient and treatment observance. Method: We conducted a retrospective study including luminal BC patients treated in the oncology department of the military hospital of Tunis between January 2015 and December 2020. Patients treated with previous chemotherapy-inducing alopecia were excluded. Results: 145 female patients were included. The median age was 59 years. EIA was reported in 44% of cases. Alopecia was attributed to aromatase inhibitors in 53% and tamoxifen in 21%. Severity was grade 1 in 80% and grade 2 in the remaining cases. ET discontinuation because of alopecia was noted in 6.5 % of patients. Moderate improvement of alopecia was observed with topical minoxidil and Thallium metallicum 9CH homeopathy during ET in 60% of patients. Conclusions: EIA is frequent in BC patients and should be considered to improve treatment observance and patients’ quality of life.

Keywords: endocrine therapy, alopecia, breast cancer, Tunisia

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4833 Carnatic Music Ragas and Their Role in Music Therapy

Authors: Raghavi Janaswamy, Saraswathi K. Vasudev

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Raga, as the soul and base, is a distinctive musical entity, in the music system, with unique structure on its construction of srutis (musical sounds) and application. One of the essential components of the music system is the ‘tala’ that defines the rhythm of a song. There are seven basic swaras (notes) Sa, Ri, Ga, Ma, Pa, Da and Ni in the carnatic music system that are analogous to the C, D, E, F, G, A and B of the western system. The carnatic music further builds on conscious use of microtones, gamakams (oscillation) and rendering styles. It has basic 72 ragas known as melakarta ragas, and a plethora of ragas have been developed from them with permutations and combinations of the basic swaras. Among them, some ragas derived from a same melakarta raga are distinctly different from each other and could evoke a profound difference in the raga bhava (emotion) during rendering. Although these could bear similar arohana and avarohana swaras, their quintessential differences in the gamakas usage and srutis present therein offer varied melodic feelings; variations in the intonation and stress given to certain swara phrases are the root causes. This article enlightens a group of such allied ragas (AR) from the perspectives of their schema and raga alapana (improvisation), ranjaka prayogas (signature phrases), differences in rendering tempo, gamakas and delicate srutis along with the range of sancharas (musical phrases). The intricate differences on the sruti frequencies and use of AR in composing kritis (musical compositions) toward emotive accomplishments such as mood of valor, kindness, love, humor, anger, mercy to name few, have also been explored. A brief review on the existing scientific research on the music therapy on some of the Carnatic ragas is presented. Studying and comprehending the AR, indeed, enable the music aspirants to gain a thorough knowledge on the subtle nuances among the ragas. Such knowledge helps leave a long-lasting melodic impression on the listeners and enable further research on the music therapy.

Keywords: Carnatic music, allied ragas, melakarta, gamakam

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4832 Effects of Bilateral Electroconvulsive Therapy on Autobiographical Memories in Asian Patients

Authors: Lai Gwen Chan, Yining Ong, Audrey Yoke Poh Wong

Abstract:

Background. The efficacy of electroconvulsive therapy (ECT) as a form of treatment to a range of mental disorders is well-established. However, ECT is often associated with either temporary or persistent cognitive side-effects, resulting in the failure of wider prescription. Of which, retrograde amnesia is the most commonly reported cognitive side-effect. Most studies found a recalling deficit in autobiographical memories to be short-term, although a few have reported more persistent amnesic effects. Little is known about ECT-related amnesic effects in Asian population. Hence, this study aims to resolve conflicting findings, as well as to better elucidate the effects of ECT on cognitive functioning in a local sample. Method: 12 patients underwent bilateral ECT under the care of Psychological Medicine Department, Tan Tock Seng Hospital, Singapore. Participants’ cognition and level of functioning were assessed at four time-points: before ECT, between the third and fourth induced seizure, at the end of the whole course of ECT, and two months after the index course of ECT. Results: It was found that Global Assessment of Functioning scores increased significantly at the completion of ECT. Case-by-case analyses also revealed an overall improvement in Personal Semantic and Autobiographical memory two months after the index course of ECT. A transient dip in both personal semantic and autobiographical memory scores was observed in one participant between the third and fourth induced seizure, but subsequently resolved and showed better performance than at baseline. Conclusions: The findings of this study suggest that ECT is an effective form of treatment to alleviate the severity of symptoms of the diagnosis. ECT does not affect attention, language, executive functioning, personal semantic and autobiographical memory adversely. The findings suggest that Asian patients may respond to bilateral ECT differently from Western samples.

Keywords: electroconvulsive therapy (ECT), autobiographical memory, cognitive impairment, psychiatric disorder

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4831 Urgency of Islamic Economic System Implementation in Indonesian Banking

Authors: Muhammad Rifqi Hafizhudin Arif, Mukhamad Zulfal Faradis, Ahmad Hidayatullah

Abstract:

Indonesia is the country that uses conventional financial system adopted from European countries as a form of finance in the national banking system. Many of the derivative products of conventional banks either investment, buy and sell, saving and loan, which is not in accordance with Islamic Ethics. While the majority population in Indonesia are belief in Islam, which Islam has had financial management guide is written in the Quran, the Hadith, as well as the opinions of experts who strongly prohibits the use of interest in each transaction activities. Many different expert opinions on the application of the Islamic financial system in Indonesia. However, as the majority of the population of Indonesia, Islamic community have not been able to get the opportunities to choose the Islamic financial system that has mutual benefit between consumers and banks, particularly fairness in transactions, ethical investment, uphold the values of solidarity and brotherhood in every transaction activities, and avoid speculation. In this paper, we will discuss the reasons for the importance of providing an option for Islamic community as the majority of the population of Indonesia to use the banking system which adopted the Islamic ethical values that have been much discussed by other researchers in various countries. The existence of this research is expected to Government, academia and the general public aware of the urgency of Islamic economic system implementation in Indonesian banking as the solution and justice especially for the Islamic community to use the values which they held.

Keywords: Islamic economic system, conventional system, Islamic value, banking

Procedia PDF Downloads 364
4830 An Assessment of the Impacts of Agro-Ecological Practices towards the Improvement of Crop Health and Yield Capacity: A Case of Mopani District, Limpopo, South Africa

Authors: Tshilidzi C. Manyanya, Nthaduleni S. Nethengwe, Edmore Kori

Abstract:

The UNFCCC, FAO, GCF, IPCC and other global structures advocate for agro-ecology do address food security and sovereignty. However, most of the expected outcomes concerning agro-ecological were not empirically tested for universal application. Agro-ecology is theorised to increase crop health over ago-ecological farms and decrease over conventional farms. Increased crop health means increased carbon sequestration and thus less CO2 in the atmosphere. This is in line with the view that global warming is anthropogenically enhanced through GHG emissions. Agro-ecology mainly affects crop health, soil carbon content and yield on the cultivated land. Economic sustainability is directly related to yield capacity, which is theorized to increase by 3-10% in a space of 3 - 10 years as a result of agro-ecological implementation. This study aimed to empirically assess the practicality and validity of these assumptions. The study utilized mainly GIS and RS techniques to assess the effectiveness of agro-ecology in crop health improvement from satellite images. The assessment involved a longitudinal study (2013 – 2015) assessing the changes that occur after a farm retrofits from conventional agriculture to agro-ecology. The assumptions guided the objectives of the study. For each objective, an agro-ecological farm was compared with a conventional farm in the same climatic conditional occupying the same general location. Crop health was assessed using satellite images analysed through ArcGIS and Erdas. This entailed the production of NDVI and Re-classified outputs of the farm area. The NDVI ranges of the entire period of study were thus compared in a stacked histogram for each farm to assess for trends. Yield capacity was calculated based on the production records acquired from the farmers and plotted in a stacked bar graph as percentages of a total for each farm. The results of the study showed decreasing crop health trends over 80% of the conventional farms and an increase over 80% of the organic farms. Yield capacity showed similar patterns to those of crop health. The study thus showed that agro-ecology is an effective strategy for crop-health improvement and yield increase.

Keywords: agro-ecosystem, conventional farm, dialectical, sustainability

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4829 Design and Study of a Low Power High Speed 8 Transistor Based Full Adder Using Multiplexer and XOR Gates

Authors: Biswarup Mukherjee, Aniruddha Ghoshal

Abstract:

In this paper, we propose a new technique for implementing a low power high speed full adder using 8 transistors. Full adder circuits are used comprehensively in Application Specific Integrated Circuits (ASICs). Thus it is desirable to have high speed operation for the sub components. The explored method of implementation achieves a high speed low power design for the full adder. Simulated results indicate the superior performance of the proposed technique over conventional 28 transistor CMOS full adder. Detailed comparison of simulated results for the conventional and present method of implementation is presented.

Keywords: high speed low power full adder, 2-T MUX, 3-T XOR, 8-T FA, pass transistor logic, CMOS (complementary metal oxide semiconductor)

Procedia PDF Downloads 349
4828 Impact of Experiential Learning on Executive Function, Language Development, and Quality of Life for Adults with Intellectual and Developmental Disabilities (IDD)

Authors: Mary Deyo, Zmara Harrison

Abstract:

This study reports the outcomes of an 8-week experiential learning program for 6 adults with Intellectual and Developmental Disabilities (IDD) at a day habilitation program. The intervention foci for this program include executive function, language learning in the domains of expressive, receptive, and pragmatic language, and quality of life. The interprofessional collaboration aimed at supporting adults with IDD to reach person-centered, functional goals across skill domains is critical. This study is a significant addition to the speech-language pathology literature in that it examines a therapy method that potentially meets this need while targeting domains within the speech-language pathology scope of practice. Communication therapy was provided during highly valued and meaningful hands-on learning experiences, referred to as the Garden Club, which incorporated all aspects of planting and caring for a garden as well as related journaling, sensory, cooking, art, and technology-based activities. Direct care staff and an undergraduate research assistant were trained by SLP to be impactful language guides during their interactions with participants in the Garden Club. SLP also provided direct therapy and modeling during Garden Club. Research methods used in this study included a mixed methods analysis of a literature review, a quasi-experimental implementation of communication therapy in the context of experiential learning activities, Quality of Life participant surveys, quantitative pre- post- data collection and linear mixed model analysis, qualitative data collection with qualitative content analysis and coding for themes. Outcomes indicated overall positive changes in expressive vocabulary, following multi-step directions, sequencing, problem-solving, planning, skills for building and maintaining meaningful social relationships, and participant perception of the Garden Project’s impact on their own quality of life. Implementation of this project also highlighted supports and barriers that must be taken into consideration when planning similar projects. Overall findings support the use of experiential learning projects in day habilitation programs for adults with IDD, as well as additional research to deepen understanding of best practices, supports, and barriers for implementation of experiential learning with this population. This research provides an important contribution to research in the fields of speech-language pathology and other professions serving adults with IDD by describing an interprofessional experiential learning program with positive outcomes for executive function, language learning, and quality of life.

Keywords: experiential learning, adults, intellectual and developmental disabilities, expressive language, receptive language, pragmatic language, executive function, communication therapy, day habilitation, interprofessionalism, quality of life

Procedia PDF Downloads 127
4827 Findings from an Access Improvement Project for Antiretroviral Therapy Uptake through Traditional Birth Attendants at Mother Theresa Hospital, Lagos, Nigeria

Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

Abstract:

In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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4826 Adalimumab Therapy for Inflammatory Discitis Associated with Spondyloarthropathy

Authors: Liu Yuhong, Hussen Mansai, Mei Chunli

Abstract:

Inflammatory discitis is a sterile inflammatary disease that typically presents with abnormalities in two adjacent vertebral bodies and the intervening disk. Diagnosis this disorder is usually difficult and ideal management remains controversial. In this report,we examine a case of inflammatory discitis in a 56 year old female in which treatment with adalimumab ameliorated symptoms. The 56-year-old female patient developed repeatedly inflammatory discitis in the past three years, presenting with severe back pain, an elevated C-reactive protein and erythrocyte sedimentation rate, radiological erosive changes in vertebral and intervertebral disk of the spine. Surgical treatment, antibiotics and non steroidal anti-inflammatory drugs(NSAIDs) were used, but the patient still suffered from recurrent onset of unbearable backache. Three years later from the patient’s first admission,adalimumab was prescribed due to the third occurrence of Anderson lesions, which she had been suffering from for years. Soon after the same day of adalimumab therapy, her symptoms had a dramatic improvement. On the following day she could stand and walk slowly, her CRP and ESR were decreased to nearly normal levels in 4 weeks. Human leukocyte antigen (HLA)-typing analysis revealed a positive result for HLA-B27, the patient’s inflammatory discitis was considered to be associated with spondyloarthropathy.

Keywords: adalimumab, inflammatory discitis, spondyloarthropathy, patient

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4825 Optimal Temperature and Duration for Dabbing Customers with the Massage Compressed Packs Reported from Customers' Perception

Authors: Wichan Lertlop, Boonyarat Chaleephay

Abstract:

The objective of this research was to study the appropriate thermal level and time for dabbing customers with the massage compressed pack reported from their perception. The investigation was conducted by comparing different angles of tilted heads done by the customers together with their perception before and after the dabbing. The variables included different temperature of the compressed packs and different dabbing duration. Samples in this study included volunteers who got massage therapy and dabbing with hot compressed packs by traditional Thai medical students. The experiment was conducted during January to June 2013. The research tool consisted of angle meters, stop watches, thermometers, and massage compressed packs. The customers were interviewed for their perceptions before and after the dabbing. The results showed that: 1. There was a difference of the average angles of tilted heads before and after the dabbing. 2. There was no difference of the average angles at different temperatures but constant duration. 3. There was no difference of the average angles at different durations. 4. The customers reported relaxation no matter what the various temperatures and various dabbing durations were. However, they reported too hot at the temperature 70 °C and over.

Keywords: massage, therapy, therapeutic systems, technologies

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4824 The Uses of Photodynamic Therapy versus Anti-vascular Endothelial Growth Factor in the Management of Acute Central Serous Chorioretinopathy: Systematic Review and Meta-Analysis

Authors: Hadeel Seraj, Mohammed Khoshhal, Mustafa Alhamoud, Hassan Alhashim, Anas Alsaif, Amro Abukhashabah

Abstract:

Central serous chorioretinopathy (CSCR) is an idiopathic retinal disease characterized by localized serous detachment of the neurosensory retina at the macula. To date, there is no high-quality evidence of recent updates on treating acute CSCR, focusing on photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF). Hence, this review aims to systematically review the latest treatment strategies for acute CSCR. Methodology: The following electronic databases were used for a comprehensive and systematic literature review: MEDLINE, EMBASE, and Cochrane. In addition, we analyzed studies comparing PDT with placebo, anti-VEGF with placebo, or PDT with anti-VEGF in treating acute CSC eyes with no previous intervention. Results: Seven studies were included, with a total of 292 eyes. The overall positive results were significantly higher among patients who received PDT compared to control groups (OR = 7.96, 95% CI, 3.02 to 20.95, p < 0.001). The proportions of positive results were 81.0% and 97.1% among patients who received anti-VEGF and PDT, respectively, with no statistically significant differences between the groups. In addition, there were no significant differences between anti-VEGF and control groups. In contrast, PDT was significantly associated with lower recurrence odds than the control groups (OR = 0.12, 95% CI, 0.04 to 0.39, p = 0.042). Conclusion: According to our findings, PDT showed higher positive results than Anti-VEGF in acute CSCR. In addition, PDT was significantly associated with a lower recurrence rate than the control group. However, the analysis needs to be confirmed and updated by large-scale, well-designed RCTs.

Keywords: central serous chorioretinopathy, Acute CSCR, photodynamic therapy, anti-vascular endothelial growth factor

Procedia PDF Downloads 79
4823 An Overview of the Islamic Banking Development in the United Kingdom, Malaysia, Saudi Arabia, Iran, Nigeria, Kenya and Uganda

Authors: Pradeep Kulshrestha, Maulana Ayoub Ali

Abstract:

The level of penetration of Islamic banking products and services has recorded a reasonable growth at an exponential rate in many parts of the world. There are many factors which have contributed to this growth including, but not limited to the rapid growth of number of Muslims who are uncomfortable with the conventional ways of banking, interest and higher interest rates scheduled by conventional banks and financial institutions as well as the financial inclusion campaign conducted in many countries. The system is facing legal challenges which open the research fdoor for practitioners and academicians for the sake of finding out solutions to those challenges. This paper tries to investigate the development of the Islamic banking system in the United Kingdom (UK), Saudi Arabia, Malaysia, Iran, Kenya, Nigeria and Uganda in order to understand the modalities which have been employed to run an Islamic banking system in the aforementioned countries. The methodology which has been employed in doing this research paper is Doctrinal, of which legislations, policies and other legal tools have been carefully studied and analysed. Again, papers from academic journals, books and financial reports have been deeply analysed for the purpose of enriching the paper and come up with a tangible results. The paper found that in Asia, Malaysia has created the smoothest legal platform for Islamic banking system to work properly in the country. The United Kingdom has tried harder to smooth the banking system without affecting the conventional banking methods and without favouring the operations of Islamic banks. It also tries harder to make UK as an Islamic banking and finance hub in Europe. The entire banking system in Iran is Islamic, while Nigeria has undergone several legal reforms to suit Islamic banking system in the country. Kenya and Uganda are at a different pace in making Islamic Banking system work alongside the conventional banking system.  

Keywords: shariah, Islamic banking, law, alternative banking

Procedia PDF Downloads 154
4822 Continuity Through Best Practice. A Case Series of Complex Wounds Manage by Dedicated Orthopedic Nursing Team

Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

Abstract:

The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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4821 Minimally Invasive versus Conventional Sternotomy for Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

Abstract:

Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

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