Search results for: acute back pain

Authors: Angga S. Fajar, A. Aminullah, J. Kiyono, R. A. Safitri

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This paper discusses about the application of ANN for optimizing of bridge structure design. ANN has been applied in various field of science concerning prediction and optimization. The structural optimization has several benefit including accelerate structural design process, saving the structural material, and minimize self-weight and mass of structure. In this paper, there are three types of bridge structure that being optimized including PSC I-girder superstructure, composite steel-concrete girder superstructure, and RC bridge pier. The different optimization strategy on each bridge structure implement back propagation method of ANN is conducted in this research. The optimal weight and easier design process of bridge structure with satisfied error are achieved.

Keywords: bridge structures, ANN, optimization, back propagation

Procedia PDF Downloads 370

Authors: A. Omeiri, A. Djellad, P. O. Logerais, O. Riou, J. F. Durastanti

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With the growing of electrical energy demand, wind power capacity has experienced tremendous growth in the past decade, thanks to wind power’s environmental benefits. Direct driven permanent magnet synchronous generator (PMSG) with a full size back-to-back converter set is one of the promising technologies employed with wind power generation. Wind grid integration brings the problems of voltage fluctuation and harmonic pollution. In the present study, the filter is placed between the wind system and the network to reduce the total harmonic distortion (THD) and enhance power quality during disturbances. The models of wind turbine, PMSG, power electronic converters and the filter are implemented in MATLAB/SIMULINK environment.

Keywords: wind energy conversion system, PMSG, PWM, THD, power quality, passive filter

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Authors: Gheimati Salar

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The objective of conducting this research was to study the influence of plyometric exercises on the biomechanical selected factor of elite teen swimmers and compare the influence of plyometric exercises on the speed of front crawl and back crawl in empirical and control groups of teens. In order to conduct these study 30 swimmers with minimum of 3 years' experience who were 11 or 12 were randomly chosen and divided into 2 groups of 15. The first group was empirical and the second was control group. The speed of the swimmer was analyzed after 25 meters of swimming and their speed were recorded in the last. The researcher was standing stable at the beginning and then started the chronometer and stopped it at the end of the swimming. He repeated the record taking two times and then the average was taken. Before conducting plyometric exercises, a speed test was taken from both groups in both types of swimming. The duration of plyometric exercises was 8 weeks, every week 3 sessions and 24 sessions in total. The exercises in this study were focused on 3 parts of the body. Upper limb part, the lower part of the body and trunk area. Upper limb exercises consisted of four parts. The lower limb exercises consisted of 5 parts, and the trunk exercises consisted of four sections. A Medicine ball, cone and different weights were used in these exercises.

Keywords: plyometric, exercises, front crawl and back crawl, speed

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Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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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

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Authors: Syue-Wen Lin

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Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.

Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns

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Authors: Ali Chitgar

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Respiratory infections including diseases in camels are important not only because of the threat of animal health but also to reduce their production. Since that deal with respiratory problems and their treatment requires adequate knowledge of the existing respiratory problems, unfortunately, there is limited information about the species of camels. This study aimed to identify lung lesions camels slaughtered in a slaughterhouse more important was performed using histopathology. Respiratory camels (n = 477) was examined after the killing fully and tissue samples were placed in 10% formalin. The samples and histological sections using hematoxylin and eosin staining and color were evaluated. In this study 79.6 % (236 of 477 samples) of the samples was at least a lung lesion. Rate acute interstitial pneumonia, chronic interstitial pneumonia, bronchopneumonia, bronchiolitis, an inflammation of the pleura and 52.8 % respectively atelectasis (236 of 477 samples), 5.4 % (24 of 477 samples), 7.8 % (35 of 477 samples), 6.7 % (30 of 477 samples), 3.4 % (15 of 477 samples) and 15.2% (68 of 477 samples). The lung lesions, acute interstitial pneumonia and bronchopneumonia in autumn winter rather than spring and summer (p <0/05) and as a result, this study showed that high rates of lung lesions in the camel population. Waste higher results in cold seasons (fall and winter) shows.

Keywords: camel, surgery, histopathology, breathing organ

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Authors: M. M. Bashandy, A. R. Ahmed, M. El-Gaffary, Sahar S. Abd El-Rahman

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This study evaluated the acute toxicity and tissue distribution of intravenously administered gold nanoparticles (AuNPs) in male rabbits. Rabbits were exposed to single dose of AuNPs (300 µg/ kg). Toxic effects were assessed via general behavior, hematological parameters, serum biochemical parameters and histopathological examination of various rabbits’ organs. Tissue distribution of AuNPs was evaluated at a dose of 300 µg/ kg in male rabbit. Inductively coupled plasma–mass spectrometry (ICP-MS) was used to determine gold concentrations in tissue samples collected at predetermined time intervals. After one week, AuNPs exerted no obvious acute toxicity in rabbits. However, inflammatory reactions in lung and liver cells were induced in rabbits treated at the300 µg/ kg dose level. The highest gold levels were found in the spleen, followed by liver, lungs and kidneys. These results indicated that AuNPs could be distributed extensively to various tissues in the body, but primarily in the spleen and liver.

Keywords: gold nanoparticles, toxicity, pathology, hematology, liver function, kidney function

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Authors: B. A. Alwahaby

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Background: The number of Total Knee Replacement (TKR) and Anterior Cruciate Ligament Reconstruction (ACLR) performed every year is increasing. The main aim of physiotherapy early recovery rehabilitation after these surgeries is to control pain and edema and regain Range of Motion (ROM) and physical activity. All of these outcomes need to be managed by safe and effective modalities. Kinesiotaping (KT) is an elastic non-invasive therapeutic tape that has become recognised in different physiotherapy situation as injury prevention, rehabilitation, and performance enhancement and been used with different conditions. However, there is still clinical doubt regarding the effectiveness of KT due to inconclusive supporting evidence. The aim of this systematic review is to collate all the available evidence on the effectiveness of KT in the early rehabilitation of ACLR and TKR patients and analyse whether the use of KT combined with standard rehabilitation would facilitate recovery of postoperative outcome than standard rehabilitation alone. Methodology: A systematic review was conducted. Medline, EMBASE, Scopus, AMED PEDro, CINAHL, and Web of Science databases were searched. Each study was assessed for inclusion and methodological quality appraisal was undertaken by two reviewers using the JBI critical appraisal tools. The studies were then synthesised qualitatively due to heterogeneity between studies. Results: Five moderate to low quality RCTs were located. All five studies demonstrated statistically significant improvements in pain, swelling, ROM, and functional outcomes (p < 0.05). Between group comparison, KT combined with standardised rehabilitation were shown to be significantly more effective than standardised rehabilitation alone for pain and swelling (p < 0.05). However, there were inconstant findings for ROM, and no statistically significant differences reported between groups for functional outcomes (p > 0.05). Conclusion: Research in the area is generally low quality; however, there is consistent evidence to support the use of KT combined with standardised post-operative rehabilitation for reducing pain and swelling. There is also some evidence that KT may be effective in combination with standardised rehabilitation to regain knee extension ROM faster than standardised rehabilitation alone, but further primary research is required to confirm this.

Keywords: anterior cruciate ligament reconstruction, ACLR, kinesio taping, KT, postoperative, total knee replacement, TKR

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Authors: Farhad Hekmatipour, M. A. Akhavan-Behabadi, Farzad Hekmatipour

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In this paper, experiments were conducted to investigate the heat transfer of Copper Oxide-Heat Transfer Oil (CuO-HTO) nanofluid laminar flow in vertical smooth and microfin tubes as the surface temperature is constant. The effect of adding the nanoparticle to base fluid and Richardson number on the heat transfer enhancement is investigated as Richardson number increases from 0.1 to 0.7. The experimental results demonstrate that the combined forced-natural convection heat transfer rate may be improved significantly with an increment of mass nanoparticle concentration from 0% to 1.5%. In this experiment, a correlation is also proposed to predict the mixed convection heat transfer rate of CuO-HTO nanofluid flow. The maximum deviation of both correlations is less than 14%. Moreover, a correlation is presented to estimate the Nusselt number inside vertical smooth and microfin tubes as Rayleigh number is between 2´105 and 6.8´106 with the maximum deviation of 12%.

Keywords: mixed convection, heat transfer, nanofluid, vertical tube, microfin tube

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Authors: Recep Kesli, Cengiz Demir, Riza Durmaz, Zekiye Bakkaloglu, Aysegul Bukulmez

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Objective: Acute diarrhea disease in children is a major cause of morbidity worldwide and is a leading cause of mortality, and it is the most common agent responsible for acute gastroenteritis in developing countries. With hospitalized children suffering from acute enteric disease up to 50% of the analyzed specimen were positive for rotavirus. Further molecular surveillance could provide a sound basis for improving the response to epidemic gastroenteritis and could provide data needed for the introduction of vaccination programmes in the country. The aim of this study was to investigate the prevalence of viral etiology of the gastroenteritis in children aged 0-6 years with acute gastroenteritis and to determine predominant genotypes of rotaviruses in the province of Afyonkarahisar, Turkey. Methods: An epidemiological study on rotavirus was carried out during 2016. Fecal samples obtained from the 144 rotavirus positive children with 0-6 years of ages and applied to the Pediatric Diseases Outpatient of ANS Research and Practice Hospital, Afyon Kocatepe University with the complaint of diarrhea. Bacterial agents causing gastroenteritis were excluded by using bacteriological culture methods and finally, no growth observed. Rotavirus antigen was examined by both the immunochromatographic (One Step Rotavirus and Adenovirus Combo Test, China) and ELISA (Premier Rotaclone, USA) methods in stool samples. Rotavirus RNA was detected by using one step real-time reverse transcription-polymerase chain reaction (RT-PCR). G and P genotypes were determined using RT-PCR with consensus primers of VP7 and VP4 genes, followed by semi nested type-specific multiplex PCR. Results: Of the total 144 rotavirus antigen-positive samples with RT-PCR, 4 (2,8%) were rejected, 95 (66%) were examined, and 45 (31,2%) have not been examined for PCR yet. Ninety-one (95,8%) of the 95 examined samples were found to be rotavirus positive with RT-PCR. Rotavirus subgenotyping distributions in G, P and G/P genotype groups were determined as; G1:45%, G2:27%, G3:13%, G9:13%, G4:1% and G12:1% for G genotype, and P[4]:33%, P[8]:66%, P[10]:1% for P genotype, and G1P[8]:%37, G2P[4]:%21, G3P[8]:%10, G4P[8]:%1, G9P[8]:%8, G2P[8]:%3 for G/P genotype . Not common genotype combination were %20 in G/P genotype. Conclusions: This study subscribes to the global agreement of the molecular epidemiology of rotavirus which will be useful in guiding the alternative and application of rotavirus vaccines or effective control and interception. Determining the diversity and rates of rotavirus genotypes will definitely provide guidelines for developing the most suitable vaccine.

Keywords: gastroenteritis, genotyping, rotavirus, RT-PCR

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Authors: Uchenna Nkiruka Umeononihu, Adenike Kuku, Oludele Odekanyin, Olubunmi Babalola, Femi Agboola, Rapheal Okonji

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In this study, a lectin from the bulb of Dioscorea bulbifera was purified, characterised, and its acute and sub-acute toxicity was investigated with a view to evaluate its toxic effects in mice. The protein from the bulb was extracted by homogenising 50 g of the bulb in 500 ml of phosphate buffered saline (0.025 M) of pH 7.2, stirred for 3 hr, and centrifuged at the speed of 3000 rpm. Blood group and sugar specificity assays of the crude extract were determined. The lectin was purified in a two-step procedure- gel filtration on Sephadex G-75 and affinity chromatography on Sepharose 4-B arabinose. The degree of purity of the purified lectin was ascertained by SDS-polyacrylamide gel electrophoresis. Detection of covalently bound carbohydrate was carried out with Periodic Acid-Schiffs (PAS) reagent staining technique. Effects of temperature, pH, and EDTA on the lectin were carried out using standard methods. This was followed by acute toxicity studies via oral and subcutaneous routes using mice. The animals were monitored for mortality and signs of toxicity. The sub-acute toxicity studies were carried out using rats. Different concentrations of the lectin were administered twice daily for 5 days via the subcutaneous route. The animals were sacrificed on the sixth day; blood samples and liver tissues were collected. Biochemical assays (determination of total protein, direct bilirubin, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), catalase (CAT), and superoxide dismutase (SOD)) were carried out on the serum and liver homogenates. The collected organs (heart, liver, kidney, and spleen) were subjected to histopathological analysis. The results showed that lectin from the bulbs of Dioscorea bulbifera agglutinated non-specifically the erythrocytes of the human ABO system as well as rabbit erythrocytes. The haemagglutinating activity was strongly inhibited by arabinose and dulcitol with minimum inhibitory concentrations of 0.781 and 6.25, respectively. The lectin was purified to homogeneity with native and subunit molecular weights of 56,273 and 29,373 Daltons, respectively. The lectin was thermostable up to 30 0C and lost 25 %, 33.3 %, and 100 % of its heamagglutinating activity at 40°C, 50°C, and 60°C, respectively. The lectin was maximally active at pH 4 and 5 but lost its total activity at pH eight, while EDTA (10 mM) had no effect on its haemagglutinating activity. PAS reagent staining showed that the lectin was not a glycoprotein. The sub-acute studies on rats showed elevated levels of ALT, AST, serum bilirubin, total protein in serum and liver homogenates suggesting damage to liver and spleen. The study concluded that the aerial bulb of D. bulbifera lectin was non-specific in its heamagglutinating activity and dimeric in its structure. The lectin shared some physicochemical characteristics with lectins from other Dioscorecea species and was moderately toxic to the liver and spleen of treated animals.

Keywords: Dioscorea bulbifera, heamagglutinin, lectin, toxicity

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Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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Authors: Alok Bapatla, Pamela Lutting, Mariastella Serrano

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Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habits in the absence of an underlying organic cause. Although the exact etiology of IBS is not fully understood, one of the leading theories postulates a pathology within the Brain-Gut Axis that leads to an overall increase in gastrointestinal sensitivity and pejorative changes in gastrointestinal motility. Research and clinical practice have shown that Gut Directed Hypnotherapy (GDH) has a beneficial clinical role in improving Mind-Gut control and thereby comorbid conditions such as anxiety, abdominal pain, constipation, and diarrhea. Aims: This study presents a 17-year old male with underlying anxiety and a one-year history of IBS-Constipation Predominant Subtype (IBS-C), who has demonstrated impressive improvement of symptoms following GDH treatment following refractory trials with medications including bisacodyl, senna, docusate, magnesium citrate, lubiprostone, linaclotide. Method: The patient was referred to a licensed clinical psychologist specializing in clinical hypnosis and cognitive-behavioral therapy (CBT), who implemented “The Standardized Hypnosis Protocol for IBS” developed by Dr. Olafur S. Palsson, Psy.D at the University of North Carolina at Chapel Hill. The hypnotherapy protocol consisted of a total of seven weekly 45-minute sessions supplemented with a 20-minute audio recording to be listened to once daily. Outcome variables included the GAD-7, PHQ-9 and DCI-2, as well as self-ratings (ranging 0-10) for pain (intensity and frequency), emotional distress about IBS symptoms, and overall emotional distress. All variables were measured at intake prior to administration of the hypnosis protocol and at the conclusion of the hypnosis treatment. A retrospective IBS Questionnaire (IBS Severity Scoring System) was also completed at the conclusion of the GDH treatment for pre-and post-test ratings of clinical symptoms. Results: The patient showed improvement in all outcome variables and self-ratings, including abdominal pain intensity, frequency of abdominal pain episodes, emotional distress relating to gut issues, depression, and anxiety. The IBS Questionnaire showed a significant improvement from a severity score of 400 (defined as severe) prior to GDH intervention compared to 55 (defined as complete resolution) at four months after the last session. IBS Questionnaire subset questions that showed a significant score improvement included abdominal pain intensity, days of pain experienced per 10 days, satisfaction with bowel habits, and overall interference of life affected by IBS symptoms. Conclusion: This case supports the existing research literature that GDH has a significantly beneficial role in improving symptoms in patients with IBS. Emphasis is placed on the numerical results of the IBS Questionnaire scoring, which reflects a patient who initially suffered from severe IBS with failed response to multiple medications, who subsequently showed full and sustained resolution

Keywords: pediatrics, constipation, irritable bowel syndrome, hypnotherapy, gut-directed hypnosis

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Authors: Khaled Igbaria

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Laila Al-Othman is a well-known feminist writer in Kuwait and the entire Arab world. She was born in 1943 in Kuwait to a large and wealthy family. The author has written several short stories, as well as novels, such as The Woman and the Cat (1985) and Wasumayya Comes out of the Sea (1986), which was chosen as one of the best 100 Arab novels of the 21st century. Another prominent novel of hers is Ṣamt al-Farāshāt [Silence of the Butterflies] (2007), which was highly controversial in her native Kuwait upon publication. For this study, her engagement in feminism was achieved by exploring the different ways in which her novel, Ṣamt al-Farāshāt [Silence of the Butterflies], addresses several feminist issues, mainly forced marriage, rape and sexual abuse, gender-based physical, sexual violence, and enforced silence. This paper focuses on demonstrating social obstacles and continuous trauma caused by a sequence of pain experienced by Arab females in their patriarchal society. This study argues that the novel reveals a sustained effort to raise the banner of feminism and a strong desire to liberate Arab women from patriarchal domination. Al-Othman successfully and uniquely represents women as gender-based traumatic victims of sexual and physical violence, forced silence, and general oppression in the patriarchal Arab society, as those needing help, support, protection, and liberation. They are not represented as independent or free. Methodologically, the study employs a qualitative literary analysis method in addition to trauma theory psychoanalysis, concentrating on feminist issues highlighted in the novel.

Keywords: Al-Othman, Arab women pain, trauma within narration., Silence of the Butterflies

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Authors: Suchao Donpudsa, Suwattana Visetnan, Anchalee Tassanakajon, Vichien Rimphanitchayakit

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The Single Wap Domain (SWD) is a type III crustin antimicrobial peptide whose function is to defense the host animal against the bacterial infection by means of antimicrobial and antiproteinase activities. A study of LvSWD from Litopenaeus vannamei is reported herein about its activities and function against bacteria, particularly the Vibrio parahaemolyticus AHPND (VPAHPND) that causes acute hepatopancreatic necrosis disease. The over-expressed mature recombinant (r)LvSWD exhibits antimicrobial activity against both Gram-positive and Gram-negative bacteria, especially VPAHPND. With four times the MIC of rLvSWD, the treated post larval shrimp infected by VPAHPND is able to survive longer with the 50% survival rate as long as 78 h as compared to 36 h of the infected shrimp without rLvSWD. To a certain extent, we have demonstrated that the rLvSWD can be applied to protect the post larval shrimp.

Keywords: crustin, Litopenaeus vannamei, Vibrio parahaemolyticus AHPND, antimicrobial activity

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Authors: Eun Gyeong Lee, Ji Young Park, Hyun Ae Woo

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Reactive oxygen species (ROS) production is involved in ischemia/reperfusion (I/R) injury in kidney of mice. Oxidative stress develops from an imbalance between ROS production and reduced antioxidant defenses. Many enzymatic and nonenzymatic antioxidant systems including peroxiredoxins (Prxs) are present in kidney to maintain an appropriate level of ROS and prevent oxidative damage. Prxs are a family of peroxidases that reduce peroxides, with a conserved cysteine residue serving as the site of oxidation by peroxides. In this study, we examined the protective role of Prx V against I/R-induced acute kidney injury (AKI) using Prx V wild type (WT) and knockout (KO) mice. We compared the response of Prx V WT and KO mice in mice model of I/R injury. Renal structure, functions, oxidative stress markers, protein levels of oxidative damage marker were worse in Prx V KO mice. Ablation of Prx V enhanced susceptibility to I/R-induced oxidative stress. Prx V KO mice were seen to have more severe renal damage than Prx V WT mice in mice model of I/R injury. Our results demonstrate that Prx V is protective against I/R-induced AKI.

Keywords: peroxiredoxin, ischemia/reperfusion, kidney, oxidative stress

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Authors: Kantha Siddhanth Gujjari, Shaani Singhal, Robert Andrew Danks, Adrian Praeger

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Background: Trigeminal neuralgia (TN) is a heterogenous pain syndrome characterised by short paroxysms of lancinating facial pain in the distribution of the trigeminal nerve, often triggered by usually innocuous stimuli. TN has a low prevalence of less than 0.1%, of which 80% to 90% is caused by compression of the trigeminal nerve from an adjacent artery or vein. The root entry zone of the trigeminal nerve is most sensitive to neurovascular conflict (NVC), causing dysmyelination. Whilst microvascular decompression (MVD) is an effective treatment for TN with NVC, all patients do not achieve long-term pain relief. Pre-operative scoring systems by Panczykowski and Hardaway have been proposed but have not been externally validated. These pre-operative scoring systems are composite scores calculated according to a subtype of TN, presence and degree of neurovascular conflict, and response to medical treatments. There is discordance in the assessment of NVC identified on pre-operative magnetic resonance imaging (MRI) between neurosurgeons and radiologists. To our best knowledge, the prognostic impact for MVD of this difference of interpretation has not previously been investigated in the form of a composite scoring system such as those suggested by Panczykowski and Hardaway. Aims: This study aims to identify prognostic factors and externally validate the proposed scoring systems by Panczykowski and Hardaway for TN. A secondary aim is to investigate the prognostic difference between a neurosurgeon's interpretation of NVC on MRI compared with a radiologist’s. Methods: This retrospective cohort study included 95 patients who underwent de novo MVD in a single neurosurgical unit in Melbourne. Data was recorded from patients’ hospital records and neurosurgeon’s correspondence from perioperative clinic reviews. Patient demographics, type of TN, distribution of TN, response to carbamazepine, neurosurgeon, and radiologist interpretation of NVC on MRI, were clearly described prospectively and preoperatively in the correspondence. Scoring systems published by Panczykowski et al. and Hardaway et al. were used to determine composite scores, which were compared with the recurrence of TN recorded during follow-up over 1-year. Categorical data analysed using Pearson chi-square testing. Independent numerical and nominal data analysed with logistical regression. Results: Logistical regression showed that a Panczykowski composite score of greater than 3 points was associated with a higher likelihood of pain-free outcome 1-year post-MVD with an OR 1.81 (95%CI 1.41-2.61, p=0.032). The composite score using neurosurgeon’s impression of NVC had an OR 2.96 (95%CI 2.28-3.31, p=0.048). A Hardaway composite score of greater than 2 points was associated with a higher likelihood of pain-free outcome 1 year post-MVD with an OR 3.41 (95%CI 2.58-4.37, p=0.028). The composite score using neurosurgeon’s impression of NVC had an OR 3.96 (95%CI 3.01-4.65, p=0.042). Conclusion: Composite scores developed by Panczykowski and Hardaway were validated for the prediction of response to MVD in TN. A composite score based on the neurosurgeon’s interpretation of NVC on MRI, when compared with the radiologist’s had a greater correlation with pain-free outcomes 1 year post-MVD.

Keywords: de novo microvascular decompression, neurovascular conflict, prognosis, trigeminal neuralgia

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Hsiao-Lin Fang

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Every life is precious, and comprehensive care should be provided to individuals who are in the final stages of their lives. Hospice-shared care aims to provide optimal symptom control and palliative care to terminal (cancer) patients through the implementation of shared care, and to support patients and their families in making various physical and psychological adjustments in the face of death. This report examines a 10-year-boy diagnosed with Out-of-Hospital Cardiac Arrest (OHCA). The individual fainted when swimming at school and underwent 31 minutes of cardiopulmonary resuscitation (CPR). While receiving treatment at the hospital, the individual received extracorporeal membrane oxygenation(ECMO) due to unstable hemodynamics. Urgent cardiac catheterization found: Suspect acute fulminant myocarditis or underlying cardiomyopathy with acute decompensation, After the active rescue by the medical team, hemodynamics still showed only mean pressure value. With respect to the patient, interdepartmental hospice-shared care was implemented and a do-not-resuscitate (DNR) order was signed after family discussions were conducted. Assistance and instructions were provided as part of the comfort care process. A farewell gathering attended by the patient’s relatives, friends, teachers, and classmates was organized in an intensive care unit (ICU) in order to look back on the patient’s life and the beautiful memories that were created, as well as to alleviate the sorrow felt by family members, including the patient’s father and sister. For example, the patient was presented with drawings and accompanied to a garden to pick flowers. In this manner, the patient was able to say goodbye before death. Finally, the patient’s grandmother and father participated in the clinical hospice care and post-mortem care processes. A hospice-shared care clinician conducted regular follow-ups and provided care to the family of the deceased, supporting family members through the sorrowful period. Birth, old age, sickness, and death are the natural phases of human life. In recent years, growing attention has been paid to human-centered hospice care. Hospice care is individual holistic care provided by a professional team and it involves the provision of comprehensive care to a terminal patient. Hospice care aims to satisfy the physical, psychological, mental, and social needs of patients and their families. It does not involve the cessation of treatment but rather avoids the exacerbation or extension of the suffering endured by patients, thereby preserving the dignity and quality of life during the end-of-life period. Patients enjoy the company of others as they complete the last phase of their lives, and their families also receive guidance on how they can move on with their own lives after the patient’s death.

Keywords: hospice-shared care, extracorporeal membrane oxygenation (ECMO), hospice-shared care, child patient

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Authors: Slimane Ouhmad, Abdellah Halimi

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In this work, we have applied neural networks method MLP type to a database from an array of six sensors for the detection of three toxic gases. As the choice of the number of hidden layers and the weight values has a great influence on the convergence of the learning algorithm, we proposed, in this article, a mathematical formulation to determine the optimal number of hidden layers and good weight values based on the method of back propagation of errors. The results of this modeling have improved discrimination of these gases on the one hand, and optimize the computation time on the other hand, the comparison to other results achieved in this case.

Keywords: MLP Neural Network, back-propagation, number of neurons in the hidden layer, identification, computing time

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Authors: Joon Ho Kim, Tae Kwon Ha

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Effect of aging treatment on microstructural aspects of interfacial layers of the Cu/Al clad sheet produced by Differential Speed Rolling (DSR) process were studied by Electron Back Scattered Diffraction (EBSD). Clad sheet of Al/Cu has been fabricated by using DSR, which caused severe shear deformation between Al and Cu plate to easily bond to each other. Rolling was carried out at 100°C with speed ratio of 2, in which the total thickness reduction was 45%. Interface layers of clad sheet were analyzed by EBSD after subsequent annealing at 400°C for 30 to 120 min. With increasing annealing time, thickness of interface layer and fraction of high angle grain boundary were increased and average grain size was decreased.

Keywords: aluminium/copper clad sheet, differential speed rolling, interface layer, microstructure, annealing, electron back scattered diffraction

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Authors: N. Dunleavy, E. Lovemore, K. Siljeur, D. Jackson, M. Hendricks, M. Hoosain, N. Plastow, S. Marais

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Background: The work requirements of sewing machine operators cause physical and emotional strain. Past ergonomic interventions have been provided to alleviate physical concerns; however, a holistic, multimodal intervention was needed to improve these factors. Aim: The study aimed to examine the effect of an occupational therapy programme on sewing machine operators’ pain, mental health, and productivity within a factory in the South African context. Methods: A pilot randomised control trial was conducted with 22 sewing machine operators within a single factory. Stratified randomisation was used to determine the experimental (EG) and control groups (CG), using measures for pain intensity, level of depression (mental health), and productivity rates as stratification variables. The EG received the multimodal intervention, incorporating education, seating adaptations, and mental health intervention. In three months, the CG will receive the same intervention. Pre- and post-intervention testing have occurred with upcoming three- and six-month follow-ups. Results: Immediate results indicate a statistically significant decrease in pain in both experimental and control groups; no change in productivity scores and depression between the two groups. This may be attributed to external factors. The values for depression further showed no statistical significance between the two groups and within pre-and post-test results. The Statistical Program for Social Sciences (SPSS) version-24 was used as the data analysis testing, where all the tests will be evaluated at a 5% significance level. Contribution of research: The research adds to the body of knowledge informing the Occupational Therapy role in work settings, providing evidence on the effectiveness of workplace-based multimodal interventions. Conclusion: The study provides initial data on the effectiveness of a pilot randomised control trial on pain and mental health in South Africa. Results indicated no quantitative change between the experimental and control groups; however, qualitative data suggest a clinical significance of the findings.

Keywords: ergonomics programme, occupational therapy, sewing machine operators, workplace-based multimodal interventions

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Authors: Syue-Wen Lin

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Objective: This article explores the nursing experience of an 84-year-old male lung cancer patient who underwent a thoracoscopic right lower lobectomy and treatment. The patient has multiple medical histories, including hypertension and diabetes. The nursing process involved cancer treatment, postoperative pain management, as well as wound care and healing. Methods: The nursing period is from February 10 to February 17, 2024. During the nursing process, pain management strategies are implemented, including morphine drugs and non-drug methods, and music therapy, essential oil massage, and extended reception time are used to make patients feel physically and mentally comfortable so as to reduce postoperative pain and encourage active participation in rehabilitation. Strict sterile wound dressing procedures and advanced wound care techniques are used to promote wound healing and prevent infection. Due to septic shock, dialysis is used to relieve worsening symptoms. Taking into account the patient's cancer status, the nursing team provides comprehensive cancer care based on the patient's physical and psychological needs. Given the complexity of the patient's condition, including advanced cancer, palliative care is also incorporated throughout the care process to relieve discomfort and provide psychological support. Results: Through comprehensive health assessment, the nursing team fully understood the patient's condition and developed a personalized care plan based on the patient's condition. The interprofessional critical care team provides respiratory therapy and lung expansion exercises to reduce muscle loss while addressing the patient's psychological status, pain management, and vital sign stabilization needs, resulting in a comprehensive approach to care. Lung expansion exercises and the use of a high-frequency chest wall oscillation vest successfully improved sputum drainage and facilitated weaning from mechanical ventilation. In addition, helping patients stabilize their vital signs and the integration of cancer care, pain management, wound care and palliative care helps the patient be fully supported throughout the recovery process, ultimately improving his quality of life. Conclusion: Lung cancer and septic shock present significant challenges to patients, and the nursing team not only provides critical care but also addresses the unique needs of patients through comprehensive infection control, cancer care, pain management, wound care, and palliative care interventions. These measures effectively improve patients' quality of life, promote recovery, and provide compassionate palliative care for terminally ill patients. Nursing staff work closely with family members to develop a comprehensive care plan to ensure that patients receive high-quality medical care as well as psychological support and a comfortable recovery environment.

Keywords: septic shock, lung cancer, palliative care, nursing experience

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Authors: Chul Hyun Park

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Background:Repair using the Achillon deviceis a representative mini-open repair technique;however, the limitations of this technique includethe need for special instruments and decreasedrepair strength.A modifiedmini-open repair using ring forcepsmight overcome these limitations. Purpose:This study was performed to compare the Achillon device with ring forceps in mini-open repairsof acute Achilles tendon rupture. Study Design:This was a retrospective cohort study, and the level of evidence was3. Methods:Fifty patients (41 men and 9 women), withacute Achilles tendon rupture on one foot, were consecutively treated using mini-open repair techniques. The first 20 patients were treated using the Achillon device (Achillon group) and the subsequent 30 patients were treated using a ring forceps (Forcep group). Clinical, functional, and isokinetic results,and postoperative complications were compared between the two groups at the last follow-up. Clinical evaluations wereperformed using the American Orthopedic Foot and Ankle Society (AOFAS) score, Achilles tendon Total Rupture Score (ATRS), length of incision, and operation time. Functional evaluationsincludedactive range of motion (ROM) of the ankle joint, maximum calf circumference (MCC), hopping test, and single limb heel-rise (SLHR) test. Isokinetic evaluations were performed using the isokinetic test for ankle plantar flexion. Results:The AOFAS score (p=0.669), ATRS (p=0.753), and length of incision (p=0.305) were not significantly different between the groups. Operative times in the Achillon group were significantly shorter than that in the Forcep group (p<0.001).The maximum height of SLHR (p=0.023) and number of SLHRs (p=0.045) in the Forcep group were significantly greater than that in the Achillon group. No significant differences in the mean peak torques for plantar flexion at angular speeds of 30°/s (p=0.219) and 120°/s (p=0.656) were detected between the groups. There was no significant difference in the occurrence of postoperative complications between the groups (p=0.093). Conclusion:The ring forceps technique is comparable with the Achillon technique with respect to clinical, functional, and isokinetic results and the postoperative complications. Given that no special instrument is required, the ring forceps technique could be a better option for acute Achilles tendon rupture repair.

Keywords: achilles tendon, acute rupture, repair, mini-open

Procedia PDF Downloads 80

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: Osung Im, Neha Yadav, Eui Hoon Lee, Joong Hoon Kim

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Artificial Neural Network (ANN) approach is commonly used in lots of fields for forecasting. In water resources engineering, forecast of water level or inflow of reservoir is useful for various kind of purposes. Due to advantages of ANN, many papers were written for inflow prediction in river networks, but in this study, ANN is used in urban sewer networks. The growth of severe rain storm in Korea has increased flood damage severely, and the precipitation distribution is getting more erratic. Therefore, effective pump operation in pump station is an essential task for the reduction in urban area. If real time inflow of pump station reservoir can be predicted, it is possible to operate pump effectively for reducing the flood damage. This study used ANN model for pump station reservoir inflow prediction using upstream sewer depth data. For this study, rainfall events, sewer depth, and inflow into Banpo pump station reservoir between years of 2013-2014 were considered. Feed – Forward Back Propagation (FFBF), Cascade – Forward Back Propagation (CFBP), Elman Back Propagation (EBP) and Nonlinear Autoregressive Exogenous (NARX) were used as ANN model for prediction. A comparison of results with ANN model suggests that ANN is a powerful tool for inflow prediction using the sewer depth data.

Keywords: artificial neural network, forecasting, reservoir inflow, sewer depth

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Authors: Attef Kouadria, Yehya Bouteghrine, Amar Manaa, Tarek Mouats, Djalel Eddine Tria, Hamid Abdelhafid Ghouti

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Personal protection systems have been used in several forms for centuries. The need for light-weight composite structures has been in great demand due to their weight and high mechanical properties ratios in comparison to heavy and cumbersome steel plates. In this regard, lighter ceramic plates with a backing plate made of high strength polymeric fibers, mostly aramids, are widely used for protection against ballistic threats. This study aims to improve the ballistic performance of ceramic/composite plates subjected to ballistic impact by reducing the back face deformation (BFD) measured after each test. A new hybridization technique was developed in this investigation to increase the energy absorption capabilities of the backing plates. The hybridization consists of combining different types of aramid fabrics with different linear densities of aramid fibers (Dtex) and areal densities with an epoxy resin to form the backing plate. Therefore, several composite structures architectures were prepared and tested. For better understanding the effect of the hybridization, a serial of tensile, compression, and shear tests were conducted to determine the mechanical properties of the homogeneous composite materials prepared from different fabrics. It was found that the hybridization allows the backing plate to combine between the mechanical properties of the used fabrics. Aramid fabrics with higher Dtex were found to increase the mechanical strength of the backing plate, while those with lower Dtex found to enhance the lateral wave dispersion ratio due to their lower areal density. Therefore, the back face deformation was significantly reduced in comparison to a homogeneous composite plate.

Keywords: aramid fabric, ballistic impact, back face deformation, body armor, composite, mechanical testing

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Authors: A. Drapeaux, S. Aviles, E. Garfoot

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Stem cell injections are a promising alternative treatment for hip osteoarthritis. Current literature has focused on short-term outcomes for both knee and hip osteoarthritis; however, there is a significant gap for longitudinal benefits for hip OA and limited firm conclusions due to small sample sizes. The purpose of this prospective study was to determine longitudinal changes in pain, function, and radiographs following bone marrow concentrate injection (BMAC) into the osteoarthritic hip joint. Methods: A prospective, cross-sectional study was conducted over the course of 12 months at an orthopedic practice. The study recruited 15 osteoarthritic pre-surgical hips with mild to moderate osteoarthritic severity who were scheduled to undergo hip arthroscopy. Data was collected at both pre-operative and post-operative time frames. Data collected included: hip radiographs, i-HOT-33 questionnaire data, BMAC autologous volume, and demographics. Questionnaire data was captured using Qualtrics XM software, and participants were sent an anonymous link at the following time frames: pre-operative, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Radiographic changes and BMAC volume were collected and reviewed by an orthopedic surgeon and sent to the primary investigator. Data was exported and analyzed in IBM-SPSS. Results: A total of 15 hips from 15 participants (mean age: 49, gender: 50% males, 50% females, BMI: 29.7) were used in the final analysis. Summative i-HOT 33 mean scores significantly changed between pre-operative status and 2-6 weeks post-operative status (p <.001) and pre-operative status and 3-6 months post-operative status (p <.001). There were no significant changes between other post-operative phases or between pre-operative status and 12 months post-operative. Significant improvements were found between summative i-HOT 33 mean (p<.001), daily pain (p<.001), daily sitting (p=.02), daily distance walked (p =.003), and daily limp (p=0.03) and post-operative status (2-6 weeks). No significant differences between demographic variables (gender, age, tobacco use, or diabetes) and i-HOT 33 summative mean scores. Discussion/Implications: The purpose of this study was to determine longitudinal changes in pain and function following a hip joint bone marrow concentrate injection. Results indicate that participants experience a significant improvement in pain and function between pre-operative and 2-6 weeks and 3-6 months post-injection. Participants also self-reported a significant change in average daily pain with sitting and walking between pre-operation and 2-6 weeks post-operative. This study includes a larger sample size of hip osteoarthritis cases; however, future research is warranted to include random controlled trials with a larger sample size.

Keywords: adult stem cell, orthopedics, osteoarthritis (hip), patient outcome assessment

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Authors: Hannah Bigelow, Marcus D. Gottlieb, Michelle Ogrodnik, Jeffrey, D. Graham, Barbara Fenesi

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders affecting approximately 6% of children worldwide. ADHD is characterized by a combination of persistent deficits including impaired inhibitory control, working memory and task-switching. Many children with ADHD also have comorbid mental health issues such as anxiety and depression. There are several treatment options to manage ADHD impairments, including drug and behavioural management therapy, but they all have drawbacks, such as worsening mood disturbances or being inaccessible to certain demographics. Both physical exercise and mindfulness meditation serve as alternative options to potentially help mitigate ADHD symptoms. Although there is extensive support for the benefits of long-term physical exercise or mindfulness meditation programs, there is insufficient research investigating how acute bouts (i.e., single, short bouts) can help children with ADHD. Thus, the current study aimed to understand how single, short bouts of exercise and mindfulness meditation impacts executive functioning and psycho-emotional well-being in children with ADHD, as well as to directly compare the efficacy of these two interventions. The study used a a pre- post-test, within-subjects design to assess the effects of a 10-minute bout of moderate intensity exercise versus a 10-minute bout of mindfulness meditation (versus 10 minutes of a reading control) on the executive functioning and psycho-emotional well-being of 16 children and youth with ADHD aged 10-14 (male=11; White=80%). Participants completed all three interventions: 10 minutes of exercise, 10 minutes of mindfulness meditation, and 10 minutes of reading (control). Executive functioning (inhibitory control, working memory, task-switching) and psycho-emotional well-being (mood, self-efficacy) were assessed before and after each intervention. Mindfulness meditation promoted executive functioning, while exercise enhanced positive mood and self-efficacy. Critically, this work demonstrates that a single, short bout of mindfulness meditation session can promote inhibitory control among children with ADHD. This is especially important for children with ADHD as inhibitory control deficits are among the most pervasive challenges that they face. Furthermore, the current study provides preliminary evidence for the benefit of acute exercise for promoting positive mood and general self-efficacy for children and youth with ADHD. These results may increase the accessibility of acute exercise for children with ADHD, providing guardians and teachers a feasible option to incorporate just 10 minutes of exercise to assist children emotionally. In summary, this research supports the use of acute exercise and mindfulness meditation on varying aspects of executive functioning and psycho-emotional well-being in children and youth with ADHD. This work offers important insight into how behavioural interventions could be personalized according to a child’s needs.

Keywords: attention-deficit hyperactivity disorder (ADHD), acute exercise, mindfulness meditation, executive functioning, psycho-emotional well-being

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