Search results for: cation disorder
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1417

Search results for: cation disorder

757 Scattering Operator and Spectral Clustering for Ultrasound Images: Application on Deep Venous Thrombi

Authors: Thibaud Berthomier, Ali Mansour, Luc Bressollette, Frédéric Le Roy, Dominique Mottier, Léo Fréchier, Barthélémy Hermenault

Abstract:

Deep Venous Thrombosis (DVT) occurs when a thrombus is formed within a deep vein (most often in the legs). This disease can be deadly if a part or the whole thrombus reaches the lung and causes a Pulmonary Embolism (PE). This disorder, often asymptomatic, has multifactorial causes: immobilization, surgery, pregnancy, age, cancers, and genetic variations. Our project aims to relate the thrombus epidemiology (origins, patient predispositions, PE) to its structure using ultrasound images. Ultrasonography and elastography were collected using Toshiba Aplio 500 at Brest Hospital. This manuscript compares two classification approaches: spectral clustering and scattering operator. The former is based on the graph and matrix theories while the latter cascades wavelet convolutions with nonlinear modulus and averaging operators.

Keywords: deep venous thrombosis, ultrasonography, elastography, scattering operator, wavelet, spectral clustering

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756 EEG-Based Screening Tool for School Student’s Brain Disorders Using Machine Learning Algorithms

Authors: Abdelrahman A. Ramzy, Bassel S. Abdallah, Mohamed E. Bahgat, Sarah M. Abdelkader, Sherif H. ElGohary

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Attention-Deficit/Hyperactivity Disorder (ADHD), epilepsy, and autism affect millions of children worldwide, many of which are undiagnosed despite the fact that all of these disorders are detectable in early childhood. Late diagnosis can cause severe problems due to the late treatment and to the misconceptions and lack of awareness as a whole towards these disorders. Moreover, electroencephalography (EEG) has played a vital role in the assessment of neural function in children. Therefore, quantitative EEG measurement will be utilized as a tool for use in the evaluation of patients who may have ADHD, epilepsy, and autism. We propose a screening tool that uses EEG signals and machine learning algorithms to detect these disorders at an early age in an automated manner. The proposed classifiers used with epilepsy as a step taken for the work done so far, provided an accuracy of approximately 97% using SVM, Naïve Bayes and Decision tree, while 98% using KNN, which gives hope for the work yet to be conducted.

Keywords: ADHD, autism, epilepsy, EEG, SVM

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755 The Effectiveness of Using Dramatic Conventions as the Teaching Strategy on Self-Efficacy for Children With Autism Spectrum Disorder

Authors: Tso Sheng-Yang, Wang Tien-Ni

Abstract:

Introduction and Purpose: Previous researchers have documented children with ASD (Autism Spectrum Disorders) prefer to escaping internal privates and external privates when they face tough conditions they can’t control or they don’t like.Especially, when children with ASD need to learn challenging tasks, such us Chinese language, their inappropriate behaviors will occur apparently. Recently, researchers apply positive behavior support strategies for children with ASD to enhance their self-efficacy and therefore to reduce their adverse behaviors. Thus, the purpose of this research was to design a series of lecture based on art therapy and to evaluate its effectiveness on the child’s self-efficacy. Method: This research was the single-case design study that recruited a high school boy with ASD. Whole research can be separated into three conditions. First, baseline condition, before the class started and ended, the researcher collected participant’s competencies of self-efficacy every session. In intervention condition, the research used dramatic conventions to teach the child in Chinese language twice a week.When the data was stable across three documents, the period entered to the maintenance condition. In maintenance condition, the researcher only collected the score of self-efficacynot to do other interventions five times a month to represent the effectiveness of maintenance.The time and frequency of data collection among three conditions are identical. Concerning art therapy, the common approach, e.g., music, drama, or painting is to use art medium as independent variable. Due to visual cues of art medium, the ASD can be easily to gain joint attention with teachers. Besides, the ASD have difficulties in understanding abstract objectives Thus, using the drama convention is helpful for the ASD to construct the environment and understand the context of Classical Chinese. By real operation, it can improve the ASD to understand the context and construct prior knowledge. Result: Bassd on the 10-points Likert scale and research, we product following results. (a) In baseline condition, the average score of self-efficacyis 1.12 points, rangedfrom 1 to 2 points, and the level change is 0 point. (b)In intervention condition, the average score of self-efficacy is 7.66 points rangedfrom 7 to 9 points, and the level change is 1 point. (c)In maintenance condition, the average score of self-efficacy is 6.66 points rangedfrom 6 to 7 points, and the level change is 1 point. Concerning immediacy of change, between baseline and intervention conditions, the difference is 5 points. No overlaps were found between these two conditions. Conclusion: According to the result, we find that it is effective that using dramatic conventions a s teaching strategies to teach children with ASD. The result presents the score of self-efficacyimmediately enhances when the dramatic conventions commences. Thus, we suggest the teacher can use this approach and adjust, based on the student’s trait, to teach the ASD on difficult task.

Keywords: dramatic conventions, autism spectrum disorder, slef-efficacy, teaching strategy

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754 Effect of Exercise and Mindfulness on Cognitive and Psycho-Emotional Functioning in Children with ADHD

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

Abstract:

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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753 Self-Regulation and School Adjustment of Students with Autism Spectrum Disorder in Hong Kong

Authors: T. S. Terence Ma, Irene T. Ho

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Conducting adequate assessment of the challenges students with ASD (Autism Spectrum Disorder) face and the support they need is imperative for promoting their school adjustment. Students with ASD often show deficits in communication, social interaction, emotional regulation, and self-management in learning. While targeting these areas in intervention is often helpful, we argue that not enough attention has been paid to weak self-regulation being a key factor underlying their manifest difficulty in all these areas. Self-regulation refers to one’s ability to moderate their behavioral or affective responses without assistance from others. Especially for students with high functioning autism, who often show problems not so much in acquiring the needed skills but rather in applying those skills appropriately in everyday problem-solving, self-regulation becomes a key to successful adjustment in daily life. Therefore, a greater understanding of the construct of self-regulation, its relationship with other daily skills, and its role in school functioning for students with ASD would generate insights on how students’ school adjustment could be promoted more effectively. There were two focuses in this study. Firstly, we examined the extent to which self-regulation is a distinct construct that is differentiable from other daily skills and the most salient indicators of this construct. Then we tested a model of relationships between self-regulation and other daily school skills as well as their relative and combined effects on school adjustment. A total of 1,345 Grade1 to Grade 6 students with ASD attending mainstream schools in Hong Kong participated in the research. In the first stage of the study, teachers filled out a questionnaire consisting of 136 items assessing a wide range of student skills in social, emotional and learning areas. Results from exploratory factor analysis (EFA) with 673 participants and subsequent confirmatory factor analysis (CFA) with another group of 672 participants showed that there were five distinct factors of school skills, namely (1) communication skills, (2) pro-social behavior, (3) emotional skills, (4) learning management, and (5) self-regulation. Five scales representing these skill dimensions were generated. In the second stage of the study, a model postulating the mediating role of self-regulation for the effects of the other four types of skills on school adjustment was tested with structural equation modeling (SEM). School adjustment was defined in terms of the extent to which the student is accepted well in school, with high engagement in school life and self-esteem as well as good interpersonal relationships. A 5-item scale was used to assess these aspects of school adjustment. Results showed that communication skills, pro-social behavior, emotional skills and learning management had significant effects on school adjustment only indirectly through self-regulation, and their total effects were found to be not high. The results indicate that support rendered to students with ASD focusing only on the training of well-defined skills is not adequate for promoting their inclusion in school. More attention should be paid to the training of self-management with an emphasis on the application of skills backed by self-regulation. Also, other non-skill factors are important in promoting inclusive education.

Keywords: autism, assessment, factor analysis, self-regulation, school adjustment

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752 The Effectiveness of Therapeutic Exercise on Motor Skills and Attention of Male Students with Autism Spectrum Disorder

Authors: Masoume Pourmohamadreza-Tajrishi, Parviz Azadfallah

Abstract:

Autism spectrum disorders (ASD) involve myriad aberrant perceptual, cognitive, linguistic, and social behaviors. The term spectrum emphasizes that the disabilities associated with ASD fall on a continuum from relatively mild to severe. People with ASD may display stereotyped behaviors such as twirling, spinning objects, flapping the hands, and rocking. The individuals with ASD exhibit communication problems due to repetitive/restricted behaviors. Children with ASD who lack the motivation to learn, who do not enjoy physical challenges, or whose sensory perception results in confusing or unpleasant feedback from movement may not become sufficiently motivated to practice motor activities. As a result, they may show both a delay in developing certain motor skills. Additionally, attention is an important component of learning. As far as children with ASD have problems in joint attention, many education-based programs are needed to consider some aspects of attention and motor activities development for students with ASD. These programs focus on the basic movement skills that are crucial for the future development of the more complex skills needed in games, dance, sports, gymnastics, active play, and recreational physical activities. The purpose of the present research was to determine the effectiveness of therapeutic exercise on motor skills and attention of male students with ASD. This was an experimental study with a control group. The population consisted of 8-10 year-old male students with ASD and 30 subjects were selected randomly from an available center suitable for the children with ASD. They were evaluated by the Basic Motor Ability Test (BMAT) and Persian version of computerized Stroop color-word test and randomly assigned to an experimental and control group (15 students in per group). The experimental group participated in 16 therapeutic exercise sessions and received therapeutic exercise program (twice a week; each lasting for 45 minutes) designed based on the Spark motor program while the control group did not. All subjects were evaluated by BMAT and Stroop color-word test after the last session again. The collected data were analyzed by using multivariate analysis of covariance (MANCOVA). The results of MANCOVA showed that experimental and control groups had a significant difference in motor skills and at least one of the components of attention (correct responses, incorrect responses, no responses, the reaction time of congruent words and reaction time of incongruent words in the Stroop test). The findings showed that the therapeutic exercise had a significant effect on motor skills and all components of attention in students with ASD. We can conclude that the therapeutic exercise led to promote the motor skills and attention of students with ASD, so it is necessary to design or plan such programs for ASD students to prevent their communication or academic problems.

Keywords: Attention, autism spectrum disorder, motor skills, therapeutic exercise

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751 An Evaluation of the Influence of Corn Cob Ash on the Strength Parameters of Lateritic SoiLs

Authors: O. A. Apampa, Y. A. Jimoh

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The paper reports the investigation of Corn Cob Ash as a chemical stabilizing agent for laterite soils. Corn cob feedstock was obtained from Maya, a rural community in the derived savannah agro-ecological zone of South-Western Nigeria and burnt to ashes of pozzolanic quality. Reddish brown silty clayey sand material characterized as AASHTO A-2-6(3) lateritic material was obtained from a borrow pit in Abeokuta and subjected to strength characterization tests according to BS 1377: 2000. The soil was subsequently mixed with CCA in varying percentages of 0-7.5% at 1.5% intervals. The influence of CCA stabilized soil was determined for the Atterberg limits, compaction characteristics, CBR and the unconfined compression strength. The tests were repeated on laterite cement-soil mixture in order to establish a basis for comparison. The result shows a similarity in the compaction characteristics of soil-cement and soil-CCA. With increasing addition of binder from 1.5% to 7.5%, Maximum Dry Density progressively declined while the OMC steadily increased. For the CBR, the maximum positive impact was observed at 1.5% CCA addition at a value of 85% compared to the control value of 65% for the cement stabilization, but declined steadily thereafter with increasing addition of CCA, while that of soil-cement continued to increase with increasing addition of cement beyond 1.5% though at a relatively slow rate. Similar behavior was observed in the UCS values for the soil-CCA mix, increasing from a control value of 0.4 MN/m2 to 1.0 MN/m2 at 1.5% CCA and declining thereafter, while that for soil-cement continued to increase with increasing cement addition, but at a slower rate. This paper demonstrates that CCA is effective for chemical stabilization of a typical Nigerian AASHTO A-2-6 lateritic soil at maximum stabilizer content limit of 1.5% and therefore recommends its use as a way of finding further application for agricultural waste products and achievement of environmental sustainability in line with the ideals of the millennium development goals because of the economic and technical feasibility of the processing of the cobs from corn.

Keywords: corn cob ash, pozzolan, cement, laterite, stabilizing agent, cation exchange capacity

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750 Calculation of Lattice Constants and Band Gaps for Generalized Quasicrystals of InGaN Alloy: A First Principle Study

Authors: Rohin Sharma, Sumantu Chaulagain

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This paper presents calculations of total energy of InGaN alloy carried out in a disordered quasirandom structure for a triclinic super cell. This structure replicates the disorder and composition effect in the alloy. First principle calculations within the density functional theory with the local density approximation approach is employed to accurately determine total energy of the system. Lattice constants and band gaps associated with the ground states are then estimated for different concentration ratios of the alloy. We provide precise results of quasirandom structures of the alloy and their lattice constants with the total energy and band gap energy of the system for the range of seven different composition ratios and their respective lattice parameters.

Keywords: DFT, ground state, LDA, quasicrystal, triclinic super cell

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749 Carbon-Based Electrodes for Parabens Detection

Authors: Aniela Pop, Ianina Birsan, Corina Orha, Rodica Pode, Florica Manea

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Carbon nanofiber-epoxy composite electrode has been investigated through voltammetric and amperometric techniques in order to detect parabens from aqueous solutions. The occurrence into environment as emerging pollutants of these preservative compounds has been extensively studied in the last decades, and consequently, a rapid and reliable method for their quantitative quantification is required. In this study, methylparaben (MP) and propylparaben (PP) were chosen as representatives for paraben class. The individual electrochemical detection of each paraben has been successfully performed. Their electrochemical oxidation occurred at the same potential value. Their simultaneous quantification should be assessed electrochemically only as general index of paraben class as a cumulative signal corresponding to both MP and PP from solution. The influence of pH on the electrochemical signal was studied. pH ranged between 1.3 and 9.0 allowed shifting the detection potential value to smaller value, which is very desired for the electroanalysis. Also, the signal is better-defined and higher sensitivity is achieved. Differential-pulsed voltammetry and square-wave voltammetry were exploited under the optimum pH conditions to improve the electroanalytical performance for the paraben detection. Also, the operation conditions were selected, i.e., the step potential, modulation amplitude and the frequency. Chronomaprometry application as the easiest electrochemical detection method led to worse sensitivity, probably due to a possible fouling effect of the electrode surface. The best electroanalytical performance was achieved by pulsed voltammetric technique but the selection of the electrochemical technique is related to the concrete practical application. A good reproducibility of the voltammetric-based method using carbon nanofiber-epoxy composite electrode was determined and no interference effect was found for the cation and anion species that are common in the water matrix. Besides these characteristics, the long life-time of the electrode give to carbon nanofiber-epoxy composite electrode a great potential for practical applications.

Keywords: carbon nanofiber-epoxy composite electrode, electroanalysis, methylparaben, propylparaben

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748 Implication of Attention Deficit and Task Avoidance on the Mathematics Performance of Pupils with Intellectual Disabilities

Authors: Matthew Bamidele Ojuawo

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To some parents, task avoidance implies the time when argument ensues between parents and their children in order to get certain things done correctly without being forced. However, some children avoid certain task because of the fears that it is too hard or cannot be done without parental help. Laziness plays a role in task avoidance when children do not want to do something because they do not feel like it is easy enough or if they just want their parent help them get it over with more quickly. Children with attention deficit disorder more often have difficulties with social skills, such as social interaction and forming and maintaining friendships. The focus of this study is how task avoidance and attention deficit have effect on the mathematics performance of pupils in the lower basic classroom. Mathematics performance of pupils with learning disabilities has been seriously low due to avoidance of task and attention deficit posed as carried out in the previous researches, but the research has not been carried out in the lower basic classroom in Oyo, Oyo state, Nigeria.

Keywords: task avoidance, parents, children with attention deficit, mathematics

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747 Body Image Dissatisfaction of Females: A Holistic Therapeutic Approach

Authors: Katy Eleanor Addinall

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Women’s body image dissatisfaction is a widespread problem, and it is present in all age groups, on every socioeconomic level, in all occupations, all cultures, and religions. Body image dissatisfaction is a broad term that is used to vary from normal discontent of a woman about one or more of her physical attributes to extreme negative causes, for example, an eating disorder. South African women were examined, and an empirical qualitative study was done to evaluate the women’s thoughts and feelings regarding their bodies. The causes and effects of body image dissatisfaction were examined, and social science literature was used to determine the etiology of body image dissatisfaction, which confirmed that it is multifactorial. A variety of therapeutic aids were studied, and cognitive behavioural therapy appeared to be the most effective. Every woman is an individual with an individual body image and must be approached as an individual holistic being. Thus, a holistic pragmatic model was developed as a possible aid in the woman’s healing process.

Keywords: body, body image, females, woman, therapy, dissatisfaction, holistic, cognitive behavioural therapy

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746 Stability of Total Phenolic Concentration and Antioxidant Capacity of Extracts from Pomegranate Co-Products Subjected to In vitro Digestion

Authors: Olaniyi Fawole, Umezuruike Opara

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Co-products obtained from pomegranate juice processing contain high levels of polyphenols with potential high added values. From value-addition viewpoint, the aim of this study was to evaluate the stability of polyphenolic concentrations in pomegranate fruit co-products in different solvent extracts and assess the effect on the total antioxidant capacity using the FRAP, DPPH˙ and ABTS˙+ assays during simulated in vitro digestion. Pomegranate juice, marc and peel were extracted in water, 50% ethanol (50%EtOH) and absolute ethanol (100%EtOH) and analysed for total phenolic concentration (TPC), total flavonoids concentration (TFC) and total antioxidant capacity in DPPH˙, ABST˙+ and FRAP assays before and after in vitro digestion. Total phenolic concentration (TPC) and total flavonoid concentration (TFC) were in the order of peel > marc > juice throughout the in vitro digestion irrespective of the extraction solvents used. However, 50% ethanol extracted 1.1 to 12-fold more polyphenols than water and ethanol solvents depending on co-products. TPC and TFC increased significantly in gastric digests. In contrast, after the duodenal, polyphenolic concentrations decreased significantly (p < 0.05) compared to those obtained in gastric digests. Undigested samples and gastric digests showed strong and positive relationships between polyphenols and the antioxidant activities measured in DPPH, ABTS and FRAP assays, with correlation coefficients (r2) ranging between 0.930 – 0.990 whereas, the correlation between polyphenols (TPC and TFC) and radical cation scavenging activity (in ABTS) were moderately positive in duodenal digests. Findings from this study also showed that the concentration of pomegranate polyphenols and antioxidant thereof during in vitro gastro-intestinal digestion may not reflect the pre-digested phenolic concentration. Thus, this study highlights the need to provide biologically relevant information on antioxidants by providing data reflecting their stability and activity after in vitro digestion.

Keywords: by-product, DPPH, polyphenols, value addition

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745 Solubility of Carbon Dioxide in Methoxy and Nitrile-Functionalized Ionic Liquids

Authors: D. A. Bruzon, G. Tapang, I. S. Martinez

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Global warming and climate change are significant environmental concerns, which require immediate global action in carbon emission mitigation. The capture, sequestration, and conversion of carbon dioxide to other products such as methane or ethanol are ways to control excessive emissions. Ionic liquids have shown great potential among the materials studied as carbon capture solvents and catalysts in the reduction of CO2. In this study, ionic liquids comprising of a methoxy (-OCH3) and cyano (-CN) functionalized imidazolium cation, [MOBMIM] and [CNBMIM] respectively, paired with tris(pentafluoroethyl)trifluorophosphate [FAP] anion were evaluated as effective capture solvents, and organocatalysts in the reduction of CO2. An in-situ electrochemical set-up, which can measure controlled amounts of CO2 both in the gas and in the ionic liquid phase, was used. Initially, reduction potentials of CO2 in the CO2-saturated ionic liquids containing the internal standard cobaltocene were determined using cyclic voltammetry. Chronoamperometric transients were obtained at potentials slightly less negative than the reduction potentials of CO2 in each ionic liquid. The time-dependent current response was measured under a controlled atmosphere. Reduction potentials of CO2 in methoxy and cyano-functionalized [FAP] ionic liquids were observed to occur at ca. -1.0 V (vs. Cc+/Cc), which was significantly lower compared to the non-functionalized analog [PMIM][FAP], with an observed reduction potential of CO2 at -1.6 V (vs. Cc+/Cc). This decrease in the potential required for CO2 reduction in the functionalized ionic liquids shows that the functional groups methoxy and cyano effectively decreased the free energy of formation of the radical anion CO2●⁻, suggesting that these electrolytes may be used as organocatalysts in the reduction of the greenhouse gas. However, upon analyzing the solubility of the gas in each ionic liquid, [PMIM][FAP] showed the highest absorption capacity, at 4.81 mM under saturated conditions, compared to [MOBMIM][FAP] at 1.86 mM, and [CNBMIM][FAP] at 0.76 mM. Also, calculated Henry’s constant determined from the concentration-pressure graph of each functionalized ionic liquid shows that the groups -OCH3 and -CN attached terminal to a C4 alkyl chain do not significantly improve CO2 solubility.

Keywords: carbon capture, CO2 reduction, electrochemistry, ionic liquids

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744 Functional Dyspepsia and Irritable Bowel Syndrome: Life sketches of Functional Illnesses (Non-Organic) in West Bengal, India

Authors: Urmita Chakraborty

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To start with, Organic Illnesses are no longer considered as only health difficulties. Functional Illnesses that are emotional in origin have become the search areas in many investigations. In the present study, an attempt has made to study the psychological nature of Functional Gastro-Intestinal Disorders (FGID) in West Bengal. In the specialty of Gastroenterology, the medically unexplained symptom-based conditions are known as Functional Gastrointestinal Disorder (FGID). In the present study, Functional Dyspepsia (FD) and Irritable Bowel Syndrome (IBS) have been taken for investigations. 72 cases have been discussed in this context. Results of the investigation have been analyzed in terms of a qualitative framework. Theoretical concepts on persistent thoughts and behaviors will be delineated in the analysis. Processes of self-categorization will be implemented too. Aspects of Attachments and controlling of affect as well as meta-cognitive appraisals are further considered for the depiction.

Keywords: functional dyspepsia, irritable bowel syndrome, self-categorization

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743 Effectiveness of Dry Needling on Pain and Pressure Point Threshold in Cervicogenic Headache

Authors: Ramesh Chandra Patra, Ajay P. Gautam, Patitapaban Mohanty

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Headache disorders are one of the 10 most disabling conditions for men and women. Headache that originated from upper cervical spine and refereed to the one side of the head and/or face is known as cervicogenic headache (CH) which constitute15% to 20% among all the headaches. In our best knowledge manual therapy is often advocated for managing CH, but very little focus given on muscle system although it is a musculoskeletal disorder. In this study, 75 patients with CH were selected and divided into two groups Group A: Manual therapy and Group B: dry needling along with manual therapy group. Assessment was done using NPRS (0-10) for pain, wide spread pressure pain threshold using an algometer at the beginning and end of the study. There is a consistent reduction in pain and tenderness in both the group but significant improvement was shown in combined group. Outcome of the study has explored that the effectiveness of dry needling along with Mulligan is more beneficial in patients with cervicogenic headaches.

Keywords: cervicogenic headaches, dry needling, NPRS, pressure point threshold

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742 Neuropsychological Aspects in Adolescents Victims of Sexual Violence with Post-Traumatic Stress Disorder

Authors: Fernanda Mary R. G. Da Silva, Adriana C. F. Mozzambani, Marcelo F. Mello

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Introduction: Sexual assault against children and adolescents is a public health problem with serious consequences on their quality of life, especially for those who develop post-traumatic stress disorder (PTSD). The broad literature in this research area points to greater losses in verbal learning, explicit memory, speed of information processing, attention and executive functioning in PTSD. Objective: To compare the neuropsychological functions of adolescents from 14 to 17 years of age, victims of sexual violence with PTSD with those of healthy controls. Methodology: Application of a neuropsychological battery composed of the following subtests: WASI vocabulary and matrix reasoning; Digit subtests (WISC-IV); verbal auditory learning test RAVLT; Spatial Span subtest of the WMS - III scale; abbreviated version of the Wisconsin test; concentrated attention test - D2; prospective memory subtest of the NEUPSILIN scale; five-digit test - FDT and the Stroop test (Trenerry version) in adolescents with a history of sexual violence in the previous six months, referred to the Prove (Violence Care and Research Program of the Federal University of São Paulo), for further treatment. Results: The results showed a deficit in the word coding process in the RAVLT test, with impairment in A3 (p = 0.004) and A4 (p = 0.016) measures, which compromises the verbal learning process (p = 0.010) and the verbal recognition memory (p = 0.012), seeming to present a worse performance in the acquisition of verbal information that depends on the support of the attentional system. A worse performance was found in list B (p = 0.047), a lower priming effect p = 0.026, that is, lower evocation index of the initial words presented and less perseveration (p = 0.002), repeated words. Therefore, there seems to be a failure in the creation of strategies that help the mnemonic process of retention of the verbal information necessary for learning. Sustained attention was found to be impaired, with greater loss of setting in the Wisconsin test (p = 0.023), a lower rate of correct responses in stage C of the Stroop test (p = 0.023) and, consequently, a higher index of erroneous responses in C of the Stroop test (p = 0.023), besides more type II errors in the D2 test (p = 0.008). A higher incidence of total errors was observed in the reading stage of the FDT test p = 0.002, which suggests fatigue in the execution of the task. Performance is compromised in executive functions in the cognitive flexibility ability, suggesting a higher index of total errors in the alternating step of the FDT test (p = 0.009), as well as a greater number of persevering errors in the Wisconsin test (p = 0.004). Conclusion: The data from this study suggest that sexual violence and PTSD cause significant impairment in the neuropsychological functions of adolescents, evidencing risk to quality of life in stages that are fundamental for the development of learning and cognition.

Keywords: adolescents, neuropsychological functions, PTSD, sexual violence

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741 Effect of the Structural Parameters on Subbands of Fibonacci AlxGa1-xAs/GaAs Superlattices

Authors: Y. Sefir, Z. Aziz, S. Cherid, Z. F. Meghoufel, F. Bendahama, S. Terkhi, B. Bouadjemi. A. Zitouni S. Bentata

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This work is to study the effect of the variation of structural parameters on the band structure in the quasiperiodic Fibonacci superlattices AlxGa1-xAs/GaAs using the formalism of the transfer matrix and Airy function. Our results show that increasing the width of Fibonacci’s wells of allows to the confinement of subminibands with a widening of minigaps, this causes a consistent and coherent fragmentation. The barrier thickness of Fibonacci bf acts on the width of subminibands by controlling the interaction force between neighboring eigenstates. Its increase gives rise to singularly extended states. The barrier height Fibonacci Vf permit to control the degree of structural disorder in these structures. The variation of these parameters permits the design of laser with modulated wavelength.

Keywords: transmission coefficient – Quasiperiodic superlattices- singularly localized and extended states- structural parameters- Laser with modulated wavelength

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740 Mood Symptom Severity in Service Members with Posttraumatic Stress Symptoms after Service Dog Training

Authors: Tiffany Riggleman, Andrea Schultheis, Kalyn Jannace, Jerika Taylor, Michelle Nordstrom, Paul F. Pasquina

Abstract:

Introduction: Posttraumatic Stress (PTS) and Posttraumatic Stress Disorder (PTSD) remain significant problems for military and veteran communities. Symptoms of PTSD often include poor sleep, intrusive thoughts, difficulty concentrating, and trouble with emotional regulation. Unfortunately, despite its high prevalence, service members diagnosed with PTSD often do not seek help, usually because of the perceived stigma surrounding behavioral health care. To help address these challenges, non-pharmacological, therapeutic approaches are being developed to help improve care and enhance compliance. The Service Dog Training Program (SDTP), which involves teaching patients how to train puppies to become mobility service dogs, has been successfully implemented into PTS/PTSD care programs with anecdotal reports of improved outcomes. This study was designed to assess the biopsychosocial effects of SDTP from military beneficiaries with PTS symptoms. Methods: Individuals between the ages of 18 and 65 with PTS symptom were recruited to participate in this prospective study. Each subject completes 4 weeks of baseline testing, followed by 6 weeks of active service dog training (twice per week for one hour sessions) with a professional service dog trainer. Outcome measures included the Posttraumatic Stress Checklist for the DSM-5 (PCL-5), Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), social support/interaction, anthropometrics, blood/serum biomarkers, and qualitative interviews. Preliminary analysis of 17 participants examined mean scores on the GAD-7, PCL-5, and PHQ-9, pre- and post-SDTP, and changes were assessed using Wilcoxon Signed-Rank tests. Results: Post-SDTP, there was a statistically significant mean decrease in PCL-5 scores of 13.5 on an 80-point scale (p=0.03) and a significant mean decrease of 2.2 in PHQ-9 scores on a 27 point scale (p=0.04), suggestive of decreased PTSD and depression symptoms. While there was a decrease in mean GAD-7 scores post-SDTP, the difference was not significant (p=0.20). Recurring themes among results from the qualitative interviews include decreased pain, forgetting about stressors, improved sense of calm, increased confidence, improved communication, and establishing a connection with the service dog. Conclusion: Preliminary results of the first 17 participants in this study suggest that individuals who received SDTP had a statistically significant decrease in PTS symptom, as measured by the PCL-5 and PHQ-9. This ongoing study seeks to enroll a total of 156 military beneficiaries with PTS symptoms. Future analyses will include additional psychological outcomes, pain scores, blood/serum biomarkers, and other measures of the social aspects of PTSD, such as relationship satisfaction and sleep hygiene.

Keywords: post-concussive syndrome, posttraumatic stress, service dog, service dog training program, traumatic brain injury

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739 Understanding the Cause(S) of Social, Emotional and Behavioural Difficulties of Adolescents with ADHD and Its Implications for the Successful Implementation of Intervention(S)

Authors: Elisavet Kechagia

Abstract:

Due to the interplay of different genetic and environmental risk factors and its heterogeneous nature, the concept of attention deficit hyperactivity disorder (ADHD) has shaped controversy and conflicts, which have been, in turn, reflected in the controversial arguments about its treatment. Taking into account recent well evidence-based researches suggesting that ADHD is a condition, in which biopsychosocial factors are all weaved together, the current paper explores the multiple risk-factors that are likely to influence ADHD, with a particular focus on adolescents with ADHD who might experience comorbid social, emotional and behavioural disorders (SEBD). In the first section of this paper, the primary objective was to investigate the conflicting ideas regarding the definition, diagnosis and treatment of ADHD at an international level as well as to critically examine and identify the limitations of the two most prevailing sets of diagnostic criteria that inform current diagnosis, the American Psychiatric Association’s (APA) diagnostic scheme, DSM-V, and the World Health Organisation’s (WHO) classification of diseases, ICD-10. Taking into consideration the findings of current longitudinal studies on ADHD association with high rates of comorbid conditions and social dysfunction, in the second section the author moves towards an investigation of the transitional points −physical, psychological and social ones− that students with ADHD might experience during early adolescence, as informed by neuroscience and developmental contextualism theory. The third section is an exploration of the different perspectives of ADHD as reflected in individuals’ with ADHD self-reports and the KENT project’s findings on school staff’s attitudes and practices. In the last section, given the high rates of SEBDs in adolescents with ADHD, it is examined how cognitive behavioural therapy (CBT), coupled with other interventions, could be effective in ameliorating anti-social behaviours and/or other emotional and behavioral difficulties of students with ADHD. The findings of a range of randomised control studies indicate that CBT might have positive outcomes in adolescents with multiple behavioural problems, hence it is suggested to be considered both in schools and other community settings. Finally, taking into account the heterogeneous nature of ADHD, the different biopsychosocial and environmental risk factors that take place during adolescence and the discourse and practices concerning ADHD and SEBD, it is suggested how it might be possible to make sense of and meaningful improvements to the education of adolescents with ADHD within a multi-modal and multi-disciplinary whole-school approach that addresses the multiple problems that not only students with ADHD but also their peers might experience. Further research that would be based on more large-scale controls and would investigate the effectiveness of various interventions, as well as the profiles of those students who have benefited from particular approaches and those who have not, will generate further evidence concerning the psychoeducation of adolescents with ADHD allowing for generalised conclusions to be drawn.

Keywords: adolescence, attention deficit hyperctivity disorder, cognitive behavioural theory, comorbid social emotional behavioural disorders, treatment

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738 Isolation and Characterization of the First Known Inhibitor Cystine Knot Peptide in Sea Anemone: Inhibitory Activity on Acid-Sensing Ion Channels

Authors: Armando A. Rodríguez, Emilio Salceda, Anoland Garateix, André J. Zaharenko, Steve Peigneur, Omar López, Tirso Pons, Michael Richardson, Maylín Díaz, Yasnay Hernández, Ludger Ständker, Jan Tytgat, Enrique Soto

Abstract:

Acid-sensing ion channels are cation (Na+) channels activated by a pH drop. These proteins belong to the ENaC/degenerin superfamily of sodium channels. ASICs are involved in sensory perception, synaptic plasticity, learning, memory formation, cell migration and proliferation, nociception, and neurodegenerative disorders, among other processes; therefore those molecules that specifically target these channels are of growing pharmacological and biomedical interest. Sea anemones produce a large variety of ion channels peptide toxins; however, those acting on ligand-gated ion channels, such as Glu-gated, Ach-gated ion channels, and acid-sensing ion channels (ASICs), remain barely explored. The peptide PhcrTx1 is the first compound characterized from the sea anemone Phymanthus crucifer, and it constitutes a novel ASIC inhibitor. This peptide was purified by chromatographic techniques and pharmacologically characterized on acid-sensing ion channels of mammalian neurons using patch-clamp techniques. PhcrTx1 inhibited ASIC currents with an IC50 of 100 nM. Edman degradation yielded a sequence of 32 amino acids residues, with a molecular mass of 3477 Da by MALDI-TOF. No similarity to known sea anemone peptides was found in protein databases. The computational analysis of Cys-pattern and secondary structure arrangement suggested that this is a structurally ICK (Inhibitor Cystine Knot)-type peptide, a scaffold that had not been found in sea anemones but in other venomous organisms. These results show that PhcrTx1 represents the first member of a new structural group of sea anemones toxins acting on ASICs. Also, this peptide constitutes a novel template for the development of drugs against pathologies related to ASICs function.

Keywords: animal toxin, inhibitor cystine knot, ion channel, sea anemone

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737 Dynamic Foot Pressure Measurement System Using Optical Sensors

Authors: Tanapon Keatsamarn, Chuchart Pintavirooj

Abstract:

Foot pressure measurement provides necessary information for diagnosis diseases, foot insole design, disorder prevention and other application. In this paper, dynamic foot pressure measurement is presented for pressure measuring with high resolution and accuracy. The dynamic foot pressure measurement system consists of hardware and software system. The hardware system uses a transparent acrylic plate and uses steel as the base. The glossy white paper is placed on the top of the transparent acrylic plate and covering with a black acrylic on the system to block external light. Lighting from LED strip entering around the transparent acrylic plate. The optical sensors, the digital cameras, are underneath the acrylic plate facing upwards. They have connected with software system to process and record foot pressure video in avi file. Visual Studio 2017 is used for software system using OpenCV library.

Keywords: foot, foot pressure, image processing, optical sensors

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736 Joubert Syndrome: A Rare Genetic Disorder Reported in Kurdish Family

Authors: Aran Abd Al Rahman

Abstract:

Joubert syndrome regards as a congenital cerebellar ataxia caused by autosomal recessive carried on X chromosome. The disease diagnosed by brain imaging—the so-called molar tooth sign. Neurological signs were present from the neonatal period and include hypotonia progressing to ataxia, global developmental delay, ocular motor apraxia, and breathing dysregulation. These signs are variably associated with multiorgan involvement, mainly of the retina, kidneys, skeleton, and liver. 30 causative genes have been identified so far, all of which encode for proteins of the primary cilium or its apparatus, The purpose of our project was to detect the mutant gene (INPP5E gene) which cause Joubert syndrome. There were many methods used for diagnosis such as MRI and CT- scan and molecular diagnosis by doing ARMS PCR for detection of mutant gene that we were used in this research project. In this research for individual family which reported, the two children with parents, the two children were affected and were carrier.

Keywords: Joubert syndrome, genetic disease, Kurdistan region, Sulaimani

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735 Neuro-Connectivity Analysis Using Abide Data in Autism Study

Authors: Dulal Bhaumik, Fei Jie, Runa Bhaumik, Bikas Sinha

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Human brain is an amazingly complex network. Aberrant activities in this network can lead to various neurological disorders such as multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and autism. fMRI has emerged as an important tool to delineate the neural networks affected by such diseases, particularly autism. In this paper, we propose mixed-effects models together with an appropriate procedure for controlling false discoveries to detect disrupted connectivities in whole brain studies. Results are illustrated with a large data set known as Autism Brain Imaging Data Exchange or ABIDE which includes 361 subjects from 8 medical centers. We believe that our findings have addressed adequately the small sample inference problem, and thus are more reliable for therapeutic target for intervention. In addition, our result can be used for early detection of subjects who are at high risk of developing neurological disorders.

Keywords: ABIDE, autism spectrum disorder, fMRI, mixed-effects model

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734 Intensifying Approach for Separation of Bio-Butanol Using Ionic Liquid as Green Solvent: Moving Towards Sustainable Biorefinery

Authors: Kailas L. Wasewar

Abstract:

Biobutanol has been considered as a potential and alternative biofuel relative to the most popular biodiesel and bioethanol. End product toxicity is the major problems in commercialization of fermentation based process which can be reduce to some possible extent by removing biobutanol simultaneously. Several techniques have been investigated for removing butanol from fermentation broth such as stripping, adsorption, liquid–liquid extraction, pervaporation, and membrane solvent extraction. Liquid–liquid extraction can be performed with high selectivity and is possible to carry out inside the fermenter. Conventional solvents have few drawbacks including toxicity, loss of solvent, high cost etc. Hence alternative solvents must be explored for the same. Room temperature ionic liquids (RTILs) composed entirely of ions are liquid at room temperature having negligible vapor pressure, non-flammability, and tunable physiochemical properties for a particular application which term them as “designer solvents”. Ionic liquids (ILs) have recently gained much attention as alternatives for organic solvents in many processes. In particular, ILs have been used as alternative solvents for liquid–liquid extraction. Their negligible vapor pressure allows the extracted products to be separated from ILs by conventional low pressure distillation with the potential for saving energy. Morpholinium, imidazolium, ammonium, phosphonium etc. based ionic liquids have been employed for the separation biobutanol. In present chapter, basic concepts of ionic liquids and application in separation have been presented. Further, type of ionic liquids including, conventional, functionalized, polymeric, supported membrane, and other ionic liquids have been explored. Also the effect of various performance parameters on separation of biobutanol by ionic liquids have been discussed and compared for different cation and anion based ionic liquids. The typical methodology for investigation have been adopted such as contacting the equal amount of biobutanol and ionic liquids for a specific time say, 30 minutes to confirm the equilibrium. Further, biobutanol phase were analyzed using GC to know the concentration of biobutanol and material balance were used to find the concentration in ionic liquid.

Keywords: biobutanol, separation, ionic liquids, sustainability, biorefinery, waste biomass

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733 Psycho-Social Associates of Deliberate Self-Harm in Rural Sri Lanka

Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

Abstract:

Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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732 Impact of Motor Behaviour Aspects of Autism on Cognitive Ability in Children with Autism Spectrum Disorder

Authors: Rana Zeina

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Cognitive and behavioral symptoms may, in fact, overlap and be related to the level of the general cognitive function. We measured the behavioral aspects of autism and its correlation to the cognitive ability in 30 children with ASD. We used a neuropsychological battery CANTAB eclipse to evaluate the ASD children's cognitive ability. Individuals with ASDs and challenging behaviors showed significant correlation between some cognitive abilities and motor behavior aspects. Based on these findings we can conclude that the motor behavioral problems in autism affect specific cognitive abilities in ASDs such as comprehension, learning, reversal, acquisition, attention set shifting, and speed of reaction to one stimulus. Future research should also focus on the relationship between motor stereotypes and other subtypes of repetitive behaviors, such as verbal stereotypes, and ritual and routine adherence and use different types of CANTAB tests.

Keywords: cognitive ability, CANTAB test, behaviour motor aspects, autism spectrum disorders

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731 Risk and Protective Factors for the Health of Primary Care-Givers of Children with Autism Spectrum Disorders or Intellectual Disability: A Narrative Review and Discussion

Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

Abstract:

Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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730 A New Co(II) Metal Complex Template with 4-dimethylaminopyridine Organic Cation: Structural, Hirshfeld Surface, Phase Transition, Electrical Study and Dielectric Behavior

Authors: Mohamed dammak

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Great attention has been paid to the design and synthesis of novel organic-inorganic compounds in recent decades because of their structural variety and the large diversity of atomic arrangements. In this work, the structure for the novel dimethyl aminopyridine tetrachlorocobaltate (C₇H₁₁N₂)₂CoCl₄ prepared by the slow evaporation method at room temperature has been successfully discussed. The X-ray diffraction results indicate that the hybrid material has a triclinic structure with a P space group and features a 0D structure containing isolated distorted [CoCl₄]2- tetrahedra interposed between [C7H11N²⁻]+ cations forming planes perpendicular to the c axis at z = 0 and z = ½. The effect of the synthesis conditions and the reactants used, the interactions between the cationic planes, and the isolated [CoCl4]2- tetrahedra are employing N-H...Cl and C-H…Cl hydrogen bonding contacts. The inspection of the Hirshfeld surface analysis helps to discuss the strength of hydrogen bonds and to quantify the inter-contacts. A phase transition was discovered by thermal analysis at 390 K, and comprehensive dielectric research was reported, showing a good agreement with thermal data. Impedance spectroscopy measurements were used to study the electrical and dielectric characteristics over a wide range of frequencies and temperatures, 40 Hz–10 MHz and 313–483 K, respectively. The Nyquist plot (Z" versus Z') from the complex impedance spectrum revealed semicircular arcs described by a Cole-Cole model. An electrical circuit consisting of a link of grain and grain boundary elements is employed. The real and imaginary parts of dielectric permittivity, as well as tg(δ) of (C₇H₁₁N₂)₂CoCl₄ at different frequencies, reveal a distribution of relaxation times. The presence of grain and grain boundaries is confirmed by the modulus investigations. Electric and dielectric analyses highlight the good protonic conduction of this material.

Keywords: organic-inorganic, phase transitions, complex impedance, protonic conduction, dielectric analysis

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729 Evaluation of Coagulation State in Patients with End Stage Renal Disease (ESRD) by Thromboelastogram (TEG)

Authors: Mohammad Javad Esmaeili

Abstract:

Background: Coagulopathy is one of the complications with end stage renal disease with high prevalence in the world. Thromboelastogram is adynamic test for evaluation of coagulopathy and we have compared our patient's coagulation profiles with the results of TEG. Material and methods: In this study 50 patients with ESRD who were on regular hemodialysis for at least 6 months was selected with simple sampling and their coagulation profile was done with blood sampling and also TEG was done for every patient. Data were analyzed with SPSS and P<0.05 consider significant. Results: Protein s, Protein c and Antithrombin III deficiency was detected in 32%, 16% and 20% of patients and activated protein c resistance was abnormal in 2% of patients. In TEG, R time in 49% and K in 22/5% of patients was lower than normal and a-angle in 26% and maximum amplitude in 36% of patients was upper than normal (Hypercoagulable state). PS with R and ATIII with K have correlation. Conclusion: R time and K in TEG can be a suitable screening test in patients with suspicious to PS and ATIII deficiency.

Keywords: thromboelastography, chronic kidney disease, Coagulating disorder, hemodialysis

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728 Atypical Intoxication Due to Fluoxetine Abuse with Symptoms of Amnesia

Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

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