Search results for: cardiac rehabilitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1243

Search results for: cardiac rehabilitation

523 Dynamic Balance and Functional Performance in Total Hip Arthroplasty

Authors: Mahmoud Ghazy, Ahmed R. Z. Baghdadi

Abstract:

Background: With the perceived pain and poor function experienced following total hip Arthroplasty (THA), patients usually feel un-satisfied. Methods: Thirty patients with THA (group I) and thirty indicated for arthroplasty but weren’t operated on yet (group II) participated in the study. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and III respectively. The Berg Balance Scale (BBS), Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively and three months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs. Results: group I had significantly lower TUG and SC time compared with group II four weeks and three months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly four weeks and three months post-operatively compared with four weeks pre- operatively in group. But no significant differences in BBS scores four weeks and three months post-operatively in group I compared with group II. Interpretation/Conclusion : Patients with THA still have defects in proprioception, so they needs more concentration on proprioception training.

Keywords: dynamic balance, functional performance, hip arthroplasty, total

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522 Evaluating and Reflecting on Virtual Exercise Programs during the COVID-19 Pandemic

Authors: Teng Minnie Y., Jarus Tal, Wong Anita

Abstract:

Introduction: The COVID-19 pandemic has altered the lifestyle of all Canadians. While "stay-at-home" public health directives have been implemented to mitigate the spread of COVID-19, they may also lead to or worsen physical and social health challenges for older adults. In particular, older adults with disabilities are especially vulnerable. In response, we quickly adapted to virtual rehabilitation exercise intervention for older adults. Objectives: First, to identify the factors that influenced the acceptability and feasibility of virtual exercise implementation, and second, to evaluate whether the virtual delivery was effective for health promotion in older adults with disabilities. Methods: We carried out weekly virtual exercise programs from January 2021 to June 2021. We conducted semi-structured focus groups and interviews to explore the perspectives of participants who are older adults. The focus group and interview data are transcribed and coded thematically. Conclusions: The acceptability and feasibility of delivering exercises virtually were influenced by the provision of a safe and supportive environment for social connection, the availability of the necessary technology, and the role of the support system.

Keywords: physical activity, virtual exercises, older adults, people with disabilities

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521 Short-Term Effects of Environmentally Relevant Concentrations of Organic UV Filters on Signal Crayfish Pacifastacus Leniusculus

Authors: Viktoriia Malinovska, Iryna Kuklina, Katerina Grabicova, Milos Buric, Pavel Kozak

Abstract:

Personal care products, including organic UV filters, are considered emerging contaminants and their toxic effects have been a concern for the last decades. Sunscreen compounds continually enter the surface waters via sewage water treatment due to incomplete removal and during human recreational and laundry activities. Despite the environmental occurrence of organic UV filters in the freshwater environment, little is known about their impacts on aquatic biota. In this study, environmentally relevant concentrations of 5-Benzoyl-4-hydroxy-2-methoxybenzenesulfonic acid (BP-4, 2.5 µg/L) and 2-Phenylbenzimidazole-5-sulfonic acid (PBSA, 3 µg/L) were used to evaluate the cardiac and locomotor responses of signal crayfish Pacifastacus leniusculus during a short time period. The effects of these compounds were evident in experimental animals. Specimens exposed to both tested compounds exhibited significantly bigger changes in distance moved and time movement than controls. Significant differences in changes in mean heart rate were detected in both PBSA and BP-4 experimental groups compared to control groups. Such behavioral and physiological alterations demonstrate the ecological effects of selected sunscreen compounds during a short time period. Since the evidence of the impacts of sunscreen compounds is scarce, the knowledge of how organic UV filters influence aquatic organisms is of key importance for future research.

Keywords: aquatic pollutants, behavior, freshwaters, heart rate, invertebrate

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520 The Genetic Architecture Underlying Dilated Cardiomyopathy in Singaporeans

Authors: Feng Ji Mervin Goh, Edmund Chee Jian Pua, Stuart Alexander Cook

Abstract:

Dilated cardiomyopathy (DCM) is a common cause of heart failure. Genetic mutations account for 50% of DCM cases with TTN mutations being the most common, accounting for up to 25% of DCM cases. However, the genetic architecture underlying Asian DCM patients is unknown. We evaluated 68 patients (female= 17) with DCM who underwent follow-up at the National Heart Centre, Singapore from 2013 through 2014. Clinical data were obtained and analyzed retrospectively. Genomic DNA was subjected to next-generation targeted sequencing. Nextera Rapid Capture Enrichment was used to capture the exons of a panel of 169 cardiac genes. DNA libraries were sequenced as paired-end 150-bp reads on Illumina MiSeq. Raw sequence reads were processed and analysed using standard bioinformatics techniques. The average age of onset of DCM was 46.1±10.21 years old. The average left ventricular ejection fraction (LVEF), left ventricular diastolic internal diameter (LVIDd), left ventricular systolic internal diameter (LVIDs) were 26.1±11.2%, 6.20±0.83cm, and 5.23±0.92cm respectively. The frequencies of mutations in major DCM-associated genes were as follows TTN (5.88% vs published frequency of 20%), LMNA (4.41% vs 6%), MYH7 (5.88% vs 4%), MYH6 (5.88% vs 4%), and SCN5a (4.41% vs 3%). The average callability at 10 times coverage of each major gene were: TTN (99.7%), LMNA (87.1%), MYH7 (94.8%), MYH6 (95.5%), and SCN5a (94.3%). In conclusion, TTN mutations are not common in Singaporean DCM patients. The frequencies of other major DCM-associated genes are comparable to frequencies published in the current literature.

Keywords: heart failure, dilated cardiomyopathy, genetics, next-generation sequencing

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519 Phytochemical Screening, Anticancer, Antibacterial and Antioxidant Activities of the Leaf Extracts of Mabolo (Diospyros philippinensis A. DC.)

Authors: Jarel Elgin Tolentino, Arby Denise Nera, Mary Rose Roco, Angela Vianca Aspa, Nikko Beltran, Else Dapat

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Drug resistance by cells has been the problem in the medical field for decades now. The use of medicinal plants as a source of creating powerful drugs has been nowadays recognized worldwide to treat such resistant diseases. In the present study, the potential for Diospyros philippinensis A. DC. to inhibit growth of both bacteria and cancer cell line was conducted. The leaf crude extracts were screened for the presence of phytochemicals and examined for potential bioactivities by employing several assays like Kirby-Bauer disc diffusion method, DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) assay and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium assay for the antibacterial, antioxidant and cytotoxic activities of the extract, respectively. Phytochemical test results of the extracts revealed the presence of alkaloids, flavonoids, saponins, phenols, quinones, cardiac glycosides, phlobatannins, carbohydrate, cardenolides and proteins. The leaf extracts were found to exhibit antibacterial activity against gram-positive bacteria, high antioxidant activity (99.22% ± 0.005) but did not show any sign of cytotoxicity towards HCT116 (ATCC CCL-247). The study therefore concludes that D. philippinensis A. DC. leaf extract can be a source of antibacterial and chemopreventive agents. This claim may be used as basis for future investigation.

Keywords: bioassay, medicinal plants, plant crude extracts, phytochemical screening

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518 Ethnographic Exploration of Elderly Residents' Perceptions and Utilization of Health Care to Improve Their Quality of Life

Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

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The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: ethnographic study, health care needs, Malay elderly people, Malaysia, Quality of life, Residential home

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517 A Real Time Ultra-Wideband Location System for Smart Healthcare

Authors: Mingyang Sun, Guozheng Yan, Dasheng Liu, Lei Yang

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Driven by the demand of intelligent monitoring in rehabilitation centers or hospitals, a high accuracy real-time location system based on UWB (ultra-wideband) technology was proposed. The system measures precise location of a specific person, traces his movement and visualizes his trajectory on the screen for doctors or administrators. Therefore, doctors could view the position of the patient at any time and find them immediately and exactly when something emergent happens. In our design process, different algorithms were discussed, and their errors were analyzed. In addition, we discussed about a , simple but effective way of correcting the antenna delay error, which turned out to be effective. By choosing the best algorithm and correcting errors with corresponding methods, the system attained a good accuracy. Experiments indicated that the ranging error of the system is lower than 7 cm, the locating error is lower than 20 cm, and the refresh rate exceeds 5 times per second. In future works, by embedding the system in wearable IoT (Internet of Things) devices, it could provide not only physical parameters, but also the activity status of the patient, which would help doctors a lot in performing healthcare.

Keywords: intelligent monitoring, ultra-wideband technology, real-time location, IoT devices, smart healthcare

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516 Design of Demand Pacemaker Using an Embedded Controller

Authors: C. Bala Prashanth Reddy, B. Abhinay, C. Sreekar, D. V. Shobhana Priscilla

Abstract:

The project aims in designing an emergency pacemaker which is capable of giving shocks to a human heart which has stopped working suddenly. A pacemaker is a machine commonly used by cardiologists. This machine is used in order to shock a human’s heart back into usage. The way the heart works is that there are small cells called pacemakers sending electrical pulses to cardiac muscles that tell the heart when to pump blood. When these electrical pulses stop, the heart stops beating. When this happens, a pacemaker is used to shock the heart muscles and the pacemakers back into action. The way this is achieved is by rubbing the two panels of the pacemaker together to create an adequate electrical current, and then the heart gets back to the normal state. The project aims in designing a system which is capable of continuously displaying the heart beat and blood pressure of a person on LCD. The concerned doctor gets the heart beat and also the blood pressure details continuously through the GSM Modem in the form of SMS alerts. In case of abnormal condition, the doctor sends message format regarding the amount of electric shock needed. Automatically the microcontroller gives the input to the pacemaker which in turn gives the shock to the patient. Heart beat monitor and display system is a portable and a best replacement for the old model stethoscope which is less efficient. The heart beat rate is calculated manually using stethoscope where the probability of error is high because the heart beat rate lies in the range of 70 to 90 per minute whose occurrence is less than 1 sec, so this device can be considered as a very good alternative instead of a stethoscope.

Keywords: missing R wave, PWM, demand pacemaker, heart

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515 The Social Construction of the Family among the Survivors of Sex Trafficking

Authors: Nisha James, Shubha Ranganathan

Abstract:

Sex trafficking is a traumatic ongoing process which includes human rights violations against the victims. Majority of the trafficked individuals in India are from families with low socioeconomic status, from rural areas, unmarried or married off at a very young age. Many of the sex trafficked feel that it is necessary to make sacrifices, for the benefit of their families. The combination of these cultural family values with the stigma of rape and prostitution are manipulated and used as a tool in the abuse of power against the sex trafficked. The rescue, rehabilitation and reintegration of these individuals are usually difficult due to the stigma and social exclusion that they face. In these circumstances, social support is very effective in social inclusion of these individuals. The present study was a qualitative one, using semi-structured interviews with 29 Indian survivors of sex trafficking and a few sex workers. Thematic analysis was done on the data derived from the semi-structured interviews. The major findings indicate that the family can be seen as both the ‘cause’ for being sex trafficked, and the factor in victim continuing to be sex trafficked. At the same time, it can also become a driver for getting rescued, rehabilitated and reintegrated. The study also explores the social construction about ‘family’ among the survivors of sex trafficking, reflecting on who they refer to as ‘family’, what they mean by the term ‘family’ and how these families emerge. Therefore the analytic concept of ‘family’ is a crucial element in sex trafficking and cannot be defined only in terms of its conventional definition of a basic unit of society.

Keywords: sex-trafficking, survivor, family, social construction

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514 Diagnostic Value of Different Noninvasive Criteria of Latent Myocarditis in Comparison with Myocardial Biopsy

Authors: Olga Blagova, Yuliya Osipova, Evgeniya Kogan, Alexander Nedostup

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Purpose: to quantify the value of various clinical, laboratory and instrumental signs in the diagnosis of myocarditis in comparison with morphological studies of the myocardium. Methods: in 100 patients (65 men, 44.7±12.5 years) with «idiopathic» arrhythmias (n = 20) and dilated cardiomyopathy (DCM, n = 80) were performed 71 endomyocardial biopsy (EMB), 13 intraoperative biopsy, 5 study of explanted hearts, 11 autopsy with virus investigation (real-time PCR) of the blood and myocardium. Anti-heart antibodies (AHA) were also measured as well as cardiac CT (n = 45), MRI (n = 25), coronary angiography (n = 47). The comparison group included of 50 patients (25 men, 53.7±11.7 years) with non-inflammatory heart diseases who underwent open heart surgery. Results. Active/borderline myocarditis was diagnosed in 76.0% of the study group and in 21.6% of patients of the comparison group (p < 0.001). The myocardial viral genome was observed more frequently in patients of comparison group than in study group (group (65.0% and 40.2%; p < 0.01. Evaluated the diagnostic value of noninvasive markers of myocarditis. The panel of anti-heart antibodies had the greatest importance to identify myocarditis: sensitivity was 81.5%, positive and negative predictive value was 75.0 and 60.5%. It is defined diagnostic value of non-invasive markers of myocarditis and diagnostic algorithm providing an individual assessment of the likelihood of myocarditis is developed. Conclusion. The greatest significance in the diagnosis of latent myocarditis in patients with 'idiopathic' arrhythmias and DCM have AHA. The use of complex of noninvasive criteria allows estimate the probability of myocarditis and determine the indications for EMB.

Keywords: myocarditis, "idiopathic" arrhythmias, dilated cardiomyopathy, endomyocardial biopsy, viral genome, anti-heart antibodies

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513 Robust Heart Rate Estimation from Multiple Cardiovascular and Non-Cardiovascular Physiological Signals Using Signal Quality Indices and Kalman Filter

Authors: Shalini Rankawat, Mansi Rankawat, Rahul Dubey, Mazad Zaveri

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Physiological signals such as electrocardiogram (ECG) and arterial blood pressure (ABP) in the intensive care unit (ICU) are often seriously corrupted by noise, artifacts, and missing data, which lead to errors in the estimation of heart rate (HR) and incidences of false alarm from ICU monitors. Clinical support in ICU requires most reliable heart rate estimation. Cardiac activity, because of its relatively high electrical energy, may introduce artifacts in Electroencephalogram (EEG), Electrooculogram (EOG), and Electromyogram (EMG) recordings. This paper presents a robust heart rate estimation method by detection of R-peaks of ECG artifacts in EEG, EMG & EOG signals, using energy-based function and a novel Signal Quality Index (SQI) assessment technique. SQIs of physiological signals (EEG, EMG, & EOG) were obtained by correlation of nonlinear energy operator (teager energy) of these signals with either ECG or ABP signal. HR is estimated from ECG, ABP, EEG, EMG, and EOG signals from separate Kalman filter based upon individual SQIs. Data fusion of each HR estimate was then performed by weighing each estimate by the Kalman filters’ SQI modified innovations. The fused signal HR estimate is more accurate and robust than any of the individual HR estimate. This method was evaluated on MIMIC II data base of PhysioNet from bedside monitors of ICU patients. The method provides an accurate HR estimate even in the presence of noise and artifacts.

Keywords: ECG, ABP, EEG, EMG, EOG, ECG artifacts, Teager-Kaiser energy, heart rate, signal quality index, Kalman filter, data fusion

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512 A Brain Controlled Robotic Gait Trainer for Neurorehabilitation

Authors: Qazi Umer Jamil, Abubakr Siddique, Mubeen Ur Rehman, Nida Aziz, Mohsin I. Tiwana

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This paper discusses a brain controlled robotic gait trainer for neurorehabilitation of Spinal Cord Injury (SCI) patients. Patients suffering from Spinal Cord Injuries (SCI) become unable to execute motion control of their lower proximities due to degeneration of spinal cord neurons. The presented approach can help SCI patients in neuro-rehabilitation training by directly translating patient motor imagery into walkers motion commands and thus bypassing spinal cord neurons completely. A non-invasive EEG based brain-computer interface is used for capturing patient neural activity. For signal processing and classification, an open source software (OpenVibe) is used. Classifiers categorize the patient motor imagery (MI) into a specific set of commands that are further translated into walker motion commands. The robotic walker also employs fall detection for ensuring safety of patient during gait training and can act as a support for SCI patients. The gait trainer is tested with subjects, and satisfactory results were achieved.

Keywords: brain computer interface (BCI), gait trainer, spinal cord injury (SCI), neurorehabilitation

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511 Steps towards Changing Students' Attitudes to Disability

Authors: Farzaneh Yazdani, Nastaran Yazdani, Laya Nobakht

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The aim of this study was to explore the changes that may happen in students attitudes regarding disability after attending the module ‘Disability: theories, nature and experiences’ designed around reflective self-awareness exercises. Literature indicates enhanced knowledge does not automatically lead to changes in attitude. Health care professionals are the most significant people to instil hope in their clients to pursue a happy life. As an advocate for people with disability, health care professionals need to believe themselves in people with disability being able to pursue a happy life as an abled body does. Researchers aimed to explore the impact of the ‘Disability’ module using discussion and reflective exercises, on students’ way of thinking and possible changes in attitude towards disability. Students were asked to write stories from the beginning and after completing the module. A thematic analysis was applied to identify the students’ way of communicating their thoughts and feelings about disable-bodied /disability before and after the module. Three major themes were identified to represent the differences before and after attending the module as: problem /solution oriented approach towards perceived problems, separating/ integrating disable/able-bodied, passive/ active role of disable-bodied and society.

Keywords: qualitative study, reflection, rehabilitation, thematic analysis

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510 Investigation of Stress and Its Effects on Health Workers in Federal Medical Centres in Nigeria

Authors: Chisom N. Nwaigwe, Blessing N. Egbulefu, Angela Uwakwem

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A study on Stress and its’ effect on the health of workers in Federal Medical Centres in Nigeria is presented. The aim is to evaluate how much stress related hazards health workers in our tertiary health institutions are exposed to and to create awareness and reduce the rate at which stress affect the health of the working population in Nigeria, using workers in Federal Medical Centre, Umuahia as a case study. The descriptive survey design was adopted with the aid of 100 questionnaires delivered to the respondents in order to obtain first-hand information. From the findings, the major causes of stress were identified as inadequate staffing, unresolved family problems and psychological/cultural factors like the return of a lactating mother to work after three months post-delivery. The effects of stress on the workers were identified as hypertension, poor job performances, depression, asthma, and peptic ulcers. The study recommended instituting counseling units for stress management, holding seminars on stress management and increasing the salary scale (remuneration) and proper roster planning as solutions to stress reduction in our hospitals. This study is important to management in planning staffing, roaster, and a rehabilitation programme for her staff.

Keywords: stress, causes, effects, workers

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509 The Comparison of Backward and Forward Running Program on Balance Development and Plantar Flexion Force in Pre Seniors: Healthy Approach

Authors: Neda Dekamei, Mostafa Sarabzadeh, Masoumeh Bigdeli

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Backward running is commonly used in different sports conditioning, motor learning, and neurological purposes, and even more commonly in physical rehabilitation. The present study evaluated the effects of six weeks backward and forward running methods on balance promotion adaptation in students. 12 male and female preseniors with the age range of 45-60 years participated and were randomly classified into two groups of backward running (n: 6) and forward running (n: 6) training interventions. During six weeks, 3 sessions per week, all subjects underwent stated different models of backward and forward running training on treadmill (65-80 of HR max). Pre and post-tests were performed by force plate and electromyogram, two times before and after intervention. Data were analyzed using by T test. On the basis of obtained data, significant differences were recorded on balance and plantar flexion force in backward running (BR) and no difference for forward running (FR). It seems the training model of backward running can generate more stimulus to achieve better plantar flexion force and strengthening ankle protectors which leads to balance improvement in pre aging period. It can be recommended as an effective method to promote seniors life quality especially in balance neuromuscular parameters.

Keywords: backward running, balance, plantar flexion, pre seniors

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508 Development of a Diagnostic Device to Predict Clinically Significant Inflammation Associated with Cardiac Surgery

Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

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Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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507 Does Mirror Therapy Improve Motor Recovery After Stroke? A Meta-Analysis of Randomized Controlled Trials

Authors: Hassan Abo Salem, Guo Feng, Xiaolin Huang

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The objective of this study is to determine the effectiveness of mirror therapy on motor recovery and functional abilities after stroke. The following databases were searched from inception to May 2014: Cochrane Stroke, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, and PEDro. Two reviewers independently screened and selected all randomized controlled trials that evaluate the effect of mirror therapy in stroke rehabilitation.12 randomized controlled trials studies met the inclusion criteria; 10 studies utilized the effect of mirror therapy for the upper limb and 2 studies for the lower limb. Mirror therapy had a positive effect on motor recover and function; however, we found no consistent influence on activity of daily living, Spasticity and balance. This meta-analysis suggests that, Mirror therapy has additional effect on motor recovery but has a small positive effect on functional abilities after stroke. Further high-quality studies with greater statistical power are required in order to accurately determine the effectiveness of mirror therapy following stroke.

Keywords: mirror therapy, motor recovery, stroke, balance

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506 Effect of Inspiratory Muscle Training on Diaphragmatic Strength Following Coronary Revascularization

Authors: Abeer Ahmed Abdelhamed

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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

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505 Themes in Aesthetic Perceptions of Restorative Urban Landscapes

Authors: Rachel Bechtold, Catherine Shoulders, Donald Johnson, Jennie Popp, Elena Garcia, Lisa Wood

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Creating successfully restored urban landscapes involves both the sound design of natural resources and the incorporation of human perceptions of landscape. Moving forward with an invested interest from society is a challenge for the efficacy of reclaimed landscape design. In particular, urban areas present a dynamic environment wherein society and nature compete for resources and space. This review is meant to examine how perceptions of urban community members, the stakeholders for the plant species that share their environment, are reflected in aesthetic considerations. Findings from this literature review include themes of (1) aesthetic perceptions of stakeholders in rehabilitated landscapes and (2) the importance of organizing indicators of aesthetic perception for future design decisions. Recommendations include addressing the gap in research on aesthetic perceptions of reclaimed urban landscapes and addressing the lack of a consistent and widely accepted framework for these interdisciplinary studies. With knowledge of stakeholder perceptions, improved aesthetic and ecologic designs can more seamlessly merge into reclaimed urban landscapes.

Keywords: phytoremediation, urban landscape design, aesthetic perception, landscape ecology, phytorestoration, landscape reclamation, rehabilitation

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504 The Proximate Composition and Phytochemical Screening of Momordica Balsamina (Balsam Apple) Fruit and Leaves

Authors: Viruska Jaichand, John Jason Mellem, Viresh Mohanlall

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Malnutrition is a global issue that affects both children and adults, irrespective of their socio-economic status. It is, therefore, important to find various means to tackle malnutrition. This is especially important as undernutrition and overnutrition can be linked to a variety of non-communicable diseases (NCDs). This study aimed to gather more insight into the nutritional and phytochemical quality of Momordica balsamina leaves and fruit (fruit pericarp, fruit flesh and seeds). Results showed that Momordica balsamina had a nutritional composition that would be advantageous to the human diet. The nutritional quality is verified by the presence of a high protein percentage across all samples (19.72%-29.08%), with the leaves containing the highest protein content (29.08%±0.77). There was also a low-fat content present across all samples, which ranged from 1.03% to 2.40%. The ash content indicated the presence of total minerals to be adequate (2.93%-21.16%), where the pericarp had the highest ash quantity (21.16%±0.09). The moisture levels were low (7.11%-13.40%). Momordica balsamina seeds had the highest carbohydrate content (67.84%±0.30). Rich in the major phytoconstituents, Momordica balsamina extracts were found to contain alkaloids, saponins, cardiac glycosides, steroids and triterpenoids. Based on these findings, it can thus be said that the incorporation of Momordica balsamina into an individual’s diet could prevent diseases associated with malnutrition, as well as it could be used to supplement the human diet in managing certain NCDs. Even though there were a number of bioactive compounds detected, further studies which would correlate the phytochemical constituents detected in Momordica balsamina and its effectiveness in treating various diseases are recommended.

Keywords: momordica balsamina, nutrients, proximate composition, bioactive compounds, phytoconstituents

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503 Iterative Method for Lung Tumor Localization in 4D CT

Authors: Sarah K. Hagi, Majdi Alnowaimi

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In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.

Keywords: automated algorithm , computed tomography, lung tumor, tumor localization

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502 Psychological Security and Its Relationship with Self-Esteem among Adolescent with Mild Intellectual Disability

Authors: Muneera Abdul Haleem Bukhari, Maryam I. Alshirawi, Elsayed S. Elkhamisi

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This study aimed at understanding the relationship between psychological security and self-esteem among Adolescent with Mild Intellectual Disability, exploring the levels of psychological security and self-esteem, as well as determining the differences between genders in psychological security and self-esteem. The sample of the study contained (60) Adolescent with Mild Intellectual Disability, (34) males and (26) females who are enrolled in the Vocational and Social Rehabilitation Center and Hope Institute in the Kingdom of Bahrain. Their ages are between (15-23) years old. The Psychological Security Scale and self-Esteem Scale (prepared by James Battle) were used by the researcher. Results showed that levels of psychological security and self-esteem among Adolescents with Mild Intellectual Disability was above average; results also showed the order of the psychological security dimensions in the following manner (future outlook – mood - family security – social security) and the order of the dimensions of self-esteem in the following manner (social self-esteem – personal self-esteem – general self-esteem) among Adolescent with Mild Intellectual Disability; as for the differences between genders, the study showed that there was an increased level of psychological security among males. However, there was no difference in self-esteem between both sexes.

Keywords: psychological security, self-esteem, adolescent, intellectual disability, the Kingdom of Bahrain

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501 Performance Based Road Asset Evaluation

Authors: Kidus Dawit Gedamu

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Addis Ababa City Road Authority is responsible for managing and setting performance evaluation of the city’s road network using the International Roughness Index (IRI). This helps the authority to conduct pavement condition assessments of asphalt roads each year to determine the health status or Level of service (LOS) of the roadway network and plan program improvements such as maintenance, resurfacing and rehabilitation. For a lower IRI limit economical and acceptable maintenance strategy may be selected among a number of maintenance alternatives. The Highway Development and Management (HDM-4) tool can do such measures to help decide which option is the best by evaluating the economic and structural conditions. This paper specifically addresses flexible pavement, including two principal arterial streets under the administration of the Addis Ababa City Roads Authority. The roads include the road from Megenagna Interchange to Ayat Square and from Ayat Square to Tafo RA. First, it was assessed the procedures followed by the city's road authority to develop the appropriate road maintenance strategies. Questionnaire surveys and interviews are used to collect information from the city's road maintenance departments. Second, the project analysis was performed for functional and economic comparison of different maintenance alternatives using HDM-4.

Keywords: appropriate maintenance strategy, cost stream, road deterioration, maintenance alternative

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500 Characteristics of Autism Spectrum Disorder Patient and Perception of Caregiver Regarding Speech and Language Therapy in Bangladesh

Authors: K. M. Saif Ur Rahman, Razib Mamun, Himica Arjuman, Fida Al Shams

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Introduction: Autism spectrum disorder (ASD) has become an emerging neurodevelopmental disorder with increasing prevalence. It has become an important public health issue globally. Many approaches including speech and language therapy (SLT), occupational therapy, behavioral therapy etc. are being applied for the betterment of the ASD patients. This study aims to describe the characteristics of ASD patients and perception of caregiver regarding SLT in Bangladesh. Methods: This cross-sectional study was conducted in a therapy and rehabilitation center at Dhaka city. Caregivers of 48 ASD patients responded regarding their perception of SLT and characteristics of patients. Results: Among 48 ASD patients, 56.3% were between 3 to 5 years age group with a male predominance (87.5%). More than half of the participants (56.3%) initiated SLT at the age of 1-3 years and the majority (43.8%) were taking SLT for less than 1 year. Majority of the patients (64.6%) were taken to a physician for healthcare as a first contact of which 29.2% were referred to SLT by physicians. More than half (56.3%) of the caregivers were moderately satisfied with SLT and most of them (62.5%) mentioned moderate improvement through SLT. Improvement rate was 10-15% in specific symptoms such as eye contact, complex mannerism, pointing, imitation etc. Conclusion: This study reveals the self-reported perception of caregivers on SLT. Despite reported improvements, more exploration of different approaches and intervention for management of ASD is recommended.

Keywords: ASD, characteristics, SLT, Bangladesh

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499 Neoliberal Settler City: Socio-Spatial Segregation, Livelihood of Artists/Craftsmen in Delhi

Authors: Sophy Joseph

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The study uses the concept of ‘Settler city’ to understand the nature of peripheralization that a neoliberal city initiates. The settler city designs powerless communities without inherent rights, title and sovereignty. Kathputli Colony, home to generations of artists/craftsmen, who have kept heritage of arts/crafts alive, has undergone eviction of its population from urban space. The proposed study, ‘Neoliberal Settler City: Socio-spatial segregation and livelihood of artists/craftsmen in Delhi’ would problematize the settler city as a colonial technology. The colonial regime has ‘erased’ the ‘unwanted’ as primitive and swept them to peripheries in the city. This study would also highlight how structural change in political economy has undermined their crafts/arts by depriving them from practicing/performing it with dignity in urban space. The interconnections between citizenship and In-Situ Private Public Partnership in Kathputli rehabilitation has become part of academic exercise. However, a comprehensive study connecting inherent characteristics of neoliberal settler city, trajectory of political economy of unorganized workers - artists/craftsmen and legal containment and exclusion leading to dispossession and marginalization of communities from the city site, is relevant to contextualize the trauma of spatial segregation. This study would deal with political, cultural, social and economic dominant behavior of the structure in the state formation, accumulation of property and design of urban space, fueled by segregation of marginalized/unorganized communities and disowning the ‘footloose proletariat’, the migrant workforce. The methodology of study involves qualitative research amongst communities and the field work-oral testimonies and personal accounts- becomes the primary material to theorize the realities. The secondary materials in the forms of archival materials about historical evolution of Delhi as a planned city from various archives, would be used. As the study also adopt ‘narrative approach’ in qualitative study, the life experiences of craftsmen/artists as performers and emotional trauma of losing their livelihood and space forms an important record to understand the instability and insecurity that marginalization and development attributes on urban poor. The study attempts to prove that though there was a change in political tradition from colonialism to constitutional democracy, new state still follows the policy of segregation and dispossession of the communities. It is this dispossession from the space, deprivation of livelihood and non-consultative process in rehabilitation that reflects the neoliberal approach of the state and also critical findings in the study. This study would entail critical spatial lens analyzing ethnographic and sociological data, representational practices and development debates to understand ‘urban otherization’ against craftsmen/artists. This seeks to develop a conceptual framework for understanding the resistance of communities against primitivity attached with them and to decolonize the city. This would help to contextualize the demand for declaring Kathputli Colony as ‘heritage artists village’. The conceptualization and contextualization would help to argue for right to city of the communities, collective rights to property, services and self-determination. The aspirations of the communities also help to draw normative orientation towards decolonization. It is important to study this site as part of the framework, ‘inclusive cities’ because cities are rarely noted as important sites of ‘community struggles’.

Keywords: neoliberal settler city, socio-spatial segregation, the livelihood of artists/craftsmen, dispossession of indigenous communities, urban planning and cultural uprooting

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498 The Plight of the Rohingyas: Design Guidelines to Accommodate Displaced People in Bangladesh

Authors: Nazia Roushan, Maria Kipti

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The sensitive issue of a large-scale entry of Rohingya refugees to Bangladesh has arisen again since August of 2017. Incited by ethnic and religious conflict, the Rohingyas—an ethnic group concentrated in the north-west state of Rakhine in Myanmar—have been fleeing to what is now Bangladesh from as early as the late 1700s in four main exoduses. This long-standing persecution has recently escalated, and accommodating the recent wave of exodus has been especially challenging due to the sheer volume of a million refugees concentrated in refugee camps in two small administrative units (upazilas) in the south-east of the country: the host area. This drastic change in the host area’s social fabric is putting a lot of strain on the country’s economic, demographic and environmental stability, and security. Although Bangladesh’s long-term experience with disaster management has enabled it to respond rapidly to the crisis, the government is failing to cope with this enormous problem and has taken insufficient steps towards improving the living conditions to inhibit the inflow of more refugees. On top of that, the absence of a comprehensive national refugee policy, and the density of the structures of the camps are constricting the upgrading of the shelters to international standards. As of December 2016, the combined number of internally displaced persons (IDPs) due to conflict and violence (stock), and new displacements due to disasters (flow) in Bangladesh had exceeded 1 million. These numbers have increased dramatically in the last few months. Moreover, by 2050, Bangladesh will have as much as 25 million climate refugees just from its coastal districts. To enhance the resilience of the vulnerable, it is crucial to methodically factorize further interventions between Disaster Risk Reduction for Resilience (DRR) and the concept of Building Back Better (BBB) in the rehabilitation-reconstruction period. Considering these points, this paper provides a palette of options for design guidelines related to the living spaces and infrastructures for refugees. This will encourage the development of national standards for refugee camps, and the national and local level rehabilitation-reconstruction practices. Unhygienic living conditions, vulnerability, and the general lack of control over life are pervasive throughout the camps. This paper, therefore, proposes site-specific strategic and physical planning and design for shelters for refugees in Bangladesh that will lead to sustainable living environments through the following: a) site survey of existing two registered and one makeshift unregistered refugee camps to document and study their physical conditions, b) questionnaires and semi-structured focus group discussions carried out among the refugees and stakeholders to understand what the lived experiences and needs are; and c) combining the findings with international minimum standards for shelter and settlement from International Federation of Red Cross and Red Crescent (IFRC), Médecins Sans Frontières (MSF), United Nations High Commissioner for Refugees (UNHCR). These proposals include temporary shelter solutions that balance between lived spaces and regimented, repetitive plans using readily available and cheap materials, erosion control and slope stabilization strategies, and most importantly, coping mechanisms for the refugees to be self-reliant and resilient.

Keywords: architecture, Bangladesh, refugee camp, resilience, Rohingya

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497 Geochemistry of Nutrients in the South Lagoon of Tunis, Northeast of Tunisia, Using Multivariable Methods

Authors: Abidi Myriam, Ben Amor Rim, Gueddari Moncef

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Understanding ecosystem response to the restoration project is essential to assess its rehabilitation. Indeed, the time elapsed after restoration is a critical indicator to shows the real of the restoration success. In this order, the south lagoon of Tunis, a shallow Mediterranean coastal area, has witnessed several pollutions. To resolve this environmental problem, a large restoration project of the lagoon was undertaken. In this restoration works, the main changes are the decrease of the residence time of the lagoon water and the nutrient concentrations. In this paper, we attempt to evaluate the trophic state of lagoon water for evaluating the risk of eutrophication after almost 16 years of its restoration. To attend this objectives water quality monitoring was untaken. In order to identify and to analyze the natural and anthropogenic factor governing the nutrients concentrations of lagoon water geochemical methods and multivariate statistical tools were used. Results show that nutrients have duel sources due to the discharge of municipal wastewater of Megrine City in the south side of the lagoon. The Carlson index shows that the South lagoon of Tunis Lagoon Tunis is eutrophic, and may show limited summer anoxia.

Keywords: geochemistry, nutrients, statistical analysis, the south lagoon of Tunis, trophic state

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496 Interaction Effects of Vitamin D Supplementation and Aerobic Exercises on Balance and Physical Performance in Children with Down Syndrome

Authors: Mohamed A. Eid, Sobhy M. Aly, Marwa M. Ibrahim, Nadia L. Radwan

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To investigate the interaction effects of vitamin D supplementation combined with aerobic exercises (AE) and conventional physical therapy program (CPTP) on balance and physical performance in children with Down syndrome (DS).Methods: A randomized controlled trial was conducted for 38 children with DS, with ages ranging from 8 to 12 years. They were divided randomly to two groups. The control group (n=19) received the CPTP, while the study group (n=19) received the CPTP, AE, and vitamin D in the form of an oral daily dose of vitamin D3 400 IU (Cholecalciferol). Evaluation of balance by using the Biodex Stability System and physical performance by using the six-minute walk test (6MWT)was performed before and after 12 weeks of the treatment program. Findings: All groups showed a significant improvement in balance and physical performance after treatment (p < 0.05). The study group showed a significant improvement in balance and physical performancecompared with that of the control group (p < 0.05). Conclusion: Vitamin D supplementation combined with AE and CPTP could improve balance and physical performance in children with DS. Therefore, vitamin D and AEshould be considered as adjunctive to the rehabilitation program of these children.

Keywords: aerobic exercises, balance, down syndrome, physical performance, vitamin D

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495 Multi-Granularity Feature Extraction and Optimization for Pathological Speech Intelligibility Evaluation

Authors: Chunying Fang, Haifeng Li, Lin Ma, Mancai Zhang

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Speech intelligibility assessment is an important measure to evaluate the functional outcomes of surgical and non-surgical treatment, speech therapy and rehabilitation. The assessment of pathological speech plays an important role in assisting the experts. Pathological speech usually is non-stationary and mutational, in this paper, we describe a multi-granularity combined feature schemes, and which is optimized by hierarchical visual method. First of all, the difference granularity level pathological features are extracted which are BAFS (Basic acoustics feature set), local spectral characteristics MSCC (Mel s-transform cepstrum coefficients) and nonlinear dynamic characteristics based on chaotic analysis. Latterly, radar chart and F-score are proposed to optimize the features by the hierarchical visual fusion. The feature set could be optimized from 526 to 96-dimensions.The experimental results denote that new features by support vector machine (SVM) has the best performance, with a recognition rate of 84.4% on NKI-CCRT corpus. The proposed method is thus approved to be effective and reliable for pathological speech intelligibility evaluation.

Keywords: pathological speech, multi-granularity feature, MSCC (Mel s-transform cepstrum coefficients), F-score, radar chart

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494 Neural Networks for Distinguishing the Performance of Two Hip Joint Implants on the Basis of Hip Implant Side and Ground Reaction Force

Authors: L. Parisi

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In this research work, neural networks were applied to classify two types of hip joint implants based on the relative hip joint implant side speed and three components of each ground reaction force. The condition of walking gait at normal velocity was used and carried out with each of the two hip joint implants assessed. Ground reaction forces’ kinetic temporal changes were considered in the first approach followed but discarded in the second one. Ground reaction force components were obtained from eighteen patients under such gait condition, half of which had a hip implant type I-II, whilst the other half had the hip implant, defined as type III by Orthoload®. After pre-processing raw gait kinetic data and selecting the time frames needed for the analysis, the ground reaction force components were used to train a MLP neural network, which learnt to distinguish the two hip joint implants in the abovementioned condition. Further to training, unknown hip implant side and ground reaction force components were presented to the neural networks, which assigned those features into the right class with a reasonably high accuracy for the hip implant type I-II and the type III. The results suggest that neural networks could be successfully applied in the performance assessment of hip joint implants.

Keywords: kinemic gait data, neural networks, hip joint implant, hip arthroplasty, rehabilitation engineering

Procedia PDF Downloads 342