Search results for: drug therapy problems
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9489

Search results for: drug therapy problems

8649 Nanopharmaceutical: A Comprehensive Appearance of Drug Delivery System

Authors: Mahsa Fathollahzadeh

Abstract:

The various nanoparticles employed in drug delivery applications include micelles, liposomes, solid lipid nanoparticles, polymeric nanoparticles, functionalized nanoparticles, nanocrystals, cyclodextrins, dendrimers, and nanotubes. Micelles, composed of amphiphilic block copolymers, can encapsulate hydrophobic molecules, allowing for targeted delivery. Liposomes, vesicular structures made up of phospholipids, can encapsulate both hydrophobic and hydrophilic molecules, providing a flexible platform for delivering therapeutic agents. Solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) are designed to improve the stability and bioavailability of lipophilic drugs. Polymeric nanoparticles, such as poly(lactic-co-glycolic acid) (PLGA), are biodegradable and can be engineered to release drugs in a controlled manner. Functionalized nanoparticles, coated with targeting ligands or antibodies, can specifically target diseased cells or tissues. Nanocrystals, engineered to have specific surface properties, can enhance the solubility and bioavailability of poorly soluble drugs. Cyclodextrins, doughnut-shaped molecules with hydrophobic cavities, can be complex with hydrophobic molecules, allowing for improved solubility and bioavailability. Dendrimers, branched polymers with a central core, can be designed to deliver multiple therapeutic agents simultaneously. Nanotubes and metallic nanoparticles, such as gold nanoparticles, offer real-time tracking capabilities and can be used to detect biomolecular interactions. The use of these nanoparticles has revolutionized the field of drug delivery, enabling targeted and controlled release of therapeutic agents, reduced toxicity, and improved patient outcomes.

Keywords: nanotechnology, nanopharmaceuticals, drug-delivery, proteins, ligands, nanoparticles, chemistry

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8648 Elucidation of Dynamics of Murine Double Minute 2 Shed Light on the Anti-cancer Drug Development

Authors: Nigar Kantarci Carsibasi

Abstract:

Coarse-grained elastic network models, namely Gaussian network model (GNM) and Anisotropic network model (ANM), are utilized in order to investigate the fluctuation dynamics of Murine Double Minute 2 (MDM2), which is the native inhibitor of p53. Conformational dynamics of MDM2 are elucidated in unbound, p53 bound, and non-peptide small molecule inhibitor bound forms. With this, it is aimed to gain insights about the alterations brought to global dynamics of MDM2 by native peptide inhibitor p53, and two small molecule inhibitors (HDM201 and NVP-CGM097) that are undergoing clinical stages in cancer studies. MDM2 undergoes significant conformational changes upon inhibitor binding, carrying pieces of evidence of induced-fit mechanism. Small molecule inhibitors examined in this work exhibit similar fluctuation dynamics and characteristic mode shapes with p53 when complexed with MDM2, which would shed light on the design of novel small molecule inhibitors for cancer therapy. The results showed that residues Phe 19, Trp 23, Leu 26 reside in the minima of slowest modes of p53, pointing to the accepted three-finger binding model. Pro 27 displays the most significant hinge present in p53 and comes out to be another functionally important residue. Three distinct regions are identified in MDM2, for which significant conformational changes are observed upon binding. Regions I (residues 50-77) and III (residues 90-105) correspond to the binding interface of MDM2, including (α2, L2, and α4), which are stabilized during complex formation. Region II (residues 77-90) exhibits a large amplitude motion, being highly flexible, both in the absence and presence of p53 or other inhibitors. MDM2 exhibits a scattered profile in the fastest modes of motion, while binding of p53 and inhibitors puts restraints on MDM2 domains, clearly distinguishing the kinetically hot regions. Mode shape analysis revealed that the α4 domain controls the size of the cleft by keeping the cleft narrow in unbound MDM2; and open in the bound states for proper penetration and binding of p53 and inhibitors, which points to the induced-fit mechanism of p53 binding. P53 interacts with α2 and α4 in a synchronized manner. Collective modes are shifted upon inhibitor binding, i.e., second mode characteristic motion in MDM2-p53 complex is observed in the first mode of apo MDM2; however, apo and bound MDM2 exhibits similar features in the softest modes pointing to pre-existing modes facilitating the ligand binding. Although much higher amplitude motions are attained in the presence of non-peptide small molecule inhibitor molecules as compared to p53, they demonstrate close similarity. Hence, NVP-CGM097 and HDM201 succeed in mimicking the p53 behavior well. Elucidating how drug candidates alter the MDM2 global and conformational dynamics would shed light on the rational design of novel anticancer drugs.

Keywords: cancer, drug design, elastic network model, MDM2

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8647 Innovative Preparation Techniques: Boosting Oral Bioavailability of Phenylbutyric Acid Through Choline Salt-Based API-Ionic Liquids and Therapeutic Deep Eutectic Systems

Authors: Lin Po-Hsi, Sheu Ming-Thau

Abstract:

Urea cycle disorders (UCD) are rare genetic metabolic disorders that compromise the body's urea cycle. Sodium phenylbutyrate (SPB) is a medication commonly administered in tablet or powder form to lower ammonia levels. Nonetheless, its high sodium content poses risks to sodium-sensitive UCD patients. This necessitates the creation of an alternative drug formulation to mitigate sodium load and optimize drug delivery for UCD patients. This study focused on crafting a novel oral drug formulation for UCD, leveraging choline bicarbonate and phenylbutyric acid. The active pharmaceutical ingredient-ionic liquids (API-ILs) and therapeutic deep eutectic systems (THEDES) were formed by combining these with choline chloride. These systems display characteristics like maintaining a liquid state at room temperature and exhibiting enhanced solubility. This in turn amplifies drug dissolution rate, permeability, and ultimately oral bioavailability. Incorporating choline-based phenylbutyric acid as a substitute for traditional SPB can effectively curtail the sodium load in UCD patients. Our in vitro dissolution experiments revealed that the ILs and DESs, synthesized using choline bicarbonate and choline chloride with phenylbutyric acid, surpassed commercial tablets in dissolution speed. Pharmacokinetic evaluations in SD rats indicated a notable uptick in the oral bioavailability of phenylbutyric acid, underscoring the efficacy of choline salt ILs in augmenting its bioavailability. Additional in vitro intestinal permeability tests on SD rats authenticated that the ILs, formulated with choline bicarbonate and phenylbutyric acid, demonstrate superior permeability compared to their sodium and acid counterparts. To conclude, choline salt ILs developed from choline bicarbonate and phenylbutyric acid present a promising avenue for UCD treatment, with the added benefit of reduced sodium load. They also hold merit in formulation engineering. The sustained-release capabilities of DESs position them favorably for drug delivery, while the low toxicity and cost-effectiveness of choline chloride signal potential in formulation engineering. Overall, this drug formulation heralds a prospective therapeutic avenue for UCD patients.

Keywords: phenylbutyric acid, sodium phenylbutyrate, choline salt, ionic liquids, deep eutectic systems, oral bioavailability

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8646 Design, Synthesis and Pharmacological Investigation of Novel 2-Phenazinamine Derivatives as a Mutant BCR-ABL (T315I) Inhibitor

Authors: Gajanan M. Sonwane

Abstract:

Nowadays, the entire pharmaceutical industry is facing the challenge of increasing efficiency and innovation. The major hurdles are the growing cost of research and development and a concurrent stagnating number of new chemical entities (NCEs). Hence, the challenge is to select the most druggable targets and to search the equivalent drug-like compounds, which also possess specific pharmacokinetic and toxicological properties that allow them to be developed as drugs. The present research work includes the studies of developing new anticancer heterocycles by using molecular modeling techniques. The heterocycles synthesized through such methodology are much effective as various physicochemical parameters have been already studied and the structure has been optimized for its best fit in the receptor. Hence, on the basis of the literature survey and considering the need to develop newer anticancer agents, new phenazinamine derivatives were designed by subjecting the nucleus to molecular modeling, viz., GQSAR analysis and docking studies. Simultaneously, these designed derivatives were subjected to in silico prediction of biological activity through PASS studies and then in silico toxicity risk assessment studies. In PASS studies, it was found that all the derivatives exhibited a good spectrum of biological activities confirming its anticancer potential. The toxicity risk assessment studies revealed that all the derivatives obey Lipinski’s rule. Amongst these series, compounds 4c, 5b and 6c were found to possess logP and drug-likeness values comparable with the standard Imatinib (used for anticancer activity studies) and also with the standard drug methotrexate (used for antimitotic activity studies). One of the most notable mutations is the threonine to isoleucine mutation at codon 315 (T315I), which is known to be resistant to all currently available TKI. Enzyme assay planned for confirmation of target selective activity.

Keywords: drug design, tyrosine kinases, anticancer, Phenazinamine

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8645 Ageing Gingiva: A New Hope for Autologous Stem Cell Therapy

Authors: Ankush M. Dewle, Suditi Bhattacharya, Prachi R. Abhang, Savita Datar, Ajay J. Jog, Rupesh K. Srivastava, Geetanjali Tomar

Abstract:

Objectives: The aim of this study was to investigate the quality of mesenchymal stem cells (MSCs) obtained from ageing gingival tissues, in order to suggest their potential role in autologous stem cell therapy for old individuals. Methods: MSCs were isolated from gingival tissues of young (18-45 years) and old (above 45 years) donors by enzymatic digestion. MSCs were analysed for cfu-f, surface marker expression by flow-cytometry and multilineage differentiation potential. The angiogenic potential was compared in a chick embryo yolk sac membrane model. The aging and differentiation markers including SA-β-galactosidase and p21 respectively were analysed by staining and flow-cytometry analysis. Additionally, osteogenic markers such as glucocorticoid receptor (GR), vitamin D receptor (VDR) were measured by flow-cytometry and RT-qPCR was performed for quantification of osteogenic gene expression. Alizarin Red S and alkaline phosphatase (ALP) activity were also quantitated. Results: Gingival MSCs (GMSCs) from both the age groups were similar in their morphology and displayed cfu-f. They had similar expression of MSC surface markers and p21, comparable rate of proliferation and differentiated to all the four lineages. GMSCs from young donors had a higher adipogenic differentiation potential as compared to the old GMSCs. Moreover, these cells did not display a significant difference in ALP activity probably due to comparable expression of GR, VDR, and osteogenic genes. Conclusions: Ageing of GMSCs occurs at a much slower rate than stem cells from other sources. Thus we suggest GMSCs as an excellent candidate for autologous stem cell therapy in degenerative diseases of elderly individuals. Clinical Significance: GMSCs could help overcome the setbacks in clinical implementation of autologous stem cell therapy for regenerative medicine in all age group of patient.

Keywords: bone regeneration, cell therapy, senescence, stem cell

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8644 Spline Solution of Singularly Perturbed Boundary Value Problems

Authors: Reza Mohammadi

Abstract:

Using quartic spline, we develop a method for numerical solution of singularly perturbed two-point boundary-value problems. The purposed method is fourth-order accurate and applicable to problems both in singular and non-singular cases. The convergence analysis of the method is given. The resulting linear system of equations has been solved by using a tri-diagonal solver. We applied the presented method to test problems which have been solved by other existing methods in references, for comparison of presented method with the existing methods. Numerical results are given to illustrate the efficiency of our methods.

Keywords: second-order ordinary differential equation, singularly-perturbed, quartic spline, convergence analysis

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8643 Increased Retention of Nanoparticle by Small Molecule Inhibitor in Cancer Cells

Authors: Neha Singh

Abstract:

Background: Nowadays, the nanoparticle is gaining unexceptional attention in targeted drug delivery. But before proceeding to this episode of accomplishment, the journey and closure of these nanoparticles inside the cells should be disentangle. Being foreign for the cells, nanoparticles will easily getcleared off without any effective outcome. As the cancer cells withhold these nanoparticles for a longer period of time, more will be the drug’s effect. Chlorpromazine is a cationic amphiphilic drug which is believed to inhibit clathrin-coated pit formation by a reversible translocation of clathrin and its adapter proteins from the plasma membrane to intracellular vesicles. Chlorpromazine has a role in increasing the retention of nanoparticles in cancer cells. The mechanism of action how this small molecule increases the retention of nanoparticles is still uncovered. Method: Polymeric nanoparticle (PLGA) with Cyanine3.5 dye were synthesized by solvent evaporation method and characterized for size and zeta potential. FTIR was also done. Pulse and chase studies with and without inhibitor were done to check the retention of nanoparticle using fluorescence microscopy. Mean fluorescence intensity was measured by ImageJ software. Results: Increased retention of nanoparticle with inhibitor was observed in both pulse and chase studies. Conclusion: Our results demonstrate that by repurposing these small molecule inhibitor, we can increase the retention of nanoparticle at the targeted site.

Keywords: nanoparticle, endocytosis, clathrin inhibitor, cancer cell

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8642 An Informed Application of Emotionally Focused Therapy with Immigrant Couples

Authors: Reihaneh Mahdavishahri

Abstract:

This paper provides a brief introduction to emotionally focused therapy (EFT) and its culturally sensitive and informed application when working with immigrant couples. EFT's grounding in humanistic psychology prioritizes a non-pathologizing and empathic understanding of individuals' experiences, creating a safe space for couples to explore and create new experiences without imposing judgment or prescribing the couple "the right way of interacting" with one another. EFT's emphasis on attachment, bonding, emotions, and corrective emotional experiences makes it a fitting approach to work with multicultural couples, allowing for the corrective emotional experience to be shaped and informed by the couples' unique cultural background. This paper highlights the challenges faced by immigrant couples and explores how immigration adds a complex layer to each partner’s sense of self, their attachment bond, and their sense of safety and security within their relationships. Navigating a new culture, creating a shared sense of purpose, and re-establishing emotional bonds can be daunting for immigrant couples, often leading to a deep sense of disconnection and vulnerability. Reestablishing and fostering secure attachment between the partners in the safety of the therapeutic space can be a protective factor for these couples.

Keywords: attachment, culturally informed care, emotionally focused therapy, immigration

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8641 Training Isolated Respiration in Rehabilitation

Authors: Marketa Kotova, Jana Kolarova, Ludek Zalud, Petr Dobsak

Abstract:

A game for training of breath (TRABR) for continuous monitoring of pulmonary ventilation during the patients’ therapy focuses especially on monitoring of their ventilation processes. It is necessary to detect, monitor and differentiate abdominal and thoracic breathing during the therapy. It is a fun form of rehabilitation where the patient plays and also practicing isolated breathing. Finally the game to practice breath was designed to evaluate whether the patient uses two types of breathing or not.

Keywords: pulmonary ventilation, thoracic breathing, abdominal breathing, breath monitoring using pressure sensors, game TRABR TRAining of BReath)

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8640 Silymarin Loaded Mesoporous Silica Nanoparticles: Preparation, Optimization, Pharmacodynamic and Oral Multi-Dose Safety Assessment

Authors: Sarah Nasr, Maha M. A. Nasra, Ossama Y. Abdallah

Abstract:

The present work aimed to prepare Silymarin loaded MCM-41 type mesoporous silica nanoparticles (MSNs) and to assess the system’s solubility enhancement ability on the pharmacodynamic performance of Silymarin as a hepatoprotective agent. MSNs prepared by soft-templating technique, were loaded with Silymarin, characterized for particle size, zeta potential, surface properties, DSC and XRPD. DSC and specific surface area data confirmed deposition of Silymarin in an amorphous state in MSNs’ pores. In-vitro drug dissolution testing displayed enhanced dissolution rate of Silymarin upon loading on MSNs. High dose Acetaminophen was then used to inflict hepatic injury upon albino male Wistar rats simultaneously receiving either free Silymarin, Silymarin loaded MSNs or blank MSNs. Plasma AST, ALT, albumin and total protein and liver homogenate content of TBARs or LDH as measures of antioxidant drug action were assessed for all animal groups. Results showed a significant superiority of Silymarin loaded MSNs to free drug in almost all parameters. Meanwhile prolonged administration of blank MSNs had no evident toxicity on rats.

Keywords: mesoporous silica nanoparticles, safety, solubility enhancement, silymarin

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8639 Employment Problems of Graduands Graduated Form Vocational High Schools

Authors: Refik Uyanöz, Sadife Güngör, Sevilay Konya

Abstract:

The aim of this study is to show the employing ability of vocational students. And also, the employment problems of these students are emphasized in this study.The rapid development in technology and information and increased qualified labor is widely affects labor market. On the other hand, labor market will look for educated, qualified, talented and young people. Because of this reason, qualified staff should be educated at vocational high schools. Vocational high schools are one of the best institutions to educate qualified staff. In this research, the conditions of vocational high schools are studied. The difference between the employment policies and current employment problems are researched.

Keywords: vocational high school, employment, employment problems, vocational students

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8638 Practical Problems as Tools for the Development of Secondary School Students’ Motivation to Learn Mathematics

Authors: M. Rodionov, Z. Dedovets

Abstract:

This article discusses plausible reasoning use for solution to practical problems. Such reasoning is the major driver of motivation and implementation of mathematical, scientific and educational research activity. A general, practical problem solving algorithm is presented which includes an analysis of specific problem content to build, solve and interpret the underlying mathematical model. The author explores the role of practical problems such as the stimulation of students' interest, the development of their world outlook and their orientation in the modern world at the different stages of learning mathematics in secondary school. Particular attention is paid to the characteristics of those problems which were systematized and presented in the conclusions.

Keywords: mathematics, motivation, secondary school, student, practical problem

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8637 Multifunctional Bismuth-Based Nanoparticles as Theranostic Agent for Imaging and Radiation Therapy

Authors: Azimeh Rajaee, Lingyun Zhao, Shi Wang, Yaqiang Liu

Abstract:

In recent years many studies have been focused on bismuth-based nanoparticles as radiosensitizer and contrast agent in radiation therapy and imaging due to the high atomic number (Z = 82), high photoelectric absorption, low cost, and low toxicity. This study aims to introduce a new multifunctional bismuth-based nanoparticle as a theranostic agent for radiotherapy, computed tomography (CT) and magnetic resonance imaging (MRI). We synthesized bismuth ferrite (BFO, BiFeO3) nanoparticles by sol-gel method and surface of the nanoparticles were modified by Polyethylene glycol (PEG). After proved biocompatibility of the nanoparticles, the ability of them as contract agent in Computed tomography (CT) and magnetic resonance imaging (MRI) was investigated. The relaxation time rate (R2) in MRI and Hounsfield unit (HU) in CT imaging were increased with the concentration of the nanoparticles. Moreover, the effect of nanoparticles on dose enhancement in low energy was investigated by clonogenic assay. According to clonogenic assay, sensitizer enhancement ratios (SERs) were obtained as 1.35 and 1.76 for nanoparticle concentrations of 0.05 mg/ml and 0.1 mg/ml, respectively. In conclusion, our experimental results demonstrate that the multifunctional nanoparticles have the ability to employ as multimodal imaging and therapy to enhance theranostic efficacy.

Keywords: molecular imaging, nanomedicine, radiotherapy, theranostics

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8636 Study Secondary Particle Production in Carbon Ion Beam Radiotherapy

Authors: Shaikah Alsubayae, Gianluigi Casse, Carlos Chavez, Jon Taylor, Alan Taylor, Mohammad Alsulimane

Abstract:

Ensuring accurate radiotherapy with carbon therapy requires precise monitoring of radiation dose distribution within the patient's body. This monitoring is essential for targeted tumor treatment, minimizing harm to healthy tissues, and improving treatment effectiveness while lowering side effects. In our investigation, we employed a methodological approach to monitor secondary proton doses in carbon therapy using Monte Carlo simulations. Initially, Geant4 simulations were utilized to extract the initial positions of secondary particles formed during interactions between carbon ions and water. These particles included protons, gamma rays, alpha particles, neutrons, and tritons. Subsequently, we studied the relationship between the carbon ion beam and these secondary particles. Interaction Vertex Imaging (IVI) is valuable for monitoring dose distribution in carbon therapy. It provides details about the positions and amounts of secondary particles, particularly protons. The IVI method depends on charged particles produced during ion fragmentation to gather information about the range by reconstructing particle trajectories back to their point of origin, referred to as the vertex. In our simulations regarding carbon ion therapy, we observed a strong correlation between some secondary particles and the range of carbon ions. However, challenges arose due to the target's unique elongated geometry, which hindered the straightforward transmission of forward-generated protons. Consequently, the limited protons that emerged mostly originated from points close to the target entrance. The trajectories of fragments (protons) were approximated as straight lines, and a beam back-projection algorithm, using recorded interaction positions in Si detectors, was developed to reconstruct vertices. The analysis revealed a correlation between the reconstructed and actual positions.

Keywords: radiotherapy, carbon therapy, monitoring of radiation dose, interaction vertex imaging

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8635 Children's Literature and the Study of the Sociological Approach

Authors: Sulmaz Mozaffari, Zahra Mozaffari, Saman Mozaffari

Abstract:

Man has always tried to find the Ideal place for life and he has experienced a lot of problems. So many internal and external limits has been on his way. Today man is threatened by so many crisis because of his specific look to the world. Literature as a universal science has not ignored this problem either. Children's literature has tried to present the social, cultural, religious and economical problems in tales and novels. This research tries to analyse social and cultural problems related to 10th century children from social point of criticism.

Keywords: social criticism, crisis, children's literature, tale

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8634 Differential Expression Profile Analysis of DNA Repair Genes in Mycobacterium Leprae by qPCR

Authors: Mukul Sharma, Madhusmita Das, Sundeep Chaitanya Vedithi

Abstract:

Leprosy is a chronic human disease caused by Mycobacterium leprae, that cannot be cultured in vitro. Though treatable with multidrug therapy (MDT), recently, bacteria reported resistance to multiple antibiotics. Targeting DNA replication and repair pathways can serve as the foundation of developing new anti-leprosy drugs. Due to the absence of an axenic culture medium for the propagation of M. leprae, studying cellular processes, especially those belonging to DNA repair pathways, is challenging. Genomic understanding of M. Leprae harbors several protein-coding genes with no previously assigned function known as 'hypothetical proteins'. Here, we report identification and expression of known and hypothetical DNA repair genes from a human skin biopsy and mouse footpads that are involved in base excision repair, direct reversal repair, and SOS response. Initially, a bioinformatics approach was employed based on sequence similarity, identification of known protein domains to screen the hypothetical proteins in the genome of M. leprae, that are potentially related to DNA repair mechanisms. Before testing on clinical samples, pure stocks of bacterial reference DNA of M. leprae (NHDP63 strain) was used to construct standard graphs to validate and identify lower detection limit in the qPCR experiments. Primers were designed to amplify the respective transcripts, and PCR products of the predicted size were obtained. Later, excisional skin biopsies of newly diagnosed untreated, treated, and drug resistance leprosy cases from SIHR & LC hospital, Vellore, India were taken for the extraction of RNA. To determine the presence of the predicted transcripts, cDNA was generated from M. leprae mRNA isolated from clinically confirmed leprosy skin biopsy specimen across all the study groups. Melting curve analysis was performed to determine the integrity of the amplification and to rule out primer‑dimer formation. The Ct values obtained from qPCR were fitted to standard curve to determine transcript copy number. Same procedure was applied for M. leprae extracted after processing a footpad of nude mice of drug sensitive and drug resistant strains. 16S rRNA was used as positive control. Of all the 16 genes involved in BER, DR, and SOS, differential expression pattern of the genes was observed in terms of Ct values when compared to human samples; this was because of the different host and its immune response. However, no drastic variation in gene expression levels was observed in human samples except the nth gene. The higher expression of nth gene could be because of the mutations that may be associated with sequence diversity and drug resistance which suggests an important role in the repair mechanism and remains to be explored. In both human and mouse samples, SOS system – lexA and RecA, and BER genes AlkB and Ogt were expressing efficiently to deal with possible DNA damage. Together, the results of the present study suggest that DNA repair genes are constitutively expressed and may provide a reference for molecular diagnosis, therapeutic target selection, determination of treatment and prognostic judgment in M. leprae pathogenesis.

Keywords: DNA repair, human biopsy, hypothetical proteins, mouse footpads, Mycobacterium leprae, qPCR

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8633 Implementation of Tissue Engineering Technique to Nursing of Unhealed Diabetic Foot Lesion

Authors: Basuki Supartono

Abstract:

Introduction: Diabetic wound risks limb amputation, and the healing remains challenging. Chronic Hyperglycemia caused the insufficient inflammatory response and impaired ability of the cells to regenerate. Tissue Engineering Technique is mandatory. Methods: Tissue engineering (TE)-based therapy Utilizing mononuclear cells, plasma rich platelets, and collagen applied on the damaged tissue Results: TE technique resulting in acceptable outcomes. The wound healed completely in 2 months. No adverse effects. No allergic reaction. No morbidity and mortality Discussion: TE-based therapy utilizing mononuclear cells, plasma rich platelets, and collagen are safe and comfortable to fix damaged tissues. These components stop the chronic inflammatory process and increase cells' ability for regeneration and restoration of damaged tissues. Both of these allow the wound to regenerate and heal. Conclusion: TE-based therapy is safe and effectively treats unhealed diabetic lesion.

Keywords: diabetic foot lesion, tissue engineering technique, wound healing, stemcells

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8632 Design and Construction of a Device to Facilitate the Stretching of a Plantiflexors Muscles in the Therapy of Rehabilitation for Patients with Spastic Hemiplegia

Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez

Abstract:

Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.

Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching

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8631 Constructing a Grounded Theory of Parents' Musical Engagement with Their Premature Baby Contributing to Their Emerging Parental Identity in a Neonatal Unit

Authors: Elizabeth McLean, Katrina Skewes-McFerran, Grace Thompson

Abstract:

Scholarship highlights the need to further examine and better understand and foster the process of becoming a parent to a premature baby in the neonatal context to support the critical development of the parent-infant relationship. Music therapy research documents significant benefits of music therapy on neonatal physiological and neurodevelopmental function, reduced maternal anxiety and validating parents’ relationship with their premature baby, yet limited studies examine the role of music in supporting parental identity. This was a multi-site study, exploring parents’ musical engagement with their hospitalised baby and parental identity in a NU. In-depth interviews with nine parents of a premature baby across varying time points in their NU journey took place. Data collection and analysis was influenced by Constructive Grounded Theory methodology. Findings in the form of a substantive grounded theory illuminated the contribution of parents’ musical engagement on their sense of parental identity in the NU. Specifically, the significance of their baby’s level and type of response during musical interactions in influencing parents’ capacity to engage in musical dialogue with their baby emerged. Specific conditions that acted as both barriers and fosters in parents’ musical engagement across a high- risk pregnancy and NU admission also emerged. Recommendations for future research into the role of music and music therapy in supporting parental coping and transition to parenthood during a high-risk pregnancy and birth and beyond the NU will be discussed.

Keywords: grounded theory, musical engagement, music therapy, parental identity

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8630 Juvenile Delinquency of Senior High School Students in Surabaya, Indonesia

Authors: Herdina Indrijati

Abstract:

This research aims to describe teenager delinquency behavior (Juvenile Delinquency) of senior high school students in Surabaya, Indonesia. Juvenile Delinquency is a broad range of behaviors start from socially unacceptable behavior (overreact in school), violation (escape from home) to crimes (like stealing). This research uses quantitative descriptive method using 498 students who come from 8 different schools in Surabaya as subjects. Juvenile Delinquency behavior form questionnaire has been completed by subjects and was used to measure and describe the behavior. The result of this research is presented in statistic descriptive forms. Result shows that 169 subjects skip school, 55 subjects get out of home without parent’s permission, 110 subjects engage in smoking behavior, 74 subjects damage other people properties, 32 subjects steal, 16 subjects exploit others and 7 subjects engage in drug abuse. Frequency of the top five mentioned behavior are 1-10 times. It is also found that subject’s peers are most likely to be the victim of Juvenile Delinquency. The reasons teenagers engage in Juvenile Delinquency include (1) feeling tired, bored or lazy – that contributes to their skip school behavior (2) Having a lot of problem with parents - contrives them to run away from home, (3) accidentally damage other people’s properties, (4) financial problems – force them to steal and exploit, (5) feeling like having a lot of life problems – that makes them do drugs (6) trying smoking for experience.

Keywords: juvenile delinquency, senior high school, student

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8629 Oral Betahistine Versus Intravenous Diazepam in Acute Peripheral Vertigo: A Randomized, Double-Blind Controlled Trial

Authors: Saeed Abbasi, Davood Farsi, Soudabeh Shafiee Ardestani, Neda Valizadeh

Abstract:

Objectives: Peripheral vertigo is a common complaint of patients who are visited in emergency departments. In our study, we wanted to evaluate the effect of betahistine as an oral drug vs. intravenous diazepam for the treatment of acute peripheral vertigo. We also wanted to see the possibility of substitution of parenteral drug with an oral one with fewer side effects. Materials and Methods: In this randomized, double-blind study, 101 patients were enrolled in the study. The patients were divided in two groups in a double-blind randomized manner. Group A took oral placebo and 10 mg of intravenous diazepam. Group B received 8mg of oral betahistine and intravenous placebo. Patients’ symptoms and signs (Vertigo severity, Nausea, Vomiting, Nistagmus and Gate) were evaluated after 0, 2, 4, 6 hours by emergency physicians and data were collected by a questionnaire. Results: In both groups, there was significant improvement in vertigo (betahistine group P=0.02 and Diazepam group P=0.03). Analysis showed more improvement in vertigo severity after 4 hours of treatment in betahistine group comparing to diazepam group (P=0.02). Nausea and vomiting were significantly lower in patients receiving diazepam after 2 and 6 hours (P=0.02 & P=0.03).No statistically significant differences were found between the groups in nistagmus, equilibrium & vertigo duration. Conclusion: The results of this randomized trial showed that both drugs had acceptable therapeutic effects in peripheral vertigo, although betahistine was significantly more efficacious after 4 hours of drug intake. As for higher nausea and vomiting in betahistine group, physician should consider these side effects before drug prescription.

Keywords: acute peripheral vertigo, betahistine, diazepam, emergency department

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8628 Modeling of Cf-252 and PuBe Neutron Sources by Monte Carlo Method in Order to Develop Innovative BNCT Therapy

Authors: Marta Błażkiewicz, Adam Konefał

Abstract:

Currently, boron-neutron therapy is carried out mainly with the use of a neutron beam generated in research nuclear reactors. This fact limits the possibility of realization of a BNCT in centers distant from the above-mentioned reactors. Moreover, the number of active nuclear reactors in operation in the world is decreasing due to the limited lifetime of their operation and the lack of new installations. Therefore, the possibilities of carrying out boron-neutron therapy based on the neutron beam from the experimental reactor are shrinking. However, the use of nuclear power reactors for BNCT purposes is impossible due to the infrastructure not intended for radiotherapy. Therefore, a serious challenge is to find ways to perform boron-neutron therapy based on neutrons generated outside the research nuclear reactor. This work meets this challenge. Its goal is to develop a BNCT technique based on commonly available neutron sources such as Cf-252 and PuBe, which will enable the above-mentioned therapy in medical centers unrelated to nuclear research reactors. Advances in the field of neutron source fabrication make it possible to achieve strong neutron fluxes. The current stage of research focuses on the development of virtual models of the above-mentioned sources using the Monte Carlo simulation method. In this study, the GEANT4 tool was used, including the model for simulating neutron-matter interactions - High Precision Neutron. Models of neutron sources were developed on the basis of experimental verification based on the activation detectors method with the use of indium foil and the cadmium differentiation method allowing to separate the indium activation contribution from thermal and resonance neutrons. Due to the large number of factors affecting the result of the verification experiment, the 10% discrepancy between the simulation and experiment results was accepted.

Keywords: BNCT, virtual models, neutron sources, monte carlo, GEANT4, neutron activation detectors, gamma spectroscopy

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8627 Acupuncture for Major Depressive Disorders: A Systematic Review of the Randomized Clinical Trials

Authors: Derick Shi-Chen Ou, Liang-Yu Chen

Abstract:

Background: Acupuncture, a potential alternative, and complementary therapy revealed insufficient evidence in depression treatment. The efficacy of acupuncture treatment was still uncertainty. To evaluate the effect of acupuncture in treating depression, the randomized controlled trials (RCTs) were examined. Methods: RCTs of the acupuncture therapy in treating major depression were searched from MEDLINE from 2007 to 2017. Keywords used for searching strategy included acupuncture, acupoint, and major depressive disorder. Results: Among the nine RCTs, four studies demonstrated great improvement in acupuncture treatment and five studies revealed the effectiveness of acupuncture intervention in medication. General trends suggest that acupuncture treatment is as effective as antidepressants with minimal side effects. Conclusion: Despite the promising results from the RCTs, there are still a variety of limitations, including small sample size, imprecise enrollment criteria, difficulties with blinding, randomization, short duration of study and lack of longitudinal follow-up. Therefore, the evidence that acupuncture as an alternative therapy for depression is inconclusive. More rigorously designed RCTs should be conducted in the future.

Keywords: acupuncture, major depressive disorders, randomized clinical trials, antidepressants

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8626 A Uniformly Convergent Numerical Scheme for a Singularly Perturbed Volterra Integrodifferential Equation

Authors: Nana Adjoah Mbroh, Suares Clovis Oukouomi Noutchie

Abstract:

Singularly perturbed problems are parameter dependent problems, and they play major roles in the modelling of real-life situational problems in applied sciences. Thus, designing efficient numerical schemes to solve these problems is of much interest since the exact solutions of such problems may not even exist. Generally, singularly perturbed problems are identified by a small parameter multiplying at least the highest derivative in the equation. The presence of this parameter causes the solution of these problems to be characterized by rapid oscillations. This unique feature renders classical numerical schemes inefficient since they are unable to capture the behaviour of the exact solution in the part of the domain where the rapid oscillations are present. In this paper, a numerical scheme is proposed to solve a singularly perturbed Volterra Integro-differential equation. The scheme is based on the midpoint rule and employs the non-standard finite difference scheme to solve the differential part whilst the composite trapezoidal rule is used for the integral part. A fully fledged error estimate is performed, and Richardson extrapolation is applied to accelerate the convergence of the scheme. Numerical simulations are conducted to confirm the theoretical findings before and after extrapolation.

Keywords: midpoint rule, non-standard finite difference schemes, Richardson extrapolation, singularly perturbed problems, trapezoidal rule, uniform convergence

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8625 The Effectiveness of Dialectical Behavior Therapy in Developing Emotion Regulation Skill for Adolescent with Intellectual Disability

Authors: Shahnaz Safitri, Rose Mini Agoes Salim, Pratiwi Widyasari

Abstract:

Intellectual disability is characterized by significant limitations in intellectual functioning and adaptive behavior that appears before the age of 18 years old. The prominent impacts of intellectual disability in adolescents are failure to establish interpersonal relationships as socially expected and lower academic achievement. Meanwhile, it is known that emotion regulation skills have a role in supporting the functioning of individual, either by nourishing the development of social skills as well as by facilitating the process of learning and adaptation in school. This study aims to look for the effectiveness of Dialectical Behavior Therapy (DBT) in developing emotion regulation skills for adolescents with intellectual disability. DBT's special consideration toward clients’ social environment and their biological condition is foreseen to be the key for developing emotion regulation capacity for subjects with intellectual disability. Through observations on client's behavior, conducted before and after the completion of DBT intervention program, it was found that there is an improvement in client's knowledge and attitudes related to the mastery of emotion regulation skills. In addition, client's consistency to actually practice emotion regulation techniques over time is largely influenced by the support received from the client's social circles.

Keywords: adolescent, dialectical behavior therapy, emotion regulation, intellectual disability

Procedia PDF Downloads 294
8624 Polynomial Chaos Expansion Combined with Exponential Spline for Singularly Perturbed Boundary Value Problems with Random Parameter

Authors: W. K. Zahra, M. A. El-Beltagy, R. R. Elkhadrawy

Abstract:

So many practical problems in science and technology developed over the past decays. For instance, the mathematical boundary layer theory or the approximation of solution for different problems described by differential equations. When such problems consider large or small parameters, they become increasingly complex and therefore require the use of asymptotic methods. In this work, we consider the singularly perturbed boundary value problems which contain very small parameters. Moreover, we will consider these perturbation parameters as random variables. We propose a numerical method to solve this kind of problems. The proposed method is based on an exponential spline, Shishkin mesh discretization, and polynomial chaos expansion. The polynomial chaos expansion is used to handle the randomness exist in the perturbation parameter. Furthermore, the Monte Carlo Simulations (MCS) are used to validate the solution and the accuracy of the proposed method. Numerical results are provided to show the applicability and efficiency of the proposed method, which maintains a very remarkable high accuracy and it is ε-uniform convergence of almost second order.

Keywords: singular perturbation problem, polynomial chaos expansion, Shishkin mesh, two small parameters, exponential spline

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8623 From Past to Present Awareness about Complementary Therapies

Authors: Olcay Çam, Ayşegül Bilge, Merve Uğuryol, Hacer Demirkol

Abstract:

Complementary and alternative medicine are important for human health. It has stood out that from past to present people have resorted to particularly Turkish bath houses, cupping therapy, mud bath, hirudotheraphy and healing waters for the purpose of recovering from diseases and refresh their souls. Now, methods such as herbal treatments, massage, aromatherapy, prayer, meditation, yoga and thermal springs have been recently observed to be the most frequently used complementary therapies in Turkey. These methods are not known by people exactly. As a result, complementary therapies are applied along with the modern therapies in Turkey, we are considered to be effective in maintaining and improving individuals’ health.

Keywords: complementary therapy, health, health services, modern therapies

Procedia PDF Downloads 265
8622 Dental Implants in Breast Cancer Patients Receiving Bisphosphonate Therapy

Authors: Mai Ashraf Talaat

Abstract:

Objectives: The aim of this review article is to assess the success of dental implants in breast cancer patients receiving bisphosphonate therapy and to evaluate the risk of developing bisphosphonate-related osteonecrosis of the jaw following dental implant surgery. Materials and Methods: A thorough search was conducted, with no time or language restriction, using: PubMed, PubMed Central, Web of Science, and ResearchGate electronic databases. Medical Subject Headings (MeSH) terms such as “bisphosphonate”, “dental implant”, “bisphosphonate-related osteonecrosis of the jaw (BRONJ)”, “osteonecrosis”, “breast cancer, MRONJ”, and their related entry terms were used. Eligibility criteria included studies and clinical trials that evaluated the impact of bisphosphonates on dental implants. Conclusion: Breast cancer patients undergoing bisphosphonate therapy may receive dental implants. However, the risk of developing BRONJ and implant failure is high. Risk factors such as the type of BP received, the route of administration, and the length of treatment prior to surgery should be considered. More randomized controlled trials with long-term follow-ups are needed to draw more evidence-based conclusions.

Keywords: dental implants, breast cancer, bisphosphonates, osteonecrosis, bisphosphonate-related osteonecrosis of the jaw

Procedia PDF Downloads 103
8621 Development of Algorithms for Solving and Analyzing Special Problems Transports Type

Authors: Dmitri Terzi

Abstract:

The article presents the results of an algorithmic study of a special optimization problem of the transport type (traveling salesman problem): 1) To solve the problem, a new natural algorithm has been developed based on the decomposition of the initial data into convex hulls, which has a number of advantages; it is applicable for a fairly large dimension, does not require a large amount of memory, and has fairly good performance. The relevance of the algorithm lies in the fact that, in practice, programs for problems with the number of traversal points of no more than twenty are widely used. For large-scale problems, the availability of algorithms and programs of this kind is difficult. The proposed algorithm is natural because the optimal solution found by the exact algorithm is not always feasible due to the presence of many other factors that may require some additional restrictions. 2) Another inverse problem solved here is to describe a class of traveling salesman problems that have a predetermined optimal solution. The constructed algorithm 2 allows us to characterize the structure of traveling salesman problems, as well as construct test problems to evaluate the effectiveness of algorithms and other purposes. 3) The appendix presents a software implementation of Algorithm 1 (in MATLAB), which can be used to solve practical problems, as well as in the educational process on operations research and optimization methods.

Keywords: traveling salesman problem, solution construction algorithm, convex hulls, optimality verification

Procedia PDF Downloads 51
8620 Management of Severe Asthma with Omalizumab in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

Abstract:

Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

Procedia PDF Downloads 364