Search results for: free flap outcome

Authors: Taylor Harris

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Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.

Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review

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Authors: Huda Ahmed Al Taisan

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This paper investigates a phonological phenomenon, which exhibits variation ‘alternation’ in terms of the uvular consonants [q] and [ʁ] in Hasawi Arabic. This dialect is spoken in Alahsa city, which is located in the Eastern province of Saudi Arabia. To the best of our knowledge, no such research has systematically studied this phenomenon in Hasawi Arabic dialect. This paper is significant because it fills the gap in the literature about this alternation phenomenon in this understudied dialect. A large amount of the data is extracted from several interviews the author has conducted with 10 participants, native speakers of the dialect, and complemented by additional forms from social media. The latter method of collecting the data adds to the significance of the research. The analysis of the data is carried out in Harmonic Serialism Optimality Theory (HS-OT), a version of the Optimality Theoretic (OT) framework, which holds that linguistic forms are the outcome of the interaction among violable universal constraints, and in the recent development of OT into a model that accounts for linguistic variation in harmonic derivational steps. This alternation process is assumed to be phonologically unconditioned and in free variation in other varieties of Arabic dialects in the area. The goal of this paper is to investigate whether this phenomenon is in free variation or governed, what governs this alternation between [q] and [ʁ] and whether the alternation is phonological or other linguistic constraints are in action. The results show that the [q] and [ʁ] alternation is not free and it occurs due to different assimilation processes. Positional, segmental sequence and vowel adjacency factors are in action in Hasawi Arabic.

Keywords: harmonic serialism, Hasawi, uvular, variation

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Authors: Chanunya Fahwan, Supat Chaiyakul

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A lactose-free diet is imperative for those with lactose intolerance and experiencing milk intolerance. This entails eliminating milk-based products, which may result in dietary and nutritional challenges and the main problems of Lactose hydrolyzed milk powder during production were the adhesion in the drying chamber and low-yield and low-quality powder. The use of lactose-free milk to produce lactose-free milk powder was studied here. Development of two milk powder formulas from cow's milk and lactose-free cow's milk by using a substitute for maltodextrin, Polydextrose (PDX), Resistant Starch (RS), Cellobiose (CB), and Resistant Maltodextrin (RMD) to improve quality and reduce the glycemic index from maltodextrin, which are carriers that were used in industry at three experimental levels 10%, 15% and 20% the properties of milk powder were studied such as color, moisture content, percentage yield (%yield) and solubility index. The experiment revealed that prebiotic carriers could replace maltodextrin and improve quality, such as solubility and percentage yield, and enriched nutrients, such as dietary fiber. CB, RMD, and PDX are three possible carriers, which are applied to both regular cow's milk formula and lactose-free cow milk.

Keywords: lactose-free milk powder, prebiotic carrier, co-particle, glycemic index

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Authors: Shi-xia Xu, Zai-wen Zhang, Ru-xue Chen, Shan Zhou, Xiang-feng Tang

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Objective: The clinical influence of HLA-DPB1 mismatches on clinical outcome of HSCT is less clear. This is the first meta-analysis to study the HLA-DPB1 matching statues on clinical outcomes after unrelated donor HSCT. Methods: We searched the CIBMTR, Cochrane Central Register of Controlled Trials (CENTRAL) and related databases (1995.01–2017.06) for all relevant articles. Comparative studies were used to investigate the HLA-DPB1 loci mismatches on clinical outcomes after unrelated donor HSCT, such as the disease-free survival (DFS), overall survival, GVHD, relapse, and transplant-related mortality (TRM). We performed meta-analysis using Review Manager 5.2 software and funnel plot to assess the bias. Results: At first, 1246 articles were retrieved, and 18 studies totaling 26368 patients analyzed. Pooled comparisons of studies found that the HLA-DPB1 mismatched group had a lower rate of DFS than the DPB1-matched group, and lower OS in non-T cell depleted transplantation. The DPB1 mismatched group has a higher incidence of aGVHD and more severe ( ≥ III degree) aGvHD, lower rate of relapse and higher TRM. Moreover, compared with 1-antigen mismatch, 2-antigen mismatched led to a higher risk of TRM and lower relapse rate. Conclusions: This meta-analysis indicated HLA-DPB1 has important influence on survival and transplant-related complications during unrelated donor HSCT and HLA-DPB1 donor selection strategies have been proposed based on a personalized algorithm.

Keywords: human leukocyte antigen, DPB1, transplant, meta-analysis, outcome

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Authors: Peter M. Maurer Maurer

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DGL is a context free grammar-based tool for generating random data. Many types of simulator input data require some computation to be placed in the proper format. For example, it might be necessary to generate ordered triples in which the third element is the sum of the first two elements, or it might be necessary to generate random numbers in some sorted order. Although DGL is universal in computational power, generating these types of data is extremely difficult. To overcome this problem, we have enhanced DGL to include features that permit direct computation within the structure of a context free grammar. The features have been implemented as special types of productions, preserving the context free flavor of DGL specifications.

Keywords: DGL, Enhanced Context Free Grammars, Programming Constructs, Random Data Generation

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Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: Sonia Ben Hamza, Sabra Habli, Nejla Mahjoub Saïd, Hervé Bournot, Georges Le Palec

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Free surface flows caused by dam breaks in channels or rivers is an attention-getting subject to the engineering practice, however, the studies are few to be reported. In this paper, a numerical investigation of unsteady free surface flows resulting from a dam-breaking in a rectangular channel is studied. Numerical computations were carried out using ANSYS Fluent which is based on the finite volume approach. The air/water interface was modeled with the volume of fluid method (VOF). Verification for a typical dam-break problem is analyzed by comparing the present results with others and very good agreement is obtained. The present approach is then used to predict the characteristics of free surface flow due to the dam breaking in channel. The characteristics of complex unsteady free surface flow in these examples are clearly explained. The numerical results show that the flow became more disturbed after impacting the vertical wall, then a recirculation zone, as well as turbulence phenomena, were created. At this instant, a cavity of air was included on the flow. The results agree well with the experimental data found in the literature.

Keywords: CFD, dam-break, free surface, turbulent flows, VOF

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Authors: Faruk Firat Çalim, Nurullah Karaca, Hakan Tacettin Türker

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In this study, out-of-plane free vibrations of a circular rods is investigated theoretically. The governing equations for naturally twisted and curved spatial rods are obtained using Timoshenko beam theory and rewritten for circular rods. Effects of the axial and shear deformations are considered in the formulations. Ordinary differential equations in scalar form are solved analytically by using transfer matrix method. The circular rods of the mass matrix are obtained by using straight rod of consistent mass matrix. Free vibrations frequencies obtained by solving eigenvalue problem. A computer program coded in MATHEMATICA language is prepared. Circular beams are analyzed through various examples for free vibrations analysis. Results are compared with ANSYS results based on finite element method and available in the literature.

Keywords: circular rod, out-of-plane free vibration analysis, transfer matrix method

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Authors: A. Morina, S. Ö. Muti, M. Öztürk

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Celiac disease is a chronic intestinal disease observed in individuals with gluten intolerance. In this study, our aim was to create a protein matrix to mimic the functional properties of gluten. For this purpose, rennet casein and four emulsifying salts (disodium phosphate (DSP), tetrasodium pyrophosphate (TSPP), sodium acid pyrophosphate (SAPP), and sodium hexametaphosphate (SHMP)) were investigated in gluten-free bread manufacture. Compositional, textural, and visual properties of the gluten-free bread dough and gluten-free breads were investigated by a two–level factorial experimental design with two-star points (α = 1.414) and two replicates of the center point. Manufacturing gluten-free bread with rennet casein and SHMP significantly increased the bread volume (P < 0.0001, R² = 97.8). In general, utilization of rennet casein with DSP and SAPP increased bread hardness while no difference was observed in samples manufactured with TSPP and SHMP. Except for TSPP, bread color was improved by the utilization of rennet casein and DSP, SAPP, and SHMP combinations. In conclusion, it is possible to manufacture gluten-free bread with acceptable texture and color by rennet casein and SHMP.

Keywords: celiac disease, gluten-free bread, emulsified salts, rennet casein, rice flour

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Authors: Negar Riazifar, Nigel G. Stocks

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This paper proposes strategies in level crossing (LC) sampling and reconstruction that provide alias-free high-fidelity signal reconstruction for speech signals without exponentially increasing sample number with increasing bit-depth. We introduce methods in LC sampling that reduce the sampling rate close to the Nyquist frequency even for large bit-depth. The results indicate that larger variation in the sampling intervals leads to an alias-free sampling scheme; this is achieved by either reducing the bit-depth or adding jitter to the system for high bit-depths. In conjunction with windowing, the signal is reconstructed from the LC samples using an efficient Toeplitz reconstruction algorithm.

Keywords: alias-free, level crossing sampling, spectrum, trigonometric polynomial

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Authors: Alireza Lohrasbi, Alireza Lavaei, Mohammadali M. Shahlaei

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The liquid flow and the free surface shape during the initial stage of dam breaking are investigated. A numerical scheme is developed to predict the wave of an unsteady, incompressible viscous flow with free surface. The method involves a two dimensional finite element (2D), in a vertical plan. The Naiver-Stokes equations for conservation of momentum and mass for Newtonian fluids, continuity equation, and full nonlinear kinematic free-surface equation were used as the governing equations. The mapping developed to solve highly deformed free surface problems common in waves formed during wave propagation, transforms the run up model from the physical domain to a computational domain with Arbitrary Lagrangian Eulerian (ALE) finite element modeling technique.

Keywords: dam break, Naiver-Stokes equations, free-surface flows, Arbitrary Lagrangian-Eulerian

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Authors: Askar Sabet, Abdolrasoul Fakhraee, Motahahre Ramezanpour, Noorallah Alipour

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An efficient and green method for oxidation of thiols to the corresponding disulfides is reported using ionic liquid [HSO3N(C2H4OSO3H)3] in the presence of free nano-Fe2O3 at 60°C. Ionic liquid is selective oxidant for S-S Coupling variety aliphatic and aromatic of thiols to corresponding disulfide in the presence of free nano-Fe2O3 as recoverable catalyst. Reaction has been performed in methanol as an inexpensive solvent. This reaction is clean and easy work-up with no side reaction.

Keywords: thiol, disulfide, ionic liquid, free nano-Fe2O3, oxidation, coupling

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Authors: Talal S. Abdullah, Shahin Mehraban, Geraint Lodwig, Nicholas P. Lavery

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The defining property of Interstitial Free (IF) steels is formability, comprehensively measured using the Lankford coefficient (r-value) on uniaxial tensile test data. The contributing factors supporting this feature are grain size, orientation, and elemental additions. The processes that effectively modulate these factors are the casting procedure, hot rolling, and heat treatment. An existing methodology is well-practised in the steel Industry; however, large-scale production and experimentation consume significant proportions of time, money, and material. Introducing small-scale rapid alloy prototyping (RAP) as an alternative process would considerably reduce the drawbacks relative to standard practices. The aim is to finetune the existing fundamental procedures implemented in the industrial plant to adapt to the RAP route. IF material is remelted in the 80-gram coil induction melting (CIM) glovebox. To birth small grains, maximum deformation must be induced onto the cast material during the hot rolling process. The rolled strip must then satisfy the polycrystalline behaviour of the bulk material by displaying a resemblance in microstructure, hardness, and formability to that of the literature and actual plant steel. A successful outcome of this work is that small-scale RAP can achieve target compositions with similar microstructures and statistically consistent mechanical properties which complements and accelerates the development of novel steel grades.

Keywords: rapid alloy prototyping, plastic anisotropy, interstitial free, miniaturised tensile testing, formability

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Authors: Khaled M. Ali, Ayman A. Mostafa, Soliman M. Soliman

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Objectives: To describe the most common clinical and endoscopic findings associated with complicated corneal ulcers in cats, and to determine the short-term outcomes after surgical treatment of these cats. Animals Eighteen client-owned cats of different breeds (52 females and 28 males), ranging in age from 3 months to 6 years, with corneal ulcers. Procedures: Cats were clinically evaluated to initially determine the concurrent corneal abnormalities. Endoscopic examination was performed to determine the anterior and posterior segments abnormalities. Superficial and deep stromal ulcers were treated using conjunctival flap. Corneal sequestrum was treated by partial keratectomy and conjunctival flap. Anterior synechia was treated via peripheral iridectomy and separation of the adhesion between the iris and the inner cornea. Symblepharon was treated by removal of the adhered conjunctival membrane from the cornea. Incurable endophthalmitis was treated surgically by extirpation. Short-term outcomes after surgical managements of selected corneal abnormalities were then assessed clinically and endoscopically. Results: Deep stromal ulcer with descemetocele, endophthalmitis, symblepharon, corneal sequestration and anterior synechia with secondary glaucoma and corneal scarring were the most common complications of corneal ulcer. FHV-1 was a common etiologic factor of corneal ulceration. Persistent corneal scars of varying shape and size developed in cats with deep stromal ulcer, anterior synechia, and corneal sequestration. Conclusions: Domestic shorthaired and Persian cats were the most predisposed breeds to FHV-1 infection and subsequent corneal ulceration. Immediate management of patients with corneal ulcer would prevent serious complications. No age or sex predisposition to complicated corneal ulceration in cats.

Keywords: cats, complicated corneal ulceration, clinical, endoscopic diagnosis, FHV-1

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Authors: Chin-Yun Chen

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Numerical integration is an essential tool for deriving different physical quantities in engineering and science. The effectiveness of a numerical integrator depends on different factors, where the crucial one is the error estimation. This work presents an error estimator that combines a derivative free method to improve the performance of verified numerical quadrature.

Keywords: numerical quadrature, error estimation, derivative free method, interval computation

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Authors: Mojtaba Aghamiri Esfahani, Mohammad Karkon, Seyed Majid Hosseini Nezhad, Reza Hosseini-Ara

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In this study, the effect of uncertainty in elastic modulus of a plate on free vibration response is investigated. For this purpose, the elastic modulus of the plate is modeled as stochastic variable with normal distribution. Moreover, the distance autocorrelation function is used for stochastic field. Then, by applying the finite element method and Monte Carlo simulation, stochastic finite element relations are extracted. Finally, with a numerical test, the effect of uncertainty in the elastic modulus on free vibration response of a plate is studied. The results show that the effect of uncertainty in elastic modulus of the plate cannot play an important role on the free vibration response.

Keywords: stochastic finite elements, plate bending, free vibration, Monte Carlo, Neumann expansion method.

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Authors: Gürkan Şakar, Fevzi Çakmak Bolat

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In this study free vibration analysis of aluminum honeycomb sandwich structures were carried out experimentally and numerically. The natural frequencies and mode shapes of sandwich structures fabricated with different configurations for clamped-free boundary condition were determined. The effects of lower and upper face sheet thickness, the core material thickness, cell diameter, cell angle and foil thickness on the vibration characteristics were examined. The numerical studies were performed with ANSYS package. While the sandwich structures were modeled in ANSYS the continuum model was used. Later, the numerical results were compared with the experimental findings.

Keywords: sandwich structure, free vibration, numeric analysis, 3D model, continuum model

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Authors: Ana B. Vivas, Antonia Ypsilanti, Aristea I. Ladas, Angeles F. Estevez

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Mild Cognitive Impairment (MCI) is considered an intermediate stage between normal and pathological aging, as a substantial percentage of people diagnosed with MCI converts later to dementia of the Alzheimer’s type. Memory is of the first cognitive processes to deteriorate in this condition. In the present study we employed the differential outcomes procedure (DOP) to improve visuospatial memory in a group of participants with MCI. The DOP requires the structure of a conditional discriminative learning task in which a correct choice response to a specific stimulus-stimulus association is reinforced with a particular reinforcer or outcome. A group of 10 participants with MCI, and a matched control group had to learn and keep in working memory four target locations out of eight possible locations where a shape could be presented. Results showed that participants with MCI had a statistically significant better terminal accuracy when a unique outcome was paired with a location (76% accuracy) as compared to a non differential outcome condition (64%). This finding suggests that the DOP is useful in improving working memory in MCI patients, which may delay their conversion to dementia.

Keywords: mild cognitive impairment, working memory, differential outcomes, cognitive process

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Authors: Basavaraj Vadavadagi, Satishkumar Shekhawat

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Interstitial free steels posses better formability and have many applications in automotive industries. Forming limit diagrams (FLDs) indicate the formability of materials which can be determined by experimental and finite element (FE) simulations. FLDs were determined experimentally by LDH test, utilizing optical strain measurement system for measuring the strains in different width specimens and by FE simulations in Interstitial Free (IF) and Interstitial Free High Strength (IFHS) steels. In this study, the experimental and FE simulated FLDs are compared and also the stress based FLDs were investigated.

Keywords: forming limit diagram, limiting dome height, optical strain measurement, interstitial

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Authors: A. K. Paul, Vinod Kumar

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Lead free magnetoelectric (ME) nanoparticulate (1−x) BNT-BKT-BMgT−x CFO (x = 0, 0.1, 0.2, 0.3) composite films were synthesized using chemical solution deposition method. The X-ray diffraction and transmission electron microscope (TEM) reveal that CFO nanoparticles were well distributed in the matrix of BNT-BKT-BMgT. The nanocomposite films exhibit both good magnetic and ferroelectric properties at room temperature (R-T). It is concluded that the modulation in compositions of piezomagnetic/piezoelectric components plays a fundamental role in the magnetoelectric coupling in these nanoparticulate composite films. These ME composites provide a great opportunity as potential lead-free systems for ME devices.

Keywords: lead free multiferroic, nanocomposite, ferroelectric, ferromagnetic and magneto-electric properties

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Authors: K. Rhea Devaiah, B. S. Premalatha

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Background: Tonsillar Lingual sulcus is the area between the tonsils and the base of the tongue. The surgical resection of the lesions in the head and neck results in changes in speech and swallowing functions. The severity of the speech and swallowing problem depends upon the site and extent of the lesion, types and extent of surgery and also the flexibility of the remaining structures. Need of the study: This paper focuses on the importance of speech and swallowing rehabilitation in an individual with the lesion in the Tonsillar Lingual Sulcus and post-operative functions. Aim: Evaluating the speech and swallow functions post-intensive speech and swallowing rehabilitation. The objectives are to evaluate the speech intelligibility and swallowing functions after intensive therapy and assess the quality of life. Method: The present study describes a report of an individual aged 47years male, with the diagnosis of basaloid squamous cell carcinoma, left tonsillar lingual sulcus (pT2n2M0) and underwent wide local excision with left radical neck dissection with PMMC flap reconstruction. Post-surgery the patient came with a complaint of reduced speech intelligibility, and difficulty in opening the mouth and swallowing. Detailed evaluation of the speech and swallowing functions were carried out such as OPME, articulation test, speech intelligibility, different phases of swallowing and trismus evaluation. Self-reported questionnaires such as SHI-E(Speech handicap Index- Indian English), DHI (Dysphagia handicap Index) and SESEQ -K (Self Evaluation of Swallowing Efficiency in Kannada) were also administered to know what the patient feels about his problem. Based on the evaluation, the patient was diagnosed with pharyngeal phase dysphagia associated with trismus and reduced speech intelligibility. Intensive speech and swallowing therapy was advised weekly twice for the duration of 1 hour. Results: Totally the patient attended 10 intensive speech and swallowing therapy sessions. Results indicated misarticulation of speech sounds such as lingua-palatal sounds. Mouth opening was restricted to one finger width with difficulty chewing, masticating, and swallowing the bolus. Intervention strategies included Oro motor exercise, Indirect swallowing therapy, usage of a trismus device to facilitate mouth opening, and change in the food consistency to help to swallow. A practice session was held with articulation drills to improve the production of speech sounds and also improve speech intelligibility. Significant changes in articulatory production and speech intelligibility and swallowing abilities were observed. The self-rated quality of life measures such as DHI, SHI and SESE Q-K revealed no speech handicap and near-normal swallowing ability indicating the improved QOL after the intensive speech and swallowing therapy. Conclusion: Speech and swallowing therapy post carcinoma in the tonsillar lingual sulcus is crucial as the tongue plays an important role in both speech and swallowing. The role of Speech-language and swallowing therapists in oral cancer should be highlighted in treating these patients and improving the overall quality of life. With intensive speech-language and swallowing therapy post-surgery for oral cancer, there can be a significant change in the speech outcome and swallowing functions depending on the site and extent of lesions which will thereby improve the individual’s QOL.

Keywords: oral cancer, speech and swallowing therapy, speech intelligibility, trismus, quality of life

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Authors: Chinelo Igwenagu

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Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

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Authors: Huihui Zhang, Zhongzhi Zhang

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Coagulation/flocculation is regarded a simple and effective wastewater treatment technology. Chlorine-containing coagulants may release chloride ions into the wastewater, causing corrosion. A green chlorine-free coagulant of polyaluminum ferric silicate (PSAF) was prepared by the copolymerization method to treat oily refractory wastewaters. Results showed that the highest removal efficiency of turbidity and chemical oxygen demand (COD) achieved 97.4% and 93.0% at a dosage of 700 mg/L, respectively. After PSAF coagulation, the chloride ion concentration was also almost the same as that in the raw wastewater. Thus, the chlorine-free coagulant is highly efficient and does not introduce additional chloride ions into the wastewater, avoiding corrosion.

Keywords: coagulation, chloride-free coagulant, oily refractory wastewater, coagulation performance

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Authors: Shih-Heng Sun, Hsiu-Yu Chang

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“Family centered service model” becomes mainstream in early intervention. Family outcome should be evaluated in addition child improvement in terms of outcome evaluation in early intervention. The purpose of this study is to develop a surveys to evaluate family outcomes in early intervention. Method: “Family Outcomes Survey- Revised Taiwan Version” (FOS-RT) was developed through translation, back-translation, and review by the original author. Expert meeting was held to determine the content validity. Two hundred and eighty six parent-child dyads recruited from 10 local Early Intervention Resource Centers (EIRC) participated in the study after they signed inform consent. The results showed both parts of FOS-RT exhibits good internal consistency and test-retest reliability. The result of confirmatory factor analysis indicated moderate fit of 5 factor structure of part A and 3 factor structure of part B of FOS-RT. The correlation between different sessions reached moderate to high level reveals some sessions measure similar latent trait of family outcomes. Correlation between FOS-RT and Parents‘ Perceived Parenting Skills Questionnaire was calculated to determine the convergence validity. The moderate correlation indicates the two assessments measure different parts of early intervention outcome although both assessments have similar sub-scales. The results of this study support FOS-RT is a valid and reliable tool to evaluate family outcome after the family and children with developmental disability receive early intervention services.

Keywords: early intervention, family service, outcome evaluation, parenting skills, family centered

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Authors: J. Jessa

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Background: Autism is a pervasive developmental disorder, the incidence of which has significantly increased in recent years. Children with autism have impairments in social skills, communication, and imagination. Children with autism has more common than healthy children feeding problems: food selectivity, problems with gastrointestinal tract: diarrhea, constipations, abdominal pain, reflux and others. Many parents of autistic children report that after implementation of gluten-, casein- and sugar free diet those symptoms disappear and even cognitive functions become better. Some children begin to understand speech and to communicate with parents, regain eye contact, become more calm, sleep better and has better concentration. Probably at the root of this phenomenon lies elimination from the diet peptides construction of which is similar to opiates. Enhanced permeability of gut causes absorption of not fully digested opioid-like peptides from food, like gluten and casein and probably others (proteins from soy and corn) which impact on brain of autistic children. Aim of the study: The aim of the study is to assess the safety of gluten-free diet in children with autism, aged 2,5-7. Methods: Participants of the study (n=70) – children aged 2,5-7 with autism are divided into 3 groups. The first group (research group) are patients whose parents want to implement a gluten-free diet. The second group are patients who have been recommended to eliminate from the diet artificial substances, such as preservatives, artificial colors and flavors, and others (control group 1). The third group (control group 2) are children whose parents did not agree for implementation of the diet. Caregivers of children on the diet are educated about the specifics of the diet and how to avoid malnutrition. At the start of the study we exclude celiac disease. Before the implementation of the diet we performe a blood test for patients (morphology, ferritin, total cholesterol, dry peripheral blood drops to detect some genetic metabolic diseases), plasma aminogram) and urine tests (excretion of ions: Mg, Na, Ca, the profile of organic acids in urine), which assess nutritional status as well as the psychological test assessing the degree of the child's psychological functioning (PEP-R). All of these tests will be repeated after one year from the implementation of the diet. Results: To the present moment we examined 42 children with autism. 12 of children are on gluten- free diet. Our preliminary results are promising. Parents of 9 of them report that, there is a big improvement in child behavior, concentration, less aggression incidents, better eye contact and better verbal skills. Conclusion: Our preliminary results suggest that dietary intervention may positively affect developmental outcome for some children diagnosed with ASD.

Keywords: gluten free diet, autism spectrum disorder, autism, blood test

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Authors: Aouina Nabila Yasmina, Chaoui Zine El Abiddine

Abstract:

This study presents a comprehensive investigation into the elastic mean free path (EMFP) of electrons colliding with pyrimidine, a precursor to the pyrimidine bases in DNA, employing the Screen Corrected Additivity Rule (SCAR) method. The SCAR method is introduced as a novel approach that combines classical and quantum mechanical principles to elucidate the interaction of electrons with pyrimidine. One of the most fundamental properties characterizing the propagation of a particle in the nuclear medium is its mean free path. Knowledge of the elastic mean free path is essential to accurately predict the effects of radiation on biological matter, as it contributes to the distances between collisions. Additionally, the mean free path plays a role in the interpretation of almost all experiments in which an excited electron moves through a solid. Pyrimidine, the precursor of the pyrimidine bases of DNA, has interesting physicochemical properties, which make it an interesting molecule to study from a fundamental point of view. These include a relatively large dipole polarizability and dipole moment and an electronic charge cloud with a significant spatial extension, which justifies its choice in this present study.

Keywords: elastic mean free path, elastic collision, pyrimidine, SCAR

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Authors: Ayman Baklizi

Abstract:

This paper discusses the problem of testing hypotheses about the lifetime distributions of a matched pair based on censored data. A distribution free test based on a runs statistic is proposed. Its null distribution and power function are found in a simple convenient form. Some properties of the test statistic and its power function are studied.

Keywords: censored data, distribution free, matched pair, runs statistics

Procedia PDF Downloads 287

Authors: Autumporn Buranapongphan, Ketsirin Meethong, Phukan Pahaphom

Abstract:

The objectives of this research is aim to study the standard formula of choux cream recipe. Formulation of choux cream were used gluten free as a replacer with flour in choux dough, quinoa milk in cream and shelf life on product. The results showed the acceptance test using 30 target consumers revealed that liking of choux dough with water 34%, egg 30% flour 19% butter 16% baking powder 1% and cream with milk 68% sugar 13% butter 6.8% egg 4.5% and vanilla 0.9%. The gluten free exhibited the formulation of dough is rice flour 12% potato starch 26% tapioca 7.7% and quinoa flour 4.3%. The ratio of corn flour at 40% had significant effects on liking of viscosity for quinoa cream. During storage by Total viable count (TVA) were kept in room temperature for 8 hours and chilled for 18 hours.

Keywords: choux cream, gluten free, quinoa, dough

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Authors: Tadesse Melaku Abegaz

Abstract:

Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

Procedia PDF Downloads 246

Authors: Ayodeji Sowale, Athanasios Kolios, Beatriz Fidalgo, Tosin Somorin, Aikaterini Anastasopoulou, Alison Parker, Leon Williams, Ewan McAdam, Sean Tyrrel

Abstract:

Recently, energy recovery systems are thriving and raising attention in the power generation sector, due to the request for cleaner forms of energy that are friendly and safe for the environment. This has created an avenue for cogeneration, where Combined Heat and Power (CHP) technologies have been recognised for their feasibility, and use in homes and small-scale businesses. The efficiency of combustors and the advantages of the free piston Stirling engines over other conventional engines in terms of output power and efficiency, have been observed and considered. This study presents the numerical analysis of a micro-combustor with a free piston Stirling engine in an integrated model of a Nano Membrane Toilet (NMT) unit. The NMT unit will use the micro-combustor to produce waste heat of high energy content from the combustion of human waste and the heat generated will power the free piston Stirling engine which will be connected to a linear alternator for electricity production. The thermodynamic influence of the combustor on the free piston Stirling engine was observed, based on the heat transfer from the flue gas to working gas of the free piston Stirling engine. The results showed that with an input of 25 MJ/kg of faecal matter, and flue gas temperature of 773 K from the micro-combustor, the free piston Stirling engine generates a daily output power of 428 W, at thermal efficiency of 10.7% with engine speed of 1800 rpm. An experimental investigation into the integration of the micro-combustor and free piston Stirling engine with the NMT unit is currently underway.

Keywords: free piston stirling engine, micro-combustor, nano membrane toilet, thermodynamics

Procedia PDF Downloads 257