Search results for: physical therapy

Authors: Rohan Bhasin

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Agrammatism in non-fluent Aphasia Cases can be defined as a language disorder wherein a patient can only use content words ( nouns, verbs and adjectives ) for communication and their speech is devoid of functional word types like conjunctions and articles, generating speech of with extremely rudimentary grammar . Past approaches involve Speech Therapy of some order with conversation analysis used to analyse pre-therapy speech patterns and qualitative changes in conversational behaviour after therapy. We describe this approach as a novel method to generate functional words (prepositions, articles, ) around content words ( nouns, verbs and adjectives ) using a combination of Natural Language Processing and Deep Learning algorithms. The applications of this approach can be used to assist communication. The approach the paper investigates is : LSTMs or Seq2Seq: A sequence2sequence approach (seq2seq) or LSTM would take in a sequence of inputs and output sequence. This approach needs a significant amount of training data, with each training data containing pairs such as (content words, complete sentence). We generate such data by starting with complete sentences from a text source, removing functional words to get just the content words. However, this approach would require a lot of training data to get a coherent input. The assumptions of this approach is that the content words received in the inputs of both text models are to be preserved, i.e, won't alter after the functional grammar is slotted in. This is a potential limit to cases of severe Agrammatism where such order might not be inherently correct. The applications of this approach can be used to assist communication mild Agrammatism in non-fluent Aphasia Cases. Thus by generating these function words around the content words, we can provide meaningful sentence options to the patient for articulate conversations. Thus our project translates the use case of generating sentences from content-specific words into an assistive technology for non-Fluent Aphasia Patients.

Keywords: aphasia, expressive aphasia, assistive algorithms, neurology, machine learning, natural language processing, language disorder, behaviour disorder, sequence to sequence, LSTM

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Authors: Michal Krecichwost, Zauzanna Miodonska, Pawel Badura

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The diagnosis of sigmatism is mostly based on the observation of articulatory organs. It is, however, not always possible to precisely observe the vocal apparatus, in particular in the oral cavity of the patient. Speech processing can allow to objectify the therapy and simplify the verification of its progress. In the described study the methodology for classification of incorrectly pronounced phoneme [s] is proposed. The recordings come from adults. They were registered with the speech recorder at the sampling rate of 44.1 kHz and the resolution of 16 bit. The database of pathological and normative speech has been collected for the study including reference assessments provided by the speech therapy experts. Ten adult subjects were asked to simulate a certain type of stigmatism under the speech therapy expert supervision. In the recordings, the analyzed phone [s] was surrounded by vowels, viz: ASA, ESE, ISI, SPA, USU, YSY. Thirteen MFCC (mel-frequency cepstral coefficients) and RMS (root mean square) values are calculated within each frame being a part of the analyzed phoneme. Additionally, 3 fricative formants along with corresponding amplitudes are determined for the entire segment. In order to aggregate the information within the segment, the average value of each MFCC coefficient is calculated. All features of other types are aggregated by means of their 75th percentile. The proposed method of features aggregation reduces the size of the feature vector used in the classification. Binary SVM (support vector machine) classifier is employed at the phoneme recognition stage. The first group consists of pathological phones, while the other of the normative ones. The proposed feature vector yields classification sensitivity and specificity measures above 90% level in case of individual logo phones. The employment of a fricative formants-based information improves the sole-MFCC classification results average of 5 percentage points. The study shows that the employment of specific parameters for the selected phones improves the efficiency of pathology detection referred to the traditional methods of speech signal parameterization.

Keywords: computer-aided pronunciation evaluation, sibilants, sigmatism diagnosis, speech processing

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Authors: Majid Galoie, Khodadad Safavi, Abdolreza Karami Nejad, Reza Roshan

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Scour downstream of a flip bucket in a plunge pool is caused by impingement of water jet force. In order to reduce this force and consequently reduce scour hole depth, flip buckets may equip by dents. The minimum scour hole depth might be occurred by optimization of dents (number, shape, placement) on flip buckets. In this study, a comprehensive physical model has been developed and various options for dents have been investigated. The experimental data for each dent option such as scour hole depth, angle of impingement jet, piezometric pressure in tail-water and jet trajectory have been measured for various discharges. Finally, the best option can be found by analysis of the experimental results which has been expressed in this paper.

Keywords: scouring process, plunge pool, scour hole depth, physical model, flip bucket

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Authors: Bassam Band, Simon Freeman, Rohan Munir, Hisham Band

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Objective: To determine efficacy of facial physiotherapy provided for patients with facial nerve palsy. Design: Retrospective study Subjects: 54 patients diagnosed with Facial nerve palsy were included in the study after they met the selection criteria including unilateral facial paralysis and start of therapy twelve months after the onset of facial nerve palsy. Interventions: Patients received the treatment offered at a facial physiotherapy clinic consisting of: Trophic electrical stimulation, surface electromyography with biofeedback, neuromuscular re-education and myofascial release. Main measures: The Sunnybrook facial grading scale was used to evaluate the severity of facial paralysis. Results: This study demonstrated the positive impact of physiotherapy for patient with facial nerve palsy with improvement of 24.2% on the Sunnybrook facial grading score from a mean baseline of 34.2% to 58.2%. The greatest improvement looking at different causes was seen in patient who had reconstructive surgery post Acoustic Neuroma at 31.3%. Conclusion: The therapy shows significant improvement for patients with facial nerve palsy even when started 12 months post onset of paralysis across different causes. This highlights the benefit of this non-invasive technique in managing facial nerve paralysis and possibly preventing the need for surgery.

Keywords: facial nerve palsy, treatment, physiotherapy, bells palsy, acoustic neuroma, ramsey-hunt syndrome

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Authors: Karima Adilla

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Aceh province, into which Islam convinced to have entered Indonesia in the 12th Century before spreading throughout the archipelago and the rest of Southeast Asia, has several early Islamic mosques that still exist until today. However, due to some circumstances, the restoration and rehabilitation towards those mosques have been made in some periods, while the background was diverse. Concerning this, the research will examine the physical changing aspects of 3 prominent historical mosques in Aceh Besar and Banda Aceh; those are, Indrapuri Mosque, Baiturrahman Grand Mosque, and Baiturrahim Mosque built coincided with the beginning of Islam’s development in Aceh and regarded as eventful mosques. The existence of Indrapuri Mosque built on the remains of the Lamuri Kingdom’s temple is a historical trace that there was Hindu-Buddhist civilization in Aceh before Islam entered and became the majority religion about 98% from Aceh total population. Also, there was the Dutch who colonialized Aceh behind the existence of two famous mosques in Aceh, namely Baiturrahman Grand Mosque and Baiturrahim Mosque, as the colonizer also assisted to rebuild those 2 sacred Mosques to quell the anger of the Acehnese people because their mosque was burnt by the Dutch. Interestingly, despite underwent a long history successively since the rise of Islam after the Hindu-Buddhist kingdom had collapsed, colonialization, conflict, in Aceh, and even experienced the earthquake and tsunami disaster in 2004, those mosques still exist. Therefore, those mosques have been considered as historical silent witnesses. However, it was not merely those reasons that led the mosques underwent several physical changes, otherwise economic, political, social, cultural and religious factors were also highly influential. Instead of directly illustrating the physical changing of those three mosques, this research intends to identify under what condition the physical appearance continuously changing during the sultanate era, the colonial period until post-independent in terms of the architectural style, detail elements, design philosophy, and how the remnants buildings act as medium to bridge the history. A framework will use qualitative research methods by collecting actual data of the mosque's physical change figures through field studies, investigations, library studies and interviews. This research aims to define every trace of historical issues embedded in the physical changing of those mosques as they are intertwined in collecting historical proof. Thus, the result will reveal the characteristic interrelation between history, the mosque architectural style in a certain period, the physical changes background and its impact. Eventually, this research will also explicate a clear inference of each mosque’s role in representing history in Aceh Besar and Banda Aceh specifically, as well as Aceh generally through architectural design concepts.

Keywords: Aceh ancient mosques, Aceh history, Islamic architecture, physical changing

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Authors: Emil Danehorn, Ulla Peterson, Marie Oscarsson, Goldina Smirthwaite, Katarina Swahnberg

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Swedish students who choose to study abroad are common, but there has been limited research on exchange students. There are indications that some Swedish exchange students have been exposed to violence, but it is not known if they, already before their semester abroad, are more exposed to violence than students who remain on campus. Our aim was to investigate potential differences in exposure to physical, sexual, and emotional violence between prospective exchange students and campus students and between male and female students in general, as well as to determine any associations between mental health and exposure to violence among students in the total sample. Method: Comparative cross-sectional design using an online survey containing the NorVold Abuse Questionnaire and the General Health Questionnaire 12. A total of 565 participants took part in the study. Results: Prospective exchange students were less exposed to emotional violence compared to campus students. About one-half of all the participating female students had been exposed to sexual violence and about one-third of all the male students had been exposed to physical violence. The results also indicated that exposure to more than one form of violence was associated with poor mental health for students as a group. Conclusion: Prospective exchange students as a group do not report more exposure to physical and sexual violence than campus students but do report less exposure to emotional violence. However, the overall frequency of exposure to violence among the students was high. This highlights the need for proactive efforts for everyone, not least for exchange students who will be staying in a new environment unknown to them.

Keywords: sexual violence, physical violence, emotional violence, exchange students, mental health

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Authors: Parveen Kundu, Zile Singh, Kunika Kundu, Swaran Kaur

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Context: Tuberculous osteomyelitis is a relatively uncommon condition that can present with various clinical and radiological features, often mimicking bone tumors or tumor-like lesions. In endemic countries like India, tuberculosis should be considered as a potential differential diagnosis for lytic bone lesions. This study aimed to highlight the different presentations of tuberculosis that can mimic tumors or tumor-like lesions in bone and emphasize the successful outcome of antitubercular therapy (ATT) in treating these cases. Research Aim: The main objective of this research was to explore the varied presentations of tuberculosis that mimic bone tumors or tumor-like lesions both clinically and radiologically, focusing on different bones. The study aimed to raise awareness among clinicians about this possibility and highlight the importance of histopathological confirmation before initiating treatment for lytic bone lesions. Methodology: This study utilized a retrospective review of 22 patients with suspected lytic bone lesions, who were subsequently diagnosed with tuberculous osteomyelitis through histopathological examination. The cases were collected over a period of ten years. Eleven cases required curettage for extensive lesions with sequestrations, while all 22 patients received 12 months of antitubercular therapy. Findings: The study included 14 male and 8 female patients, ranging in age from 3 to 61 years, with an average age of 22.05. The clinical and radiological presentations varied, with examples including bone cysts in the metaphyseal area of long bones, lesions resembling chondroblastomas, giant cell tumors, and osteoid osteoma, as well as multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had lesions in both the clavicle and hand. Lesions mimicking chondromas were also observed in the phalanges of the hand and foot metatarsal. All patients showed resolution of the lesions and no residual disability following ATT. Theoretical Importance: This study highlights the importance of considering tuberculosis as a potential differential diagnosis for lytic bone lesions, particularly in endemic regions. It emphasizes the need for histopathological confirmation to accurately diagnose tuberculous osteomyelitis, as this is considered the gold standard. Data Collection and Analysis Procedures: Data for this study were collected retrospectively from medical records and radiological images of the 22 patients. The cases were analyzed based on clinical presentation, radiological findings, and histopathological confirmation. The outcomes of antitubercular therapy were also assessed. The data were summarized and presented descriptively. Question Addressed: This study aimed to address the question of how tuberculosis can mimic different bone tumors and tumor-like lesions clinically and radiologically. It also aimed to assess the successful outcome of antitubercular therapy in treating these cases. Conclusion: Tuberculous osteomyelitis can present with varied clinical and radiological features, often mimicking bone tumors or tumor-like lesions. Clinicians should consider tuberculosis as a potential diagnosis for lytic bone lesions, especially in endemic areas. Histopathological confirmation is essential for accurate diagnosis. Antitubercular therapy is an effective treatment for tuberculous osteomyelitis, leading to the resolution of the lesions with no residual disability.

Keywords: tuberculosis, tumor, curettage, bone

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Authors: A. Douara, N. Kermas, B. Djellouli

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In this study, we report calculations of gate capacitance of AlGaN/GaN HEMTs with nextnano device simulation software. We have used a physical gate capacitance model for III-V FETs that incorporates quantum capacitance and centroid capacitance in the channel. These simulations explore various device structures with different values of barrier thickness and channel thickness. A detailed understanding of the impact of gate capacitance in HEMTs will allow us to determine their role in future 10 nm physical gate length node.

Keywords: gate capacitance, AlGaN/GaN, HEMTs, quantum capacitance, centroid capacitance

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Authors: Laura C. Dapp, Claudia M. Roebers

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Being physically active has many benefits for children and adolescents. It is crucial for various aspects of physical and mental health, the development of a healthy self-concept, and also positively influences academic performance and school achievement. In addressing the still incomplete understanding of the link between physical activity (PA) and academic achievement, the current study scrutinized the open issue of how PA has to be implemented to positively affect mathematical outcomes in N = 138 fourth graders. Therefore, the current study distinguished between structured PA (formal, organized, adult-led exercise and deliberate sports practice) and unstructured PA (non-formal, playful, peer-led physically active play and sports activities). Results indicated that especially structured PA has the potential to contribute to mathematical outcomes. Although children spent almost twice as much time engaging in unstructured PA as compared to structured PA, only structured PA was significantly related to mathematical achievement as well as to mathematical self-concept. Furthermore, the pending issue concerning the quantity of PA needed to enhance children’s mathematical achievement was addressed. As to that, results indicated that the amount of time spent in structured PA constitutes a critical factor in accounting for mathematical outcomes, since children engaging in PA for two hours or more a week were shown to be both the ones with the highest mathematical self-concept as well as those attaining the highest mathematical achievement scores. Finally, the present study investigated the indirect effect of PA on mathematical achievement by controlling for the mathematical self-concept as a mediating variable. The results of a maximum likelihood mediation analysis with a 2’000 resampling bootstrapping procedure for the 95% confidence intervals revealed a full mediation, indicating that PA improves mathematical self-concept, which, in turn, positively affects mathematical achievement. Thus, engaging in high amounts of structured PA constitutes an advantageous leisure activity for children and adolescents, not only to enhance their physical health but also to foster their self-concept in a way that is favorable and encouraging for promoting their academic achievement. Note: The content of this abstract is partially based on a paper published elswhere by the authors.

Keywords: Academic Achievement, Mathematical Performance, Physical Activity, Self-Concept

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Authors: Imed Feki, Faouzi Msahli

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Selection of relevant parameters from a high dimensional process operation setting space is a problem frequently encountered in industrial process modelling. This paper presents a method for selecting the most relevant fabric physical parameters for each sensory quality feature. The proposed relevancy criterion has been developed using two approaches. The first utilizes a fuzzy sensitivity criterion by exploiting from experimental data the relationship between physical parameters and all the sensory quality features for each evaluator. Next an OWA aggregation procedure is applied to aggregate the ranking lists provided by different evaluators. In the second approach, another panel of experts provides their ranking lists of physical features according to their professional knowledge. Also by applying OWA and a fuzzy aggregation model, the data sensitivity-based ranking list and the knowledge-based ranking list are combined using our proposed percolation technique, to determine the final ranking list. The key issue of the proposed percolation technique is to filter automatically and objectively the relevant features by creating a gap between scores of relevant and irrelevant parameters. It permits to automatically generate threshold that can effectively reduce human subjectivity and arbitrariness when manually choosing thresholds. For a specific sensory descriptor, the threshold is defined systematically by iteratively aggregating (n times) the ranking lists generated by OWA and fuzzy models, according to a specific algorithm. Having applied the percolation technique on a real example, of a well known finished textile product especially the stonewashed denims, usually considered as the most important quality criteria in jeans’ evaluation, we separate the relevant physical features from irrelevant ones for each sensory descriptor. The originality and performance of the proposed relevant feature selection method can be shown by the variability in the number of physical features in the set of selected relevant parameters. Instead of selecting identical numbers of features with a predefined threshold, the proposed method can be adapted to the specific natures of the complex relations between sensory descriptors and physical features, in order to propose lists of relevant features of different sizes for different descriptors. In order to obtain more reliable results for selection of relevant physical features, the percolation technique has been applied for combining the fuzzy global relevancy and OWA global relevancy criteria in order to clearly distinguish scores of the relevant physical features from those of irrelevant ones.

Keywords: data sensitivity, feature selection, fuzzy logic, OWA operators, percolation technique

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Authors: Bulus Kpame, Mukhtar Mohammed Alhaji, Garba Jibril

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In any team sport, the most important variables that should be used to measure performance are physical condition, and technical and tactical performance. In a complex game like football, it is extremely difficult to measure the relative importance of each of these variables. However, physical fitness itself has been shown to consist of several components, like endurance, strength, flexibility, agility, coordination and speed. Each of these components has been shown to consist of several subcomponents. This paper attempts to describe a test battery to assess and evaluate physical performance in football players. This battery comprises a functional, structured training session of about 2.5hrs. it consists of quality rating of the warm-up procedure, tests of flexibility, football skills, power, speed, and endurance. Acceptable values for performance in each of the tests are also presented under each test. It is hoped that this battery of tests will be helpful to the coach in determining the effect of a specific training program. It would also be helpful to train physician and trainer, to monitor progress during rehabilitation after sustaining any injury.

Keywords: assessment, evaluation, performance, programs

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Authors: Kathie Records, R. Jeanne Ruiz, Kimberly Ayers, Rebecca Pasillas

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Background: Preterm births of less than 37 weeks gestation occur disproportionately to Hispanics living along the U.S.-Mexico border. Prematurity has devastating and costly effects on children, families and the health care system. Few preventive interventions have been tested for this vulnerable group. Objectives: To present the modeling and pilot testing of the theory-based Mastery Lifestyle Intervention (MLI), designed to reduce and prevent PTB among Mexican American women (the terms Hispanics or Latinas will also be used to represent this group) living in the United States. Design and Methods: The conceptualization of the problem of preterm births and the available literature underpinning the mastery lifestyle intervention will be reviewed. The lifestyle intervention includes foundational components of problem solving therapy and acceptance and commitment therapy. Findings from implementation of a one-group pilot test and focus group evaluated the feasibility and acceptability of the MLI. Summary: Participants found the MLI to be feasible and acceptable, and reported perceiving improved health status and familial relationships. Suggestions were provided for modifications prior to efficacy testing. The MLI appears to be a theoretically and empirically grounded intervention that holds promise for preventing preterm births among Latinas.

Keywords: birth, Hispanic, intervention, stress

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Authors: Malakeh Zuhdi Malak, Mahmoud Taher Kalaldeh

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In Jordan, no available data exists regarding violence and unintentional injuries among secondary school students aged 15-19 years. The purpose of this study was to assess the violence and unintentional injuries among those students, and to compare these two behaviors between male and female students. A descriptive cross-sectional design was carried out on randomly selected eight comprehensive secondary schools (four schools for females and four schools for males) from the public school educational directorate located in Amman. A modified Arabic version of the General School Health Survey questionnaire was used to measure violence and unintentional injuries. A sample of 750 secondary school students was studied. The findings showed that 26.8 % of students had been physically attacked. Overall, 43.3 % of students had been involved in a physical fight and 20.1% of them had been bullied. Overall, 45.3% of students were seriously injured. There was a difference between male and female students regarding to physical attack, physical fight, and serious injuries. In conclusion, it is necessary to develop effective training program in life skills for students that functions to reduce risk-taking behaviors that often leading to violence and unintentional injuries.

Keywords: secondary school students, violence, unintentional injuries, bullying

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Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

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Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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Authors: Ananya Pal, Neelakshi Sarkar, Debraj Saha, Dipanwita Das, Subhashish Kamal Guha, Bibhuti Saha, Runu Chakravarty

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Presently, tenofovir disoproxil fumurate (TDF) is the most effective anti-viral agent for the treatment of hepatitis B virus (HBV) in individuals co-infected with HIV and HBV as TDF has activity to suppress both wild-type and lamivudine (3TC)-resistant HBV. However, suboptimal response to TDF was reported in HIV-HBV co-infected individuals with prior 3TC therapy from different countries recently. The incidence of 3TC-resistant HBV strains is quite high in HIV-HBV co-infected patients experiencing long-term anti-retroviral therapy (ART) in eastern India. In spite of this risk, most of the patients with long-term 3TC treatment are continued with the same anti-viral agent in this country. Only a few have received TDF in addition to 3TC in the ART regimen since TDF has been available in India for the treatment of HIV-infected patients in 2012. In this preliminary study, we investigated the virologic and biochemical parameters among HIV-HBV co-infected patients who are non-responders to 3TC treatment during the continuation of 3TC or TDF add-on to 3TC in their ART regimen. Fifteen HIV-HBV co-infected patients who experienced long-term 3TC (mean duration months 36.87 ± 24.08 months) were identified with high HBV viremia ( > 20,000 IU/ml) or harbouring 3TC-resistant HBV. These patients receiving ART from School of Tropical Medicine Kolkata, the main ART centre in eastern India were followed-up semi-annually for next three visits. Different virologic parameters including quantification of plasma HBV load by real-time PCR, detection of hepatitis B e antigen (HBeAg) by commercial ELISA and anti-viral resistant mutations by sequencing were studied. During three follow-up among study subjects, 86%, 47%, and 43% had 3TC-mono-therapy (mean treatment-duration 41.54±18.84, 49.67±11.67, 54.17±12.37 months respectively) whereas 14%, 53%, and 57% experienced TDF in addition to 3TC (mean treatment duration 4.5±2.12, 16.56±11.06, and 23±4.07 months respectively). Mean CD4 cell-count in patients receiving 3TC was tended to be lower during third follow-up as compared to the first and the second [520.67±380.30 (1st), 454.8±196.90 (2nd), and 397.5±189.24 (3rd) cells/mm3) and similar trend was seen in patients experiencing TDF in addition to 3TC [334.5±330.218 (1st), 476.5±194.25 (2nd), and 461.17±269.89 (3rd) cells/mm3]. Serum HBV load was increased during successive follow-up of patients with 3TC-mono-therapy. Initiation of TDF lowered serum HBV-load among 3TC-non-responders at the time of second visit ( < 2,000 IU/ml), interestingly during third follow-up, mean HBV viremia increased >1 log IU/ml (mean 3.56±2.84 log IU/ml). Persistence of 3TC-resistant double and triple mutations was also observed in both the treatment regimens. Mean serum alanine aminotransferase remained elevated in these patients during this follow-up study. Persistence of high HBV viraemia and 3TC-resistant mutation in HBV during the continuation of 3TC might lead to major public health threat in India. The inclusion of TDF in the ART regimen of 3TC non-responder HIV-HBV co-infected patients showed adverse treatment response in terms of virologic and biochemical parameters. Therefore, serious attention is necessary for proper management of long-term 3TC experienced HIV-HBV co-infected patients with high HBV viraemia or 3TC-resistant HBV mutants in India.

Keywords: HBV, HIV, TDF, 3TC-resistant

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Authors: Elham Ahmadi, Mehrdad Ravanshad, Joyce Fingeroth, Mazyar Ziyaeyan, Rajesh Panigrahi, Jun Xie, Gao Guangping

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B-cell proliferative disorders often occur among persons that are T-cell compromised. These disorders are primarily EBV+ and can first present with a focal lesion. Direct introduction of oncolytic viruses into localized tumors provides theoretical advantages over chemotherapy and immunotherapy by reducing systemic toxicity, to which the immunocompromised host is most vulnerable. Widely studied as a vehicle for gene therapy, AAV has only rarely been applied to treat cancer. As a prelude to development of a therapeutic vehicle, we assessed the ability of 15 distinct recombinant AAV serotypes (rAAV1, rAAV2, rAAV3b, rAAV4, rAAV5, rAAV6, rAAV6.2, rAAV6TM, rAAV7, rAAV8, rAAVrh8, rAAV9, rAAVrh10, rAAV39, rAAV43) bearing eGFP to infect human B-cell tumor lines compared with primary B-cells in vitro. Enhanced infection of tumor lines by AAV 6.2 was demonstrated by flow cytometry. EBV superinfection of EBV negative B-cell tumor lines increased susceptibility to AAV6.2 infection. As proof of concept, AAV6.2 bearing HSV-1 thymidine kinase in place of eGFP eliminated tumor cells upon exposure to ganciclovir.

Keywords: AAV, gene therapy, lymphoma, malignancy, tropism

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Authors: Veepaul Kaur Mann Balwinder Singh

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The COVID-19 had an intense impact on several countries across the world. National governments have imposed widespread restrictions to prevent the growth of this pandemic. The new health competitive scenario induced by the COVID-19 crisis raised many issues on how business activities should be reorganized due to the difficulties of physical interactions with distributors, suppliers and customers. The pandemic has particularly affected the whole selling process because of the relevant issues that emerged in managing physical sale channels and interactions with one another, both in the Business-to-Consumer and in the Business-to-Business markets. Recent research about the appropriate actions and strategies that could help firms overcome the crisis has highlighted the key role of digital expertise that may ensure connections and, thus, help business activities run smoothly. This could be true, especially with the occurrence of strong limitations on physical interactions during the COVID-19 pandemic. The catastrophe changes life publically and economically. People are living alone for following the social distancing norms. In that set-up, Digital Marketing is playing an important role in civilization. Anyone can buy any item, pay bills, transfer money and compare items through Digital Marketing without physical interactions. After COVID-19, people will be more aware of health safety and trust. So, through Digital Marketing, organizations can approach customers and provide good service environments. In such a situation, the online network becomes the most important encouraging for online customers to get in contact with the firm and carry out online selling and purchasing activities around the world.

Keywords: COVID-19, business, digital marketing, online customer

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Authors: Akbarova Gulnozakhon

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Relevance. Physical exercises can prolong the function of the growth zones of long tubular bones, delay the fusion of the epiphyses and diaphyses of bones and, thus, increase the growth of the body. At the same time, intensive strength exercises can accelerate the process of ossification of bone growth zones and slow down their growth in length. The influence of physical exercises on the process of biological maturation is noted. Gymnastics, which requires intense speed and strength loads, delays puberty. On the other hand, it is indicated that the relatively slow puberty of gymnasts is associated with the selection of girls with a special somatotype in this sport. It was found that the later onset of menstruation in female athletes does not have a negative effect on the maturation process and fertility (the ability to procreate). Observations are made about the normalizing influence of sports on the puberty of girls. The purpose of the study. Our goal is to study physical activity of varying intensity on the formation of secondary sexual characteristics and hormonal status of girls in adolescence. Each biological process peculiar to a given organism is not in a stationary state, but fluctuates with a certain frequency. According to the duration, there are, for example, circadian cycles, and infradian cycles, a typical example of which is the menstrual cycle. Materials and methods, results. Violations of menstrual function in athletes were detected by applying a questionnaire survey that contains several paragraphs and sub-paragraphs where passport data, anthropometric indicators, taking into account anthropometric indices, information about the menstrual cycle are indicated. Of 135 female athletes aged 1-3 to 16 years engaged in various sports - gymnasts, menstrual function disorders were noted in 86.7% (primary or secondary amenorrhea, irregular MC), in swimming-in 57.1%. The general condition also changes during the menstrual cycle. In a large percentage of cases, athletes indicate an increase in irritability in the premenstrual (45%) and menstrual (36%) phases. During these phases, girls note an increase in fatigue of 46.5% and 58% (respectively). In girls, secondary sexual characteristics continue to form during puberty and the clearest indicator of the onset of puberty is the age of the onset of the first menstruation - menarche. Conclusions. 1. Physical exercise has a positive effect on all major systems of the body and thus promotes health.2. Along with a beneficial effect on human health, physical exercise, if the requirements of sports are not observed, can be harmful.

Keywords: girls health, anthropometric, physical development, reproductive health

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Authors: Desmond Agbolade Ademola

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This work aimed to introduce a theory, called Guided Energy Theory of a particle that answered questions that arise from quantum foundation, quantum mechanics theory, and interpretation such as: what is nature of wavefunction? Is mathematical formalism of wavefunction correct? Does wavefunction collapse during measurement? Do quantum physical entanglement and many world interpretations really exist? In addition, is there uncertainty in the physical reality of our nature as being concluded in the Quantum theory? We have been able to show by the fundamental analysis presented in this work that the way quantum mechanics theory, and interpretation describes nature is not correlated with physical reality. Because, we discovered amongst others that, (1) Guided energy theory of a particle fundamentally provides complete physical observable series of quantized measurement of a particle momentum, force, energy e.t.c. in a given distance and time.In contrast, quantum mechanics wavefunction describes that nature has inherited probabilistic and indeterministic physical quantities, resulting in unobservable physical quantities that lead to many worldinterpretation.(2) Guided energy theory of a particle fundamentally predicts that it is mathematically possible to determine precise quantized measurementof position and momentum of a particle simultaneously. Because, there is no uncertainty in nature; nature however naturally guides itself against uncertainty. Contrary to the conclusion in quantum mechanics theory that, it is mathematically impossible to determine the position and the momentum of a particle simultaneously. Furthermore, we have been able to show by this theory that, it is mathematically possible to determine quantized measurement of force acting on a particle simultaneously, which is not possible on the premise of quantum mechanics theory. (3) It is evidently shown by our theory that, guided energy does not collapse, only describes the lopsided nature of a particle behavior in motion. This pretty offers us insight on gradual process of engagement - convergence and disengagement – divergence of guided energy holders which further highlight the picture how wave – like behavior return to particle-like behavior and how particle – like behavior return to wave – like behavior respectively. This further proves that the particles’ behavior in motion is oscillatory in nature. The mathematical formalism of Guided energy theory shows that nature is certainty whereas the mathematical formalism of Quantum mechanics theory shows that nature is absolutely probabilistics. In addition, the nature of wavefunction is the guided energy of the wave. In conclusion, the fundamental mathematical formalism of Quantum mechanics theory is wrong.

Keywords: momentum, physical entanglement, wavefunction, uncertainty

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Authors: Zhang Jun Xiong

Abstract:

Objective: To explore the effect of physical exercise and outdoor lighting on the improvement of pupils' eyesight. Methods: A total of 208 first grade students in a primary school in Chengdu were enrolled in the study, 104 of whom were nearsighted and 104 had normal vision. They were randomly divided into indoor exercise group, outdoor exercise group, indoor control group and outdoor control group. Indoor and outdoor exercise groups performed moderate and high-intensity aerobic exercise three times a week, 60 minutes each time; The indoor and outdoor control groups had normal study and life during the experiment, without exercise intervention. The experiment lasted for one academic year, and the visual indicators of the subjects were tested before and after the experiment. Results: After the experiment, the visual fatigue index of the subjects with normal vision in the outdoor exercise group, indoor exercise group and outdoor control group decreased by 1.5 ± 2.89, 1.4 ± 3.05, 2.12 ± 2.66 respectively, and the diopter index decreased by 0.30D ± 0.09, 0.41D ± 0.16, 0.40D ± 0.19 respectively, while the visual fatigue score of the subjects with normal vision in the indoor control group increased by 2.3 ± 2.15, and the diopter decreased by 0.53D ± 0.22, There were significant differences in visual fatigue and diopter among the subjects with normal vision in each group (P<0.001). After the experiment, the visual fatigue index of the myopic subjects in the outdoor exercise group, indoor exercise group and outdoor control group decreased by 1.8 ± 1.95, 0.8 ± 1.81, 1.1 ± 1.85 respectively, and the diopter index decreased by 0.35D ± 0.21, 0.52D ± 0.24, 0.52D ± 0.15 respectively, while the visual fatigue score of the myopic subjects in the indoor control group increased by 1.3 ± 2.66, and the diopter decreased by 0.62D ± 0.29. There were significant differences between groups in visual fatigue and diopter (P<0.001). Conclusion: Both physical exercise and outdoor lighting can have a beneficial effect on children's vision, and the superposition effect of the two is better. It is suggested that outdoor physical exercise should be carried out more in primary school.

Keywords: physical exercise, outdoor lighting, pupil, vision, myopia

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Authors: Qian Mao, Xiaozan Wang, Jiarong Zhong, Xiaolin Zou

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Introduction: As a result of the decline of students' physical health level and the increase of study pressure, students’ academic performance is not so good. Objective: This study aims to verify whether the Brain-Break intervention in the fourth-grade classroom of primary school can improve students' physical health and academic performance. Methods: According to the principle of no difference in pre-test data, students from two classes of grade four in Fuhai Road Primary School, Fushan district, Yantai city, Shandong province, were selected as experimental subjects, including 50 students in the experimental class (25 males and 25 females) and 50 students in the control class (24 males and 26 females). The content of the experiment was that the students were asked to perform a 4-minute Brain-Berak program designed by the researcher in the second class in the morning and the afternoon, and the intervention lasted for 12 weeks. In addition, the lung capacity, 50-meter run, sitting body forward bend, one-minute jumping rope and one-minute sit-ups stipulated in the national standards for physical fitness of students (revised in 2014) were selected as the indicators of physical health. The scores of Chinese, Mathematics, and English in the unified academic test of the municipal education bureau were selected as the indicators of academic performance. The independent-sample t-test was used to compare and analyze the data of each index between the two classes. The paired-sample t-test was used to compare and analyze the data of each index in the two classes. This paper presents only results with significant differences. Results: in terms of physical health, lung capacity (P=0.002, T= -2.254), one-minute rope skipping (P=0.000, T=3.043), and one-minute sit-ups (P=0.045, T=6.153) were significantly different between the experimental class and the control class. In terms of academic performance, there is a significant difference between the Chinese performance of the experimental class and the control class (P=0.009, T=4.833). Conclusion: Adding Brain-Berak intervention in the classroom can effectively improve the cardiorespiratory endurance (lung capacity), coordination (jumping rope), and abdominal strength (sit-ups) of fourth-grade students. At the same time, it can also effectively improve their Chinese performance. Therefore, it is suggested to promote micro-sports in the classroom of primary schools throughout the country so as to help students improve their physical health and academic performance.

Keywords: academic performance, brain break, fourth grade, physical health

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Authors: Ummeh Saika, Toshio Kikuchi

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Population growth and urbanization is a global phenomenon. As the rapid progress of technology, many cities in the international community are facing serious problems of urbanization. There is no doubt that the urbanization will proceed to have significant impact on the ecology, economy and society at local, regional, and global levels. The inhabitants of Dhaka city suffer from lack of proper urban facilities. The green spaces are needed for different functional and leisure activities of the urban dwellers. Again growing densification, a number of green space are transferred into open space in the Dhaka city. As a result greenery of the city's decreases gradually. Moreover, the existing green space is frequently threatened by encroachment. The role of green space, both at community and city level, is important to improve the natural environment and social ties for future generations. Therefore, it seems that the green space needs to be more effective for public interaction. The main objective of this study is to address the effectiveness of urban green space (Urban Park) of Dhaka City. Two approaches are selected to fulfill the study. Firstly, analyze the long-term spatial changes of urban green space using GIS and secondly, investigate the relationship of urban park network with physical and social environment. The case study site covers eight urban parks of Dhaka metropolitan area of Bangladesh. Two aspects (Physical and Social) are applied for this study. For physical aspect, satellite images and aerial photos of different years are used to find out the changes of urban parks. And for social aspect, methods are used as questionnaire survey, interview, observation, photographs, sketch and previous information of parks to analyze about the social environment of parks. After calculation of all data by descriptive statistics, result is shown by maps using GIS. According to physical size, parks of Dhaka city are classified into four types: Small, Medium, Large and Extra Large parks. The observed result showed that the physical and social environment of urban parks varies with their size. In small size parks physical environment is moderate by newly tree plantation and area expansion. However, in medium size parks physical environment are poor, example- tree decrease, exposed soil increase. On the other hand, physical environment of large size and extra large size parks are in good condition, because of plenty of vegetation and well management. Again based on social environment, in small size parks people mainly come from surroundings area and mainly used as waiting place. In medium-size parks, people come to attend various occasion from different places. In large size and extra large size parks, people come from every part of the city area for tourism purpose. Urban parks are important source of green space. Its influence both physical and social environment of urban area. Nowadays green space area gradually decreases and transfer into open space. The consequence of this research reveals that changes of urban parks influence both physical and social environment and also impact on urban life.

Keywords: physical environment, social environment, urban life, urban parks

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Authors: K. C. R. Perera, B. M. Hapuwatte

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This paper presents an effective method to divide panels for mesh-less methods of source, vortex and doublet panel methods. In this research study the physical domain of air-foils were transformed into computational domain of a circle using conformal mapping technique of Joukowsky transformation. Then the circle is divided into panels of equal length and the co-ordinates were remapped into physical domain of the air-foil. With this method the leading edge and the trailing edge of the air-foil is panelled with a high density of panels and the rest of the body is panelled with low density of panels. The high density of panels in the leading edge and the trailing edge will increase the accuracy of the solutions obtained from panel methods where the fluid flow at the leading and trailing edges are complex.

Keywords: conformal mapping, Joukowsky transformation, physical domain, computational domain

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Authors: Amin Amani, Masomeh Reihany Shirvan, Mahla Nabizadeh Mashizi, Mohadese Khoshtinat, Mohammad Elyas Ansarinia

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The purpose of this study is the relationship between a healthy lifestyle and risky behavior in physical education students of Bojnourd schools. The study sample consisted of teenagers studying in second and third grade of Bojnourd's high schools. According to level sampling, 604 students studying in the second grade, and 600 students studying in third grade were tested from physical education schools in Bojnourd. For sample selection, populations were divided into 4 area including north, East, West and South. Then according to the number of students of each area, sample size of each level was determined. Two questionnaires were used to collect data in this study which were consisted of three parts: The demographic data, Iranian teenagers' risk taking (IARS) and prevention methods with emphasize on the importance of family role were examined. The Central and dispersion indices, such as standard deviation, multiple variance analysis, and multivariate regression analysis were used. Results showed that the observed F is significant (P ≤ 0.01) and 21% of variance related to risky behavior is explained by the lack of awareness. Given the significance of the regression, the coefficients of risky behavior in teenagers in prediction equation showed that each of teenagers' risky behavior can have an impact on healthy lifestyle.

Keywords: healthy lifestyle, high-risk behavior, students, physical education

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Authors: Sasan Khademnematolahi, Kevine Kamga Silihe, Katarína Pružinská, Martina Chrastina, Elisabeth Louise Ndjengue Mindang, František Dráfi, Katarína Bauerová

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Background: In ethnomedicine, plant parts and compounds are traditionally utilized to treat many disorders. Azadirachta indica, known as Neem, has been traditionally used in medicinal practices. Neem has various pharmaceutical activities, such as antioxidant and anti-inflammatory, due to the content of bioactive compounds like nimbolide, azadirachtin, and gedunin.Through its effect on pathological inflammatory processes, supplementation with it could alleviate the symptoms of rheumatoid arthritis (RA). Methods: This research aimed to assess Neem seed oil's impact on rats with adjuvant arthritis. Three doses in monotherapy and two in combination with methotrexate (MTX) have been studied and their effect was compared. Neem p.o. doses of 100, 200, and 300 mg/kg and MTX p.o. doses of 0.3 mg/kg were examined. After clinical parameters assessment, biochemical analysis was performed in plasma. Results: During the acute phase of the experimental arthritis (Day21), levels of MMP-9, MCP-1 and cytokines IL-1beta and IL-17A were measured. The positive results of inflammatory mediators evaluation in plasma encourage additional analysis also in related tissues to prove if Neem seed oil can be used as an adjuvant therapy for RA. Conclusion: In this study, the combination therapy of Neem with MTX was most effective from all therapies investigated.

Keywords: adjuvant, neem, methotrexate, arthritis

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Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

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Authors: Lawan Muhammad Adam, Abduljabar Hilal Alsayoud

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One of the most promising techniques to produce pure hydrogen is through a palladium-based membrane (Pd-membrane). Density functional theory (DFT) is employed in this work to examine how the physical and chemical adsorption properties of hydrogen on the surface of Pd-Pt can be mutated in the presence of contaminating gases, CH₄, CO, and CO₂. The main target is to survey the energy topology related to hydrogen adsorption while adjusting the stages of freedom in both the structure and composition. The adsorption sites, crystal plane of the slab, and relative orientation of the adsorbed molecules on its surface, as well as various arrangements of adsorbed species, have been considered in this study. The dependency of hydrogen adsorption on surface coverage is studied. The study demonstrated the physical adsorption energies of the molecules on the surface concerning the different coverages of hydrogen atoms. The most stable combinations of the adsorption sites (Top, Hollow, and Bridge) with various orientations of gaseous molecules on the Pd-Pt surface were identified according to their calculated energies. When the binding of contaminating gaseous species to the Pd-Pt surface and their impact on the physical adsorption energies of the H₂ are examined, it is observed that the most poisonous gas relative to all other gases modifies the energetics of the adsorption process of hydrogen on the surface.

Keywords: DFT, Pd-Pt-membrane, H₂, CO, CO₂

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Authors: Ana Cristina Lindsay, Mary L. Greaney

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Background: Racial/ethnic minority children of low-income immigrant families remain at increased risk of obesity. Consistent with high rates of childhood obesity among racial/ethnic minority children are high rates of physical inactivity and increased levels of sedentary behaviors (e.g., TV and other screen viewing). Brazilians comprise a fast-growing immigrant population group in the US, yet little research has focused on the health issues affecting Brazilian immigrant children. The purpose of this qualitative study was to explore how Brazilian-born immigrant mothers living in the United States obtain information about physical activity and screen-time for their young children. Methods: Qualitative research including focus groups with Brazilian immigrant mothers of preschool-age children living in the U.S. Results: Results revealed that Brazilian immigrant mothers obtain information on young children’s physical activity and screen-time from a variety of sources including interpersonal communication, television and magazines, government health care programs (WIC program) and professionals (e.g., nurses and pediatricians). A noteworthy finding is the significant role of foreign information sources (Brazilian TV shows and magazines) on mothers’ access to information about these early behaviors. Future research is needed to quantify and better understanding Brazilian parents’ access to accurate and sound information related to young children’s physical activity and screen-viewing behaviors. Conclusions: To our knowledge, no existing research has examined how Brazilian immigrant mothers living in the United States obtain information about these behaviors. This information is crucial for the design of culturally appropriate early childhood obesity prevention interventions tailored to the specific needs of this ethnic group.

Keywords: physical activity, scree-time, information, immigrant, mothers, Brazilian, United States

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Authors: June Tay, Ivy Chia

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There are numerous changes, both mental and physical, taking place when people age. We need to understand the different aspects required for healthy living, including meeting nutritional needs, regular physical activities to keep agility, sufficient rest and sleep to have physical and mental well-being, social engagement to avoid the risk of social isolation and depression, and access to healthcare to detect and manage chronic conditions. Promoting physical activities for an ageing population is necessary as many may have enjoyed sedentary lifestyles for some time. In our study, we evaluate the considerations when designing a computer vision video game for the elderly. We need to design some low-impact activities, such as stretching and gentle movements, because some elderly individuals may have joint pains or mobility issues. The exercise game should consist of simple movements that are easy to follow and remember. It should be fun and enjoyable so that they can be motivated to do some exercise. Social engagement can keep the elderly motivated and competitive, and they are more willing to engage in game exercises. Elderly citizens can compare their game scores and try to improve them. We propose a computer vision-based video game for the elderly that will capture and track the movement of the elderly hand pushing a ball on the screen into a circle. It can be easily set up using a PC laptop with a webcam. Our video game adhered to the design framework we employed, and it encompassed ease of use, a simple graphical interface, easy-to-play game exercise, and fun gameplay.

Keywords: about computer vision, video games, gerontology technology, caregiving

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Authors: Snezana Mugosa, Zoran Todorovic, Zoran Bukumiric, Ivan Radosavljevic, Natasa Djordjevic

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Introduction: Various studies have shown that the frequency of clopidogrel resistance ranges from 4-40%. The aim of this study was to provide in depth analysis of genetic and non-genetic factors that influence clopidogrel resistance in cardiology patients. Methods: We have conducted a prospective study in 200 hospitalized patients hospitalized at Cardiology Centre of the Clinical Centre of Montenegro. CYP2C19 genetic testing was conducted, and the PREDICT score was calculated in 102 out of 200 patients treated with clopidogrel in order to determine the influence of genetic and non-genetic factors on outcomes of interest. Adverse cardiovascular events and adverse reactions to clopidogrel were assessed during 12 months follow up period. Results: PREDICT score and CYP2C19 enzymatic activity were found to be statistically significant predictors of expressing lack of therapeutic efficacy of clopidogrel by multivariate logistic regression, without multicollinearity or interaction between the predictors (p = 0.002 and 0.009, respectively). Conclusions: Pharmacogenetics analyses that were done in the Montenegrin population of patients for the first time suggest that these analyses can predict patient response to the certain therapy. Stepwise approach could be used in assessing the clopidogrel resistance in cardiology patients, combining the PREDICT score, platelet aggregation test, and genetic testing for CYP2C19 polymorphism.

Keywords: clopidogrel, pharmacogenetics, pharmacotherapy, PREDICT score

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