Search results for: retention period of orthodontic treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13687

Search results for: retention period of orthodontic treatment

12787 The Gold Standard Treatment Plan for Vitiligo: A Review on Conventional and Updated Treatment Methods

Authors: Kritin K. Verma, Brian L. Ransdell

Abstract:

White patches are a symptom of vitiligo, a chronic autoimmune dermatological condition that causes a loss of pigmentation in the skin. Vitiligo can cause issues of self-esteem and quality of life while also progressing the development of other autoimmune diseases. Current treatments in allopathy and homeopathy exist; some treatments have been found to be toxic, whereas others have been helpful. Allopathy has seemed to offer several treatment plans, such as phototherapy, skin lightening preparations, immunosuppressive drugs, combined modality therapy, and steroid medications to improve vitiligo. This presentation will review the FDA-approved topical cream, Opzelura, a JAK inhibitor, and its effects on limiting vitiligo progression. Meanwhile, other non-conventional methods, such as Arsenic Sulphuratum Flavum used in homeopathy, will be debunked based on current literature. Most treatments still serve to arrest progression and induce skin repigmentation. Treatment plans may differ between patients due to depigmentation location on the skin. Since there is no gold standard plan for treating patients with vitiligo, the oral presentation will review all topical and systemic pharmacological therapies that fight the depigmentation of the skin and categorize their validity from a systematic review of the literature. Since treatment plans are limited in nature, all treatment methods will be mentioned and an attempt will be made to make a golden standard treatment process for these patients.

Keywords: vitiligo, phototherapy, immunosuppressive drugs, skin lightening preparations, combined modality therapy, arsenic sulphuratum flavum, homeopathy, allopathy, golden standard, Opzelura

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12786 Effect of Rubber Treatment on Compressive Strength and Modulus of Elasticity of Self-Compacting Rubberized Concrete

Authors: I. Miličević, M. Hadzima Nyarko, R. Bušić, J. Simonović Radosavljević, M. Prokopijević, K. Vojisavljević

Abstract:

This paper investigates the effects of different treatment methods of rubber aggregates for self-compacting concrete (SCC) on compressive strength and modulus of elasticity. SCC mixtures with 10% replacement of fine aggregate with crumb rubber by total aggregate volume and with different aggregate treatment methods were investigated. The rubber aggregate was treated in three different methods: dry process, water-soaking, and NaOH treatment plus water soaking. Properties of SCC in a fresh and hardened state were tested and evaluated. Scanning electron microscope (SEM) analysis of three different SCC patches were made and discussed. It was observed that applying the proposed NaOH plus water soaking method resulted in the improvement of fresh and hardened concrete properties. It resulted in a more uniform distribution of rubber particles in the cement matrix, a better bond between rubber particles and the cement matrix, and higher compressive strength of SCC rubberized concrete.

Keywords: compressive strength, modulus of elasticity, NaOH treatment, rubber aggregate, self-compacting rubberized concrete, scanning electron microscope analysis

Procedia PDF Downloads 108
12785 The Pomade for Treatment of Bovine Papilomavirus-Induced Warts in Teats

Authors: Mehmet Kale, Ramazan Sencan, Sibel Yavru, Ahmet Ak, Nuri Mamak, Sibel Hasırcıoglu, Mesih Kocamuftuoglu, Yakup Yıldırım, Hasbi Sait Saltık

Abstract:

Bovine Papilloma Virus (BPV)-induced warts can cause mastitis, teat blindness, reduction of milk yield, udder deformities, and a difficulty in getting the teats into the milking machine. Especially, surgical operations cannot be performed in BPV-induced teat warts because of the increased sensitivity of the breast region and small-sized papillomas. Thus, there is a need to find new topical treatment methods. We have developed a pomade for treatment of BPV in cattle. The pomade is consists of lanoline, snakeskin (two special kind of snake), alcohol, vaseline, and ether. Firstly, we determined 46 cattle with teat warts. In the study, BPV antigen was detected in 28 cattle blood samples (61%) by ELISA. The pomade was applied to all BPV infected animals. The regression and recovery of warts were 100% in all animals. We advised using the pomade for treatment of BPV-induced warts in teats.

Keywords: bovine papilloma virus, pomade, teat, udder

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12784 Assessment of Energy Efficiency and Life Cycle Greenhouse Gas Emission of Wheat Production on Conservation Agriculture to Achieve Soil Carbon Footprint in Bangladesh

Authors: MD Mashiur Rahman, Muhammad Arshadul Haque

Abstract:

Emerging conservation agriculture (CA) is an option for improving soil health and maintaining environmental sustainability for intensive agriculture, especially in the tropical climate. Three years lengthy research experiment was performed in arid climate from 2018 to 2020 at research field of Bangladesh Agricultural Research Station (RARS)F, Jamalpur (soil texture belongs to Agro-Ecological Zone (AEZ)-8/9, 24˚56'11''N latitude and 89˚55'54''E longitude and an altitude of 16.46m) to evaluate the effect of CA approaches on energy use efficiency and a streamlined life cycle greenhouse gas (GHG) emission of wheat production. For this, the conservation tillage practices (strip tillage (ST) and minimum tillage (MT)) were adopted in comparison to the conventional farmers' tillage (CT), with retained a fixed level (30 cm) of residue retention. This study examined the relationship between energy consumption and life cycle greenhouse gas (GHG) emission of wheat cultivation in Jamalpur region of Bangladesh. Standard energy equivalents megajoules (MJ) were used to measure energy from different inputs and output, similarly, the global warming potential values for the 100-year timescale and a standard unit kilogram of carbon dioxide equivalent (kg CO₂eq) was used to estimate direct and indirect GHG emissions from the use of on-farm and off-farm inputs. Farm efficiency analysis tool (FEAT) was used to analyze GHG emission and its intensity. A non-parametric data envelopment (DEA) analysis was used to estimate the optimum energy requirement of wheat production. The results showed that the treatment combination having MT with optimum energy inputs is the best suit for cost-effective, sustainable CA practice in wheat cultivation without compromising with the yield during the dry season. A total of 22045.86 MJ ha⁻¹, 22158.82 MJ ha⁻¹, and 23656.63 MJ ha⁻¹ input energy for the practice of ST, MT, and CT was used in wheat production, and output energy was calculated as 158657.40 MJ ha⁻¹, 162070.55 MJ ha⁻¹, and 149501.58 MJ ha⁻¹, respectively; where energy use efficiency/net energy ratio was found to be 7.20, 7.31 and 6.32. Among these, MT is the most effective practice option taken into account in the wheat production process. The optimum energy requirement was found to be 18236.71 MJ ha⁻¹ demonstrating for the practice of MT that if recommendations are followed, 18.7% of input energy can be saved. The total greenhouse gas (GHG) emission was calculated to be 2288 kgCO₂eq ha⁻¹, 2293 kgCO₂eq ha⁻¹ and 2331 kgCO₂eq ha⁻¹, where GHG intensity is the ratio of kg CO₂eq emission per MJ of output energy produced was estimated to be 0.014 kg CO₂/MJ, 0.014 kg CO₂/MJ and 0.015 kg CO₂/MJ in wheat production. Therefore, CA approaches ST practice with 30 cm residue retention was the most effective GHG mitigation option when the net life cycle GHG emission was considered in wheat production in the silt clay loam soil of Bangladesh. In conclusion, the CA approaches being implemented for wheat production involving MT practice have the potential to mitigate global warming potential in Bangladesh to achieve soil carbon footprint, where the life cycle assessment approach needs to be applied to a more diverse range of wheat-based cropping systems.

Keywords: conservation agriculture and tillage, energy use efficiency, life cycle GHG, Bangladesh

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12783 Full-Face Hyaluronic Acid Implants Assisted by Artificial Intelligence-Generated Post-treatment 3D Models

Authors: Ciro Cursio, Pio Luigi Cursio, Giulia Cursio, Isabella Chiardi, Luigi Cursio

Abstract:

Introduction: Full-face aesthetic treatments often present a difficult task: since different patients possess different anatomical and tissue characteristics, there is no guarantee that the same treatment will have the same effect on multiple patients; additionally, full-face rejuvenation and beautification treatments require not only a high degree of technical skill but also the ability to choose the right product for each area and a keen artistic eye. Method: We present an artificial intelligence-based algorithm that can generate realistic post-treatment 3D models based on the patient’s requests together with the doctor’s input. These 3-dimensional predictions can be used by the practitioner for two purposes: firstly, they help ensure that the patient and the doctor are completely aligned on the expectations of the treatment; secondly, the doctor can use them as a visual guide, obtaining a natural result that would normally stem from the practitioner's artistic skills. To this end, the algorithm is able to predict injection zones, the type and quantity of hyaluronic acid, the injection depth, and the technique to use. Results: Our innovation consists in providing an objective visual representation of the patient that is helpful in the patient-doctor dialogue. The patient, based on this information, can express her desire to undergo a specific treatment or make changes to the therapeutic plan. In short, the patient becomes an active agent in the choices made before the treatment. Conclusion: We believe that this algorithm will reveal itself as a useful tool in the pre-treatment decision-making process to prevent both the patient and the doctor from making a leap into the dark.

Keywords: hyaluronic acid, fillers, full face, artificial intelligence, 3D

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12782 Efficacy and Safety of Sublingual Sufentanil for the Management of Acute Pain

Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

Abstract:

Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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12781 Physico-chemical and Biological Characterization of Urban Municipal Landfill Leachate and Treatment by Ozone Process

Authors: Ramdani Nadia, Kheddaoui Abdelkrim, Nemmich Said, Tilmatine Amar

Abstract:

The waste production nationwide is increasing every year, on account of therapid urbanization and growing populations, also consumption modes. Algerian political authorities have chosen Technical Landfill Centres (TLC) as a competitive and safe technique of waste management. However, storing these wastes in a bad way poses several environmental challenges, especially in the Department of Saïda, the latter have significant groundwaters. The major problem registered on this Landfill is the leachate resulting from the degradation of buried wastes which were disposed off the outside of the leachate basin and present a source of pollution for the local groundwaters by heavy metals and pathogenic germs. The present paper investigates the leachate treatment ozone process produced by Dielectric Barrier Discharge (DBD) under high potential. The experimental results obtained allowed us to show the efficiency of the treatment process by ozone based on the micro pollutant analysis (DCO, DBO5 , COT, heavy metals) and microbial analysis, after ozonation treatment. The results show that 80% of micro pollutants are eliminated and 100% destruction of all bacteria which reveals the high efficiency of the process.

Keywords: landfill, leachate, treatment, ozone, polluants, bacteria, micropolluant

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12780 Elastic Constants of Heat Treated Wood

Authors: Ergun Guntekin

Abstract:

Effects of heat treatment on elastic constants of Black pine (Pinus nigra) wood were investigated. Specimens were exposed to heat under atmospheric pressure at two different temperatures (180 and 210 °C) and three different time levels (2, 5, 8 hours). Three Young’s modulus in three anatomical directions, six Poisson’s ratios and three Shear modulus values associated with the main directions were evaluated by compression tests. Compression strength of the samples in three principal directions was also determined. All of the properties of the specimens tested were altered by heat treatment. The degree of alteration depends on the temperature as well as duration applied. Results indicate that EL and compression strength in L direction were not significantly influenced, compression strength in R direction significantly decreased, ER, ET and compression strength in T direction were increased for shorter periods, then dropped for 8-hour application of 180 ºC. ER was not significantly affected, compression strength in R direction and EL was significantly decreased, ET and compression strength in T direction were increased for shorter periods, then decreased for 8-hour application of 210 ºC. The shear modulus of the samples was decreased with application of treatment combinations. Most of the Poisson’s ratios were not affected by heat treatment.

Keywords: black pine, elastic constants, heat treatment, wood

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12779 Performance and Economics of Goats Fed Poultry Litter and Rumen Content

Authors: A. Mohammed, A. M. Umar, S. H. Adamu

Abstract:

The study was conducted to evaluate the growth performance and nutrients utilization using 20 entire males of Sahelian goats fed Rumen content (fore-stomach digest) and poultry litter waste (PLW) at various levels of inclusion. The experimental animals were randomly allocated to diet A (Control), B (10% each of FSD and PLW), C (6.67%PLW and 13.33 FSD) and D(13.33% PLW and 6.67% FDS) at the rate of five animals per treatment. After 90 days of feeding trial, It was observed that Diets D had best feed intake and body weight gain which might be due to the good palatability of PLW and less odour of FSD in the diet. Diet C had the least feed cost then followed by diet B and while diet A(control) was more expensive than other treatments. There was the significant difference (P<0.05) between the treatments in the cost of daily feed consumption. Treatment A had the highest value while treatment C recorded the lowest cost of daily feed consumption. There was no significant difference (P > 0.05) between all treatments in terms of Cost of feed kg/ live weight gain, where treatment B had the highest value while the lowest obtained in treatment D. However, it is recommended that more research trial should be carried out to ascertain the true value of incorporating poultry litter waste and fore-stomach digest.

Keywords: poultry litter, rumen content, weight gain, economics

Procedia PDF Downloads 642
12778 Development of a Mobile Image-Based Reminder Application to Support Tuberculosis Treatment in Africa

Authors: Haji Ali Haji, Hussein Suleman, Ulrike Rivett

Abstract:

This paper presents the design, development and evaluation of an application prototype developed to support tuberculosis (TB) patients’ treatment adherence. The system makes use of graphics and voice reminders as opposed to text messaging to encourage patients to follow their medication routine. To evaluate the effect of the prototype applications, participants were given mobile phones on which the reminder system was installed. Thirty-eight people, including TB health workers and patients from Zanzibar, Tanzania, participated in the evaluation exercises. The results indicate that the participants found the mobile graphic-based application is useful to support TB treatment. All participants understood and interpreted the intended meaning of every image correctly. The study findings revealed that the use of a mobile visual-based application may have potential benefit to support TB patients (both literate and illiterate) in their treatment processes.

Keywords: ICT4D, mobile technology, tuberculosis, visual-based reminder

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12777 Water Reclamation and Reuse in Asia’s Largest Sewage Treatment Plant

Authors: Naveen Porika, Snigdho Majumdar, Niraj Sethi

Abstract:

Water, food and energy securities are emerging as increasingly important and vital issues for India and the world. Hyderabad urban agglomeration (HUA), the capital city of Andhra Pradesh State in India, is the sixth largest city has a population of about 8.2 million. The Musi River, which is a tributary of Krishna river flows from west to east right through the heart of Hyderabad, about 80% of the water used by people is released back as sewage, which flows back into Musi every day with detrimental effects on the environment and people downstream of the city. The average daily sewage generated in Hyderabad city is 950 MLD, however, treatment capacity exists only for 541 Million Liters per Day (MLD) but only 407 MLD of sewage is treated. As a result, 543 MLD of sewage daily flows into Musi river. Hyderabad’s current estimated water demand stands at 320 Million Gallons per Day (MGD). However, its installed capacity is merely 270 MGD; by 2020 estimated demand will grow to 400 MGD. There is huge gap between current supply and demand, and this is likely to widen by 2021. Developing new fresh water sources is a challenge for Hyderabad, as the fresh water sources are few and far from the City (about 150-200 km) and requires excessive pumping. The constraints presented above make the conventional alternatives for supply augmentation unsustainable and unattractive .One such dependable and captive source of easily available water is the treated sewage. With proper treatment, water of desired quality can be recovered from the waste water (sewage) for recycle and reuse. Hyderabad Amberpet sewage treatment of capacity 339 MLD is Asia’s largest sewage treatment plant. Tertiary sewage treatment Standard basic engineering modules of 30 MLD,60 MLD, 120MLD & 180 MLD for sewage treatment plants has been developed which are utilized for developing Sewage Reclamation & Reuse model in Asia’s largest sewage treatment plant. This paper will focus on Hyderabad Water Supply & Demand, Sewage Generation & Treatment, Technical aspects of Tertiary Sewage Treatment and Utilization of developed standard modules for reclamation & reuse of treated sewage to overcome the deficit of 130 MGD as projected by 2021.

Keywords: water reclamation, reuse, Andhra Pradesh, hyderabad, musi river, sewage, demand and supply, recycle, Amberpet, 339 MLD, engineering modules, tertiary treatment

Procedia PDF Downloads 617
12776 Attraction and Retention of Newly Graduated Medical Doctors to Deprived Regions in Ghana: A Qualitative Case Study

Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

Abstract:

Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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12775 Development of Femoral Head Osteonecrosis Due to Corticosteroids Consumption; Probable Role of OCP: A Case Report

Authors: S. Alireza Mirghasemi, Shervin Rashidinia, Mohammad Saleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, Seyed Shahin Eftekhari, Sara Shahmoradi

Abstract:

Avascular necrosis of femoral head is a pathologic condition that the main cause is decreased blood supply of femoral head. Among predisposing risk factors, chronic use of corticosteroids, alcoholism, smocking and hip traumas have more important role. Also we can mention OCP consumption as a risk factor among less common predisposing factors that lead to AVNF, in this study we introduce another cause of AVNF with a period of treatment with moderate dose of corticosteroids accompanied by OCP as a probable facilitating factor that leads to AVNF.

Keywords: AVN, corticosteroids consumption, femoral head osteonecrosis, OCP

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12774 Employee Wellbeing: The Key to Organizational Success

Authors: Crystal Hoole

Abstract:

Employee well-being has become an area of concern for top executives and organizations worldwide. In developing countries such as South Africa, and especially in the educational sector, employees have to deal with anxiety, stress, fear, student protests, political and economic turmoil and excessive work demands on a daily basis. Research has shown that workplaces with higher resilience and better well-being strategies also report higher productivity, increased innovation, better employee retention and better employee engagement. Many organisations offer standard employee assistance programs and once-off short interventions. However, most of these well-being initiatives are perceived as ineffective. Some of the criticism centers around a lack of holistic well-being approaches, no proof of the success of well-being initiatives, not being part of the organization’s strategies and a lack of genuine leadership support. This study attempts to illustrate how a holistic well-being intervention, over a period of 100 days, is far more effective in impacting organizational outcomes. A quasi-experimental design, with a pre-test and pro-test design with a randomization strategy, will be used. Measurements of organizational outcomes are taken at three-time points throughout the study, before, middle and after. The constructs that will be measured are employee engagement, psychological well-being, organizational culture and trust, and perceived stress. The well-being is imitative follows a salutogenesis approach and is aimed at building resilience through focusing on six focal areas, namely sleep, mindful eating, exercise, love, gratitude and appreciation, breath work and mindfulness, and finally, purpose. Certain organizational constructs, including employee engagement, psychological well-being, organizational culture and trust and perceived stress, will be measured at three-time points during the study, namely before, middle and after. A quasi-experimental, pre-test and post-test design will be applied, also using a randomization strategy to limit potential bias. Repeated measure ANCOVA will be used to determine whether any change occurred over the period of 100 days. The study will take place in a Higher Education institution in South Africa. The sample will consist of academic and administrative staff. Participants will be assigned to a test and control group. All participants will complete a survey measuring employee engagement, psychological well-being, organizational culture and trust, and perceived stress. Only the test group will undergo the well-being intervention. The study envisages contributing on several levels: Firstly, the study hopes to find a positive increase in the various well-being indicators of the participants who participated in the study and secondly to illustrate that a longer more holistic approach is successful in improving organisational success (as measured in the various organizational outcomes).

Keywords: wellbeing, resilience, organizational success, intervention

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12773 Pattern of Anisometropia, Management and Outcome of Anisometropic Amblyopia

Authors: Husain Rajib, T. H. Sheikh, D. G. Jewel

Abstract:

Background: Amblyopia is a frequent cause of monocular blindness in children. It can be unilateral or bilateral reduction of best corrected visual acuity associated with decrement in visual processing, accomodation, motility, spatial perception or spatial projection. Anisometropia is an important risk factor for amblyopia that develops when unequal refractive error causes the image to be blurred in the critical developmental period and central inhibition of the visual signal originating from the affected eye associated with significant visual problems including anisokonia, strabismus, and reduced stereopsis. Methods: It is a prospective hospital based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 50 anisometropic amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 3 to 13 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over month, then occlusion treatment was started. Occlusion was done daily for 6-8 hours (full time) together with vision therapy. The occlusion was carried out for 3 months. Results: In this study about 8% subjects had anisometropia from myopia, 18% from hyperopia, 74% from astigmatism. The initial mean visual acuity was 0.74 ± 0.39 Log MAR and after intervention of amblyopia therapy with active vision therapy mean visual acuity was 0.34 ± 0.26 Log MAR. About 94% of subjects were improving at least two lines. The depth of amblyopia associated with type of anisometropic refractive error and magnitude of Anisometropia (p<0.005). By doing this study 10% mild amblyopia, 64% moderate and 26% severe amblyopia were found. Binocular function also decreases with magnitude of Anisometropia. Conclusion: Anisometropic amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Occlusion therapy with at least one instructed hour of active visual activity practiced out of school hours was effective in anisometropic amblyopes who were diagnosed at the age of 8 years and older, and the patients complied well with the treatment.

Keywords: refractive error, anisometropia, amblyopia, strabismic amblyopia

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12772 How OXA GENE Expression is Implicated in the Treatment Resistance and Poor Prognosis in Glioblastoma

Authors: Naomi Seidu, Edward Poluyi, Chibuikem Ikwuegbuenyi, Eghosa Morgan

Abstract:

The current poor prognosis of glioblastoma has called for the need for an improvement in treatment methods in order to improve its survival rate. Despite the different interventions currently available for this tumor, the average survival is still only a few months. (12-15). The aim is to create a more favorable prognosis and have a reduction in the resistance to treatment currently being experienced, even with surgical interventions and chemotherapy. From the available literature, there is a relationship between the presence of HOX genes (Homeobox genes) and glioblastoma, which could be attributable to the increasing treatment resistance. Hence silencing these genes can be a key to improving survival rates of glioblastoma. A series of studies have highlighted the role that HOX genes play in glioblastoma prognosis. Promotion of human glioblastoma initiation, aggressiveness, and resistance to Temozolomide has been associated with HOXA9. The role of HOX gene expression in cancer stem cells should be studied as it could provide a means of designing CSC-targeted therapies, as CSCs play a part in the initiation and progression of solid tumors.

Keywords: GBM- glioblastoma, HOXA gene- homeobox genes cluster, signaling pathways, temozolomide

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12771 Treatment of Leather Industry Wastewater with Advance Treatment Methods

Authors: Seval Yilmaz, Filiz Bayrakci Karel, Ali Savas Koparal

Abstract:

Textile products produced by leather have been indispensable for human consumption. Various chemicals are used to enhance the durability of end-products in the processing of leather products. The wastewaters from the leather industry which contain these chemicals exhibit toxic effects on the receiving environment and threaten the natural ecosystem. In this study, leather industry wastewater (LIW), which has high loads of contaminants, was treated using advanced treatment techniques instead of conventional methods. During the experiments, the performance of electrochemical methods was investigated. During the electrochemical experiments, the performance of batch electrooxidation (EO) using boron-doped diamond (BDD) electrodes with monopolar configuration for removal of chemical oxygen demand (COD) from LIW were investigated. The influences of electrolysis time, current density (which varies as 5 mA/cm², 10 mA/cm², 20 mA/cm², 30 mA/cm², 50 mA/cm²) and initial pH (which varies as 3,80 (natural pH of LIW), 7, 9) on removal efficiency were investigated in a batch stirred cell to determine the best treatment conditions. The current density applied to the electrochemical reactors is directly proportional to the consumption of electric energy, so electrical energy consumption was monitored during the experiment. The best experimental conditions obtained in electrochemical studies were as follows: electrolysis time = 60 min, current density = 30.0 mA/cm², pH 7. Using these parameters, 53.59% COD removal rates for LIW was achieved and total energy consumption was obtained as 13.03 kWh/m³. It is concluded that electrooxidation process constitutes a plausible and developable method for the treatment of LIW.

Keywords: BDD electrodes, COD removal, electrochemical treatment, leather industry wastewater

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12770 Cost-Effectiveness Analysis of the Use of COBLATION™ Knee Chondroplasty versus Mechanical Debridement in German Patients

Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

Abstract:

Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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12769 Fear and Anxiety among School Age Children Undergoing Dental Treatment in an Oral Health Unit

Authors: Maha Ibrahim Mohamed Khalifa

Abstract:

Background: Dental fear and anxiety lead to avoidance of dental treatment and deterioration of oral health. Aim of the study: To assess the levels of fear and anxiety among school-age children undergoing dental treatment. Setting: The study was conducted in Outpatient Dental Clinics at Benha Teaching Hospital. Research design: A descriptive research design was utilized to conduct the study. Sample: A purposive sample of 60 school-age children and their mothers attending at the previously mentioned setting was included. Tools: Three tools were used: Tool one: A structured interviewing questionnaire for Personal characteristics of children and their mothers. Tool two: Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). Tool three: Modified Dental Anxiety Scale (MDAS). Results: It was illustrated that more than two-fifths (43.3%) of children had maximum fear and more than half of children (53.3%) had maximal anxiety. Conclusion: Many school-age children undergoing dental treatment suffer from high levels of fear and anxiety. Recommendations: The study recommended further research should be conducted to assess levels of fear and anxiety among children undergoing dental treatments and preferable nursing interventions for reducing their fears and anxieties.

Keywords: fear, anxiety, children, dental treatment

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12768 Assessment of HIV/Hepatitis B Virus Co-Infection among Patients Living with HIV in Northern and Southern Region of Nigeria

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

Abstract:

Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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12767 Synthesis of Iron Oxide Doped Zeolite: An Antimicrobial Nanomaterial for Drinking Water Purification Applications

Authors: Muhammad Zeeshan, Rabia Nazir, Lubna Tahir

Abstract:

Low cost filter based on iron doped zeolite (Fe-Z) and pottery clay was developed for an effective and efficient treatment of the drinking water contaminated with microbes. Fe-Z was characterized using powder XRD, SEM and EDX and shown to have average particle size of 49 nm with spongy appearance. The simulated samples of water self-contaminated with six microbes (S. typhi, B. subtilus, E. coli, S. aures, K. pneumoniae, and P. aeruginosa) after treatment with Fe-Z indicated effective removal of all the microbes in less than 30 min. Equally good results were obtained when actual drinking water samples, totally unfit for human consumption, were treated with Fe-Z.

Keywords: iron doped zeolite, biological and chemical treatment, drinking water

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12766 Application of Adaptive Neuro Fuzzy Inference Systems Technique for Modeling of Postweld Heat Treatment Process of Pressure Vessel Steel AASTM A516 Grade 70

Authors: Omar Al Denali, Abdelaziz Badi

Abstract:

The ASTM A516 Grade 70 steel is a suitable material used for the fabrication of boiler pressure vessels working in moderate and lower temperature services, and it has good weldability and excellent notch toughness. The post-weld heat treatment (PWHT) or stress-relieving heat treatment has significant effects on avoiding the martensite transformation and resulting in high hardness, which can lead to cracking in the heat-affected zone (HAZ). An adaptive neuro-fuzzy inference system (ANFIS) was implemented to predict the material tensile strength of post-weld heat treatment (PWHT) experiments. The ANFIS models presented excellent predictions, and the comparison was carried out based on the mean absolute percentage error between the predicted values and the experimental values. The ANFIS model gave a Mean Absolute Percentage Error of 0.556 %, which confirms the high accuracy of the model.

Keywords: prediction, post-weld heat treatment, adaptive neuro-fuzzy inference system, mean absolute percentage error

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12765 Psychedelic Assisted-Treatment for Patients with Opioid Use Disorder

Authors: Daniele Zullino, Gabriel Thorens, Léonice Furtado, Federico Seragnoli, Radu Iuga, Louise Penzenstadler

Abstract:

Context: Since the start of the 21st century, there has been a resurgence of interest in psychedelics, marked by a renewed focus on scientific investigations into their therapeutic potential. While psychedelic therapy has gained recognition for effectively treating depression and anxiety disorders, notable progress has been made in the clinical development of substances like psilocybin. Moreover, mounting evidence suggests promising applications of Lysergic acid diethylamide (LSD) and psilocybin in the field of addiction medicine. In Switzerland, compassionate treatment with LSD and psilocybin has been permitted since 2014 through exceptional licenses granted by the Federal Office of Public Health. This treatment approach is also available within the Geneva treatment program, extending its accessibility to patients undergoing opioid-assisted treatment involving substances like morphine and diacetylmorphine. The aim of this study is to assess the feasibility of psychedelic-assisted therapy in patients with opioid use disorder who are undergoing opioid-assisted treatment. This study addresses the question of whether psychedelic-assisted therapy can be successfully implemented in patients with opioid use disorder. It also explores the effects of psychedelic therapy on the patient's experiences and outcomes. Methodology: This is an open case series on six patients who have undergone at least one session with either LSD (100-200 micrograms) or psilocybin (20-40 mg). The patients were assessed using the Five Dimensional Altered States of Consciousness (5D-ASC)-Scale. The data were analyzed descriptively to identify patterns and trends in the patients' experiences. Results: The patients experienced substantial positive psychedelic effects during the psychedelic sessions without significant adverse effects. The patients reported positive experiences and improvements in their condition. Conclusion: The findings of this study support the feasibility and potential efficacy of psychedelic-assisted therapy in patients undergoing opioid-assisted treatment.

Keywords: psychedelics, psychedelic-assisted treatment, opioid use disorder, addiction, LSD, psilocybin

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12764 Effect of Hormones Priming on Enzyme Activity and Lipid Peroxidation in Wheat Seed under Accelerated Aging

Authors: Amin Abbasi, Fariborz Shekari, Seyed Bahman Mousavi

Abstract:

Seed aging during storage is a complex biochemical and physiological processes that can lead to reduce seed germination. This phenomenon associated with increasing of total antioxidant activity during aging. To study the effects of hormones on seed aging, aged wheat seeds (control, 90 and 80% viabilities) were treated with GA3, Salicylic Acid, and paclobutrazol and antioxidant system were investigated as molecular biomarkers for seed vigor. The results showed that, seed priming treatment significantly affected germination percentage, normality seedling percentage, H2O2, MDA, CAT, APX, and GPX activates. Maximum germination percentage achieve in GA3 priming in control treatment. Germination percentage and normal seedling percentage increased in other GA3 priming treatment compared with other hormones. Also aging increased MDA, H2O2 content. MDA is considered sensitive marker commonly used for assessing membrane lipid peroxidation and H2O2result in toxicity to cellular membrane system and damages to plant cells. Amount of H2O2 and MDA declined in GA3 treatment. CAT, GPX and APX activities were reduced by increasing the aging time and at different levels of priming. The highest APX activity was observed in Salicylic Acid control treatment and the highest GPX and CAT activity was obtained in GA3 control treatment. The lowest MDA and H2O2 showed in GA3 control treatment, too. Hormone priming increased Antioxidant enzyme activity and decreased amount of reactive oxygen space and malondialdehyde (MDA) under aging treatment. Also, GA3 priming treatments have a significant effect on germination percentage and number of normal seedling. Generally aging seed, increase ROS and lipid peroxidation. Antioxidant enzymes activity of aged seeds increased after hormone priming.

Keywords: hormones priming, wheat, aging seed, antioxidant, lipid peroxidation

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12763 The Use of Medicinal Plants among Middle Aged People in Rural Area, West Java, Indonesia

Authors: Rian Diana, Naufal Muharam Nurdin, Faisal Anwar, Hadi Riyadi, Ali Khomsan

Abstract:

The use of traditional medicine (herbs and medicinal plants) are common among Indonesian people especially the elderly. Few study explore the use of medicinal plants in middle aged people. This study aims to collect information on the use of medicinal plants in middle aged people in rural areas. This cross sectional study included 224 subjects aged 45-59 years old and conducted in Cianjur District, West Java in 2014. Semi-structured questionnaires were used to collect information about preference in treatment of illness, the use of medicinal plants, and their purposes. Information also recorded plant names, parts used, mode of preparation, and dosage. Buying drugs in stall (83.9%) is the first preference in treatment of illness, followed by modern treatment 19.2% (doctors) and traditional treatment 17.0% (herbs/medicinal plants). 87 subjects (38.8%) were using herbs and medicinal plants for curative (66.7%), preventive (31.2%), and rehabilitative (2.1%) purposes. In this study, 48 species are used by the subjects. Physalis minima L. 'cecenet', Orthosiphon aristatus Mic. 'kumis kucing', and Annona muricata 'sirsak' are commonly used for the treatment of hypertension and stiffness. Leaves (64.6%) are the most common part used. Medicinal plants were washed and boiled in a hot water. Subject drinks the herbs with a different dosage. One in three middle aged people used herbal and medicinal plants for curative and preventive treatment particularly hypertension and stiffness. Increasing knowledge about herbal or medicinal plants dosage and their interaction with medical drugs are important to do.Doses vary between 1-3 glasses/day for treatment and 1-2 glasses/months for prevention of diseases.

Keywords: herbs, hypertension, medicinal plants, middle age, rural

Procedia PDF Downloads 243
12762 A Universal Hybrid Adsorbent Based on Chitosan for Water Treatment

Authors: Sandrine Delpeux-Ouldriane, Min Cai, Laurent Duclaux, Laurence Reinert, Fabrice Muller

Abstract:

A novel hybrid adsorbent, based on chitosan biopolymer, clays and activated carbon was prepared. Hybrid chitosan beads containing dispersed clays and activated carbons were prepared by precipitation in basic medium. Such a composite material is still very porous and presents a wide adsorption spectrum. The obtained composite adsorbent is able to handle all the pollution types including heavy metals, polar and hydrophobic organic molecules and nitrates. It could find a place of choice in tertiary water treatment processes or for an ‘at source’ treatment concerning chemical or pharmaceutical industries.

Keywords: adsorption, chitosan, clay mineral, activated carbon

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12761 Adsorption of Phenolic Compounds on Activated Carbon DSAC36-24

Authors: Khaoula Hidouri, Ali Benhmidene, Bechir Chouachi, Dhananjay R. Mishra, Ammar Houas

Abstract:

Activated carbon DSAC36-24 iy is adsorbent materials, characterized by a specific surface area of 548.13 m²g⁻¹. Their manufacture uses the natural raw materials like the nucleus of dates. In this study the treatment is done in two stages: A chemical treatment by H3PO4 followed by a physical treatment under nitrogen for 1 hour then under stream of CO2 for 24 hours. A characterization of the various parameters was determined such as the measurement of the specific surface area, determination of pHPZC, bulk density, iodine value. The study of the adsorption of organic molecules (hydroquinone, paranitrophenol, 2,4-dinitrophenol, 2,4,6-trinitrophenol) indicates that the adsorption phenomena are essentially due to the van der Waals interaction. In the case of organic molecules carrying the polar substituents, the existence of hydrogen bonds is also proved by the donor-acceptor forces. The study of the pH effect was done with modeling by different models (Langmuir, Freundlich, Langmuir-Freundlich, Redlich-Peterson), a kinetic treatment is also followed by the application of Lagergren, Weber, Macky.

Keywords: adsoprtion ishoterms, adsorption kinetics, DSAC36-24, organic molecule

Procedia PDF Downloads 279
12760 Telemedicine and Telemonitoring for Interstitial Lung Disease Patients with Nintedanib

Authors: M. Brockes, S. Beck, A. Sigaroudi, C. Brockes

Abstract:

Over the last years, telemedicine and telemonitoring have become a popular way of treatment, especially in other chronic diseases. Therefore this type of treatment methodology was also implemented in interstitial lung disease (ILD) patients. In January 2024, a new service for patients with interstitial lung disease (ILD) treated with Nintedanib was established, which contains daily telemonitoring (home spirometry, pulse oximetry, and daily level of activity), daily evaluation of parameters as well as a telemedical availability answered by doctors and telemedical specialists throughout 365 days per year. The main motivational points of this service are the early detection of first signs of exacerbations and/or other symptoms/complications as well as easier access to healthcare professionals. The evaluation of the patient’s quality of life and the subjective feeling of safetyness was measured through patient reported experience measurements (PREMs) and patient reported outcome measurements (PROMs). Patients were introduced to the telemedical and telemonitoring service six-months ago. Within this period, every sixty days, the questionnaires were conducted by the scientific employees. Due to the unlimited time frame of the long-term service the evaluation is not completed. The first analysis of patient reported experience measurements (PREMs) and patient reported outcome measurements (PROMs) have shown an increased positive effect on the patients' quality of life as well as an increased positive effect on the subjective feeling of safety at home, plus a reduction and avoidance of secondary damages (e.g., exacerbations, deterioration of typical interstitial lung disease ILD symptoms and pharmaceutical side effects). The first results have shown a tendency that the telemedical treatment combined with telemonitoring at home and the encouragement of patients to actively participate in their healthcare has a positive effect on the patient’s overall well-being and could be implemented as a complementation of the traditional standard of care.

Keywords: avoidance of secondary damages, interstitial lung disease, telemedicine and telemonitoring, subjective feeling of safety

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12759 Outcome of Unilateral Retinoblastoma: A Ten Years Experience of Children's Cancer, Hospital Egypt

Authors: Ahmed Elhussein, Hossam El-Zomor, Adel Alieldin, Mahmoud A. Afifi, Abdullah Elhusseiny, Hala Taha, Amal Refaat, Soha Ahmed, Mohamed S. Zagloul

Abstract:

Background: A majority of children with retinoblastoma (60%) have a disease in one eye only (unilateral disease). This is a retrospective study to evaluate two different treatment modalities in those patients for saving their lives and vision. Methods: Four hundred and four patients were diagnosed with unilateral intraocular retinoblastoma at Children’s Cancer, Hospital Egypt (CCHE) through the period of July/2007 until December/2017. Management strategies included primary enucleation versus ocular salvage treatment. Results: Patients presented with mean age 24.5 months with range (1.2-154.3 months). According to the international retinoblastoma classification, Group D (n=172, 42%) was the most common, followed by group E (n=142, 35%), group C (n=63, 16%), and group B (n=27, 7%). All patients were alive at the end of the study except four patients who died, with 5-years overall survival 98.3% [CI, (96.5-100%)]. Patients presented with advanced disease and poor visual prognosis (n=241, 59.6%) underwent primary enucleation with 6 cycles adjuvant chemotherapy if they had high-risk features in the enucleated eye; only four patients out of 241 ended-up either with extraocular metastasis (n=3) or death (n=1). While systemic chemotherapy and focal therapy were the primary treatment for those who presented with favorable disease status and good visual prognosis (n=163, 40.4%); seventy-seven patients of them (47%) ended up with a pre-defined event (enucleation, EBRT, off protocol chemotherapy or 2ry malignancy). Ocular survival for patients received primary chemotherapy + focal therapy was [50.9% (CI, 43.5-59.6%)] at 3 years and [46.9% (CI,39.3-56%)] at 5 years. Comparison between upfront enucleation and primary chemotherapy for occurrence of extraocular metastasis revealed that there was no statistical difference between them except in group D (p value). While for occurrence of death, no statistical difference in all classification groups. Conclusion: In retinoblastoma, primary chemotherapy is a reasonable option and has a good probability for ocular salvage without increasing the risk of metastasis in comparison to upfront enucleation except in group D.

Keywords: CCHE, chemotherapy, enucleation, retinoblastoma

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12758 Efficacy and Mechanisms of Acupuncture for Depression: A Meta-Analysis of Clinical and Preclinical Evidence

Authors: Yimeng Zhang

Abstract:

Major depressive disorder (MDD) is a prevalent mental health condition with a substantial economic impact and limited treatment options. Acupuncture has gained attention as a promising non-pharmacological intervention for alleviating depressive symptoms. However, its mechanisms and clinical effectiveness remain incompletely understood. This meta-analysis aims to (1) synthesize existing evidence on the mechanisms and clinical effectiveness of acupuncture for depression and (2) compare these findings with pharmacological interventions, providing insights for future research. Evidence from animal models and clinical studies indicates that acupuncture may enhance hippocampal and network neuroplasticity and reduce brain inflammation, potentially alleviating depressive disorders. Clinical studies suggest that acupuncture can effectively relieve primary depression, particularly in milder cases, and is beneficial in managing post-stroke depression, pain-related depression, and postpartum depression, both as a standalone and adjunctive treatment. Notably, combining acupuncture with antidepressant pharmacotherapy appears to enhance treatment outcomes and reduce medication side effects, addressing a critical issue in conventional drug therapy's high dropout rates. This meta-analysis, encompassing 12 studies and 710 participants, draws data from eight digital databases (PubMed, EMBASE, Web of Science, EBSCOhost, CNKI, CBM, Wangfang, and CQVIP) covering the period from 2012 to 2022. Utilizing Stata software 15.0, the meta-analysis employed random-effects and fixed-effects models to assess the distribution of depression in Traditional Chinese Medicine (TCM). The results underscore the substantial evidence supporting acupuncture's beneficial effects on depression. However, the small sample sizes of many clinical trials raise concerns about the generalizability of the findings, indicating a need for further research to validate these outcomes and optimize acupuncture's role in treating depression.

Keywords: Chinese medicine, acupuncture, depression, meta-analysis

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