Search results for: cell-based therapy

Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Mahesh S. Harne, Sunil V. Deshmukh

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A continuous passive motion machine improves and helps the patient to restore range of motion in various physiotherapy activities. The paper presents a concept for portable CPM. The device is used for various joint for upper and lower body extremities. The device is designed so that the active and passive motion is incorporated. During development, the physiotherapist and patient need is integrated with designer aspects. Various tools such as Analytical Higher Hierarchy process (AHP) and Quality Function Deployment (QFD) is used to integrate the need at the design stage. With market survey of various commercial CPM the gaps are identified, and efforts are made to fill the gaps with ergonomic need. Indian anthropomorphic dimension is referred. The device is modular to best suit for all the anthropomorphic need of different human. Experimentation is carried under the observation of physiotherapist and doctor on volunteer patient. We reported better results are compare to conventional CPM with comfort and less pain. We concluded that the concept will be helpful to reduces therapy cost and wide utility of device for various joint and physiotherapy exercise.

Keywords: continuous passive motion machine, ergonomics, physiotherapy, quality function deployment

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Authors: Adriana Haulica

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Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

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Authors: Mohd Anuar Awang Idris, Muhammad Nubli Abdul Wahab, Nora Yusma Mohamed Yusoff

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Wudu’ (Ablution) and Zikr are amongst some of the spiritual tools which may help an individual control his mind, emotion and attitude. These tools are deemed to be able to deliver a positive impact on an individual’s psychophysiology. The main objective of this research is to determine the effects of Wudu’ (Ablution) and Zikr therapy using the biofeedback emWave application and technology. For this research, 13 students were selected as samples from the students’ representative body at the University Tenaga National, Malaysia. The DASS (Depression Anxiety Stress Scale) questionnaire was used to help with the assessment and measurement of each student’s ability in controlling his or her emotions before and after the therapies. The biofeedback emWave technology was utilized to monitor the student’s psychophysiology level. In addition, the data obtained from the Heart rate variability (HRV) test have also been used to affirm that Wudu’ and Zikr had had significant impacts on the student’s success in controlling his or her emotional pressure.

Keywords: biofeedback EmWave, emotion, psychophysiology, wudu’, zikr

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Authors: Harjyot Khosa

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In India and south Asia, stigma and discrimination against transgender community remain disproportionately high. Lack of mental health care restricts effective treatment and care for both physical and mental health. Knowledge assessment of 80 counsellors across India reflected that only 28% counsellors knew about the transgender community. Whereas, only 6% of them felt, that transgender community require a specific mental health support, considering the stigma they face in day to day life. Lastly, 62% did agree that they require specific training to address unmet needs of transgender community. A robust counselling module was developed with focus on technical counselling skills and strategies, specific counselling issues, identity and sexuality, disclosure, hormone therapy and sex reassignment surgery. Mental health related support should be an integral part of government and non-government programs for the overall well-being of transgender community who face stigma and discrimination at every level. Needs based capacity building and technical assistance is required towards providing mental health support for transgender populations and their partners.

Keywords: identity and sexuality, mental health, stigma, transgender

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Authors: Ines Zemni, Maher Slimane, Jamel Ben Hassouna, Khaled Rahal

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Background: Neurofibromatosis type 1 (NF1) is a genetic disease, which is associated with an increased risk of developing different malignancies including breast cancer. The association between NF1 band breast sarcoma is a rare entity. Herein we present a 25-year-old woman with NF1 who had fibrosarcoma of the left breast. Case presentation: The patient has multiple thoraco-abdominal 'café au lait' spots. Clinical examination showed a lump of the left breast measuring 9 cm of diameter, which was noticed for 6 months. There was a left inguinal mass of 6 cm of diameter. The patient underwent first a left lumpectomy. Histopathological exam revealed a high-grade fibrosarcoma of the left breast measuring 7.5 cm. Three months later, the patient underwent a left mastectomy and excision of the inguinal mass, which was a neurofibroma. An adjuvant chemotherapy and radiation therapy were indicated, but not applied because of the timeout. The patient is now alive after a follow up of 6 years, with no loco-regional recurrence or metastasis. Conclusion: The relationship between NF1 and breast cancer need to be more clarified by further studies. Establishing a specific screening program of these patients may help to make an earlier diagnosis of breast cancer.

Keywords: neurofibromatosis, breast, sarcoma, cancer

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Authors: Nabila N. El-Maraghy, Amany Essa, Yousra Abdel–Mottaleb, Nada Ismail

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The use of combination of chemotherapy and natural products to influence the cell death with low doses of chemotherapeutic agents and few side effects has recently emerged as a new method of cancer therapy. Aim: Evaluation the modulatory effect of Thymoquinone on HepG2 cells treated with Sorafenib. Methods: Hepatocellular Carcinoma HepG2 cell line was treated with Sorafenib and TQ individually and in combination. The effect of these treatments on cell viability (MTT assay), apoptosis (Expression of Caspase-3) and oxidative markers (GSH content and extent of lipid peroxidation) was determined. Results: When compared the effect of both agents alone and the combination of the IC50 of Sorafenib and the IC50 TQ, the combination resulted in reduction of cell inhibition and apoptosis and antagonize their actions on GSH content and extent of lipid peroxidation which are increased. This study showed potent anti-tumor activity of both TQ and Sorafenib separately on HepG2 but upon combination surprisingly they interacted and give antagonistic effect. Conclusion: Co-treatment resulted in antagonistic interaction between Sorafenib and Thymoquinone.

Keywords: antagonism, hepatocellular carcinoma, sorafenib, thymoquinone

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Authors: Abdallah Habbab, Khaled Sekkoum, Nasser Belboukhari

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Objective: This study is designed to examine the chemical composition, antioxidant and antibacterial activities of the essential oil extracted from leaves of Vitex agnus-castus. Methods: The essential oils of dry leaves of Vitex agnus-castus L. were obtained by hydro-distillation, afforded oil in the yield of 5.5% and their volatile constituents were identified by GC/MS. Antioxidant activity of the sample was determined by test system DPPH. Antifungal activity was tested against three fungal strains (Aspergillus flavus, Penicillium escpansum and Aspergillus ochraceus) by direct contact method. Results: Forty-three compounds were identified, representing 98.02% of the oil. Major components of the oil were 1,8-cineole (18.27 %), caryophyllene (8.60 %), N-(M-fluorophenyl)-maleimide (6.30 %), (+)-epi-bicyclosesquiphellandrene (6.00 %), terpinen-4-ol (5.57 %), pyrrolo (3,2,1-jk) carbazole (5.43 %), caryophyllene oxide (4.79 %), and phenol (4.09 %). Conclusion: The chemical constituents in the essential oil from the locally grown Vitex agnus-castus were identified. Therefore, the essential oil of Vitex agnus-castus is an active candidate which would be used as antioxidant, or antifungal agent in new drugs preparation for therapy of diseases.

Keywords: Vitex agnus-castus, essential oil, GC/MS, DPPH, 1, 8-cineole

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Authors: M. Trousselard, D. Steiler, C. Drogou, P. van-Beers, G. Lamour, S. N. Crosnier, O. Bouilland, P. Dubost, M. Chennaoui, D. Léger

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According to published data, undersea navigation for long periods (nuclear-powered ballistic missile submarine, SSBN) constitutes an extreme environment in which crews are subjected to multiple stresses, including the absence of natural light, illuminance below 1,000 lux, and watch schedules that do not respect natural chronobiological rhythms, for a period of 60-80 days. These stresses seem clearly detrimental to the submariners’ sleep, with consequences for their affective (seasonal affective disorder-like) and cognitive functioning. In the long term, there are abundant publications regarding the consequences of sleep disruption for the occurrence of organic cardiovascular, metabolic, immunological or malignant diseases. It seems essential to propose countermeasures for the duration of the patrol in order to reduce the negative physiological effects on the sleep and mood of submariners. Light therapy, the preferred treatment for dysfunctions of the internal biological clock and the resulting seasonal depression, cannot be used without data to assist knowledge of submariners’ chronobiology (melatonin secretion curve) during patrols, given the unusual characteristics of their working environment. These data are not available in the literature. The aim of this project was to assess, in the course of two studies, the benefits of two environmental techniques for managing chronobiological stress: techniques for optimizing potential (TOP; study 1)3, an existing programme to help in the psychophysiological regulation of stress and sleep in the armed forces, and dawn and dusk simulators (DDS, study 2). For each experiment, psychological, physiological (sleep) or biological (melatonin secretion) data were collected on D20 and D50 of patrol. In the first experiment, we studied sleep and depressive distress in 19 submariners in an operational setting on board an SSBM during a first patrol, and assessed the impact of TOP on the quality of sleep and depressive distress in these same submariners over the course of a second patrol. The submariners were trained in TOP between the two patrols for a 2-month period, at a rate of 1 h of training per week, and assigned daily informal exercises. Results show moderate disruptions in sleep pattern and duration associated with the intensity of depressive distress. The use of TOP during the following patrol improved sleep and depressive mood only in submariners who regularly practiced the techniques. In light of these limited benefits, we assessed, in a second experiment, the benefits of DDS on chronobiology (daily secretion of melatonin) and depressive distress. Ninety submariners were randomly allocated to two groups, group 1 using DDS daily, and group 2 constituting the control group. Although the placebo effect was not controlled, results showed a beneficial effect on chronobiology and depressive mood for submariners with a morning chronotype. Conclusions: These findings demonstrate the difficulty of practicing the tools of psychophysiological management in real life. They raise the question of the subjects’ autonomy with respect to using aids that involve regular practice. It seems important to study autonomy in future studies, as a cognitive resource resulting from the interaction between internal positive resources and “coping” resources, to gain a better understanding of compliance problems.

Keywords: chronobiology, light therapy, seasonal affective disorder, sleep, stress, stress management, submarine

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Authors: Valerie Porr, Sydney A. DeCaro

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TARA for borderline personality disorder (BPD), an education and advocacy organization, helps families to compassionately and effectively deal with troubling BPD behaviors. Our psychoeducational programs focus on understanding underlying neurobiological features of BPD and evidence-based methodology integrating dialectical behavior therapy (DBT) and mentalization based therapy (MBT,) clarifying the inherent misunderstanding of BPD behaviors and improving family communication. TARA4BPD conducts online surveys, workshops, and topical webinars. For over 25 years, we have collected data from BPD helpline callers. This data drew our attention to particular childhood idiosyncrasies that seem to characterize many of the children who later met the criteria for BPD. The idiosyncrasies we observed, heightened sensory sensitivity and hypervigilance, were included in Adolf Stern’s 1938 definition of “Borderline.” This aspect of BPD has not been prioritized by personality disorder researchers, presently focused on emotion processing and social cognition in BPD. Parents described sleep reversal problems in infants who, early on, seem to exhibit dysregulation in circadian rhythm. Families describe children as supersensitive to sensory sensations, such as specific sounds, heightened sense of smell, taste, textures of foods, and an inability to tolerate various fabrics textures (i.e., seams in socks). They also exhibit high sensitivity to particular words and voice tones. Many have alexithymia and dyslexia. These children are either hypo- or hypersensitive to sensory sensations, including pain. Many suffer from fibromyalgia. BPD reactions to pain have been studied (C. Schmahl) and confirm the existence of hyper and hypo-reactions to pain stimuli in people with BPD. To date, there is little or no data regarding what comprises a normative range of sensitivity in infants and children. Many parents reported that their children were tested or treated for sensory processing disorder (SPD), learning disorders, and ADHD. SPD is not included in the DSM and is treated by occupational therapists. The overwhelming anecdotal data from thousands of parents of children who later met criteria for BPD led TARA4BPD to develop a sensitivity survey to develop evidence of the possible role of early sensory perception problems as a pre-cursor to BPD, hopefully initiating new directions in BPD research. At present, the research community seems unaware of the role supersensory sensitivity might play as an early indicator of BPD. Parents' observations of childhood sensitivity obtained through family interviews and results of an extensive online survey on sensory responses across various ages of development will be presented. People with BPD suffer from a sense of isolation and otherness that often results in later interpersonal difficulties. Early identification of supersensitive children while brain circuits are developing might decrease the development of social interaction deficits such as rejection sensitivity, self-referential processes, and negative bias, hallmarks of BPD, ultimately minimizing the maladaptive methods of coping with distress that characterizes BPD. Family experiences are an untapped resource for BPD research. It is hoped that this data will give family observations the critical credibility to inform future treatment and research directions.

Keywords: alexithymia, dyslexia, hypersensitivity, sensory processing disorder

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Authors: Ghada M. R. Koura, Ahmed M. F. El Shiwi

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Background: structural scoliosis is a twisting deformity in the curve of vertebral column to the lateral side with simultaneous rotation of the vertebrae, which occurs during the growing years from 10 years to the puberty. Purpose: Studies investigating balance problems specific to scoliotic patients showed that those patients reveal variable balance abnormalities. In this study we evaluated the difference in postural stability responses between female patients (students, office worker and shish weapon players) with structural scoliosis and normal subjects. Methods: sixty subjects participated in this study. Thirty female patients with structural scoliosis with a mean age of (19.5 ± 3.26) years, with Cobb's angle ranged from 20º to 40° in the major curves, and thirty healthy female subjects with a mean age of (19.36 ± 2.41) years. Postural stability of both groups were evaluated by the Biodex Stability System. Results: There was no significant difference between both groups in dynamic balance test. Interpretation/Conclusion: As there was no significant difference between both groups in balance response, it is not recommended to add balance training as an extra physical therapy program for AIS female patients.

Keywords: structural scoliosis, postural stability, female patients, evaluation

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Authors: Douglas Shabe

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The world of the performing musician is one of high pressure that comes from the expected high standards they have to live up to and that they expect from themselves. The pressure that musicians put themselves under can manifest itself in physical problems such as focal dystonia. Knowledge of the contributing factors and potential rehabilitation strategies cannot only give players hope for recovery but also the information to prevent it from happening in the first place. This dissertation presents a multiple case study of two performing brass musicians who developed focal dystonia of the embouchure, also known as embouchure dystonia, combined with an autoethnography of the author’s experience of battling embouchure dystonia and our attempts at recovery. Extensive research into the current state of focal dystonia research was done to establish a base of knowledge. That knowledge was used to develop interview questions for the two participants and interpret the findings of the qualitative data collected. The research knowledge, as well as the qualitative data from the case studies, was also used to interpret the author’s experience. The author determined that behavioral, environmental, and psychological factors were of prime importance in the subjects’ development of focal dystonia and that modifications of those factors are essential for the best chance at recovery.

Keywords: focal dystonia, embouchure dystonia, music teaching and learning, music education

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Authors: I-En Lin, Feng-Jung Yang

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In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.

Keywords: automatic connection, catheter, glomerulonephritis, peritoneal dialysis

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Authors: Selen Muftuoglu, Dilara Kefeli

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The present study was conducted by using the cross-sectional study design and to determine the relationship between body image, eating behavior and nutritional status in 80 female athletes who were basketball, volleyball, flag football, indoor soccer, and ice hockey players. This study demonstrated that 70.0% of the female athletes had skipped meal. Also, female athletes had a normal body mass index (BMI), but 65.0% of them indicated that want to be thinner. On the other hand, we analyzed that their daily nutrients intake, so we observed that 43.4% of the energy was from the fatty acids, especially saturated fatty acids, and they had lower fiber, calcium and iron intake. Also, we found that BMI, waist circumference, waist to hip ratio were negatively correlated with Multidimensional Body-Self Relations Questionnaire and The Dutch Eating Behavior Questionnaire score and they were lower in who had meal skipped or not received diet therapy. As a conclusion, nutrition education is frequently neglected in sports programs. There is a paucity of nutrition education interventions among different sports.

Keywords: body image, eating behavior, eating disorders, female athletes, nutritional status

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Authors: Shuo Li, Yannick Coffinier, Chann Lagadec, Fabrizio Cleri, Katsuhiko Nishiguchi, Akira Fujiwara, Soo Hyeon Kim, Nicolas Clément

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The need for single cell detection and analysis techniques has increased in the past decades because of the heterogeneity of individual living cells, which increases the complexity of the pathogenesis of malignant tumors. In the search for early cancer detection, high-precision medicine and therapy, the technologies most used today for sensitive detection of target analytes and monitoring the variation of these species are mainly including two types. One is based on the identification of molecular differences at the single-cell level, such as flow cytometry, fluorescence-activated cell sorting, next generation proteomics, lipidomic studies, another is based on capturing or detecting single tumor cells from fresh or fixed primary tumors and metastatic tissues, and rare circulating tumors cells (CTCs) from blood or bone marrow, for example, dielectrophoresis technique, microfluidic based microposts chip, electrochemical (EC) approach. Compared to other methods, EC sensors have the merits of easy operation, high sensitivity, and portability. However, despite various demonstrations of low limits of detection (LOD), including aptamer sensors, arrayed EC sensors for detecting single-cell have not been demonstrated. In this work, a new technique based on 20-nm-thick nanopillars array to support cells and keep them at ideal recognition distance for redox-labeled aptamers grafted on the surface. The key advantages of this technology are not only to suppress the false positive signal arising from the pressure exerted by all (including non-target) cells pushing on the aptamers by downward force but also to stabilize the aptamer at the ideal hairpin configuration thanks to a confinement effect. With the first implementation of this technique, a LOD of 13 cells (with5.4 μL of cell suspension) was estimated. In further, the nanosupported cell technology using redox-labeled aptasensors has been pushed forward and fully integrated into a single-cell electrochemical aptasensor array. To reach this goal, the LOD has been reduced by more than one order of magnitude by suppressing parasitic capacitive electrochemical signals by minimizing the sensor area and localizing the cells. Statistical analysis at the single-cell level is demonstrated for the recognition of cancer cells. The future of this technology is discussed, and the potential for scaling over millions of electrodes, thus pushing further integration at sub-cellular level, is highlighted. Despite several demonstrations of electrochemical devices with LOD of 1 cell/mL, the implementation of single-cell bioelectrochemical sensor arrays has remained elusive due to their challenging implementation at a large scale. Here, the introduced nanopillar array technology combined with redox-labeled aptamers targeting epithelial cell adhesion molecule (EpCAM) is perfectly suited for such implementation. Combining nanopillar arrays with microwells determined for single cell trapping directly on the sensor surface, single target cells are successfully detected and analyzed. This first implementation of a single-cell electrochemical aptasensor array based on Brownian-fluctuating redox species opens new opportunities for large-scale implementation and statistical analysis of early cancer diagnosis and cancer therapy in clinical settings.

Keywords: bioelectrochemistry, aptasensors, single-cell, nanopillars

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Authors: Mahkameh Asadi, Habibollah Dadgar

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The precise definition margin of high and low-grade glioma is crucial for choosing best treatment approach after surgery and radio-chemotherapy. The aim of the current study was to assess the O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) positron emission tomography (PET)/computed tomography (CT) in patients with low (LGG) and high grade glioma (HGG). We retrospectively analyzed 18F-FET PET/CT of 10 patients (age: 33 ± 12 years) with suspicious for recurrent LGG and HGG. The final decision of recurrence was made by magnetic resonance imaging (MRI) and registered clinical data. While response to radio-chemotherapy by MRI is often complex and sophisticated due to the edema, necrosis, and inflammation, emerging amino acid PET leading to better interpretations with more specifically differentiate true tumor boundaries from equivocal lesions. Therefore, integrating amino acid PET in the management of glioma to complement MRI will significantly improve early therapy response assessment, treatment planning, and clinical trial design.

Keywords: positron emission tomography, amino acid positron emission tomography, magnetic resonance imaging, low and high grade glioma

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Authors: Mitra JahangirRad, Sheida Sodagar, Maryam Bahrami Hidaji

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This study was conducted with the aim of comparing anxiety, stress, depression and attitude towards death among patients with breast cancer who have undergone mastectomy or breast-conserving surgery. The study method is causal-comparative. Statistical population was all patients with breast cancer referring to Medical Center of Panjom Azar Hospital in Gorgan or oncologists' offices in this city within eight months. They were selected using purposive sampling. Sample size of this study was 45 patients with breast cancer undergoing mastectomy and 70 patients under breast-conserving surgery. Measurement tools in this study were depression, anxiety, and stress scale (Dass-21) as well as Death Attitude Profile-Revised (DAPR). Results of this study in hypotheses investigation showed that anxiety, stress and depression among patients with breast cancer, undergoing mastectomy or breast-conserving surgery is significantly different. However, their attitudes towards death do not differ. From these findings, it can be concluded that although most patients with breast cancer encounter many psychological problems, patients undergoing mastectomy experience more anxiety, stress and depression relative to patients with breast-conserving surgery and it seems that they need more supportive therapy.

Keywords: anxiety, breast cancer, depression, death, mastectomy

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Authors: Soon-Mi Park, Ihn Sook Jeong

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This retrospective study was aimed to identify risk factors of intravenous (IV) infiltration for hospitalized children. The participants were 1,174 children for test and 424 children for validation, who admitted to a general hospital, received peripheral intravenous injection therapy at least once and had complete records. Data were analyzed with frequency and percentage or mean and standard deviation were calculated, and decision tree analysis was used to screen for the most important risk factors for IV infiltration for hospitalized children. The decision tree analysis showed that the most important traditional risk factors for IV infiltration were the use of ampicillin/sulbactam, IV insertion site (lower extremities), and medical department (internal medicine) both in the test sample and validation sample. The correct classification was 92.2% in the test sample and 90.1% in the validation sample. More careful attention should be made to patients who are administered ampicillin/sulbactam, have IV site in lower extremities and have internal medical problems to prevent or detect infiltration occurrence.

Keywords: decision tree analysis, intravenous infiltration, child, validation

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Authors: Marco Frieslaar, Bing Chu, Eric Rogers

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Stroke is a devastating illness that is the second biggest cause of death in the world (after heart disease). Where it does not kill, it leaves survivors with debilitating sensory and physical impairments that not only seriously harm their quality of life, but also cause a high incidence of severe depression. It is widely accepted that early intervention is essential for recovery, but current rehabilitation techniques largely favor hospital-based therapies which have restricted access, expensive and specialist equipment and tend to side-step the emotional challenges. In addition, there is insufficient funding available to provide the long-term assistance that is required. As a consequence, recovery rates are poor. The relatively unexplored solution is to develop therapies that can be harnessed in the home and are formulated from technologies that already exist in everyday life. This would empower individuals to take control of their own improvement and provide choice in terms of when and where they feel best able to undertake their own healing. This research seeks to identify how effective post-stroke, rehabilitation therapy can be applied to upper limb mobility, within the physical context of a home rather than a hospital. This is being achieved through the design and construction of an automation scheme, based on iterative learning control and the Riener muscle model, that has the ability to adapt to the user and react to their level of fatigue and provide tangible physical recovery. It utilizes a SMART Phone and laptop to construct an iterative learning control (ILC) system, that monitors upper arm movement in three dimensions, as a series of exercises are undertaken. The equipment generates functional electrical stimulation to assist in muscle activation and thus improve directional accuracy. In addition, it monitors speed, accuracy, areas of motion weakness and similar parameters to create a performance index that can be compared over time and extrapolated to establish an independent and objective assessment scheme, plus an approximate estimation of predicted final outcome. To further extend its assessment capabilities, nerve conduction velocity readings are taken by the software, between the shoulder and hand muscles. This is utilized to measure the speed of response of neuron signal transfer along the arm and over time, an online indication of regeneration levels can be obtained. This will prove whether or not sufficient training intensity is being achieved even before perceivable movement dexterity is observed. The device also provides the option to connect to other users, via the internet, so that the patient can avoid feelings of isolation and can undertake movement exercises together with others in a similar position. This should create benefits not only for the encouragement of rehabilitation participation, but also an emotional support network potential. It is intended that this approach will extend the availability of stroke recovery options, enable ease of access at a low cost, reduce susceptibility to depression and through these endeavors, enhance the overall recovery success rate.

Keywords: home-based therapy, iterative learning control, Riener muscle model, SMART phone, stroke rehabilitation

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Authors: Marzieh Ebrahimi, Vahid Changizi, Mohammad Reza Kardan, Seyed Mahdi Hosseini Pooya, Parham Geramifar

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Radiation exposure to the patient's family members is one of the major concerns during thyroid cancer radionuclide therapy. The aim of this study was to measure the total effective dose of the family members by means of thermoluminescence personal dosimeter, and compare with those calculated by analytical methods. Eighty-five adult family members of fifty-one patients volunteered to participate in this research study. Considering the minimum and maximum range of dose rate from 15 µsv/h to 120 µsv/h at patients' release time, the calculated mean and median dose values of family members were 0.45 mSv and 0.28 mSv, respectively. Moreover, almost all family members’ doses were measured to be less than the dose constraint of 5 mSv recommended by Basic Safety Standards. Considering the influence parameters such as patient dose rate and administrated activity, the total effective doses of family members were calculated by TEDE and NRC formulas and compared with those of experimental results. The results indicated that, it is fruitful to use the quantitative calculations for releasing patients treated with I-131 and correct estimation of patients' family doses.

Keywords: effective dose, thermoluminescence, I-131, thyroid cancer

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Authors: P. C. Li, R. H. Feng, S. J. Chen, Y. J. Yu, Y. L. Chen, X. Y. Fan

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The purpose of this study is to investigate the effect of mindfulness and wisdom comprehensive strategy intervention on addiction to the Internet of college students by engaging fourteen intensive full-day mindfulness-based wisdom retreat curriculum. Wisdom, one of the practice method from the threefold training. Internet addiction, a kind of impulse control disorder, which attract the attentions of society due to its high prevalence and harmfulness in the last decade. Therefore, the study of internet addiction intervention is urgent. Participants with internet addiction were Chinese college students and screened by internet addiction disorder diagnose questionnaire (IAD-DQ). A quasi-experimental pretest and posttest design was used as research design. The finding shows that the mindfulness-based wisdom intervention strategy appeared to be effective in reducing the Internet addiction. Moreover, semi-structure interview method was conducted and outcomes included five themes: the reduction of internet use, the increment of awareness on emotion, self-control, present concentration and better positive lifestyle, indicating that mindfulness could be an effective intervention for this group with internet addiction.

Keywords: mindfulness, internet addiction, wisdom comprehensive intervention, cognitive-behavior therapy

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Authors: Mariam Fishere

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The proposed research study aims at developing an Internet-based transdiagnostic treatment and evaluating its efficacy. Based on the Common Elements Treatment Approach (CETA), a combined low-intensity and technology supported transdiagnostic treatment protocol will be culturally adapted for usage by nonprofessional therapists in Arabic-speaking countries. This Internet-based CETA intervention will target individuals suffering from one or more of the following disorders: depression, anxiety and posttraumatic stress disorder (PTSD), which are all major contributors to the global burden of mental illness. The growing body of research in the area of transdiagnostic treatment has proven to be effective in high-income countries (HICs), but there remain questions about its efficacy, cultural appropriateness, and validity for low- to middle-income countries (LMICs). The aim of this dissertation project is to investigate the efficacy of a newly developed Internet-delivery of an evidence-based transdiagnostic treatment – CETA – for a sample of Arabic-speaking individuals suffering from at least one of the following disorders; depression, anxiety, and PTSD.

Keywords: transdiagnostic, internet-based interventions, mental health, Arab world

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Authors: Hamid Ghasemzadeh- Nava, Maziar Kaveh Baghbadorani, Amin Tamadon

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Considering response of uterus to ecbolic effect of oxytocin near the time of parturition, this study was done for investigating the effect of prophylactic administration of this hormone on duration of fetal membrane retention, time interval to first detectable estrus, time interval to first service, and conception rate at first service in cases of both normal parturition and dystocia. For this reason cows with (n=18) and without (n=18) dystocia assigned randomly to treatment (n=12) or control (n=6) groups and received intramuscular injection of 100 IU of oxytocin or 10 mL of normal saline respectively. Further observations and investigations indicate that duration of fetal retention is significantly shorter in treatment group cows compared to control groups, regardless of having dystocia (P=0.002) or normal spontaneous calving (P=0.001). The same trend exists for conception rate at first service in which cows in treatment groups had significantly higher conception rate (CR) in comparison to cows in control groups with (P=0.0003) or without dystocia (P=0.017). The time interval to first detected heat and first service didn’t show any difference between groups.

Keywords: conception rate, oxytocin, RFM, time to first service

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Authors: Lacramioara Ochiuz, Aurelia Vasile, Iulian Stoleriu, Cristina Ghiciuc, Maria Ignat

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Topical administration of chemotherapeutic agents (eg. carmustine, bexarotene, mechlorethamine etc.) in local treatment of cutaneous T-cell lymphoma (CTCL) is accompanied by multiple side effects, such as contact hypersensitivity, pruritus, skin atrophy or even secondary malignancies. A known method of reducing the side effects of anticancer agent is the development of modified drug release systems using drug incapsulation in biocompatible nanoporous inorganic matrices, such as mesoporous MCM-41 silica. Mesoporous MCM-41 silica is characterized by large specific surface, high pore volume, uniform porosity, and stable dispersion in aqueous medium, excellent biocompatibility, in vivo biodegradability and capacity to be functionalized with different organic groups. Therefore, MCM-41 is an attractive candidate for a wide range of biomedical applications, such as controlled drug release, bone regeneration, protein immobilization, enzymes, etc. The main advantage of this material lies in its ability to host a large amount of the active substance in uniform pore system with adjustable size in a mesoscopic range. Silanol groups allow surface controlled functionalization leading to control of drug loading and release. This study shows (I) the amino-grafting optimization of mesoporous MCM-41 silica matrix by means of co-condensation during synthesis and post-synthesis using APTES (3-aminopropyltriethoxysilane); (ii) loading the therapeutic agent (carmustine) obtaining a modified drug release systems; (iii) determining the profile of in vitro carmustine release from these systems; (iv) assessment of carmustine release kinetics by fitting on four mathematical models. Obtained powders have been described in terms of structure, texture, morphology thermogravimetric analysis. The concentration of the therapeutic agent in the dissolution medium has been determined by HPLC method. In vitro dissolution tests have been done using cell Enhancer in a 12 hours interval. Analysis of carmustine release kinetics from mesoporous systems was made by fitting to zero-order model, first-order model Higuchi model and Korsmeyer-Peppas model, respectively. Results showed that both types of highly ordered mesoporous silica (amino grafted by co-condensation process or post-synthesis) are thermally stable in aqueous medium. In what regards the degree of loading and efficiency of loading with the therapeutic agent, there has been noticed an increase of around 10% in case of co-condensation method application. This result shows that direct co-condensation leads to even distribution of amino groups on the pore walls while in case of post-synthesis grafting many amino groups are concentrated near the pore opening and/or on external surface. In vitro dissolution tests showed an extended carmustine release (more than 86% m/m) both from systems based on silica functionalized directly by co-condensation and after synthesis. Assessment of carmustine release kinetics revealed a release through diffusion from all studied systems as a result of fitting to Higuchi model. The results of this study proved that amino-functionalized mesoporous silica may be used as a matrix for optimizing the anti-cancer topical therapy by loading carmustine and developing prolonged-release systems.

Keywords: carmustine, silica, controlled, release

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Authors: Elnaz Dabiri, Somayeh Hamidnezhad

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Background and Objective: This study aims at investigating the effect of whole word method on Mean Length of Utterance (MLU) of 3 to 6 years old children with cochlear implants having normal IQ. Materials and Methods: In this quasi-experimental and interventional study, 20 children with cochlear implants, aged between 3and 6 years, and normal IQ were selected from Tabriz cochlear implants center using convenience sampling. Afterward, they were randomly bifurcated. The first group was educated by whole-word reading method along with traditional methods and the second group by traditional methods. Both groups had three sessions of 45-minutes each, every week continuously for a period of 3 months. Pre-test and post-test language abilities of both groups were assessed using the TOLD test. Results: Both groups before training have the same age, IQ, and MLU, but after training the first group shows a considerable improvement in MLU in comparison with the second group. Conclusions: Reading training by the whole word method have more effect on MLU of children with cochlear implants in comparison of the traditional method.

Keywords: cochlear implants, reading training, traditional methods, language therapy, whole word method, Mean Length of Utterance (MLU)

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Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

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Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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Authors: Chang Li-Yu

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Aims: This study investigates the impact of psychological capital on the mental health of economically disadvantaged youth and examines whether family cohesion acts as a mediating variable between psychological capital and mental health. Methods: The sample for the study was drawn from the "Taiwan Poverty Children's Database: Survey on the Living Trends of Disadvantaged Children and Youth." The data analysis methods included descriptive statistics, confirmatory factor analysis, and structural equation modeling. Results: The results indicated that both psychological capital and family cohesion can significantly negatively predict mental health, with psychological capital significantly positively predicting family cohesion. The mediation effect analysis revealed that family cohesion fully mediates the relationship between psychological capital and mental health, meaning that psychological capital influences mental health through family cohesion. Recommendations: Based on these findings, the study concretely discusses the significance of psychological capital and family cohesion for the mental health of economically disadvantaged youth and offers suggestions for psychological counseling, therapy, and future research.

Keywords: psychological capital, mental health, economically disadvantaged youth, family cohesion

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Authors: Upasana Sharma, Jayanti Dutta, Amarjeet Singh

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Background: Ayurveda is a comprehensive natural health care system. It is widely used in India as a system of primary health care, and interest in it is growing worldwide. Objectives: 1) To assess the extent and pattern of use of Ayurvedic medicines/ products by the people of Chandigarh. 2) To assess the perceived impact of use of Ayurvedic medicines/ products among the users. Methods: A cross-sectional community based study was conducted in a city of North India. Overall 371 households were covered from rural, urban and slum areas from December 2010 to April 2011. Respondents were interviewed regarding practices about Ayurveda products. Results: Around 160 (43%; 95% CI= 38.15, 47.85) of the respondents were using Ayurvedic products in one form or the other. Out of them, 91 (57%) had used Ayurvedic medicines in combination with some other system of medicine rather than as a standalone therapy. Most of them (81%) preferred Ayurveda products for chronic digestive system related problems. Conclusion: The present study revealed that respondents had keen interest in Ayurveda. A section of population was taking Ayurvedic treatment for their health ailments. There was a great level of satisfaction among the users but high cost bothered them at times.

Keywords: ayurveda, alternative medicine, chronic diseases, complimentary medicine

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Authors: Matthew Perkins-McVey

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The pharmacological arm of mental health treatment is in a state of crisis. The promises of the Prozac century have fallen short; the number of different therapeutically significant medications that successfully complete development shrinks with every passing year, and the demand for better treatments only grows. Answering these hardships is a renewed optimism concerning the efficacy of controlled psychedelic therapy, a renaissance that has seen the return of a familiar concept: intoxication as a model psychosis. First appearing in the mid-19th century and featuring in an array of 20th century efforts in psychedelic research, model psychosis has, once more, come to the foreground of psychedelic research. And yet, little has been made of where this peculiar, perhaps even intoxicatingly mad, the idea originates. This paper seeks to uncover the conceptual foundations underlying the early emergence of model psychosis. This narrative will explore the conceptual foundations behind their independent development of the concept of model psychosis, considering their similarities and differences. In the course of this examination, it becomes apparent that the definition of endogenous psychosis, which formed in the mid-19th century, is the direct product of emerging understandings of exogenous psychosis, or model psychosis. Ultimately, the goal is not merely to understand how and why model psychosis became thinkable but to examine how seemingly secondary concept changes can engender new ways of being a psychiatric subject.

Keywords: history of psychiatry, model psychosis, history of medicine, history of science

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Authors: Sally Shepherd, Richard De Boer, Craig Murphy

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Background: Invasive lobular carcinoma (ILC) can metastasize to atypical sites within the peritoneal cavity, gastrointestinal, or genitourinary tract. Management varies depending on the symptom presentation, extent of disease burden, particularly if the primary disease is occult, and patient wishes. Case Series: 6 patients presented with general surgical presentations of ILC, including incomplete large bowel obstruction, cholecystitis, persistent lower abdominal pain, and faecal incontinence. 3 were diagnosed with their primary and metastatic disease in the same presentation, whilst 3 patients developed metastasis from 5 to 8 years post primary diagnosis of ILC. Management included resection of the metastasis (laparoscopic cholecystectomy), excision of the primary (mastectomy and axillary clearance), followed by a combination of aromatase inhibitors, biologic therapy, and chemotherapy. Survival post diagnosis of metastasis ranged from 3 weeks to 7 years. Conclusion: Metastatic ILC must be considered with any gastrointestinal or genitourinary symptoms in patients with a current or past history of ILC. Management may not be straightforward to chemotherapy if the acute pathology is resulting in a surgically resectable disease.

Keywords: breast cancer, gastrointestinal metastasis, invasive lobular carcinoma, metastasis

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