Search results for: shock waves therapy

Authors: V. I. Kozyavkin, L. F. Shestopalova, T. B. Voloshyn

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Introduction: Rehabilitation of children with Autism is the issue of the day in psychiatry and neurology. It is attributed to constantly increasing quantity of autistic children - Autistic Spectrum Disorders (ASD) Existing rehabilitation approaches in treatment of children with Autism improve their medico- social and social- psychological adjustment. Experience of treatment for different kinds of Autistic disorders in International Clinic of Rehabilitation (ICR) reveals the necessity of complex intensive approach for healing this malady and wider implementation of a Kozyavkin method for treatment of children with ASD. Methods: 19 children aged from 3 to 14 years were examined. They were diagnosed ‘Autism’ (F84.0) with comorbid neurological pathology (from pyramidal insufficiency to para- and tetraplegia). All patients underwent rehabilitation in ICR during two weeks, where INRS approach was used. INRS included methods like biomechanical correction of the spine, massage, physical therapy, joint mobilization, wax-paraffin applications. They were supplemented by art- therapy, ergotherapy, rhythmical group exercises, computer game therapy, team Olympic games and other methods for improvement of motivation and social integration of the child. Estimation of efficacy was conducted using parent’s questioning and done twice- on the onset of INRS rehabilitation course and two weeks afterward. For efficacy assessment of rehabilitation of autistic children in ICR standardized tool was used, namely Autism Treatment Evaluation Checklist (ATEC). This scale was selected because any rehabilitation approaches for the child with Autism can be assessed using it. Results: Before the onset of INRS treatment mean score according to ATEC scale was 64,75±9,23, it reveals occurrence in examined children severe communication, speech, socialization and behavioral impairments. After the end of the rehabilitation course, the mean score was 56,5±6,7, what indicates positive dynamics in comparison to the onset of rehabilitation. Generally, improvement of psychoemotional state occurred in 90% of cases. Most significant changes occurred in the scope of speech (16,5 before and 14,5 after the treatment), socialization (15.1 before and 12,5 after) and behavior (20,1 before and 17.4 after). Conclusion: As a result of INRS rehabilitation course reduction of autistic symptoms was noted. Particularly improvements in speech were observed (children began to spell out new syllables, words), there was some decrease in signs of destructiveness, quality of contact with the surrounding people improved, new skills of self-service appeared. The prospect of the study is further, according to evidence- based medicine standards, deeper examination of INRS and assessment of its usefulness in treatment for Autism and ASD.

Keywords: intensive neurophysiological rehabilitation system (INRS), international clinic od rehabilitation, ASD, rehabilitation

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Authors: Kamal Kaushik, Dandpani Epili, Ajay G. V., Ashutosh, S. Pradhaan

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Introduction: Radiation therapy has come a long way over a period of decades, from 2-dimensional radiotherapy to intensity-modulated radiation therapy (IMRT) or VMAT. For advanced radiation therapy, we need better patient position reproducibility to deliver precise and quality treatment, which raises the need for better image guidance technologies for precise patient positioning. This study presents a two tattoo simulation with roll correction technique which is comparable to other advanced patient positioning techniques. Objective: This is a site-specific study is aimed to perform a comparison between various treatment positioning techniques used for the treatment of patients of Ca- Breast undergoing radiotherapy. In this study, we are comparing 5 different positioning methods used for the treatment of ca-breast, namely i) Vacloc with 3 tattoos, ii) Breast board with three tattoos, iii) Thermoplastic cast with three fiducials, iv) Breast board with a thermoplastic mask with 3 tattoo, v) Breast board with 2 tattoos – A roll correction method. Methods and material: All in one (AIO) solution immobilization was used in all patient positioning techniques for immobilization. The process of two tattoo simulations includes positioning of the patient with the help of a thoracic-abdomen wedge, armrest & knee rest. After proper patient positioning, we mark two tattoos on the treatment side of the patient. After positioning, place fiducials as per the clinical borders markers (1) sternum notch (lower border of clavicle head) (2) 2 cm below from contralateral breast (3) midline between 1 & 2 markers (4) mid axillary on the same axis of 3 markers (Marker 3 & 4 should be on the same axis). During plan implementation, a roll depth correction is applied as per the anterior and lateral positioning tattoos, followed by the shifts required for the Isocentre position. The shifts are then verified by SSD on the patient surface followed by radiographic verification using Cone Beam Computed Tomography (CBCT). Results: When all the five positioning techniques were compared all together, the produced shifts in Vertical, Longitudinal and lateral directions are as follows. The observations clearly suggest that the Longitudinal average shifts in two tattoo roll correction techniques are less than every other patient positioning technique. Vertical and lateral Shifts are also comparable to other modern positioning techniques. Concluded: The two tattoo simulation with roll correction technique provides us better patient setup with a technique that can be implemented easily in most of the radiotherapy centers across the developing nations where 3D verification techniques are not available along with delivery units as the shifts observed are quite minimal and are comparable to those with Vacloc and modern amenities.

Keywords: Ca. breast, breast board, roll correction technique, CBCT

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Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

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Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

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Authors: Andreea Cârâc, Elena Morosan, Ana Corina Ionita, Rica Bosencu, Geta Carac

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Lanthanum carbonate exhibits a considerable ability to bind phosphate and the substitution of Ca2+ ions by divalent or trivalent lanthanide metal ions attracted attention during the past few years. Although Lanthanum carbonate has not been approved by the FDA for treatment of hyperphosphatemia, we prospectively evaluated the efficacy of the combination of Calcium hydroxyapatite and Lanthanum carbonate for the treatment of hyperphosphatemia on mice. Calcium hydroxyapatite commonly referred as CHAp is a bioceramic material and is one of the most important implantable materials due to its biocompatibility and osteoconductivity. We prepared calcium hydroxyapatite and lanthanum carbonate. CHAp was prepared by co-precipitation method using Ca(OH)2, H3PO4, NH4OH with calcination at 1200ºC. Lanthanum carbonate was prepared by chemical method using NaHCO3 and LaCl3 at low pH environment , ph below 4.0 The confirmation of both substances structures was made using XRD characterization, FTIR spectra and SEM /EDX analysis. The study group included 20 subjects-mice divided into four groups according to the administered substance: lanthanum carbonate (group A), lanthanum carbonate + CHAp (group B), CHAp (group C) and salt water (group D). The results indicate a phosphate decrease when subjects (mice) were treated with CHAp and lanthanum carbonate (0.5 % CMC), in a single dose of 1500 mg/kg. Serum phosphate concentration decreased [from 4.5 ± 0.8 mg/dL) to 4.05 ± 0.2 mg/dL), P < 0.01] in group A and to 3.6 ± 0.2 mg/dL] only after the 24 hours of combination therapy. The combination of CHAp and lanthanum carbonate is a suitable regimen for hyperphosphatemia treatment subjects because it avoids both the hypercalcemia of CaCO3 and the adverse effects of CHAp. The ability of CHAp to decrease the serum phosphate concentration is 1/3 that of lanthanum carbonate.

Keywords: calcium hydroxyapatite, hyperphosphatemia, lanthanum carbonate, phosphate, structures

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Authors: M. Sasajima, T. Yamaguchi, Y. Hu, Y. Koike

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In this paper, we discuss the propagation of sound in the narrow pathways of an occluded-ear simulator typically used for the measurement of insert-type earphones. The simulator has a standardized frequency response conforming to the international standard (IEC60318-4). In narrow pathways, the speed and phase of sound waves are modified by viscous air damping. In our previous paper, we proposed a new finite element method (FEM) to consider the effects of air viscosity in this type of audio equipment. In this study, we will compare the results from the ear simulator FEM model, and those from a three dimensional human ear canal FEM model made from computed tomography images, with the measured frequency response data from the ear canals of 18 people.

Keywords: ear simulator, FEM, viscosity, human ear canal

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Authors: Wiesława Klimek-Piotrowska, Mateusz K. Hołda, Mateusz Koziej, Katarzyna Piątek, Jakub Hołda

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Introduction: The coronary sinus venous system (CSVS), which has always been overshadowed by the coronary arterial tree, has recently begun to attract more attention. Since it is a target for clinicians the knowledge of its anatomy is essential. Cardiac resynchronization therapy, catheter ablation of cardiac arrhythmias, defibrillation, perfusion therapy, mitral valve annuloplasty, targeted drug delivery, and retrograde cardioplegia administration are commonly used therapeutic methods involving the CSVS. The great variability in the course of coronary veins and tributaries makes the diagnostic and therapeutic processes difficult. Our aim was to investigate detailed anatomy of most common clinically used CSVS`s structures: the coronary sinus with its ostium, great cardiac vein, posterior vein of the left ventricle, middle cardiac vein and oblique vein of the left atrium. Methodology: This is a prospective study of 70 randomly selected autopsied hearts dissected from adult humans (Caucasian) aged 50.1±17.6 years old (24.3% females) with BMI=27.6±6.7 kg/m2. The morphology of the CSVS was assessed as well as its precise measurements were performed. Results: The coronary sinus (CS) with its ostium was present in all hearts. The mean CS ostium diameter was 9.9±2.5mm. Considered ostium was covered by its valve in 87.1% with mean valve height amounted 5.1±3.1mm. The mean percentage coverage of the CS ostium by the valve was 56%. The Vieussens valve was present in 71.4% and was unicuspid in 70%, bicuspid in 26% and tricuspid in 4% of hearts. The great cardiac vein was present in all cases. The oblique vein of the left atrium was observed in 84.3% of hearts with mean length amounted 20.2±9.3mm and mean ostium diameter 1.4±0.9mm. The average length of the CS (from the CS ostium to the Vieussens valve) was 31.1±9.5mm or (from the CS ostium to the ostium of the oblique vein of the left atrium) 28.9±10.1mm and both were correlated with the heart weight (r=0.47; p=0.00 and r=0.38; p=0.006 respectively). In 90.5% the ostium of the oblique vein of the left atrium was located proximally to the Vieussens valve, in remaining cases was distally. The middle cardiac vein was present in all hearts and its valve was noticed in more than half of all the cases (52.9%). The posterior vein of the left ventricle was observed in 91.4% of cases. Conclusions: The CSVS is vastly variable and none of basic hearts parameters is a good predictor of its morphology. The Vieussens valve could be a significant obstacle during CS cannulation. Caution should be exercised in this area to avoid coronary sinus perforation. Because of the higher incidence of the presence of the oblique vein of the left atrium than the Vieussens valve, the vein orifice is more useful in determining the CS length.

Keywords: cardiac resynchronization therapy, coronary sinus, Thebesian valve, Vieussens valve

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Authors: Nasrin Hosseinzad, Ramin Ghasemi Shayan

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Chemotherapy is the most common procedure in the treatment of advanced cancers but is justsoberlyoperativeand toxic. Nevertheless, the efficiency of chemotherapy is restrictedowing to multiple drug resistance(MDR). Lately, plentiful preclinical experiments have revealedthatPaclitaxel-Curcumin could be an ultimateapproach to converse MDR and synergistically increase their efficiency. The connotationsamongst B-cell-lymphoma2(BCL-2) and multi-drug-resistance-associated-P-glycoprotein(MDR1) consequence of patients forecast the efficiency of paclitaxel-built chemoradiotherapy. There are evidences of the efficacy of paclitaxel in the treatment of surface-transmission of bladder-cell-carcinoma by manipulating bio-adhesive microspheres accomplishedthroughout measured release of drug at urine epithelium. In Genetically-Modified method, muco-adhesive oily constructionoftricaprylin, Tween 80, and paclitaxel group showed slighter toxicity than control in therapeutic dose. Postoperative chemotherapy-Paclitaxel might be more advantageous for survival than adjuvant chemo-radio-therapy, and coulddiminish postoperative complications in cervical cancer patients underwent a radical hysterectomy.HA-Se-PTX(Hyaluronic acid, Selenium, Paclitaxel) nanoparticles could observablyconstrain the proliferation, transmission, and invasion of metastatic cells and apoptosis. Furthermore, they exhibitedvast in vivo anti-tumor effect. Additionally, HA-Se-PTX displayedminor toxicity on mice-chef-organs. Briefly, HA-Se-PTX mightprogress into a respectednano-scale agentinrespiratory cancers. To sum up, Paclitaxel is considered a profitable anti-cancer drug in the treatment and anti-progress symptoms in malignant cancers.

Keywords: cancer, paclitaxel, chemotherapy, tumor

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Authors: Patcharin Saechan, Isares Dhuchakallaya

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Thermoacoustic refrigerator is a cooling device which uses the acoustic waves to produce the cooling effect. The aim of this paper is to explore the experimental and numerical feasibility of a standing-wave thermoacoustic refrigerator. The effects of the stack length, position of stack and operating frequency on the cooling performance are carried out. The circular pore stacks are tested under the atmospheric pressure. A low-cost loudspeaker is used as an acoustic driver. The results show that the location of stack installed in resonator tube has a greater effect on the cooling performance than the stack length and operating frequency, respectively. The temperature difference across the ends of the stack can be generated up to 13.7°C, and the temperature of cold-end is dropped down by 5.3°C from the ambient temperature.

Keywords: cooling performance, refrigerator, standing-wave, thermoacoustics

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Authors: Nadia Sghaier

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In this paper, we examine the influence of the COVID-19 pandemic on the performance of the Tunisian stock market and 12 sectors over a recent period from 23 March 2020 to 18 August 2021, including several waves and the introduction of vaccination. The empirical study is conducted using cointegration techniques which allows for long and short-run relationships. The obtained results indicate that both daily growth in confirmed cases and deaths have a negative and significant effect on the stock market returns. In particular, this effect differs across sectors. It seems more pronounced in financial, consumer goods and industrials sectors. These findings have important implications for investors to predict the behavior of the stock market or sectors returns and to implement hedging strategies during the COVID-19 pandemic.

Keywords: Tunisian stock market, sectors, COVID-19 pandemic, cointegration techniques

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Authors: Henok Mezemr Besfat, Haftom Gebreslassie Gebregwergs

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wireless network is one of the most important mediums of transmission of information from one device to another devices. Wireless communication has a broad range of applications, including mobile communications through cell phones and satellites, Internet of Things (IoT) connecting several devices, wireless sensor networks for traffic management and environmental monitoring, satellite communication for weather forecasting and TV without requiring any cable or wire or other electronic conductors, by using electromagnetic waves like IR, RF, satellite, etc. This paper summarizes different wireless network technologies, applications of different wireless technologies and different types of wireless networks. Generally, wireless technology will further enhance operations and experiences across sectors with continued innovation. This paper suggests different strategies that can improve wireless networks and technologies.

Keywords: wireless senser, wireless technology, wireless network, internet of things

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Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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Authors: Lenka Markovičová, Viera Zatkalíková, Tomasz Garbacz

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The development of composite materials and the related design and manufacturing technologies is one of the most important advances in the history of materials. Composites are multifunctional materials having unprecedented mechanical and physical properties that can be tailored to meet the requirements of a particular application. Some composites also exhibit great resistance to high-temperature corrosion, oxidation, and wear. Polymers are widely used indoors and outdoors, therefore they are exposed to a chemical environment which may include atmospheric oxygen, acidic fumes, acidic rain, moisture heat and thermal shock, ultra-violet light, high energy radiation, etc. Different polymers are affected differently by these factors even though the amorphous polymers are more sensitive. Ageing is also important and it is defined as the process of deterioration of engineering materials resulting from the combined effects of atmospheric radiation, heat, oxygen, water, micro-organisms and other atmospheric factors.

Keywords: composites with glass fibers, mechanical properties, polyamides, UV degradation

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Authors: Tsang K. L. V., Lewis L. A., Griffith S., Tucker P.

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Background:  Many children with high incidence disabilities, such as autism spectrum disorder (ASD), struggle to participate in the community in a socially acceptable manner. There are limitations for clinical settings to provide natural, real-life scenarios for them to practice the life skills needed to meet their real-life challenges. Virtual reality (VR) offers potential solutions to resolve the existing limitations faced by clinicians to create simulated natural environments for their clients to generalize the facilitated skills. Research design: The research aimed to develop a prototype of an interactive VR system to provide realistic and immersive environments for clients to practice skills. The descriptive qualitative methodology is employed to design and develop the Artificial Interactive Reality Unified System (AIRUS) prototype, which provided insights on how to use advanced VR technology to create simulated real-life social scenarios and enable users to interact with the objects and people inside the virtual environment using natural eye-gazes, hand and body movements. The eye tracking (e.g., selective or joint attention), hand- or body-tracking (e.g., repetitive stimming or fidgeting), and facial tracking (e.g., emotion recognition) functions allowed behavioral data to be captured and managed in the AIRUS architecture. Impact of project: Instead of using external controllers or sensors, hand tracking software enabled the users to interact naturally with the simulated environment using daily life behavior such as handshaking and waving to control and interact with the virtual objects and people. The AIRUS protocol offers opportunities for breakthroughs in future VR-based psychosocial assessment and intervention in occupational therapy. Implications for future projects: AI technology can allow more efficient data capturing and interpretation of object identification and human facial emotion recognition at any given moment. The data points captured can be used to pinpoint our users’ focus and where their interests lie. AI can further help advance the data interpretation system.

Keywords: occupational therapy, psychosocial assessment and intervention, simulated interactive environment, virtual reality

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Authors: Lista Andriyati, Nurpudji A Taslim

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The human immunodeficiency virus (HIV) patients have potential nutritional and metabolic problems. HIV is a virus that attacks cells T helper and impairs the function of immune cells. Infected individuals gradually become immunodeficient, results in increased susceptibility to a wide range of infections such as tuberculosis (TB). Malnutrition has destructive effects on the immune system and host defense mechanisms. Effective and proper nutritional therapies are important to improve medical outcomes and quality of life, which is associated with functional improvement. A case of 38-years old man admitted to hospital with loss of consciousness and was diagnosed HIV infection and relapse lung TB with severe malnutrition, fever, oral candidiasis, anemia (6.3 g/dL), severe hypoalbuminemia (1.9 g/dL), severe hypokalemia (2.2 mmol/L), immune depletion (1085 /µL) and elevated liver enzyme (ALT 1198/AST 375 U/L). Nutritional intervention by giving 2300 kcal of energy, protein 2 g/IBW/day, carbohydrate 350 g, fat 104 g through enteral and parenteral nutrition. Supplementations administered are zinc, vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin C, vitamin D, and snakehead fish extract high content of protein albumin (Pujimin®). After 46 days, there are clinical and metabolic improvement in Hb (6.3 to 11.2 g/dL), potassium (2.2 to 3.4 mmol/L), albumin (1.9 to 2.3 g/dL), ALT 1198 to 47/AST 375 to 68 U/L) and improved awareness. In conclusion, nutritional therapy in HIV infection with adequate macronutrients and micronutrients fulfillment and immunonutrition is very important to avoid cachexia and to improve nutritional status and immune disfunction.

Keywords: HIV, hypoalbuminemia, malnutrition, tuberculosis

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Authors: Mohamed Elshobaki, Alessandro Valiani, Valerio Caleffi

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In this paper, we solve 1-D shallow water equation for sub-critical and super-critical water flow at junction. The water flow at junction has been studied for the last 50 years from the physical-hydraulic point of views and for numerical computations need more attention. For numerical simulation, we need to establish an inner boundary condition at the junction to avoid an oscillation which rise from the waves interactions at the junction. Indeed, we introduce a new boundary condition at the junction based on the mass conservation, total head, and the admissible wave relations between the flow parameters in the three branches to predict the water depths and discharges at the junction. These boundary conditions are valid for sub-critical flow and super-critical flow.

Keywords: numerical simulation, junction flow, sub-critical flow, super-critical flow

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Authors: Akulov M. A., Orlova O. R., Zaharov V. O., Tomskij A. A.

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Introduction: One of the common postoperative complications of posterior cranial fossa (PCF) and cerebello-pontine angle tumor treatment is a facial nerve palsy, which leads to multiple and resistant to treatment impairments of mimic muscles structure and functions. After 4-6 months after facial nerve palsy with insufficient therapeutic intervention patients develop a postparalythic syndrome, which includes such symptoms as mimic muscle insufficiency, mimic muscle contractures, synkinesis and spontaneous muscular twitching. A novel method of treatment is the use of a recent local neuromuscular blocking agent– botulinum toxin A (BTA). Experience of BTA treatment enables an assumption that it can be successfully used in late facial nerve palsy complications to significantly increase quality of life of patients. Study aim. To evaluate the efficacy of botulinum toxin A (BTA) (Xeomin) treatment in patients with late facial nerve palsy complications. Patients and Methods: 31 patients aged 27-59 years 6 months after facial nerve palsy development were evaluated. All patients received conventional treatment, including massage, movement therapy etc. Facial nerve palsy developed after acoustic nerve tumor resection in 23 (74,2%) patients, petroclival meningioma resection – in 8 (25,8%) patients. The first group included 17 (54,8%) patients, receiving BT-therapy; the second group – 14 (45,2%) patients continuing conventional treatment. BT-injections were performed in synkinesis or contracture points 1-2 U on injured site and 2-4 U on healthy side (for symmetry). Facial nerve function was evaluated on 2 and 4 months of therapy according to House-Brackman scale. Pain syndrome alleviation was assessed on VAS. Results: At baseline all patients in the first and second groups demonstrated аpostparalytic syndrome. We observed a significant improvement in patients receiving BTA after only one month of treatment. Mean VAS score at baseline was 80,4±18,7 and 77,9±18,2 in the first and second group, respectively. In the first group after one month of treatment we observed a significant decrease of pain syndrome – mean VAS score was 44,7±10,2 (р<0,01), whereas in the second group VAS score was as high as 61,8±9,4 points (p>0,05). By the 3d month of treatment pain syndrome intensity continued to decrease in both groups, but, the first group demonstrated significantly better results; mean score was 8,2±3,1 and 31,8±4,6 in the first and second group, respectively (р<0,01). Total House-Brackman score at baseline was 3,67±0,16 in the first group and 3,74±0,19 in the second group. Treatment resulted in a significant symptom improvement in the first group, with no improvement in the second group. After 4 months of treatment House-Brockman score in the first group was 3,1-fold lower, than in the second group (р<0,05). Conclusion: Botulinum toxin injections decrease postparalytic syndrome symptoms in patients with facial nerve palsy.

Keywords: botulinum toxin, facial nerve palsy, postparalytic syndrome, synkinesis

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Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

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Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

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Authors: Mehravar Javid, Rohma Hassan, J. DeSilva

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In this exploratory case study, a 37-year-old male patient who previously terminated treatment after four months of therapy with a different therapist begins anew with a 38-year-old female therapist and undergoes a similar cycle of premature termination, with added discourse caused by erotic transference. Process notes and records of the therapy treatment indicate that during the short course of treatment, the patient explored his difficulties navigating personal relationships, both current and past, and his difficulties coping with hypochondriasis. The therapist becomes tasked with not only navigating the patient’s inner conflict but also how she relates to the patient in the countertransference process while maintaining professional boundaries. This includes empathizing with the patient while also experiencing discomfort in the erotic transference from a professional standpoint. When the patient terminates once more, the therapist reflects on the possible reasons for termination. This includes the patient’s difficulties with tolerating interpretations, which cause him to blame himself for past events. These interpretations were also very frequent, contributing to the emotional burden the patient experienced. The therapist reflected on the use of interpretation versus exploration of the patient’s feelings and how exploring his feelings, including his feelings towards her, would have allowed for an opportunity to explore the emotions that troubled him more deeply. This includes exploring the patient’s anger and fear, which stem from unresolved conflicts from his childhood. Moreover, the erotic transference served as an enactment of previous experiences in which the patient feared losing what he loved, leading him to opt for premature termination instead of losing his ability to control the relationship and experience loss.

Keywords: countertransference, erotic transference, premature termination, therapist-client boundaries, transference

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Authors: Imene Soufli, Abdelkrim Hablal, Manel Amri, Moussa Labsi, Rania Sihem Boussa, Nassim Sid Idris, Chafia Touil-Boukoffa

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Crohn’s Disease (CD) is a relapsing–remitting inflammatory bowel disease with a progressive course. The aim of our study was to evaluate the relationship between the immunomarkers: Nitric Oxide (NO), pro-inflammatory cytokines, and blood count-based ratios and the outcome of corticosteroid or anti-TNF-α therapy in patients with complicated Crohn’s Disease. In this context, we evaluated the NLR as the ratio of neutrophil count to lymphocyte count, PLR as the ratio of platelet counts to lymphocyte count, and MLR as the ratio of monocyte count to lymphocyte count in patients and controls. Furthermore, we assessed NO production by the Griess method in plasma along with iNOS and NF-κB expression by immunofluorescence method in intestinal tissues of patients and controls. In the same way, we evaluated plasma TNF-α, IL-17A, and IL-10 levels using ELISA. Our results indicate that blood count-based ratios NLR, PLR, and MLR were significantly higher in patients compared to controls. In addition, increased systemic levels of NO, TNF-α, and IL-17A and colonic expression of iNOS and NF-κB were observed in the same patients. Interestingly, the high ratio of NLR and MLR, as well as NO production, was significantly decreased in treated patients. Collectively, our findings suggest that Nitric Oxide, as well as the blood count-based ratios (NLR, PLR, MLR), could constitute useful immuno-markers in complicated Crohn’s Disease, predicting the response to treatment

Keywords: complicated crohn’s disease, nitric oxide, blood count-based ratios, treatments, pro-inflammatory cytokines

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Authors: Ane Larrea, Victor Sebastian, Manuel Arruebo, Jesus Santamaria

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We present a gas-liquid microfluidic system as a reactor to obtain magnetite nanoparticles with an excellent degree of control regarding their crystalline phase, shape and size. Several types of microflow approaches were selected to prevent nanomaterial aggregation and to promote homogenous size distribution. The selected reactor consists of a mixer stage aided by ultrasound waves and a reaction stage using a N2-liquid segmented flow to prevent magnetite oxidation to non-magnetic phases. A milli-fluidic reactor was developed to increase the production rate where a magnetite throughput close to 450 mg/h in a continuous fashion was obtained.

Keywords: continuous production, magnetic nanoparticles, microfluidics, nanomaterials

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Authors: Gursimran Jandu, Melissa Nelson, Mia Ingram, Hana Jalal

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There is a significant overlap between autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD), with up to 90% of young people diagnosed with ASD having this co-morbidity. Distinguishing between the symptoms of the two leads to issues with accurate treatment, yet this is paramount in benefiting the young person. There are two distinct methods of treatment, psychological or pharmacological, with clinicians tending to choose one or the other, potentially due to the lack of research available. This report reviews the efficacy of psychological and pharmacological treatments for young people diagnosed with ASD and co-morbid OCD. A literature review was performed on papers from the last fifteen years including ‘ASD’, ‘OCD’ and individuals under the age of 18. Eleven papers were selected as relevant. The report looks at the comparison between more traditional methods, such as selective-serotonin-reuptake-inhibitors (SSRI) and Cognitive behaviour therapy (CBT), and newer therapies, such as modified or intensive ASD focused psychotherapies, and the use of other medication classes. On reviewing the data, it was identified that there was a distinct lack of information on this important topic. The most widely used treatment was medication such as Fluoxetine, an SSRI, which rarely showed improvement in symptoms or outcomes. This is in contrast to modified forms of CBT which often reduces symptoms or even results in OCD remission. With increased research into non-traditional management of these co-morbid conditions, it is clear there is scope that modified CBT may become the future treatment of choice for OCD in young people with ASD.

Keywords: autism spectrum disorder, intensive or adapted cognitive behavioural therapy, obsessive compulsive disorder, pharmacological management

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Authors: Chi-Chang Lin, Jiun-Yan Chiu

Abstract:

Periodontal disease, oral cancer relating trauma is the prominent factor devastating bone tissue that is crucial to reestablishing in clinical. As we know, common symptom, osteoporosis, and infection limiting the ability of the bone tissue to recover cause difficulty before implantation therapy. Regeneration of bone tissue is the fundamental therapy before surgical processes. To promote the growth of bone tissue, many commercial products still have sophisticated problems that need to overcome. Regrettably, there is no available material which is apparently preferable for releasing and controlling of loading dosage, or mitigating inflammation. In our study, a hydrogel-based composite membrane has been prepared by using Gellan gum (GG), gamma-polyglutamic acid (γ-PGA) and glycerol with simple sol-gel method. GG is a natural material that is massively adopted in cartilage. Unfortunately, the strength of pure GG film is a manifest weakness especially under simulating body fluidic conditions. We utilize another biocompatible material, γ-PGA as cross-linker which can form tri-dimension structure that enhancing the strength. Our result indicated the strength of pure GG membrane can be obviously improved by cross-linked with γ-PGA (0.5, 0.6, 0.7, 0.8, 0.9, 1.0 w/v%). Besides, blending with glycerol (0, 1.0, 2.0, 3.0 w/v%) can significantly improve membrane toughness that corresponds to practical use. The innovative composited hydrogel made of GG, γ-PGA, and glycerol is attested with neat results including elongation and biocompatibility that take the advantage of extension covering major trauma. Recommendations are made for treatment to build up the foundation of bone tissue that would help patients to escape from the suffering and shorten the amount of time in recovery.

Keywords: bone tissue, gellan gum, regeneration, toughness

Procedia PDF Downloads 143

Authors: Shiuh-Jer Huang, Yun-Han Yeh

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A 40 steps manual adjusting shock absorber was refitted with DC motor driving mechanism to construct as a semi-active suspension system for a four-wheel drive electric vehicle. Accelerometer and potentiometer sensors are installed to measure the sprung mass acceleration and suspension system compression or rebound states for control purpose. A fuzzy logic controller was designed to derive appropriate damping target based on vehicle running condition for semi-active suspension system to follow. The damping ratio control of each wheel axis suspension system is executed with a robust fuzzy sliding mode controller (FSMC). Different road surface conditions are chosen to evaluate the control performance of this semi-active suspension system based on wheel axis acceleration signal.

Keywords: semi-active suspension, electric vehicle, fuzzy sliding mode control, accelerometer

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Authors: R. Borghol, T. Aguili

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In this paper, we investigate theoretically the waves propagation in a lossless double-negative grounded slab (DNG). This study is performed by the Transverse Resonance Method (TRM). The proper or improper nature of real and complex modes is observed. They are highly dependent on metamaterial parameters, i.e. ɛ_r-negative, µ_r-negative, or both. Numerical results provided that only the proper complex modes (i.e., leaky modes) exist in DNG slab, and only the improper complex modes exist in single-negative grounded slab.

Keywords: double negative grounded slab, real and complex modes, single negative grounded slab, transverse resonance method

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Authors: Gaspar J. Machado, Stéphane Clain, Raphael Loubère

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The goal of the present work is to numerically study steady-state nonlinear hyperbolic equations in the context of the finite volume framework. We will consider the unidimensional Burgers' equation as the reference case for the scalar situation and the unidimensional Euler equations for the vectorial situation. We consider two approaches to solve the nonlinear equations: a time marching algorithm and a direct steady-state approach. We first develop the necessary and sufficient conditions to obtain the existence and unicity of the solution. We treat regular examples and solutions with a steady shock and to provide very-high-order finite volume approximations we implement a method based on the MOOD technology (Multi-dimensional Optimal Order Detection). The main ingredient consists in using an 'a posteriori' limiting strategy to eliminate non physical oscillations deriving from the Gibbs phenomenon while keeping a high accuracy for the smooth part.

Keywords: Euler equations, finite volume, MOOD, steady-state

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Authors: Rugang Tian

Abstract:

In this study, we generated whole-genome sequence (WGS) data from110 native cattle. Together with whole-genome sequences from world-wide cattle populations, we estimated the genetic diversity and population genetic structure of different cattle populations. Our findings revealed clustering of cattle groups in line with their geographic locations. We identified noticeable genetic diversity between indigenous cattle breeds and commercial populations. Among all studied cattle groups, lower genetic diversity measures were found in commercial populations, however, high genetic diversity were detected in some local cattle, particularly in Rashoki and Mongolian breeds. Our search for potential genomic regions under selection in native cattle revealed several candidate genes related with immune response and cold shock protein on multiple chromosomes such as TRPM8, NMUR1, PRKAA2, SMTNL2 and OXR1 that are involved in energy metabolism and metabolic homeostasis.

Keywords: cattle, whole-genome, population structure, adaptation

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Authors: V. Giacometti, R. Mirabelli, V. Patera, D. Pinci, A. Sarti, A. Sciubba, G. Traini, M. Marafini

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The particle therapy (PT) is a very modern technique of non invasive radiotherapy mainly devoted to the treatment of tumours untreatable with surgery or conventional radiotherapy, because localised closely to organ at risk (OaR). Nowadays, PT is available in about 55 centres in the word and only the 20\% of them are able to treat with carbon ion beam. However, the efficiency of the ion-beam treatments is so impressive that many new centres are in construction. The interest in this powerful technology lies to the main characteristic of PT: the high irradiation precision and conformity of the dose released to the tumour with the simultaneous preservation of the adjacent healthy tissue. However, the beam interactions with the patient produce a large component of secondary particles whose additional dose has to be taken into account during the definition of the treatment planning. Despite, the largest fraction of the dose is released to the tumour volume, a non-negligible amount is deposed in other body regions, mainly due to the scattering and nuclear interactions of the neutrons within the patient body. One of the main concerns in PT treatments is the possible occurrence of secondary malignant neoplasm (SMN). While SMNs can be developed up to decades after the treatments, their incidence impacts directly life quality of the cancer survivors, in particular in pediatric patients. Dedicated Treatment Planning Systems (TPS) are used to predict the normal tissue toxicity including the risk of late complications induced by the additional dose released by secondary neutrons. However, no precise measurement of secondary neutrons flux is available, as well as their energy and angular distributions: an accurate characterization is needed in order to improve TPS and reduce safety margins. The project MONDO (MOnitor for Neutron Dose in hadrOntherapy) is devoted to the construction of a secondary neutron tracker tailored to the characterization of that secondary neutron component. The detector, based on the tracking of the recoil protons produced in double-elastic scattering interactions, is a matrix of thin scintillating fibres, arranged in layer x-y oriented. The final size of the object is 10 x 10 x 20 cm3 (squared 250µm scint. fibres, double cladding). The readout of the fibres is carried out with a dedicated SPAD Array Sensor (SBAM) realised in CMOS technology by FBK (Fondazione Bruno Kessler). The detector is under development as well as the SBAM sensor and it is expected to be fully constructed for the end of the year. MONDO will make data tacking campaigns at the TIFPA Proton Therapy Center of Trento, at the CNAO (Pavia) and at HIT (Heidelberg) with carbon ion in order to characterize the neutron component and predict the additional dose delivered on the patients with much more precision and to drastically reduce the actual safety margins. Preliminary measurements with charged particles beams and MonteCarlo FLUKA simulation will be presented.

Keywords: secondary neutrons, particle therapy, tracking detector, elastic scattering

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Authors: Georgiana Ciobotaru

Abstract:

The vocabulary that foreign students assimilate once they start studying the Romanian language must allow them to develop the linguistic competence of oral and written expression, but also the intercultural one, necessary for their integration into the new socio-cultural environment. Therefore, the familiarization courses with Romanian as a foreign language aim at fundamental language acquisitions in order to obtain the expected level of Romanian language. They also relate differently to the new culture and the new language they come in contact with, having a distinct way of expressing themselves. Foreign students want to continue their university and postgraduate studies at specialized faculties in the country; therefore, they need both a general language for their integration into society and for interaction with others, Romanians or students from countries other than their own, but also from a specialized language that facilitates didactic communication and professional development. The complexity of the vocabulary must thus cover the daily communication needs, but also the subsequent evolution of each one. This paper aims to illustrate the most important semantic fields that students must assimilate in order to crystallize a linguistic identity in the new context of their personal and professional development and to help them cope with the culture shock.

Keywords: integration, intercultural, language, linguistic, vocabulary

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Authors: Yawen Xia, Rubi Yang, Jing Zhao

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By using the Reputation Risk Index (RRI) to measure company environmental, social, and governance (ESG) activities, this research studies firms’ ESG comovement with their industry and local peers. This comovement is attenuated during the Covid-19 pandemic. Further analysis shows that corporate governance plays an important role in comovement decrease. We classify companies by region (city, state, region) and industry and calculate the average RRI of companies of the same type. We run separate regressions to test 1) industry comovement; 2) local comovement; 3) Covid-19 pandemic and reputation risk comovement; 4) corporate governance and reputation risk comovement. Our findings are consistent with previous literature that companies follow their industry and local counterparts in engaging in irresponsible activities and reducing ESG engagement. We speculate Covid shock led to a reduction in social activities and information sharing among enterprise managers, and comovement between enterprises, as a result, decreased during the pandemic.

Keywords: ESG, Covid, peer pressure, local comovement, corporate governance

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Authors: Juliani Rianto, Emma Lumby, Tracey Smith

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Cancer patients’ survival are growing with the new approach and therapy in oncology medicine. Cancer is now a new chronic disease, and rehabilitation program has become an ongoing program as part of cancer care. The focus of Cancer rehabilitation is maximising person’s physical and emotional function, stabilising general health and reducing unnecessary hospital admission. In Australia there are 150000 newly diagnosed cancer every year, and the most common Cancer are prostate, Breast, Colorectal, Melanoma and Lung Cancer. Through referral from the oncology team, we recruited cancer patient into our cancer rehabilitation program. Patients are assessed by our multi-disciplinary team including rehabilitation specialist, physiotherapist, occupational therapist, dietician, exercise physiologist, and psychologist. Specific issues are identified, including pain, side effect of chemo and radiation therapy and mental well-being. The goals were identified and reassessed every fortnight. Common goals including nutritional status, improve endurance and exercise performance, working on balance and mobility, improving emotional and vocational state, educational program for insomnia and tiredness, and reducing hospitalisation are identified and assessed. Patients are given 2 hours exercise program twice a week for 6 weeks with focus on aerobic and weight exercises and education sessions. Patients are generally benefited from the program. The quality of life is improved, support and interaction from the therapist has played an important factor in directing patient for their goals.

Keywords: cancer, exercises, benefit, mental health

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