Search results for: complementary therapy

Authors: Nancy N. Sharmila, Aparna Mishra

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Hemiparesis affects almost 80% of stroke patients each year. It is marked by paralysis or weakness on one half of the body. Our model provides both assistance and physical therapy for hemiparesis patients for swift recovery. In order to accomplish our goal a force is provided that pulls the forearm up (as in flexing the arm), and pushes the forearm down (as in extending the arm), which will also assist the user during ADL (Activities of Daily Living). The model consists of a mechanical component which is placed around the patient’s bicep and an EMG control circuit to assist patients in daily activities, which makes it affordable and easy to use. In order to enhance the neuromuscular system’s effectiveness in synchronize the movement, proprioceptive neuromuscular facilitation (PNF) concept is used. The EMG signals are acquired from the unaffected arm as an input to drive the orthosis. This way the patient is invigorated to use the orthosis for regular exercise.

Keywords: EMG, hemiparesis, orthosis, rehabilitation

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Authors: S. Mohd Afzal, R. O'Connell

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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.

Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus

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Authors: Wilai Masanga, Chirapha Tannanonta, Sangutid Thongsawad, Sasikarn Chamchod, Todsaporn Fuangrod

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The major factors of radiotherapy for head and neck (HN) cancers include patient’s anatomical changes and tumour shrinkage. These changes can significantly affect the planned dose distribution that causes the treatment plan deterioration. A measured transit EPID images compared to a predicted EPID images using gamma analysis has been clinically implemented to verify the dose accuracy as part of adaptive radiotherapy protocol. However, a global gamma analysis dose not sensitive to some critical organ changes as the entire treatment field is compared. The objective of this feasibility study is to evaluate the dosimetric response to patient anatomical changes during the treatment course in HN IMRT (Head and Neck Intensity-Modulated Radiation Therapy) using a novel comparison method; organ-of-interest gamma analysis. This method provides more sensitive to specific organ change detection. Random replanned 5 HN IMRT patients with causes of tumour shrinkage and patient weight loss that critically affect to the parotid size changes were selected and evaluated its transit dosimetry. A comprehensive physics-based model was used to generate a series of predicted transit EPID images for each gantry angle from original computed tomography (CT) and replan CT datasets. The patient structures; including left and right parotid, spinal cord, and planning target volume (PTV56) were projected to EPID level. The agreement between the transit images generated from original CT and replanned CT was quantified using gamma analysis with 3%, 3mm criteria. Moreover, only gamma pass-rate is calculated within each projected structure. The gamma pass-rate in right parotid and PTV56 between predicted transit of original CT and replan CT were 42.8%( ± 17.2%) and 54.7%( ± 21.5%). The gamma pass-rate for other projected organs were greater than 80%. Additionally, the results of organ-of-interest gamma analysis were compared with 3-dimensional cone-beam computed tomography (3D-CBCT) and the rational of replan by radiation oncologists. It showed that using only registration of 3D-CBCT to original CT does not provide the dosimetric impact of anatomical changes. Using transit EPID images with organ-of-interest gamma analysis can provide additional information for treatment plan suitability assessment.

Keywords: re-plan, anatomical change, transit electronic portal imaging device, EPID, head, and neck

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Authors: Sohayla Khaled El Fakahany

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Cultural and structural limitations and conservative social norms have direct effects on the availability of sources of sexual and reproductive health and rights (SRHR) in the Arab Region. Nevertheless, SRHR advocates, healthcare providers, and organizations have created online spaces like websites, blogs, and social media platforms to increase people’s access and ability to share information, experiences, and services. While these efforts help increase the accessibility to information and services, they also create and reflect inequalities based on limited internet access. Furthermore, these emergent ways of sharing and raising awareness online cannot be seen as a substitute for the urgent need for public healthcare systems and services to address SRHR issues in Arab states. This research aims to analyze the impact of the increasing importance of the role of social media platforms and technologies in the dissemination of SRHR-related information online to the youth as well as the associated inequalities of access. It also seeks to assess the effects and inequalities of the dependence on online platforms, which should be complementary to public and private SRHR services. The theoretical framework adopts Asef Bayat’s concept of social non-movements to analyze how collective mobilization around SRHR issues is exercised in repressive and conservative settings in the Arab region. Using digital ethnography of four prominent digital platforms and a qualitative survey of people aged 18-30 years, the research draws attention to the urgent need for better access to knowledge and services around gender, bodily autonomy, and sexual and reproductive health in the Arab region.

Keywords: sexual and reproductive health and rights, social non-movements, digital platforms, Arab region

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Authors: Hamide Farshad, Mohammadreza Javidi Abdollah Zadeh Aval

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As a result of the growing penetration of the media into human life, a new role under the title of "audience" is defined in the social life .A kind of role which is dramatically changed since its formation. This article aims to define the audience position in the new media equations which is concluded to the transformation of the media role. By using the Library and Attributive method to study the history, the evolutionary outlook to the audience and the recognition of the audience and the media relation in the new media context is studied. It was perceived in past that public communication would result in receiving the audience. But after the emergence of the interactional media and transformation in the audience social life, a new kind of public communication is formed, and also the imaginary picture of the audience is replaced by the audience impact on the communication process. Part of this impact can be seen in the form of feedback which is one of the public communication elements. In public communication, the audience feedback is completely accepted. But in many cases, and along with the audience feedback, the media changes its direction; this direction shift is known as media feedback. At this state, the media and the audience are both doers and consistently change their positions in an interaction. With the greater number of the audience and the media, this process has taken a new role, and the role of this doer is sometimes taken by an audience while influencing another audience, or a media while influencing another media. In this article, this multiple public communication process is shown through representing a model under the title of ”The bilateral influence of the audience and the media.” Based on this model, the audience and the media power are not the two sides of a coin, and as a result, by accepting these two as the doers, the bilateral power of the audience and the media will be complementary to each other. Also more, the compatibility between the media and the audience is analyzed in the bilateral and interactional relation hypothesis, and by analyzing the action law hypothesis, the dos and don’ts of this role are defined, and media is obliged to know and accept them in order to be able to survive. They also have a determining role in the strategic studies of a media.

Keywords: audience, effect, media, interaction, action laws

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Authors: May Zaw, Amber Latif, William Lim

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Postpartum dyspnea can be due to many causes, such as pulmonary embolism, amniotic fluid embolism, and peripartum cardiomyopathy, but less frequently due to acute pulmonary edema. The incidence of acute pulmonary edema during pregnancy and in the postpartum period has been estimated to be around 0.08%. About half of the cases are attributed to tocolytic therapy. Herein, we present a case of a young woman presenting with acute hypoxia after induction of labor with oxytocin and found to have acute pulmonary edema. This case aims to illustrate and add to a growing body of literature regarding oxytocin-induced acute pulmonary edema and highlights the importance of recognizing the rare complication of oxytocin and necessary interventions to avoid complications. Oxytocin-induced pulmonary edema is a relatively uncommon condition, but physicians should have a high index of suspicion to initiate timely intervention and avoid fetal complications.

Keywords: pulmonary, pregnancy, oxytocin, postpartum

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Authors: Surekha Tony, Roshan Mevada

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Wiskott-Aldrich syndrome (WAS) is a primary immunodeficiency disease resulting in recurrent infections, eczema, and microthrombocytopenia. In its classical form, significant combined immune deficiency, autoimmune complications, and risk of hematological malignancy necessitate early correction, preferably before 2 years of age, with hematopoietic stem cell transplant (HSCT) or gene therapy. Clinical features and severity are varied, making the diagnosis difficult in milder cases. We report an Omani boy diagnosed in early infancy with WAS based on clinical presentation and confirmed by genetic diagnosis with cure by HSCT from an HLA-identical sibling donor.

Keywords: genetic diagnosis, hematopoietic stem cell transplant, infant, Wiskott-Aldrich syndrome

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Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

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We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance

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Authors: Jeongyeon Park, Yeo Jun Yoon, Jiyoung Seo, In Seok Moon, Hae Jun Lee, Kiwon Song

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Cold Atmospheric Pressure Plasma (CAPP) is defined as a partially ionized gas with electrically charged particles at room temperature and atmospheric pressure. CAPP generates reactive oxygen species (ROS) and reactive nitrogen species (RNS), and has potential as a new apoptosis-promoting cancer therapy. With an annular type dielectric barrier discharge (DBD) CAPP-generating device combined with a helium (He) gas feeding system, we showed that CAPP selectively induced apoptosis in various cancer cells while it promoted proliferation of the adipose tissue-derived stem cell (ASC). The apoptotic effect of CAPP was highly selective toward p53-mutated cancer cells. The intracellular ROS was mainly responsible for apoptotic cell death in CAPP-treated cancer cells. CAPP induced apoptosis even in doxorubicin-resistant cancer cell lines, demonstrating the feasibility of CAPP as a potent cancer therapy. With the same device and exposure conditions to cancer cells, CAPP stimulated proliferation of the ASC, a kind of mesenchymal stem cell that is capable of self-renewing and differentiating into adipocytes, chondrocytes, osteoblasts and neurons. CAPP-treated ASCs expressed the stem cell markers and differentiated into adipocytes as untreated ASCs. The increase of proliferation by CAPP in ASCs was offset by a NO scavenger but was not affected by ROS scavengers, suggesting that NO generated by CAPP is responsible for the activated proliferation in ASCs. Usually, cancer stem cells are reported to be resistant to known cancer therapies. When we applied CAPP of the same device and exposure conditions to cancer cells to liver cancer stem cells (CSCs) that express CD133 and epithelial cell adhesion molecule (EpCAM) cancer stem cell markers, apoptotic cell death was not examined. Apoptotic cell death of liver CSCs was induced by the CAPP generated from a device with an air-based flatten type DBD. An exposure of liver CSCs to CAPP decreased the viability of liver CSCs to a great extent, suggesting plasma be used as a promising anti-cancer treatment. To validate whether CAPP can be a promising anti-cancer treatment or an adjuvant modality to eliminate remnant tumor in cancer surgery of vestibular schwannoma, we applied CAPP to mouse schwannoma cell line SC4 Nf2 ‑/‑ and human schwannoma cell line HEI-193. A CAPP treatment leads to anti-proliferative effect in both cell lines. We are currently studying the molecular mechanisms of differential physiological effect of CAPP; the proliferation of ASCs and apoptosis of various cancer cells and CSCs.

Keywords: cold atmospheric pressure plasma, apoptosis, proliferation, cancer cells, adult stem cells

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Authors: Michael Nolte, Iwona Kasior, Kala Flagg, Spiro Karavatas

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Background: Cryotherapy has been used as a post-exercise recovery modality for decades. Whole-body cryotherapy (WBC) is an intervention which involves brief exposures to extremely cold air in order to induce therapeutic effects. It is currently being investigated for its effectiveness in treating certain exercise-induced impairments. Purpose: The purpose of this systematic review was to determine whether WBC as a recovery intervention is more, less, or equally as effective as other interventions at reducing perceived levels of muscle soreness and promoting recovery of muscle function after exercise-induced muscle damage (EIMD) from running. Methods: A systematic review of the current literature was performed utilizing the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases utilized were PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published within the last ten years, had a CEBM level of evidence of IIb or higher, had a PEDro scale score of 5 or higher, studied runners as primary subjects, and utilized both perceived levels of muscle soreness and recovery of muscle function as dependent variables. Articles were excluded if subjects did not include runners, if the interventions included PBC instead of WBC, and if both muscle performance and perceived muscle soreness were not assessed within the study. Results: Two of the four articles revealed that WBC was significantly more effective than treatment interventions such as far-infrared radiation and passive recovery at reducing perceived levels of muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running, respectively. One of the four articles revealed no significant difference between WBC and passive recovery in terms of reducing perceived muscle soreness and restoring muscle power following sprint intervals. One of the four articles revealed that WBC had a harmful effect compared to CWI and passive recovery on both perceived muscle soreness and recovery of muscle strength and power following a marathon. Discussion/Conclusion: Though there was no consensus in terms of WBC’s effectiveness at treating exercise-induced muscle damage following running compared to other interventions, it seems as though WBC may at least have a time-dependent positive effect on muscle soreness and recovery following high-intensity interval runs and endurance running, marathons excluded. More research needs to be conducted in order to determine the most effective way to implement WBC as a recovery method for exercise-induced muscle damage, including the optimal temperature, timing, duration, and frequency of treatment.

Keywords: cryotherapy, physical therapy intervention, physical therapy, whole body cryotherapy

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Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann

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Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.

Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke

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Authors: Babarina Maria, Andropova Margarita

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Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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Authors: Patcharaporn Sakulpong, Wiriya Phokhwang

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Background: Banpunrug (Love Sharing House) established in 2013 provides a community-based palliative care for patients with cancer from 7 provinces in southern Thailand. These patients come to receive outpatient chemotherapy and radiotherapy at Suratthani Cancer Hospital. They are poor and uneducated; they need an accommodation during their 30-45 day course of therapy. Methods: A community-participatory action research (PAR) was employed to establish a model of palliative care for patients with cancer. The participants included health care providers, community, and patients and families. The PAR process includes problem identification and need assessment, community and team establishment, field survey, organization founding, model of care planning, action and inquiry (PDCA), outcome evaluation, and model distribution. Results: The model of care at Banpunrug involves the concepts of HHHS model, in that Banpunrug is a Home for patients; patients live in a house comfortable like in a Hotel resource; the patients are given care and living facilities similarly to those in a Hospital; the house is a School for patients to learn how to take care themselves, how to live well with cancer, and most importantly how to prepare themselves for a good death. The house is also a humanized care school for health care providers. Banpunrug’s philosophy of care is based on friendship therapy, social and spiritual support, community partnership, patient-family centeredness, Live & Love sharing house, and holistic and humanized care. With this philosophy, the house is managed as a home of the patients and everyone involved; everything is costless for all eligible patients and their family members; all facilities and living expense are donated from benevolent people, friends, and community. Everyone, including patients and family, has a sense of belonging to the house and there is no authority between health care providers and the patients in the house. The house is situated in a temple and a community and supported by many local nonprofit organizations and healthcare facilities such as a health promotion hospital at sub-disctrict level and Suratthani Cancer Hospital. Village health volunteers and multi-professional health care volunteers have contributed not only appropriate care, but also knowledge and experience to develop a distinguishing HHHS community-based palliative care model for patients with cancer. Since its opening the house has been a home for more than 400 patients and 300 family members. It is also a model for many national and international healthcare organizations and providers, who come to visit and learn about palliative care in and by community. Conclusions: The success of this palliative care model comes from community involvement, multi-professional volunteers and distributions, and concepts of HHHS model. Banpunrug promotes a consistent care across the cancer trajectory independent of prognosis in order to strengthen a full integration of palliative

Keywords: community-based palliative care, model, participatory action research, patients with cancer

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Authors: Emilie Zimet

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During our department meetings for teachers of children with learning disabilities and difficulties, we often discuss the best practices for supporting students who come to school with literacy difficulties. After completing Sounds Write and Writing Revolution courses, it seems there is a possibility to link approaches and still maintain fidelity to a program and provide individualised instruction to support students with such difficulties and disabilities. In this case study, the researcher has been focussing on how best to use the knowledge acquired to provide quality intervention that targets the varied areas of challenge that students require support in. Students present to school with a variety of co-occurring reading and writing deficits and with complementary approaches, such as The Writing Revolution and Sounds Write, it is possible to support students to improve their fundamental skills in these key areas. Over the next twelve weeks, the researcher will collect data on current students with whom this approach will be trialled and then compare growth with students from last year who received support using Sounds-Write only. Maintaining fidelity may be a potential challenge as each approach has been tested in a specific format for best results. The aim of this study is to determine if approaches can be combined, so the implementation will need to incorporate elements of both reading (from Sounds Write) and writing (from The Writing Revolution). A further challenge is the time length of each session (25 minutes), so the researcher will need to be creative in the use of time to ensure both writing and reading are targeted while ensuring the programs are implemented. The implementation will be documented using student work samples and planning documents. This work will include a display of findings using student learning samples to demonstrate the importance of co-targeting the reading and writing challenges students come to school with.

Keywords: literacy difficulties, intervention, individual differences, methods of provision

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Authors: Maquiling Jhuvie Jane R., Ojastro Regine B., Peroja Loreille Marie B., Pinili Joy Angela., Salve Genial Gail M., Villavicencio Marielle Irene B., Yap Alther Francis Garth B.

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Introduction: This study investigated the impact of prolonged device usage on wrist pain and perceived academic performance among college students in Computer Studies. The research aims to explore the correlation between the frequency of technological device use and the incidence of wrist pain, as well as how this pain affects students' academic performance. The study seeks to provide insights that could inform interventions to promote better musculoskeletal health among students engaged in intensive technology use to further improve their academic performance. Method: The study utilized descriptive-correlational and comparative design, focusing on bona fide students from Silliman University’s College of Computer Studies during the second semester of 2023-2024. Participants were recruited through a survey sent via school email, with responses collected until March 30, 2024. Data was gathered using a password-protected device and Google Forms, ensuring restricted access to raw data. The demographic profile was summarized, and the prevalence of wrist pain and device usage were analyzed using percentages and weighted means. Statistical analyses included Spearman’s rank correlation coefficient to assess the relationship between wrist pain and device usage and an Independent T-test to evaluate differences in academic performance based on wrist pain presence. Alpha was set at 0.05. Results: The study revealed that 40% of College of Computer Studies students experience wrist pain, with 2 out of every 5 students affected. Laptops and desktops were the most frequently used devices for academic work, achieving a weighted mean of 4.511, while mobile phones and tablets received lower means of 4.183 and 1.911, respectively. The average academic performance score among students was 29.7, classified as ‘Good Performance.’ Notably, there was no significant relationship between the frequency of device usage and wrist pain, as indicated by p-values exceeding 0.05. However, a significant difference in perceived academic performance was observed, with students without wrist pain scoring an average of 30.39 compared to 28.72 for those with wrist pain and a p-value of 0.0134 confirming this distinction. Conclusion: The study revealed that about 40% of students in the College of Computer Studies experience wrist pain, but there is no significant link between device usage and pain occurrence. However, students without wrist pain demonstrated better academic performance than those with pain, suggesting that wrist health may impact academic success. These findings imply that physical therapy practices in the Philippines should focus on preventive strategies and ergonomic education to improve student health and performance.

Keywords: wrist pain, frequency of use of technological devices, perceived academic performance, physical therapy

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Authors: Markus Bredel, Sindhu Nair, Hoa Q. Trummell, Rajani Rajbhandari, Christopher D. Willey, Lewis Z. Shi, Zhuo Zhang, William J. Placzek, James A. Bonner

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Purpose: EGFR-targeted monoclonal antibodies (mAbs) provide clinical benefit in some patients with H&N squamous cell carcinoma (HNSCC), but others progress with minimal response. Missense mutations in the EGFR ectodomain (ECD) can be acquired under mAb therapy by mimicking the effect of large deletions on receptor untethering and activation. Little is known about the contribution of EGFR ECD mutations to EGFR activation and anti-EGFR response in HNSCC. Methods: We selected patient-derived HNSCC cells (UM-SCC-1) for resistance to mAb Cetuximab (CTX) by repeated, stepwise exposure to mimic what may occur clinically and identified two concurrent EGFR ECD mutations (UM-SCC-1R). We examined the competence of the mutants to bind EGF ligand or CTX. We assessed the potential impact of the mutations through visual analysis of space-filling models of the native sidechains in the original structures vs. their respective side-chain mutations. We performed CRISPR in combination with site-directed mutagenesis to test for the effect of the mutants on ligand-independent EGFR activation and sorting. We determined the effects on receptor internalization, endocytosis, downstream signaling, and radiation sensitivity. Results: UM-SCC-1R cells carried two non-synonymous missense mutations (G33S and N56K) mapping to domain I in or near the EGF binding pocket of the EGFR ECD. Structural modeling predicted that these mutants restrict the adoption of a tethered, inactive EGFR conformation while not permitting association of EGFR with the EGF ligand or CTX. Binding studies confirmed that the mutant, untethered receptor displayed a reduced affinity for both EGF and CTX but demonstrated sustained activation and presence at the cell surface with diminished internalization and sorting for endosomal degradation. Single and double-mutant models demonstrated that the G33S mutant is dominant over the N56K mutant in its effect on EGFR activation and EGF binding. CTX-resistant UM-SCC-1R cells demonstrated cross-resistance to mAb Panitumuab but, paradoxically, remained sensitive to the reversible receptor tyrosine kinase inhibitor Erlotinib. Conclusions: HNSCC cells can select for EGFR ECD mutations under EGFR mAb exposure that converge to trap the receptor in an open, constitutively activated state. These mutants impede the receptor’s competence to bind mAbs and EGF ligand and alter its endosomal trafficking, possibly explaining certain cases of clinical mAb and radiation resistance.

Keywords: head and neck cancer, EGFR mutation, resistance, cetuximab

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Authors: M. Kobylanski, D. Buskulic, P.-H. Duron, D. Revuz, F. Ruggieri, E. Sandier, C. Tijus

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In order to design a cooperative e-learning platform, we observed teams of Teacher [T], Computer Scientist [CS] and exerciser's programmer-designer [ED] cooperating for the conception of a self-correcting exercise, but without the use of such a device in order to catch the kind of interactions a useful platform might provide. To do so, we first run a task analysis on how T, CS and ED should be cooperating in order to achieve, at best, the task of creating and implementing self-directed, self-paced, repeatable self-correcting exercises (RSE) in the context of open educational resources. The formalization of the whole process was based on the “objectives, activities and evaluations” theory of educational task analysis. Second, using the resulting frame as a “how-to-do it” guide, we run a series of three contrasted Hackathon of RSE-production to collect data about the cooperative process that could be later used to design the collaborative e-learning platform. Third, we used two complementary methods to collect, to code and to analyze the adequate survey data: the directional flow of interaction among T-CS-ED experts holding a functional role, and the Means-End Problem Solving analysis. Fourth, we listed the set of derived recommendations useful for the design of the exerciser as a cooperative e-learning platform. Final recommendations underline the necessity of building (i) an ecosystem that allows to sustain teams of T-CS-ED experts, (ii) a data safety platform although offering accessibility and open discussion about the production of exercises with their resources and (iii) a good architecture allowing the inheritance of parts of the coding of any exercise already in the data base as well as fast implementation of new kinds of exercises along with their associated learning activities.

Keywords: editorialization, open educational resources, pedagogical alignment, produsage, repeatable self-correcting exercises, team roles

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Authors: Christopher Spiewak, M. R. Islam, Mohammad Arifur Rahaman, Mohammad H. Rahman, Roger Smith, Maarouf Saad

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For those who have lost the ability to move their hand, going through repetitious motions with the assistance of a therapist is the main method of recovery. We have been developed a robotic assistive device to rehabilitate the hand motions in place of the traditional therapy. The developed assistive device (RAD-HR) is comprised of four degrees of freedom enabling basic movements, hand function, and assists in supporting the hand during rehabilitation. We used a nonlinear computed torque control technique to control the RAD-HR. The accuracy of the controller was evaluated in simulations (MATLAB/Simulink environment). To see the robustness of the controller external disturbance as modelling uncertainty (±10% of joint torques) were added in each joints.

Keywords: biorobotics, rehabilitation, robotic assistive device, exoskeleton, nonlinear control

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Authors: Yongsheng Guo

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This study explores the perceptions and conducts of Chinese foreign direct investment (FDI) in Africa from ethical and cultural perspectives. It offers a better understanding of how ethical and cultural factors affect Chinese investment in Africa and how the investment projects performed in Africa from both Chinese investors and African stakeholders’ perceptions. It adopted a grounded theory approach and conducted 30 in-depth interviews with corporate managers. Grounded theory models are developed to link the ethical and cultural factors, actions, and consequences. Results reveal that some ethical concepts like the unity of humans and nature, benevolence, virtue and responsibility, and cultural traits including propriety, righteousness, sincerity, equilibrium, long-term orientation, and principles affect Chinese investors when making investments in Africa. Most Chinese investors harmonize with local managers, cooperate with each other, and are gentle and courteous to partners. They take stable and steady actions and invest in infrastructure and agriculture projects and adopt a virtue governance system in the organization. This study finds that consequently, Chinese investors and local partners take complementary advantages, make achievements sequentially, and therefore both sides can win. They recognize great potentials and make sustainable development in Africa to achieve the Great Together in the future. This study proposes a Chinese ethics and governance system including economic, social, and political perspectives and compares it with alternative systems. It makes implications to the world island theory and propose suggestions to solve the Clash of Civilizations problem.

Keywords: foreign direct investment, ethics, national culture, China, Africa

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Authors: Azwin Lubis, Rika Hapsari, Zahrah Hikmah, Anang Endaryanto, Ariyanto Harsono

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Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.

Keywords: erythema multiforme exudativum major, hypersensitivity, elimination test, provocation test

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Authors: Ojiegbe Ikenna Nathan

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Obesity is a medical condition in which excess body fat has accumulated to the extent that it leads to reduced life expectancy and or increased health problems. Obesity as a worldwide problem is seen clustered in the families and it moves from generation to generation. It causes some disabilities, mortality and morbidity if left unattended to. The predisposing factors to obesity are either genetic or environment in origin. Nevertheless, the main predisposing factor to obesity is the excessive consumption of food rich in low-density lipoprotein (LDL) such as organ meats, saturated fats etc. This low-density lipoprotein causes an increase in adipose tissue and complicates to obesity. There are varieties of obesity which one needs to take appropriate measures to avoid; such as android, gynoid and morbid obesity. Nonetheless, studies have shown that there is hope for the obese individuals, despite the cause, type and degree of their obesity. This is through the use of the different available treatment measures which increase in physical activities, caloric restrictions, drug therapy and surgical intervention.

Keywords: low-density, lipoprotein, culprit, obesity

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Authors: Jie Bai, Yongsheng Gao, Shengxin Wang, Jie Zhao

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Through the establishment of the elbow biomechanical model, it can provide theoretical guide for rehabilitation therapy on the upper limb of the human body. A biomechanical model of the elbow joint can be built by the connection of muscle force model and elbow dynamics. But there are many undetermined coefficients in the model like the optimal joint angle and optimal muscle force which are usually specified as the experimental parameters of other workers. Because of the individual differences, there is a certain deviation of the final result. To this end, the RMS value of the deviation between the actual angle and calculated angle is considered. A set of coefficients which lead to the minimum RMS value will be chosen to be the optimal parameters. The direct search method and the conjugacy search method are used to get the optimal parameters, thus the model can be more accurate and mode adaptability.

Keywords: elbow biomechanical model, RMS, direct search, conjugacy search

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Authors: Laith F. Gulli, Nicole M. Mallory

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We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.

Keywords: addiction, competency, curriculum, psychotherapy

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Authors: Băilă Diana Irinel, Păcurar Răzvan, Păcurar Ancuța

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In the last years, composite materials are increasingly used in automotive, aeronautic, aerospace, construction applications. Composite materials have been used in aerospace in applications such as engine blades, brackets, interiors, nacelles, propellers/rotors, single aisle wings, wide body wings. The fields of use of composite materials have multiplied with the improvement of material properties, such as stability and adaptation to the environment, mechanical tests, wear resistance, moisture resistance, etc. The composite materials are classified concerning type of matrix materials, as metallic, polymeric and ceramic based composites and are grouped according to the reinforcement type as fibre, obtaining particulate and laminate composites. Production of a better material is made more likely by combining two or more materials with complementary properties. The best combination of strength and ductility may be accomplished in solids that consist of fibres embedded in a host material. Polyester is a suitable component for composite materials, as it adheres so readily to the particles, sheets, or fibres of the other components. The important properties of the reinforcing fibres are their high strength and high modulus of elasticity. For applications, as in automotive or in aeronautical domain, in which a high strength-to-weight ratio is important, non-metallic fibres such as fiberglass have a distinct advantage because of their low density. In general, the glass fibres content varied between 9 to 33% wt. in the composites. In this article, high-performance types of composite materials glass-epoxy and glass-polyester used in automotive domain will be analyzed, performing tensile and flexural tests and SEM analyzes.

Keywords: glass-polyester composite, glass fibre, traction and flexion tests, SEM analyzes

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Authors: Agnieszka Szczudlińska-Kanoś

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Nowadays the participation of citizens in public life increasingly effect on management at all levels of public authority. Today, however, democratic systems in many countries, also in Poland, based on the first - on the institutions of representative democracy, which is mainly on elections, party activity, on the other hand - on the basic instruments of direct democracy, which, in particular, we can include a referendum or initiative of citizenship - although these are often rather complementary. Other forms of participatory democracy, such as deliberative democracy, participatory budgeting, public consultation in practice in many countries are still rare. Appropriate use of the potential invested in participatory democracy can bring enormous and multilateral benefits. On the one hand, local and regional communities taking an active part in public life express their needs, point out problems and thus affect the decisions of public authorities. Authorities using knowledge acquired from the citizens also implement the policy tailored to their needs, thus obtaining support in the next election. The purpose of this study is to show how the Polish citizens affect to resolve issues of social policy pursued at different levels of government. This problem is very important because today the observed changes seen in virtually all fields of life create new social problems, which nowadays are no longer only the problems of the region, the country but they are international, global issues. From such this perspective we should talk about them, discuss, try to solve at all levels. Article will be useful not only theorists involved in the management of the public, local government, or social but also practitioners - local government acting as their functions at different levels of government. Conclusions drawn from the publication will also be useful to politicians and those directly affecting for: functioning social security systems, the scope and quality of public services and the overall shape of the contemporary social policy in different countries.

Keywords: social policy, local government, social participation, social services

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Authors: Savin Phoeun

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Long time civil war, economic, infrastructure, social, and political structure were destroyed and everything starts from zero. Transport and communication are the key feature of the national economic growth, especially inland transport and other mode take a complementary role which supported by government and international organization both direct and indirect to private sector and small and medium size enterprises. The objectives of this study are to study the general characteristics, capacity and competitive KPIs of Cambodian Inland Transport Operators. Questionnaire and interview were formed from capacity and competitiveness key performance indicators to take apart in survey to Inland Transport Companies in Phnom Penh capital city of Cambodia. And descriptive statistics was applied to identify the data. The result of this study divided into three distinct sectors: 1). Management ability of transport operators – capital management, financial and qualification are in similar level which can compete between local competitors (moderated level). 2). Ability in operation: customer service providing is better but seemed in high cost operation because mostly they are in family size. 3). Local Cambodian Inland Transport Service Providers are able to compete with each other because they are in similar operation level while Thai competitors mostly higher than. The suggestion and recommendation from the result that inland transport companies should access to new technology, improve strategic management, build partnership (join/corporate) to be bigger size of capital and company in order to attract truthfulness from customers and customize the services to satisfy. Inland Service Providers should change characteristic from only cost competitive to cost saving and service enhancement.

Keywords: assessment, competitiveness, inland transport, operator

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Authors: Farman Ali, Asif Mahmood

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The utilization of genetic markers in prostate cancer management represents a significant advance in personalized medicine, offering the potential for more precise diagnosis and tailored treatment strategies. This paper explores the pivotal role of genetic markers in the diagnosis and treatment of prostate cancer, emphasizing their contribution to the identification of individual risk profiles, tumor aggressiveness, and response to therapy. By integrating current research findings, we discuss the application of genetic markers in developing targeted therapies and the implications for patient outcomes. Despite the promising advancements, challenges such as accessibility, cost, and the need for further validation in diverse populations remain. The paper concludes with an outlook on future directions, underscoring the importance of genetic markers in revolutionizing prostate cancer care.

Keywords: prostate cancer, genetic markers, personalized medicine, BRCA1 and BRCA2

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Authors: Karima Merchant

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The aim of this study was to analyze the impact of the Writing Eight Exercise, an exercise from the Brain Integration Therapy, with Kindergartners who are struggling with writing tasks in school. With the help of this exercise, children were able to cross the midline, an invisible line running from our brain to our feet, which separates the body’s right from left. Crossing the midline integrates the brain hemispheres, thus encouraging bilateral movement. The study was spread over 15 weeks where the children were required to do the Writing Eight Exercise 4 times a week. The data collection methods included observations, student work samples and feedback from teachers and parents. Based on the results of this study, it can be concluded that the Writing Eight Exercise had a positive impact on students’ approach towards writing tasks, letter formation, and fine motor skills.

Keywords: crossing the midline, fine motor skills, letter formation, writing

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Authors: Kunal Mankodi, Sudhir Pandey

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This study aims to assess the factors that play a role in setting up and running a social enterprise driven towards sustainability at the intersection of energy, environment, and poverty alleviation. According to the theory of sustainability-oriented innovation (SOI), conventional organisations adapt their processes to focus on sustainability-oriented innovations. On the other hand, social enterprises that are purpose-driven are also influenced by the context of innovation, which need due attention. This paper presents an account of innovation at Oorja - an Indian social enterprise operating with a farming-as-a-service business model. It aims to illustrate the contexts in which the innovative solutions were developed to work at an intersection between agriculture and clean energy, thereby allowing small farmers access to efficient solutions in the agriculture cycle. Primary data was collected through in-depth interviews, and secondary data was collected from company sources. The study finds that in the case of a social enterprise, the definition of innovation assumes a wider scope by going beyond the introduction of a new product/service. The context of innovation for social enterprise is affected by organisational factors such as organisation’s philosophical mindset, behaviour towards innovation, organisation’s capabilities, regulatory environment, and customer receptiveness. Additionally, the study also finds that the context of innovation for a social enterprise is affected by its organizational structure. A majority of these organizational factors are, in turn, affected by individual (Founder’s) factors such as the founder’s formative years, education, direct exposure to relevant issues, complementary skills of co-founders, and a common calling.

Keywords: context of innovation, social enterprise, sustainability oriented innovations, emerging markets, agriculture

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Authors: Angela T. H. Kwan, Wenjun Liang, Jack Wellington, Mohammad Mofatteh, Thanh N. Nguyen, Pingzhong Fu, Juanmei Chen, Zile Yan, Weijuan Wu, Yongting Zhou, Shuiquan Yang, Sijie Zhou, Yimin Chen

Abstract:

Background: Endovascular Therapy (EVT)—in the form of mechanical thrombectomy—following intravenous thrombolysis is the standard gold treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It is well established that an ASPECTS ≥ 7 is associated with an increased likelihood of positive post-EVT outcomes, as compared to an ASPECTS < 7. There is also prognostic utility in coupling posterior circulation ASPECTS (pc-ASPECTS) with magnetic resonance imaging for evaluating the post-EVT functional outcome. However, the value of pc-ASPECTS applied to CT must be explored further to determine its usefulness in predicting functional outcomes following EVT. Objective: In this study, we aimed to determine whether pc-ASPECTS on CT can predict post-EVT functional outcomes among patients with AIS due to LVO. Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data were retrospectively analyzed between March 2019 to February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People's Hospital of Foshan in China. Patient parameters included EVT within 24hrs of symptom onset, premorbid modified Rankin Scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24–72-hour post-stroke onset CT scan. Univariate comparisons were performed using the Fisher exact test or χ2 test for categorical variables and the Mann–Whitney U test for continuous variables. A p-value of ≤ 0.05 was statistically significant. Results: A total of 247 patients met the inclusion criteria; however, 3 were excluded due to the absence of post-CTs and 8 for pre-EVT ASPECTS < 7. Overall, 236 individuals were examined: 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion. We found that both baseline post- and pc-ASPECTS ≥ 7 serve as strong positive markers of favorable outcomes at 90 days post-EVT. Moreover, lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 anterior circulation group had shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture-time (LKNPT). Conclusion: Patients of anterior and posterior circulation ischemic strokes with baseline post- and pc-ASPECTS ≥ 7 may benefit from EVT.

Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS

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