Search results for: mixed methods

Authors: Makhosi Buthelezi

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Mitochondrial DNA cytochrome c oxidase I (COI) gene analyses linked the South African groundnut leaf miner (GLM) to the Australian soya bean moth Aproaerema simplexella (Walker) and Indian Aproaerema modicella (Deventer). Thus, the genetic relatedness of GLM, A. simplexela, and A. modicella was examined by performing mitochondrial and nuclear (COI, cytochrome oxidase subunit II (COII), mitochondrial cytochrome b (CYTB), nuclear ribosomal 28S (28S) and intergenic spacer elongation factor-1 alpha ( EF-1 ALPHA) on 44 specimens collected from South Africa, four from Mozambique, and three each from single locations in India and Australia. Phylogenetic analyses were conducted using the Maximum Parsimony (MP) and Neighbour-Joining (NJ) methods. All of the datasets of the five DNA gene regions that were sequenced were also analyzed using the Basic Local Alignment Search Tool (BLAST) to find the closest matches for inclusion in the phylogenetic trees as outgroups and for purposes of information. In the phylogenetic trees for COI, COII, cytb and EF-1 ALPHA, a similar pattern was observed in the way that the sequences assembled into different groups; i.e., some sequences of A. simplexella from Australia were grouped separately from the others, but some Australian sequences grouped with those of the GLM from South Africa, India, and Mozambique. In the phylogenetic tree for 28S, all sequences from South Africa, Australia, India, and Mozambique grouped together and formed one group. For COI, genetic pairwise distance ranged from 0.97 to 3.60 %, for COII it ranged from 0.19% to 2.32%, for cytb it ranged from 0.25 to 9.77% and for EF-1 ALPHA it ranged 0.48 to 6.99%. Results of this study indicate that these populations are genetically related and presumably constitute a single species. Thus, further molecular and morphological studies need to be undertaken in order to resolve this apparent conundrum on the taxonomy of these populations.

Keywords: aproaerema modicella, aproaerema simplexella, mitochondrial DNA, nuclear DNA

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Authors: Rimel Mwamba, Mohan Gundeti

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Introduction: The use of robot-assisted laparoscopic surgeries (RALS) has largely increased in recent years, offering faster and safer treatment options for pediatric patients. In the field of urology, RALS has shown a significant advantage over laparoscopic and open surgeries but continues to be controversial in pediatric cases due to limited comprehensive data on its use. Methods: In this review, we aim to summarize the factors associated with RALS use in pediatric cases involving pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction. We used PubMed, EMBASE, and the Cochrane Database of Systematic Reviews to systematically search for literature on the topic. We then critically assessed and compiled data on RALS outcomes, complications, and associated factors. Results: To date, numerous comparative studies have been conducted on pediatric RALS, with only one randomized control trial investigating the nuances of robotic use against standard of care treatments. These robotic approaches have shown promise in post-surgical outcomes for pediatric patients undergoing upper and lower urinary tract reconstruction. Barriers to use still persist, however, showcasing a need to increase access to the technology, refine instruments for pediatric use, address cost barriers, and provide proper training for surgeons. Conclusion: RALS providesan opportunity to improve pediatric patient outcomes for numerous urologic complications. Additional studies are required to better compare the use of RALS with current standard practices. Due to the difficult nature of conducting randomized control trials, additional prospective observational studies are needed.

Keywords: pediatric urology, robot-assisted laparoscopic surgeries (RALS), pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction

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Authors: Ayesha Siddiqua

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Background: Hypertension is a silent killer disease and a common risk factor for considerable morbidity and mortality. Its effects can be seen on the organs like Heart; Brain; Kidneys. In Saudi Arabia, hypertension affects a sizeable enough proportion of the population, with a prevalence of 27.9% in urban and 22.4 in rural population. Despite these features, the magnitude and epidemiological characteristics of this disease have been rarely studied in Saudi Arabia. To fill this gap, we conducted a survey in Abha to study the KAP of hypertension. KAP study shows what people know about certain things, their feelings and behavior towards the disease management. An improvement in the Knowledge and Attitudes towards disease management can reform the kinds of practices which are followed. Objectives: To assess the level of Knowledge, Attitude and Practice of patients who suffer from Hypertension. To improve the Quality of life of patients. Methods: A prospective cross-sectional survey was conducted on a sample size of 130 Hypertensive patients of both the genders enrolled by simple random sampling technique admitted in the Aseer Central Hospital of Abha during the period from October 2016 to December 2016. Results: Altogether 130 hypertensive patients were enrolled in this study with equal no. of Males and Females. Most of the respondents were aged between 18-40 years (45%). On assessing the KAP of the patients, we found that the Knowledge and Attitude score was good but the Practice scores were moderate in both the genders. Conclusion: Our study concludes that a significant proportion of hypertensive patients show less Practice towards the disease management which can lead to severe complications in time being and also result in damage of other vital organs. So there is a need of intense educational intervention for the patients which can be done by Patient counselling by the clinical pharmacist. Strategies to modify lifestyle which help in control of hypertension can include providing leaflets as well as direct educational programs.

Keywords: Attitude, hypertension, Knowledge, practices

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Authors: Taiebe Shokri, Shahram Yazdani, Leila Afshar, Soleiman Ahmadi

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Introduction: The importance of professionalism in higher education not only determines the appropriate and inappropriate behaviors and guides faculty members in the implementation of professional responsibilities, but also guarantees faculty members' adherence to professional principles and values, ensures the quality of teaching and facilitator will be the teaching-learning process in universities and will increase the commitment to meet the needs of students as well as the development of an ethical culture based on ethics. Therefore, considering the important role of medical education teachers to prepare teachers and students in the future, the need to determine the concept of professional teacher and teacher, and the characteristics of teacher professionalism, we have explained the concept of professionalism in teachers in this study. Methods: The concept analysis method used in this study was Walker and Avant method which has eight steps. Walker and Avant state the purpose of concept analysis as follows: The process of distinguishing between the defining features of a concept and its unrelated features. The process of concept analysis includes selecting a concept, determining the purpose of the analysis, identifying the uses of the concept, determining the defining features of the concept, identifying a model, identifying boundary and adversarial items, identifying the precedents and consequences of the concept, and defining empirical references. is. Results: Professionalism in its general sense, requires deep knowledge, insight, creating a healthy and safe environment, honesty and trust, impartiality, commitment to the profession and continuous improvement, punctuality, criticism, professional competence, responsibility, and Individual accountability, especially in social interactions, is an effort for continuous improvement, the acquisition of these characteristics is not easily possible and requires education, especially continuous learning. Professionalism is a set of values, behaviors, and relationships that underpin public trust in teachers.

Keywords: concept analysis, medical education, professionalism, faculty members

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Authors: Ann Dashwood

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Using standard Australian English with confidence is a cultural expectation of parents of primary school aged children who want to engage effectively with their children’s teachers and school administration. That confidence in support of their children’s learning at school is seldom experienced by parents whose first language is not English. Sharing language with competence in an intercultural environment is the common denominator for meaningful communication and engagement to occur in a school community. Experience in relevant interactive sessions is known to enhance engagement and participation. The purpose of this paper is to identify interactional settings for which parents who are isolated from the daily use of functional Australian cultural language learned to engage more effectively in their children’s learning at school. The outcomes measured parents’ intercultural engagement with classroom teachers and attention to the school’s administrative procedures. The study used quantitative and qualitative methods. The principles of communicative task-based language learning combined with intercultural communication principles provided the theoretical base for intensive English task-based learning and engagement. The quantitative analysis examined data samples collected by classroom teachers and administrators and parents’ writing samples. Interviews and observations qualitatively informed the study. Currently significant numbers of projects are active in community centres and schools to enhance English language knowledge of parents from Language Backgrounds Other Than English (LBOTE). The study was significant to explore the effects of conducting intensive English with parents of varied English language backgrounds by targeting language use for social interactions in the community, specific engagement in school activities, cultural interaction with teachers and responsiveness to complying with school procedures.

Keywords: engagement, intercultural communication, LBOTE, school community

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Authors: Checkfaith I. Aizebeoje, Temitope O. Lawal, Bolanle A. Adeniyi

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The overuse and abuse of antibiotics in treating zoonotic infections in humans and opportunistic infections in rabbit has contributed to the increase in antimicrobial drug resistance, therefore, an alternative to antibiotics is needed in treating these infections. The study was carried out to determine the antimicrobial activity of lactic acid bacteria (LAB) isolated from rabbit’s faeces against multidrug-resistant (MDR) pathogens isolated from the same rabbit. Twelve faecal samples and twelve swabs from fur samples were randomly collected aseptically from apparently healthy rabbits from Ajibode, Ibadan and University of Ibadan research farm in Ibadan, Oyo state, Nigeria. Lactic acid bacteria and multidrug-resistant pathogens were isolated using appropriate agar media and identified by partial sequencing of the 16SrRNA gene. Antibiotic susceptibility pattern of isolated bacteria and LAB were determined by the agar diffusion method. The antibacterial activity of the LAB against the test pathogens was determined using the agar overlay and agar diffusion methods. The pathogens Myroides gitamensis, Citrobacter rodentium, Acinetobacter johnsonii, Enterobacter oryzendophyticus and Serratia marcescens as well as twenty-eight (28) species of LAB belonging to Acetobacter and Lactobacillus genera were identified and characterized. Lactobacillus plantarum had the highest (60.71%) occurrence of the LAB. Viable cells and cell free supernatant (CFS) of isolated LAB inhibited the growth of the test organisms with the largest zone of inhibition (40 mm) produced by Lactobacillus plantarum against Citrobacter rodentium. This study showed that LAB from rabbit possess considerable antibacterial activity against multidrug-resistant bacteria from the same environment.

Keywords: antibacterial activities, cell-free supernatant, lactic acid bacteria; multidrug-resistant pathogens, rabbits’ faeces

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Authors: S. AliReza Mirghasemi, Zameer Hussain, Mohammad Saleh Sadeghi, Narges Rahimi Gabaran, Mohamadreza Baghaban Eslaminejad

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Background: Despite promising results have shown by osteogenic cell-based demineralized bone matrix composites, they need to be optimized for grafts that act as structural frameworks in load-bearing defects. The purpose of this experiment is to determine the effect of bone-marrow-mesenchymal-stem-cells seeding on partially demineralized laser-perforated structural allografts that have been implanted in critical femoral defects. Materials and Methods: P3 stem cells were used for graft seeding. Laser perforation in four rows of three holes was achieved. Cell-seeded grafts were incubated for one hour until they were planted into the defect. We used four types of grafts: partially demineralized only (Donly), partially demineralized stem cell seeded (DST), partially demineralized laser-perforated (DLP), and partially demineralized laser-perforated stem cell seeded (DLPST). histologic and histomorphometric analysis were performed at 12 weeks. Results: Partially demineralized laser-perforated had the highest woven bone formation within graft limits, stem cell seeded demineralized laser-perforated remained intact, and the difference between partially demineralized only and partially demineralized stem cell seeded was insignificant. At interface, partially demineralized laser-perforated and partially demineralized only had comparable osteogenesis, but partially demineralized stem cell seeded was inferior. The interface in stem cell seeded demineralized laser-perforated was almost replaced by distinct endochondral osteogenesis with higher angiogenesis in the vicinity. Partially demineralized stem cell seeded and stem cell seeded demineralized laser-perforated graft surfaces had extra vessel-ingrowth-like porosities, a sign of delayed resorption. Conclusion: This demonstrates that simple cell-based composites are not optimal and necessitates the supplementation of synergistic stipulations and surface changes.

Keywords: structural bone allograft, partial demineralization, laser perforation, mesenchymal stem cell

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Authors: Nasrin Nejatbakhsh, Anita Kaiser, Sander Hitzig, Colleen McGillivray

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Following spinal cord injury (SCI), many individuals experience anxiety in adjusting to their lives, and its impacts on their sexuality. Research has demonstrated that regaining sexual function is a very high priority for individuals with SCI. Despite this, sexual health is one of the least likely areas of focus in rehabilitating individuals with SCI. There is currently a considerable gap in appropriate education and resources that address sexual health concerns and needs of people with spinal cord injury. Furthermore, the determinants of sexual health in individuals with SCI are poorly understood and thus poorly addressed. The purpose of this study was to improve current practices by informing a service delivery model that rehabilitation centers can adopt for appropriate delivery of their services. Methodology: We utilized qualitative methods in the form of a semi-structured interview containing open-ended questions to assess 1) sexual health concerns, 2) helpful strategies in current resources, 3) unhelpful strategies in current resources, and 4) Barriers to obtaining sexual health information. In addition to the interviews, participants completed surveys to identify socio-demographic factors. Data gathered was coded and evaluated for emerging themes and subthemes through a ‘code-recode’ technique. Results: We have identified several robust themes that are important for SCI sexual health resource development. Through analysis of these themes and their subthemes, several important concepts have emerged that could provide agencies with helpful strategies for providing sexual health resources. Some of the important considerations are that services be; anonymous, accessible, frequent, affordable, mandatory, casual and supported by peers. Implications: By incorporating the perspectives of individuals with SCI, the finding from this study can be used to develop appropriate sexual health services and improve access to information through tailored needs based program development.

Keywords: spinal cord injury, sexual health, determinants of health, resource development

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Authors: Cristina Hotoleanu

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Introduction: The recent Covid-19 pandemic accelerated the development of e-health, including telemedicine, smartphone applications, and medical wearable devices. Providing remote teleconsultations supposes challenges which may require further face-to-face medical interactions. The aim of this study was to assess the correlation between the types of teleconsultations and the need of onsite medical services (investigations and medical visits) for the diagnosis and treatment. Methods: a retrospective study including all the teleconsultations using the platform offered by a telehealth provider in Romania (Telios Care SA) between May 1, 2021- April 30, 2022, was performed. Binary data were analysed using the chi-square test with a significance level of p < 0.05. Results: out of 7163 consultations, 3961 were phone calls, 1981 were online messages, and 1221 were video calls. Onsite medical services were indicated in 3327 (46.44%) cases; the onsite investigations or the onsite visits were recommended for 2908 patients as follows: 2326 in case of phone calls, 582 in case of online messages, none in case of video calls. Both onsite investigations and visits were indicated for 419 patients. The need for onsite additional medical services was significantly higher in the case of phone calls than in the other 2 types of teleconsultations (Chi square= 1207.06, p= 0.00001). The indication for onsite services was done mainly after teleconsultations covering medical specialties (87.34%), significantly higher than the other specialties (Chi square=914.59, p=0.00001). Teleconsultations in surgical specialties and other fields (pharmacy, dentistry, psychology, wellbeing- nutrition, fitness) resulted in 12.13%, respective less than 1%, indication for onsite investigations or visits, explained by using of video calls in most of the cases. Conclusion: a further onsite medical service was necessary in less than a half of the teleconsultations. This indication was done mainly after phone calls and teleconsultations in medical specialties. Video calls were used mostly in psychology, nutrition, and fitness teleconsultations and did not require a further onsite medical service. Other studies are necessary to assess better the types of teleconsultations and the specialties bringing the biggest benefit for the patients.

Keywords: onsite medical services, phone calls, teleconsultations, telemedicine

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Authors: Namekong Fokeng Armand

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Background: Zoonoses are nowadays a serious public health problem in both developing and developed countries. They contribute to increase the economic burden. In case of emergence, rural populations are the most affected, hence the need to investigate risk practices in rural households of Penka-Michel (West Cameroon). Methods: This cross-sectional study was conducted from October to November 2021 among 200 heads of households living in the Penka-Michel health district (West Cameroon). It was done using a pre-tested and validated questionnaire, allowing to obtain socio-demographic, economic data, and data on zoonotic risk practices. Results: The participants [women (56%), men (44%)] worked mainly in the informal private sector (53%) and practiced agriculture secondarily (90%). Their highest level of education, for the most part, was a secondary school (50%); the average household size was 06 persons with a monthly income > 36270 FCFA (72%). 74% of household heads thought that animals can transmit diseases, and 17% had heard about zoonotic diseases through the media (65%). Rats caught in households (60%) were consumed there (74%), as was bush meat (61%) or dog meat (18%). For family food (90%), animals were slaughtered within the household (97%), rarely preceded by a veterinary inspection (6%). 87% of households practiced traditional rites with animal blood, 65% shared the same habitat as their animals, 41% did not systematically wash their hands after handling animals. More than 50% of households owned one or more dogs, usually strays (41%) and 48% of which were vaccinated (rabies). Many households had at least one: poultry (98%); pig (50%); dog (57%), cat (52%). 25% of households slaughtered sick animals for consumption, and 27% ate dead animals. Conclusion: This study identified numerous zoonotic risk practices in households in the Penka-Michel health district (West Cameroon). Concerted, multisectoral communication / awareness-raising actions are needed to break with these practices.

Keywords: zoonoses, risky practices, rural households, penka-michel, cameroon

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Authors: Bihan Qaimari

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In many areas of the world there are political conflicts the consequences of which have an inevitable impact on the educational system. Palestine is one such country where the experience of political conflict, going back over many years, has had a devastating effect on the development and maintenance of a stable educational environment for children and their teachers. Up to now there have been few studies that have focussed on the effects of living and working in a war zone on the professional identity of teachers. The aim of this study is to explore how the formation of Palestinian teachers’ professional identity is affected by their experience of the current political conflict its impact on the school social culture. In order to gain an in-depth understanding of the impact of political violence on the formation of the professional identity of Palestinian teachers, a qualitative multiple case-study approach was adopted which draws on sociocultural theories of identity formation. An initial study was first conducted in six schools and this was followed by an in-depth study of teachers working in three further primary schools. Data sources included participant observation, a research diary, semi-structured group and individual interviews. Grounded theory, constant-comparative methods, and discourse analysis procedures were used to interpret the data. The findings suggest that the Palestinian primary school teachers negotiate multiple conflicting identities through their every day experiences of political conflict and the schools’ social culture. This tension is formed as a result of the historical cultural meaning that teachers construct about themselves and within the current unstable and unsettling conditions that exist in their country. In addition, the data indicate that the geographical location of the schools in relation of their proximity to the events of the political conflict also had an influence on the degree of tension inherent in teachers’ professional identity. The study makes significant theoretical, practical, and methodical contributions to the study of the formation of teachers’ professional identity in countries affected by political conflict.

Keywords: identity, political conflict, Palestine, teacher's professional identity

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Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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Authors: B. Adini, M. Oren

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Introduction: Communicable diseases and pandemics pose a growing threat to the well-being of the global population. A vital component of protecting the public health is the creation and sustenance of a continuous preparedness for such hazards. A joint Israeli-German task force was deployed in order to develop an advanced tool for self-evaluation of emergency preparedness for variable types of biological threats. Methods: Based on a comprehensive literature review and interviews with leading content experts, an evaluation tool was developed based on quantitative and qualitative parameters and indicators. A modified Delphi process was used to achieve consensus among over 225 experts from both Germany and Israel concerning items to be included in the evaluation tool. Validity and applicability of the tool for medical institutions was examined in a series of simulation and field exercises. Results: Over 115 German and Israeli experts reviewed and examined the proposed parameters as part of the modified Delphi cycles. A consensus of over 75% of experts was attained for 183 out of 188 items. The relative importance of each parameter was rated as part of the Delphi process, in order to define its impact on the overall emergency preparedness. The parameters were integrated in computerized web-based software that enables to calculate scores of emergency preparedness for biological events. Conclusions: The parameters developed in the joint German-Israeli project serve as benchmarks that delineate actions to be implemented in order to create and maintain an ongoing preparedness for biological events. The computerized evaluation tool enables to continuously monitor the level of readiness and thus strengths and gaps can be identified and corrected appropriately. Adoption of such a tool is recommended as an integral component of quality assurance of public health and safety.

Keywords: biological events, emergency preparedness, bioterrorism, natural biological events

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Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

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Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.

Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19

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Authors: Rui Calejo Rodrigues

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Building Refurbishing and Maintenance is a major area of knowledge ultimately dispensed to user/occupant criteria. The optimization of the service life of a building needs a special background to be assessed as it is one of those concepts that needs proficiency to be implemented. ISO 15686-2 Buildings and constructed assets - Service life planning: Part 2, Service life prediction procedures, states a factorial method based on deterministic data for building components life span. Major consequences result on a deterministic approach because users/occupants are not sensible to understand the end of components life span and so simply act on deterministic periods and so costly and resources consuming solutions do not meet global targets of planet sustainability. The estimation of 2 thousand million conventional buildings in the world, if submitted to a probabilistic method for service life planning rather than a deterministic one provide an immense amount of resources savings. Since 1989 the research team nowadays stating for CEES–Center for Building in Service Studies developed a methodology based on Montecarlo method for probabilistic approach regarding life span of building components, cost and service life care time spans. The research question of this deals with the importance of probabilistic approach of buildings life planning compared with deterministic methods. It is presented the mathematic model developed for buildings probabilistic lifespan approach and experimental data is obtained to be compared with deterministic data. Assuming that buildings lifecycle depends a lot on component replacement this methodology allows to conclude on the global impact of fixed replacements methodologies such as those on result of deterministic models usage. Major conclusions based on conventional buildings estimate are presented and evaluated under a sustainable perspective.

Keywords: building components life cycle, building maintenance, building sustainability, Montecarlo Simulation

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Authors: Pradeep Kulshrestha, Maulana Ayoub Ali

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The level of penetration of Islamic banking products and services has recorded a reasonable growth at an exponential rate in many parts of the world. There are many factors which have contributed to this growth including, but not limited to the rapid growth of number of Muslims who are uncomfortable with the conventional ways of banking, interest and higher interest rates scheduled by conventional banks and financial institutions as well as the financial inclusion campaign conducted in many countries. The system is facing legal challenges which open the research fdoor for practitioners and academicians for the sake of finding out solutions to those challenges. This paper tries to investigate the development of the Islamic banking system in the United Kingdom (UK), Saudi Arabia, Malaysia, Iran, Kenya, Nigeria and Uganda in order to understand the modalities which have been employed to run an Islamic banking system in the aforementioned countries. The methodology which has been employed in doing this research paper is Doctrinal, of which legislations, policies and other legal tools have been carefully studied and analysed. Again, papers from academic journals, books and financial reports have been deeply analysed for the purpose of enriching the paper and come up with a tangible results. The paper found that in Asia, Malaysia has created the smoothest legal platform for Islamic banking system to work properly in the country. The United Kingdom has tried harder to smooth the banking system without affecting the conventional banking methods and without favouring the operations of Islamic banks. It also tries harder to make UK as an Islamic banking and finance hub in Europe. The entire banking system in Iran is Islamic, while Nigeria has undergone several legal reforms to suit Islamic banking system in the country. Kenya and Uganda are at a different pace in making Islamic Banking system work alongside the conventional banking system.  

Keywords: shariah, Islamic banking, law, alternative banking

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Authors: Mohamed A. Eid, Sobhy M. Aly

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Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.

Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose

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Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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Authors: Radegunda Kessy, Justus Ochieng, Victor Afari-Sefa, Takemore Chagomoka, Ngoni Nenguwo

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Vegetables are excellent sources of dietary fiber, vitamins, and minerals which constitute an indispensable constituent of diets, but in Tanzania and other Sub-Saharan African countries, they are not readily available all year round due to seasonal variations in the production cycle. Drying of vegetables is one of the traditional methods for food preservation known to man. The Dodoma and Singida regions of Tanzania are characterized by semi-arid agro-climate, thereby experiencing short seasonal supply of fresh vegetables followed by long drought in which dried vegetables become an alternative to meet high household demands. A primary survey of 244 of rural consumers was carried out to understand how knowledge, attitudes, and perceptions of rural consumers affect consumption of dried vegetables. The sample respondents were all found to be aware of open sun drying of vegetables while less than 50% of them were aware of solar-dried vegetables. Consumers were highly concerned with the hygiene, nutritional values, taste, drying method, freshness, color of dried vegetables, timely availability and easiness of cooking as important factors they consider before they purchase dried vegetables. Logit model results show that gender, income, years of consuming dried vegetables, awareness of the importance of solar dried vegetables vis-à-vis sun-dried alternatives and employment status influenced rural consumer’s decision to purchase dried vegetables. Preference on dried vegetables differs across the regions which are also important considerations for any future planned interventions. The findings imply that development partners and policymakers need to design better social marketing and promotion techniques for the enhanced adoption of solar drying technology, which will greatly improve the quality and utilization of dried vegetables by target households.

Keywords: dried vegetables, postharvest management, sun drying, solar drying

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Authors: Paul Rowley, Adam Thirkill, Nick Doylend, Philip Leicester, Becky Gough

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The dynamic performance of all energy generation technologies is impacted to varying degrees by the stochastic properties of the wider system within which the generation technology is located. This stochasticity can include the varying nature of ambient renewable energy resources such as wind or solar radiation, or unpredicted changes in energy demand which impact upon the operational behaviour of thermal generation technologies. An understanding of these stochastic impacts are especially important in contexts such as highly distributed (or embedded) generation, where an understanding of issues affecting the individual or aggregated performance of high numbers of relatively small generators is especially important, such as in ESCO projects. Probabilistic evaluation of monitored or simulated performance data is one technique which can provide an insight into the dynamic performance characteristics of generating systems, both in a prognostic sense (such as the prediction of future performance at the project’s design stage) as well as in a diagnostic sense (such as in the real-time analysis of underperforming systems). In this work, we describe the development, application and outcomes of a new approach to the acquisition of datasets suitable for use in the subsequent performance and impact analysis (including the use of Bayesian approaches) for a number of distributed generation technologies. The application of the approach is illustrated using a number of case studies involving domestic and small commercial scale photovoltaic, solar thermal and natural gas boiler installations, and the results as presented show that the methodology offers significant advantages in terms of plant efficiency prediction or diagnosis, along with allied environmental and social impacts such as greenhouse gas emission reduction or fuel affordability.

Keywords: renewable energy, dynamic performance simulation, Bayesian analysis, distributed generation

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Authors: Omneya Messallam

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Technology has been developed dramatically in most of the educational disciplines. For instance, digital rendering subject, which is being taught in both Interior and Architecture fields, is witnessing almost annually updated software versions. A lot of students and educators argued that there will be no need for manual rendering techniques to be learned. Therefore, the Interior Design Visual Presentation 1 course (ID133) has been chosen from the first level of the Interior Design (ID) undergraduate program, as it has been taught for six years continually. This time frame will facilitate sound observation and critical analysis of the use of appropriate teaching methodologies. Furthermore, the researcher believes in the high value of the manual rendering techniques. The course objectives are: to define the basic visual rendering principles, to recall theories and uses of various types of colours and hatches, to raise the learners’ awareness of the value of studying manual render techniques, and to prepare them to present their work professionally. The students are female Arab learners aged between 17 and 20. At the outset of the course, the majority of them demonstrated negative attitude, lacking both motivation and confidence in manual rendering skills. This paper is a reflective appraisal of deploying two student-centred teaching pedagogies which are: Project-based learning (PBL) and Outcome-based education (OBE) on ID133 students. This research aims of developing some teaching strategies to enhance the quality of teaching in this given course over an academic semester. The outcome of this research emphasized the positive influence of applying such educational methods on improving the quality of students’ manual rendering skills in terms of: materials, textiles, textures, lighting, and shade and shadow. Furthermore, it greatly motivated the students and raised the awareness of the importance of learning the manual rendering techniques.

Keywords: project-based learning, outcome-based education, visual presentation, manual render, personal competences

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Authors: Asieh Abbassi Daloii, Ahmad Abdi

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Introduction: Sports information suggests that physical inactivity increases the risk of many diseases, including atherosclerosis. Coronary heart disease, stroke and peripheral vascular disease, atherosclerosis and clinical protests. However, exercise can have beneficial effects on risk factors for atherosclerosis by reducing hyperlipidemia, hypertension, obesity, plaque density, increased insulin sensitivity and glucose tolerance is improved. Despite these findings, there is little information about the molecular mechanisms of interaction between the body and its relation to sport and there arteriosclerosis. The present study aims to investigate the effect of six weeks of progressive aerobic training and aqueous extract of crataegus monogyna on vascular endothelial growth factor (VEGF) variations and angiopoetin-1/2 (ANG- 1/2) in plasma and heart tissue in male Wistar rats. Methods: 30 male Wistar rats, 4-6 months old, were randomly divided into four groups: control crataegus monogyna (N=8), training crataegus monogyna (N=8), control saline (N=6), and training saline (N=8). The aerobic training program included running on treadmill at the speed of 34 meters per minute for 60 minutes per day. The training was conducted for six weeks, five days a week. Following each training session, both experimental and control subjects of crataegus monogyna groups were orally fed with 0.5 mg crataegus monogyna extract per gram of the body weight. The normal saline group was given the same amount of the normal saline solution (NS). Eventually, 72 hours after the last training session, blood samples were taken from inferior Verna cava. Conclusion: It is likely that crataegus monogyna extract compared with aerobic training and even combination of both training and crataegus monogyna extract is more effective on angiogenesis.

Keywords: angiopoietin 1, 2, vascular endothelial growth factor, aerobic exercise

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Authors: Abanoub Mikhael, Darryl Hardie, Derek Smith, Helena Petrosova, Robert Ernst, David Goodlett

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Lipopolysaccharide (LPS) is a hallmark virulence factor of Gram-negative bacteria. It is a complex, structurally het- erogeneous mixture due to variations in number, type, and position of its simplest units: fatty acids and monosaccharides. Thus, LPS structural characterization by traditional mass spectrometry (MS) methods is challenging. Here, we describe the benefits of field asymmetric ion mobility spectrometry (FAIMS) for analysis of intact R-type lipopolysaccharide complex mixture (lipooligo- saccharide; LOS). Structural characterization was performed using Escherichia coli J5 (Rc mutant) LOS, a TLR4 agonist widely used in glycoconjugate vaccine research. FAIMS gas phase fractionation improved the (S/N) ratio and number of detected LOS species. Additionally, FAIMS allowed the separation of overlapping isobars facilitating their tandem MS characterization and un- equivocal structural assignments. In addition to FAIMS gas phase fractionation benefits, extra sorting of the structurally related LOS molecules was further accomplished using Kendrick mass defect (KMD) plots. Notably, a custom KMD base unit of [Na-H] created a highly organized KMD plot that allowed identification of interesting and novel structural differences across the different LOS ion families, i.e., ions with different acylation degrees, oligosaccharides composition, and chemical modifications. Defining the composition of a single LOS ion by tandem MS along with the organized KMD plot structural network was sufficient to deduce the composition of 181 LOS species out of 321 species present in the mixture. The combination of FAIMS and KMD plots allowed in-depth characterization of the complex LOS mixture and uncovered a wealth of novel information about its structural variations.

Keywords: lipopolysaccharide, ion mobility MS, Kendrick mass defect, Tandem mass spectrometry

Procedia PDF Downloads 42

Authors: N. Zarghami, M. Mohammadinejad, A. Akbarzadeh, Y. Pilehvar-Soltanahmadi, F. Zarghami

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Breast cancer is known to be the most common cancer in women. Cyclin D1 is a proto-oncogene and over expression of cyclin D1 is directly associated with tumorgenesis. Cyclin D1 is overexpressed in more than 50% of breast cancer cases. Curcumin is derived from turmeric (curcuma longa) and chrysin is a component that could be extracted from many plants and honey. These two plants derived compounds are believed to assist in inhibition of the cancer cells growth and reducing cyclin D1 expression. In this work, the hypothesis is to combine curcumin and chrysin in order to analyze the potential synergistic effect in inhibition of cell proliferation and down regulation of cyclin D1. In addition, use of PLGA-PEG to improve bioavailability of pure curcumin and chrysin, while reinforcing the potential effect of this combination. PLGA-PEG nanoparticles were synthesized and characterized with FT-IR and 1HNMR methods. Although morphological features were analyzed by SEM. Afterward curcumin and chrysin were encapsulated with synthesized PLGA-PEG and MTT-assay was performed to measure cytotoxicity effect of these plant constitutes. T-47D cells were treated with proper concentration of these constituents and Real-time PCR was carried out to evaluate cyclin D1 expression levels. Curcumin, chrysin and combination of curcumin –chrysin in intact and nano-capsulated form affected T-47D cells in time and dose dependent manner and the combination of these compounds had synergistic effects. Real-time PCR results, revealed that curcumin, chrysin and combination of curcumin-chrysin in pure and encapsulated form inhibited cyclin D1 expression. Compared to pure components, different concentrations of nano-curcumin, nano chrysin and nano-combination caused further decline in cyclin D12 expression by 5-11%, 8-22% and 6-18% respectively. Our results demonstrated that, combination of chrysin-curcumin had synergistic effect and nano capsulated form of this component had grater inhibition on cyclin D1 expression.

Keywords: breast cancer, cyclin D1, curcumin, chrysin, nanoparticles

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Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

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Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

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Authors: Roya Pournaghi

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Measuring the extent of daily use of the libraries study space is of utmost significance in order to develop, re-organize and maintain the efficiency of the study space. The current study aimed to employ GIS in analyzing the study halls space of the document center and central library of Tehran University and determine the extent of use of the study chairs and desks by the students-intended users. This combination of survey methods - descriptive design system. In order to collect the required data and a description of the method, To implement and entering data into ArcGIS software. It also analyzes the data and displays the results on the library floor map design method were used. And spatial database design and plan has been done at the Central Library of Tehran University through the amount of space used by members of the Library and Information halls plans. Results showed that Biruni's hall is allocated the highest occupancy rate to tables and chairs compared to other halls. In the Hall of Science and Technology, with an average occupancy rate of 0.39 in the tables represents the lowest users and Rashid al-Dins hall, and Science and Technology’s hall with an average occupancy rate (0.40) represents the lowest users of seats. In this study, the comparison of the space is occupied at different period as a study’s hall in the morning, evenings, afternoons, and several months was performed through GIS. This system analyzed the space relationship effectively and efficiently. The output of this study can be used by administrators and librarians to determine the exact amount of using the Equipment of study halls and librarians can use the output map to design more efficient space at the library.

Keywords: geospatial information system, spatial analysis, reading room, academic libraries, library’s user, central library of Tehran university

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Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: Pawan Kumar Gupta, Sumana Ghosh

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Parkinson's Disease (PD) is a long-term neurodegenerative movement disorder of the central nervous system with vast symptoms related to the motor system. The common symptoms of PD are tremor, rigidity, bradykinesia/akinesia, and postural instability, but the clinical symptom includes other motor and non‐motor issues. The motor symptoms of the disease are consequence of death of the neurons in a region of the midbrain known as substantia nigra pars compacta, leading to decreased level of a neurotransmitter known as dopamine. The cause of this neuron death is not clearly known but involves formation of Lewy bodies, an abnormal aggregation or clumping of the protein alpha-synuclein in the neurons. Unfortunately, there is no cure for PD, and the management of this disease is challenging. Therefore, it is critical for a patient to be diagnosed at early stages. A limited choice of drugs is available to improve the symptoms, but those become less and less effective over time. Apart from that, with rapid growth in the field of science and technology, other methods such as multi-area brain stimulation are used to treat patients. In order to develop advanced techniques and to support drug development for treating PD patients, an accurate mathematical model is needed to explain the underlying relationship of dopamine secretion in the brain with the hand tremors. There has been a lot of effort in the past few decades on modeling PD tremors and treatment effects from a computational point of view. These models can effectively save time as well as the cost of drug development for the pharmaceutical industry and be helpful for selecting appropriate treatment mechanisms among all possible options. In this review paper, an effort is made to investigate studies on PD modeling and analysis and to highlight some of the key advances in the field over the past centuries with discussion on the current challenges.

Keywords: Parkinson's disease, deep brain stimulation, tremor, modeling

Procedia PDF Downloads 123