Search results for: shock waves therapy

Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

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Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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Authors: Yuan-Chung Tsai, Masao Kamimura, Kohei Soga, Hsin-Cheng Chiu

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In order to enhance the photodynamic/photothermal therapeutic efficacy on glioblastoma, the functionized upconversion nanoparticles with the capability of converting the deep tissue penetrating near-infrared light into visible wavelength for activating photochemical reaction were developed. The drug-loaded nanoparticles (NPs) were obtained from the self-assembly of oleic acid-coated upconversion nanoparticles along with maleimide-conjugated poly(ethylene glycol)-cholesterol (Mal-PEG-Chol), as the NP stabilizer, and hydrophobic photosensitizers, IR-780 (for photothermal therapy, PTT) and mTHPC (for photodynamic therapy, PDT), in aqueous phase. Both the IR-780 and mTHPC were loaded into the hydrophobic domains within NPs via hydrophobic association. The peptide targeting ligand, angiopep-2, was further conjugated with the maleimide groups at the end of PEG adducts on the NP surfaces, enabling the affinity coupling with the low-density lipoprotein receptor-related protein-1 of tumor endothelial cells and malignant astrocytes. The drug-loaded NPs with the size of ca 80 nm in diameter exhibit a good colloidal stability in physiological conditions. The in vitro data demonstrate the successful targeting delivery of drug-loaded NPs toward the ALTS1C1 cells (murine astrocytoma cells) and the pronounced cytotoxicity elicited by combinational effect of PDT and PTT. The in vivo results show the promising brain orthotopic tumor targeting of drug-loaded NPs and sound efficacy for brain tumor dual-modality treatment. This work shows great potential for improving photodynamic/photothermal therapeutic efficacy of brain cancer.

Keywords: drug delivery, orthotopic brain tumor, photodynamic/photothermal therapies, upconversion nanoparticles

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Authors: Elvin P. Chizenga, Heidi Abrahamse

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Cancer cell resistance to therapy is the main cause of treatment failures and the poor prognosis of cancer convalescence. The progression of cervical cancer to other parts of the genitourinary system and the reported recurrence rates are overwhelming. Current treatments, including surgery, chemo and radiation have been inefficient in eradicating the tumor cells. These treatments are also associated with poor prognosis and reduced quality of life, including fertility loss. This has inspired the need for the development of new treatment modalities to eradicate cervical cancer successfully. Photodynamic Therapy (PDT) is a modern treatment modality that induces cell death by photochemical interactions of light and a photosensitizer, which in the presence of molecular oxygen, yields a set of chemical reactions that generate Reactive Oxygen Species (ROS) and other free radical species causing cell damage. Enhancing PDT using modified drug delivery can increase the concentration of the photosensitizer in the tumor cells, and this has the potential to maximize its therapeutic efficacy. In cervical cancer, all infected cells constitutively express genes of the E6 and E7 HPV viral oncoproteins, resulting in high concentrations of E6 and E7 in the cytoplasm. This provides an opportunity for active targeting of cervical cancer cells using immune-mediated drug delivery to maximize therapeutic efficacy. The use of nanoparticles in PDT has also proven effective in enhancing therapeutic efficacy. Gold nanoparticles (AuNps) in particular, are explored for their use in biomedicine due to their biocompatibility, low toxicity, and enhancement of drug uptake by tumor cells. In this present study, a biomolecule comprising of AuNPs, anti-E6 monoclonal antibodies, and Aluminium Phthalocyanine photosensitizer was synthesized for use in targeted PDT of cervical cancer. The AuNp-Anti-E6-Sulfonated Aluminium Phthalocyanine mix (AlPcSmix) photosensitizing biomolecule was synthesized by coupling AuNps and anti-E6 monoclonal antibodies to the AlPcSmix via Polyethylene Glycol (PEG) chemical links. The final product was characterized using Transmission Electron Microscope (TEM), Zeta Potential, Uv-Vis Spectrophotometry, Fourier Transform Infrared Spectroscopy (FTIR), and X-ray diffraction (XRD), to confirm its chemical structure and functionality. To observe its therapeutic role in treating cervical cancer, cervical cancer cells, HeLa cells were seeded in 3.4 cm² diameter culture dishes at a concentration of 5x10⁵ cells/ml, in vitro. The cells were treated with varying concentrations of the photosensitizing biomolecule and irradiated using a 673.2 nm wavelength of laser light. Post irradiation cellular responses were performed to observe changes in morphology, viability, proliferation, cytotoxicity, and cell death pathways induced. Dose-Dependent response of the cells to treatment was demonstrated as significant morphologic changes, increased cytotoxicity, and decreased cell viability and proliferation This study presented a synthetic biomolecule for targeted PDT of cervical cancer. The study suggested that PDT using this AuNp- Anti-E6- AlPcSmix photosensitizing biomolecule is a very effective treatment method for the eradication of cervical cancer cells, in vitro. Further studies in vivo need to be conducted to support the use of this biomolecule in treating cervical cancer in clinical settings.

Keywords: anti-E6 monoclonal antibody, cervical cancer, gold nanoparticles, photodynamic therapy

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Authors: Shahzad Karim Bhatti

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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.

Keywords: pain, prolapse, Ozone, backpain

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Authors: M. R. Akbari, H. Yousefnia, A. Ghasemi

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Al2O3:C,Mg fluorescent nuclear track detector (FNTD) and Al2O3:C optically stimulated luminescence detector (OSLD) are becoming two of the applied detectors in ion dosimetry. Therefore, the response of these detectors to hadron beams is highly of interest in radiation therapy (RT) using ion beams. In this study, these detectors' responses to proton and Helium-4 ion beams were compared using Monte Carlo simulations. The calculated data for proton beams were compared with Markus ionization chamber (IC) measurement (in water phantom) from M.D. Anderson proton therapy center. Monte Carlo simulations were performed via the FLUKA code (version 2011.2-17). The detectors were modeled in cylindrical shape at various depths of the water phantom without shading each other for obtaining relative depth dose in the phantom. Mono-energetic parallel ion beams in different incident energies (100 MeV/n to 250 MeV/n) were collided perpendicularly on the phantom surface. For proton beams, the results showed that the simulated detectors have over response relative to IC measurements in water phantom. In all cases, there were good agreements between simulated ion ranges in the water with calculated and experimental results reported by the literature. For proton, maximum peak to entrance dose ratio in the simulated water phantom was 4.3 compared with about 3 obtained from IC measurements. For He-4 ion beams, maximum peak to entrance ratio calculated by both detectors was less than 3.6 in all energies. Generally, it can be said that FLUKA is a good tool to calculate Al2O3:C,Mg FNTD and Al2O3:C OSLD detectors responses to therapeutic proton and He-4 ion beams. It can also calculate proton and He-4 ion ranges with a reasonable accuracy.

Keywords: comparison, FNTD and OSLD detectors response, light ion beams, Monte Carlo simulations

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Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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Authors: Shiuh-Jer Huang, Yun-Han Yeh

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A four-wheel drive electric vehicle was built with hub DC motors and FPGA embedded control structure. A 40 steps manual adjusting motorcycle shock absorber was refitted with DC motor driving mechanism to construct as a semi-active suspension system. Accelerometer and potentiometer sensors are installed to measure the sprung mass acceleration and suspension system compression or rebound states for control purpose. An intelligent fuzzy logic controller was proposed to real-time search appropriate damping ratio based on vehicle running condition. Then, a robust fuzzy sliding mode controller (FSMC) is employed to regulate the target damping ratio of each wheel axis semi-active suspension system. Finally, different road surface conditions are chosen to evaluate the control performance of this semi-active suspension and compare with that of passive system based on wheel axis acceleration signal.

Keywords: acceleration, FPGA, Fuzzy sliding mode control, semi-active suspension

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Authors: Chutamas Thepmalee, Aussara Panya, Mutita Junking, Jatuporn Sujjitjoon, Nunghathai Sawasdee, Pa-Thai Yenchitsomanus

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Cholangiocarcinoma (CCA) is an aggressive malignancy of bile duct epithelial cells in which the standard treatments, including surgery, radiotherapy, chemotherapy, and targeted therapy are partially effective. Many solid tumors including CCA escape host immune responses by creating tumor microenvironment and generating immunosuppressive cytokines such as interleukin-10 (IL-10) and transforming growth factor-β (TGF-β). These cytokines can inhibit dendritic cell (DC) differentiation and function, leading to decreased activation and response of effector CD4+ and CD8+ T cells for cancer cell elimination. To overcome the effects of these immunosuppressive cytokines and to increase ability of DC to activate effector CD4+ and CD8+ T cells, we generated self-differentiated DCs (SD-DCs) with down-regulation of IL-10 and TGF-β receptors for activation of effector CD4+ and CD8+ T cells. Human peripheral blood monocytes were initially transduced with lentiviral particles containing the genes encoding GM-CSF and IL-4 and then secondly transduced with lentiviral particles containing short-hairpin RNAs (shRNAs) to knock-down mRNAs of IL-10 and TGF-β receptors. The generated SD-DCs showed up-regulation of MHC class II (HLA-DR) and co-stimulatory molecules (CD40 and CD86), comparable to those of DCs generated by convention method. Suppression of IL-10 and TGF-β receptors on SD-DCs by specific shRNAs significantly increased levels of IFN-γ and also increased cytolytic activity of DC-activated effector T cells against CCA cell lines (KKU-213 and KKU-100), but it had little effect to immortalized cholangiocytes (MMNK-1). Thus, SD-DCs with down-regulation of IL-10 and TGF-β receptors increased activation of effector T cells, which is a recommended method to improve DC function for the preparation of DC-activated effector T cells for adoptive T-cell therapy.

Keywords: cholangiocarcinoma, IL-10 receptor, self-differentiated dendritic cells, TGF-β receptor

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Authors: Irtaza M. Syed, Kaamran Raahemifar

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This paper presents a model predictive control (MPC) of a utility interactive (UI) single phase inverter (SPI) for a photovoltaic (PV) system at residential/distribution level. The proposed model uses single-phase phase locked loop (PLL) to synchronize SPI with the grid and performs MPC control in a dq reference frame. SPI model consists of boost converter (BC), maximum power point tracking (MPPT) control, and a full bridge (FB) voltage source inverter (VSI). No PI regulators to tune and carrier and modulating waves are required to produce switching sequence. Instead, the operational model of VSI is used to synthesize sinusoidal current and track the reference. Model is validated using a three kW PV system at the input of UI-SPI in Matlab/Simulink. Implementation and results demonstrate simplicity and accuracy, as well as reliability of the model.

Keywords: phase locked loop, voltage source inverter, single phase inverter, model predictive control, Matlab/Simulink

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Authors: Yan Zeng, Li Tao, Liujun Han, Tianye Zhang, Yongan Yu, Kaijun Ma, Long Chen

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Mechanical asphyxia is one of the main cause of death; however, death by mechanical asphyxia may be difficult to prove in court, particularly in cases in which corpses exhibit no obvious signs of asphyxia. To identify a credible biomarker of asphyxia, we first examined the expression levels of all the mRNAs in human cardiac tissue specimens subjected to mechanical asphyxia and compared these expression levels with those of the corresponding mRNAs in specimens subjected to craniocerebral injury. A total of 119 differentially expressed mRNAs were selected and the expression levels of these mRNAs were examined in 44 human cardiac tissue specimens subjected to mechanical asphyxia, craniocerebral injury, hemorrhagic shock and other causes of death. We found that DUSP1 and KCNJ2 were up-regulated in tissue specimens of mechanical asphyxia compared with control tissues, with no significant correlation between age, environmental temperature and PMI, indicating that DUSP1 and KCNJ2 may associate with mechanical asphyxia-induced death and can thus serve as useful biomarkers of death by mechanical asphyxia.

Keywords: mechanical asphyxia, biomarkers, DUSP1, KCNJ2, cardiac tissue

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Authors: Kristine Kalnica-Dorosenko, Aiga Svede

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Amblyopia or 'lazy eye' is impaired or dim vision without obvious defect or change in the eye. It is often associated with abnormal visual experience, most commonly strabismus, anisometropia or both, and form deprivation. The main task of amblyopia treatment is to ameliorate etiological factors to create a clear retinal image and, to ensure the participation of the amblyopic eye in the visual process. The treatment of amblyopia and eccentric fixation is usually associated with problems in the therapy. Eccentric fixation is present in around 44% of all patients with amblyopia and in 30% of patients with strabismic amblyopia. In Latvia, amblyopia is carefully treated in various clinics, but eccentricity diagnosis is relatively rare. Conflict which has developed relating to the relationship between the visual disorder and the degree of eccentric fixation in amblyopia should to be rethoughted, because it has an important bearing on the cause and treatment of amblyopia, and the role of the eccentric fixation in this case. Visuoscopy is the most frequently used method for determination of eccentric fixation. With traditional visuoscopy, a fixation target is projected onto the patient retina, and the examiner asks to look straight directly at the center of the target. An optometrist then observes the point on the macula used for fixation. This objective test provides clinicians with direct observation of the fixation point of the eye. It requires patients to voluntarily fixate the target and assumes the foveal reflex accurately demarcates the center of the foveal pit. In the end, by having a very simple method to evaluate fixation, it is possible to indirectly evaluate treatment improvement, as eccentric fixation is always associated with reduced visual acuity. So, one may expect that if eccentric fixation in amlyopic eye is found with visuoscopy, then visual acuity should be less than 1.0 (in decimal units). With occlusion or another amblyopia therapy, one would expect both visual acuity and fixation to improve simultaneously, that is fixation would become more central. Consequently, improvement in fixation pattern by treatment is an indirect measurement of improvement of visual acuity. Evaluation of eccentric fixation in the child may be helpful in identifying amblyopia in children prior to measurement of visual acuity. This is very important because the earlier amblyopia is diagnosed – the better the chance of improving visual acuity.

Keywords: amblyopia, eccentric fixation, visual acuity, visuoscopy

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Authors: Vinay Kumar Vanjakula, Frank Adam, Nils Goseberg

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Wind power is one of the leading renewable energy generation methods. Due to abundant higher wind speeds far away from shore, the construction of offshore wind turbines began in the last decades. However, installation of offshore foundation-based (monopiles) wind turbines in deep waters are often associated with technical and financial challenges. To overcome such challenges, the concept of floating wind turbines is expanded as the basis from the oil and gas industry. The unfolding of Universal heavyweight gravity anchor (UGA) for floating based foundation for floating Tension Leg Platform (TLP) sub-structures is developed in this research work. It is funded by the German Federal Ministry of Education and Research) for a three-year (2019-2022) research program called “Offshore Wind Solutions Plus (OWSplus) - Floating Offshore Wind Solutions Mecklenburg-Vorpommern.” It’s a group consists of German institutions (Universities, laboratories, and consulting companies). The part of the project is focused on the numerical modeling of gravity anchor that involves to analyze and solve fluid flow problems. Compared to gravity-based torpedo anchors, these UGA will be towed and lowered via controlled machines (tug boats) at lower speeds. This kind of installation of UGA are new to the offshore wind industry, particularly for TLP, and very few research works have been carried out in recent years. Conventional methods for transporting the anchor requires a large transportation crane vessel which involves a greater cost. This conceptual UGA anchors consists of ballasting chambers which utilizes the concept of buoyancy forces; the inside chambers are filled with the required amount of water in a way that they can float on the water for towing. After reaching the installation site, those chambers are ballasted with water for lowering. After it’s lifetime, these UGA can be unballasted (for erection or replacement) results in self-rising to the sea surface; buoyancy chambers give an advantage for using an UGA without the need of heavy machinery. However, while lowering/rising the UGA towards/away from the seabed, it experiences difficult, harsh marine environments due to the interaction of waves and currents. This leads to drifting of the anchor from the desired installation position and damage to the lowering machines. To overcome such harsh environments problems, a numerical model is built to investigate the influences of different outer contours and other fluid governing shapes that can be installed on the UGA to overcome the turbulence and drifting. The presentation will highlight the importance of the Computational Fluid Dynamics (CFD) numerical model in OpenFOAM, which is open-source programming software.

Keywords: anchor lowering, towing, waves, currrents, computational fluid dynamics

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Authors: Sasan Khademnematolahi, Kevine Kamga Silihe, Katarína Pružinská, Martina Chrastina, Elisabeth Louise Ndjengue Mindang, František Dráfi, Katarína Bauerová

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Background: In ethnomedicine, plant parts and compounds are traditionally utilized to treat many disorders. Azadirachta indica, known as Neem, has been traditionally used in medicinal practices. Due to the presence of bioactive substances such as nimbolide, azadirachtin, and gedunin, Neem offers a variety of medicinal properties, including anti-inflammatory and antioxidant properties. Through its effect on pathological inflammatory processes, supplementation with it could alleviate the symptoms of rheumatoid arthritis (RA). Methods: This research aimed to assess Neem seed oil's impact on rats with adjuvant arthritis. Three doses in monotherapy and two in combination with methotrexate (MTX) have been studied, and their effect was compared. Neem p.o. doses of 100, 200, and 300 mg/kg and MTX p.o. doses of 0.3 mg/kg were examined. After clinical parameters assessment, biochemical analysis was performed in plasma. Results: During the acute phase of the experimental arthritis (Day21), levels of MMP-9, MCP-1, and cytokines IL-1beta and IL-17A were measured. The positive results of inflammatory mediators evaluation in plasma encourage additional analysis also in related tissues to prove if Neem seed oil can be used as an adjuvant therapy for RA. Conclusion: In this study, the combination therapy of Neem with MTX was the most effective of all therapies investigated. Acknowledgement: SAIA PROJECT of Kevine Kamga Silihe, Slovakia-Cameroon 2023: “The effect of Crocus sativus L (Saffron), Azadirachta indica (Neem) and their main bioactives compounds in combinatory treatment with methotrexate on experimental arthritis”, VEGA 2/0079/24, VEGA 2/0136/20, VEGA 2/0126/23 and VEGA 2/0091/23.

Keywords: adjuvant, Neem, methotrexate, arthritis

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Authors: Ke Guek Nee, Wong Siew Fan, Nigel V. Marsh

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Excessive use of the Internet has become a cause for concern in many countries, including Malaysia. Such behaviour is reported to be more prevalent amongst young adults who are reported to be spending large amount of time on the Internet. The present study has three objectives. First one is designing a manual-based Cognitive Behavioural Therapy (CBT) programme to reduce problematic Internet use among young adults in Malaysia. Second one is examining the effectiveness of a manual-based CBT programme at the pilot study stage. Thirdly, the programme focuses on reducing the level of stress and anxiety in problematic Internet users. We adopted CBT with single subject experimental design method. A total of six participants completed the entire program. They were asked to report their daily Internet use and software was installed on their devices to record actual use. The data collection involved three time frame measurements: T1 (baseline), T2 (immediately during the last session of the intervention sessions), and T3 (follow-up). Three scales were used to measure the effectiveness of the program: Depression, Anxiety, Stress Scales (DASS), Social Interaction Anxiety Scale (SIAS), and Problematic Internet Use Questionnaire (PIUQ). The results revealed that the intervention programme has significantly improved two dimensions of problematic Internet use which were obsession and control disorder. The participants’ mental health also showed a deduction in means scores for depression, anxiety and stress with depression showing the greatest improvement after the intervention programme. The participants’ social anxiety showed a slight deduction in means scores. We concluded that the intervention programme designed was effective. However, its limitations need to be addressed in future research.

Keywords: excessive internet use, cognitive behavioral thearapy (CBT), psychological well-being, young adults

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Authors: Wael Salah Shendy, Moataz Mohamed EL Semary, Hosam Salah Murad, Adham A. Mohamed

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Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objectives: To determine the effect of C1-C2 Mulligan SNAGs mobilizations on cervicogenic headache and associated dizziness symptoms. Methods: Forty-eight patients with cervicogenic headache included in the study; from the outpatient clinic of Faculty of Physical Therapy, Cairo University, and New Cairo outpatient clinics, were randomly assigned into three equal groups; group A ( Headache SNAG), group B (C1-C2 SNAG rotation) and group C (combined). Their mean age was (29.37 ± 2.6), (29.31 ± 2.54) and (29.68 ± 2.65). Neck Disability Index used to examine neck pain intensity and CEH symptoms. 6 Items Headache Impact test '6-HIT' scale used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test 'FRT' also used to assess rotation ROM at the level of C1-C2 by 'CROM' device. Dizziness Handicap Inventory 'DHI' scale was used to evaluate dizziness symptoms. Evaluation is done pre and post treatment, and comparison between groups was quantified. Correlations between the examined parameters were also measured. Headache SNAG and C1-C2 Rotation SNAGs were done separately in group (A- B) and combined in group C as a treatment intervention. Results: Group C has Significant improvement in whole parameters compared to group A and B, positive correlation was found between NDI and 6-HIT scores compared to negative correlation between NDI and DHI scores. Conclusion: SNAGs mobilizations used in the study were effective in reducing cervicogenic headache and dizziness symptoms in all groups with a noticeable improvement in the combined group.

Keywords: cervicogenic headache, cervical headache snag, cervical snag half rotation, cervical dizziness

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Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

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Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

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Authors: Dong Liu

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By sending a high-frequency probe wave and a low-frequency pump wave to a specimen, the vibroacoustic method evaluates the defect’s severity according to the modulation index of the received signal. Many studies experimentally proved the significant sensitivity of the modulation index to the tiny contact type defect. However, it has also been found that the modulation index was highly affected by the frequency of probe or pump waves. Therefore, the chirp signal has been introduced to the VAM method since it can assess multiple frequencies in a relatively short time duration, so the robustness of the VAM method could be enhanced. Consequently, the signal processing method needs to be modified accordingly. Various studies utilized different algorithms or combinations of algorithms for processing the VAM signal method by chirp excitation. These signal process methods were compared and used for processing a VAM signal acquired from the steel samples.

Keywords: vibroacoustic modulation, nonlinear acoustic modulation, nonlinear acoustic NDT&E, signal processing, structural health monitoring

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Authors: Joao Paulo Matheus, Renan Fangel

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Rheumatoid arthritis is a chronic, inflammatory, systemic and progressive disease that affects the synovial joints bilaterally, causing definitive orthopedic damage. It has a higher prevalence in postmenopausal female patients. It is a disabling disease that causes joint deformities that may compromise the functionality of the affected segment. The aim of this study was to evaluate the influence of low-intensity therapeutic laser on the perception of pain and quality of life in patients with rheumatoid arthritis. This is a randomized clinical study involving 6 women with a mean age of 56.8+6.3 years. Exclusion criteria: patients with acute pain, chronic infectious disease, underlying acute or chronic underlying disease. An AsGaAl laser with 808nm wavelength, 100mW power, beam output area of 0.028cm2, power density of 3.57W/cm2 was used. The laser was applied at pre-defined points in the interphalangeal and metacarpophalangeal joints, totaling 24 points, 2 times a week, for 4 weeks, totaling 8 sessions. The Pain Inventory (IBD) and Visual Analogue Scale (VAS) were used for the analysis of pain and for the WHOQOL-bref quality of life assessment. There was no statistical difference between the onset (5.67±2.66) and the final (4.67±3.78) of treatments (p=0.70). There was also no statistical difference between the beginning (5.67±2.66) and the final (4.67±3.78) of the treatments in the VAS analysis (p=0.68). The overall mean quality of life obtained by the questionnaire at the start of treatment was 42.3±7.6, while at the end of treatment it was 58.5±7.6 (p=0.01) and the domains of the questionnaire with significant differences were: psychological domain 42.9±6.8 and 66.7±12.9 (p=0.004), social domain 39.9±5.7 and 68.1±6.3 (p=0,0005) and environmental domain 36.3±7.3 and 56.3±12.5 (p=0.003). It can be concluded that the low-intensity therapeutic laser did not produce significant changes in the painful period of rheumatoid arthritis patients. However, there was an improvement in patients' quality of life in the psychological, social and environmental aspects.

Keywords: laser therapy, pain, quality of life, rheumatoid arthritis

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Authors: Mengesha Mamo Wogari

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In this paper, low voltage multiphase brushless DC motor with square wave air-gap flux distribution for electric vehicle application is proposed. Ten-phase, 5 kW motor, has been designed and simulated by finite element methods demonstrating the desired high torque capability at low speed and flux weakening operation for high-speed operations. The motor torque is proportional to number of phases for a constant phase current and air-gap flux. The concept of vector control and simple space vector modulation technique is used on MATLAB to control the motor demonstrating simple switching pattern for selected number of phases. The low voltage DC and inverter output AC are desired characteristics to avoid any electric shock in the vehicle, accidentally and during abnormal conditions. The switching devices for inverter are of low-voltage rating and cost effective though their number is equal to twice the number of phases.

Keywords: brushless DC motors, electric Vehicle, finite element methods, Low-voltage inverter, multiphase

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Authors: Fiona Jensen, Barb Goodwin, Nancy Kleiman, Rhonda Usunier

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Background: Clinical simulation is now a common component in many health profession curricula in preparation for clinical practice. In the Rady Faculty of Health Sciences (RFHS) college leads in simulation and interprofessional (IP) education, planned an eight hour simulated hospital day shift, where seventy students from six health professions across two campuses, learned with each other in a safe, realistic environment. Learning about interprofessional collaboration, an expected competency for many health professions upon graduation, was a primary focus of the simulation event. Method: Faculty representatives from the Colleges of Nursing, Medicine, Pharmacy and Rehabilitation Sciences (Physical Therapy, Occupation Therapy, Respiratory Therapy) and Pharmacy worked together to plan the IP event in a simulation facility in the College of Nursing. Each college provided a faculty mentor to guide the same profession students. Students were placed in interprofessional teams consisting of a nurse, physician, pharmacist, and then sharing respiratory, occupational, and physical therapists across the team depending on the needs of the patients. Eight patient scenarios were role played by health profession students, who had been provided with their patient’s story shortly before the event. Each team was guided by a facilitator. Results and Outcomes: On the morning of the event, all students gathered in a large group to meet mentors and facilitators and have a brief overview of the six competencies for effective collaboration and the session objectives. The students assuming their same profession roles were provided with their patient’s chart at the beginning of the shift, met with their team, and then completed professional specific assessments. Shortly into the shift, IP team rounds began, facilitated by the team facilitator. During the shift, each patient role-played a spontaneous health incident, which required collaboration between the IP team members for assessment and management. The afternoon concluded with team rounds, a collaborative management plan, and a facilitated de-brief. Conclusions: During the de-brief sessions, students responded to set questions related to the session learning objectives and expressed many positive learning moments. We believe that we have a sustainable simulation IP collaborative learning opportunity, which can be embedded into curricula, and has the capacity to grow to include more health profession faculties and students. Opportunities are being explored in the RFHS at the administrative level, to offer this event more frequently in the academic year to reach more students. In addition, a formally structured event evaluation tool would provide important feedback and inform the qualitative feedback to event organizers and the colleges about the significance of the simulation event to student learning.

Keywords: simulation, collaboration, teams, interprofessional

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Authors: Xiao-Yin Liu, Liang-Xue Zhou

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Traumatic brain injury (TBI), as a kind of nerve trauma caused by an external force, affects people all over the world and is a global public health problem. Although there are various clinical treatments for brain injury, including surgery, drug therapy, and rehabilitation therapy, the therapeutic effect is very limited. To improve the therapeutic effect of TBI, scaffolds combined with exosomes are a promising but challenging method for TBI repair. In this study, we examined whether a novel 3D-printed collagen/chitosan scaffold/exosomes derived from neural stem cells (NSCs) pretreated with insulin growth factor-1 (IGF-I) scaffolds (3D-CC-INExos) could be used to improve TBI repair and functional recovery after TBI. Our results showed that composite scaffolds of collagen-, chitosan- and exosomes derived from NSCs pretreated with IGF-I (INExos) could continuously release the exosomes for two weeks. In the rat TBI model, 3D-CC-INExos scaffold transplantation significantly improved motor and cognitive function after TBI, as assessed by the Morris water maze test and modified neurological severity scores. In addition, immunofluorescence staining and transmission electron microscopy showed that the recovery of damaged nerve tissue in the injured area was significantly improved by 3D-CC-INExos implantation. In conclusion, our data suggest that 3D-CC-INExos might provide a potential strategy for the treatment of TBI and lay a solid foundation for clinical translation.

Keywords: traumatic brain injury, exosomes, insulin growth factor-1, neural stem cells, collagen, chitosan, 3D printing, neural regeneration, angiogenesis, functional recovery

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Authors: Mahmood Heshmati, Farhang Daneshmand

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Material scientists and engineers have introduced novel materials with complex geometries due to the recent technological advances and promotion of manufacturing methods. Among them, lattice structures with graded architectures denoted by functionally graded porous materials (FGPMs) have been developed to optimize the structural response. FGPMs are achieved by tailoring the size and density of the internal pores in one or more directions that lead to the desired mechanical properties and structural responses. Also, FGPMs provide more flexible transition and the possibility of designing and fabricating structural elements with complex and variable properties. In this paper, wave propagation in lattice structures with functionally graded (FG) porosity is investigated in order to examine the ability of shock absorbing effect. The behavior of FG porous beams with different porosity distributions under impact load and the effects of porosity distribution and porosity content on the wave speed are studied. Important conclusions are made, along with a discussion of the future scope of studies on FGPMs structures.

Keywords: functionally graded, porous materials, wave propagation, impact load, finite element

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Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska

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Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.

Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT

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Authors: Ava Zarif Sanayei, Sedigheh Sina

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Despite the advancement of radiation-free interventions in the gastrointestinal and hepatobiliary fields, endoscopy and endoscopic retrograde cholangiopancreatography (ERCP) remain indispensable procedures that necessitate radiation exposure. ERCP, in particular, relies heavily on radiation-guided imaging to ensure precise delivery of therapy. Meanwhile, interventional radiology (IR) procedures also utilize imaging modalities like X-rays and CT scans to guide therapy, often under local anesthesia via small needle insertion. However, the complexity of these procedures raises concerns about radiation exposure to healthcare professionals, including nurses, who play a crucial role in these interventions. This study aims to assess the radiation exposure to the hands and fingers of nurses 1 and 2, who are directly involved in ERCP procedures utilizing (TLD-100) dosimeters at the Gastrointestinal Endoscopy department of a clinic in Shiraz, Iran. The dosimeters were initially calibrated using various phantoms and then a group was prepared and used over a two-month period. For personal equivalent dose measurement, two TLD chips were mounted on a finger ring to monitor exposure to the hands and fingers. Upon completion of the monitoring period, the TLDs were analyzed using a TLD reader, showing that Nurse 1 received an equivalent dose of 298.26 µSv and Nurse 2 received an equivalent dose of 195.39 µSv. The investigation revealed that the total radiation exposure to the nurses did not exceed the annual limit for occupational exposure. Nevertheless, it is essential to prioritize radiation protection measures to prevent potential harm. The study showed that positioning staff members and placing two nurses in a specific location contributed to somehow equal doses. To reduce exposure further, we suggest providing education and training on radiation safety principles, particularly for technologists.

Keywords: dose measurement, ERCP, interventional radiology, medical imaging

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Authors: Setareh Yousife

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Introduction: Studies suggest that Extramarital Infidelity (EMI) variants, such as sexual and emotional infidelities are increasing in marriage relationships. To our knowledge, less is known about what therapies and mental-hygiene factors can prevent more effective this behavior and address it. Spiritual and cognitive-behavioural health have proven to reduce marital conflict, Increase marital satisfaction and commitment. Objective: This study aims to discuss the effectiveness of spiritual counseling combined with Cognitive-behavioural techniques in addressing Extramarital Infidelity. Method: Descriptive, analytical, and intervention articles indexed in SID, Noormags, Scopus, Iranmedex, Web of Science and PubMed databases, and Google Scholar were searched. We focused on Studies in which Women with extramarital relationships, including heterosexual married couples-only studies and spirituality/religion and CBT as coping techniques used as EMI therapy. Finally, the full text of all eligible articles was prepared and discussed in this review. Results: 25 publications were identified, and their textual analysis facilitated through four thematic approaches: The nature of EMI in Women, the meaning of spirituality in the context of mental health and human behavior as well as psychotherapy; Spirituality integrated into Cognitive-Behavioral approach, The role of Spirituality as a deterrent to EMI. Conclusions: The integration of the findings discussed herein suggests that the application of cognitive and behavioral skills in addressing these kinds of destructive family-based relationships is inevitable. As treatments based on religion/spirituality or cognition/behavior do not seem adequately effective in dealing with EMI, the combination of these approaches may lead to higher efficacy in fewer sessions and a shorter time.

Keywords: spirituality, religion, cognitive behavioral therapy, extramarital relation, infidelity

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Authors: Ali Kassem, Aly Taha, Abeer Hassan, Kazuhide Higuchi

Abstract:

Introduction: Trans arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is usually followed by hepatic dysfunction that limits its efficacy. L-carnitine is recently studied as hepatoprotective agent. Our aim is to evaluate the L-carnitine effects against the deterioration of liver functions after TACE. Method: 53 patients with intermediate stage HCC were assigned into two groups; L-carnitine group (26 patients) who received L-carnitine 300 mg tablet twice daily from 2 weeks before to 12 weeks after TACE and control group (27 patients) without L-carnitine therapy. 28 of studied patients received branched chain amino acids granules. Results: There were significant differences between L-carnitine Vs. control group in mean serum albumin change from baseline to 1 week and 4 weeks after TACE (p < 0.05). L-Carnitine maintained Child-Pugh score at 1 week after TACE and exhibited improvement at 4 weeks after TACE (p < 0.01 Vs 1 week after TACE). Control group has significant Child-Pugh score deterioration from baseline to 1 week after TACE (p < 0.05) and 12 weeks after TACE (p < 0.05). There were significant differences between L-carnitine and control groups in mean Child-Pugh score change from baseline to 4 weeks (p < 0.05) and 12 weeks after TACE (p < 0.05). L-carnitine displayed improvement in (PT) from baseline to 1 week, 4 w (p < 0.05) and 12 weeks after TACE. PT in control group declined less than baseline along all follow up intervals. Total bilirubin in L-carnitine group decreased at 1 week post TACE while in control group, it significantly increased at 1 week (p = 0.01). ALT and C-reactive protein elevation were suppressed at 1 week after TACE in Lcarnitine group. The hepatoprotective effects of L-carnitine were enhanced by concomitant use of branched chain amino acids. Conclusion: L-carnitine and BCAA combination therapy offer a novel supportive strategy after TACE in HCC patients.

Keywords: hepatocellular carcinoma, L-carnitine, liver functions , trans-arterial embolization

Procedia PDF Downloads 155

Authors: Inbal Zuriely, Yonit Weiss, Hilla Zaharoni, Hadas Lewkowicz, Tatiana Vander, Tarif Bader

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early active movement, along with adjusting optimal nutrition, prevents aggravation of muscle degeneracy and functional decline. Eating is a basic activity of daily life, which reflects the patient's independence. When eating and feeding are experienced successfully, they lead to a sense of pleasure and satisfaction. However, when they are experienced as a difficulty, they might evoke feelings of helplessness and frustration. This stresses the essential process of gradual weaning off the enteral feeding tube. the work describes the collaboration of a dietitian, determining the nutritional needs of patients undergoing enteral tube weaning as part of the rehabilitation process, with the suited treatment of an occupational therapist. Occupational therapy intervention regarding eating capabilities focuses on improving the required motor and cognitive components, along with environmental adjustments and aids, imparting eating strategies and training to patients and their families. The project was conducted in the long-term, ventilated patients’ department at the Herzfeld Rehabilitation Geriatric Medical Center on patients undergoing enteral tube weaning with the staff’s assistance. Establishing continuous collaboration between the dietician and the occupational therapist, starting from the beginning of the feeding-tube weaning process: 1.The dietician updates the occupational therapist about the start of the process and the approved diet. 2.The occupational therapist performs cognitive, motor, and functional assessments and treatments regarding the patient’s eating capabilities and recommends the required adjustments for independent eating according to the FIM (Functional Independence Measure) scale. 3.The occupational therapist closely follows up on the patient’s degree of independence in eating and provides a repeated update to the dietician. 4.The dietician accordingly guides the ward staff on whether and how to feed the patient or allow independent eating. The project aimed to promote patients toward independent feeding, which leads to a sense of empowerment, enjoyment of the eating experience, and progress of functional ability, along with performing active movements that will motivate mobilization. From the beginning of 2022, 26 patients participated in the project. 79% of all patients who started the weaning process from tube feeding achieved different levels of independence in feeding (independence levels ranged from supervision (FIM-5) to complete independence (FIM-7). The integration of occupational therapy and dietary treatment is based on a patient-centered approach while considering the patient’s personal needs, preferences, and goals. This interdisciplinary partnership is essential for meeting the complex needs of prolonged mechanically ventilated patients and promotes independent functioning and quality of life.

Keywords: dietary, mechanical ventilation, occupational therapy, tube feeding weaning

Procedia PDF Downloads 79

Authors: Domenica Tambasco, Riina Bray, Sophia Jaworski, Gillian Grant, Celeste Corkery

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Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in var-ious musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recog-nized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Methods: Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two Physiotherapists knowledgeable in this physical treat-ment modality. The main outcome measure was an overall impact score for function and symp-toms based on the validated assessment tool for Fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre and post-intervention. Both descriptive and analytical methods were applied and reported. Results: We analyzed results using a paired t-test to deter-mine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Conclusions: Our pilot study showed that SMR appeared to be a safe and effective intervention for our Fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an RCT are recommended.

Keywords: fibromyalgia, myofascial release, physical therapy, FIQR

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Authors: Ainur Mukhambetova, Miras Karzhauov, Vyacheslav Ogay

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Introduction: Mesenchymal stem cells (MSCs) have the capacity to be differentiated into several cell lineages and are a promising source for cell therapy and tissue engineering. However, currently most MSCs culturing protocols use media supplemented with fetal bovine serum (FBS), which limits their application in clinic due to the possibility of zoonotic infections, contamination and immunological reactions. Consequently, formulating effective serum free culture medium becomes one of the important problems in contemporary cell biotechnology. Objectives: The aim of this study was to define an optimal serum-free medium for culturing of periosteum derived MSCs. Materials and methods: The MSCs were extracted from human periosteum and transferred to the culture flasks pretreated with CELLstart™. Immunophenotypic characterization, proliferation and in vitro differentiation of cells grown on STEM PRO® MSC SFM were compared to the cells cultured in the standard FBS containing media. Chromosome analysis and flow cytometry were also performed. Results: We have shown that cells were grown on STEM PRO® MSC SFM retained all the morphological, immunophenotypic (CD73, CD90, CD105, vimentin and Stro-1) and cell differentiation characteristics specific to MSCs. Chromosome analysis indicated no anomalies in the chromosome structure. Flow cytometry showed a high expression of cell adhesion molecules CD44 (98,8%), CD90 (97,4%), CD105 (99,1%). In addition, we have shown that cell is grown on STEM PRO® MSC SFM have higher proliferation capacity compared to cell expanded on standard FBS containing the medium. Conclusion: We have shown that STEM PRO® MSC SFM is optimal for culturing periosteum derived human MSCs which subsequently can be safely used in cell therapy.

Keywords: cell technologies, periosteum-derived MSCs, regenerative medicine, serum-free medium

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