Search results for: shock waves therapy

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

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Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist

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Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.

Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma

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Authors: Rizvi Hasan

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Male factor infertility due to abnormalities in prolactin levels is encountered in a significant proportion. This was a case-control study carried out to determine the effects of prolactin abnormalities in normal males with infertility, recruiting 297 male infertile patients with informed written consent. All underwent a Basic Seminal Fluid Analysis (BSA) and endocrine profiles of FSH, LH, testosterone and prolactin (PRL) hormones using the random access chemiluminescent immunoassay method (normal range 2.5-17ng/ml). Age, weight, and height matched voluntary controls were recruited for comparison. None of the cases had anatomical, medical or surgical disorders related to infertility. Among the controls; mean age 33.2yrs ± 5.2, BMI 21.04 ± 1.39kgm-2, BSA 34×106, a number of children fathered 2±1, PRL 6.78 ± 2.92ng/ml. Of the 297 patients, 28 were hyperprolactinaemic while one was hypoprolactinaemic. All the hyperprolactinaemic patients had oligoasthenospermia, abnormal morphology and decreased viability. The serum testosterone levels were markedly lowered in 26 (92.86%) of the hyperprolactinaemic subjects. In the other 2 hyperprolactinaemic subjects and the single hypoprolactinaemic subject, the serum testosterone levels were normal. FSH and LH were normal in all patients. The 29 male patients with abnormalities in their serum PRL profiles were followed up for 12 months. The 28 patients suffering from hyperprolactinaemia were treated with oral bromocriptine in a dose of 2.5 mg twice daily. The hypoprolactinaemic patient defaulted treatment. From the follow-up, it was evident that 19 (67.86%) of the treated patients responded after 3 months of therapy while 4 (14.29%) showed improvement after approximately 6 months of bromocriptine therapy. One patient responded after 1 year of therapy while 2 patients showed improvements although not up to normal levels within the same period. Response to treatment was assessed by improvement in their BSA parameters. Prolactin abnormalities affect the male reproductive system and semen parameters necessitating further studies to ascertain the exact role of prolactin on the male reproductive tract. A parallel study was carried out incorporating 200 male white rats that were grouped and subjected to variations in their serum PRL levels. At the end of 100 days of treatment, these rats were subjected to morphological studies of their male reproductive tracts.Varying morphological changes depending on the levels of PRL changes induced were evident. Notable changes were arrest of spermatogenesis at the spermatid stage, a reduced testicular cellularity, a reduction in microvilli of the pseudostratified epithelial lining of the epididymis, while measurement of the tubular diameter showed a 30% reduction compared to normal tissue. There were no changes in the vas deferens, seminal vesicles, and the prostate. It is evident that both hyperprolactinaemia and hypoprolactinaemia have a direct effect on the morphology and function of the male reproductive tract. The morphological studies carried out on the groups of rats who were subjected to variations in their PRL levels could be the basis for infertility in male human beings.

Keywords: male factor infertility, morphological studies, prolactin, seminal fluid analysis

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Authors: Monika Singh

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A carbon nanotube thin film coated on dielectric interface is employed to produce THz surface plasma wave (SPW). The carbon nanotube has its plasmon frequency in the THz range. The SPW field falls off away from the metal film both inside the dielectric as well as in free space. An amplitude modulated laser pulse normally incident, from free space on slow wave structure, exert a modulation frequency ponderomotive force on the free electrons of the CNT film and resonantly excite the THz surface plasma wave at the modulation frequency. Carbon nanotube based plasmonic nano-structure materials provides potentially more versatile approach to tightly confined surface modes in the THz range in comparison to noble metals.

Keywords: surface plasmons, surface waves, thin films, THz radiation

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Authors: Xiaoyong He

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The manipulation of THz waves is still a challenging task due to lack of natural materials interacted with it strongly. Designed by tailoring the characters of unit cells (meta-molecules), the advance of metamaterials (MMs) may solve this problem. However, because of Ohmic and radiation losses, the performance of MMs devices is subjected to the dissipation and low quality factor (Q-factor). This dilemma may be circumvented by Fano resonance, which arises from the destructive interference between a bright continuum mode and dark discrete mode (or a narrow resonance). Different from symmetric Lorentz spectral curve, Fano resonance indicates a distinct asymmetric line-shape, ultrahigh quality factor, steep variations in spectrum curves. Fano resonance is usually realized through symmetry breaking. However, if concentric double rings (DR) are placed closely to each other, the near-field coupling between them gives rise to two hybridized modes (bright and narrowband dark modes) because of the local asymmetry, resulting into the characteristic Fano line shape. Furthermore, from the practical viewpoint, it is highly desirable requirement that to achieve the modulation of Fano spectral curves conveniently, which is an important and interesting research topics. For current Fano systems, the tunable spectral curves can be realized by adjusting the geometrical structural parameters or magnetic fields biased the ferrite-based structure. But due to limited dispersion properties of active materials, it is still a tough work to tailor Fano resonance conveniently with the fixed structural parameters. With the favorable properties of extreme confinement and high tunability, graphene is a strong candidate to achieve this goal. The DR-structure possesses the excitation of so-called “trapped modes,” with the merits of simple structure and high quality of resonances in thin structures. By depositing graphene circular DR on the SiO2/Si/ polymer substrate, the tunable Fano resonance has been theoretically investigated in the terahertz regime, including the effects of graphene Fermi level, structural parameters and operation frequency. The results manifest that the obvious Fano peak can be efficiently modulated because of the strong coupling between incident waves and graphene ribbons. As Fermi level increases, the peak amplitude of Fano curve increases, and the resonant peak position shifts to high frequency. The amplitude modulation depth of Fano curves is about 30% if Fermi level changes in the scope of 0.1-1.0 eV. The optimum gap distance between DR is about 8-12 μm, where the value of figure of merit shows a peak. As the graphene ribbon width increases, the Fano spectral curves become broad, and the resonant peak denotes blue shift. The results are very helpful to develop novel graphene plasmonic devices, e.g. sensors and modulators.

Keywords: graphene, metamaterials, terahertz, tunable

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Authors: A. Dudek, P. Tylec, G. Torbicz, P. Duda, K. Proniewska, P. Major, M. Pedziwiatr

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Background: Conservative treatments of obesity, based only on a proper diet and physical activity, without the support of an interdisciplinary team of specialist does not bring satisfactory bariatric results. Long-term maintenance of a proper metabolic results after rapid weight loss due to bariatric surgery requires engagement from patients. Mobile health tool may offer alternative model that enhance participant engagement in keeping the therapy. Objective: We aimed to assess the influence of constant monitoring and subsequent motivational alerts in perioperative period and on post-operative effects in the bariatric patients. As well as the study was designed to identify factors conductive urge to change lifestyle after surgery. Methods: This prospective clinical control study was based on a usage of a designed prototype of bariatric mHealth system. The prepared application comprises central data management with a comprehensible interface dedicated for patients and data transfer module as a physician’s platform. Motivation system of a platform consist of motivational alerts, graphic outcome presentation, and patient communication center. Generated list of patients requiring urgent consultation and possibility of a constant contact with a specialist provide safety zone. 31 patients were enrolled in continuous monitoring program during a 6-month period along with typical follow-up visits. After one year follow-up, all patients were examined. Results: There were 20 active users of the proposed monitoring system during the entire duration of the study. After six months, 24 patients took a part in a control by telephone questionnaires. Among them, 75% confirmed that the application concept was an important element in the treatment. Active users of the application indicated as the most valuable features: motivation to continue treatment (11 users), graphical presentation of weight loss, and other parameters (7 users), the ability to contact a doctor (3 users). The three main drawbacks are technical errors (9 users), tedious questionnaires inside the application (5 users), and time-consuming tasks inside the system (2 users). Conclusions: Constant monitoring and successive motivational alerts to continue treatment is an appropriate tool in the treatment after bariatric surgery, mainly in the early post-operative period. Graphic presentation of data and continuous connection with a clinical staff seemed to be an element of motivation to continue treatment and a sense of security.

Keywords: bariatric surgery, mHealth, mobile health tool, obesity

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Authors: Camilo Andres Agudelo-Velez, Lina María Martinez-Sanchez, Natalia Perilla-Hernandez, Maria De Los Angeles Rodriguez-Gazquez, Felipe Hernandez-Restrepo, Dayana Andrea Quintero-Moreno, Camilo Ruiz-Mejia, Isabel Cristina Ortiz-Trujillo, Monica Maria Zuluaga-Quintero

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Chronic obstructive pulmonary disease is common condition, characterized by a persistent blockage of airflow, partially reversible and progressive, that represents 5% of total deaths around the world, and it is expected to become the third leading cause of death by 2030. Objective: To establish the clinical and epidemiological profile of patients with chronic obstructive pulmonary disease in a medical institution from the city of Medellin, Colombia. Methods: A cross-sectional study was performed, with a sample of 50 patients with a diagnosis of chronic obstructive pulmonary disease in a private institution in Medellin, during 2015. The software SPSS vr. 20 was used for the statistical analysis. For the quantitative variables, averages, standard deviations, and maximun and minimun values were calculated, while for ordinal and nominal qualitative variables, proportions were estimated. Results: The average age was 73.5±9.3 years, 52% of the patients were women, 50% of them had retired, 46% ere married and 80% lived in the city of Medellín. The mean time of diagnosis was 7.8±1.3 years and 100% of the patients were treated at the internal medicine service. The most common clinical features were: 36% were classified as class D for the disease, 34% had a FEV1 <30%, 88% had a history of smoking and 52% had oxygen therapy at home. Conclusion: It was found that class D was the most common, and the majority of the patients had a history of smoking, indicating the need to strengthen promotion and prevention strategies in this regard.

Keywords: pulmonary disease, chronic obstructive, pulmonary medicine, oxygen inhalation therapy

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Authors: Mounir Belattar

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In this paper the Analysis of voltage waves that propagate along a lossless exponential nonuniform line is presented. For this analysis the parameters of this line are assumed to be varying function of the distance x along the line from the source end. The approach is based on the tow-port networks cascading presentation to derive the ABDC parameters of transmission using Picard-Carson Method which is a powerful method in getting a power series solution for distributed network because it is easy to calculate poles and zeros and solves differential equations such as telegrapher equations by an iterative sequence. So the impedance, admittance voltage and current along the line are expanded as a Taylor series in x/l where l is the total length of the line to obtain at the end, the main transmission line parameters such as voltage response and transmission and reflexion coefficients represented by scattering parameters in frequency domain.

Keywords: ABCD parameters, characteristic impedance exponential nonuniform transmission line, Picard-Carson's method, S parameters, Taylor's series

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Authors: Elham Ahmadi

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This study is conducted with the aim of investigating the effect of moderate physical activity (60% of maximal heart rate-MHR) on blood pressure in an elderly female with hypertension. Hypertension is considered a modifiable risk factor for cardiovascular disease through physical activity. The purpose and significance of this study were to investigate the role of exercise as an alternative therapy since some patients exhibit sensitivity/intolerance to some drugs. Initially, 65 hypertensive females (average age = 49.7 years) (systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) and 25 hypertensive females as a control group (average age = 50.3 years and systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) were selected. The subjects were divided based on their age, duration of disease, physical activity, and drug consumption. Then, blood pressure and heart rate (HR) were measured in all of the patients using a sphygmomanometer (pre-test). The exercise sessions consisted of warm-up, aerobic activity, and cooling down (total duration of 20 minutes for the first session up to 55 minutes in the last session). At the end of the 12th session (mid-test) and final session (24th session), blood pressure was measured for the last time (post-test). The control group was without any exercise during the study. The results were analyzed using a t-test. Our results indicated that moderate physical activity was effective in lowering blood pressure by 6.4/5.6–mm Hg for SBP and 2.4/4.3mm Hg for DBP in hypertensive patients, irrespective of age, duration of disease, and drug consumption ( P<.005). The control group indicates no changes in BP. Physical activity programs with moderate intensity (approximately at 60% MHR), three days per week, can be used not only as a preventive measure for diastolic hypertension (DBP>90 mmHg high blood pressure) but also as an alternative to drug therapy in the treatment of hypertension, as well.

Keywords: endurance exercise, elderly female, hypertension, physical activity

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Authors: Murad A. Bein

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This paper empirically examines the time-varying relationship and spillover effects between the international crude oil price and ten emerging equity markets, namely three oil-exporting countries (Brazil, Mexico, and Russia) and seven Central and Eastern European (CEE) countries (Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, and Slovakia). The results revealed that there are spillover effects from oil markets into almost all emerging equity markets save Slovakia. Besides, the oil supply glut had a homogenous effect on the emerging markets, both net oil-exporting, and oil-importing countries (CEE). Further, the time variance drastically increased during financial turmoil. Indeed, the time variance remained high from 2009 to 2012 in response to aggregate demand shocks (global financial crisis and Eurozone debt crisis) and quantitative easing measures. Interestingly, the time variance was slightly higher for the oil-exporting countries than for some of the CEE countries. Decision-makers in emerging economies should therefore seek policy coordination when dealing with financial turmoil.

Keywords: crude oil, spillover effects, emerging equity, time-varying, aggregate demand shock

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Authors: Ashok K. Gupta

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Over the past few decades, since the bio-engineering revolution, autologous cell therapy (ACT) has become a rapidly evolving field. Currently, this form of therapy has broad applications in modern medicine and plastic surgery, ranging from the treatment/improvement of wound healing to life-saving operations. A study was conducted on 50 patients having to disfigure, and deform post burn scars and was treated by injection of extracted, refined adipose tissue grafts with their unique stem cell properties. To compare the outcome, a control of 20 such patients was treated with conventional skin or soft-tissue flaps or skin grafting, and a control of 10 was treated with more advanced microsurgical techniques such as Pre-fabricated flaps/pre laminated flaps / free flaps. Assessment of fat volume and survival post- follow up period was done by radiological aid, using MRI and clinically (Survival of the autograft and objective parameters for scar elasticity were evaluated skin elasticity parameters 3 to 9 months postoperatively). Recently, an enzyme that is involved in collagen crosslinking in fibrotic tissue, lysyl hydroxylase (LH2), was identified. This enzyme is normally active in bone and cartilage but hardly in the skin. It has been found that this enzyme is highly expressed in scar tissue and subcutaneous fat; this is in contrast to the dermis, where the enzyme is hardly expressed. Adipose tissue-derived stem cell injections are an effective method in the treatment of various extensive post-burn scar deformities that makes it possible to re-create the lost sub-dermal tissue for improvement in the function of involved joint movements.

Keywords: adipose tissue-derived stem cell injections, treatment of various extensive post-burn scar deformities, re-create the lost sub-dermal tissue, improvement in function of involved joint movements

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Authors: Alireza Lohrasbi, Alireza Lavaei, Mohammadali M. Shahlaei

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The liquid flow and the free surface shape during the initial stage of dam breaking are investigated. A numerical scheme is developed to predict the wave of an unsteady, incompressible viscous flow with free surface. The method involves a two dimensional finite element (2D), in a vertical plan. The Naiver-Stokes equations for conservation of momentum and mass for Newtonian fluids, continuity equation, and full nonlinear kinematic free-surface equation were used as the governing equations. The mapping developed to solve highly deformed free surface problems common in waves formed during wave propagation, transforms the run up model from the physical domain to a computational domain with Arbitrary Lagrangian Eulerian (ALE) finite element modeling technique.

Keywords: dam break, Naiver-Stokes equations, free-surface flows, Arbitrary Lagrangian-Eulerian

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Authors: Rekaya A. Shabbir, Marco Mingarelli, Glenn Flux, Ananya Choudhury, Tim A. D. Smith

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Introduction: Heterogeneity of dose distributions across a tumour is problematic for targeted radiotherapy. Gold nanoparticles (AuNPs) enhance dose-distributions of targeted radionuclides. The aim of this study is to demonstrate if tumour dose-distribution of targeted AuNPs radiolabelled with either of two radioisotopes (¹⁷⁷Lu and ⁹⁰Y) in breast cancer cells produced homogeneous dose distributions. Moreover, in vitro and in vivo studies were conducted to study the importance of receptor level on cytotoxicity of EGFR-targeted AuNPs in breast and colorectal cancer cells. Methods: AuNPs were functionalised with DOTA and OPPS-PEG-SVA to optimise labelling with radionuclide tracers and targeting with Erbitux. Radionuclides were chelated with DOTA, and the uptake of the radiolabelled AuNPs and targeted activity in vitro in both cell lines measured using liquid scintillation counting. Cells with medium (HCT8) and high (MDA-MB-468) EGFR expression were incubated with targeted ¹⁷⁷Lu-AuNPs for 4h, then washed and allowed to form colonies. Nude mice bearing tumours were used to study the biodistribution by injecting ¹⁷⁷Lu-AuNPs or ⁹⁰Y-AuNPs via the tail vein. Heterogeneity of dose-distribution in tumours was determined using autoradiography. Results: Colony formation (% control) was 81 ± 4.7% (HCT8) and 32 ± 9% (MDA-MB-468). High uptake was observed in the liver and spleen, indicating hepatobiliary excretion. Imaging showed heterogeneity in dose-distributions for both radionuclides across the tumours. Conclusion: The cytotoxic effect of EGFR-targeted AuNPs is greater in cells with higher EGFR expression. Dose-distributions for individual radiolabelled nanoparticles were heterogeneous across tumours. Further strategies are required to improve the uniformity of dose distribution prior to clinical trials.

Keywords: cancer cells, dose distributions, radionuclide therapy, targeted gold nanoparticles

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Authors: Iwona Kasior

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Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

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Authors: Minas Balyan

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Nowadays X-ray nonlinear diffraction and nonlinear effects are investigated due to the presence of the third generation synchrotron sources and XFELs. X-ray third order nonlinear dynamical diffraction is considered as well. Using the nonlinear model of the usual visible light optics the third-order nonlinear Takagi’s equations for monochromatic waves and the third-order nonlinear time-dependent dynamical diffraction equations for X-ray pulses are obtained by the author in previous papers. The obtained equations show, that even if the Fourier-coefficients of the linear and the third order nonlinear susceptibilities are zero (forbidden reflection), the dynamical diffraction in the nonlinear case is related to the presence in the nonlinear equations the terms proportional to the zero order and the second order nonzero Fourier coefficients of the third order nonlinear susceptibility. Thus, in the third order nonlinear Bragg diffraction case a nonlinear analogue of the well-known Renninger effect takes place. In this work, the 'third order nonlinear Renninger effect' is considered theoretically.

Keywords: Bragg diffraction, nonlinear Takagi’s equations, nonlinear Renninger effect, third order nonlinearity

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Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

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Authors: Bhavesh N. Bhatt, Zozimus D. Labana

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This work is mainly focused on the analysis of heat transfer of blade by using internal cooling method. By using conjugate heat transfer technology we can effectively compute the cooling and heat transfer analysis of blade. Here blade temperature is limited by materials melting temperature. By using CFD code, we will analyze the blade cooling with the help of CHT method. There are two types of CHT methods. In the first method, we apply coupled CHT method in which all three domains modeled at once, and in the second method, we will first model external domain and then, internal domain of cooling channel. Ten circular cooling channels are used as a cooling method with different mass flow rate and temperature value. This numerical simulation is applied on NASA C3X turbine blade, and results are computed. Here results are showing good agreement with experimental results. Temperature and pressure are high at the leading edge of the blade on stagnation point due to its first faces the flow. On pressure side, shock wave is formed which also make a sudden change in HTC and other parameters. After applying internal cooling, we are succeeded in reducing the metal temperature of blade by some extends.

Keywords: gas turbine, conjugate heat transfer, NASA C3X Blade, circular film cooling channel

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Authors: Nathainail Bashir, Neil Anderson

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The objective of this study site was to investigate the current state of the practice with regards to karst detection methods and recommend the best method and pattern of arrays to acquire the desire results. Proper site investigation in karst prone regions is extremely valuable in determining the location of possible voids. Two geophysical techniques were employed: multichannel analysis of surface waves (MASW) and electric resistivity tomography (ERT).The MASW data was acquired at each test location using different array lengths and different array orientations (to increase the probability of getting interpretable data in karst terrain). The ERT data were acquired using a dipole-dipole array consisting of 168 electrodes. The MASW data was interpreted (re: estimated depth to physical top of rock) and used to constrain and verify the interpretation of the ERT data. The ERT data indicates poorer quality MASW data were acquired in areas where there was significant local variation in the depth to top of rock.

Keywords: dipole-dipole, ERT, Karst terrains, MASW

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Authors: Anoosh Eghdami

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Background and aim: Conventional anticancer drugs display significant shortcomings which limit their use in cancer therapy. For this reason, important progress has been achieved in the field of nanotechnology to solve these problems and offer a promising and effective alternative for cancer treatment. Tumor markers may also be measured periodically during cancer therapy. Tumor markers may also be measured after treatment has ended to check for recurrence the return of cancer. The aim of this study was to evaluate the effect of nano drug delivery in induced breast cancer with DMBA by using CA15-3 tumor marker. Material and method: the rats were divided into five groups. The first group (control n=15) were fed only sesame oil as a gavage. In the second group n=15,10 mg DMBA was dissolved in 5ml of sesame oil and were fed as a gavage. In addition to DMBA treatment as the second group, in the 3,4and 5 groups after cancer creation, respectively affected by alpha interferon (α-IFN),alpha interferon conjugated with single walled carbon nano tube (α-IFN-SWNT) and encapsulated in poly lactic poly glycolic acid (α-IFN-PLGA). Tumor marker was measured in recent three groups. Results: The ANOVA test was used to determine the differences among the groups. Cancer inducing in rats (group 2) caused a significant increase in blood levels of CA15-3 (P<0.05). Administration of α-IFN, α-IFN –SWNT and α-IFN-PLGA in 3 groups of cancerous rats caused a significant decrease in blood levels of CA15-3 only the group that treated with α-IFN-PLGA (p<0.05). Conclusion: the results of this study indicate that nano drugs more effective than traditional drug in cancer treatment, although further work is needed to elucidate the safety and side effect of these compound in human.

Keywords: breast cancer, nano drug, tumor markers, CA15-3, α-IFN-PLGA, -IFN –SWNT

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Authors: Yueguang Gao, Qi Huang, Shunshan Feng

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In order to study the process and characteristic of the fragments in the warhead with one end cap under full constraint condition, we established a cylindrical casing with two end caps which one of which was fully constrained using the simulation analysis. The result showed that the fragmentation of cylindrical casing with one end full constrained has its own characteristic. The Mach stem was generated when the detonation wave propagated to the fully constrained end cap under the condition of one end detonation, working on unreactive explosives and causing the nearby fragment subjected to nearly 2.5 times the normal pressure to obtain a higher speed. The cylindrical casing first ruptured at the contact surface with the fully constrained end, and then at the end cover of the initiating end, and then the rupture extends to the whole cylindrical casing. The detonation products started to leak out from the rupture. Driving fragments to fly and forming two dense flying areas. The analysis of this paper can provide a reference for the optimal design of this kind of warhead.

Keywords: fragment, cylindrical casing, detonation waves, numerical simulation

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Authors: A.Zitouni, S.Bentata, B.Bouadjemi, T.Lantri, W. Benstaali, Z.Aziz, S.Cherid

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We investigate the structural, electronic and magnetic properties of the diluted magnetic semiconductors (DMSs) CdCoTe and CdMnTe in the zinc blende phase with 25% of Co and Mn. The calculations are performed by the recent ab initio full potential augmented plane waves (FP_L/APW) method within the spin polarized density-functional theory (DFT) and the generalized gradient approximation GGA. Structural properties are determined from the total energy calculations and we found that these compounds are stable in the ferromagnetic phase. We discuss the electronic structures, total and partial densities of states and total magnetic moments. The calculated densities of states presented in this study identify the half-metallic of CdCoTe and CdMnTe.

Keywords: electronic structure, half-metallic, magnetic moment, total and partial densities of states

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Authors: Alison Brown

Abstract:

Through stories, children make sense of their world, see themselves through the eyes of another, and process emotions and lived experiences in a non-threatening and indirect manner. Building on research around the use of narrative techniques with adults and families, this research looked directly at the use of narratives as a therapeutic technique with children in counseling. Based on individual therapy sessions with children over a six-year period, this work of collective case studies tells the story of a practice incorporating children’s narratives, of children’s experiences in writing and sharing their narratives, and of the clinical impact of the use of narratives with children. Not all stories were narratives of success or happiness. Children documented their fears and anger as well as their achievements and hope for the future. What emerged through this study was an awareness of recurring themes in the way children responded to the narrative process and in the benefits and limitations of story writing with children. Consistent with previous studies focusing on narrative work with adults and families, the use of narratives with children provided opportunities for healing, acceptance, developing greater understanding, externalizing, and re-authoring a preferred future. In terms of the children’s experiences in writing and sharing their narratives, consistent themes emerged again, with many children finding the experience cathartic and liberating, empowering and hopeful, but most importantly, an opportunity that allowed them to feel and understand that they were not alone. Whilst a small collection of case studies tells the stories of a limited number of children, it is hoped that this research provides both a model and inspiration for others to explore similar uses of narratives with children. As a greater number of children’s narratives are created, the potential to share and benefit from the many rich stories and experiences of other children becomes more of a reality. Across cultures, economic and social settings, rural and urban environments, and varying family structures, it is important that we hear the voices of our children – ‘In their own words’.

Keywords: narrative therapy children counselling, social, emotional, zone of proximal development, scaffolding

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Authors: Aristi Alopoudi, Sofia Beloka, Vassiliki Pliogou

Abstract:

Autism is a complex neuro-developmental disorder with a variety of difficulties in many aspects such as social interaction, communication skills and verbal communication (speech). The aim of this study was to examine the impact of therapeutic horseback riding in improving the verbal and communication skills of children diagnosed with autism during 16 sessions. The researcher examined whether the expression of speech, the use of vocabulary, semantics, pragmatics, echolalia and communication skills were influenced by the therapeutic horseback riding when we increase the frequency of the sessions. The researcher observed two subjects of primary-school aged, in a two case observation design, with autism during 16 therapeutic horseback riding sessions (one riding session per week). Compared to baseline, at the end of the 16th therapeutic session, therapeutic horseback riding increased both verbal skills such as vocabulary, semantics, pragmatics, formation of sentences and communication skills such as eye contact, greeting, participation in dialogue and spontaneous speech. It was noticeable that echolalia remained stable. Increased frequency of therapeutic horseback riding was beneficial for significant improvement in verbal and communication skills. More specifically, from the first to the last riding session there was a great increase of vocabulary, semantics, and formation of sentences. Pragmatics reached a lower level than semantics but the same as the right usage of the first person (for example, I make a hug) and echolalia used for that. A great increase of spontaneous speech was noticed. The eye contact was presented in a lower level, and there was a slow but important raise at the greeting as well as the participation in dialogue. Last but not least; this is a first study conducted in therapeutic horseback riding studying the verbal communication and communication skills in autistic children. According to the references, therapeutic horseback riding is a therapy with a variety of benefits, thus; this research made clear that in the benefits of this therapy there should be included the improvement of verbal speech and communication.

Keywords: Autism, communication skills, speech, therapeutic horseback riding

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Authors: Delia Enyedi

Abstract:

Throughout film history, the regular return of 3D cinema has been discussed in connection to crises caused by the advent of television or the competition of the Internet. In addition, the three waves of stereoscopic 3D (from 1952 up to 1983) and its current digital version have been blamed for adding a challenging technical distraction to the viewing experience. By discussing the films Dial M for Murder (1954) and Goodbye to Language (2014), the paper aims to analyze the response of recognized auteurs to the use of 3D techniques in filmmaking. For Alfred Hitchcock, the solution to attaining perceptual immersion paradoxically resided in restraining the signature effect of 3D, namely protrusion. In Jean-Luc Godard’s vision, 3D techniques allowed him to explore perceptual absorption by means of depth of field, for which he had long advocated as being central to cinema. Thus, both directors contribute to the foundation of an auteur aesthetic in 3D filmmaking.

Keywords: Alfred Hitchcock, authorship, 3D filmmaking, Jean-Luc Godard, perceptual absorption, perceptual immersion

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Authors: B. Mahfoud, A. Bendjagloli

Abstract:

The effect of an axial magnetic field on the flow produced by co-rotation of the top and bottom disks in a vertical cylindrical heated from below is numerically analyzed. The governing Navier-Stokes, energy, and potential equations are solved by using the finite-volume method. It was observed that the Reynolds number is increased, the axisymmetric basic state loses stability to circular patterns of axisymmetric vortices and spiral waves. In mixed convection case the axisymmetric mode disappears giving an asymmetric mode m=1. It was also found that the primary thresholds Recr corresponding to the modes m=1and 2, increase with increasing of the Hartmann number (Ha). Finally, stability diagrams have been established according to the numerical results of this investigation. These diagrams giving the evolution of the primary thresholds as a function of the Hartmann number for various values of the Richardson number.

Keywords: bifurcation, co-rotating end disks, magnetic field, stability diagrams, vortices

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Authors: Lucas Derks, Christine Beenhakker, Michiel Brandt, Gert Arts, Ruud van Langeveld

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Background: The method Depression in Awareness Space (DAS) is a psychotherapeutic intervention technique based on the principles of spatial cognition and imagination therapy with spatial components. The basic assumptions are: mental space is the primary organizing principle in the mind, and all psychological issues can be treated by first locating and by next relocating the conceptualizations involved. The most clinical experience was gathered over the last 20 years in the area of social issues (with the social panorama model). The latter work led to the conclusion that a mental object (image) gains emotional impact when it is placed more central, closer and higher in the visual field – and vice versa. Changing the locations of mental objects in space thus alters the (socio-) emotional meaning of the relationships. The experience of depression seems always associated with darkness. Psychologists tend to see the link between depression and darkness as a metaphor. However, clinical practice hints to the existence of more literal forms of darkness. Aims: The aim of the method Depression in Awareness Space is to reduce the distress of clients with depression in the clinical counseling practice, as a reliable alternative method of psychological therapy for the treatment of depression. The method Depression in Awareness Space aims at making dark areas smaller, lighter and more transparent in order to identify the problem or the cause of the depression which lies behind the darkness. It was hypothesized that the darkness is a subjective side-effect of the neurological process of repression. After reducing the dark clouds the real problem behind the depression becomes more visible, allowing the client to work on it and in that way reduce their feelings of depression. This makes repression of the issue obsolete. Results: Clients could easily get into their 'sadness' when asked to do so and finding the location of the dark zones proved pretty easy as well. In a recent pilot study with five participants with mild depressive symptoms (measured on two different scales and tested against an untreated control group with similar symptoms), the first results were also very promising. If the mental spatial approach to depression can be proven to be really effective, this would be very good news. The Society of Mental Space Psychology is now looking for sponsoring of an up scaled experiment. Conclusions: For spatial cognition and the research into spatial psychological phenomena, the discovery of dark areas can be a step forward. Beside out of pure scientific interest, it is great to know that this discovery has a clinical implication: when darkness can be connected to depression. Also, darkness seems to be more than metaphorical expression. Progress can be monitored over measurement tools that quantify the level of depressive symptoms and by reviewing the areas of darkness.

Keywords: depression, spatial cognition, spatial imagery, social panorama

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Authors: Christine Ysabelle G. Roman, Pauline Torres

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Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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Authors: B. Mahfoud, R. Harouz

Abstract:

The present work examine numerically the effect of axial magnetic field on mixed convection through a cylindrical cavity, filled with a liquid metal and having a rotating top and bottom disks. Effects of Richardson number (Ri = 0, 0.5, 1, and 2) and Hartman number (Ha = 0, 5, 10, and 20) on temperature and flow fields were analyzed. The basic state of this system is steady and axisymmetric, when the counter-rotation is sufficiently large, producing a free shear layer. This shear layer is unstable and different complex flows appear successively: steady states with an azimuthal wavenumber of 1; travelling waves and steady states with an azimuthal wavenumber of 2. Mixed modes and azimuthal wavenumber of 3 are also found with increasing Hartmann number. The stability diagram (Recr-Ha) corresponding to the axisymmetric-three-dimensional transition for increasing values of the axial magnetic field is obtained.

Keywords: axisymmetric, counter-rotating, instabilities, magnetohydrodynamic, magnetic field, wavenumber

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Authors: Xiaobo Xi, Ruihong Zhang

Abstract:

At present, the orchard ditching and fertilizing technology has a series of problems, such as easy tree roots damage, high energy consumption and uneven fertilizing. In this paper, a gas explosion subsoiling and fertilizer injection machine was designed, which used high pressure gas to shock soil body and then injected fertilizer. The drill pipe mechanism with pneumatic chipping hammer excitation and hydraulic assistance was designed to drill the soil. The operation of gas and liquid fertilizer supply was controlled by PLC system. The 3D model of the whole machine was established by using SolidWorks software. The machine prototype was produced, and field experiments were carried out. The results showed that soil fractures were created and diffused by gas explosion, and the subsoiling effect radius reached 40 cm under the condition of 0.8 MPa gas pressure and 30 cm drilling depth. What’s more, the work efficiency is 0.048 hm²/h at least. This machine could meet the agronomic requirements of orchard, garden and city greening fertilization, and the tree roots were not easily damaged and the fertilizer evenly distributed, which was conducive to nutrient absorption of root growth.

Keywords: gas explosion subsoiling, fertigation, pneumatic chipping hammer exciting, soil compaction

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Authors: Wai Yan Shih, Sau Man Wong, Wing Chung Chang, Wai Chi Chan

Abstract:

Background: Late-life depression is associated with significant consequences. Although symptomatic reduction is achievable through pharmacological interventions, older adults are more vulnerable to the side effects than their younger counterparts. In addition, drugs do not address underlying cognitive dysfunctions such as rumination and reduced autobiographical memory specificity (AMS), both shown to be maladaptive coping styles that are associated with a poorer prognosis in depression. Considering how aging is accompanied by cognitive, psychological and physical changes, the interplay of these age-related factors may potentially aggravate and interfere with these depressive cognitive dysfunctions in late-life depression. Special care should, therefore, be drawn to ensure these cognitive dysfunctions are adequately addressed. Aim: This randomized controlled trial aims to examine the effect of mindfulness-based cognitive therapy (MBCT) on depressed older adults, and whether the potential benefits of MBCT are mediated by improvements in rumination and AMS. Method: Fifty-seven participants with an average age of 70 years old were recruited from multiple elderly centers and online mailing lists. Participants were assessed with: (1) Hamilton depression scale, (2) ruminative response scale, (3) autobiographical memory test, (4) mindful attention awareness scale, and (5) Montreal cognitive assessment. Eligible participants with mild to moderate depressive symptoms and normal cognitive functioning were randomly allocated to an 8-week MBCT group or active control group consisting of a low-intensity exercise program and health education. Post-intervention assessments were conducted after the 8-week program. Ethics approval was given by the Institutional Review Board of the University of Hong Kong/Hospital Authority. Results: Mixed-factorials ANOVAs demonstrated significant time x group interaction effects for depressive symptoms, AMS, and dispositional mindfulness. A marginally significant interaction effect was found for rumination. Simple effect analyses revealed a significant reduction in depressive symptoms for the both the MBCT group (mean difference = 7.1, p = .000), and control group (mean difference = 2.7, p = .023). However, only participants in the MBCT group demonstrated improvements in rumination, AMS, and dispositional mindfulness. Bootstrapping-based mediation analyses showed that the effect of MBCT in alleviating depressive symptoms was only mediated by the reduction in rumination. Conclusions: The findings support the use of MBCT as an effective intervention for depressed older adults, considering the improvements in depressive symptoms, rumination, AMS and dispositional mindfulness despite their age. Reduction in ruminative tendencies plays a major role in the cognitive mechanism of MBCT.

Keywords: mindfulness-based cognitive therapy, depression, older adults, rumination, autobiographical memory specificity

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